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Boards 3 CN & Reflex
Cranial Nerves and reflexes
| Question | Answer |
|---|---|
| Cranial nerve I and function | Olfactory, Sensory, sense of smell |
| Anosmia | Sense of smell is lost |
| Parosmia | Distorted sense of smell |
| Cranial nerve II and function | Optic, sensory, visual acuity - snellen eye chart, peripheral vision, light reflex, consensual reflex, accommodation reflex |
| Light reflex | CN II and III |
| Consensual Reflex | CN III |
| Accommodation reflex | CN II and III |
| Cranial Nerve III and function | oculomotor, motor |
| Cranial Nerve IV and function | Trochlear, motor |
| Cranial Nerve VI and function | Abducens, Motor |
| Cranial Nerve V and function | Trigeminal, Motor and Sensory. Motor: jaw jerk reflex, Sensory: corneal reflex, touch forehead |
| Cranial Nerve VII and function | Facial, Motor and Sensory, facial expressions and taste to anterior 2/3 of the tongue (sweet, sour, salty) |
| Cranial Nerve VIII and function | Vestibulo-Cochlear, Sensory Balance & Sensory Hearing |
| Cranial Nerve IX and function | Glossopharyngeal, Sensory, Motor, Taste to the posterior 1/3 of the tongue (bitter) |
| Cranial Nerve X and function | Vagus, Sensory, Motor, Gag reflex, muscles for larynx, carotid reflex (IX and X) |
| Cranial Nerve XI and function | Spinal Accessory, Motor, Test scm and trapezius |
| Cranial Nerve XII and funtion | Hypoglossal, Motor, Tests muscles of the tongue. Tested by asking the patient to stick out their tongue. Look for atrophy, deviation, and fasciculations |
| Jaw jerk reflex tests which nerve or root? | CN V Trigeminal |
| Biceps reflex tests which nerve or root? | C-5 level musculocutaneous nerve |
| Brachioradialis reflex tests which nerve or root? | C-6 Level Radial nerve |
| Triceps reflex tests which nerve or root? | C-7 Level Radial nerve |
| Pectoralis reflex tests which nerve or root? | C-5 through T1 anterior throacic nerve |
| Patellar reflex tests which nerve or root? | L2 through L4 Femoral Nerve |
| Posterior Tibial reflex tests which nerve or root? | L5 |
| Medial Hamstring reflex tests which nerve or root? | L5 |
| Achilles reflex tests which nerve or root? | S-1 Level Tibial Nerve |
| Wexler Scale 0 | absent even with reinforment |
| Wexler Scale 1 | hypoactive or normal response with reinforcement |
| Wexler Scale 2 | Normal |
| Wexler Scale 3 | hyperactive |
| Wexler Scale 4 | hyperactive with transient clonus |
| Wexler Scale 5 | hyperactive with sustained clonus |
| Westphal's sign | absense of any DTR, especially patellar; LMNL |
| Jendrassik's maneuver | brings out reflex by cortical distraction |
| Corneal reflex afferent nerve or root | CN V |
| Corneal reflex efferent nerve or root | CN VII |
| Pharyngeal Reflex afferent nerve or root | CN IX |
| Pharyngeal Refex efferent nerve or root | CN X |
| Abdominal reflex nerve or root | Upper T7 to T9, Lower T10 to T12 |
| Cremasteric reflex afferent nerve or root | femoral N. |
| Cremasteric reflex efferent nerve or root | Genitofemoral nerve, L1, L2 |
| Geigel's reflex nerve or root | same as cremasteric |
| Plantar reflex nerve or root | Tibial N. L4 to S2 |
| Ciliospinal Reflex nerve or root | Cervical Sympathetics |
| Oculocardiac Reflex afferent nerve or root | CN V |
| Oculocardiac Reflex efferent nerve or root | CN X |
| Carotid Sinus Reflex afferent Nerve or root | CN IX |
| Carotid Sinus Reflex efferent Nerve or root | CN X |
| Stroke up on lateral aspect of foot across ball of foot to great toe | Babinski -dorsiflexion of great toe withsplaying of other toes |
| Stroke lateral malleolus to small toe | Chaddock - babinski response |
| Stroke down tibial crest to ankle | Oppenheim - babinski response |
| Squeeze the calf | Gordon's calf- babinski response |
| Squeeze the achilles tendon | Schaefer - babinski response |
| Tap the ball of the foot | Rossolimo - plantar flexion of great toe with curling of other toes |
| Examiner presses the 4th toe downward and releases it with a snap | Gonda - Dorsiflexion of the big toe |
| Examiner extends middle phalanx of patient and flicks distal phalanx down | Hoffman - Flexion and adduction of the thumb and flexion of the fingers |
| Examiner sharply taps tips of the middle three fingers | Tromner - Flexion of all the fingers including the thumb |
| Examiner strokes the pisiform of the patient | Gordon's finger -flexion of wrist and fingers or thumb and index finger |
| Exminer strokes the distal ulnar side of the forearm nera the wrist | Chaddock's wrist - flexion of wrist and extension and fanning of the fingers |
| Patient's hands placed together, palms up. Doctor hands jar patient's hands from below up. | Babinski pronation - affected hand falls in pronation. Good hand remains horizontal |
| Examiner taps bewtween eyebrows with index finger | Glabella - Tonic spasm of orbicularis muscle with closing of the eyes |
| Sharp tapping of the nose or middle of the upper lip | Snout - exaggerated reflex contraction of the lips |
| UMNL | Lesion of the brain and spinal cord not including the anterior horn cell |
| Lesion of the anterior horn cell out to the myoneural junction | LMNL |
| UMNL paralysis | spastic |
| UMNL DTR | hyperactive |
| UMNL Pathological reflexes | Present |
| UMNL Clonus | Present |
| UMNL Tone | Hypertonic |
| UMNL Reaction of Degeneration | Absent |
| UMNL Atrophy | Absent |
| UMNL Fasciculation | Absent |
| UMNL Superficial Reflexes | Absent |
| LMNL Paralysis | Flaccid |
| LMNL DTR | Hypoactive/absent |
| LMNL Pathological Reflexes | Absent |
| LMNL Clonus | Absent |
| LMNL Tone | Hypotonic |
| LMNL Reaction of Degeneration | Present |
| LMNL Atrophy | Present |
| LMNL Fasciculation | Present |
| LMNL Superficial Reflexes | Absent |