N5315 Advanced Pathophysiology Neurologic System Core Knowledge Objectives with Advanced Organizers Examine the anatomy and physiology of the Central Nervous System. 1. Discuss the anatomy and physiology of the brain and brain stem. a. Explain the function of the twelve cranial nerves Cranial Nerve Function Sign of Dysfunction I Olfactory; carries impulses for sense of smell, purely sensory Inability to smell (anosmia) Distortion in sense of smell (parosmia) Distortion or lack of taste II Optic; carries impulses for vision, purely sensory Depends on location of damage; inability to see
objects on left or right side or difficulty seeing objects in the periphery, blind III *works with CN IV & VI Oculomotor; moves eyelid and moves eyeball in different directions (superior, inferior, and medial rectus and inferior oblique), adjusts lens for near vision, constricts pupil; mixed, primarily motor Double vision (diplopia) Eyelid drooping (ptosis) Pupil dilation (mydriasis) Inability to coordinate movement of both eyes Inability to open eyes IV *works with CN III & VI Trochlear; movement of eyeballs upward, downward, and outward; rotates eyeball in eye socket; mixed, mainly motor Diplopia Inability to move eye downwards V Trigeminal; motor fibers that stimulate chewing, sensory fibers that conduct impulses from mouth, nose, surface of eye, and dura mater (convey sensations of touch, pain, and temp); mixed ipsilateral damage or paralysis resulting in difficulty chewing, swallowing, or articulation. Inability to feel different portions of face or they may feel pain VI *works with CN III & IV Abducens; lateral movement of eyeballs (moves eyes outward) Diplopia VII Facial; motor fibers control secretion of tears and saliva as well as facial expression, sensory fibers are concerned with taste on front of tongue; mixed Facial palsy Bell’s Palsy Difficulty chewing VIII Vestibulocochlear; Vestibular: transmits impulses for sense of equilibrium (posture, movement, and balance) Cochlear: transmits impulses for sense of hearing Purely sensory Dizziness Sensation of spinning Hearing loss/deafness Nystagmus IX Glossopharyngeal; motor fibers serve pharynx (throat) and salivary glands stimulating swallowing and secretion of saliva, sensory fibers carry impulses from pharynx, posterior tongue, and pressure receptors in carotid arteries (monitors BP, O2/CO2 levels, coordination of some muscles involved in swallowing, and sensations of taste, touch, pain, and temp from posterior tongue and tissues of soft palate); mixed Loss of gag reflex Dysphagia Loss of bitter and sour taste *similar and overlapping fxn as CN X, damage can occur simultaneously with these 2 nerves, S/S can be similar, damage to this nerve may be asymptomatic as CN X will pick up slack X Vagus; large part is parasympathetic motor fibers for smooth muscle of abd organs, sensory & motor fibers carry impulses for pharynx, receives sensory impulses from viscera; (sensory: monitors BP & O2/CO2 levels, sensation of touch, pain, and temp from pharynx and sensations from visceral
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- Fall '15