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13 june fnp


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13 june fnp

  2. 2. Anatomy <ul><li>7 th cranial nerve </li></ul><ul><li>Facial nerve is a mixed nerve, having a motor root and a sensory root. </li></ul>
  3. 3. Facial Nerve Nuclei <ul><li>3 nuclei </li></ul><ul><li>Motor nucleus – lower pons below 4 th ventricle </li></ul><ul><li>Parasympathetic (Superior salivatory ,lacrimal nucleus) – dorsal to motor N </li></ul><ul><li>Sensory /N of tractus solitarius </li></ul>
  4. 6. Anatomy: Course <ul><li>Motor fibers originate … </li></ul><ul><li>Winds around … </li></ul><ul><li>Sensory roots </li></ul><ul><li>Emerge from the ant.surface of the brain b/w pons and med obl </li></ul><ul><li>laterally in PCF with 8 th nerve </li></ul><ul><li>Enters the IAM. </li></ul><ul><li>Then enters facial canal </li></ul><ul><li>Geniculate ganglion turns above the promontry. </li></ul><ul><li>In the middle ear cavity descend behind the pyramid </li></ul><ul><li>Emerges from the stylomastoid foramen </li></ul><ul><li>Finally divides into terminal branches. </li></ul>
  5. 9. Terminal branches
  6. 11. Bell’s Palsy
  7. 12. <ul><li>one of the most common neurologic disorders affecting the cranial nerves. </li></ul><ul><li>abrupt, unilateral, peripheral facial paralysis without a detectable cause. </li></ul>
  8. 13. Incidence: <ul><li>The incidence of Bell palsy in the United States is approximately 23 cases per 100,000 persons. </li></ul><ul><li>Internationally: The incidence is the same as in the United States. </li></ul>
  9. 14. Demographics: <ul><li>Race: slightly higher in persons of Japanese descent. </li></ul><ul><li>Sex: No difference exists </li></ul><ul><li>Age: highest in persons aged 15-45 years. Bell palsy is less common in those younger than 15 years and in those older than 60 years. </li></ul>
  10. 15. Pathophysiology: <ul><li>Main cause of Bell's palsy is latent herpes viruses which are reactivated from cranial nerve ganglia </li></ul>
  11. 16. History: <ul><li>The palsy is often sudden in onset and evolves rapidly, with maximal facial weakness developing within two days. </li></ul><ul><li>Associated symptoms may be decreased production of tears, and altered taste. </li></ul>
  12. 17. Physical exam: <ul><li>Bell's palsy causes a peripheral lower motor neurone palsy, </li></ul><ul><li>which manifests as the unilateral impairment of movement in the facial muscles, drooping of the brow and corner of the mouth, and impaired closure of the eye and mouth. </li></ul>
  13. 19. Management, Eye care <ul><li>It focuses on protecting the cornea from drying and abrasion due to problems with lid closure and the tearing mechanism. </li></ul><ul><li>Lubricating drops should be applied </li></ul>
  14. 21. <ul><li>Thanks </li></ul>