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16 Cards in this Set
- Front
- Back
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Ipsilateral Ptosis
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-drooping of upper eyelid due to paralysis of levator palpebrae superioris muscle
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Ipsilateral
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-eye fixed in down & lateral position (lateral strabismus)
-due to unopposed superior oblique & lateral rectus muscles respectively |
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Diplopia
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-double vision due to abnormal fixed position of ipsilateral eye
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Ipsilateral Proptosis
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-bug eyed due to relaxation of 4 of the 6 extraocular eye mm.
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Ipsilateral Mydriasis
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-dilation of pupil due to paralyzed sphincter pupillae muscle and unopposed dilator pupillae muscle (sympathetic innervation from superior cervical ganglion)
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Ipsilateral Loss of Accomodation
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-inability to focus on close objects
-due to paralysis of ciliary m. leading to permanently flat lens, set for distant viewing |
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Ipsilateral Loss of Pupillary Light Reflex
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-loss of pupillary reflex to light
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Cranial Nerve VII (Motor Test)
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-Motor tested by having patient wrinkle forehead, smile, show teeth, and whistle
-A peripheral lesion of the primary root will result in an entire paralysis or paresis of one half of ipsilateral face -A central lesion will spare upper half -Hyperacusis --> sensitivity to loud sounds; paralysis or paresis of ipsilateral stapedius muscle |
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Cranial Nerve VII (Sensory Test)
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-Corneal Reflex --> a wisp of cotton touched to ipsilateral cornea should elicit a corneal reflex & both eyes to shut
-Damage to CN VII is a loss of the efferent limb of the reflex -Taste is tested using salt, sugar, and bitter solutions applied to sides of tongue protruded from mouth -taste is to be identified before tongue is drawn back into mouth |
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Cranial Nerve VII (Parasympathetic Test)
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-Parasympathetic fibers are secretomotor to sublingual, submandibular, and lacrimal glands
-patients will have symptoms of dry mouth if chorda tympani nerve, submandibular ganglion, or postganglionic fibers have been damaged and/or dry eye if deep petrosal nerve, nerve of the pteryogoid canal, pterygopalatine ganglion or postganglionic fibers in lacrimal gland have been damaged |
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Damage/Lesion Proximal to Geniculate Ganglion and origin of Greater Petrosal Nerve
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-Flaccid paralysis of ipsilateral half of face (Bells Palsy)
-Decreased musous production in ipsilateral nasal and oral cavities -Decreased lacrimation by ipsilateral lacrimal gland -Decreased salivation from ipsilateral submandibular and sublingual glands -Some loss of cutaneous innervation from ipsilateral pinna and external auditory canal (tough to test though) -decreased taste sensation from ipsilateral anterior 2/3 of tongue -loss of corneal reflex |
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Damage/Lesion Distal to Geniculate Ganglion but Proximal to Exit of Nerve to Stapedius m. & Chorda Tympani
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-Decreased Salivation & Taste
-Flaccid Paralysis of Half of Face -Hyperacusis all ipsilateral but with sparing lacrimation, muscous production, and the corneal reflex as the Greater Petrosal N. is spared |
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Damage/Lesion at or Distal to Stylomastoid Foramen
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-Flaccid paralysis of half of face with no parasympathetic symptoms or loss of taste
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Left Colic Flexure
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-Distal limit of Vagus N.
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Damage/Lesion to Ipsilateral Glossopharyngeal Nerve
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-Loss of taste & general sensation from ipsilateral half of posterior 1/3 of tongue
-Loss of gag reflex from ipsilateral half of pharynx -Glossopharyngeal Neuralgia --> idiopathic attacks of severe pain in sensory territories |
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Damage to the Root of the Vagus Nerve Would Result In
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-Dysphagia: difficulty in swallowing due to flaccid paralysis of ipsilateral pharyngeal & laryngeal muscles
-Dysarthria: weakness in vocalization due to flaccid paralysis of ipsilateral vocalis & other laryngeal muscles --> may also be seen in patients where the recurrent laryngeal nerve is damaged during thyroid surgery |
