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Cranial Nerves and dysfunctions

Cranial Nerves and dysfunctions. Prof.Dr . S. Naz Yeni. I. Cranial nerve ; olfactorius. Loss of olfaction ; ANOSMIA Causes ; fractures at the base of the skull Tumors at the base of frontal lobe ( meningioma like ..) Sphenoidal wing tumors Hypophis tumors Craniophranygeoma

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Cranial Nerves and dysfunctions

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  1. CranialNervesanddysfunctions Prof.Dr. S. Naz Yeni

  2. I. Cranialnerve; olfactorius • Loss of olfaction; ANOSMIA • Causes; fractures at thebase of theskull • Tumors at thebase of frontallobe (meningiomalike..) • Sphenoidalwingtumors • Hypophistumors • Craniophranygeoma • Menengitis • Vitamin, zincdeficiencies, • Olfactoryhallucinations; temporallobeseizures • Examination; checkeachnostrilwithnonirritatingodours

  3. II. Cranialnerve; opticus • Blindness, amourosis (blindness as a result of indirectreasons), ampliyopia (blindness as a result of eyeandrelatedstructures) Examination Lightreflex; lightsource Funduscopy; ophtalmascope Visualacuity; fingercounting Visualfields; confrontation test

  4. Visualfielddefects Onesidedamplyopia; inflamation, ischemia, tumors (glioma ), toxicreasons MS(opticneuritis) orbitaltumors Onesidedtransient Amourosisfugax Heteronymhemianopsia Homonymhemianopsia

  5. III. Cranialnerve; oculomotorius • The Edinger-Westphal nucleus supplies parasympathetic fibres to the eye via the ciliary ganglion, and thus controls the sphincter pupillae muscle (affecting pupil constriction) and the ciliary muscle (affecting accommodation). • Itinnervateslevatorpalpebraesuperioris. • Itinnervates ocular muscles; medialrectus, inferioroblique, superior, inferiorrectusmuscles

  6. Features • Ptosis • Diplopia (eyedeviatestolaterally) • Mydriasis (anisocoria) Etiology Vascularlesions in themidbrain Multiplsclerosis(demyelinatinglesions in themidbrain) Tumors Uncalherniation Aneurysms Meningitis Cavernoussinustrombosis DiabetesMellitus Thyroidophtalmopathy

  7. IV cranialnerve; trochlearis Itinnervatessuperiorobliquemuscle Features; diplopiawhilereadingbooks, …. SOM whencontracted Theeyeconverges Etiology Trauma Meningitis Cavernoussinustrombosis Fissuraorbitalissuperiorinflamations Thyroidophtalmopathy

  8. VI cranialnerve; abducensnerve • Itinnervateslateralrectusmuscle • Theeyedeviatestothelateralside. • 6. nervepalsy Features; diplopia, deviation of theeyemedially Etiologies • Increasedintarcranialpressure • Vascular • MS • Meningitis • Nasopharyngealtumors • Cavernoussinustrombosis • Fissuraorbitalissuperiortumors, inflamations • Thyroidophtalmopathy

  9. V cranialnerve; trigeminus • Threesensorydivisions; ophtalmic (FOS), maxillary (FR), mandibular(FO) • Innervatesfacial sensation • Afferent of corneareflex • Massaters , temporalismuscles • Loss of touchandpainandtemperature sensation • Weakness in mast. muscles • Loss of cornealreflex • Pain

  10. Etiologies • Vascular • Tumors • MS • Herpeszoster (zona) • Meningitis • Cavernoussinustrombosis ( I. Division) • Fissuraorbitalissuperiorinflamations (I. Division) • Trigeminalneuralgia Aftergasserianganglion…

  11. VII cranialnerve; facialis • Parasymphatic • Sensory • Motor Nervusintermedius; lacrimation Chordatympani; 2/3 tonguestaste sensation, salivation Motor branches; m. stapedius,mimicmuscles

  12. Peripheral vs centraltype of VII. Nervepalsy • Motor fibersforblink , eyebrowshavebilateralsupranucleerinnervation Lower motor fibersdonthavebilateralinnervation. Peripheral 7. nervepalsy Centraltype of palsy; spare of uppermuscles Allmimicmuscles

  13. 7. Nervepalsy Etiologies Peripheral • Bell’spalsy • Herpeszoster • Trauma • Menengitis Central • Vascular • MS • Tumors

  14. VIII cranialnerve; acousticus • Hearingloss (sensorineuraltype) • Vertigo • Tinnitus Weber –Rinnetests Etiologies Vascular MS Meningitis Acousticnörinoma Acoustic –petrous bone tumors, infections Trauma

  15. IX. Cranialnerve; glossopharnygeusX. Cranialnerve; vagus • Motor, sensory, autonomicfunctions • Musclestylopharnygeus (elevateslarenkswhileswallowing; 9), rest 10. nerve • 1/3 of taste sensation of thetongue (9) • Somatic sensation of pharyngeus, tonsilla, laryngeus, externalauricula, membranetympanicus(9, 10). • Innervatesparotisgland(9). • Chemo, baro reseptors in carotid body(9) • Autonomicfunctions of visceralorgans(10)

  16. IX. GlossopharyngealnerveX. Vagusnerve • Nucleiarelocated in themedullaoblangata. • theyleavefromforamenjugularetogetherwith n. Accessorius. • Closetoarteriacarotisinternaand vena jugularis in theneck.

  17. Examination • Gag reflex (swallowingdifficulty) • Afferent is 9. nerve, efferent is 10.nerve. Lesions; • Pseudobulbarpalsy • Vascularlesions in thebulb • Foramenjugularetumors • Trauvma • DM • 9. nervenevralgia

  18. XI. Cranialnerve; accessorius • Thenuclei is in themedullaoblangataandupperspinalcord. • Fibersentertheintracranialcavitythroughforamenmagnumandjoinstointracranialportionandleavethecavitythroughforamenjugulare.

  19. Itinnervates SCM, trapeziusmuscles Lesions • Vascular • Motor neurondisease • Syringobulbi, syringomyeli • Tumors • Trauma • Nasopharnygealtumors Torticollis

  20. XII. Cranialnerve; hypoglossus • Itinnervatestonguesintrinsicmuscles. • Itleavesthecavitythroughforamenhypoglossi; ıt is closeto 10, 11 nerves. Lesions Vascular Tumors Motor neurondisease Nasopharnygealtumors Trauma Carotisinternadissections Inthemouth; thetonguedeviatestohealthyside. Afterprotrusionout; it deviatestothepalsiedside

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