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Cranial Nrvs

Quiz yourself by thinking what should be in each of the black spaces below before clicking on it to display the answer.
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Question
Answer
show medulla and meninges, spinal accessory nerve, vertebral arteries, anterior and posterior spinal arteries  
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show CN IX, X and XI  
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show CN VII and VIII  
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Name the structure(s) that exit through or enter the foramen ovale.   show
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Name the structure(s) that exit through or enter the foramen lacerum.   show
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Name the structure(s) that exit through or enter the foramen rotundum.   show
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show CN III, IV, VI and V1 of trigeminal nerve  
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show cribriform plate of the ethmoid bone  
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show superior rectus  
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show inferior rectus  
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show superior rectus and superior oblique  
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show inferior rectus and inferior oblique  
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show superior oblique  
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show inferior oblique  
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show inferior oblique  
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What extraocular muscles in each eye does a physician test when he asks the patient to look to the pt's right and down?   show
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What will the globe do if the SO muscle is activated while a patient's eye is abducted?   show
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show extorsion  
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show abduction  
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show unable to look to the right with the right eye when eyes are looking straight forward  
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show gaze palsy - left MR muscle would move the eye laterally, but very slowly. The LR on the right wouldn't move at all.  
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show R eye elevated and extorted  
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show inferior oblique  
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show inferior rectus  
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Identify the muscle producing: pure intorsion with the eye positioned 39 deg away the nose.   show
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Besides the EOM, what else do the motor fibers of CN III directly innervate?   show
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show presbyopia  
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show midbrain stroke or any type of lesion that would affect the bilat oculomotor nuclei; impingement of CN IIIs as they exit interpeduncular fossa  
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show CN III/nucleus damage  
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show the affected eye will be abducted, depressed and slightly intorted  
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Describe the manifestations of Horner's syndrome.   show
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What might an astute triage nurse be looking for if she suspects the pt has a R sided CN III parasympathetic nerve problem?   show
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My ciliary muscles are relaxed because I'm giving my Edinger-Westphal nucleus a break. Which activity will be the easiest for me - reading the newest JAMA issue or spotting a bird across the street?   show
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show Nerve itself; one nucleus complex feeds parasympathetics to both sides and their close proximity makes it hard to obliterate just one  
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show misalignment of gaze due to deviation of a globe  
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What tract is just ventral to the trochlear nucleus in brainstem cross-section?   show
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show trochlear nerve  
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show CN IV  
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show normally  
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show extorted and elevated, causing diplopia  
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show Head tilted to the R to offset the induced extorsion and held with chin downwards to elevate the normal eye to the level the affected eye is abnormally elevated to  
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Monocular diplopia is due to...   show
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Binocular diplopia is due to...   show
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3 year-old Trinity is mimicking Nemo on TV and tilts to follow the screen. If she rolls her head to the R, what do her eyes naturally do?   show
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What muscle's paralysis would result in esotropia?   show
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show ipsilateral LR and contralateral MR  
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show unilateral abducens and MLF lesion cause only contralateral LR to be functional  
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What is typically the cause of bilateral internuclear ophthalmoplegia (INO) in a young pt?   show
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show MLF (in this case via L CN III nucleus)  
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Explain the mechanism behind internuclear ophthalmoplegia.   show
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List the 3 nuclei associated with CN VII.   show
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What might a physician expect to see if her pt has a LR muscle paralysis?   show
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show It allows for smooth voluntary eye movement during lateral gaze by innervating the abducens nucleus ipsilaterally and sending fibers that travel in the MLF to the oculomotor nucleus contralaterally  
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show Just ventral to the MLF at levels of III, IV and V and in similar place at levels of VI and VII  
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Which Brodmann's area includes the frontal eye fields (FEF)?   show
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show rapid movement of eye under conscious control to allow abrupt change of point of fixation  
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What Brodmann's areas include the extrastriate visual cortex?   show
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3 structures that are important for saccadic eye movements   show
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show through the posterior commissure  
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show false  
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Fibers coming from the retina traveling in the optic tract eventually reach the pretectal nuclei via what structure?   show
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show convergence of the eyes, rounding of both lenses and constriction of the pupils  
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show syphilis  
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show syphilis likely selectively attacks the fibers that enter the E-W nucleus ventromedially; these fibers are only responsible for destroying light reflex fibers. Near triad fibers are ventrolateral and thus spared.  
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Argyll-Robertson pupil   show
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show retina - hypothalamus - reticular formation - down to C8-T2 preganglionic neurons in IML column - up sympathetic chain - superior cervical ganglion - carotid plexus - cavernous sinus - pupil  
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show obliteration of sympathetic fibers feeding the affected side's eye - Horner's syndrome sx  
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show False: only para synapses, symp just rides through the ganglion  
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Eye exam findings: direct light into the R eye shows sluggish pupillary response, direct light into the L causes a brisk constriction of the R pupil. IMMEDIATELY after, direct light in the R pupil shows no constriction, but a steady dilation. Condition?   show
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Which trigeminal nucleus is closest to the MLF in a pontine cross-section?   show
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show spinal nucleus of CN V is contiguous with substantia gelatinosa as far down as C6  
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show CN V, VII, IX and X  
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show EOMs have sensory receptors that originate in mes. nucleus of trigeminal that relay to CN III, IV and VI to control eye movements  
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show mesencephalic nucleus of CN V  
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show nerve from motor nucleus of trigeminal  
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show corneal reflex, chief sensory nucleus of trigeminal and its peripheral afferent through V1  
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show the jaw will be towards the L; the L. lateral pterygoid moves the jaw to the R. Therefore, the strong R. lateral pterygoid will move jaw to same side as lesion  
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If the nerve going to ocular muscles on the R is severed and a physician takes a wisp of cotton to touch the R cornea, what should she see the pt do?   show
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show nasal mucosa sensation and nociceptors - CN V  
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Name the condition arising from lesions to the motor nucleus or root of CN VII.   show
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show dorsal - lower face ventral - upper face  
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show CN VII - stapedius CN V - tensor tympani  
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show bilateral  
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show Bell's palsy affects the nerve after it leaves the facial motor nucleus and thus an entire side of the face. Stroke will cause a total lower face paresis but just weakness of the upper face.  
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show lagophthalmos  
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An UMN lesion in the motor cortex in the facial region would cause what else in addition to facial muscle paralysis in the contralateral lower face?   show
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show lacrimal, submandibular and sublingual glands  
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What is the most easily detectable symptom of a lesion of the division of the facial nerve that arose from the salivatory nucleus?   show
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What are the CNs involved in swallowing?   show
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Where do fibers innervating the parotid gland originate (what nucleus)?   show
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In which direction will the palate deviate in a pt with a glossopharyngeal lower motor nerve lesion?   show
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A pt comes to you for uncontrolled BP. You test her CNs and notice her palate deviates to the right. What might this tell you?   show
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show the portion of the nucleus solitarius receiving afferents via CNs VII and IX  
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If an 84 yr old woman can press her tongue into her R cheek, what is your conclusion about her neuromuscular status?   show
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What section of the brainstem is the hypoglossal nucleus within?   show
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show C1-2 for SCM C3-4 for trapezius  
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What CN nucleus must be intact to elecit a negative chronotropic effect on the heart?   show
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show glossopharyngeal  
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Which CN(s) innervate the pharyngeal constrictors?   show
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show any interruption of CN X innervating laryngeal muscles  
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show bulbar portion of CN XI  
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True/False: Unilateral lesions of the nucleus ambiguus will not produce detectable alterations of the voice.   show
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Trace the pathway for saccadic eye movements beginning with the retina.   show
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Input from what 2 structures is needed for initiation and accurate targeting of saccadic eye movements?   show
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Smooth pursuit eye movements require input from what cortical structures for initiation and accurate guidance of eyes to track visual targets?   show
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