Chapter 11 - Cranial Nerves

Instructions: Each group of extended matching questions consists of lettered options followed by a list of numbered problems/questions. For each numbered problem/question select the one lettered option that most closely answers the question. You can use the lettered options once, more than once, or not at all.

Options:

Olfactory nerve (Cranial nerve I)
Optic nerve (Cranial nerve II)
Oculomotor nerve (Cranial nerve III)
Trochlear nerve (Cranial nerve IV)
Trigeminal Nerve (Cranial nerve V)
Abducens Nerve (Cranial nerve VI)
Facial Nerve (Cranial nerve VII)
Vestibulocochlear Nerve (Cranial nerve VIII)
Glossopharyngeal Nerve (Cranial nerve IX)
Vagus Nerve (Cranial nerve X)
Accessory Nerve (Cranial nerve XI)
Hypoglossal Nerve (Cranial nerve XII)

Choose the affected cranial nerve from the list, which are involved in the clinical scenarios below.

Scenario 1

Scenario 2

a)	A woman woke up to find the right side of her face drooping. She had difficulty blinking with the right eyelid and found food tasted funny.
Correct. She has a Bell's Palsy ie a lower motor neurone lesion of the facial nerve. It is a lower motor neurone lesion because of the inability to close the eyelid on the affected side. Because taste is affected the chorda tympani branch of the facial nerve must also be affected. See pages 304, 307, 409.Incorrect. See pages 304, 307, 409.Your answer has been saved.

Scenario 3

a)	A man is having difficulty swallowing when you inspect the uvula with a torch. When he says 'aah' the uvula moves across to the right. The vagus nerve is clearly affected, which other nerve is involved?
Correct. The uvula moves away from the affected side, so it will be the left vagus and glossopharyngeal muscles that are affected. See pages 311-312.Incorrect. See pages 311-312..Your answer has been saved.

Scenario 4

a)	A right-handed man is asked as part of a cranial nerve examination to shrug his shoulders. As you press gently on both shoulders you note that the right shoulder is much weaker than the left. Which cranial nerve is affected?
Correct. It is the right spinal accessory nerve that is affected. See page 313.Incorrect. See page 313.Your answer has been saved.

Scenario 5

a)	A man complains double vision in most directions of gaze. He has an obvious ptosis of the left eye. When the eyelid is pulled up, the left eye is observed to be depressed and out towards the lateral canthus of the eye.
Correct. The eye's position of being 'down and out' gives a big clue to a third nerve palsy. Ptosis is also another feature and it pays to lift up the eyelid to examine the eye beneath so this (and other pathology) is not missed. See pages 299-300.Incorrect. See pages 299-300.Your answer has been saved.