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Finals > Exam 2 Material (cranial Nerves) > Flashcards

Exam 2 Material (cranial Nerves) Flashcards

1
Q 
On
Occasion
Our
Trusty
Truck
Acts
Funny
Very
Good
Vehicle
Any
How
A
  1. Olfactory
  2. Optic
  3. Oculomotor
  4. Trochlear
  5. Trigeminal
  6. Abducens
  7. Facial
  8. Vestibulocochlear
  9. Glossopharyngeal
  10. Vagus
  11. Spinal Accessory
  12. Hypoglossal
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2
Q

CN 1 exits skull through?

A

Cribriform plate

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3
Q

CN 2 exits through?

A

Optic canal

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4
Q

CN 3, 4, 6 and 5 V1 exit through?

A

Superior orbital fissure

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5
Q

CN 5 V2 exits through?

A

Foramen rotundum

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6
Q

CN 5 V3 exits through?

A

Foramen ovale

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7
Q

CN 7 and 8 exit through?

A

Internal auditory canal/acoustic meatus

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8
Q

CN 9,10,11 exit through?

A

Jugular foramen

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9
Q

CN 12 exits through

A

Hypoglossal canal

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10
Q

The brainstem consists of what 3 things?

The bulb consists of what 2 things?

A

Midbrain, pons, medulla

Pons and medulla

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11
Q

The _________ tract connects the motor cortex with the brainstem motor nuclei neurons via the ____ of the internal capsule.

A

Corticobulbar

Genu (knee)

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12
Q

______ palsy is a flaccid paralysis of the LMN units of any or all of the cranial nerves.

A

Bulbar palsy

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13
Q

______ _______ generally refers to signs and symptoms of bilateral impairment of the lower cranial nerve motor neurons (CN 9, 10, 11, 12) causing difficulty chewing, swallowing, regurg, choking, slurred speech,weakness of the soft palate, and absent gag reflex.

A

Bulbar palsy

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14
Q

_______ _______ is a similar syndrome secondary to an UMN lesion ( ie: hemorrhage or infarction of the cortex or upper motor pathway in the internal capsule)

A

Pseudobulbar palsy

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15
Q

Generally, the corticobulbar tracts innervate the ______ and ______ cranial nerve nuclei.

A

Ipsilateral

Contralateral

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16
Q

_____ and _____ are projected to the contralateral cerebral cortex.

A

Pain and temp

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17
Q

____ and ____ are projected bilaterally to both the contralateral and ipsilateral cerebral cortices.

A

Pressure and touch

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18
Q

Cavernous sinus:
top to bottom OTOM
medial to lateral CAT

A

Oculomotor 3
Trochlear 4
Ophthalmic 5 V1
Maxillary 5 V2

Internal Carotid artery
Abducens
Trochlear/Trigem

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19
Q

parasympathetic components of CN
(Remember, the parasympathetic CN’s are 3, 7, 9, 10)

CN 2, 3 pathway and PSNS function

A

Light enters eye: CN 2

Midbrain (Edinger-Westphal nucleus)>ciliary ganglion>eye>pupil constriction through ciliary body

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20
Q

CN 7 PSNS pathways

A

CN 7

Pons>Pterygopalatine ganglion>lacrimal gland and nasal gland>tears and mucus

Pons>submandibular ganglion>submandibular and sublingual glands>salivation

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21
Q

CN 9 PSNS pathway

A

CN 9:

Medulla>otic ganglion>parotid gland>salivation

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22
Q

CN 10 pathways

A

CN 10:

No ganglion>directly innervate effector organs
Heart: slows HR, decreases contraction
Bronchial: bronchoconstricts
Stomach/small intestine/large intestine: digestion, increased blood flow and motility

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23
Q

Sympathetic components of the cranial nerves

Eye
Eyelid
Facial skin

A

Eye: pupil dilation (mydriasis) of Iris through dilator pupilae
Eyelid: retraction of eyelid through levator palpebrae superioris muscle
Facial skin: sweat glands of face

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24
Q

CN 1 enters nose through what plate of what bone?

A

Cribriform plate

Ethmoid

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25
Q

CN 2 optic serves as ____ limb of pupillary light reflex and ______.

A

Afferent

Accommodation

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26
Q

CN 2 pupillary light reflex and accommodation are via the ______-_______ ________ in the midbrain

A

Edinger-westphal nucleus

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27
Q

CN 2 lesions can cause ______ and ______ abnormalities.

A

Blindness

Pupillary abnormalities

28
Q

CN 2 vision concepts

Ipsilateral blindness:
Bitemporal hemianopia:
R or L hemianopia with macular sparing:

A

Ipsilateral blindness: complete loss of vision in one eye> damage occurs at optic nerve between eye and optic chiasm

Bitemporal hemianopia: complete loss of peripheral vision>damage occurs in optic chiasm (ex: pituitary tumor)

R/L hemianopia with macular sparing: can only see either right or left side for both eyes, with central vision spared>damage occurs in occipital region

29
Q

White reflex in a kid makes you think of?

A

Retinoblastoma

30
Q

Efferent limb of pupillary light reflex?

A

CN 3

31
Q

PSNS of CN 3 causes the pupil to _____ and the lens to become ________ for ______ vision.

A

Constrict
Convex
Near vision

32
Q

SNS of CN3 causes the pupil to _____.

A

Dilate

33
Q

Extraocular muscles are ?

A

CN 3,4,6
Oculomotor ( inferior oblique, medial rectus, superior rectus, inferior rectus)
Trochlear (superior oblique)
Abducens (lateral rectus)

34
Q

CN 3 innervates the ______ muscle for _____ for near vision.

A 
Ciliary muscle (that attaches to iris)
Accommodation
35
Q

SNS of CN 3 via sympathetic ganglia _______ the pupil

A

Dilates (mydriasis)

Dilator pupillae muscle

36
Q

Horner’s syndrome is an SNS malfunction of the sympathetic trunk, which can be from compression, such as a lung tumor, neck tumor, aortic dissection. What are the 3 signs?

A

Miosis, anhydrosis, ptosis

37
Q

What 3 things happen during a “near reaction”?

A
  1. Convergence of the eyes mediated by EOM’s
  2. Pupillary constriction (miosis) both direct and consensual
  3. Accommodation (of lens) parasympathetic fibers contract the ciliary muscles, relaxing suspenseful ligaments and increasing the convexity of the lenses allowing focusing on near objects
38
Q

CN 3 motor nerve originates from where? Goes through the _____ _____, and then through the ____ _____ _____.

A

Midbrain
Cavernous sinus
Superior orbital fissure

39
Q

CN 3 innervates the superior and inferior rectus, inferior oblique, and medial rectus. What other muscle does it innervate?

A

Levator palpebrae (raises eyelid)

40
Q

Directions the eye muscles move the eye starting from superior rectus going clockwise:

A 
SR: up and inwards
MR: medially 
IR: down and inwards
SObq: down and out
LR: laterally
IObq: up and out
41
Q

CN 3 does what 4 things?

A
  1. Moves the eye
  2. Constricts the pupil (efferent pupillary light reflex)
  3. Accommodates the lens for near vision
  4. Converges the eyes
42
Q

The ____ _____ ____ is found in the brain stem and links the eye muscle nerves of CN 3,4,6, as well as CN 8. This input, along with peripheral nerve proprioception gives information about the direction the eyes should move.

A

Medial longitudinal fasciculus

43
Q

In Multiple sclerosis, injury to the medial longitudinal fasciculus causes what three things?

A
  1. Ophthalmoplegia (paralysis)
  2. Diplopia (dbl vision)
  3. Nystagmus (eyes snapping back and forth)
44
Q

CN 3 lesions are seen with transtentorial or ______ herniation, usually from increase in ICP, causing _____ and ______ pupils.

A

Uncal herniation

Fixed and dilated pupils

45
Q

Masses such as _______ and _____ can press on CN 3 in brainstem or cavernous sinus. Oculomotor paralysis causes the eyes to look ____ and ____. It also causes double vision because the eyes are looking in separate directions. Finally, paralysis of what muscle leads to a droop eyelid (ptosis)?

A

Aneurysms and Tumors
Down and out (lateral strabismus)
Levator palpebrae

46
Q

CN 4 trochlear does what?

A

Innervates Superior Oblique (SO4)
Depresses, intorts, abducts
(Down and out)

47
Q

When there is damage to CN 3, the trochlear and abducens take over, which is why the eye goes ____ and ___.

A

Down and out

48
Q

If there is damage to the trochlear nerve, the pt can’t look?

A

You guessed it gang, down and out

49
Q

Lesion to the trochlear nerve can cause the pt to be unable to look down and out, but it also can lead to _____ diplopia, causing the pt to tilt their head.

A

Vertical

50
Q

With damage/lesion to trochlear nerve, the eye can’t look down and out and has a _____ strabismus, where the eye looks out and up.

A

Vertical strabismus

51
Q

Trigeminal exits where?
V1
V2
V3

A

Superior orbital fissure
Foramen rotundum
Foramen ovale

52
Q

Which two parts of CN 5 go through cavernous sinus?

A

V1/V2 (Oculomotor, Maxillary)

53
Q

The Trigeminal nerve exits the brain stem from the pons and goes to the Trigeminal ganglion in _________ cave.

A

Meckel’s cave (not Black Bart’s cave, that’s at Casa Bonita, highly recommend their food)

54
Q

Trigeminal nerve is responsible for what?

A
  1. Facial sensation (V1,2,3)
  2. Mastication with masseter and pterygoid muscles
  3. Sensation to ant. 2/3 of tongue (not taste, that’s CN 7)
55
Q

Trigeminal CN 5 V1 is afferent limb of _____ reflex.

A

Corneal blink reflex (CN 7 is efferent via chorda tympani)
*important to note this is a direct and consensual reflex going from the eye via CN 5 V1, to the Edinger-Westphal nucleus in the midbrain, and coming back to the eye via CN 7, causing a blink reflex.

56
Q

Trigeminal CN 5 ____ is mandibular and responsible for pain/temp/touch/position sense from ant. 2/3 of tongue (pizza mouth).

A

V3 (posterior 1/3 is CN 9)

57
Q

Cavernous sinus syndrome leads to paralysis of CN 5 ____, ___, CN __, and CN ___.

A

V1, V2
CN 3
CN 4

58
Q

Lesions to CN 5 can also cause loss of sensation to palate and roof of oropharynx, in addition to face, tongue, eye, forehead. Lesions to V3 can cause _____ ______ of the muscles of mastication, which are?

A

Flaccid paralysis

Masseter/pterygoid muscles

59
Q

_____ is secondary to a paralyzed tensor tympani muscle, innervated by CN 5, which dampens sounds.

A

Hyperacusis

60
Q

___ ______, a recurrent stabbing pain leading to twitching, is from a lesion to CN 5.

A

Tic Douloureux

61
Q

Which nerve is affected in an orbital blowout fracture leading to infraorbital numbness?

A

CN 5 V2

62
Q

What is the nerve dentists numb in the back of your mouth to block CN 5 mandibular V3?

A

Inferior alveolar nerve (a branch of V3)

63
Q

The _______ nerve, a branch of V3, is a mixed nerve also carrying the chorda tympani of CN 7.

A

Lingual nerve

64
Q

Along with the masseter and pterygoid muscles of mastication, V3 also innervates this muscle found along the side of the skull.

A

Temporalis muscle

65
Q

Parasympathetic innervation of CN 7 piggybacks on V3. The _____ _____ provides taste to ant. 2/3 of tongue via lingual nerve. PS fibers of CN 7 also innervate the ____ and ______ glands for salivation.

A

Chorda tympani
Submandibular
Sublingual

66
Q

Abducens nerve, CN 6, does what? Lesions to this nerve cause what kind of diplopia?

A 
Abducts the eye laterally
Horizontal diplopia (CN 4 trochlear lesion causes vertical)

Finals (24 decks)

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