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Principles of Clinical Anatomy > 1 CRANIAL NERVES > Flashcards

1 CRANIAL NERVES Flashcards

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1
Q

6

What are the cranial nerves?

On occasion our trusty truck acts funny, very good vehicle any how

A

Olfactory I, optic II, oculomotor III, trochlear IV, trigeminal V, abducens VI, facial VII, vestibulocochlear VIII, glossopharyngeal IX, vagus X, accessory XI, hypoglossal XII

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2
Q

Which cranial nerves are sensory and which are motor?

A

Some say marry money but my brother says big brains matter most
S = sensory; M = motor; B = both

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3
Q

What are the cranial nerves?

A

bundles of sensory or motor fibres that innervate muscles/glands, relay sensory information or perform a combination of both

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4
Q

CN1 foramen

A

Foramina within
cribriform plate
(ethmoid bone)

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5
Q

CN1 function

A

Smell

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6
Q

CN2 foramen

A

Optic canal

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7
Q

CN2 function

A

Vision

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8
Q

CN3 foramen

A

Superior orbital
fissure

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9
Q

CN3 function

A

Ciliary muscles,
sphincter pupillae, all
extrinsic muscles of the
eye except superior
oblique and lateral
rectus

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10
Q

CN4 foramen

A

Superior orbital
fissure

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11
Q

CN4 function

A

Superior oblique

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12
Q

CN5 branches

A

Opthamic branch (V1)
Maxillary Branch (V2)
Mandibular Branch (V3)

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13
Q

CN5 foramen

A

V1 - Superior orbital
fissure
V2 - Foramen Rotundum
V3 - Foramen Ovale

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14
Q

CN5V1 function

A

Sensation to cornea,
forehead, scalp, nose,
mucosa of nasal cavity
and paranasal sinuses

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15
Q

CN5V2 function

A

Sensation to skin
overlying maxilla,
including upper
lip, maxillary teeth,
mucosa of nose,
maxillary sinuses,
palate.

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16
Q

CN5V3 function

A

Sensation to skin
overlying mandible
including lower lip,
mandibular teeth, TMJ,
mucosa of mouth,
anterior 2/3rds of
tongue.

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17
Q

CN6 foramen

A

Superior orbital
fissure

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18
Q

CN6 function

A

Lateral rectus

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19
Q

CN7 foramen

A

Internal auditory
meatus

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20
Q

CN7 function

A

Special sensory: taste to
anterior 2/3rds of
tongue (via chorda
tympani).
Motor: muscles of facial
expression, stapedius,
stylohyoid, posterior
belly of digastric.
Parasympathetic
innervation of
submandibular,
sublingual salivary
glands, lacrimal gland.

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21
Q

CN8 foramen

A

Internal auditory
meatus

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22
Q

CN8 function

A

Hearing and vestibular
sensation

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23
Q

CN9 Foramen

A

Jugular foramen

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24
Q

CN9 function

A

Sensation to posterior
1/3rd of tongue.
Special sensory: taste to
posterior 1/3rd Of
tongue. Visceral
innervation of carotid
body and sinus, middle
ear and pharynx.
Motor to
stylopharyngeus
(swallowing).
Parasympathetic
innervation of parotid
gland.

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25
CN10 foramen
Jugular foramen
26
CN10 function
Sensation to auricle, external auditory meatus. Visceral sensation to pharynx, larynx, trachea, bronchi, heart, oesophagus, stomach, intestine to left colic flexure. Parasympathetic innervation of smooth muscle/glands of trachea, bronchi, digestive tract, conduction system of heart. Motor to muscles of pharynx, palatoglossus, intrinsic muscles of larynx, muscles of palate (except tensor veli palatini), striated muscle of upper 2/3rds of oesophagus.
27
CN11 foramen
Jugular foramen
28
CN11 function
Motor to trapezius, sternocleidomastoid.
29
CN12 foramen
Hypoglossal canal
30
CN12 function
Motor to intrinsic and extrinsic muscles of tongue (except palatoglossus)
31
What is this and what are its principle components?
Optic foramen - opening to the optic canal. *CN2, ophthalmic artery
32
What is this and what are its principle components?
Sylomastoid foramen *CN7
33
What is this and what are its principle components?
Jugular foramen *CN9,10,11 and internal jugular vein.
34
What is this and what are its principle components?
Hypoglossal canal *CN12
35
What is this and what are its principle components?
Superior orbital fissure *CN3, CN4, CN6, Ophthalmic branch of CN5
36
What is this and what are its principle components?
Internal acoustic meatus *CN7, CN8, labyrinthine artery
37
What innervates the dura?
Sensory innervation to the dura mater: **CN V and CN X**​
38
What is this and what are its principle components?
Foramen rotundum * maxillary trigeminal (CN5V2)
39
What is this and what are its principle components?
Foramen Ovale *Mandibular trigeminal (CN5V3)
40
41
42
Which sensory CN nuclei are in the midbrain?
Mesencephalic nucleus of trigeminal
43
Which sensory CN nuclei are in the Pons?
Principal sensory nucleus of trigeminal (CNV & IX), Vestibulocochlear (CNVII).
44
Which sensory CN nuclei are in the Medulla?
Spinal trigeminal nucleus (CNV, VII, IX and X), Nucleus solitarius (CNVII and IIX – Taste; CNX – visceral sensation, chemo- and baroreceptors), Vestibulocochlear
45
Which motor CN nuclei are in the midbrain?
Oculomotor and Trochelar
46
Which motor CN nuclei are in the Pons?
Trigeminal motor, abducens, facial,
47
Which motor CN nuclei are in the Medulla?
Nucleus ambiguus (CNIX and X), Accessory, Hypoglossal
48
Which autonomic CN nuclei are in the midbrain?
Edinger-Westphal (CNVII)
49
Which autonomic CN nuclei are in the Medulla?
Salivatory nucleus (CNVII and IX), Dorsal motor nucleus of Vagus (cardiac muscles and smooth muscle & glands of Resp & GI tracts)
50
What are the extraocular muscles?
The extra-ocular muscles of the orbit are the levator palpebrae superioris, four recti (superior, inferior, medial and lateral) and two obliques (superior and inferior).
51
What is the innervation of the Levator Palpebrae?
Oculomotor nerve + Sympathetic fibres
52
Which extraocular muscles does the oculomotor nerve supply?
Levator palpebrae superioris, superior rectus, inferior rectus, medial rectus, inferior oblique.
53
What innervates the lateral rectus?
Abducens nerve
54
What innervates the superior oblique?
Trochlear nerve
55
What are two things that can occur with a facial nerve lesion?
Bell's palsy Hyperacusis
56
How is the function of the hypoglossal nerve tested?
Asked to protrude the tongue Observe speech
57
What would happen if there was a lesion on one side of the hypoglossal nerve and a patient was asked to protrude the tongue?
Tongue deviates towards the side of the lesion (Normally, simultaneous contraction of the paired genioglossus muscles cause the tongue to protrude straight and forward)
58
What is the clinical test for CN1? Why is it important to test notrils separately?
Ask subject to identify various common cells impregnated into cotton wool. The olfactory tract remains unilateral until they reach to cerebral cortex.
59
What is the intracranial course of CN3?
Arises from midbrain, passes through the lateral wall of the cavernous sinus then entres the orbit via the superior orbital fissure.
60
What is the intracranial course of CN4?
Originates from mid-brain. The only nerve to emerge from the dorsal aspect of the brainstem. Passess through cavenous sinus and lateral aspect of superior orbital fissure to reach the orbit.
61
What is the intracranial course of CN6?
Originates from Pons and exits brainstem at pons-medulla junction. Passess through cavernous sinus (MEDIAL wall where it lies on lateral aspect of internal carotid artery) and enters orbit via superior orbital fissure.
62
What is the role of the medial longitudinal fasciculus w/ regards to eye movement?
It is a prominent bundle of nerve fibres containing the interstitial mucleus of Cajal, responsible for oculomotor control, head posture, and verticle eye movement. * Connects interneurons of abducens nucli w/ motor neurons of contralateral oculomotor nucles --> coordination of hornizontal movement. * Contains fibres projecting from vestibular nuclei to oculomotor + trochlear nuclei + interstitial nucleus of Cajal --> coordinates eye and head movements.
63
What is the role of the cerebellum in the control of eye movement? What areas are involved?
It is a network hub for optimising eye movements. Flocculus/ paraflocculus (tonsil) complex Nodules/ ventral uvula Dorsal vermis/ posterior fastigal nucleus.
64
What is the role of the Flocculus/ paraflocculus (tonsil) complex in controlling eye movement?
primarily high-frequency, transient vestibular responses, and also smooth pursuit maintenance and steady gaze holding
65
What is the role of the nodules/ uvula in the control of eye movement?
primarily low-frequency, sustained vestibular responses
66
What is the role of teh dorsal vermis/ posterior fastigal nucleus in the control of eye movement?
primarily accuracy of saccades.
67
What is the role of the vestibular system in the control of eye movement?
Variety of functions contributing to sense of proprioception and equilibrium. E.g. the vestibulo-ocular and vestibulospinal reflexes. (the sensation of orientation and acceleration of the head in any direction w/ associated compensation in eye movement and posture respectively)
68
What is trigeminal neuralgia?
Trigeminal neuralgia is characterized by sudden, brief, and excruciating facial pain attacks in one or more of the CNV branches, leading to a severe reduction in the quality of life of affected patients.
69
What is trigeminal neuralgia caused by?
Classic trigeminal neuralgia is associated with neurovascular compression in the trigeminal root entry zone, which can lead to demyelination and a dysregulation of voltage-gated sodium channel expression in the membrane. (compression of trigemincal nerve)
70
What is Bell's Palsy?
The Facial nerve VII lesion (Bell’s palsy) Paralysis of muscles of facial expression. Hyperacusis due to loss of stapedius.
71
What are the signs of damage to the oculomotor nerve (III)?
- Diplopia (double vision) - Ptosis - Pupil dilation - DOWN and OUT movement of eye (bc unopposed left superior oblique and lateral rectus muscles)
72
What are the signs of damage to the trochlear nerve (IV)?
Diplopia when looking downward and medially bc affected eye cannot move in and down
73
What are the signs of damage to the abducens nerve (VI)?
Loss of lateral movement of eye --> diplopia when looking to affected side bc lateral rectus paralysed
74
What are the signs of damage to the facial nerve (VII)?
Facial muscle paralysis (CN7 --> muslces for facial expression) Can cause facial asymmetry, impaired eye closure, speech disturbance, eating difficulties, emotional/ social side-effects.

Principles of Clinical Anatomy (38 decks)

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