This link directory works to subvert the aims of Section K1(i) from the 2017 CICM Primary Syllabus, which asks the exam candidate to "describe the anatomy of cranial nerves relevant to brainstem reflexes". It is literally the first item in the syllabus, and it remains completely forgotten by the CICM First Part examiners, with absolutely no questions about it in any of the past exam papers. On the other hand, the Second Part Exam is practically lousy with them. An incomplete list of representative questions is as follows:
- Question 21.2 from the first paper of 2014 - CN IX, CN XII, CN VII, CN VI.
- Question 21.3 from the first paper of 2014 - CN VI
- Question 10.1 from the second paper of 2013 - Horner's Syndrome
- Question 15.3 from the second paper of 2012 - Fundoscopy
- Question 26.2 from the second paper of 2011 - CN III palsy
- Question 25.2 from the first paper of 2011 - Horner's Syndrome
- Question 25.4 from the first paper of 2011 - Oculocephalic reflex
- Question 24.4 from the first paper of 2009 - Examination of eye movements
- Question 7.2 from the second paper of 2008 - Visual fields and lesions
- Question 5 from the first paper of 2007 - Pupil reactivity and diameter
- Question 10 from the first paper of 2003 - Causes of Horner's Syndrome
The topic of cranial nerve anatomy and reflex examination is a complicated one, which requires the reader to memorise all sorts of tabulated material. The material itself also resists being learned because of the fact that it is completely illogical, i.e. it is impossible to learn some sort of theory and then apply it to all cases - instead, each bit of information needs to be memorised, because there is no unifying principle describing them. From this, a heretical statement follows: that this part of the CICM syllabus document can be safely ignored until after the primary exam. No one is saying that the cranial nerves are unimportant, but pragmatic self-preservation instincts of the learner should direct them to leave them alone, focusing instead on topics like the production of the CSF, which for some reason seems to come up in almost every second paper.
Still, not wanting to leave the trainee without some direction, the following chapters from the Second Part preparation section will be of interest:
- Examination of the cranial nerves
- Examination and lesions of the olfactory nerve (CN I)
- Examination of visual acuity and blindness (CN II)
- Fundoscopy: characteristic findings (CN II)
- Examination of pupil reactivity and diameter (CN II, III)
- Visual fields and lesions of the visual pathways (CN II)
- Examination of eye movements (CN III, IV, VI)
- Lesions of the oculomotor nerve (CN III)
- Lesions of the trochlear nerve (CN IV)
- Lesions of the abducens nerve (CN VI)
- Disorders of conjugate gaze
- Lesions of the trigeminal nerve (CN V)
- Lesions of the facial nerve (CN VII)
- Corneal reflex (CN V, VII)
- Oculocephalic and cold caloric reflexes (CN III, IV, VI and VIII)
- Lesions of the vestibulocochlear nerve (CN VIII)
- Lesions of the glossopharyngeal and vagus nerves (CN IX and X)
- Lesions of the accessory nerve (CN XI)
- Lesions of the hypoglossal nerve (CN XII)
- Horner's Syndrome
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