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Irene Gold Part 4 – Questions And Answers
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Irene Gold Part 4 – Questions And Answers
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Irene Gold Part 4 – Questions And AnswersPupil light response:
CN2 optic nerve
CN3 oculomotor ✔️Ans - sensory:
•direct light reflex: same eye light, pupil should constrict, hold, relax
•indirect light reflex and accomodation: (CN 2/3)- eyes converge, pupils
constrict, lens convexity
cardinal fields of gaze ✔️Ans - CN 3/4/6
"Follow my finger with eyes only" Pause 1-2 seconds at each end range.
LR6- lateral rectus m
SO4- superior oblique
AO3- levator palpebre, superior/inferior oblique, medial/inferior rectus
Tic Douloureaux AKA Trigeminal Neuralgia ✔️Ans - Extreme, sporadic
sudden burning or shock like face pain that lasts anywhere from a few
seconds to as long as 2 minutes per episode
Lightening like, excruciating pain is repetitive, occurring several times per day
Pain is typically felt on one side of the jaw or cheek
Bells palsy vs stroke ✔️Ans - Bells palsy (LMN lesion CN 7). Ispi motor loss
of entire face, cannot wrinkle forehead
Stroke: (UMN lesion CN 7). Contralateral motor loss below eye. Forehead can
wrinkle
CN 9 Glossopharyngeal ✔️Ans - Gag reflex: CN 9 sensory, CN 10 motor
Carotid reflex: CN 9 sensory, CN 10 motor.
Taste to posterior 1/3 tongue
motor: stylopharyngeus mm. Elevates pharynx and larynx, dilates pharynx to
permit swallowing
CN 10 Vagus ✔️Ans - Sensory: epiglottis and laryngeal mm of swallowing
(palate, pharynx, contracting mm)
, Motor: Gag and carotid reflex.
Uvular reflex: palate and uvula deviate to contralateral side of lesion when pt
says "ahhhh" = *curtain sign*
CN 11 Spinal Accessory ✔️Ans - motor: trapezius and SCM mm. Shoulder
shrugs (traps) and lateral flexion with head rotation (SCM) against resistance
condition: torticollis aka Wry Neck - spasm of SCM mm
CN 12 Hypoglossal ✔️Ans - motor, tongue movement.
Deviates to side of lesion, fasciculation and atrophy on tongue with LMNL
ciliospinal reflex
(visceral organic reflex - brainstem. Absent in UMNL/LMNL) ✔️Ans - pinch
neck while noting dilation of eyes
sensory from neck- cervical sympathetics
Oculocardiac reflex
(visceral organic reflex - brainstem. Absent in UMNL/LMNL) ✔️Ans - press
on eye note slowing of heart by 10 bpm
CN 5 and CN 10
carotid sinus reflex
(visceral organic reflex - brainstem. Absent in UMNL/LMNL) ✔️Ans - press
on carotid sinus. slowing of heart and decreased pressure
CN 9 and CN 10
convergence ✔️Ans - CN 3/4/6
follow this pen 3x, bringing in towards nose to see if eyes converge
finger rub (present or absent) ✔️Ans - CN 8
close eyes, rub fingers together to see if pt can hear it.
if absent do rinne's and webers
accommodation reflex ✔️Ans - CN 3
focus on spot on wall for me, now look at this pen
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