Deck 7: The Cranial Nerves

Question 1

One week after the onset of a stroke,a clinician examines a patient's oral cavity,and finds the palate does not elevate upon the phonation of "ah." Why does the examiner then test the gag reflex?

A)An intact gag reflex means that cranial nerves IX and X are functioning.
B)The lack of a gag reflex will tell the examiner there is an upper motor neuron lesion.
C)The absence of a gag reflex will tell the examiner that the patient has both upper and lower motor neuron lesions.
D)If the gag reflex is intact,the lesion is limited to the lower motor neuron.

Answer 1

A
Because the gag is a reflex,its presence will tell the examiner that the lower motor neurons (IX and X,in this case)are intact,and the lack of palatal elevation is due to an upper motor neuron lesion.

Question 2

Which of the following cranial nerves are developed embryologically from branchial arches?

A)III
B)VIII
C)VII
D)II

Answer 2

C
Cranial nerves V,VII,IX,X,and XI,those responsible for the structure,muscles,and nerves of the face and neck,developed from branchial arches.

Question 3

It is difficult to assess the integrity of cranial nerve IX apart from X because:

A)cranial nerve IX mediates the gag reflex elicited at the base of the tongue,which is also a function of X
B)it is difficult to elicit the sensory portion of the pharyngeal gag reflex,which is the only function of cranial nerve IX
C)it is often the case that the sensory portion of the gag reflex is intact without a motor component
D)the vagus nerve has a larger role in the sensory and motor functions of the glossopharyngeal nerve
E)both B and D

Answer 3

D
The glossopharyngeal nerve mediates the sensory portion of the palatal and pharyngeal gag,as well as mediating general sensation of the pharynx and other oral structures.The integrity of the nerve is difficult to test because the vagus nerve has predominant control over many of the functions of the glossopharyngeal nerve.

Question 4

The __ provides efferent innovation to pharyngeal muscles.

A)nucleus solitarius
B)inferior salivatory nucleus
C)nucleus ambiguus
D)dorsal nucleus of the vagus
E)dorsal motor nucleus of the facial nerve

Question 5

Which of these groups of cranial nerves can be found in a dissection of the medulla?

A)the hypoglossal,trigeminal,and the spinal accessory
B)the facial,glossopharyngeal,and the vagus
C)the vagus,vestibulocochlear,and abducens
D)the vagus,glossopharyngeal,and spinal accessory

Question 6

Which of the following is NOT a function of the superior laryngeal nerve of cranial nerve X?

A)sensory information from the epiglottis and larynx
B)innervation of the cricothyroid muscle
C)sensory information from the tip of the tongue
D)general sensation from the pharynx
E)general sensation from the external ear

Question 7

A patient who cannot move the jaw to one side has a:

A)unilateral lesion of the facial nerve
B)unilateral lesion of the trigeminal nerve
C)bilateral lesion of the facial nerve
D)bilateral lesion of the trigeminal nerve
E)unilateral lesion of the spinal accessory nerve

Question 8

Diplopia would result from a lesion of the:

A)visual cortex
B)abducens
C)oculomotor nerve
D)optic nerve
E)trochlear nerve

Question 9

The cochlear nerve is located in:

A)Scarpa's ganglion
B)the spiral ganglion
C)the lateral lemniscus
D)the medial geniculate body

Question 10

An examiner who brushes a patient's forehead with a cotton swab is testing the integrity of:

A)the branchial motor component of the facial nerve
B)the maxillary branch of the trigeminal nerve
C)the special sensory component of the facial nerve
D)the ophthalmic branch of the trigeminal nerve
E)the general sensory component of the facial nerve

Question 11

The __ enables a person to spread the lips.

A)motor component of the trigeminal nerve
B)branchial motor component of the facial nerve
C)visceral motor component of the facial nerve
D)hypoglossal nerve
E)ventral motor nucleus of cranial nerve VII

Question 12

The __ has a primary role in chewing.

A)branchial motor component of the facial nerve
B)maxillary nerve of the trigeminal
C)mandibular nerve of the trigeminal
D)hypoglossal nerve

Question 13

Cranial nerve VIII:

A)has a visceral component
B)is a special sensory nerve
C)developed from somites
D)developed from branchial arches

Question 14

A patient who is able to smile while laughing but cannot smile on command likely has a:

A)unilateral lesion of the facial nerve
B)unilateral lesion of an upper motor neuron innervating the facial nerve
C)bilateral lesion of the facial nerve
D)bilateral lesion of the upper motor neurons innervating the facial nerve

Question 15

Which of these nerves has a visceral component?

A)olfactory
B)optic
C)oculomotor
D)trochlear
E)abducens

Question 16

A lesion in the superior laryngeal nerve would likely result in:

A)weakness of the laryngeal closure
B)a strained,strangled voice
C)an inability to change pitch
D)a hoarse,breathy voice

Question 17

An insect lands on your ear,and goes into the auditory canal.Which of these cranial nerves will help transmit the sense of touch to the somatic sensory cortex?

A)V
B)VII
C)VIII
D)X
E)V,VII,and X

Question 18

Which of the following is NOT a function of the vagus nerve,recurrent laryngeal branch?

A)general sensation from the vocal folds
B)innervation of all the intrinsic muscles of the larynx
C)visceral sensation below the larynx
D)All of these are functions of the recurrent laryngeal branch of the vagus.

Question 19

The visceral component of cranial nerve __ is responsible for salivation.

A)V
B)VII
C)IX
D)X
E)both B and C

Question 20

Which of these cranial nerves does not have a visceral component?

A)III
B)V
C)VII
D)IX
E)X

Question 21

A clinician has determined that a patient's vagus nerve has been damaged,affecting the contraction of the pharyngeal constrictor muscles.Knowing this,which type of swallowing assessment is indicated?

A)Have the patient swallow a liquid,semisolid,and solid in a clinic setting.
B)Test the sensation of taste.
C)Request a modified barium swallow.
D)Request an ultrasound to assess the oral stage of swallowing.

Question 22

The vestibular nerve is exclusively afferent,receiving impulses from the utricle,saccule,and semicircular canals.

Question 23

Upon protrusion,a patient's tongue deviates to one side,which is evidence of:

A)unilateral lower motor neuron damage
B)bilateral lower motor neuron damage
C)unilateral upper motor neuron damage
D)bilateral upper motor neuron damage
E)both A and C,depending on the side of the lesion

Question 24

The primary afferent nerve in the swallow response is the vagus.

Question 25

The purpose of pharyngeal constriction during the pharyngeal phase of swallowing is to:

A)open the cricopharyngeus
B)generate enough pressure to push the bolus through the pharynx
C)trigger the elevation of the larynx
D)clear the bolus from the laryngeal vestibule
E)invert the epiglottis

Question 26

Pharyngeal contractions (peristalsis)are the major force that pushes the bolus through the pharynx in the pharyngeal phase of swallowing.

Question 27

Which of the following muscles is NOT innervated by the hypoglossal nerve?

A)hyoglossus
B)intrinsic muscles of the tongue
C)genioglossus
D)styloglossus
E)All of these muscles are innervated by the hypoglossal nervE.

Question 28

__ are the cranial nerves that innervate muscles involved in swallowing.

A)V,VII,IX,X,and XII
B)V,IX,X,XI,and XII
C)V,VII,VIII,IX,and X
D)VII,IX,X,XI,and XII

Question 29

During the __ phase of deglutition,the larynx is elevated.

A)oral preparatory
B)oral
C)pharyngeal
D)esophageal

Question 30

Cranial nerve ___ has a spinal as well as a cranial root.

A)VII
B)IX
C)X
D)XI
E)XII

Question 31

Rarely are both focal folds completely paralyzed as a result of an upper motor neuron lesion.

Question 32

___ are the cranial nerves that mediate sensory stimuli that trigger the swallow response.

A)V,VII,IX,and X
B)V,IX,and X
C)IX and X
D)IX,X,and XII

Question 33

Asking a patient to produce the phoneme /t/ is a good test of the strength of elevation of the tongue tip.

Question 34

The trigeminal nerve has a special sensory component involved in taste.

Question 35

The __ stage of deglutition is voluntary and is approximately 1 second in duration.

A)oral preparatory
B)oral
C)pharyngeal
D)esophageal
E)both B and C

Question 36

A clinician places a few fingers on a patient's cheek and asks him to resist the pressure on his cheek by pushing his cheek with his tongue.The clinician is likely testing for:

A)the patient's ability to elevate the tongue
B)the lateral strength of the tongue
C)the strength of tongue protrusion
D)the ability to lower the tongue