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Year 2 Neuro > Cranial Nerves > Flashcards

Cranial Nerves Flashcards

(65 cards)

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1
Q

What are the 12 cranial nerves

A

Olfactory
Optic
Oculomotor
Trochlear
Trigeminal
Abducens
Facial
Vestibulocochlear
Glossopharyngeal
Vagus
Accessory
Hypoglossal

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2
Q

What are the Four main functions of the Cranial Nerves

A

“special” senses
“ordinary” senses
Control of muscle activity
Autonomic functions

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3
Q

What Nerves are responsible for special senses

A

Olfaction (I)
Vision (II)
Taste (VII, IX, X)
Hearing - and balance (VIII)

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4
Q

What nerves are responsible for ordinary sensation

A

Mainly Trigeminal Nerve
Area around ear (facial, glossopharyngeal nerves)

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5
Q

what nerves Control of Muscle activity

A

Eye muscles (III,IV,VI: SO4,LR6 rest 3)
Muscle of mastication - V trigeminal
Muscles of facial expression - VII facial
Muscles of larynx and pharynx - mainly vagus X
Sternomastoid and trapezius muscles - XI accessory
IX
XII - intrinsic and extrinsic muscles of tongue

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6
Q

what are the Autonomic functions (all parasympathetic) and the nerves that supply them

A

pupillary constriction (oculomotor)
Lacrimation (facial)
Salivation - submandibular and sublingual - facial VII
Salivation - Parotid gland - IX glossopharyngeal
Vagal (x) input to organs in thorax and abdomen

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7
Q

How to test Olfactory?

A

Smell test: unilateral/bilateral

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8
Q

How to test optic nerves

A

Visual acuity
visual fields
pupillary reactions
fundoscopy
colour vision

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9
Q

How to test III,IV,VI

A

looking at occulomotor, trochlear, abduncence
look for evidence of Ptosis (drooping eyelid)
pupil of equal size
pupillary reactions
Eye movements: vertical and horizontal (H)

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10
Q

How do we test trigmeninal nerve

A

Sensation in the opthalmic, maxillary and mandibular divisions
Power of muscles of mastication
corneal reflex
jaw jerk

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11
Q

How do we test the facial nerve

A

Muscle of facial expression
corneal reflex
Taste

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12
Q

How do we test Vestibulocochlear nerve

A

Hearing: Rhinne and Weber test
Vestibular function: Dix-Hallpike manoerve and Untenberger’s (marching on spot) test

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13
Q

How do we test the Glosopharyngeal and Vagal nerves

A

movement of the palate
Gag reflex
Quality of speech
quality of cough

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14
Q

How do we test the accessory nerve

A

Head turning and shoulder shrugging
(sternocliedomastoid and trapezius function)

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15
Q

How do we test the Hypoglossal nerve

A

Appearance, movement and power of the tongue.

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16
Q

What are the 4 Cranial nerve reflexes

A

Pupillary light reflex
Corneal reflex
jaw jerk
Gag Reflex

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17
Q

What are the afferent and efferent nerves in the pupillary reflex

A

Afferent: Optic (II), Efferent: Oculomotor (III)

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18
Q

What are the afferent and efferent nerves in the corneal reflex

A

Afferent: Trigeminal (V), Efferent: Facial (VII)

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19
Q

What are the afferent and efferent nerves in Jaw Jerk

A

Afferent and Efferent: Trigeminal (V)

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20
Q

What are the afferent and efferent nerves in the Gag reflex

A

Afferent: Glossopharyngeal (IX), Efferent: Vagus (X)

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21
Q

What is the afferent fibres role

A

to bring the sensory information to the CNS.

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22
Q

What is the efferent fibres role

A

To take the motor repsonse to from the CNS to the Limb.

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23
Q

What Cranial nerves nuclei are found in the Mid Brain

A

Occulomotor and Trochlear

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24
Q

Where are the Trochlear and Oculomotor nevre nuclei found

A

Midbrain

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25
Where do the nuclei of the Trigeminal, Abducens, Facial lie
Pons
26
What Cranial nerve nuclei are found in the PONS
V, VI, VII (Trigeminal, Abducens, Facial)
27
What cranial nerve nuclei is found at the pontomedullary junction
Vestibulocochlear (VIII)
28
Where is the Vestibulocochlear nuclei found
At the Pontomedullary Junction
29
What cranial nerve nuclei lie in the Medulla
(IX--XII), Glossopharyngeal, Vagus, Accessory, Hypoglossal)
30
Where do the nuclei of the Glossopharyngeal, Vagus, Accessory, Hypoglossal nerves lie
The Medulla
31
What combination of cranial nerves are affected if theres a lesion at the Superior Orbital Fissure
III + IV + VI (oculomotor, trochlear, abducens)
32
Where might the lesion be if the VI and VII are affected
PONS
33
Where might the lesion be if the V + VIII are affected
Cerebellopontine angle
34
If there was Bilateral III signs where might the lesion be
Midbrain
35
What would random patterns of affected nerves suggest
Chronic or malignant menigitis
36
What would only motor signs (defects) in the face suggest
Myasthenia gravis
37
What is Optic Neuritis
Demyelination within the Optic Nerve
38
Symptoms and signs of Optic Neuritis
Monocular Visual Loss Pain on eye movement reduced visual acuity reduced colour vision optic disc may be swollen (associated with Multiple scelorsis
39
What Causes contriction of the pupil
Parasympathetic innervation from the oculomotor nerve on the sphincter pupillae
40
What happens to pupillary response with lack of parasympathetic input
Results in Fixed Dilated pupil Due to Complete Third nerve Palsy
41
What causes dilatation of the pupil
Sympathetic innervation of the dilator pupillae by the long cilary nerves
42
What does damage of the sympathetic innervation of the eye cause
Damage ANYWHERE within sympathetic pathway can lead to constricted pupil.
43
What can cause dilated pupils (III damage/palsy)
Youth Dim lighting Anxiety, excitement 'Mydriatic' eye drops (relax eye muscles) Amphetamine, cocaine overdose Third Nerve Palsy Brain Death Brain Aneurysm
44
What can cause Constricted Pupils
Old Age Bright light 'Miotic' eye drops Opiate overdose Horner's Syndrome
45
What level does the sympathetic innervation arise from the spinal cord and its pathway
T1-T2 (synapse 1st -2nd order neurons) crosses apex of lung up carotid plexus (synpase (2nd - 3rd order neurons) Long Ciliary nerve
46
What are types of eye movement disorders
Isolated 3rd/4th/6th nerve palsy combination of the above Supranuclear Gaze palsy (neurodegenerative disease) Nystagmus
47
What can cause isolated 3rd nerve palsy
Microvascular: Diabetes, Hypertension (painless, pupil spared) Compressive: Posterior Communicating artery aneurysm (Thunder Clap Headache), raised ICP: painful,Pupil affected
48
What Causes Isolated sixth nerve palsy
Idiopathic Diabetes meningitis raised intracranial pressure.
49
What can cause Nystagmus
Congenital Serious Visual impairment Peripheral vestibular problem Central vestibular/brainstem disease Cerebellar disease Toxins (medications and alcohol)
50
What are signs of trigeminal neuralgia
Paroxysmal attacks of lancinating pain triggers Onset: middle age +
51
What causes Trigeminal neuralgia
Caused by vascular loop: compresses fifth nerve in the posterior fossa (and irritates it)
52
What is the treatment for trigeminal neuralgia
Medical: Carbamazepine Surgical options if medication resistant.
53
What is Bell's Palsy and its signs/symptoms
Idiopathic Facial nerve Palsy Lower motor neuron type Unilateral facial weakness pain behind ear eye closure affected
54
What are the risks and treatment of Bell's Palsy
Risk of corneal Damage (eye management essential, due to inability to close eye) Treated with steroids Usually good recovery
55
What is the difference between UMN and LMN facial palsy and examples
UMN (Stroke, tumour), Forehead and eyebrow not involved LMN (Bell's palsy, lyme, sarcoid) Forehead and eyebrow involved
56
What are the Characteristics of Vestibular Neuronitis
Sudden onset Disabling Vertigo Vomiting Gradual recovery Uncertain cause? Viral.
57
What is Dysarthia
Disordered articulation and slurring of speech
58
What is it called if you have slurred speech
Dysarthia
59
What is it called when you have difficulty swallowing
Dysphagia
60
What is the difference between Bulbar and pseudobulbar palsy
Bulbar palsy: LMN Pseudobulbar palsy: UMN
61
What is Pseudobulbar Palsy
Bilateral UMN lesion (vascular lesions of both internal capsules, MND
62
Pseudobulbar palsy symptoms
Dysphagia Dysphonia Dysarthia Spastic, immobile tongue Brisk Jaw jerk Brisk Gag relfex
63
What is Bulbar Palsy
Bilateral LMN lesions affecting IX-XII (MND, polio, tumours, vascular lesion of the medulla and syphilis)
64
Signs + symptoms of Bulbar palsy
Wasted, fasciculating tongue dysarthia dysphonia dysphagia
65
What is the danger with bulbar and pseudobulbar palsy patients
Feeding them, they may aspirate the food and develop pneumonia or LRTI.

Year 2 Neuro (14 decks)

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