Bell's palsy is disorder of - - RUHS, Jaipur, PB B.Sc Nursing Entrance-2023

RUHS, Jaipur, PB B.Sc Nursing Entrance-2023

Medical & Surgical Nursing

Easy

Appeared in: RUHS, Jaipur, PB B.Sc Nursing Entrance-2023

Explanation

Bell's palsy is an acute peripheral facial nerve palsy, meaning it affects the seventh cranial nerve (CN VII), also known as the facial nerve.
The facial nerve controls the muscles of facial expression. Inflammation and swelling of this nerve lead to the characteristic unilateral facial weakness or paralysis.
Symptoms include drooping of the mouth, inability to close the eyelid, and loss of the nasolabial fold on the affected side.
While the cause is often idiopathic, it is strongly associated with the reactivation of viruses like herpes simplex virus (HSV).

Option A: The fifth cranial nerve (trigeminal nerve) is primarily responsible for facial sensation and muscles of mastication (chewing). Its most common disorder is trigeminal neuralgia, which causes intense facial pain, not paralysis.
Option C: The eighth cranial nerve (vestibulocochlear nerve) is responsible for hearing and balance. Disorders of this nerve lead to symptoms like vertigo, tinnitus, and hearing loss.
Option D: The tenth cranial nerve (vagus nerve) has many functions, including parasympathetic control of internal organs and motor control of the larynx and pharynx. Damage can cause hoarseness, difficulty swallowing (dysphagia), or affect heart rate, but not facial expression paralysis.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Pathophysiology of Bell's Palsy and associated cranial nerve as background academic context rather than a clinical decision trigger.
A key nursing priority for patients with Bell's palsy is protecting the affected eye. Since the patient cannot blink or close the eye completely, the cornea is at high risk for drying, ulceration, and permanent damage. Instilling artificial tears and applying an eye patch are critical interventions.
Patient education is vital. Nurses should reassure patients that Bell's palsy is not a stroke and that recovery is likely, although it may take several weeks to months. This helps alleviate significant patient anxiety about their sudden change in appearance.
What if? If the facial palsy is accompanied by a vesicular rash in the ear canal, the diagnosis is likely Ramsay Hunt syndrome (caused by varicella-zoster virus), not idiopathic Bell's palsy. This is a more severe condition requiring immediate antiviral treatment in addition to steroids, and the prognosis for full recovery is less favorable.

How to Approach the Question

First, identify the key term in the question stem, which is 'Bell's palsy'.
Access your knowledge base regarding this specific neurological condition. Recall its definition, primary symptoms, and underlying pathophysiology.
The core feature of Bell's palsy is unilateral facial paralysis. Your goal is to link this symptom to the correct cranial nerve.
Systematically evaluate the options provided, which are all cranial nerves. Consider the primary function of each nerve: V (sensation/chewing), VII (facial expression), VIII (hearing/balance), and X (visceral/pharyngeal).
Match the primary symptom of Bell's palsy (paralysis of facial expression muscles) with the function of the facial nerve (CN VII).
Eliminate the other options because their functions do not align with the clinical presentation of Bell's palsy.

Concept Tested & Keywords

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E6 Medicine Harrison 22e Part 2 p. 1458-1460

E6 Nelson Textbook of Pediatrics(2024) — Volume 2 p. 1714-1716

E6 Nursing Brunner Adult Health 3SA Vol 2 Part 2 p. 140-142