Section 1
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Archicerebellum
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Cards (200)
Section 1
(50 cards)
Archicerebellum
(flocculonodular lob) connects with vestibular system and is concerned with equillibrium and regulation of muscle tone helps coordinate vestibulo-occular reflex
Reticulospinal system
Descending fiber systems (motor pathways) Arises in the reticular formation of the brainstem and descends (crossed and uncrossed) in ventral and lateral columns, terminates both on dorsal gray (modifies transmission of sensation, especially pain) and on ventral gray (influences gamma motor neurons and spinal reflexes)
Parietal lobe
Post central gyrus: - primary sensory cortex for integration of sensation - Receives fibers conveying touch, proprioceptive, pain, and temperature sensations from opposite side of body
Frontal lobe
Precentral gyrus: - Primary motor cortex for voluntary muscle activation - Prefrontal cortex: Controls emotions and judgement - Broca's area: Control motor aspect of speech
Delta
There are several different type A nerve fibers,which are large myelinated fibers and conduct the fastest. Which type of A fibers is responsible for pain, temperature and touch?
Primary auditory cortex
This area of the temporal lobe that receives/processes auditory stimuli
Corticospinal tracts
Descending fiber systems (motor pathways) Arise from primary motor cortex, descend in brainstem, cross in medulla (pyramidal decussation) - Important for voluntary motor control
Anterior spinothalamic tract
Ascending tract (sensory pathways) that convey crude touch
Transverse commissural fibers
This fibers interconnect two hemispheres, including the corpus callosum (the largest), anterior commissure, and hipocampal comissure
Primary motor cortex
This area is part of the frontal lobe of the brain and is concerned with voluntary muscle activations
Tectospinal tract
Descending fiber systems (motor pathways) Arises from superior colliculus (midbrain) and descends to ventral gray; Assists in head-turning responses to visual stimuli
A fiber
There are several different nerve fiber types, A, B and C fibers. This type of nerve fiber is large, myelinated and fast conducting. Which nerve fiber type is?
Spinoreticular tratcs
Ascending tract (sensory pathways) that convey deep ande chronic pain to reticular formation of brainstem via diffuse polysynaptic pathways
Primary sensory cortex
This area is part of the parietal lobe of the brain and is responsible for integration of sensation. it receives fibers conveying touch, proprioception, pain, and temperature sensation from opposite side of body
Temporal lobe
Primary auditory cortex: receives/processess auditory stimuli Associative auditory cortex: process auditory stimuli Wernicke's area: language comprehension
Basal Ganglia
Which part of the brain is this? Masses of gray matter deep within the cerebral hemispheres including: - the corpus striatum (caudate nucleus and lenticular nuclei - amygdalid nucleus, and claustrum - lenticular nuclei are further divided into the putamen and globus pallidus Forms an associated motor system (extrapyramidal system) with other nuclei in the subthalmus and midbrain
Alpha
There are several different type A nerve fibers,which are large myelinated fibers and conduct the fastest. Which type of A fibers is responsible for proprioception, somatic motor?
Prefrontal corex
This area is part of the frontal lobe of the brain for control of emotions and judgements
Primary visual cortex
Located in the occipital lobe, it receives/process visual stimuli
Neocerebellum
Receives input from corticopontecerebellar tracts and olivocerebellar fibers -It is concerned with the soomth coordination of voluntary movements, ensures accurate force, direction and extent of movement - Important for motor learning sequencing of movements, and visually triggered movements - May have a role in assisting cognitive function and mental imagery
Limbic circuit
Originates in prefrontal and limbic areas of cortex to Basal Ganglia, to prefrontal cortex functions to organize behaviors (executive functions, problem solving, motivation) and for procedural learning (repeating a complex activity over and over again until all of the relevant neural systems work together to automatically produce the activity).
White Matter
Myelinated nerve fibers located centrally. This is called?
Sensory (afferent) fibers
These fibers originate in cells outside of the brainstem or spina cord with sensory ganglia (cranial nerves) or dorsal root ganglia (spinal nerves).
Fasciculus gracilis
Ascending fibers systems (sensory pathways) Dorsal columns/medial lemniscal system (Lower extremity tracts, medially located) convey sensations of proprioception, vibration and tactile discrimination
Saltatory conduction
Myelinated axons, are axons overed with myelin with small gaps called nodes of Ranvier where myelin is absent. Myelin functions to increase speed of conduction and conserve energy. The action potential jumps from one node to the next. This type of conductions where the action potential jump from one node to the next is called?
Alert
As part of the mental status examination assessment of of level of consciousness is important. It is important to determine if the patient is alert, lethargic, obtundent stuporous, or coma. - Patient responds appropriately, can open eyes, look at the examiner, respond fully and appropriately to stimuli. Patient is completely awake, aware of all stimuli and able to interact meaningfully with clinician. Based on the above description, Identify which level of consciouness it represents?
Posterior horn cells
It contain afferent (sensory) neurons with cell bodies located in the dorsal root ganglia.
C fiber
There are several different nerve fiber types, A, B and C fibers. This type of nerve fiber is the smallest, unmyelinated, slowest conducting fiber. Which nerve fiber type is?
Broca's area
This area of the brain controls the motor aspect of speech
Skeletomotor circuit
Putamen loop: Originates in precentral motor and postcentral somatosensory areas; - projects to putamen functions to scale amplitude and velocity of movements - reinforces selected pattern, supresses conflicting patterns; preparatory for movement (i.e. motor set, anticipatroy movement)
-70mV
Resting membrane potential: positive on outside, and negative on the inside. What is the value of the resting membrane potential on the inside?
occulomotor circuit
Caudate loop: originte in frontal and supplementary motor eye fields projects to caudate functions with saccadic eye movements
Spinocerebellum
Receives input from proprioceptive patways and is concerned with modifying muscle tone and synergistic actions of muscles It is important in maintenance of posture and voluntary movement control
Spinocerebellar tracts
Ascending tract (sensory pathways) that convey proprioception information from muscle spindles, golgi tendon organs, and touch and pressure receptors to cerebellum for control of voluntary movements
Vestibulospinal tract
Descending fiber systems (motor pathways) Important for control of muscle tone, antigravity muscles, and postural reflexes.
Fasciculus cuneatus
Ascending fibers systems (sensory pathways) Dorsal columns/medial lemniscal system (Upper extremity tracts, laterally located) convey sensations of proprioception, vibration and tactile discrimination
Insula
Located deep within lateral sulcus, it is associated with viceral functions
Beta
There are several different type A nerve fibers,which are large myelinated fibers and conduct the fastest. Which type of A fibers is responsible for touch and pressure?
Limbic system
Part of the brain concerned with: - instincts and emotions contributing to preservation of the individual. - basic functions inlcude: feeding, aggression, emotions, and endocrine aspects of sexual response
Occipital lobe
Primary visual cortex: receives/processes visual stimuli Visual association cortex: process visual stimuli
Anterior horn cells
It contains cell bodies that give rise efferent (motor) neurons: Alpha motor neurons to effect muscles and gamma motor neurons to muscle spindles.
Neuroglia
Supports cells that do not transmit signals; important for myelin and neuron production;maintenance of K+ levels and reuptake of neurotransmitters after neural transmission at synapses
B fiber
There are several different nerve fiber types, A, B and C fibers. This type of nerve fiber is small, myelinated and conduct less rapidly; preganglionic autonomic. Which nerve fiber type is?
Cheyne-Stokes respiration
A period of apnea lasting for 10 - 60 seconds followed by gradually increasing depth and frequency of respirations. Accompanies depression of FRONTAL LOBE and diencephalic dysfunction
Dorsal root
C fibers are the smallest, unmyelinated, slowest conducting fibers, Whic type of C fiber is responsible for pain and reflex responses?
Wernicke's area
Area of the temporal lobe of the brain reponsible for language comprehension
Lateral spinothalamic tract
Ascending tract (sensory pathways) that convey sensations of pain and temperature
Rubrospinal tract
Descending fiber systems (motor pathways) Assist in motor function
Gamma
There are several different type A nerve fibers,which are large myelinated fibers and conduct the fastest. Which type of A fibers is responsible for motor to muscle spindles?
Motor (efferent) fibers
These fibers originate from motor nuclei (cranial nerves) or anteior horn cells (spinal nerves). These are?
Section 2
(50 cards)
V. Confused-Inappropriate
Rancho Los Amigos level of cognitive function, assesses cognitive recovery from traumatic brain injury (TBI). - Patient is able to respond to simple commands fairly consistently. However, with increased complexity of commands or lack of any external structure, responses are non-purposeful, random, or fragmented. - Demonstrates gross attention to the environment but is highly distractible and lacks the ability to focus attention on a specific task. With structure, may be able to converse on a social automatic level for short periods of time. - Verbalization is often inappropriate and confabulatory. - Memory is severly impaired; often shows inappropriate use of objects; - May perform previously learned tasks with structure, but is unable to learn new information. Based on the above description, This patient is said to be at what level/category?
Calculation
A physical therapist asks a patient to perform the following mathematical operations. 9+3 =?; 4+7=? 8 ÷ 4 =?; 7 - 4 =? etc... Also the therapist aske to count backward from 100 by 7s. What cognitive function is being tested?
II. Generalized Response
Rancho Los Amigos level of cognitive function, assesses cognitive recovery from traumatic brain injury (TBI). - Patient reacts inconsistently and non-purposefully to stimuli in a nonspecific manner. - Responses are limited and often the same regardless of stimulus. - Responses may be physiological changes, gross body movements, and/or vocalization. Based on the above description, This patient is said to be at what level/category?
Glasgow coma scale
It is a widely accepted measure of level of consciouness and responsiveness. It relates consciousness to three elements or response. Eye opening (E) with a max possible score = 4, Motor response (M) with a max possible score = 6, and verbal response (V) with a max possible score = 5. Score = (E+M+V) Max score = 15 and lowest score = 3. A score of ≤ 8 signifies coma or severe brain injury
Global aphasia
A severe form of aphasia characterized by marked impairments in comprehension and production of language
Olfactory (CN I)
Which cranial nerve is responsible for sense of smell
Abstraction
Bases on definition and task,what type of cognitive function is being assess? - Defined as the ability to reason in an abstract rather than a literal or concrete fashion. i.e., discuss how two objects are similar or different
Orientation
Bases on definition and task,what cognitive function is being assess? - It is defined as the ability to orient to person, place and time - Identify name, age, current date, and season, birth date, present location, town etc...
III. Localized Response
Rancho Los Amigos level of cognitive function, assesses cognitive recovery from traumatic brain injury (TBI). - Patient reacts specifically but inconsistently to stimuli. - Responses are directly related to the type of stimulus presented. - May follow simple commands such as closing the eyes or squeezing the hand in an inconsistent, delayed manner. Based on the above description, This patient is said to be at what level/category?
Sustained attention
In testing cognitive function, attention can be subdivided into sustained attention, divided attention, and focused attention. Defined as the ability to attend to a task without redirection. As therapists determine time on task, and frequency of redirection. Based on definition this is called?
Obtundation
As part of the mental status examination assessment of of level of consciousness is important. It is important to determine if the patient is alert, lethargic, obtundent stuporous, or coma. - Patient can open eyes, look at examiner, but responds slowly and is confused; demonstrates decreased alertness and interest in environment. Difficult to arouse, requires CONSTANT stimulation for all activities. Based on the above description, Identify which level of consciouness it represents?
Levels I
Rancho Los Amigos level of cognitive function, assesses cognitive recovery from traumatic brain injury (TBI). What levels are called the no response level?
VII. Automatic-Appropriate
Rancho Los Amigos level of cognitive function, assesses cognitive recovery from traumatic brain injury (TBI). - Patient appears appropriate and oriented within the hospital and home settings; goes gthrough daily routine automatically, but frequently robot-like. - Patient shows minimal to no confusion and has shallow recall of activities. - Shows carryover for new learning, but at a decreased rate. With structure is able to initiate social or recreational activities; judgment remains impaired. Based on the above description, This patient is said to be at what level/category?
Minor brain injury
Using the glasgow coma scale. A score between 13 - 15 signifies what?
Lethargy
As part of the mental status examination assessment of of level of consciousness is important. It is important to determine if the patient is alert, lethargic, obtundent stuporous, or coma. - Patient appears drowsy; can open eyes and look at exminer, respond to questions, but fall asleep easily. Arousal with stimuli, that is falls asleep when not stimulated. Decreased awareness, loss of train of thought. Based on the above description, Identify which level of consciouness it represents?
Moderate cognitive impairment
Mini-mental status examination or MMSE. A score between 16 - 20 indicates?
daiylight, radio or television sound, or a cold cloth on the forehead
Changes in body position, especially the transition from a recumbent position to a sitting position often stimulate increased alertness. Other stimuli that can be used to stimulate alertness include:?
VI. Confused-Appropriate
Rancho Los Amigos level of cognitive function, assesses cognitive recovery from traumatic brain injury (TBI). - Patient shows goal-directed behavior, but is dependent on external input or direction. - Follows simple directions consistently and shows carryover for relearned tasks such as self-care. - Responses may be incorrect due to memory problems, but they are appropriate to the situation. - Past memories show more depth and detail than recent memory. Based on the above description, This patient is said to be at what level/category?
Mini-mental status examination
Produced by Folstein, Folstein, and McHugh, in 1975. aka as Folstein test. It is a brief 30-point questionnaire test that is used to screen for cognitive impairment. Includes screenings items for orientation, registration, attention, calculation, recall and language. The max possible score is 30 points, and a score ≤ 15 indicates severe impairment. This test is called
VII. Purposeful-Appropriate
Rancho Los Amigos level of cognitive function, assesses cognitive recovery from traumatic brain injury (TBI). - Patient is able to recall and integrate past and recent events and is aware of and responsive to environment. -Shows carryover for new learning and needs no supervision once activities are learned. - May continue to show a decreased ability relative to premorbid abilities, abstract reasoning, tolerance for stress, and judgment in emergencies or unusual circumstances. Based on the above description, This patient is said to be at what level/category?
Level VIII
Rancho Los Amigos level of cognitive function, assesses cognitive recovery from traumatic brain injury (TBI). What levels are called the purposeful appropriate level?
Levels IV, V, VI
Rancho Los Amigos level of cognitive function, assesses cognitive recovery from traumatic brain injury (TBI). What levels are called the confused levels?
Long-term memory
Bases on definition and task,what type of memory (cognitive function) is being assess? - Recount past events (i.e., Where were you born?; Where did you grow up?)
Attention
As part of neurological examination, testing of cognitive function is important to assess attention, orientation, memory, abstract thought, and the ability to perform calculations or construct figures. Bases on definition and task,what cognitive function is being assess? - It is defined as the ability to attend to a specific stimulus or task. The patient is asked to repeat a series of numbers or letters, spelling words forward and backward
Coma
As part of the mental status examination assessment of of level of consciousness is important. It is important to determine if the patient is alert, lethargic, obtundent stuporous, or coma. - Patient cannot be aroused, eyes remain closed; no response to external stimuli or environment. Patient is unrousable and non-verbal. Based on the above description, Identify which level of consciouness it represents?
Dysarthria
Dys = having problem with; Arthr = articulating Impairment of speech production, in the CNS/PNS mechanisms that control respiration, articulation, phonation, and movements of jaw and tongue. It is a condition in which problems occur with the muscles that help you talk; this makes it very difficult to pronounce words. It is unrelated to any problem with understanding cognitive language.Patient may present with a "slur speech", or speak softly or barely able to whisper. This condition is called?
Wernicke's aphasia
A type of aphasia considered to be a fluent aphasia, receptive aphasia. It is central language disorder in which spontaneous speech is preserved and flows smoothly, while auditory comprehension is impaired. It is the result of a lesion in the posterior first temporal gyrus of the left hemisphere. Individuals with this type of aphasia have difficulty understanding spoken language but are able to produce sounds, phrases, and word sequences. While these utterances have the same rhythm as normal speech, they are not language because no information is conveyed. This is called?
Abstraction
A therapist shows a patient a two cans of sodas. A can of regular Coca-Cola and a can of regular Pepsi. The therapis asks the patient what are the differences and similarities between the two objects. What cognitive function is being tested?
Calculation
Bases on definition and task,what type of cognitive function is being assess? - Defined as the ability to perform verbal or written mathematical problems (add,substract,multiply or divide whole numbers). i.e., 8 ÷ 4 =?; 7+5 =? etc..
Short-term memory
Bases on definition and task,what type of memory (cognitive function) is being assess? - Recounts words (after a few minutes) or recall recent events (i.e., What did you have for breakfast?)
Levels II, III
Rancho Los Amigos level of cognitive function, assesses cognitive recovery from traumatic brain injury (TBI). What levels are called the decreased response levels?
Verbal apraxia
Impairment of volitional articulatory control secondary to a cortical, dominant hemisphere lesion. A person has trouble saying what he or she wants to say correctly and consistently, and it is not related to facial muscle weakness.
Construction
Bases on definition and task,what type of cognitive function is being assess? - Defined as the ability to construct a 2D or 3D figure or shape. i.e., Draw a figure after a verbal command or reproduce a figure from a picture
Jugdement
Bases on definition and task,what type of cognitive function is being assess? - Defined as the ability to reason (according to age and lifestyle). Demonstrate common sense and safety.
Mild cognitive impairment
Mini-mental status examination or MMSE. A score between 21 - 24 indicates?
Severe cognitive impairment
Mini-mental status examination or MMSE. A score ≤ 15 Indicates?
Immediate recall
Bases on definition and task,what type of memory (cognitive function) is being assess? - Name three items previously presented after a brief interval (a few seconds to a few minutes) for example, the patient repeats, a red car, black pants, green tomatoes.
Moderate brain injury
Using the glasgow coma scale. A score between 9 - 12 signifies what?
Severe brain injury or coma
Using the glasgow coma scale. A score ≤ 8 signifies what?
Stupor
As part of the mental status examination assessment of of level of consciousness is important. It is important to determine if the patient is alert, lethargic, obtundent stuporous, or coma. - Patient can be aroused from sleep ONLY with PAINFUL or VIGOROUS stimuli; verbal responses are slow or absent; patient returns to unresponsiveness state when stimuli are removed. Demonstrates minimal awareness of self and environment. Unable to complete mental status examination because responses are usually incomprehensible words. Based on the above description, Identify which level of consciouness it represents?
Construction
A physical therapist ask a patient (verbal command) to draw house and tree next to it. Also the therapist shows a picture of a red barn with white fences around it, and ask can you draw this picture in the best possible way you could? What cognitive function is being tested?
IV. Confused-Agitated
Rancho Los Amigos level of cognitive function, assesses cognitive recovery from traumatic brain injury (TBI). - Patient is in a heightened state of activity. - Behavior is bizarre and non-purposeful relative to the immediate environment. - Does not discriminate among persons or objects; is unable to cooperate directly with treatment efforts. - Verbalizations frequently are incoherent and/or innappropriate to the environment; confabulation may be present. - Gross attention to environment to very brief; selective attention is often nonexistent. Patient lacks short and long-term recall. Based on the above description, This patient is said to be at what level/category?
Attention
A therapist ask a patient to recall up to seven numbers in order presented. Then asks, can you spell backwards bottle, then fork, garden (using small words, and then ask progressively longer words) What cognitive function is being tested?
Broca's motor aphasia
Part of the neurological examination, is the assessment of speech and language. Aphasias can be divided into fluent aphasias and non-fluent aphasias. It is a central language disorder in which speech is typically awkward, restricted, interrupted, and produced with effort. Typically the result of a lesion involving the 3rd. frontal convolution of the left hemisphere. Example of a normal speech: It's been 5 years since I have the stroke. I feel fine now, I am able to drive my car to the store, and to my relatives' house. Speech impairment: ah...man..strooke.. uh..I.. geez. ... Drive car... uhh........I.. five yearshh.....housess... This type of speech impairment is called?
No cognitive impairment
Mini-mental status examination or MMSE. A score ≥ 25 indicates?
Apraxia
Comes from the greek word praxis = work, act, deed. A = no. It is characterized by loss of the ability to execute or carry out learned purposeful movements, despite having the desire and the physical ability to perform the movements. Another definition: It is a disorder of the brain and nervous system in which a person is unable to perform tasks or movements when asked, even though: - The request or command is understood - They are willing to perform the task - The muscles needed to perform the task work properly - The task may have already been learned
I. No Response
Rancho Los Amigos level of cognitive function, assesses cognitive recovery from traumatic brain injury (TBI). - Patient appears to be in a deep sleep and is completely unresponsive to any stimuli. Based on the above description, This patient is said to be at what level/category?
Divided attention
In testing cognitive function, attention can be subdivided into sustained attention, divided attention, and focused attention. - Defined as the ability to shift attention from one task to another. As therapists, assess ability of dual taks control. (i.e., can the patient perform two activities simultaneously?) Also assess for perseveration (mental inertia) getting stuck on a task.
Level VII
Rancho Los Amigos level of cognitive function, assesses cognitive recovery from traumatic brain injury (TBI). What levels are called the automatic appropriate level?
Focused attention
In testing cognitive function, attention can be subdivided into sustained attention, divided attention, and focused attention. - Defined as the ability to stay on a task in presence of detractors. As therapists assess impact of environmental vs. internal detractors. This cognitive function is called?
Section 3
(50 cards)
Myopia
Defined as impaired far vision
Hypoglossal (CN XII)
Which cranial nerve is responsible for motor control of pharynx and larynx, and movement and proprioception of tongue for chewing and speech?
Spinal accessory (CN XI)
Which cranial nerve is responsible for motor control and proprioception of head rotation, and shoulder elevation (sternocleidomastoid, trapezius)?
Vestibulocochlear (CN VIII)
Which cranial nerve is reponsible for gaze stability with head rotations?
Bell's palsy
A therapist asks a patient to smile, show your teeth,frown,raise eyebrows, wrinkle brows, purse lips, puff out both cheeks and close eyes tightly; however, he is unable to control the facial muscles which produce the above movements on the right side, but no problem with his left side. As a result of this paralysis, the patient's face looks and feels stiff or pulled to one side. He also presents with drooling and drooping of the face, such as the eyelid or corner of the mouth. has trouble closing one eye. In addition other symptoms that this patient presents are: Dry eye or mouth, headache,loss of sense of taste(anterior 2/3 of tongue),sound that is louder in one ear (hyperacusis),twitching in face. The patient's wife added that he has difficulty eating and drinking, and that food falls out of one side of the mouth. Based on the above description, the patient's condition is called?
Hypoglossal (CN XII)
Which cranial nerve is being tested? - Listen to patient's articulation problems - Examine the resting position of the tongue - Ask patient to stick out his/her tongue and observe for midline. (deviation of tongue to weak side on protrusion) - Ask patient to move tongue side to side
Trigeminal (CN V)
If a patient lost his/her facial sensation, or has numbness, which cranial nerve is involved?
Rinne's test
This test compares air and bone conduction. Place a vibrating tunning fork on the mastoid process, then close to ear canal; sound heard longer through air than bone. (+) test = sound heard on bone longer than air. This test is called?
Glossopharyngeal (IX)
Which cranial nerve is responsible for gag reflex, motor and proprioception of superior pharyngeal muscle, Autonomic innervation of salivary gland, Taste (posterior 1/3 of tongue?
Facial (VII)
A therapist asks a patient to: smile, show your teeth,frown,raise eyebrows, wrinkle brows, purse lips, puff out both cheeks and close eyes tightly. Which cranial nerve is being tested?
Anisocoria
Condition defined as unequal pupils
Trigeminal (CN V)
Which cranial nerve is responsible for sensation of face, cornea and for mastication (motor: temporal and masseter muscles)?
Vestibulocochlear (CN VIII)
Testing of the vestibular branch involves the occulocephalic reflex aka Doll's eyes, or vestibular-occular reflex. It is a reflex that is tested by turning the patient's head from side to side, adn watch for eye movement. The eyes movement should be opposite to the direction of the head. Which cranial nerve is being tested?
Vestibulocochlear (CN VIII)
Vertigo, dysequilibrium,nystagmus, neural deafness, impaired hearing, tinnitus, unilateral conductive loss: sound lateralized to impaired ear, conductive loss: sound heard through bone = or longer than air, sensorineural loss: Sound heard in good ear, sound heard longer through air. All of above conditions are the result of which cranial nerve impairment?
Blindness, myopia, presbyopia, homonymous hemianopsia
Possible dysfunction or impairments of cranial nerve II (optic nerve) include?
Strabismus
Condition where eyes deviate from normal conjugate position i.e., eyes are not properly aligned with each other. one eye might be aligned while the other is either up (hypertropia), down (hypotropia), inward (esotropia), and outward (exotropia). This is called?
Wisp of cotton on the patient's cornea
How would you test for cornea reflex?
Horner's syndrome
This condition is not a disease itself, but rather, it's a sign of another medical problem — such as a stroke, tumor or spinal cord injury. Typically involves, miosis (constriction of pupil), Ptosis (drooping of eyelid), and decreased sweating of the face on the same side.
Optic (CN II)
Which cranial nerve is being tested? - Acuity: Have patient cover one eye, and ask patient to read a visual chart (snellen eye chart) - Fields: Have patient cover one eye, and hold an object (e.g., pen cap) at arm's length from the patient in his or her peripheral field. Hold the patient's head steady. Slowly move the object centrally, and ask the patient to state when he or she first sees the object. Repeat the process in all quadrants
Facial (VII)
Which cranial nerve is responsible for Facial expressions, autonomic innervation of lacrimal and salivary glands, and sense of taste of anterior 2/3 of the tongue?
Occulomotor (CN III)
Which cranial nerve is being tested? - Pupil reaction to light: Shine a flashlight into one eye and observe bilateral pupil reaction. Normal is bilateral pupil constriction occurs with flashing into one eye. Also hold an object about 10 cm from the patient's eye and ask him/her to look at the near object and to look off into the distance. Watch for pupil constriction with near object and pupil dilation with distance objects.
Facial (VII)
A therapist asks a patient to smile, show your teeth,frown,raise eyebrows, wrinkle brows, purse lips, puff out both cheeks and close eyes tightly; however, he is unable to control the facial muscles which produce the above movements on the right side, but no problem with his left side. Which cranial nerve is impaired?
Olfactory (CN I)
A patient at a rehab center was told at a request of a therapist to use deodorant before the coming to therapy session. The patient replied to the therapist " I am sorry, I did not I had a strong smell, I could not smell at all anything". Which cranial nerve is being affected?
Trochlear (CN IV)
Which cranial nerve is being tested? - Patient follows with eyes,(head steady) downward, lateral gaze
Occulomotor (CN III)
Which cranial nerve is being tested? - Gaze: Hold objects (e.g., pen) at arm's length from the patient, and hold the patient's head steady. Ask the patient to follow the object with a full horizontal, vertical and diagonal gaze.
Olfactory (CN I)
Which cranial nerve is being tested in the following example? - Have the patient close one nostril, and ask him/her to sniff a mils smelling substance and identify it. (e.g., coffee, vanilla etc.)
Trigeminal (CN V)
A patient demosntrates weakness of muscles of mastication (temporal and masseter muscles). When asked to open his mouth, the jaw not the tongue deviates ipsilaterally. Which cranial nerve is involved?
Abducens (CN VI)
Inability to turn eye out is an impairment of which cranial nerve?
Spinal accessory (CN XI)
Which cranial nerve is being tested? - Ask a patient to rotate the head or shrug the shoulders (with/without gentle resistance)
Vestibulocochlear (CN VIII)
A therapist is testing for lateralization (weber's test). a vibrating tunning fork is placed on top of the head, mid position. The sound of the tunning fork is checked to see if it is heard in one ear or equally in both. This is testing for which cranial nerve impairment?
Spinal accessory (CN XI)
Weakness/ inability with head turning to the opposite side and ipsilateral shoulder shrug, shoulder droops are signs & symptoms of which cranial nerve impairment?
Facial (VII)
Bell's palsy is a condition where facial muscles are paralyzed on the affected side. This is due to a dysfunction of which cranial nerve?
Glossopharyngeal (IX)
Which cranial nerve is being tested? - Induce gag with tongue depressor (one side at a time) - Patient phonates a prolonged vowel sound or talks for an extended period oftime. - Listen for voice quality and pitch
Occulomotor (CN III)
Which cranial nerve is responsible for eyelid elevation, pupil constriction (pupillary reflexes), visual focusing, upward, downward inward and infero-medial eye movement?
Trigeminal (CN V)
If a patient lost his/her corneal reflex ipsilaterally (involuntary blinking in response to corneal touch), which cranial nerve is involved?
Occulomotor (CN III)
If a patient is exhibiting absence of pupillary constriction, Ptosis (drooping of eyelid), unequal pupils; Horner's syndrome this condition is likely to be an impairment of which cranial nerve?
Vagus (X)
Examine for difficulty swallowing. Have the patient say "ah"; observe motion of soft palate (eleveates) and position of uvula (remains midline). Stimulate back of throat lightly on each side (gag reflex). Which cranial nerve is being tested?
Anosmia
A patient at a rehab center was told at a request of a therapist to use deodorant before the coming to therapy session. The patient replied to the therapist " I am sorry, I did not I had a strong smell, I could not smell at all anything". This condition of inability to detect smells is called?
Abducens (CN VI)
Which cranial nerve is responsible for lateral eye movement and proprioception?
Homonymouse hemianopsia
Defined as the loss of half of the field of view on the same side in both eyes. i.e., the patient cannot see from the left half of the left and right eye.
Weber's test
A therapist places a vibrating tunning fork on top of the head, mid forehead, and ask the patient if sound is heard equally (normal) or if it is heard louder in one ear (lateralized;the defective ear). This test is called?
Vagus (X)
Which cranial nerve is responsible for swallowing, proprioception of pharynx and larynx, parasympathetic innervation of heart, lungs, and abdominal viscera?
Facial (VII)
A patient presents with ipsilateral paralysis of upper and lower facial muscles, loss of lacrimation, dry mouth, loss of taste of anterior 2/3 of the tongue on the ipsilateral side. Which cranial nerve is affected?
Vagus (X)
Dysphagia, soft palate paralysis, contralateral deviation of uvula, ipsilateral anesthesia of pharynx and larynx, hoarseness:denotes vocal cord paralysis, nasal quality denotes palatal weakness. All these are signs & symptoms of which cranial nerve impairment?
Vestibulocochlear (CN VIII)
Which cranial nerve is responsible for sense of equilibrium (vestibular branch) and a sense of hearing (cochlear branch)?
Optic (CN II)
Which cranial nerve for central and peripheral vision?
Anosmia
This condition is characterized by inability to detect smells. It is seen with frontal lobe lesions of patients with dysfunction of impairment of the CN I (Olfactory)
Presbyopia
Defined as impaired near vision
Trochlear (CN IV)
Which cranial nerve is responsible for infero-lateral (downward and lateral) eye movement?
Glossopharyngeal (IX)
Loss of gag reflex, dysphagia (difficult swallowing), dysphonia: hoarseness denotes vocal cord paralysis, nasal quality denotes palatal weakness,dry mouth, loss of taste ipsilateral 1/3 of tongue are signs/symptoms of impairment of which cranial nerve?
Section 4
(50 cards)