Cranial Nerves

Front 1

Which nerves are sensory?
Which nerves are motor?
Which nerves are both?

Back 1

Sensory- I,II,VIII
Motor- III,IV,VI,XI,XII
Both- V,VII,IX,X

Front 2

What is an infranuclear Disorder?

Back 2

Damage to the nerve in the brainstem of after it exits the brainstem

Front 3

Which nerves are not in the brain stem?

Back 3

I and II

Front 4

What is the only area in the CNS that continuously regenerates cells?

Back 4

Olfactory nerve. 60 day turnover

Front 5

What is the only nerve with primary sensory nerves in the epithelium?

Back 5

Olfactory

Front 6

What are some signs and symptoms associated with II N damage?

Back 6

Difficulty smelling- Anosmia
Dimisnished taste of food-ageusia
Pathology may be- cold/allergy, virus, trauma, primary axon neoplasm.

Front 7

What are some symptoms associated with frontal lobe dysfunction?

Back 7

seizures
mental changes
depression or euphoria
inappropiate language/behavior
Nonfluent Aphasia(can't produce/comprehend language)
confabulation(false memories)
Contralateral Hemiparesis(partial paralysis), and grasping reflex

Front 8

What are some optometric concerns with nerve 1?

Back 8

ON compression
Eye movement anomalities

Front 9

What are some optometric concerns with nerve 3?

Back 9

4/6 EOMs affected
Diplopia
Possible torsion

Front 10

What are some optometric concerns with nerve IV?

Back 10

Vertical Diplopia
Torsion
Head Tilt

Front 11

What are some optometric concerns with nerve V?

Back 11

Afferent portion of corneal blink reflex

Front 12

What are some optometric concerns with nerve VI?

Back 12

Horizontal Diplopia
Esotropia
Common post stroke, trauma(half resolve completely)

Front 13

What are some optometric concerns with nerve 7?

Back 13

Lid closure. Corneal exposure if not compensated

Front 14

What are some optometric concerns with nerve VIII?

Back 14

Nystagmus
Oscillopsia(objects appear to oscillate)
Equilibrium
Puts greater responsibility on binocularity
Common following head trauma

Front 15

What are some optometric concerns with nerve X?

Back 15

Vaso-Vagal response

Front 16

What are some optometric concerns about a carotid dissection?

Back 16

pupillary anomalies

Front 17

What are some signs/symptoms of 3rd nerve palsy?

Back 17

eyes won't go up, down, inward.
Ptosis
Pupil Dilation
Intorsion

Front 18

If the pupil is not affected it is likely not an ________?

Back 18

Aneurysm

Other pupil info: when there is a compressive problem, the pupillary fibers are usually hit first.

Problems like diabetes affect the internal nerve and usually doesn't affect the pupil.

Front 19

What is affected in superior 3rd nerve palsy?

Back 19

Levator and Superior Rectus

Front 20

What is affected in inferior 3rd nerve palsy?

Back 20

MR, IR, IO

Front 21

What is an aberrant regeneration?

Back 21

nerve growth to a new target

Front 22

What is a netrin?

Back 22

a protein that attracts a nerve to a target

Front 23

What are some common causes of aberrant regeneration?

Back 23

Congenital(usually kids)
Trauma
Neoplasm
Aneurysms!!(timebomb, berryaneurysm on the posterior communicating branch)

Front 24

Rank in order from most likely to get and aneurysm to least likely: III, IV, VI

Back 24

III, IV, VI

Front 25

What are some signs of Superior Oblique (IV) palsy?

Back 25

Diplopia in downgaze
Head tilt
Large vertical fusion amplitudes
Intermittent diplopia when tired

Front 26

What is the longest CN?
Hint* it is also the most susceptible to trauma

Back 26

CNIV trochlear

Front 27

What are the 3 branches of the trigeminal nerve?

Back 27

1- ophthalmic
2- Maxillary
3- Mandibular

Front 28

What are the 3 branches of the ophthalmic nerve and where do they innervate?

Back 28

Frontal Nerve- medial upper eyelid
Lacrimal Nerve- Lateral upper eyelid, conjunctiva, lacrimal gland
Nasocilliary Nerve- Medial eyelid, side of nose, ethmoid, ciliary nerves- afferent corneal reflex

Front 29

What is Tic Douloureux?

Back 29

Trigeminal Neuralgia
Severe pain triggered by specific stimuli. ex. person may have a dirt spot on their face and won't wash it

Front 30

Palsy of which nerve most common causes ophthalmoplegia strabismus?

Back 30

CN-VI Abducens

Front 31

What is Gradenigo Syndrome?

Back 31

infection in petrous portion of temporal bone damaging the CN VI. Causes Photophobia, increased lacrimation, decreased corneal sensitivity.
Originates as Otitis Media in kids.

Front 32

What are the 4 components of CN VII (facial) and what do they do?

Back 32

1. Somatic Motor- starts in Pons. Closes lids, move lips, facial expressions, efferent corneaal reflex.
2. Visceral Motor- Sup Salivatory Nucleus- Lacrimates and salivates(PS)
3. Somatosensory- minor around ear
4. Visceral Sensory- anterior 2/3 tongue, pharynx, taste buds, touch, pain, pressure nucleus solitarius

Front 33

wHAT ARE THE 2 GROUPED NUCLEI?
Where are they and what do they do?

Back 33

Solitarius- Sensory VII, IX, X
Ambiguous- Motor IX, X
Important with vertigo evaluation
Located near vestibular nuclei
If trouble with taste, swallowing, speech-suspect brainstem.

Front 34

What is Bells palsy? How is it caused? signs/symptoms?

Back 34

Ipsilateral facial palsy from cold temp, virus, ideopathic, or trauma.
unable to wrinkle brow, nose, smile, and poor lid closure.
Crocodile tears. Difficulty say 'm' or 'p'
80% recovery within 2 months

Front 35

If someone has multiple cranial nerve palsy, what should you suspect?

Back 35

Problems in cavenous sinus or brain stem

Front 36

What are the 2 branches of the CN VIII(vestibulocochlear)?

Back 36

Vestibular- info on head position and movement
Cochlear- info on hearing

Front 37

What is the vestibular nuclar complex?

Back 37

the VNC integrates signals from vestibular and sensory input from SC, cerebellum, and Visual system. Coordinates motor activities involved in eye and skeletal movements

Front 38

What happens if there is peripheral vestibular dysfunction?

Back 38

recurring periods of vertigo
Nystagmus

Front 39

What happens if there is central vestibular dysfunction?

Back 39

Damage to vestibular nuclei or connections
Milder symptoms than peripheral

Front 40

What are vestibular schwanomas?

Back 40

tumors- don't necessarily effect the hearing

Front 41

Tell me about BPPV.
Duration?
Hearing loss?
How's it caused and treated?

Back 41

Positional true vertigo.
Duration-seconds
No associated hearing loss
Causes: Head trauma, post labyrinthitis, elderly.
Treated with the Epley maneuver for otoconial repositioning. Also Cawthorne habituation exercises

Front 42

What is labyrinthitis?

Back 42

Sudden severe true vertigo, nausea, difficulty walking, motion sensitivity.
No associated auditory probs.
Severe symptoms for 1-3 days, gradually resolving.
10% have chronic symptoms

Front 43

How do you treat labyrinthitis?

Back 43

Acute phase- estibular suppressants, steroids, anti-emetics
Subacute Phase- discontinue meds, activity
Chronic Phase- Exercise, PT, occasionally disabling(cut nerve)

Front 44

What is meniere's disease?

Back 44

Episodic vertigo, hearing loss, tinnitus, aural fullness. Usually unilateral. No known identifiable cause.

Front 45

How do you treat meniere's disease?

Back 45

low sodium diet
Diuretics
Vestibular Suppressants
Benzodiazepines
Gentamicin injections
Surgery
Shunt, VIII nerve section, labyrinthectomy

Front 46

Where does the sensory information come from in the glossopharyngeal nerve?

Where do the motor nerves innervate?

Back 46

Sensory- soft palate and pharynx. Chem receptors in posterior tongue. Afferent of gage reflex

Motor- pharyngeal muscles and parotid salivary gland

Front 47

What is vagus visceral?

Back 47

decreased heart rate
constricted bronchi
affect apeech
increased digestive activity