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NMS I palmer > cranial nerve details > Flashcards

cranial nerve details Flashcards

1
Q

where does CN I terminate?

A

it is a CNS tract that terminates in the olfactory bulb

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2
Q

what are true olfactory nerves?

A

2nd order ganglion nerve cells which pierce the cribiform plate

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3
Q

what is a perversion of smell?

A

parosmia

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4
Q

what is an abnormally disagreeable smell?

A

cacosmia

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5
Q

describe the pathway of the neurons of CN I

A

primary- unmyelinated; through cribiform plate to olfactory bulb
secondary- myelinated bipolar cells; form olfactory tract and terminate in primary olfactory cortex
tertiary- from primary olfactory cortex to entorhinal cortex (area 28), lateral preoptic, amygdaloid body, medial forebrain

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6
Q

what are the peripheral connections of CN II?

A

1st order- rods and cones of retina- connect with bipolar cells
2nd order- retinal bipolar cells synapse with ganglion cells near retina surface
3rd order- ganglion cells; myelinated and form optic nerve fibers
4th order- geniculocalcarine tract from lateral geniculate bodies; pass to occipital cortex

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7
Q

what part of the optic radiation curves around the inferior horn of the lateral ventricle?

A

Meyer’s loop

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8
Q

where does the optic tract pass to?

A

lateral geniculate bodies
superior colliculi
pretectal region

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9
Q

how does the optic nerve connect to the Edinger-Westphal nucleus?

A

posterior commissure

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10
Q

how does the optic nerve connect to the other cranial and spinal nuclei?

A

from superior colliculi via tectobulbar and tectospinal tracts

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11
Q

how does the optic nerve connect to other cortical and subcortical areas?

A

from the occipital cortex

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12
Q

which fibers are responsible for simple and consensual light reflexes?

A

fibers from pretectal region

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13
Q

which tract is responsible for visual perception?

A

geniculocalcarine tract

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14
Q

what area is concerned with light reflex?

A

pretectal area

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15
Q

what area is responsible for reflex movements of the eye?

A

superior colliculus

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16
Q

the tectobulbar and tectospinal tracts carry information to?

A
  1. cranial and spinal nuclei for involuntary reflexes (accommodation)
  2. pontine nuclei via corticopontine tract for postural reflexes
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17
Q

what is the retinal area for central vision?

A

macula

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18
Q

where is vision sharpest and color discrimination best?

A

fovea centralis

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19
Q

what are the cones responsible for?

A

sharp vision and color discrimination

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20
Q

what involves the optic nerve or tract, MC cause is MS?

A

retrobulbar neuritis

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21
Q

what includes various forms of retinitis?

A

optic or bulbar neuritis

simple, proteinuric, syphilitc, diabetic, hemorrhagic, hereditary

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22
Q

what is associated with decreased visual acuity and change in color of optic disc?

A

optic atrophy

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23
Q

what involves the optic nerve but doesn’t produce papilledema?

A

primary optic atrophy- may be d/t tabes dorsalis, MS, or hereditary

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24
Q

what is the sequel to papilledema?

A

secondary optic atrophy- may be d/t neuritis, glaucoma or increased intracranial pressure

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25
Q

what are the syndromes that involve the optic apparatus?

A

foster kennedy
amaurotic familial idiocy (tay- sachs)
argyll robertson pupil
holmes-adie

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26
Q

what may be caused by tumors at the base of the frontal lobe and what are its characteristic symptoms?

A

Foster-Kennedy
ipsilateral blindness and anosmia (atrophy of CN I and II)
contralateral papilledema

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27
Q

what syndrome is cerebromacular degeneration with severe mental deficiency and what is it associated with?

A

amaurotic familial idiocy (tay-sachs)

blindness, optic atrophy, dark cherry red macula

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28
Q

what reacts only to accommodation is pathologic in tabes dorsalis and also a diabetic complication?

A

argyll robertson pupil

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29
Q

what is characterized by tonic pupil reaction (myotonic pupil) and absence of one or more tendon reflexes?

A

Holmes-adie syndrome

30
Q

what is an inward sinking of the eyeball d/t sympathetic paralysis of small muscle of muller?

A

enopthalmos

31
Q

ptosis associated with Horner’s syndrome is due to paralysis of what muscle?

A

superior tarsal

32
Q

what are the 3 components of accommodation and what nerve is being tested?

A

convergence
pupilloconstriction
lens thickening

CN III or higher

33
Q

what is the Marcus Gunn phenomenon?

A

pupillodilation with light introduction

34
Q

what does the swinging light test tell you if the test is positive?

A

retinal or CN II lesion with the sensory arc decreasing the amount of pupillary motor response

35
Q

red reflex that is partially or completely blocked indicates

A 
disease of translucent structures of eyes:
cornea
lens
vitreous 
retinal pigment
36
Q

what are the findings typically seen with papilledema?

A

blurred nerve fibers and cup
tortuous, engorged veins and loss of venous pulsations at disc margin
obliteration of cup
disc elevation and edema

37
Q

what is seen in 5% of population, usually blond caucasians that is hereditary and benign?

A

pseudopapilledema

38
Q

inflammation of the optic nerve

A

optic neuritis

39
Q

inflammation of the optic disc

A

papillitis

40
Q

if inflammation is behind the optic disc and the fundus looks normal but the patient reports vision loss we would assume?

A

acute retrobulbar neuritis

41
Q

what are 2 eye signs of arteriosclerosis?

A

venous engorgement distal to arterial crossing

light reflection off the artery- silver wiring

42
Q

what are a collection of degenerative deposits that often appear in the fundus of elderly but don’t have clinical significance

A

drusen bodies

43
Q

where do the 3 peripheral sensory divisions of trigeminal have their nuclei?

A

gasserian (semilunar) ganglion

44
Q

what is the cutaneous area over the angle of the jaw supplied by?

A

great auricular nerve of cervicoplexus (C2,C3)

45
Q

the mandibular branch of trigeminal has a recurrent or meningeal branch that innervates what? this explains its association with head pain

A

dura of middle and anterior cranial fossa

46
Q

what do the lateral pterygoids do?

A

right- move jaw tip to left

left- move jaw tip to right

47
Q

when the ophthalmic division trigeminal is involved in a lesion what happens?

A

neuroparalytic keratitis- corneal inflammation and ulceration

48
Q

what disorder is idiopathic, with sharp painful sensation in the 3 branches of trigeminal and what are the AKAs?

A

trigeminal neuralgia

tic douloureux, fothergill’s neuralgia

49
Q

what lesion results in paralysis and denervation atrophy of mastication muscles?

A

LMN lesion of CN V anywhere from pontine nucleus to peripheral cranial nerve

50
Q

what is a line of communication with the opposite cerebellum to allow for the coordination of planned motor functions

A

corticopontine fibers

51
Q

what carries the sensory arc of the corneal reflex and where does it synapse?

A

CN V carries and synapses of CN VII motor nuclei causing eye to blink

52
Q

the corneal blink reflex may be absent in the early stages of?

A

MS

53
Q

what are the divisions of CN VII in the parotid gland?

A

temporal
zygomatic
upper buccal

54
Q

what are the cervicofacial divisions of CN VII?

A

lower buccal
mandibular
cervical branches

55
Q

what CN innervates the stapedius muscle?

A

CN VII

56
Q

what supplies parasympathetic secretory and vasodilator impulses to the submaxillary, sublingual salivary and lacrimal glands as well as mucus membranes of mouth and tongue?

A

chorda tympani- branch of facial nerve

57
Q

what is prosopoplegia?

A

peripheral facial paralysis

58
Q

where is the lesion located in Bell’s palsy?

A

lateral to geniculate ganglion

59
Q

what are the common factors of peripheral CN VII paralysis?

A 
flaccid paralysis (LMN) 
ipsilateral facial muscles distal to lesion site
60
Q

what differentiates stroke from Bell’s palsy?

A

stroke is central type paralysis- forehead is spared, eyes partially involved, neck and mouth fully involved

61
Q

peripheral lesions in CN VII must be where to affect taste?

A

proximal to stylomastoid foramen

62
Q

complete hemifacial paralysis without loss of taste on ipsilateral 2/3 tongue indicates what?

A

Bell’s palsy

63
Q

the vestibular division of CN VIII is connected to what other nerves for coordinating movement of eyes, head and neck in response to stimulation of semicircular canals?

A

CN III, IV, VI

64
Q

a “short circuit” or abnormal impulse from what areas can result in nystagmus?

A

CN III, CN IV, VI and vestibular division of CN VIII

65
Q

what can be the cause of hyperacusis?

A

CN VII- stapedius muscle or

centrally located problem

66
Q

what is the term for visual perception of to and fro movements often accompanying nystagmus?

A

oscillopia- vestibular disease symptom

67
Q

a loud noise from out of sight should cause patient to blink. what is the test and reflex?

A

malingering test

auditopalpebral reflex

68
Q

CN IX motor fibers innervate what?

A

stylopharyngeus muscle- elevate larynx, pharynx soft palate

69
Q

what area controls reflex of pupil and lens?

A

pretectum

70
Q

what area controls head and eye movements?

A

superior colliculus

NMS I palmer (10 decks)

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