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E1 Nervous System + Pain > Cranial Nerve Tests > Flashcards

Cranial Nerve Tests Flashcards

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1
Q

what is the origin of CN I?

A

forebrain

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2
Q

where do CN I fibers synapse?

A

olfactory glomeruli in olfactory bub

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3
Q

where does CN I project?

A

olfactory cortex of the temporal lobe

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4
Q

what is the clinical relevance for CN I?

A

cribriform plate is weak spot of anterior cranial fossa trauma/fracture here can lead to ANOSMIA

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5
Q

what is the origin of CN II?

A

forebrain

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6
Q

what passes through the optic canal?

A

retinal ganglion cell axons

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7
Q

where does info from optic nerve go?

A

optic chiasm, optic tract, left geniculate nuc, optic radiations

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8
Q

where does the optic radiations project?

A

occipital lobe

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9
Q

how can issue with the optic nerve present?

A

transection or pathologic damage can lead to anopsia (unilateral blindness)

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10
Q

what is the function of CN III?

A

somatic innervation to several extraocular muscles, sup/med/inf rectus, inf oblique, levator palpabrae

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11
Q

what is the parasympathetic function of CN III?

A

intraocular muscles
pupillary constrictor, ciliary muscle

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12
Q

where does CN III originate?

A

midbrain

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13
Q

where does CN III exit the skull

A

SOF

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14
Q

where are CN III nuclei?

A

in midbrain (including Edinger Westphal which are parasympathetic nuc)

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15
Q

where does CN III project?

A

frontal eye field in frontal lobe

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16
Q

what clinical presentation occurs with CN III lesions?

A

CN III palsy
ptosis, mydriasis, globe position down and out

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17
Q

what are some possible causes of CN III lesion?

A

trauma, aneurism, herniation in brain

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18
Q

what does CN IV do?

A

somatic control of superior oblique

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19
Q

what is the action of superior oblique?

A

intorsion
depression
abduction

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20
Q

where does CN IV originate?

A

dorsal midbrain (only CN to emerge dorsal)

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21
Q

where does info from CN IV go?

A

trochlear nucleus in midbrain

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22
Q

where does CN IV project?

A

frontal lobe

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23
Q

how might a CN IV lesion present?

A

-left eye elevated and adducted due to unopposed superior and medial rectus

-right eve extorted due to unopposed action if inferior oblique, compensatory head tilt to better align eyes

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24
Q

where is ganglia of sensory parts of CN V?

A

trigeminal sensory ganglion

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25
where is the ganglia for the motor aspect of CN V3?
motor nucleus in pons
26
what is the job of CN VI?
somatic efferent innervation to lateral rectus
27
what is the origin of CN VI?
pontomedullary junction
28
where does CN VI exit skull?
SoF
29
where is CN VI nucleus?
abducens nucleus in pons
30
where does CN VI project?
frontal lobe
31
how might a CN VI palsy present?
ask pt to look straight and eye moves toward midline
32
where does CN VII project?
frontal lobe precentral gyrus
33
how to treat bells palsy?
corticosteroids, usually self resolving, protect effected eye from drying out
34
what does CN VIII do?
auditory and vestibular
35
where does CN VIII originate?
pontomedullary junction
36
where does CN VII have its nucleus?
vestibular and cochlear in pons/medulla
37
where does CN VII project?
auditory: temporal vestibular: parietal
38
what is the sensory function of glossopharyngeal nerve?
general: posterior tongue, oropharynx, middle ear, Eustachian tube special: taste posterior 1/3 tongue
39
what is the motor innervation for CN IX?
autonomic: secretomotor to parotid gland
40
where does CN IX originate?
medulla
41
where does CN IX, X and XI exit skull?
internal jugular foramen
42
where is the nuclei for CN IX?
medulla
43
where does taste register for CN IX?
insular cortex
44
what detects trigger for gag reflex?
sensory receptors for CN IX
45
what is the sensory functions of CN X?
larynx and pharynx, visceral organs, special sense taste on eppigottis
46
what is the motor function of CN X?
larynx, pharynx, soft palate
47
where does CN X originate?
medulla (nuc here too)
48
where does CN X project?
motor: frontal lobe sensory: insular cortex
49
what is special about the spinal part of spinal accessory nerve?
fibers ascend spinal cord and enter skull through foramen magnum
50
what does CN XII innervate?
genioglossus hyoglossus styloglossus
51
where does CN VII exit skull?
hypoglossal canal
52
lesions superior to the hypoglossal nucleus will cause:
contralateral tongue deviation
53
CBT to hypoglossal nucleus what happens?
decussates
54
CN XII to genioglossus is
ipsilateral
55
lesions inferior to the CN XII nucleus cause:
ipsilateral tongue deviation
56
what is hypoalgesia?
(low pain) should feel pain but do not
57
what is allodynia?
lowered pain threshold, feel pain where should not
58
what is consciousness dependent on?
interaction between intact cerebral hemispheres and the upper brain stem where activating mechanisms reside
59
how do you check CN I?
make sure nasal path is clear, check each side individually seeing if pt can smell different things
60
what is anosmia?
loss of smell
61
what can cause temporary loss of smell?
swelling or congestion
62
what can cause permanent loss of smell?
fractures to cribriform plate, olfactory groove or tumors
63
what four procedures is needed to examine the optic nerve?
-measurement of visual acuity -test visual fields -pupillary light reflex -visualization of the fundus
64
what does the afferent and efferent for pupillary light reflex?
CN II (afferent) CN III (motor)
65
what is pupillary light reflex?
light shone on one pupil, if both sensory and motor intact the other pupil will also constrict
66
what can be done to test CN III, IV and VI?
eyelid position, pupillary light reflex, accommodation, extraocular eye movement
67
what is accommodation?
allows eyes to focus on near objects, and then far by changing vergence, lens shape, and pupil size
68
what symptoms present with oculomotor nerve palsy?
ptosis- inactivation of lev palp mydriasis- decreased tone to P constrictor down and out gaze
69
what is anisocoria?
unequal size of the pupils
70
what does cocaine do to pupils?
dilates
71
what does opiates do to pupils?
makes smaller
72
what is the corneal reflex?
touch cornea and both eye should blink
73
what does an UMN lesion of CN VII cause?
contralateral lesion with forehead sparing
74
what does lMN lesion oc CN VII cause?
damage from the facial nuc or lower causes ipsilateral paralysis
75
how do you test for a CN X lesion?
listen for hoarseness in voice, look at back of throat if uvula is midline, gag reflex on both sides
76
how do you test hypoglossal nerve?
stick out tongue straight, left then right DEVIATE TOWARDS PARAIZED OR WEAK SIDE
77
what is quantitative sensory testing?
offers incite on potential mechanisms contributing to individuals experience of pain
78

E1 Nervous System + Pain (6 decks)

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