-
The pt's L eyelid was drooping and partially closed
- L CN III
- oculomotor nucleus (midbrain)
-
Pt had flaccid paralysis of tongue mm and it pointed to the R when the pt tried to stick it out
- R CN XII
- nucleus XII (medulla)
-
Pt could not see either right or left visual fields from the R eye
- R CN II
- cell bodies in ganglion cell of retina (rods/cones)
-
Pt could no longer perceive taste from the posterior 1/3 of the R side of the tongue
- R CN IX
- inferior ganglion of IX
-
pt could no longer perceive taste from the anterior 2/3 of the L side of the tongue
- L CN VII
- solitary Nucl/geniculate ganglion
-
pt did not respond to auditory and equilibrium stimulation of the L ear
- L CN VIII (ipsilateral) both vestibular and cochlear
- spiral ganglion/cochlear nucleus and vestibular ganglion/nucleus
-
when light was placed directly in front of pt's L eye, there was not a direct pupillary light reflex
- L CN II (afferent)
- ganglion cell of retina (rods/cones)
- OR
- L CN III (efferent)
- Edinger-Westphal nucleus (midbrain)
-
pt displayed flaccid paralysis of the L sternomastoid m.
- L CN XI
- mesencephalic nucleus of V
-
R side of tongue became atrophied and wrinkled
- R CN XII
- nucleus of XII (medulla)
-
pt's L eye became dry
- L CN VII
- salivatory nucleus
-
R corner of pt's mouth sagged when he tried to smile; R side of forehead was immobile; and saliva dripped from the corner of the mouth which was sagging
- R CN VII
- motor nucl. of VII (pons)
-
R scapula of pt depressed downward and rotated outward (lateral). Muscle involved displayed flaccid paralysis
- R CN XI
- mesencephalic nucleus of V
-
upon examination by physician, it was noted that the pt had decreased carotid sinus reflex on L side
- L CN IX
- inferior ganglion IX/solitary nucleus
-
pt stated that the R side of mouth was dryer than usual. Physician found that R parotid gland was no longer functioning due to a lesion of which nerve?
- R CN IX
- salivatory nucleus (medulla)
-
after an accident the exam revealed that the pt could no longer perceive general sensation (anesthesia) from R side of face
- R CN V
- trigeminal ganglia/spinal nucleus of V/Chief sensory nucleus
-
following a severe traumatic accident on the R side of neck, pt developed dysphonia
- R CN X
- nucleus ambiguus (medulla)
-
when physician touched R side of soft palate w/ a tongue depressor, there was loss of gag reflex. It had already been established that there was no motor involvement
- CN IX (not CN X b/c there's no motor involvement)
- nucleus ambiguus (medulla)
-
R eye of pt deviated laterally (abducted)
- R CN III
- oculomotor nucleus (midbrain)
-
pt could no longer perceive odors from L nostril
- L CN I
- olfactory epithelial cells
-
after accident, pt could no longer perceive pressure and vibratory sensation from L mandibular region
- L CN V
- mesencephalic nucleus of V (pons)
-
ophthalmologist told pt that she had diplopia (double vision) and strabismus
- CN III, IV, VI
- mesencephalic nucleus of V (midbrain)
-
computerized axial tomography (CAT scan) revealed a small benign neoplasm associated w/ brain stem. Physical exam revealed loss of salivation from R submandibular gland. Which CN was involved?
- R CN VII
- salivatory nucleus
-
ophthalmologist noted that the R cornea was sensitive to touch, however; there was loss of direct corneal reflex. Under this limited set of circumstances, could this pt demonstrate a consensual corneal reflex?
CN VI ipsilateral (could get a consensual reflex -- opposite eye will constrict)
-
pt's L eye adducted an there was loss of direct pupillary light reflex in the L eye while the R eye demonstrated a consensual pupillary light reflex. Which two nn had lesions?
L CN VI and L CN III
-
Pt lost (theoretical) L side carotid body reflexes
- CN IX
- inferior ganglion IX/Solitary nucleus
-
pt demonstrated dysphagia on L side. Which 2 nn would be involved?
L CNs IX and X
-
exam showed no involvement of sensory systems, but there was bilateral loss of gag reflex
- CN X (not CN XI because sensory system isn't involved)
- nucleus ambiguus (medulla)
-
ophthalmologist found mydriasis of the L eye. Which CN or nucleus was involved?
- L CN III
- Edinger-Westphal Nucleus (midbrain)
-
if pt history indicated anisocoria, what physical sign would you expect to find and why?
- CN III
- mecencephalic nucleus of V (midbrain)
-
pt had loss of jaw jerk reflex on L side as well as atrophy of L mm of mastication on L. Which nerve was involved?
- L CN V (V3 b/c mixed)
- motor nucleus of V (pons)
- mesencephalic nucleus of V
-
trauma to neck from a car wreck resulted in multiple symptoms to include tachycardia. Which CN was involved? Very theoretical.
- CN X (loss parasympathetic innervation to heart)
- ganglion X/solitary nucleus
-
pt lost left direct corneal reflex b/c of motor problems but had a functional R consensual corneal reflex
L CN III
-
Pt had L sided anosmia and flaccid paralysis of majority of extrinsic eye mm of L
CN I and CN III
-
pt lost L direct corneal reflex but had the consensual reflex. he also had mydriasis of L eye
L CN III
-
pt had diplopia, abduction of R eye, and loss of pain sensations (analgesia) from R side of face
R CN III and V
-
pt could not hear high-pitched sounds from L ear, and found his tongue protruded to the L when asked to stick it out
L CN VIII and XII
-
physical exam revealed flaccid L sternomastoid muscle, and impaired palatal and uvular reflexes on the L
L CN XI and X
-
pt could not whistle well, lost facial sulci on left side, had saliva dripping from L corner of her mouth, and had flaccid paralysis of mm of mastication on L
CN VII, V3 of CN V
-
pt had dysphagia due to dryness of mouth. Which 2 nn would be involved? What nucleus do they share in relation to this function?
CN IX and X
-
pt had impaired gag reflex due to a motor problem
CN X (sensory problem would be CN IX)
-
pt had impaired gag reflex due to a sensory problem
CN IX
-
loss of taste perception from R side of anterior 2/3 of tongue and loss of vibratory sense from teeth in R mandible would involve which 2 nn?
R CN V and VII
-
eaxm revealed strabismus and ptosis of R eyelid as well as loss of direct corneal reflex of R eye due to a sensory deft
R CN III
-
pt had diplopia due to loss of function of L superior oblique m. and flaccid paralysis of L masseter muscle
L CN IV and V
-
pt did not have a consensual pupillary eye reflex when light was directed toward both L and R eyes. Pt also had strabismus of both eyes. Which CN was involved and was it unilateral or bilateral?
CN III bilateral?
-
anosmia
loss of smell (lesion of CN I only if bilateral)
-
flaccid paralysis
LMN causing structure not to move
-
ptosis
drooping of upper eyelid due to dysfunction of possibly levator palpebrae sup. m (CN III)
-
diplopia
double vision (CN III, IV, VI)
-
abduction of eye
- CN III
- pupil directed laterally away from nose due to inability of eye to move medially, upward, and downward (lateral rectus and sup. oblique are unopposed)
-
strabismus
- eyes are crossed and not synchronized during movement
- occurs when extrinsic eye mm are not properly innervated or mm themselves are damaged
- CN III
-
mydriasis
- dilated pupil
- due to loss of preganglionic parasympathetic fibers in N
- CN III
-
anisocoria
- pupils of unequal size due to one iris being innervated and one not due to loss of preganglionic parasympathetic fibers in affected N
- CN III
-
direct pupillary light reflex
pupil responds to light shined in eye
-
consensual corneal reflex
cornea reacts when touched
-
adduction of eye
- CN VI
- pointing toward nose due to unopposed action of innervated med. rectus muscle
-
palatal and uvular reflexes
- respond when touched
- CN IX (sensory) and X (motor)
-
carotid sinus and carotid body reflexes
- carotid sinus (blood pressure)
- carotid body (CO2/O2 and pH)
- CN IX
-
dysphagia
- difficulty in swallowing
- CN IX (sensory), X (motor), XII
-
dysphonia
- LMN paralysis of ipsilateral intrinsic laryngeal mm results in vocal cord becoming fixed and partially adducted
- voice is hoarse and reduced to a whisper
- CN X
-
gag (pharyngeal) reflex
- CN IX (sensory)
- CN X (motor)
-
transient tachycardia
- increased heart rate due to reduced parasympathetic input to heart
- CN X
-
anesthesia
loss of all general sensations
-
analgesia
absence of sense of pain w/o loss of consciousness
-
If pt lost proprioception from L side of body and also experienced adduction of R eye ball, where might the lsion exist?
R pons
-
If pt lost pain and temp sensations from L side of the body and experienced flaccid paralysis of the facial mm on the R side where might there be a lesion?
R pons
-
Spinothalamic pathway -> spinal lemniscus -> end up in thalamus to synapse with:
3rd orders (pain, temp, crude touch)
-
Flaccid paralysis =
- LMN
- SO: somewhere in R pons it will be damaged; accounts from the same side facial paralysis but contralteral loss of temp and pain in body
|
|
