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Phase 2A > Extra Mixed Deck (P1 stuff etc) > Flashcards

Extra Mixed Deck (P1 stuff etc) Flashcards

1
Q

CN I - name - function - modality (sensory / motor / both)

A

Olfactory - smell - sensory

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2
Q

How would you test CN I

A
  • ask if they’ve noticed any change Formally: - strong and characteristic smells - lemon, peppermint, coffee - UPenn smell identification test
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3
Q

How would you interpret the results of CN I tests

A

If **anosmia**: causes are - meningioma - trauma - skull or cribriform plate - Parkinson’s - mucus block / covid / genetics

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4
Q

CN II - name - function - modality (sensory / motor / both)

A

Optic - vision - sensory retina to primary visual cortex

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5
Q

How would you test CN II

A

visual acuity - distance - Snellen chart & pinhole - colour vision - ishihara plates fields - neglect / inattention - field - formal is **Amsler chart** - blind spot optic disc - fundoscopy Pupil - pupillary light reflex (direct - ipslateral, consensual - contralateral, swing check relative afferent pupillary defect) - accomodation reflex - distant to near - size, shape

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6
Q

Visual field defects - key in investigation?

A

Test one eye while covering the other! Patient often do not realise

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7
Q

**bitemporal hemianopia** - what is it? - pathology?

A
  • loss of temporal visual field in both eyes - optic chiasm tumour
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8
Q

**Homonymous field defects** - types - pathology?

A
  • hemianopias or quadrantanopias - same side of visual field in each eye - pathology is behind optic chiasm in visual pathways: stroke, tumour, abscess
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9
Q

**Scotoma** - what is it? - pathology?

A
  • absent or reduced vision surrounded by areas of possible vision - wide range, including demyelinating (MS, DM)
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10
Q

**Monocular vision loss** - what is it? - pathology?

A
  • total loss of vision in one eye secondary to optic nerve pathology or ocular disease
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11
Q

How would you interpret results of a fundoscope exam?

A

if papilloedema, causes are - usually **ischaemia** - intracranial bleed possible - **hypertension** - systemic, intracranial (benign & malignant → suspect a brain tumour!) - **headache** - **brain tumour** causing compression - prolonged CNS infection

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12
Q

Nerves of the eye again!! (mnemonic & what they stand for)

A

SO4 LR6 3

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13
Q

CN III - name - function - modality (sensory / motor / both) - ?

A

Oculomotor - motor - mvt of the eye! - pupillary sphincter, extrinsic eye muscles and levator palpebrae superioris - parasympathetic !!

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14
Q

CN IV - name - function - modality (sensory / motor / both)

A

Trochlear - motor - superior oblique

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15
Q

CN VI - name - function - modality (sensory / motor / both)

A

Abducens - motor - lateral rectus

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16
Q

CN VI - name - function - modality (sensory / motor / both)

A

Abducens - motor - lateral rectus

17
Q

What palsy & which nerve is affected when patient presents with **down and out** appearance of the ye?

A

Oculomotor nerve palsy - CN III supplies all muscles except SO & LR so if they have unopposed action, inferolateral action of eye = CN III palsy!

18
Q

What palsy and which nerve is affected when patient tilts their head forward and tuck their chin in, or they tilt their head to the side?

A

Trochlear nerve (CN IV) palsy - forward, chin in: minimise vertical diplopia when looking down due to loss of SO’s action of pulling the eye downwards - tilt: SO also assist with intorsion of eye as head tilts so patient will tilt head to fuse two images together

19
Q

What palsy and which nerve is affected when patient presents with a convergent squint, and/or a horizontal diplopia?

A

Abducens nerve (CN VI) palsy - convergent squint is due to unopposed adduction of eye by MR - also can’t abduct

20
Q

CN V - name - function - modality (sensory / motor / both) - branches, mod, func?

A

Trigeminal - facial sensations, motor info to muscles of mastication - sensory and motor 1. Ophthalmic - sensory - scalp, forehead, nose, upper eyelid 2. Maxillary - sensory - lower eyelid, cheek, lips and gums 3. Mandibular - sensory chin, jaw, motor to mastication & part ear

21
Q

CN VII - name - function - modality (sensory / motor / both) - ?

A

Facial - Sensory - taste anterior 2/3 tongue - Motor - facial expressions, upper bilateral, lower contralateral - Parasympathetic - salivary glands x 3

22
Q

How would you test CN VII?

A

By facial expressions: - raising eyebrows - closing eyes - blowing out cheeks - smiling - pursing lips

23
Q

CN VIII - name - function - modality (sensory / motor / both)

A

Vestibulocochlear - sensory - sound and balance

24
Q

How would you test CN VIII

A

Hearing - gross hearing - Rine’s = bone conduction - Weber’s = transfer issues Vestibular - Unterberger / Turning = march on the spot - Head thrust / vestibular-ocular reflex = you turn patient’s head and see head of neck turns first - Caloric test for labyrinthe

25
Q

CN IX - name - function - modality (sensory / motor / both) - ?

A

Glossopharyngeal - Sensory - taste, posterior 1.3 of tongue, pharynx, tube - Motor - swallow speech (1 in pharynx) - Parasympathetic for parotid gland

26
Q

CN X - name - function - modality (sensory / motor / both) - ?

A

Vagus - Sensory - generaal sensation ENT - Motor - speech, efferent gag reflex - Parasympathetic - thoracic and abdominal viscera

27
Q

How would you test CN IX and CN X?

A
  • Gag reflex (aff 9 eff 10), swallow assessment - Inspection - vagus nerve lesion will cause asymmetrical elevation of palate and uvula deviate away from lesion
28
Q

CN XI - name - function - modality (sensory / motor / both)

A

Accessory - Motor - info to sternocleidomastoid and trapezius

29
Q

How would you assess CN XI

A

WEAKNESS = PALSY - raise and resist you pushing down: trapezius - turn head left or right while you resist

30
Q

CN XII - name - function - modality (sensory / motor / both)

A

Hypoglossal - motor info to extrinsic muscle of the tongue

31
Q

How would you assess CN XII

A
  • open mouth: inspect tongue for wasting and fasciculation - protrude tongue for deviation (toward lesion) - hand on cheek, ask patient to push tongue against it - compare both sides to check

Phase 2A (12 decks)

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