@About this App@Contributers@DeveloperACTH (Adrenocorticotropic hormone)AFP (Alpha-fetoprotein) TestingAIDS Dementia Complex (HIV)AIDS HIV InfectionAPGAR Scoring (Children)APTT and CoagulationAbacavirAbataceptAbbreviated Mental Test Score (AMTS)AbciximabAbdominal Aortic AneurysmAbdominal paracentesis for ascitesAbducent NerveAbetalipoproteinaemiaAbnormal Vaginal bleedingAcamprosateAcanthocytosisAcanthosis NigricansAcarboseAccelerated Idioventricular RhythmAcetazolamideAcetylcholine Receptor AntibodiesAcetylcholinesterase inhibitorsAchalasiaAchilles Tendon ruptureAchondroplasia (Children)AciclovirAcid maltase deficiency (Pompe disease)Acne RosaceaAcne VulgarisAcoustic Neuroma (Schwannoma)Acrodermatitis enteropathica (Children)Acromegaly and GiantismAcromio-clavicular jointActinomyces israeliAction PotentialActivated CharcoalActrapid (Insulin)Acute Abdominal Pain - Acute PeritonitisAcute Acalculous CholecystitisAcute Anaphylactoid ReactionsAcute AnaphylaxisAcute Angle Closure GlaucomaAcute AppendicitisAcute Bacterial MeningitisAcute BronchitisAcute CholangitisAcute CholecystitisAcute Colonic Pseudo-obstructionAcute Coronary Syndrome (ACS) GeneralAcute Coronary Syndrome (ACS) NSTEMI USAAcute Coronary Syndrome (ACS) STEMIAcute Coronary Syndrome (Cardiac Troponins)Acute Coronary Syndrome Grace scoreAcute DeliriumAcute Disc lesionsAcute Disseminated EncephalomyelitisAcute Diverticulitis - Diverticular diseaseAcute Dystonic ReactionAcute EncephalitisAcute Eosinophilic PneumoniaAcute EpiglottitisAcute Exacerbation of COPDAcute HepatitisAcute HydrocephalusAcute HypotensionAcute InflammationAcute Intermittent Porphyria (AIP)Acute Interstitial nephritisAcute Kidney Injury (AKI)Acute Limb IschaemiaAcute Liver FailureAcute Lymphoblastic Leukaemia (ALL)Acute MastoiditisAcute MonoarthritisAcute Myeloid Leukaemia (AML)Acute MyocarditisAcute PancreatitisAcute Pelvic Inflammatory DiseaseAcute PericarditisAcute Phase reactantsAcute PorphyriasAcute Promyelocytic LeukaemiaAcute Respiratory Distress Syndrome (Adults)Acute Retroviral Syndrome (HIV)Acute RhabdomyolysisAcute Rheumatic feverAcute Rotator cuff tearAcute Severe AsthmaAcute Severe ColitisAcute SinusitisAcute Stroke Assessment (ROSIER&NIHSS)Acute TonsilitisAcute Urinary RetentionAcute and Chronic GoutAcute and Chronic Heart FailureAcute on Chronic Liver Disease DecompensationAcutely Ill PatientAdalimumabAddenbrooke's Cognitive Examination-Revised (ACER)Addison Disease (Adrenal Insufficiency)AdefovirAdenosineAdenosine deaminase deficiencyAdhesive Capsulitis (Frozen Shoulder)Adjustment - Anxiety disordersAdrenal AntibodiesAdrenal PhysiologyAdrenaline (Epinephrine)AdrenoleukodystrophyAdrenomyeloneuropathyAdult Onset Still's DiseaseAfrican Trypanosomiasis (Sleeping sickness)Age related macular degenerationAicardi syndromeAir EmbolismAlbuminAlbumin-Protein Creatinine Ratio (PCR)Alcohol AbuseAlcohol Withdrawal (Delirium Tremens)Alcoholic (Steato)HepatitisAlcoholic KetoacidosisAldosterone PhysiologyAlendronate (Alendronic acid)AlfacalcidolAlkaline phosphatase (ALP)Alkalinisation of urineAlkaptonuriaAllergic Bronchopulmonary AspergillosisAllogeneic stem cell transplantationAllopurinolAlogliptin (Vipidia)AlopeciaAlpha FetoproteinAlpha ThalassaemiaAlpha subunit (ASU) of TSHAlpha-1 Antitrypsin (AAT) deficiencyAlport's SyndromeAlteplaseAltitude sicknessAluminium and Magnesium AntacidsAlveolar Gas EquationAlzheimer disease (Dementia)AmantadineAmenorrhoeaAmerican Trypanosomiasis (Chagas Disease)AmilorideAmino acidsAminoglycosidesAminophyllineAminosalicylatesAmiodaroneAmiodarone and Thyroid diseaseAmitriptylineAmlodipineAmmonia EncephalopathyAmnestic syndromesAmoebiasis (Entamoeba histolytica)AmoxicillinAmphetamine toxicityAmphotericin BAmpicillinAnaemia of Chronic DiseaseAnagrelideAnakinraAnal CancerAndexanet alfaAndrogen insensitivity syndromeAneurysmsAngina bullosa haemorrhagicaAngiodysplasiaAngiomyolipomaAngioneurotic OedemaAngiotensin Converting Enzyme InhibitorsAngiotensin Converting enzyme (ACE)Angular Stomatitis - CheilitisAnion GapAnkle and Foot fractures and InjuriesAnkle-Brachial pressure Index (ABPI)Ankylosing spondylitisAnorexia NervosaAntacid medicationAntepartum haemorrhageAnterior Horn Cell diseasesAnterior circulationAnti Dementia DrugsAnti-Cyclic Citrullinated Peptide (CCP) AntibodyAnti-D immunoglobulinAnti-Hu antibodiesAnti-OKT3 antibodiesAnti-RNP AntibodyAnti-Yo antibodiesAnti-neutrophilic cytoplasmic antibodies (ANCA)Antibiotics for Abdominal InfectionsAnticholinergic BurdenAnticholinergic syndromeAnticipationAnticoagulation and AntithromboticsAntidiuretic hormone (Vasopressin)Antigen presenting cellsAntimicrobial ChoicesAntimuscarinic drugsAntiphospholipid syndromeAntithrombin III deficiency (AT3)Aorta anatomyAortic DissectionAortic Regurgitation (Incompetence)Aortic SclerosisAortic StenosisAortoenteric fistulaApathetic thyrotoxicosisApixabanAplastic anaemiaApomorphineAppendix Cancer TumoursApproach to Assessing Sick ChildApproach to child with Acute GastroenteritisApproach to child with respiratory DistressArnold Chiari malformationArrhythmogenic Right ventricular CardiomyopathyArtemisininsArterial Blood gas analysisArterial Pulse assessmentArterial blood gas samplingArterial vs Venous vs Other Leg UlcersArteriovenous malformationsArtery of Percheron strokeArtery-to-artery embolic strokeArtesunateAsbestos Related Lung diseaseAscites Assessment and ManagementAspergillomaAspergillus fumigatusAspirinAspirin Salicylates toxicityAssessing Abdominal PainAssessing BreathlessnessAssessing Chest PainAssessing FallsAsteatotic eczemaAsthmaAstigmatismAstrocytomasAsystoleAtaxia TelangiectasiaAtazanavirAtenololAtherosclerosisAtopic Eczema or Atopic DermatitisAtorvastatinAtracuriumAtrial Ectopic beatsAtrial Fibrillation (Chemical cardioversion)Atrial Natriuretic Peptide (ANP)Atrial fibrillation (AF)Atrial flutterAtrial myxomaAtrial septal defect (ASD)Atrioventricular nodal reentrant tachycardiaAtropine SulfateAutoantibodiesAutoimmune Haemolytic anaemia (AIHA)Autoimmune HepatitisAutonomic neuropathyAutosomal DominantAutosomal Dominant Polycystic kidney diseaseAutosomal RecessiveAzathioprineAzithromycinB lymphocytesBRCA genes (Familial Breast Cancer)Bacillus anthracisBacillus cereus poisoningBackpain / BackacheBaclofenBacteriaBacteroides fragilisBalanitis (Adults)Balanitis (Children)Balkan endemic nephropathy (BEN)Balsalazide (Aminosalicylate)Barrett's oesophagusBartonellaBartters syndromeBasal Cell Carcinoma (BCC)Basic Fracture managementBasilar artery thrombosisBecker Muscular dystrophyBeclometasoneBeer PotomaniaBehavioural and Psychological Symptoms of DementiaBehcet's syndromeBell's palsyBendroflumethiazide (Bendrofluazide)Benign Paroxysmal Positional Vertigo (BPPV)Benign Prostatic HyperplasiaBenign recurrent intrahepatic cholestasisBenzodiazepine ToxicityBenzodiazepinesBenzylpenicillin Sodium (Penicillin G)Berg Balance ScaleBeriplexBerylliosisBeta AgonistsBeta Blocker toxicityBeta ThalassaemiaBeta-2 MicroglobulinBeta-lactamasesBetahistine (Serc)BezafibrateBiceps ruptureBilateral adrenalectomyBiliary atresiaBilirubinBiochemical Lab valuesBisacodylBisoprololBisphosphonatesBladder CancerBladder StonesBleedingBleeding disordersBleeding due to DrugsBleomycinBlindness - global causesBlood products - Packed cells blood transfusionBlood Products - CryoprecipitateBlood Products - Fresh Frozen PlasmaBlood Products - PlateletsBlood film interpretationBlood gas valuesBloody DiarrhoeaBlotting Techniques: Gel ElectrophoresisBone Marrow TransplantationBone disease Lab resultsBone metabolism RANK RANKL OPG pathwayBone scintigraphy (Bone scan)Bordetella pertussis - Whooping coughBorrelia burgdorferiBorrelia recurrentisBotulismBrachial neuritis (neuralgic amyotrophy)Brachial plexus anatomyBrachial plexus and associated injuryBrain AbscessBrain Anatomy and functionBrain MRIBrain Natriuretic Peptide (BNP)Brain PhysiologyBrain Tumours (Cancer)Brainstem anatomyBranchial cleft cystBreast CancerBreast FibroadenomaBretyliumBroad complex TachycardiaBromocriptineBronchial adenomaBronchiectasisBronchiolitisBronchoscopyBrown-Sequard syndromeBrucellaBrugada syndromeBudd-Chiari syndromeBudesonideBuerger disease (Thromboangiitis obliterans )Bulbar vs Pseudobulbar palsyBulimia NervosaBullous PemphigoidBumetanideBunionsBuprenorphineBupropionBurkholderia cepaciaBurkitt's lymphomaBurnsBusulphan (Busulfan)ByssinosisC reactive protein (CRP)CADASILCARASILCHADS2 - CHA2DS2-VASc scoreCMV retinitisCNS fungal InfectionsCNS infectionsCSF RhinorrhoeaCT Head Basics (Stroke)CT Pulmonary angiogram (CTPA)CT imaging basics for StrokeCURB 65 scoreCabergolineCaecal VolvulusCaisson Disease - Decompression sicknessCalcitoninCalcitriol (1,25 Dihydroxycholecalciferol)Calcium Chloride or GluconateCalcium PhysiologyCalcium Pyrophosphate Deposition (Pseudogout)Calcium ResoniumCalcium channel blockers toxicityCalot's triangleCampylobacterCancer of Unknown PrimarCandesartanCandidiasisCannabis toxicityCapecitabineCapnocytophaga canimorsusCapnographyCapreomycinCaptopriCarbamazepineCarbapenemase-producing EnterobacteriaceaeCarbimazoleCarbon monoxide poisoningCarcinoembryonic antigen (CEA)Carcinoid Heart DiseaseCarcinoid Tumour SyndromeCarcinoma of the Bile DuctCarcinoma of the GallbladderCardiac Amyloid heart diseaseCardiac Anatomy and PhysiologyCardiac Catheter ablationCardiac InfectionsCardiac MRICardiac Resynchronisation Therapy (CRT) PacemakerCardiac Valve replacementCardioembolic strokeCardiogenic Pulmonary OedemaCardiogenic shockCardiology - History TakingCardiology Exam ListCardiology ExaminationCardiology Valves SummaryCardiopulmonary bypassCarmustineCarotid Artery anatomyCarotid Body TumourCarotid EndarterectomyCarotid Sinus SyncopeCarotid StentingCarotid artery DissectionCarotid sinus massageCarpal tunnel syndromeCarvedilolCase 01 Sudden weaknessCase 02 Loss of speechCase 03 Adult male weak legsCase 04 High calciumCase 05 High Potassium and heart failureCase 06 High calcium and weight lossCase 07 Weak eyesCase 08 Weak faceCase 09 A cause of DeliriumCase 10 Older patient presenting post strokeCase 11 Young patient with acute headacheCase 20 Young patient with acute headacheCase 21 HypoglycaemiaCase 22Case 23 Old man with tremorCase 24 Cancer and weakCase 99 (Acute breathlessness)Case TemplateCat Scratch DiseaseCataractCatheter Related Urinary Tract infection UTICatheter related Blood stream infectionCatheter related UTICauda equina syndromeCaudate NucleusCauses of Airway ObstructionCauses of Avascular Necrosis of Femoral headCauses of Sore throatCauses of WeaknessCavernous angiomas (Cavernomas)Cavernous sinusCavernous sinus thrombosisCefaclorCefalexinCefotaximeCeftazidimeCeftriaxoneCefuroximeCelecoxibCell Response to InjuryCellular Anatomy and PhysiologyCellulitisCentral Cord SyndromeCentral Retinal Vein Occlusion (CRVO)Central Retinal artery Occlusion (CRAO)Central Venous line InsertionCentral pontine myelinolysisCephalosporinsCerebellar Anatomy Physiology Signs DiseaseCerebellar HaemorrhageCerebellar StrokeCerebral Amyloid angiopathy (CAA)Cerebral AneurysmsCerebral AngiitisCerebral Atrophy vs HydrocephalusCerebral CortexCerebral MetastasesCerebral PalsyCerebral PerfusionCerebral Salt WastingCerebral Venous Sinus thrombosisCerebral arteritisCerebral microbleedsCervical Cancer screeningCervical Spine injuryCervical cancerCervical spondylosisCetirizineChancroidCharcot Foot Syndrome (CFS)Charcot Marie Tooth (CMT) diseaseChediak Higashi syndromeChest Abdomen anatomyChest X Ray #1Chest X Ray InterpretationChest drain InsertionChlamydia - Chlamydophila pneumoniaeChlamydia psittaciChlamydia trachomatisChlorambucilChloramphenicolChlordiazepoxideChloroquineChlorphenamine(Chlorpheniramine)ChlorpromazineCholangiocarcinomaCholera (Vibrio cholera)Cholestatic JaundiceCholesteatomaCholesterol - LipidsCholinergic crisis-syndromeChondrocalcinosisChorea - BallismusChoreoacanthocytosisChromosome instability syndromesChronic BronchitisChronic HepatitisChronic InflammationChronic Inflammatory Demyelinating polyneuropathyChronic Interstitial NephritisChronic Kidney Disease (CKD)Chronic Lymphocytic leukaemia (CLL)Chronic Myeloid Leukaemia (CML)Chronic Obstructive Pulmonary Disease (COPD)Chronic PancreatitisChronic PeritonitisChronic Radiation EnteritisChronic Urinary RetentionChronic Vision Uni-Bilateral loss (Blindness)Chronic and recurrent MeningitisChronic liver diseaseChronic mucocutaneous candidiasisChronic stable anginaChylomicronsCiclosporinCimetidineCinacalcetCiprofloxacinCirrhosisCisplatinCitalopramCladribineClarithromycinCleft lip or palateClindamycinClopidogrelClostridium botulinumClostridium difficileClostridium perfringensClostridium tetani - TetanusClotrimazole creamClotting pathwaysClozapineCo Careldopa (Sinemet)Co-Amoxiclav (Augmentin)Co-Beneldopa (Madopar)Co-codamolCo-trimoxazoleCoagulopathyCoal Worker's PneumoconiosisCoarctation of the Aorta (CoA aortopathy)Cocaine abuseCocaine induced chest painCocaine toxicityCoccidioidomycosisCodeineCoeliac diseaseCogan SyndromeColchicineCold Agglutinin Disease (CAD/AIHA)CollagenColloid cyst in the third ventricleColloidsColonic (Large bowel) ObstructionColonoscopyColorectal cancerColorectal polypsColposcopyComa managementCombined Oral contraceptive pill (COCP)Common Peroneal Nerve (CPN)Common variable immunodeficiencyComparing Rheumatoid and OsteoarthritisComplementComprehensive Geriatric Assessment (CGA)Confirming DeathCongenital Acyanotic Heart Disease (Children)Congenital Adrenal hyperplasiaCongenital Complete Heart BlockCongenital Cyanotic Heart Disease (Children)Congenital HypothyroidismCongenital Talipes Equinovarus - ClubfootConstipationConstrictive PericarditisContact allergic dermatitisContinuous Positive Airways Pressure (CPAP)Continuous ambulatory peritoneal dialysisContraceptionConus Medullaris syndromeCor PulmonaleCoronary artery bypass graft surgeryCoronavirus SARS-CoV-2 COVID 19Corticobasal degeneration (Dementia)Corticosteroid-related psychosisCorticosteroidsCorynebacterium diphtheriaeCotard delusionCoxiella BurnetiiCranial nerves and examinationCraniopharyngiomaCreatinine ClearanceCremation forms (UK)Creutzfeldt Jakob disease (Dementia)Crimean-Congo haemorrhagic feverCritical illness neuromuscular weaknessCrohn's diseaseCroupCryptococcus neoformans infectionsCryptogenic Fibrosing AlveolitisCryptogenic Organising Pneumonia (COP-BOOP)CryptosporidiosisCrysal arthritisCrystalloidsCushing diseaseCushing syndromeCutaneous LeishmaniasisCyanide toxicityCyanosis - Central and PeripheralCyclizineCyclo-oxygenase (COX) enzymesCyclophosphamideCycloserineCys leukotriene receptor antagonistsCystic FibrosisCystinosisCystinuriaCytokinesCytomegalovirus infectionsD DimerDNA and RNA short notesDNA replicationDabigatranDalteparinDandy Walker syndromeDantroleneDapagliflozinDarier's DiseaseDarunavirDeQuervain's thyroiditisDeath Certificates (UK)Deep brain stimulationDeep vein thrombosis (DVT)Dehydration PhysiologyDelayed Puberty CriteriaDemeclocyclineDementia with Lewy bodiesDementiasDemyelinating DiseasesDengue FeverDenosumab (Prolia)Dental AnatomyDentatorubral pallidoluysian atrophyDepressionDermatitis HerpetiformisDermatology termsDermatomesDermatomyositisDermoid cystsDesferrioxamineDesmopressin (DDAVP)Desogestrel (Progestogen Only Pill)Developmental Dislocation (Dysplasia) of the HipDevelopmental MilestonesDexamethasoneDiGeorge syndrome (thymic aplasia)Diabetes Insipidus (Cranial and Nephrogenic)Diabetes Mellitus Type 1Diabetes Mellitus Type 1 and DKA (children)Diabetes Mellitus Type 2Diabetes Mellitus in pregnancyDiabetes on the wardDiabetic Autonomic Neuropathy (DAN)Diabetic Ketoacidosis (DKA) AdultsDiabetic Ketoacidosis (DKA) with SGLT2 InhibitorsDiabetic NephropathyDiabetic RetinopathyDiabetic amyotrophyDiabetic footDiamond-Blackfan anaemiaDiamorphineDiaphragmatic disordersDiarrhoeaDiazepamDidanosine (ddI)DiethylstilbestrolDifferentials causes of Foot DropDifferentials of ABCDifferentials of Generalised lymphadenopathyDifferentials of Painful thighDifferentials of XXXDiffuse Oesophageal spasmDiffuse large B-cell lymphomaDiffusion CapacityDigoxinDigoxin ToxicityDihydrocodeineDilated cardiomyopathyDiltiazemDiphtheriaDipyridamoleDischarges against adviceDiscoid lupus erythematosus (DLE)Disease templateDiseases with associated cancersDislocation Sternoclaivcular jointDisopyramideDisseminated Intravascular Coagulation (DIC)Distributive ShockDisulfiram (Antabuse)DobutamineDog BitesDog Bites HandDominant R wave in V1DomperidoneDonepezil (Aricept)DonovanosisDopamine HydrochlorideDopamine agonistsDown's syndrome (Trisomy 21)DoxapramDoxazosin (Cardura)DoxepinDoxorubicin (Adriamycin)DoxycyclineDrivingDrowningDrug Induced Parkinson diseaseDrug Reaction Eosinophilia Systemic Symptoms DRESSDrug TemplateDrug Toxicity - clinical assessmentDrug Toxicity with Specific AntidotesDrug induced Lupus ErythematosusDrug induced liver diseaseDrugsDrugs ListDrugs to Avoid in Acute Renal failureDrugs to avoid ElderlyDrugs to avoid in Liver failureDry and Wet GangreneDual X-ray absorptiometry (DEXA)Duchenne muscular dystrophyDulaglutide GLP-1 agonistDuloxetineDuodenal Atresia (Children)Dupuytrens contractureDysenteryDysphagiaECG - Acute Coronary SyndromeECG - Acute ST Elevation Myocardial InfarctionECG - Atrial fibrillationECG - Atrial flutterECG - BasicsECG - Broad complex tachycardia (possible VT)ECG - Brugada syndromeECG - Causes of a Dominant R wave in V1ECG - Early Repolarisation vs STEMIECG - First degree AV BlockECG - Heart BlockECG - HyperkalaemiaECG - InterpretationECG - Ischaemic Heart DiseaseECG - Left Axis DeviationECG - Left Bundle Branch Block LBBBECG - Left Ventricular HypertrophyECG - Low Voltage ComplexesECG - Narrow complex tachycardiaECG - Normal appearanceECG - Pathological Q wavesECG - QT intervalECG - Right Axis DeviationECG - Right Bundle Branch Block RBBBECG - ST-T T waves changesECG - Supraventricular tachycardia ECG - The QRS complexECG - Tutorial from Queens UniversityECG - Ventricular fibrillationECG - Ventricular tachycardiaECG - Wolff Parkinson White syndrome (WPW)ECG - short PR intervalECG - sinus pauseECG - tall R wave V1ENT Exam - Assessing hearingENT infectionsEbola Virus DiseaseEbstein anomalyEchinocytesEchocardiogramEcstasy toxicityEctopia lentis (subluxation of the lens)Ectopic PregnancyEctropionEculizumabEdoxaban (Lixiana)Edward syndrome (trisomy 18 syndrome)Efavirenz (Sustiva) EFVEhlers-Danlos syndromesEhrlichiosisEikenella corrodensEisenmenger's syndrome (Children)Elbow fractures and InjuriesElectrical injuryEloquent brainEmergency DrugsEmphysemaEmpty sella syndromeEmtricitabine (Emtriva) FTCEnalaprilEnd of Life Care PrescribingEndocarditis and StrokeEndocrinology Lab valuesEndometrial (Uterine) CancerEndometriosisEndoscopic Retrograde Cholangiopancreatography XEndothelinsEnfuvirtideEnoxaparin Sodium (Clexane-Lovenox)EnoximoneEntacaponeEnterococciEnteropathic SpondyloarthritisEnzyme inducers and inhibitorsEosinophilic granulomatosis (Churg Strauss)EpendymomaEpidural HaematomaEpidural abscessEpilepsy - General ManagementEpilepsy - Idiopathic Generalised EpilepsyEpilepsy - Mesial temporal lobe epilepsyEpilepsy - Post TraumaticEpilepsy in PregnancyEpiscleritisEpistaxisEplerenoneEponymous brainstem strokesEpstein-Barr Virus infectionEquivalent doses of OpiatesErb PalsyErgocalciferol (Calciferol)Erlotinib (Tarceva)Erysipelothrix rhusiopathiaeErythema MultiformeErythema NodosumErythrocyte Sedimentation rate (ESR)ErythrocytesErythrodermic PsoriasisErythromycinEscherichia coliEscitalopramEsomeprazoleEssential Thrombocythaemia (ET)Essential TremorEtanerceptEthambutolEthanolEthanol toxicityEthylene glycol toxicityEtomidateEtravirine (intelence) ETREwing sarcomaExenatide (Byetta) GLP1 agonistExercise stress testExploding head syndromeExtradural haematomaExtrapyramidal symptomsExtrinsic Allergic alveolitis (Hypersensitivity)Eye infectionsEzetimibeFabry diseaseFacial NerveFacioscapulohumeral muscular dystrophyFactor V Leiden DeficiencyFaecal CalprotectinFahr syndromeFailure to thrive or Faltering growthFamilial Adenomatous polyposis (FAP)Familial AmyloidosisFamilial HypercholesterolaemiaFamilial Mediterranean Fever (FMF)Familial hypocalciuric hypercalcaemia (FHH)Family Tree (Pedigree)FamotidineFanconi AnaemiaFanconi SyndromeFat embolismFatigue - CausesFatty acidsFebrile seizuresFelodipine (Dihydropyridine)Femoral HerniaFemoral triangleFemur fractures and InuriesFentanyl - FentanilFerritinFerrous Fumarate - Gluconate - SulphateFetal Alcohol SyndromeFetal circulationFever - Pyrexia of unknown origin (FUO PUO)Fever in a travellerFibratesFibrinogenFibromuscular dysplasiaFibromyalgiaFidaxomicinFinasteride (5 alpha-reductase inhibitor)First SeizureFitz-Hugh Curtis SyndromeFlail ChestFlecainide AcetateFlexor sheath infection (flexor tenosynovitis)FlucloxacillinFluconazoleFlucytosineFludrocortisoneFluid balances statusFlumazenil (Annexate - Romazicon)FluoxetineFocal Segmental Glomerulosclerosis (FSGS)Foix-Alajouanine syndromeFolate (Folic) acidFolate deficiencyFolinic acid (Leucovorin)FomepizoleFondaparinuxFood borne diseaseFoscarnet SodiumFosfomycinFosphenytoinFoster Kennedy SyndromeFournier's gangreneFracture TemplateFractured ClavicleFractured Neck of FemurFractured Pubic RamusFractured ScapulaFractured Shaft FemurFractured Tibia and FibulaFractures Shaft HumerusFractures in ChildrenFractures of Upper humerusFragile X syndromeFrailtyFraser guidelines and Gillick CompetenceFree RadicalsFriedreich's AtaxiaFrontotemporal dementiaFull or Complete Blood Count (FBC CBC)FungiFurosemide (Frusemide)Fusidic acidFusobacteria - Tropical ulcerFusobacteriumG protein-coupled receptorsGP Emergency Drugs CarriedGabapentinGalactorrhoeaGalantamineGamete intra-fallopian tube transfer (GIFT)Gamma Glutamyl Transferase (GGT)Gamma hydroxy butyrate (GHB) toxicityGanciclovir - ValganciclovirGardner syndromeGardnerella vaginalisGas GangreneGastric (MALT) LymphomaGastric CancerGastric Outlet obstruction (pyloric stenosis)GastrinomaGastro Intestinal Stromal Tumours (GIST)Gastro-Oesophageal Reflux (Adult GORD)Gastro-Oesophgeal Reflux (Paediatrics GORD)GastroenteritisGastroenterology Exam ListsGastroenterology ExaminationGastroenterology HistoryGastroenterology assessment - JaundiceGastrointestinal anatomy and physiologyGastrointestinal perforationGastrostomy (PEG) tubesGaucher's diseaseGene componentsGenetic DiseasesGentamicinGiardiasisGilbert's syndromeGingival (Gum) hyperplasia-hypertrophyGitelman's syndromeGlasgow Blatchford ScoreGlasgow Coma scaleGlatiramer acetate (Copaxone)GlibenclamideGliclazideGlimepirideGlipizideGlobus PallidusGlomerulonephritisGlossitisGlucagonGlucagonomaGlucose 6 phosphate dehydrogenase deficiencyGlucose Tolerance TestGlutamateGlycated HaemoglobinGlyceryl Trinitrate (GTN)Glycogen storage diseasesGlycolysis_Krebs_Electron_Transport_ChainGlycopyrronium BromideGoitreGolfer's ElbowGolimumab (Simponi)Goodpasture's syndrome (Anti GBM disease)Goserelin (Zoladex)Gradenigo's syndromeGrades of RecommendationGram StainGranuloma annulareGranulomatosis with Polyangitis GPA (Wegener)Graves DiseaseGriseofulvinGrowth Hormone DeficiencyGuillain Barre SyndromeGum hypertrophyGuthrie test New Born blood spotGynaecological History TakingGynaecomastiaHAS-BLED scoreHIV and Post-Exposure Prophylaxis (PEP)HIV and Pre-exposure prophylaxisHIV associated nephropathy (HIVAN)HIV disease AssessmentHTLV-1 Associated myelopathyHaematemesisHaematology Examination - SplenomegalyHaematology Lab valuesHaematuria Mild to SevereHaemodialysisHaemoglobinsHaemolysisHaemolytic AnaemiaHaemolytic Uraemic syndromeHaemolytic disease of the newbornHaemophilia AHaemophilia BHaemophilus aegyptiusHaemophilus ducreyiHaemophilus influenzaeHaemophilus parainfluenzaeHaemopoiesisHaemorrhagic TransformationHaemorrhagic strokeHaemorrhoids (Piles)Hairy Cell LeukaemiaHairy LeukoplakiaHallervorden-Spatz disease (PKAN)HaloperidolHamman-Rich syndromeHand foot and mouth diseaseHand fractures and InjuriesHantavirus infectionsHartmann's solution (Ringer's lactate)Hartnup disease*Hashimoto's (Steroid responsive) EncephalopathyHashimoto's thyroiditisHbA1cHead (Brain) InjuryHead and Neck CancersHeadache - Analgesic overuseHeadache - Assessing Acute and SevereHeadache - Basilar MigraineHeadache - ClusterHeadache - Low CSF pressureHeadache - MigraineHeadache - TensionHeadaches - GeneralHearing aidsHeat StrokeHelicobacter pyloriHelvetica Spotted feverHemicraniectomyHenoch-Schonlein purpuraHeparin - GeneralHeparin - Low Molecular Weight HeparinHeparin - Unfractionated HeparinHeparin-induced thrombocytopenia (HIT)Hepatic EncephalopathyHepatitis AHepatitis BHepatitis CHepatitis DHepatitis EHepatocellular CarcinomaHepatorenal syndromesHereditary ElliptocytosisHereditary HaemochromatosisHereditary Haemorrhagic TelangiectasiaHereditary Spastic ParaparesisHereditary SpherocytosisHereditary angio-oedemaHereditary neuropathy with pressure palsiesHereditary non polyposis coli (Lynch syndrome)Herpes GestationisHerpes SimplexHerpes Simplex Encephalitis (HSV)Herpes VirusesHerpes Zoster Ophthalmicus (HZO) ShinglesHerpes simplex keratitis (HSK)Heyde syndromeHiatus herniaHiccups (Singultus)High Dose Dexamethasone Suppression TestHip pain in childrenHirschsprung disease (congenital megacolon)Hirsuitism XXXHistonesHistoplasmosisHodgkin LymphomaHolt-Oram syndromeHolter monitor (tape) 24-72 hHomocystinuriaHookwormHorner's syndromeHospital acquired Pneumonia (NICE 139)Human albumin solution (HAS)Human prion diseasesHumeral fractures and injuriesHunter's syndrome (MPS-2)Huntington ChoreaHurler's syndrome (MPS-1)Hydatid disease (Echinococcus)Hydatidiform moleHydralazineHydrocortisoneHydrogen BondsHydrops fetalisHydroxocobalaminHydroxocobalamin - Cyanocobalamin (B12)HydroxychloroquineHydroxyurea-HydroxycarbamideHyoscine (Buscopan)Hyper IgM syndromeHyperbaric Oxygen therapyHypercalcaemiaHyperglycaemic Hyperosmolar State (HHS)Hyperinsulinaemic-euglycemic therapy (HIET)HyperkalaemiaHyperkalaemic and Hypokalaemic Periodic ParalysisHypermagnesaemiaHypernatraemiaHyperphosphataemia (High phosphate)HyperprolactinaemiaHypersensitivity reactionsHypertensionHypertension in PregnancyHypertriglyceridaemia (HTG)Hypertrophic cardiomyopathy (HCM - HOCM)Hyperventilation SyndromeHyperviscosity syndromeHypocalcaemiaHypoglycaemiaHypogonadism (Female)Hypogonadism (male)HypokalaemiaHypokalaemic Periodic ParalysisHypomagnesaemiaHyponatraemiaHypoparathyroidismHypophosphataemia (Low phosphate)Hypopituitarism (Pituitary Failure)HypospadiasHypothermiaHypothyroidismHypovolaemic or Haemorrhagic ShockIL-12 receptor deficiencyIV ImmunoglobulinIbandronic acid (Bisphosphonate)IbuprofenIcatibantIdiopathic Intracranial hypertensionIdiopathic Parkinson diseaseIdiopathic Pulmonary FibrosisIgA Nephropathy (Berger's disease)Images - Spot diagosesImatinib mesylateImipenem (Primaxin) with CilastinImmune Reconstitution SyndromeImmune(Idiopathic) Thrombocytopenic Purpura (ITP)Immunoglobulin G4-related disease (IgG4-RD)ImpetigoImplantable cardioverter defibrillator (ICD)Impulse control disordersInclusion Body MyositisIncubation periodsIndapamideIndinavir (IND)Infection screening in Septic patientInfections and their Microbial causeInfectious MononucleosisInfective ConjunctivitisInfective EndocarditisInfertilityInfliximabInfluenzaInguinal HerniaInitial Trauma AssessmentInjury Severity Score (ISS)Insomnia - sleep issuesInsulinInsulinomaInterferon BetaIntermittent ClaudicationInternal CapsuleInternuclear OphthalmoplegiaInterpreting HaematinicsInterstitial KeratitisIntestinal obstruction (Children)Intra Aortic Balloon PumpIntraabdominal abscessIntracerebral Haemorrhage (ICH) ScoreIntracranial HypertensionXIntravenous Iron Replacement (Ferrous)Intraventricular haemorrhage (neonates)Intubation and Mechanical VentilationIntussusception (Adults)Intussusception (Children)Iodine deficiency GoitreIpratropium Bromide (Atrovent)IrbesartanIron SaltsIron deficiency AnaemiaIron toxicityIrritable bowel syndromeIschaemic ColitisIschaemic StrokeIschaemic heart diseaseIsoniazidIsoprenalineIsosorbide DinitrateIsosorbide mononitrateIsotretinoin (Accutane)Ispaghula Husk (Fybogel)IvabradineJansen DiseaseJanus kinase 2Jervell and Lange-Nielsen syndromeJob Syndrome (Hyper IgE syndrome)Jugular Venous Pressure (JVP)Junctional TachycardiaJuvenile DermatomyositisJuvenile Idiopathic arthritis (Stills Disease)Juvenile Myoclonic epilepsy (JME)Kallmann's syndromeKaposi sarcoma (KS)Karnofsky performance status scaleKawasaki diseaseKennedy SyndromeKeratoconusKernicterusKetamineKetoconazoleKlebsiella pneumoniaKlinefelter Syndrome (Children)Klumpke palsyKnee fractures and InjuriesKoebner phenomenonKugelberg Welander syndromeKwashiorkorL-Thyroxine (T4)Labetalol (Trandate)Labyrinthitis - 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Dystropica myotonicaMyxoedema comaN-Acetylcysteine (Parvolex)NEWS Reacting to Low Oxygen SaturationsNICE Guidelines LinksNICE Trauma Guidance Summary 2016NSAID toxicityNaloxone (Narcan) Opiate antagonistNaproxenNarcolepsyNasal polypsNasogastric tube insertionNatalizumab (Tysabri)National Early Warning Score NEWS 2 ScoreNeck PainNeck swellings and lumpsNecrotising Enterocolitis (Infants)Necrotising fasciitisNeedlestick injuryNefopamNeisseria gonorrhoeaeNeisseria meningitidisNelson SyndromeNeomycinNeonatal Abstinence Syndrome NASNeonatal JaundiceNeonatal Lupus ErythematosusNeonatal meningitisNeostigmineNephritic syndromeNephroblastoma (Wilm's tumour)Nephrotic syndromeNephrotoxic drugsNerve conduction studiesNerve fibresNeuroanatomy 101Neuroanatomy imagesNeuroblastomaNeurocysticercosisNeuroferrinopathyNeurofibromatosis Type 1Neurofibromatosis Type 2Neuroleptic Malignant SyndromeNeurological - Relative Afferent pupillary defectNeurological - Vision and Eye movementsNeurological Examination - 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History TakingRespiratory AcidosisRespiratory AlkalosisRespiratory Anatomy and PhysiologyRespiratory Disease InvestigationsRespiratory Distress Syndrome (Neonates)Respiratory ExaminationRespiratory Examination - Finger ClubbingRespiratory Failure (hypoxia-hypercarbia)Resting membrane potentialRestless legs syndromeRestriction enzymesRestrictive CardiomyopathyResuscitation - Adult Bradycardia AlgorithmResuscitation - Adult Tachycardia AlgorithmResuscitation - Advanced Life SupportResuscitation - Basic Life Support ABCDEResuscitation - Choking AlgorithmResuscitation - Post Resuscitation AlgorithmReteplaseReticulocytesRetinal detachmentRetinitis pigmentosaRetinoblastomaRetinoidsRetroperitoneal fibrosisRett SyndromeReversible cerebral vasoconstriction syndromeReye syndromeRhesus haemolytic diseaseRheumatoid arthritisRheumatology AutoantibodiesRheumatology Lab valuesRhodococcus equiRibavirinRicin ToxicityRickettsia (General Principles)Rickettsia africae (Tick Bite Fever)Rickettsia akariRickettsia conorii (Tick Bite Fever)Rickettsia prowazekiiRickettsia rickettsiiRickettsia tsutsugamushiRickettsia typhiRifampicin (Rifabutin Rifampin)RifaximinRilipivirine (Edurant) RVPRiluzole (Rilutek)Risedronate (Bisphosphonate)RisperidoneRitonavir (Norvir) RTVRituximab (Mabthera)Rivaroxaban (Xarelto)Rivastigmine (Exelon)Rocky Mountain Spotted FeverRocuroniumRotigotineRubella (German Measles) NotifiableSCL70 AntibodySMASH U Intracerebral Haemorrhage ClassificationSOCRATES mnemonicST segment changesSacubitril with ValsartanSalivary Gland DiseaseSalivary glandsSalmonella entericaSalmonella typhiSaquinivir (Invirase) SQVSarcoidosisSaxagliptin (Onglyza)ScabiesScarlet Fever (Scarlatina)SchistosomiasisSchizophreniaSchmidt's syndromeSciaticaSeborrheic DermatitisSecondary Brain TumoursSecondary MessengersSecondary dysmenorrhoeaSecondary hyperparathyroidismSedation and Analgesia on ITUSelective IgA deficiencySelective Serotonin reuptake Inhibitor toxicitySelective serotonin reuptake inhibitors (SSRI)SelegilineSelenium deficiencySennaSeptic Shock and Sepsis 3Septic arthritisSepticaemiaSeronegative SpondyloarthropathiesSerotonin syndromeSerratiaSevelamerSevere combined immunodeficiency disordersSex Linked RecessiveSheehan's syndromeShigella characteristicsShigellosis (Bacillary Dysentery)Shock (General Assessment)Short Synacthen test (SST)Short and Tall stature Growth in ChildrenShoulder dislocationsSick Euthyroid SyndromeSickle Cell DiseaseSideroblastic AnaemiaSigmoid VolvulusSildenafil (Viagra)SilicosisSilver Trauma - Age over 65SimvastatinSinus BradycardiaSinus Node diseaseSinus TachycardiaSitagliptinSitosterolemiaSjogren's syndromeSkin and soft tissue infectionsSkull AnatomySleep physiologySlipped Upper Femoral Epiphysis (SUFE)Small Bowel IschaemiaSmall Bowel ObstructionSmall vessel diseaseSmallpoxSmokingSnake BitesSneddon SyndromeSodium BicarbonateSodium NitroprussideSodium PhysiologySodium PicosulfateSodium Thiopental - Sodium ThiopentoneSodium Valproate (Epilim Depakote)Sodium Zirconium Cyclosilicate (Lokelma)Soft tissue injuries (sprains, strains)SolifenacinSolitary Pulmonary NoduleSotalol HydrochlorideSpetzler-Martin Grading of AVMSpina BifidaSpinal Cord AnatomySpinal Cord Arteriovenous MalformationsSpinal Cord CompressionSpinal Cord HaematomaSpinal Cord InfarctionSpinal StenosisSpirometrySpironolactoneSpleenSplenic RuptureSpondylolisthesisSpontaneous Bacterial PeritonitisSpontaneous intracranial hypotensionSquamous Cell CarcinomaSt John's WortStaphylococcal InfectionsStaphylococcus aureusStaphylococcus epidermidisStaphylococcus saprophyticusStatinStatus Epilepticus (Epilepsy)Stavudine (Zerit) d4TStevens-Johnson SyndromeStiff Person SyndromeStrabismus (Lazy Eye)Streptobacillus moniliformisStreptococci - anaerobesStreptococcusStreptococcus agalactiaeStreptococcus milleriStreptococcus pneumoniae (Pneumococcus)Streptococcus pyogenesStreptococcus viridansStreptokinaseStreptomycinStridorStroke - Arterial Occlusion and clinical correlateStroke - Epidemiology and risk factorsStroke - General ManagementStroke - ImagingStroke ASPECTS scoringStroke CollateralsStroke Risk FactorsStroke ThrombolysisStrongyloides stercoralis (threadworm)StrontiumSubacute Sclerosing PanencephalitisSubacute ThyroiditisSubarachnoid HaemorrhageSubclavian Steal SyndromeSubclavian vein thrombosisSubdural haematomaSucralfateSudden Cardiac Death (SCD)Sudden Infant Death Syndrome (SIDS)Sudden sensorineural hearing loss (SNHL)SuicideSulfasalazine - SulphasalazineSulphonamide (Sulphamethoxazole)SumatriptanSuperior Mesenteric Artery (SMA) SyndromeSuperior Sagittal Sinus ThrombosisSuperior vena caval obstruction syndromeSupracondylar Femur FracturesSupracondylar Humerus FracturesSupraspinatus tendonitisSupraventricular TachycardiaSurgical CricothyroidotomySurgical prophylaxisSurgical site infectionSusac syndromeSuxamethoniumSydenham's choreaSynchronised DC CardioversionSyncopeSyndrome X (Cardiology)Syndrome of Inappropriate ADH (SIADH) secretionSyndromes with Severe Cognitive IssuesSyphilisSyringobulbiaSyringomyeliaSystemic AmyloidosisSystemic Lupus Erythematosus (SLE)Systemic MastocytosisSystemic SclerosisT cellsTIMI scoreTMN Staging tumoursTNF receptor-associated periodic syndromeTORCH infectionsTURP Hyponatraemia syndromeTabes dorsalisTacrolimusTafamidisTakayasu arteritis (pulseless disease)Takotsubo CardiomyopathyTamoxifenTamsulosin (Flomax)Tanner Stages of Pubertal DevelopmentTardive DyskinesiasTay-Sachs diseaseTazocin (Tazobactam - Piperacillin)TeicoplaninTelomeresTemazepamTemozolomide (Temodal)Template XTemplate two columns listTemporal (Giant Cell GCA) ArteritisTenecteplaseTennis ElbowTensilon testTension PneumothoraxTerbutalineTeriparatideTerlipressinTertiary hyperparathyroidismTesticular CancerTesticular torsionTestingTetrabenazineTetracosactide (Synacthen)TetracyclinesTetralogy of Fallot (Children)Thalamic HaemorrhageThalamic Pain SyndromeThalamic Stroke SyndromeThalidomideTheophyllineTheophylline toxicityThiamineThird Degree (complete) Heart BlockThoracic TraumaThoracic anatomyThoracic outlet syndromeThrombocytosisThrombolysisThrombophilia testingThrombotic Thrombocytopenic purpura (TTP)Thyroglossal Cyst (Children)Thyroid CancerThyroid Function Tests and antbodiesThyroid GlandThyroid Storm - Thyrotoxic crisisThyroid Surgery (Thyroidectomy)Thyroid noduleThyrotoxicosis and HyperthyroidismTiagabineTibia and Fibula fractures and InjuriesTicagrelorTick ParalysisTimololTinea capitisTinidazoleTinzaparin (Innohep)Tiotropium (Spiriva)Titre - 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Paratyphoid fever (Enteric Fever)Tyrosine Kinase receptorsUS vs UK Drug namesUbiquitinUlcerative ColitisUlnar nerveUltrasound - Echo basicsUndifferentiated Inflammatory Arthritis (Children)Unexplained symptomsUpper Gastrointestinal Bleed (GI Bleed)Upper-Lower Motor Neurone signsUrea and ElectrolytesUrethral syndomeUrinary CatheterisationUrinary Incontinence (Stress and Urge)Urinary Tract Infection (UTI Children)Urinary Tract InfectionsUrinary Tract ObstructionUrinary UTI Antibiotic guidanceUrine AnalysisUrothelial tumoursUrticariaUterusVIPomasVTE DVT PE in PregnancyVaginal CarcinomaValaciclovirValsartanVancomycinVariable rate intravenous insulin infusion VRIIIVariant (Prinzmetal) AnginaVaricella-Zoster (Chickenpox Shingles) InfectionVariegate PorphyriaVascular DementiaVasculitis - General Issues and ClassificationVasopressin (AVP) Antidiuretic hormoneVasovagal syncopeVaughan-Williams ClassificationVecuroniumVedolizumab (Entyvio)VenlafaxineVenous Insufficiency and Leg UlcersVenous access Venflons and Central linesVentilator associated pneumonia (VAP)Ventricular FibrillationVentricular Septal defect (VSD) (Children)Ventricular TachycardiaVentricular ectopic beatsVerapamilVertebral artery dissectionVertigoVesicoureteric reflux (VUR) (Children)Vibrio parahaemolyticusVibrio vulnificusVibrio vulnificus Vigabatrin (Sabril)VinblastineVincristineViral MeningitisViral associated cancersVirusesVisual acuityVitamin A deficiency (Children)Vitamin B1 Thiamine deficiencyVitamin B12 deficiencyVitamin B12 excessVitamin C deficiency (Scurvy)Vitamin D (1,25 OH2)Vitamin D (25 OH D)Vitamin D deficiencyVitamin D resistant rickets (Children)Vitamin K (Phytomenadione)Vitamin K deficiencyVitiligoVoltarol (Diclofenac)Von Gierke Disease (Children)Von Hippel LindauVon Willebrand DiseaseWaardenburg's syndrome (Children)Wagner Classification Diabetic foot ulcersWaldenstrom Macroglobulinaemia (WM)Wallerian DegenerationWarfarinWarfarin and BleedingWater PhysiologyWatershed InfarctsWerdnig Hoffman Disease (Children)Wernicke Korsakoff SyndromeWhite Blood Cells - LeukocytesWilliams Syndrome (Children)Wilson diseaseWiskott-Aldrich syndrome (Children)Wolff-Parkinson White syndrome (WPW)Wolfram syndrome (DIDMOAD)Wound healingX linked Agammaglobulinaemia (Bruton)X linked Hypophosphataemic ricketsX-linked IchthyosisX-linked lymphoproliferative disease (Children)Xeroderma pigmentosumYellow FeverYellow Nail SyndromeYersinia enterocoliticaYersinia pestis - Bubonic PlagueYersinia pseudotuberculosisZZAAAZZ_Abnormal charZabramski Classification of CavernomasZidovudine (Retrovir) AZT - ZDVZieve's syndromeZika virusZinc deficiencyZoledronic acidZollinger Ellison syndromeZolpidemZopicloneeGFR

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Cranial nerves and examination


Brain Stem Anatomy/ Cranial nerves

The Brainstem contains all the cranial nerves other than Olfactory and optic nerves

NerveLevel
I. Olfactory Above Brainstem
II. Optic Above Brainstem synapses with lateral geniculate ganglion of the thalamus
III. Oculomotor Midbrain. Oculomotor (IIIrd) nucleus at level of the superior colliculus. Cranial nerve III innervates all the extraocular muscles except for the lateral rectus and superior oblique. In innervates the medial rectus, superior rectus, inferior rectus, and inferior oblique muscles. It exits the brain stem anterior-medially from the midbrain between the posterior cerebral artery and the superior cerebellar artery. It can be affected by aneurysms of these arteries.
IV. Trochlear Midbrain. Trochlear nerve (IV): nucleus at level of lower colliculus. Exits brainstem posteriorly, Innervates the superior oblique muscle. It travels posteriorly and medially, crosses the midline, wraps around the midbrain, and exits the brain stem laterally between the posterior cerebral artery and superior cerebellar artery. Long intracranial course. Travels through the cavernous sinus and enters the orbit through the superior orbital fissure. Because it crosses the midline, the right trochlear nerve innervates the left superior oblique muscle. If the left superior oblique muscle is weak, then tilting the head to the right reduces the diplopia, and tilting the head to the left would worsen the diplopia. So a patient tilts his or her head away from the affected eye
V. Trigeminal Pons. Large trunks exit anteriorly as trigeminal ganglion and splits into Ophthalmic, Maxillary and Mandibular branches. Its fibres contain elements from 4 different nuclei
  • Mesencephalic nucleus (which is a nucleus of unipolar cell bodies similar to the dorsal root ganglion, with no synapse)
  • Chief sensory nucleus
  • Descending spinal nucleus
  • Motor nucleus: muscles of mastication
  • VI. Abducent Pons. The abducens(t) nerve, abducts the eye.
    VII Facial Pons. Muscles of facial expression (special visceral efferent): The innervation can be separated into the muscles of the upper part of the face and the muscles of the lower part of the face. The supranuclear input responsible for the movement of the upper facial musculature is a bilateral input from the cortex to the nucleus. The supranuclear input responsible for the movement of the lower facial musculature is only a contralateral input from the cortex to the facial nucleus
  • Innervates the lacrimal, submandibular, sublingual, and parotid glands (general visceral efferent)
  • supplies taste sensation to the anterior two-thirds of the tongue (special visceral afferent)
  • supplies sensation to the external ear (general somatic afferent).
  • VIII. Auditory Pons
    IX. Glossopharyngeal Medulla
    X. Vagus Medulla
    XI. Spinal accessory Medulla
    XII. Hypoglossal Medulla
    CN I: Olfactory
    • Test each nostril in turn with orange peel or coffee, vanilla, peppermint. Do not use smelling salts.
    • Affected in meningioma, frontal tumour , An early sign in Parkinson’s disease and perhaps some dementias
    CN II: Optic nerve (covered elsewhere)
    • Visual acuity
    • : Use finger counting, newspaper print ideally a Snellen chart
    • Visual fields
    • : by confrontation
    • Pupil size
      • Large:mydiasis
      • Small: Miosis
    • Pupil response to light
    • Pupil response to accommodation
    • Ophthalmoscopy
    • : look at retina
    CN III, IV, VI: Oculomotor, Trochlear, Abducens - see eye section
    • Look at pupils: shape, relative size, ptosis.
    • Shine light in from the side to gauge pupil's light reaction.
    • Assess both direct and consensual responses.
    • Assess afferent pupillary defect by moving light in arc from pupil to pupil.
    • Follow hand with eyes – placing a hand on head usually stops head moving. Do an H pattern.
    • Look for failure of the movement, nystagmus [pause to check it during upward/ lateral gaze] and ask about diplopia
    • Convergence by moving finger towards the bridge of pt's nose.
    • Test accommodation by pt looking into the distance, then a finger 10cm from the nose.
    CN V: Trigeminal
    • Basics: Mixed sensory (face, gums, teeth, cornea, sinuses) and motor nerve (mastication muscles)
    • Largest of the cranial nerves. Several brainstem nuclei.
    • Examination: Corneal reflex: patient looks up and away as you touch the cornea with a wisp of cotton wool. Look for afferent blink (VII) reflex in both eyes, ask if could feel it.
    • Facial sensation: sterile sharp item on forehead, cheek, jaw. Occiput and angle of jaw are supplied by C2. Repeat with a dull object. Ask to report sharp or dull. If abnormal, then temperature [heated/ water-cooled tuning fork], light touch [cotton].
    • Motor: pt opens mouth, clenches teeth (pterygoids). Palpate temporal, masseter muscles as they clench. Test jaw jerk: Finger on tip of the jaw. Grip patellar hammer halfway up shaft and tap finger lightly. Usually, nothing happens, or just a slight closure. If increased closure, think UMNL, esp pseudobulbar palsy.
    • Lesions seen with brainstem vascular disease, posterior fossa tumour s, herpes simplex and zoster infections, MS can cause neuralgia, Trigeminal neuralgia dealt with later on
    CN VII: Facial
    • Basics: Nucleus lies in the pons
    • Examination: Inspect facial droop or asymmetry. Subtle weaknesses may not be apparent until tested. Loss of nasolabial fold on the affected side. Unable to close eye or attempts to close and eye elevates (Bell's sign).
    • Facial expression muscles: pt looks up and wrinkles forehead. Examine wrinkling loss.
    • Feel muscle strength by pushing down on each side [UMN preserved because of bilateral innervation].
    • Pt shuts eyes tightly: Try to open, compare each side.
    • Pt grins, ask patient to whistle, puff cheeks. Ask to close your mouth and try to move lips apart.
    • Corneal Blink reflex already done. See CN V
    • Causes: LMN - Bells palsy, parotid tumour , Herpes Zoster (Ramsay Hunt syndrome with vesicles in outer ear) UMN - Stroke, SOL
    CN VIII: Vestibulocochlear
    • Basics : Hearing, Balance
    • Nucleus in the Pons
    • Rub one hand's fingers with noise on one side, another hand noiselessly. Ask pt. which ear they hear you rubbing. Repeat with louder intensity, watching for abnormality.
    • Weber's test: Lateralization. 512/ 1024 Hz [256 if deaf] vibrating fork on top of patients head/ forehead. "Where do you hear sound coming from?" Normal reply is midline.
    • Rinne's test: Air vs. Bone Conduction: 512/ 1024 Hz [256 if deaf] vibrating fork on mastoid behind the ear. Ask when stop hearing it. When stop hearing it, move to the patients ear so can hear it. Normal: air conduction [ear] better than bone conduction [mastoid].
    • If indicated, look at external auditory canals, eardrums.
    CN IX, X: Glossopharyngeal, Vagus
    • Basics: Both Lie in the medulla
    • Examination Voice: hoarse or nasal. Pt. swallows, coughs (bovine cough: recurrent laryngeal). >
    • Examine palate for uvular displacement. (unilateral lesion: uvula drawn to normal side).
    • Pt says "Ah": symmetrical soft palate movement.
    • Gag reflex [sensory IX, motor X]: Stimulate back of throat each side. Normal to gag each time.
    CN XI: Accessory
    • Basics: Lies in the medulla
    • Examination: From behind, examine for trapezius atrophy, asymmetry.
    • Pt. shrugs shoulders (trapezius).
    • Pt. turns head against resistance: watch, palpate SCM on the opposite side.
    CN XII: Hypoglossal
    • Basics: Lies in the medial medulla
    • Examination: Listen to articulation.
    • Inspect tongue in mouth for wasting, fasciculation.
    • Protrude tongue: unilateral deviates to the affected side.