Kaufman Ch 4

Front 1

Only sensation that does not synapse in the thalamus before going to the cerebral cortex and deep brain structures

Back 1

Olfaction: terminates in underside of frontal cortex and some terminate in amyg and hypothalamus

Front 2

Foster–Kennedy syndrome

Back 2

a meningioma compresses the olfactory nerve and the nearby optic nerve. Damage to those two nerves causes the combination of unilateral blindness and anosmia. If the tumor grows into the frontal lobe, it can also produce personality
changes, dementia, or seizures.

Front 3

Causes of anosmia

Back 3

Head trauma can shear off the olf. nerves as they pass through the cribriform plate. Inhaling chromium, aluminum, iron. 90% of patients with parkinson, lewy bodies, Alz, etc. lose sense of smell

Front 4

Two functions of optic nerves

Back 4

vision, adjusting the size of pupil

Front 5

pupillary light reflex

Back 5

change in pupil size after exposure to light. small branches from optic nerve travel to midbrain (afferent) -> CNIII (efferent)->constricts pupil size. Lack of light reflex signals brain death

Front 6

How does MS cause optic neuritis when CNII is in the PNS?

Back 6

CNII myelin is derived from oligodendrocytes rather than schwann cells so it is an extension of the CNS. Thus, CNS diseases impact CNII.

Front 7

Function of CNIII, CNIV, CNVI

Back 7

maintains conjugate gaze; dysconjugate gaze is marked by diplopia

Front 8

Occulomotor impairment

Back 8

distinctive constellation: a dilated pupil, ptosis, and outward deviation (abduction)
of the eye (also loss of pupil reflex)

Front 9

trochlear nerve damage

Back 9

Function: controls superior oblique muscle responsible for depression of the eye when adducted (turned inward). To compensate pts will tilt head away from affected side.

Front 10

abducens nerve function

Back 10

innervates its ipsilateral lateral rectus muscle, which abducts the eye. Damage leads to inward deviation (adduction) of the eye from the unopposed medial pull of the oculomotor
nerve, but no ptosis or pupil changes

Front 11

strabismus

Back 11

congenital dysconjugate or “crossed” eyes, strabismus, does not cause double vision
because the brain suppresses one of the images. If uncorrected in childhood leads to blindness of the deviated eye

Front 12

Trigeminal (fifth) nerve

Back 12

convey sensation from the face and innervate the large, powerful muscles that protrude and close the jaw. Because these muscles’ main function is to chew, neurologists often call them “muscles of mastication.”

Front 13

Ways to test the trigeminal nerve

Back 13

touch sides of face, test corneal reflex, jaw jerk reflex (closing jaw after tap)

Front 14

MLF syndrome (medial longitudinal fasciculus) syndrome

Back 14

heavily myelinated midline tract between pons and midbrain that links oculomotor and abducens nerves. Interruption causes nystagmus of abducting eye, failure of adducting eye to cross midline (common in MS)

Front 15

Injury to trigeminal nerve causes:

Back 15

hypoactive jaw jerk; corneal reflex impairment; deviation of jaw toward side of lesion, facial hypalgesia - common causes include gun shot wounds, tumor of nasopharyngeal area, acoustic neuromas; herpes infects trigeminal often causing trigeminal neuralgia (terrible pain)

Front 16

Facial Nerve does what?

Back 16

CNVII: both sensory and motor, conveys taste and innervates the facial muscles. (smile, frown, wink, raise eyebrows, etc.).

Front 17

CNVII Damage

Back 17

ipsilateral paresis of face (upper and lower). Note: injuries of CNS cause only lower facial paresis. loss of sensation from first 2/3rds of tongue.

Front 18

Bell's palsy

Back 18

sudden onset, idiopathic facial paralysis, usually with loss of taste sensation (due to infection of CNVII, lyme disease, lacerations, cerebellopontine tumors

Front 19

Acoustic Nerve functions

Back 19

CNVIII has two divisions: cochlear nerve transmits auditory impulses from middle and inner ear to superior temporal gyri. Vestibular nerve transmits info about equilibrium, orientation, and change of position aiding in balance.

Front 20

Most common form of hearing loss with aging?

Back 20

presbycusis: 25% of older adults, loss of high frequency sound and progresses to all frequencies. CNVIII cochlear mechanism withers as we age. Can be misdiagnoses as dementia due to sensory deprivation

Front 21

tinnitus

Back 21

ringing, buzzing, whistling in the ears. Aspirin can damage inner ear, ischemia, possible symptom of acoustic neuroma if unilateral.

Front 22

function of CNIX

Back 22

glossopharngeal brings taste sensation from posterior 2/3rds of tongue. Innervates (increases secretion of) parotid salivary gland. Motor: one pharyngeal muscle (stylopharyngeus)

Front 23

Vagus Nerve Sensory functions

Back 23

CNX visceral sensory information from pharynx, larynx, carotid bodies, heart, lungs, most abdominal organs. general sensory information from external auditory canal, eardrum, and pharynx

Front 24

Vagus Nerve Motor Functions

Back 24

most pharyngeal muscles, laryngeal muscles

Front 25

Bulbar Palsy

Back 25

damage to the "bulbar" nerves IX, X, XI causes dysarthria, dysphagia with hypoactive jaw and gag reflexes. Usually a brainstem lesion and can also be associated with damage to corticospinal tract (UMN signs like babinski reflex)

Front 26

Spinal Accessory functions

Back 26

Accessory nerve is a cranial nerve that controls certain neck muscles. It is coiled in appearance. It is divided into spinal and cranial parts, but its cranial part is often disregarded. The spinal accessory nerve provides the sternocleidomastoid and trapezius neck muscles with motor function.

Front 27

How to assess for bulbar palsy

Back 27

spontaneous speech will have a thick, nasal intonation or will be mute. Palatal and pharyngeal paresis will lead to absent jaw jerk reflex. Respiration may also be damaged and require "Iron lung" (guillann-barre, ALS, etc. can cause this)

Front 28

Pseudobulbar Palsy

Back 28

when frontal lobe damage rather than brainstem causes dysarthria and dysphagia. Also associated with sudden unprovoked episodes of laughter or emotional outbursts. Aphasia and dementia may occur. Speech has an explosive cadence. Will have hyperactive jaw jerk and face will sag due to corticobulbar tract damage.

Front 29

Hypoglossal

Back 29

CNXII innervates muscles of the tongue. Damage will cause tongue to deviate in direction of weak side (tongue points to the lesion).