Disorders of Cranial Nerves Flashcards Preview

Y2 Neurology > Disorders of Cranial Nerves > Flashcards

Flashcards in Disorders of Cranial Nerves Deck (81)
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1
Q

what are the four special senses?

A

smell
vision
taste
hearing/balance

2
Q

what nerve is responsible for smelling?

A

olfaction

3
Q

what nerve is responsible for smelling?

A

optic

4
Q

what nerves is responsible for taste?

A

facial
vagus
glossopharyngeal

5
Q

what nerve is responsible for hearing ?

A

vestibulocochlear

6
Q

what nerve supplies sensation to the face?

A

trigeminal

7
Q

what nerve supplies the lateral rectus ?

A

abducens

8
Q

what nerve supplies the superior oblique ?

A

trochlear

9
Q

what nerves supply the muscles of mastication ?

A

mandibular branch of trigeminal

10
Q

what nerves supply the muscles of mastication ?

A

the facial nerve

11
Q

what nerve supplies taste to the anterior part of the tongue ?

A

chorda tympani of the facial nerve

12
Q

what nerve supplies the trapezius and SCM?

A

accessory nerve

13
Q

what nerve supplies the muscles of the pharynx and larynx ?

A

vagus

14
Q

what nerves contain parasympathetic fibres ?

A

3 - oculomotor
7 - facial
9 - glossopharyngeal
10 - vagus

15
Q

what nerve causes pupillary constriction ?

A

oculomotor

16
Q

what nerve causes tearing of the eye from the lacrimal gland ?

A

facial

17
Q

what nerve causes salvation from the parotid gland ?

A

glossopharyngeal

18
Q

what nerve causes salvation from the submandibular and sublingual gland ?

A

facial

19
Q

what tests can be dine to test the optic nerve ?

A
visual acuity 
visual fields 
pupillary reactions 
fundoscopy 
colour vision
20
Q

what four tests can be done to test the trigeminal nerve ?

A
sensation 
- light touch and neurotip 
power of muscles of mastication 
corneal reflex 
jaw jerk
21
Q

what three tests can be done to test the facial nerve ?

A

muscles of facial expression
corneal reflex
taste

22
Q

what facial movements should be done to test the facial nerve ?

A
  • raise eyebrows
  • clench teeth
  • bloat out cheeks
  • clench eyes together
23
Q

what is the rinnes test ?

A

hearing test testing the vestibulocochlear nerve

- by placing a 512Hz tuning fork on the persons forehead and asking if they can hear the vibrations in both ears

24
Q

what is webers test?

A

hearing test testing the vestibulocochlear nerve

  • by placing the 512Hz tuning fork in front of the external ear canal and then placing it on the mastoid process on the temporal bone and asking if the person can hear both and which one is louder.
  • the one in front of the ear should be louder
25
Q

what is Dix-Hallpike manoeuvre used for ?

A

for vertigo and dizziness

26
Q

what does the Untenbergers test involve ?

A

standing patient closing their eyes and checking if they fall over or not

27
Q

what tests can be done to test the glossopharyngeal and vagus nerve ?

A

movement of palate
gag reflex
quality of speech
quality of cough

28
Q

what can be done to check the function of the hypoglossal nerve ?

A

appearance, movement and power of the tongue

29
Q

how is the power of the tongue tested?

A

asking the person to push their tongue into the side of their cheek and feel how strong it is

30
Q

what nerves nuclei lie in the mid brain ?

A

3rd and 4th

oculomotor and trochlear

31
Q

what nerves nuclei lie in the pons ?

A

5th, 6th, 7th and 8th

32
Q

which nerve nuclei lies in the pontomedullary junction ?

A

8th

- vestibulocochlear

33
Q

what nerves nuclei lie in the medulla ?

A

9th, 10th, 11th and 12th

34
Q

what condition results in loss of pure motor signs?

A

myasthenia gravis

35
Q

give 3 examples of conditions which can damaged cranial nerves within the brain ?

A
  • ischaemia
  • tumour
  • increased ICP
36
Q

give an example of conditions which can damaged cranial nerves crossing the subarachnoid space ?

A

meningitis

37
Q

give an example of conditions which can damaged cranial nerves outside the skull?

A

base of the skull tumours

38
Q

what does optic neuritis result in, in relation to the optic nerve ?

A

demyelination within the optic nerve

39
Q

what causes demyelination in the optic nerve during optic neuritis ?

A

inflammation

40
Q

the symptoms does someone with optic neuritis experience ?

A

monocular visual loss
pain on eye movement
reduced visual acuity and colour vision

41
Q

what condition is optic neuritis associated with ?

A

multiple sclerosis

42
Q

what would be seen on fundoscopy fora patient with optic neuritis ?

A

optic disc may be swollen

43
Q

what test can be done to test the conduction of the optic nerve ?

A

visual evoked response

- delayed response would suggest demyelination

44
Q

what autonomic response causes pupil dilation ?

A

sympathetic

45
Q

what autonomic response causes pupil constriction ?

A

parasympathetic

46
Q

what would the pupil look like if the sympathetic fibres were damaged ?

A

fixed constricted

47
Q

what would the pupil look like if the 3rd cranial nerve fibres were damaged ?

A

fixed dilated pupil

48
Q

state some causes of dilated pupils?

A
  • youth
  • dim lighting
  • anxiety, excitement
  • “mydriatric” eye drops
  • cocaine, amphetmine
  • third nerve palsy
  • brain death
49
Q

state some causes of small pupils?

A
  • old age
  • bright lights
  • “miotic” eye drops
  • opiates overdose
  • Horners syndrome
50
Q

what are the two categories of causes of third nerve palsy ?

A

microvascular

compressive

51
Q

state some microvascular causes of 3rd nerve palsy?

A

HT

Diabetes

52
Q

state some compressive causes of 3rd nerve palsy?

A

SAH
Raised ICP
Aneurysm

53
Q

state the two clinical signs of microvascular 3rd nerve palsy

A

painless

pupil is spared

54
Q

state the two clinical signs of compressive 3rd nerve palsy

A

painful

pupil is affected

55
Q

state four causes of 6th nerve palsy ?

A

idiopathetic
diabetes
meningitis
raised ICP

56
Q

state some causes of nystagmus

A
congenital 
serious visual impairment 
peripheral vestibular problem 
central vestibular disease 
cerebellar disease 
toxins
57
Q

what two toxins can cause nystagmus ?

A

alcohol

anti epileptics

58
Q

what symptom is experienced with trigeminal neuralgia ?

A

paroxysmal (short frequent) attacks of laminating (piercing stabbing) pain

59
Q

what age range is most effected by trigeminal neuralgia ?

A

middle aged and older people

60
Q

what causes trigeminal neuralgia ?

A

compression of 5th nerve

61
Q

what medication is used to treat trigeminal neuralgia ?

A

carbamazepine

62
Q

as well as medication what other options are available for trigeminal neuralgia ?

A

surgical options when medication is resistant

63
Q

what is the cause of idiopathic facial nerve palsy (bells palsy)?

A

unknown cause

64
Q

what is the symptom of bells palsy ?

A

unilateral facial weakness

65
Q

what can a complication be of a bells palsy patient when they can’t come their eye properly ?

A

their eye can dye out and they can lose their vision

- risk of corneal damage

66
Q

what is bells palsy treated with ?

A

steroids

67
Q

how are UMN and LMN disorders involving paralysis of the face differ?
- UMN

A

UMN disorders (stroke)

  • for example if the lesion was in the internal capsule on one side
  • then some fibres from the contralateral side of the lesion will ipsilaterally to the forehead
  • so patients with UMN will not have complete unilateral paralysis as the forehead may still be able to move
68
Q

how are UMN and LMN disorders involving paralysis of the face differ?
- LMN

A

LMN disorders (Bells palsy)

  • the lesion is lower down as the nerve has already left the brain stem
  • all fibres travelling to the contralateral side of the lesion will be affected so the forehead will not be able to move
  • therefore the patient will have complete unilateral paralysis
69
Q

what is dysarthria ?

A

slurring of speech

70
Q

what is dysphagia?

A

difficulty swallowing

71
Q

what is dysphasia ?

A

difficulty to generate speech

72
Q

is pseudo bulbar palsy an UMN or LMN disease?

A

UMN

73
Q

is bulbar palsy an UMN or LMN disease?

A

LMN

74
Q

are bulbar and pseudo bulbar palsy caused by unilateral or bilateral lesions ?

A

bilateral

75
Q

what are two causes of pseudo bulbar palsy ?

A

vascular lesions in both internal capsules

motor neurone disease

76
Q

what are some causes of bulbar palsy ?

A
motor neurone disease 
polio 
syphilis 
tumours 
lesions in the medulla
77
Q

what cranial nerves are affected during bulbar palsy ?

A

9-12 nerves

- nerves passing out go the medulla

78
Q

state some symptoms/clincal signs of pseudo bulbar palsy ?

A
dysarthria 
dysphonia 
dysphagia 
immobile tongue 
brisk jaw and gag reflex
79
Q

what is dysphonia ?

A

loss in volume

80
Q

what is dysarthria ?

A

difficulty to articulate speech as muscles don’t work properly

81
Q

state some symptoms and clinical signs for bulbar palsy ?

A

wasted, fasciculating tongue
dysarthria
dysphonia
dysphagia