Easy question's
What bony structure does the Olfactory nerve pass through
Cribriform plate
Name the branches of the trigeminal and facial nerves
Trigeminal
V1 - ophthalmic
V2 - maxillary
V3 - mandibular
Facial
Temporal
Zygomatic
Buccal
Mandibular
Cervical
Which nerve is responsible for the jaw jerk reflex
V3
What nerves are involved in the pupillary light reflex
Afferent: CN II
Efferent: CN III
How to assess cranial nerve II
Acuity
Fields
Fundi
Which regions of the brain do the CN arise from
2 from the diencephalon
2 from the midbrain
4 from the pons
4 from the medulla oblongata
Remember: 2,2,4,4 rule
What are the muscles of mastication
Temporalis
Masseter
Lateral and medial pterygoids
Which receptor does ETOH bind and what effect does it have?
GABAA - increased frequency and duration of opening of the Cl- channel
What type of metabolism does Ethanol undergo - explain what this means and compare to the metabolism of Morphine
Zero order kinetics - A constant amount is metabolized per hour regardless of the BAC (usually ~8-10g/hr)
Most other substances undergo First-order kinetics where a constant proportion is metabolized per hour
How to assess glossopharyngeal and vagus nerves in CN exam
Uvula - say ahh
Gag reflex
voice
Cough
sip water
What are the afferent and efferent nerves of the gag reflex
Afferent: CN IX
Efferent: CNX
Which compound is primarily responsible for hangover? What is its inactive metabolite?
Can you name a drug that exploits this stage of ETOH metabolism?
Acetaldehyde
Acetate
Disulfiram - Acetaldehyde dehydrogenase inhibitor
What is a standard drink of alcohol
10g
Outline the signs of UMN and LMN lesion
UMN
Spasticity (Hypertonia) and Clonus
Hyperreflexia
Positive Babinski (toes extend)
Muscle Weakness
LMN
Muscle Weakness (more obvious in the distal musculature)
Hypotonia
Hyporeflexia
Fasciculations
What is the MOA of Macrolides
50s Ribosomal sub-unit inhibitors - Protein synthesis inhibitors
Outline the innervation of the external ocular muscles
LR6 SO4 O3
Lateral rectus = CN VI
Superior oblique = CN IV
All others (including levator palpabrae) = CN III
Which CN is affected:
Down and out
mydriasis
Ptosis
CN III
List the fat-soluble vitamins
E
D
K
Deficiencies of what vitamins can cause peripheral neuropathy
Vit B12
B1 (thiamine)
B6
E
What vitamin is calcium absorption dependent on at low conc.
Vit D (aids in the synthesis of calbindin)
Through which cranial foramina do the branches of CN V pass through
V1 - Superior orbital fissure
V2 - foramen rotundum
V3 - foramen ovale
What are the main 6 components of the peripheral nervous exam?
Inspection
Tone
Power
Reflexes
Coordination
Sensation
What reflexes need to be assessed in the upper limb examination and what nerve routes are associated with each?
Biceps (C5,C6)
Triceps (C6,C7)
Supinator (C5,C6)
Finger jerk (C8)
What reflexes need to be assessed in the lower limb examination and what nerve routes are associated with each?
Patella (L3, L4)
Ankle (S1, S2)
Plantars (L5, S1, S2)
If a patient complains of vertigo during the cranial nerve exam, which maneuver should be conducted.
Hallpike