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Disorders of Cranial Nerves Flashcards

1
Q

name the cranial nerves

A 
I - Olfactory		VII - Facial
 II - Optic			VIII-Vestibulocochlear
 III - Oculomotor	IX - Glossopharyngeal
 IV - Trochlear		X - Vagus
 V - Trigeminal		XI - Accessory
 VI - Abducens		XII - Hypoglossal
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2
Q

where does the olfactory nerve supply?

A

nose

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3
Q

where does the optic nerve supply?

A

eye

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4
Q

where do the oculomotor, trochlear and abducens supply?

A

eye muscles

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5
Q

where does the trigeminal nerve supply?

A

sensory to the face, sinuses, teeth etc

ophthalmic, maxilary and mandible

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6
Q

where does the facial nerve supply?

A

facial muscles of face

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7
Q

where does the vestibulocochlear supply?

A

ear

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8
Q

where does the glossopharyngeal supply?

A

sensory- posterior part of tongue, tonsil, pharynx

motor- pharyngeal, musculature

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9
Q

where does the vagus nerve supply?

A

motor- heart, lungs, bronchi, GI tract

sensory- heart, lungs, bronchi, trachea, larynx, external ear

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10
Q

where does the accessory nerve supply?

A

sternocleidomastoid, trapezius

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11
Q

where does the hypoglossal nerve supply?

A

tongue muscle

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12
Q

what are the functions of the cranial nerves?

A

“Special” senses
“Ordinary” sensation
Control of muscle activity
Autonomic functions

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13
Q

what nerves have “special” senses?

A

Olfaction (I)

  • Vision (II)
  • Taste (VII, IX and X)
  • Hearing - and balance (VIII)
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14
Q

what nerves have “ordinary” sensation?

A

Mainly the Vth (trigeminal nerve)

The ear from the VIIth (facial) and IXth (glossopharyneal) nerves

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15
Q

what muscles control the eye muscles?

A

III (oculomotor), IV (trochlear) and VI (abducence)

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16
Q

what muscles control mastication?

A

V (trigeminal)

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17
Q

what mucles control facial expression?

A

VII (facial)

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18
Q

what muscles control larynx and pharynx?

A

mainly X (vagus)

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19
Q

what is the parasympathetic innervation for pupillary contraction?

A

III (oculomotor)

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20
Q

what is the parasympathetic innervation for lacrimation?

A

VII facial

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21
Q

what is the parasympathetic innervation for salivation?

A

submandibular and sublingual glands – VII (facial)

parotid gland - IX (glossopharyngeal)

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22
Q

what is the parasympathetic innervation for organs in the thorax and abdomen?

A

vagus X

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23
Q

what do we test in olfactory nerve?

A

smell – unilateral or bilateral loss

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24
Q

what do we test in optic nerve?

A 
visual acuity
visual fields
pupillary reactions
fundoscopy
colour vision
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25
what do we test in oculomotor, trochlear, abducens nerve?
any evidence of ptosis? pupil of equal size? pupillary reactions eye movements – vertical and horizontal
26
what do we test in trigeminal nerve?
sensation in the ophthalmic, maxillary and mandibular divisions power in the muscles of mastication corneal reflex jaw jerk
27
what do we test in facial nerve?
Muscles of facial expression Corneal reflex Taste
28
what do we test in vestibulocochlear nerve?
Hearing using Rinne’s and Weber’s tests Vestibular function using Dix-Hallpike manoevre and Untenberger’s test balance
29
what do we test in glossopharyngeal and vagus nerve?
movement of the palate gag reflex quality of speech quality of cough
30
what do we test in accesory nerve?
Head turning and shoulder shrugging
31
what do we test in hypoglossal nerve?
Appearance, movement and power of tongue
32
what are the afferent and efferent reflexes of pupillary light reaction?
afferent – II ; efferent – III
33
what are the afferent and efferent reflexes of corneal reflex?
afferent – V ; efferent – VII
34
what are the afferent and efferent reflexes of jaw jerk
afferent and efferent – V
35
what are the afferent and efferent reflexes ofgag reflex
afferent – IX ; efferent - X
36
where does the III and IV (Oculomotor and Trochlear) nuclei lie?
in the MID-BRAIN
37
where does the V, VI AND VII (Trigeminal, Abducent and Facial) lie ?
in the PONS
38
where does the VIII (Vestibulocochlear) lie
at the PONTOMEDULLARY junction
39
where does the IX, X XI and XII (Glossopharyngeal, Vagus, Accessory and Hypoglossal ) lie
in the MEDULLA
40
what can cause double vision other than cranial nerve lesion?
myasthenia or thyroid eye | disease
41
what can cause cranial nerve damage within the brain ?
ischaemia, tumour
42
what causes cranial nerve damage crossing the sub-arachnoid space?
meningitis
43
what causes cranial nerve damage outside the skull?
base of skull tumours arising in nasopharynx
44
what happens as a result of optic neuritis?
``` demyelination within the optic nerve monocular visual loss pain on eye movement reduced visual acuity reduced colour vision optic disc may be swollen often associated with multiple sclerosis ```
45
what are the parasympathetic pupillary responses?
constriction of the pupil
46
what would happen if there was a loss of parasympathetic input to pupillary response?
loss of parasympathetic input results in a fixed, dilated pupil e.g. complete third nerve palsy
47
what are the sympathetic pupillary responses?
pupillary dilatation
48
what would happen if there was loss of sympathetic input to pupillary response?
constricted pupil
49
what are the causes of dilated pupils?
``` Youth Dim lighting Anxiety, excitement “Mydriatic” eye drops Amphetamine, cocaine overdose Third nerve palsy Brain death ```
50
what are the causes of small pupils?
``` Old age Bright light “Miotic” eye drops Opiate overdose Horner’s Syndrome ```
51
what are eye movement disorders?
``` Isolated third nerve palsy Isolated fourth nerve palsy Isolated sixth nerve palsy Combination of the above Supranuclear gaze palsy Nystagmus ```
52
why would microvascular isolated third nerve palsy happen?
diabetes, hypertension
53
what is the result of microvascular isolated third nerve palsy?
Painless, pupil spared
54
why would compressive isolated third nerve palsy happen?
posterior communicating | artery aneurysm, raised ICP
55
what are the result of a compressive isolated 3rd nerve palsy
painful, pupil affected
56
what are the causes of isolated sixth nerve palsy?
idiopathic diabetes meningitis raised intracranial pressure
57
what is Nystagmus
``` Congenital Serious visual impairment Peripheral vestibular problem Central vestibular / brainstem disease Cerebellar disease Toxins (medication and alcohol) ```
58
what is trigeminal neuralgia?
Paroxysmal attacks of lancinating pain
59
what causes trigeminal neurlgia?
Caused by vascular loop | Compression fifth nerve in the posterior fossa
60
how is trigeminal neuralgia treated?
with carbamazepine | Surgical options if medication resistant
61
what is bells palsy?
Idiopathic facial nerve palsy) Unilateral facial weakness Lower motor neurone type Often preceded by pain behind ear
62
what is affected by bells palsy?
Eye closure affected | Risk of corneal damage
63
how is bells palsy treated?
steroids
64
give examples of UMN and LMN facial paralysis
UMN- stroke, tumour LMN- bells palsy, lyme, saarcoid forehead involvement is unilateral in LMN
65
what are the symptoms of vestibular neuritis?
``` Sudden onset Disabling vertigo Vomiting Gradual recovery Cause uncertain ? viral ```
66
what is dysarthria?
disordered articulation, slurring of speech
67
what is dysphagia?
difficulty swallowing
68
does dysarthria and dysphagia occur in both bulbar and pseudo bulbar palsy?
yes
69
which one out of bulbar- and pseudobulbar palsy are UMN
Pseudobulbar palsy – upper motor neurone Bulbar – lower motor neurone
70
what is pseudobulbar palsy?
Bilateral UMN lesions e.g. in vascular lesions of both internal capsules, MND
71
symptoms of pseudonulbar palsy?
dysarthria - dysphonia - dysphagia - spastic, immobile tongue - brisk jaw jerk - brisk gag reflex
72
what is bulbar palsy?
Bilateral LMN lesions affecting IX - XII | eg. MND, polio, tumours, vascular lesions of the medulla and syphilis
73
symptoms of bulbar palsy?
wasted, fasciculating tongue - dysarthria - dysphonia - dysphagia

systems- neuro- oc (51 decks)

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