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Flashcards in Cranial Nerves Deck (24)
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1

CN1.

Olfactory
-Q. symptoms
- scent markers

2

CN2.

Optic
-visual acuity
-visual fields
-visual inattention
-accomidation
-pupilarly reflex direct and consensual
(-colour vision/ishihara plates)
(-fundoscopy)

3

CN3.

Occulomotor
TEST: H shape tracking- double vision
Palsy: visible strabismus, double vision in most directions, down and out. ptosis.

4

CN4.

Throchlea
H shape tracking- double vision
Palsy: Vertical double vision, tilting of head, unable to look down and it (convergence)

5

CN5.

Trigeminal
TEST: soft touch forehead, cheek and jawline
Clench jaw, open mouth against resistance
(-corneal reflex)
(-jaw jerk)

6

CN6.

Abducens
H shape tracking- double vision
convergent squint on distance vision, unable to abductt

7

CN7.

Facial
-raise eybrows
-close eyes
-puff out cheecks
-smile show teeth

8

CN8

Vestibulocochlear
-whisper
-rinnes
webber

9

CN9

Glossopharengeal
(-gag reflex)
any changes to your sense of taste?

10

CN10

Vagal
- open your mouth and say ahh (deviation uvula)
- give me a cough

11

CN 11

Accessory
-shrug shoulders against resistance
- turn head, sternocleinomastoid, against resistance

12

CN 12

Hypoglossal
-stick your tongue out
-leave it there for a while (fasciculations)

13

Noticeable stabismus (cock eye) with double vision (side by side) in most directions and eye rests down and out

Cranial Nerve 3
Occulomotor nerve palsy (if pupils fixed surgical cause, if pupil spared medical cause)

(congenital / diabetes / posterior communicating artery occlusion/ infection / inflammation/ tumour / MG/ MS/ Cavernous sinus thrombosis / iatrogenic)

14

vertical plain diplopia, patient unable to converge eyes and tilts head to focus

Fourth nerve / trochlear palsy
longest intracranial and thinnest nerve, traumatic damage common. congenital

15

Convergent squint and unable to look outward on affected side, diploplia on transverse gaze.

6th nerve / abducens/ palsy

Early sign of raised ICP

vasculopathic (giant cell arteritis /cavernous sinus mass / multiple sclerosis, sarcoidosis/vasculitis, postmyelography/ lumbar puncture, stroke /Chiari Malformation, hydrocephalus, tuberculosis meningitis)

16

Altered sensation in the face, weakness of jaw muscles

Trigeminal (5th) nerve palsy

tumour
aneurysm
chronic meningitis
a lesion of the trigeminal ganglion:(acoustic neuroma meningioma)
fracture of the middle fossa
a lesion in the cavernous sinus

17

Hemifacial paresis

7th /Facial/ palsy

Bells palsy (idiopathic) most common, often spares forehead.
Central causes (stroke, tumour) do not spare forehead.
other peripheral causes: Ramsay Hunt syndrome (herpes) Lyme disease, petrous bone fractures, chronic meningitis

18

Hearing loss which is louder on air conduction and localises to unaffected side +/- tinnitus

Vestibulocochlear (8th) nerve palsy
Sesorineural hearing loss

Neurofibromatosis 2
vestibular schwanoma / acoustic neuroma
pagets disease of bone
meneires disease
lead / asprin poisoning

19

Hearing loss which is louder on bone conduction and localises to affected side

Conductive hearing loss (infection, foreign body, eardrum damage)

20

Loss of gag reflex unilaterally and altered sense of taste

cranial nerve 9 / glossopharyngeal palsy
very rare, normally combined with CNX

21

deviation of uvula, ipsilateral loss of gag reflex and altered voice

Vagal nerve palsy

rare in isolation, can be severed surgically

22

Loss of gag reflex, swallowing difficulties, strangled cough hoarse voice, wasted fasiculating tongue

Bulbar palsy (pseudobulbar palsy)

Lesion in cranial nerve motor nuclei
(supranuclear lesion affecting lower CN nerves -will have other symptoms too)

Causes: polio / MND / vascular insufficiency / brain stem tumour

23

weak shoulder shrug and head turn

11th / accessory nerve palsy

commonly injured during surgery to the neck

24

MN symptoms in tongue
wasting /tongue deviation /flacid /fasiculations /spastic

12th / hypoglossal/ palsy

Extremely rare in isolation