Neuro Exam 4.10

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brau2308
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216552
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Neuro Exam 4.10
Updated:
2013-04-29 17:21:13
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neurology neuroscience neuroanatomy
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review for neuro part 10 for exam 4
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  1. Which CN is the trigeminal N?
    CN V
  2. What occurs with damage to CN V?
    • loss of general sensation
    • LMN paralysis
    • loss of direct and consensual corneal reflexes
  3. CN V Loss of general sensation:
    • areas innervated by opthalmic (V1), maxillary (V2), and mandibular (V3)
    • Damage to CN V will ruin all of these
  4. CN V LMN paralysis occurs in which muscle?
    mm of mastication on ipsilateral side (masseter, temporalis, medial and lateral pterygoids)
  5. What occurs with LMN paralysis of CN V?
    • jaw deviates and points to paralyzed side
    • loss of ipsilateral jaw jerk reflex
    • fibrillation, weakness, and atrophy of mm of mastication
  6. CN V Loss of direct and consensual corneal reflexes:
    loss of input from cornea from V1
  7. What does the corneal reflex cause your eye to do?
    shut if you touch the cornea w/ cotton swab
  8. What happens when you touch cornea w/ cotton swab?
    sensory input through V1 (ophthalmic N) of trigeminal nerve goes to main sensory nucleus of trigeminal where it synapses w/ motor nucleus of facial N (CN VII)
  9. What does the facial nerve do in response to the sensory input from the cornea?
    tells orbicularis oculi to contract
  10. If you damage V1, then you:
    won't get a reflex b/c you won't get sensory info in (touch cornea, and eye doesn't close, then you injured V1)
  11. Direct reflex:
    • sensory info from V1 goes to main sensory nucleus of V in pons ->
    • medial longitudinal fasiculus in pons ->
    • motor nucleus of CN VII ->
    • synapses w/ LMN (alpha motor neurons) ->
    • CN VII goes to orbicularis oculi m and causes it to close
  12. Consensus reflex:
    • sensory info from V1 sends off collateral to main sensory nucleus of V in pons of L eye ->
    • MLF in pons of L eye ->
    • motor nucleus of facial nerve VII ->
    • synapses w/ LMN ->
    • CN VII goes to orbicularis oculi m and closes L eye
  13. Touch R cornea and R doesn't close but L does:
    • sensory info is getting into brain stem so nothing wrong w/ V1
    • nothing wrong w/ CN VII on L side since closing
    • R CN VII is not working since R eye is not closing
  14. Touch R cornea and no direct or consensus reflexes:
    V1 is not sending sensory info to brain stem so not getting any response in either eye
  15. Which CN is the abducens n?
    CN VI
  16. What does CN VI innervate?
    lateral extrinsic rectus m; abducts the eyeball
  17. What happens with damage to CN VI?
    • diplopia
    • adducted eye
  18. CN VI diplopia:
    double vision due to loss of innervation of lateral rectus
  19. CN VI adducted eye:
    • ipsilateral (affected) eye will be adducted toward nose due to unopposed action of medial rectus
    • CN III will override CN VI (which controls lateral rectus), so eye will be adducted since CN VI is damaged
  20. Which CN is the facial n?
    CN VII
  21. What occurs with damage to CN VII?
    • LMN paralysis
    • loss of tearing
    • loss of salvation
    • loss of taste perception on anterior 2/3 tongue
  22. CN VII LMN paralysis reveals itself as which disease?
    Bell's palsy
  23. What occurs with CN VII LMN paralysis?
    • forehead may be immobile
    • corner of mouth sags
    • facial lines are lost
    • nasolabial folds of the face are flat
    • saliva may drip from affected corner of mouth
    • can't whistle or puff due to affected buccinator m
    • smiling: normal mm draw up appropriately, but corner of mouth sags
    • corneal sensitive remains, but pt is unable to close or blink involved eyelid
  24. With CN VII LMN paralysis, is the direct corneal reflex possible?
    no
  25. With CN VII LMN paralysis, is the consensual reflex possible?
    yes
  26. With CN VII LMN paralysis, what happens to the sensory portion?
    sensory portion is ok but efferent limb on paralyzed side is not working
  27. CN VII Loss of tearing:
    ipsilateral side due to loss of preganglionic parasympathetic neurons w/ subsequent loss of innervation of lacrimal glands
  28. What is the result from a loss of tearing with CN VII damage?
    • cornea is dry and painful
    • opthalmologic problems
  29. CN VII Loss of salvation:
    ipsilateral due to loss of preganglionic parasympathetic neurons w/ subsequent loss of innervation of sublingual and submandibular glands
  30. What is the result from a loss of salvation w/ CN VII damage?
    • dryness of mouth
    • difficulty in swallowing
  31. Is the loss of taste perception with CN VII damage contralateral or ipsilateral?
    ipsilateral
  32. Which CN is the vestibulocochlear n?
    CN VIII
  33. What occurs with damage to CN VIII?
    • loss of hearing (cochlear)
    • loss of equilibrium input (semicircular canals)
  34. Is the damage to CN VIII contralateral or ipsilateral?
    ipsilateral
  35. Which CN is the glossopharyngeal n?
    CN IX
  36. What occurs with damage to CN IX?
    • loss of general sensation
    • loss of tast perception
    • ipsilateral loss of gag reflex
    • ipsilateral loss of palatal and uvular reflexes
    • diminished carotid sinus and carotid body reflexes
    • dysphagia
    • affected uvula and soft palate deviate to unaffected side
    • ipsilateral loss of salvation
  37. CN IX loss of general sesnation occurs at:
    ipsilateral posterior 1/3 of tongue and adjacent areas
  38. CN IX loss of taste perception occurs:
    ipsilateral posterior 1/3 tongue
  39. CN IX ipsilateral loss of gag reflex is what kind of reflex?
    pharyngeal reflex
  40. CN IX ipsilateral loss of gag reflex is due to:
    loss of general sensation input from posterior 1/3 of tongue, tonsilar region, and soft palate
  41. CN IX ipsilateral loss of palatal and uvular reflexes is due to:
    loss of general sensation input from posterior 1/3 of tongue, tonsilar region, and soft palate
  42. With the CN IX ipsilateral loss of palatal and uvular reflexes, if you lose afferent aspect then:
    you lose the ability to constrict
  43. CN IX Dysphagia:
    difficulty in swallowing due to loss of ipsilateral innervation of soft palate and stylopharyngeus mm
  44. Why does the affect uvula and soft palate with CN IX damage deviate to unaffected side?
    b/c they are unopposed (this is opposite of the tongue)
  45. Why is there ipsilateral loss of salvation with CN IX damage?
    parotid gland --loss of pregagnlionic parasympathetic neurons
  46. Which CN is responsible for the sensory (afferent) tract of the gag reflex?
    CN IX
  47. Which CN is responsible for the Motor (efferent) tract of the gag reflex?
    CN X
  48. Which CN is the vagus N?
    CN X
  49. What occurs with damage to CN X?
    • LMN paralysis
    • dysphagia
    • LMN paralysis of laryngeal mm
    • loss of gag reflex
    • loss of palatal and uvular reflexes
    • transient tachycardia
  50. CN X LMN paralysis:
    • ipsilateral soft palate
    • twang when speaking
  51. CN X Dysphagia:
    flaccid paralysis of pharyngeal mm
  52. CN X LMN paralysis of laryngeal mm:
    • change vocal cord tension
    • vocal cord becomes fixed and partially adducted
    • voice is hoarse (dysphonia) and reduced to a whisper (deeper sounding voice)
  53. CN X loss of gag reflex:
    ipsilateral due to loss of LMN innervation to soft palate and pharyngeal mm
  54. CN X loss of palatal and uvular reflexes:
    ipsilateral due to loss of LMN innervation to soft palate and pharyngeal mm
  55. CN X transient tachycardia:
    • increased heart rate
    • reduced parasympathetic input to the heart
    • lose ability to slow down heart (parasympathetic); instead sympathetic system can speed it up all it wants
  56. Which CN is the spinal accessory n?
    CN IX
  57. What occurs with damage to CN XI?
    LMN paralysis of SCM and trapezius
  58. CN XI LMN paralysis (flaccidity of ipsilateral SCM):
    inability to rotate head so that chin points to opposite side of lesion
  59. CN XI LMN paralysis (flaccidity of trapezius m):
    downward and outward rotation of scapula
  60. Which CN is the hypoglossal n?
    CN XII
  61. What occurs with damage to CN XII?
    • LMN paralysis
    • paralyzed side atrophy and wrinkles
    • dysphagia
  62. CN XII damage causes LMN paralysis to:
    • flaccidity of ipsilateral intrinsic and extrinsic tongue mm
    • tongue will point to paralyzed side due to normal side being unopposed
  63. CN XII dysphagia:
    difficulty swallowing

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