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Title: Cranial Nerves Neurology
Description: This note is about cranial nerves, their anatomy, testing and diseases associated with cranial nerve lesions. It will be immensly helpful for your med school examinations.
Description: This note is about cranial nerves, their anatomy, testing and diseases associated with cranial nerve lesions. It will be immensly helpful for your med school examinations.
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Cr
ani
al
Ner
v
eExami
nat
i
onandAssessment
Cr
ani
al
ner
v
esar
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edst
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uct
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om br
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Hy
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om r
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i
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v
eexami
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oni
sdoneunder5headi
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est
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sual
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el
dt
est
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ng
3)Col
ourv
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ng
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l
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nat
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on
5)Opht
hal
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cexami
nat
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...
Snel
l
en'
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orassessmentat6met
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egof
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aucoma
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obul
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sual
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mpul
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Vi
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h
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of
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enott
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osed
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Exami
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weensubj
ectandexami
ner
f
r
om out
si
det
hev
i
sual
f
i
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owar
dsmi
dl
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ne
...
Usi
ngr
edhatpi
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aceoff
i
nger
i
ncr
easessensi
t
i
v
i
t
yoft
est
...
No
...
Opt
i
cner
v
eon
l
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tsi
de
Tot
al
l
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oni
nl
ef
tey
e
2
...
Opt
i
ct
r
acton
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Ri
ght
homony
mous
hemi
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a
4
...
Upperf
i
br
esof Lowerr
i
ght
opt
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at
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n quadr
ant
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par
i
et
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l
obeon
l
ef
tsi
de
6
...
3)Col
ourv
i
si
ont
est
i
ng-Test
edbyI
shi
har
achar
t
...
Nor
mal
pupi
l
di
amet
erunderav
er
agei
l
l
umi
nat
i
oni
s
3-5mm
...
Pi
npoi
ntpupi
l
-Pupi
l
di
amet
erl
esst
han1mm
...
My
dr
i
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l
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amet
ermor
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han5mm
...
Nor
mal
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ypupi
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hey
esshoul
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const
r
i
ct
...
Pupi
l
l
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yl
i
ghtr
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l
expat
hway:
Opt
i
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c
chi
asma-Opt
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ct
r
act-Lat
er
al
geni
cul
at
ebody-
Pr
et
ect
al
nucl
eus-Fi
br
esf
r
om pr
et
ect
al
nucl
eus
pr
oj
ectt
oEdi
ngerWest
phal
Nucl
eusonbot
hsi
desPar
asy
mat
het
i
cf
i
br
esr
eachci
l
i
ar
ygangl
i
on-Shor
t
ci
l
i
ar
yner
v
esuppl
y
i
ngsphi
nct
erpupi
l
l
aeonbot
h
si
des-Bot
hpupi
l
sconst
r
i
ct
...
Thi
swi
l
l
l
eadt
oadduct
i
onandpupi
l
l
ar
y
const
r
i
ct
i
on
...
Ar
gy
l
l
Rober
t
sonPupi
l
-Accomodat
i
onr
ef
l
ex
pr
esent+Pupi
l
l
ar
yl
i
ghtr
ef
l
exabsent
...
Adi
est
oni
cpupi
l
-Abnor
mal
l
ydi
l
at
edpupi
l
whi
ch
r
eact
spoor
l
yt
ol
i
ght
,
butoncei
tconst
r
i
ct
saf
t
er
pr
ol
ongedst
i
mul
at
i
on,
di
l
at
esv
er
ysl
owl
y
...
Maybepar
tof
Hol
mes-Adi
esy
ndr
omewhi
chi
schar
act
er
i
zedby
abnor
mal
l
ydi
l
at
edpupi
l
whi
chr
eact
spoor
l
yt
ol
i
ght
,
l
ossofdeept
endonr
ef
l
exes,
sweat
i
ngabnor
mal
i
t
i
es
...
Test
edbyswi
ngi
ngf
l
ashl
i
ghtt
est-Showi
ngl
i
ghtt
o
i
ncompl
et
el
ydamagedopt
i
cner
v
esi
dewi
l
l
cause
appar
entdi
l
at
i
onofbot
ht
hepupi
l
swhi
l
eshowi
ng
l
i
ghtt
onor
mal
si
dewi
l
l
const
r
i
ctbot
hpupi
l
s
...
5)Opht
hal
moscopi
cexami
nat
i
on-Fundus
exami
nat
i
oni
sdoneaf
t
erdi
l
at
i
ngpupi
l
usual
l
ywi
t
h
t
r
opi
cami
de
...
Ther
ear
e4st
agesofpapi
l
l
edema:
a)Ear
l
yPapi
l
l
oedema-Ear
l
i
estchangei
sbl
ur
r
i
ngof
super
i
orandi
nf
er
i
ormar
gi
nofopt
i
cdi
sc
...
C)Chr
oni
cPapi
l
l
oedema-Haemor
r
hageand
exudat
egr
adual
l
yr
esol
v
e
...
CausesofPapi
l
l
oedema:
*Meni
ngi
t
i
s
*I
nt
r
acr
ani
al
haemor
r
hage
*CNSneopl
asm
*Br
ai
nabscess
*Beni
gni
nt
r
acr
ani
al
hy
per
t
ensi
on
...
Pseudopapi
l
l
oedema-Congeni
t
al
di
scabnor
mal
i
t
i
es
gi
v
i
ngr
i
set
oappar
entr
at
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hant
r
uedi
scswel
l
i
ng
...
Papi
l
l
i
t
i
s:
I
nf
l
ammat
i
onofopt
i
cner
v
ehead
...
Di
scedemai
sl
esst
han3di
opt
er(
Mor
et
han3
di
opt
r
ei
npapi
l
l
edema)
,
v
i
si
onl
ossandpupi
l
l
ar
y
changesar
eusual
l
ypr
esent(
Usual
l
yabsenti
n
papi
l
l
edema)
...
Opt
i
c
at
r
ophyi
scl
assi
f
i
edi
nt
ot
hr
eecl
assesasdi
scussed
i
nt
het
abl
e:
Pr
i
mar
y
Secondar
y Ter
t
i
ar
y
Di
sc
Paperwhi
t
e Gr
aywhi
t
e Waxypal
e
Mar
gi
n
Cl
earcut
Bl
ur
r
ed
mar
gi
n
Nor
mal
Cup
Seenwel
l
Fi
l
l
edup
Pr
esent
Pseudot
umourcer
ebr
i
-I
di
pat
hi
ccondi
t
i
onseeni
n
y
oungobesef
emal
e
...
Dr
ugswhi
chcanpr
eci
pi
t
at
e
pseudot
umourcer
ebr
i
-Nal
i
di
xi
caci
d,
Ami
odar
one,
Vi
t
ami
nAexcess,
OCPandTet
r
acy
cl
i
ne
...
Ocul
omot
orner
v
e:
I
t
snucl
eusl
i
esi
nmi
dbr
ai
n-Fi
br
espasscl
oset
o
post
er
i
orcommuni
cat
i
ngar
t
er
y-Passest
hr
oughcav
er
noussi
nus-Ent
er
s
or
bi
tt
hr
oughsuper
i
oror
bi
t
al
f
i
ssur
et
osuppl
yext
r
aocul
armuscl
es
...
Par
asy
mpat
het
i
cf
i
br
esf
r
om Edi
ngerWest
phal
Nucl
eussuppl
ysphi
nct
er
pupi
l
l
aewhi
chconst
r
i
ctpupi
l
s
...
Abducensner
v
e:
Fi
br
esar
i
sef
r
om nucl
eusi
nmi
dbr
ai
n-Pi
er
cesdur
at
o
ent
ercav
er
noussi
nus-Ent
er
ssuper
i
oror
bi
t
al
f
i
ssur
et
osuppl
yLat
er
al
Rect
usmuscl
e
...
Muscl
e
Pr
i
mar
y
act
i
on
Secondar
y
act
i
on
Ter
t
i
ar
y
act
i
on
Cr
ani
al
ner
v
e
suppl
y
Medi
al
r
ect
us Adduct
i
on
-
-
Ocul
omot
or
Lat
er
al
r
ect
us
Abduct
i
on
-
-
Abducens
Super
i
or
r
ect
us
El
ev
at
i
on
I
nt
or
si
on
Adduct
i
on
Ocul
omot
or
I
nf
er
i
or
r
ect
us
Depr
essi
on
Ext
or
si
on
Adduct
i
on
Ocul
omot
or
Super
i
or
obl
i
que
I
nt
or
si
on
Depr
essi
on
Abduct
i
on
Tr
ochl
ear
I
nf
er
i
or
obl
i
que
Ext
or
si
on
Depr
essi
on
Abduct
i
on
Ocul
omot
or
Tor
ememberabov
et
abl
e:
Obl
i
quemuscl
esar
eabduct
or
sanddepr
essor
s,
whi
l
ei
nf
er
i
ormuscl
esar
eext
or
t
or
sanddepr
essor
s,
whi
l
esuper
i
or
muscl
esar
ei
nt
or
t
or
s
...
Compr
essi
v
el
esi
onsl
i
kepost
er
i
orcer
ebr
al
ar
t
er
y
aneur
y
sm i
nv
ol
v
epar
asy
mpat
het
i
cf
i
br
essuppl
y
i
ngpupi
l
whi
char
el
ocat
ed
per
i
pher
al
l
ybutnoncompr
essi
v
el
esi
onsl
i
kei
nf
ar
ctori
schemi
aand
di
abet
esspar
eper
i
pher
al
par
asy
mpat
het
i
cpupi
l
l
ar
yf
i
br
es
...
Abducenspal
syf
eat
ur
es:
Abduct
i
oni
sweak(
duet
oLat
er
al
Rect
uspal
sy
)Adduct
edey
e+Def
ect
i
v
eabduct
i
on
...
Ther
ei
si
mpai
r
ed
adduct
i
onwi
t
habduct
i
ngny
st
agmusi
nopposi
t
eey
e
...
CommoncausesofPt
osi
s:
A)Ocul
omot
orpal
syB)Hor
nersy
ndr
omeC)
My
est
heni
agr
av
i
sD)Snakebi
t
eE)GBsy
ndr
ome
...
I
nMy
est
heni
a,
Snakebi
t
eandGB
sy
ndr
omepupi
l
wi
l
l
beusual
l
ynor
mal
...
Condi
t
i
ons
associ
at
edwi
t
hHor
nersy
ndr
omear
e:
A)Lat
er
al
medul
l
ar
ysy
ndr
ome
B)Spi
nal
cor
dl
esi
onabov
eC8
C)Pancoastt
umour
D)Car
ot
i
dar
t
er
yaneur
y
sm anddi
ssect
i
on
E)Cer
v
i
cal
cor
dt
umour
...
I
ti
sof2
t
y
pesA)Pendul
arny
st
agmus:
Hor
i
zont
al
osci
l
l
at
i
onst
oei
t
hersi
deoft
hemi
dl
i
ne
ofequal
v
el
oci
t
yandampl
i
t
ude,
seeni
nr
ef
r
act
i
v
eer
r
or
,
i
nf
ant
i
l
emy
opi
a,
Mi
ner
'
sny
st
agmus(
wor
ker
sofcoal
mi
newor
ki
ngi
ndi
ml
i
ghtf
orl
ong
dur
at
i
ons)
...
Commont
y
pesofny
st
agmus:
1
...
2
...
3
...
4
...
5
...
6
...
Sl
owl
ar
ge
ampl
i
t
ude(
gazepar
et
i
c)ny
st
agmuswhi
l
el
ooki
ngt
owar
dsl
esi
on,
whi
l
e
l
ooki
ngawayf
r
om si
deofl
esi
onpr
oducesf
ast
,
smal
l
ampl
i
t
ude(
v
est
i
bul
ar
)
ny
st
agmus
...
Opt
oki
net
i
cny
st
agmus-Ny
st
agmusdev
el
opi
ngwhi
l
ei
ndi
v
i
dual
l
ooks
outoff
astmov
i
ngt
r
ai
n
...
8
...
I
ti
snott
r
ueny
st
agmus,
seeni
nmi
dbr
ai
nl
esi
on
...
I
ti
sof2t
y
pes:
A)Uni
ocul
ardi
pl
opi
a:
Di
pl
opi
aoccur
i
ngwi
t
hmonocul
arv
i
si
ononl
y
...
I
fmedi
um i
scl
eari
nuni
ocul
ardi
pl
opi
a,
i
ti
s
i
ndi
cat
i
v
eofhy
st
er
i
cal
di
pl
opi
a
...
One
r
eal
(
cl
oset
oey
eanddi
st
i
nct
)andonef
al
se(
f
arf
r
om ey
eandi
ndi
st
i
nct
)
i
magear
ef
or
med
...
Whenadduct
or
sar
epar
al
y
sedt
her
ei
scr
osseddi
pl
opi
aandwhen
abduct
or
sar
epar
al
y
seduncr
osseddi
pl
opi
aoccur
s
...
Mesencephal
i
cnucl
eusr
ecei
v
espr
opr
i
ocept
i
v
ei
nf
or
mat
i
onf
r
om j
awwhi
l
e
chi
efsensor
ynucl
eusr
ecei
v
esf
i
net
ouchandv
i
br
at
i
onf
r
om f
aceand
spi
nal
nucl
eusr
ecei
v
espai
nandt
emper
at
ur
esensef
r
om f
ace
...
Sensor
yexami
nat
i
onf
ort
r
i
gemi
nal
ner
v
ei
sdonei
nabov
et
hr
eezonesand
compar
i
ngbot
hsi
deswi
t
hey
escl
osed
...
Mot
orexami
nat
i
onf
ort
r
i
gemi
nal
ner
v
ei
sdonebyaski
ngt
he
subj
ectt
ocl
enchhi
st
eet
h:
Masset
erandTempor
al
i
smuscl
esst
andout
pr
omi
nentwhi
chcanbef
el
tbyexami
neri
nnor
mal
subj
ect
...
Thr
eer
ef
l
exesar
emedi
at
edbyTr
i
gemi
nal
ner
v
e:
A)Cor
neal
r
ef
l
ex-El
i
ci
t
edbyt
ouchi
ngl
at
er
al
mar
gi
nofcor
neawi
t
hwi
sp
ofcot
t
onwhi
l
esubj
ecti
sl
ooki
ngupt
owar
dscei
l
i
ng
...
B)Jawj
er
k-Subj
ecti
saskedt
osl
i
ght
l
yhangopenhi
smout
h,
l
ef
tt
humbi
s
keptbel
owl
owerl
i
pandt
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gemi
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mpt
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Abov
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a
Title: Cranial Nerves Neurology
Description: This note is about cranial nerves, their anatomy, testing and diseases associated with cranial nerve lesions. It will be immensly helpful for your med school examinations.
Description: This note is about cranial nerves, their anatomy, testing and diseases associated with cranial nerve lesions. It will be immensly helpful for your med school examinations.