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NMS > Cranial Nerve Examination > Flashcards

Cranial Nerve Examination Flashcards

1
Q

There are __ pairs of cranial nerves, all of which are innervated to musculature arise bilaterally from the same side from which they emerge, except for C.N. _______

A

12

VII (Facial- arises contralaterally)

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2
Q

Volitional movements from cranial nerves arise bilaterally from the ___________ of the cerebral motor cortex and descend along the ______________ of the brain

A

Precentral gyrus

Corticobulbar

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3
Q

________ refers to cortex while ____________ refers to the brain stem

A 
Cortico = cortex
Bulbar = brainstem
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4
Q

T/F Both the right and left hemisphere have control over the right and left parts of the body due to bilateral innervation

A

True

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5
Q

Alternate names for the neurons of the corticobulbar tract

A

Upper motor neurons

Supranuclear neurons

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6
Q

Upper motor neurons synapse with ____________ which form the synpatic link to the ____________ which go on to innervate specific muscles

A

Lower motor neurons (alpha-neurons)

Peripheral cranial nerves

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7
Q

Connections that have long thought to be responsible for some of the clinical relationships between headaches, dizziness, and the neck

A
  • Vestibular cranial nerve nuclei
  • Cervically innervated muscle and joint proprioceptors
  • Trigeminal nuclei
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8
Q

What may be the greatest cause of headaches and dizziness?

A

Cervicogenic pain

Cervicogenic vertigo

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9
Q

T/F Movements that are mainly unilateral receive primary innervation from the contralateral hemisphere

A

True

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10
Q

Cranial nerves I and II are not true nerves, but instead are ____________

A

Fiber tracts of the brain

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11
Q

T/F Except for part of C.N. XII, the caudal 10 pairs of cranial nerves emerge from the brain stem in which lies their nuclei of origin

A

FALSE.

All except I, II, and part of XI

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12
Q

The area of the brain where the nerve appears or attaches

A

Superficial origin

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13
Q

C.N. that have motor function take their nuclei of origin from a collection of cells deep within the brain stem (motor nuclei) which are analogous to what part of the spinal cord?

A

Anterior horn cells

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14
Q

Sensory C.N. originate from a collection of cells outside the brain stem, usually in ganglia that may be considered analogous to the _______________ of spinal nerves

A

Dorsal root ganglion

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15
Q

Several reasons that may cause cranial nerve abnormalities

A

1) Specific lesion to the nerve
2) Lesion in the nucleus
3) Lesion in the communicating pathways to and from the cortex, diencephalon, cerebellum, or other parts of the brain stem
4) Generalized problem of nerve of muscle

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16
Q

What would allow a lesion to affect multiple nerves?

A

1) Lesion is where several C.N together in the brain stem or in the skull
2) When they are affected by a generalized disorder
3) Following multiple lesions

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17
Q

Cerebellopontine angle lesion would cause abnormalities in what nerves?

A

V, VII, VIII

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18
Q

Cavernous sinus lesion would cause abnormalities in what nerves?

A

III, IV, V, VI

19
Q

Jugular foramen syndrome lesion would cause abnormalities in what nerves?

A

IX, X, XI

20
Q

In Cerebellopontine angle lesions, Cavernous sinus lesions, and Jugular foramen syndrome lesions, would it affect the nerves bilaterally or unilaterally?

A

All conditions would cause unilateral abnormalities to their respected nerves

21
Q

What condition would cause abnormalities in C.N. X, XI, and XII if it affected a lower motor neuron?

A

Bulbar palsy

22
Q

What condition would cause abnormalities in C.N. X, XI, and XII if it affected a upper motor neuron?

A

Psuedobulbar palsy

23
Q

The sensory nuclei develop within the dorsal or__________ of the neuro tube, the motor nuclei develop within the ______________

A

Alar plate

Basal plate

24
Q

Name and location of C.N. III motor nucleus

A

Edinger-Westphal nucleus

Level of Superior colliculus

25
Q

Name and location of C.N. IV motor nucleus

A

Nucleus of Trochlear nerve

in midbrain at level of the inferior colliculus

26
Q

Name and location of C.N. V motor nucleus

A

Motor nucleus of the Trigeminal nerve

at level of mid Pons

27
Q

Name and location of C.N. VI motor nucleus

A

Nucleus of Abducens Nerve

in dorsal Pons

28
Q

Name and location of C.N. VII motor nucleus

A

Nucleus of the Facial Nerve

near caudal border of the Pons

29
Q

Name and location of C.N. VII and IX motor nuclei

A

VII = Nucleus Salivatorius superior
IX = Nucleus Salivatorius inferior
both are at border of Pons and Medulla

30
Q

Name and location of C.N. X motor nucleus

A

Dorsal motor nucleus of the Vagus nerve

in dorsal medulla

31
Q

Name and location of C.N. IX, X, and XI motor nuclei

A 
Nucleus ambiguous (IX, X, and XI)
in dorsal medulla
32
Q

Name and location of C.N. XII motor nucleus

A

Nucleus of Hypoglossal nerve

in medulla beneath 4th ventricle

33
Q

Name and location for the sensory nuclei of C.N. V

A

V= Trigeminal nerve
Mesencephalic nucleus of Trigmeinal (mid brain)
Main sensory nucleus of Trigeminal (pons)
Nucleus of Spinal tract of Trigeminal (dorsal lateral medulla)

34
Q

Name and location of C.N VIII sensory nuclei

A

VIII = Vestibulocochlear

Vestibular and cochlear nuclei of acoustic nerve (pons and medulla)

35
Q

Name and location of C.N. VII and IX sensory nuclei

A

Nucleus of Tractus Solitarius

dorsal medulla

36
Q

How to assess C.N. I

A
  • Observation of external nose
  • Observation of the internal nasal passage
  • Check sense of smell by testing each side separately and with a different scent
37
Q

How to assess C.N. II

A
  • Observation of the eyes (limbus to lid, limbus to canthi)
  • Test visual acuity (near and far)
  • Test gross visual field (peripheral vision a.k.a. Confrontation)
  • Pupillary light reflex (II or III)
  • Ophthalmoscopic exam
38
Q

How to assess C.N. III, IV, and VI

A
  • Observation of the eyes (limbus to lid, limbus to canthi)
  • Corneal light reflex
  • Pupillary light reflex
  • Cardinal fields of gaze
39
Q

How to assess C.N. V

A
  • Corneal blink reflex
  • Light touch sensation on the face
  • Sharp sensation on the face
  • Inspect muscles of mastication for tine and strength
  • Jaw jerk reflex
  • General sensation of the anterior 2/3 of the tongue
40
Q

How to assess C.N. VII

A
  • Check musculature of the face (smile, look up, etc.)

- Check taste (anterior 2/3 of the tongue)

41
Q

How to assess C.N. VIII

A
  • Observation of the external ears
  • Observation of the internal ears
  • Rinne test
  • Weber test
  • Finger rustle test
  • Schwabach test
  • Watch tick test
42
Q

How to assess C.N. IX and X

A
  • Have the patient say “Ahhhhhhh” (soft palate should rise
  • Gag reflex (posterior 1/3 of the tongue)
  • Check phonation (K-L-M test. pronounce the sounds kuh la mi)
43
Q

How to assess C.N. XI

A
  • Shoulder elevation

- Muscle strength (SCM and Trapezius)

44
Q

How to assess C.N. XII

A
  • Stick out tongue

- Tongue in check

NMS (16 decks)

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