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Y6 Senior Med COPY > Neuro cranial nerves > Flashcards

Neuro cranial nerves Flashcards

(53 cards)

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1
Q

Olfactory nerve function

A

smell

parkinsons, kallman

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2
Q

optic n function

A

vision

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3
Q

oculomotor nerve innervates…? what is their function

A

medial rectus, inferior rectus, superior rectus, inferior oblique > MOST EYE MOVEMENTS

palpebral muscles > HOLDS EYELIDS OPEN

ciliary muscles > PUPIL CONSTRICTION and ACCOMODATION

palsy: down and out eye, ptosis, dilated, fixed pupil

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4
Q

trochlear nerve innervates…? what is function

A

SO4: superor oblique - down and out eye movement

PALSY = VERICAL DIPLOPIA

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5
Q

trigeminal nerve innervates…? what is function

A

sensation: forehead (opthalmic), cheeks (maxillary), jaw (mandibular), corneal reflex
motor: muscles of mastication = temporalis and masseter

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6
Q

abducens nerve innervates…? what is function

A

LR6: lateral rectus –> abduction

Palsy results in defective abduction → horizontal diplopia

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7
Q

facial nerve innervates…? what is function

A
  • motor: muscles for facial movement, stapedius (damage leads to HYPERACUSIS)
  • sensory: taste to anterior 2/3 of tongue, salivation/lacrimation
  • flaccid paralysis of upper + lower face
  • loss

Lesions may result in:

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8
Q

vestibulocochlear nerve innervates…? what is function

A

balance

hearng

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9
Q

glossopharyngeal nerve innervates…? what is function

A

poost 1/3 of tongue (taste+ sensation)

AND gag reflex

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10
Q

vagus nerve innervates…? what is function

A

sensation and motor to pharynx and laynx

include swallowing and speech

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11
Q

accessory nerve innervates…? what is function

A

SCM, trapezius

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12
Q

hypoglossal nerve innervates…? what is function

A

tongue muscles > tongue movement

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13
Q

what dermatome are the nipples

A

T4

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14
Q

what dermatome is the umbilicus

A

T10

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15
Q

CNIII palsy presentation

A

DOWN and OUT
ptosis (drooping eyelid –> unable to open eye)
fixed dilated pupil (if PNS fibres also affected)

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16
Q

causes of CN3 palsy

A

stroke (posterior cerebral artery)
MS
basal skull fracture

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17
Q

What are causes of ptosis

A

Unilateral:

  • Horner’s
  • CN3 palsy

Bilateral:

  • Myasthenia gravis
  • Myotonic dystrophy
  • congenital absence of muscles

Either: infection, inflammation, tumour

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18
Q

What is Horner’s syndrome, and what general pathophysiology is it caused by

A

CAUSED BY DAMAGE to SYMPATHETIC TRYNK

TRIAD OF:

  • miosis (constricted pupil)
  • ptosis
  • facial anhydrosis
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19
Q

what can cause Horner’s syndrome

A

Vascular (carotid dissection, brainstem stroke)
Infection (pneumonia of lung apex)
Neoplasm (incl Pancoast tumour)
Idiopathic

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20
Q

Causes of Ptosis

A

nerve: (unilateral) CN3 palsy, Horner’s

NMJ: MG (bilateral)

muscle: myotonic dystrophy

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21
Q

How does pupil size vary between CN3 palsy and Horner’s

A

CN3: dilated

Horner’s: constricted

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22
Q

What is pupil like in MG

23
Q

how does CN4 palsy present

Study These Flashcards
A

unable to turn eye down and out + diplopia

24
Q

How does C5 palsy present

Study These Flashcards
A

Loss of sensation to face (location depends on whether it is V1,2,3)
Absent corneal reflex (V1)
Muscle of mastication weakness (V3)

25
How does CN6 palsy present
inability to abduct eye
26
what is bell's palsy
acute, unilateral, idiopathic, facial nerve paralysis
27
are cranial nerves UMN or LMN
They are LMN | They synapse with their UMN at the brainstem nuclei
28
so what type of lesion is Bell's palsy
LMN lesion
29
sx of Bell's palsy
- ipsilateral paralysis of face incl forehead - post auricular pain preceding paralysis - inability to close eyes --> dry eyes, conjunctivitis, keratopathy - hyperacusis (due to stapediius paralysis) ~ everyday sounds much louder - altered taste (metallic taste) in mouth -
30
How is an UMN lesion different to Bell's palsy?
UMN lesion will be FOREHEAD SPARING | because forehead has dual UMN innervation
31
How do you manage Bell's palsy
* Oral Prednisolone within 72 hours for 10 days * eye care (to prevent keratopathy) --> artificla tears/eye lubricants. use a microporous tape to close eyes if cant be closed | consider acyclovir
32
when to urgently refer Bell's palsy to ENT
* No sign of improvement after 3 weeks of treatment * red flag symptoms of cancer * worsening or new neurological findings
33
What are causes of UMN lesion facial droop
stroke tumour haematoma
34
What is Ramsay Hunt syndrome
unilateral LMN facial palsy due to HERPES ZOSTER reactivation
35
How does Ramsay Hunt syndrome present
severe ear pain, ipsilateral vertigo, hyperacusis, tintinnus | vescicles in ear, anterior 2/3 of tongue
36
CN8 palsy presentation
sensorineural hearing loss nystagmys vertigo
37
CN9 presentation
loss of gag reflex
38
CN10 pallsy presentation
ulna deviates AWAY from lesion side | dysphagia
39
CN12 palsy presentatin
atrophy of tongue + fasciculations | tongue deviates towards lesion
40
Lesions where in the motor pathway cause ONLY MOTOR SYMPTOMSS?
Muscle NMJ Anterior Horn
41
what is the difference in lesion location between spasticity and rigidity
spasticity: lesion in PYRAMIDAL TRACT (corticospinal) rigidity: lesion in EXTRAPYRAMIDAL TRACT (rubrospinal / vestibulospinal)
42
How does spastity present
INCREASED TONE which is: - velocity dependent - greatest at the initial part of movement
43
How does rigidity present
INCREASED TONE which is - NOT velocity dependent - same resistance in all directions
44
which pathway supplies the limbs
the LATERAL corticospinal tract (where UMN decussates at medulla)
45
which pathway supplies trunk and axial muscles
the ANTERIOR corticospinal tract (where UMN do NOT decussate)
46
what causes MONOOCULAR VISION LOSS
Lesion in optic nerve (ipsilateral side)
47
what causes BITEMPORAL HEMIANOPIA
Lesion at optic chiams
48
What lesion causes a HOMONOMOUS HEMIANOPIA
CONTRALATERAL lesion of OPTIC TRACT or OPTIC RADIATIONS (beyond the optic chiasm)
49
What is a another name for. Relative Afferent Pupillary Defect
Marcus-Gunn pupil
50
what test allows you to detect RAPD
Swinging torch reflex
51
What occurss in RAPD
The afferent pathway of the eye is disrupted | This leads to a non-responsive direct stimulation and a responsive indirect stimulation (light in the opposite eye)
52
what conditions cause RAPD
Multiple sclerosis --> optic neuritis glaucoma retinal disease -> detachment, infection (herpes) | Glaucoma
53
What is an Argyll Robertson pupil and what causes it
Small irregular pupils present with accomodation reflex but without pupillary refleex causes by diabetes or NEUROSYPHILIS (prostitute's pulpil)

Y6 Senior Med COPY (29 decks)

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