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NE Exam 1 > Head Neurology > Flashcards

Head Neurology Flashcards

1
Q

What are the 3 divisions of the Trigeminal Nerve (CN V)?

A

(1) V1 - Ophthalmic Division
(2) V2 - Maxillary Division
(3) V3 - Mandibular Division

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2
Q

What are the 5 cutaneous nerves that are derived from the Ophthalmic Nerve (CN V1)?

A

(1) Supra-orbital
(2) Supratrochlear
(3) Lacrimal
(4) Infratrochlear
(5) External Nasal

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3
Q

Ophthalmic Nerve (CN V1)

A
  • Provides cutaneous innervation from forehead to the tip of the nose
  • Sensory only
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4
Q

Maxillary Nerve (CN V2)

A
  • Provides cutaneous innervation from lateral nose, cheeks and maxillary region
  • Sensory only
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5
Q

Mandibular Nerve (CN V3)

A
  • Provides cutaneous innervation to the Mandible, lateral to the side of the head, anterior to the ear (also sensation to chin)
  • Mixed motor and sensory
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6
Q

Cutaneous innervation of the posterior head is from what nerve?

A

Posterior Rami of Cervical Spinal Nerves

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7
Q

Cutaneous innervation of the lateral head, posterior to the ear, is from what nerve?

A

Anterior Rami of Spinal Nerves

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8
Q

Cutaneous Nerve Derivatives of CN V1: Supra-Orbital N
- Origin:
- Course:
- Distribution:

A
  • Origin: Largest branch from bifurcation of Frontal N, approximately in the middle of orbital roof
  • Course: Continues anteriorly along the roof of the orbit, emerging via supra-orbital notch or foramen; ascends forehead, breaking into branches
  • Distribution: Mucosa of Frontal Sinus; skin and conjuctiva of middle superior eyelid; skin and pericranium of anterolateral forehead and scalp to vertex
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9
Q

Cutaneous Nerve Derivatives of CN V1: Supratrochlear N
- Origin:
- Course:
- Distribution:

A
  • Origin: Smaller branch from bifurcation of Frontal N, approximately in middle of orbital roof
  • Course: Continues anteromedially along roof of orbit, passing lateral to trochlea and ascending forehead
  • Distribution: Skin and conjuctiva of medial aspect of superior eyelid; skin and pericranium of anteromedial forehead
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10
Q

Cutaneous Nerve Derivatives of CN V1: Lacrimal N
- Origin:
- Course:
- Distribution:

A
  • Origin: Smallest branch from trifurcation of CN V1, proximal to superior orbital fissure
  • Course: Runs superolaterally through orbit, receiving secretomotor fibers via a communicating branch from the Zygomaticotemporal N
  • Distribution: Lacrimal Gland (secretomotor fibers); small area of skin and conjuctiva of lateral part of superior eye
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11
Q

Cutaneous Nerve Derivatives of CN V1: Infratrochlear N
- Origin:
- Course:
- Distribution:

A
  • Origin: Terminal branch (with Anterior Ethmoidal N) of Nasociliary N
  • Course: Follows medial wall of orbit, passing inferior to the trochlea
  • Distribution: Skin lateral to roof of nose; skin and conjuctiva of eyelids adjacent to medial canthus, lacrimal sac and lacrimal caruncle
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12
Q

Cutaneous Nerve Derivatives of CN V1: External Nasal N
- Origin:
- Course:
- Distribution:

A
  • Origin: Terminal branch of Anterior Ethmoidal N (of Nasociliary N)
  • Course: Emerges from nasal cavity by passing between nasal bone and lateral nasal cartilage
  • Distribution: Skin of nasal ala, vestibule, and dorsum of nose including apex
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13
Q

What are the 3 cutaneous nerves that are derived from the Maxillary Nerve (CN V2)?

A

(1) Infra-orbital
(2) Zygomaticofacial
(3) Zygomaticotemporal

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14
Q

Cutaneous Nerve Derivatives of CN V2: Infra-Orbital N
- Origin:
- Course:
- Distribution:

A
  • Origin: Continuation of CN V2 distal to its entrance into the orbit via the inferior orbital fissure
  • Course: Traverses infra-orbital groove and canal in orbital floor, giving rise to superior alveolar branches; emerges via infra-orbital foramen and divides into inferior palpebral, internal and external nasal, and superior labial branches
  • Distribution: Mucosa of maxillary sinus; premolar, canine, and incisor maxillary teeth; skin and conjuctiva of inferior eyelid; skin of cheek, lateral nose and anteroinferior nasal septum; skin and oral mucosa of superior lip
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15
Q

Cutaneous Nerve Derivatives of CN V2: Zygomaticofacial N
- Origin:
- Course:
- Distribution:

A
  • Origin: Smaller terminal branch (with zygomaticotemporal n) of Zygomatic N
  • Course: Traverses zygomaticofacial canal in zygomatic bone at inferolateral angle of orbit
  • Distribution: Skin on prominence of cheek
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16
Q

Cutaneous Nerve Derivatives of CN V2: Zygomaticotemporal N
- Origin:
- Course:
- Distribution:

A
  • Origin: Larger terminal branch (with zygomaticofacial n) of Zygomatic N
  • Course: Sends communicating branch to Lacrimal N in orbit; then passes to temporal fossa via zygomaticotemporal canal in zygomatic bone
  • Distribution: Hairless skin anterior part of temporal fossa
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17
Q

What are the 3 cutaneous nerves that are derived from the Mandibular Nerve (CN V3)?

A

(1) Auriculotemporal
(2) Buccal
(3) Mental

18
Q

Cutaneous Nerve Derivatives of CN V3: Auriculotemporal N
- Origin:
- Course:
- Distribution:

A
  • Origin: In infratemporal fossa via two roots from posterior trunk of CN V3 that encircle middle meningeal A
  • Course: Passes posteriorly deep to ramus of mandible and superior deep part of parotid gland, emerging posterior to TMJ
  • Distribution: Skin anterior to auricle and posterior 2/3rds of temporal region; skin of tragus and adjacent helix of auricle; skin of roof of external acoustic meatus; skin of superior tympanic membrane
19
Q

Cutaneous Nerve Derivatives of CN V3: Buccal N
- Origin:
- Course:
- Distribution:

A
  • Origin: In infratemporal fossa as sensory branch of anterior trunk of CN V3
  • Course: Passes between two parts of lateral pterygoid muscle, emerging anteriorly from cover of ramus of mandible and masseter, uniting with buccal branches of Facial N
  • Distribution: Skin and oral mucosa of cheek; buccal gingivae (gums) adjacent to second and third molars
20
Q

Cutaneous Nerve Derivatives of CN V3: Mental N
- Origin:
- Course:
- Distribution:

A
  • Origin: Terminal branch of Inferior Alveolar N (CN V3)
  • Course: Emerges from mandibular canal via mental foramen in anterolateral aspect of body of mandible
  • Distribution: Skin of chin; oral mucosa of inferior lip
21
Q

Ophthalmic Nerve (CN V1)

A
  • Superior division of the Trigeminal N
  • Smallest of the three divisions of CN V
  • Sensory
  • Enters the orbit through the Superior Orbital Fissure -> trifurcates into the frontal, nasociliary, and lacrimal nerves
  • Except for the external nasal nerve, the cutaneous branches of CN V1 reach the skin of the face via the orbital opening
22
Q

Branches of Ophthalmic N: Frontal N

A
  • Located between the Lacrimal and Nasociliary nerves
  • Largest branch of V1
  • Runs along the roof of the orbit toward the orbital opening, bifurcating midway into the cutaneous supra-orbital and supratrochlear nerves, distributed to the forehead and scalp
23
Q

Branches of Ophthalmic N: Lacrimal N

A
  • Most lateral of the nerves that branch off the Ophthalmic N
  • Smallest branch of V1
  • Primarily a cutaneous branch but also conveys some secretomotor fibers via a communicating branch from a ganglion associated with the maxillary n for innervation of the lacrimal gland
24
Q

Branches of Ophthalmic N: Nasociliary N

A
  • Most medial of the nerves that branch off the Ophthalmic N
  • Intermediate branch of V1
  • Supplies branches to the eyeball and divides within the orbit into the Posterior Ethmoidal, Anterior Ethmoidal, and Infratrochlear nerves that supply the cutaneous innervation of the external nose
25
Q

Maxillary Nerve (CN V3)

A
  • Intermediate division of the Trigeminal Nerve
  • Sensory
  • Leaves the cranium through the Foramen Rotundum
  • Enters the Pterygopalatine Fossa where it gives off branches to the Pterygopalatine Ganglion and continues anteriorly, entering the orbit through the Inferior Orbital Fissure
  • Gives off the Zygomatic N and passes anteriorly into the Infra-orbital Groove and Foramen as it gives rise to the Infra-orbital nerves
26
Q

What are the two terminal branches of the Zygomatic Nerve?

A

(1) Zygomaticofacial
(2) Zygomaticotemporal

27
Q

What nerve sends a communicating branch to convey secretomotor fibers to the Lacrimal N?

A

Zygomatic Nerve

28
Q

Where does the Maxillary N enter the orbit?

A

Through the Inferior Orbital Fissure

29
Q

Infra-orbital nerve gives off ___ branches, branches to the mucosa of the ___ sinus, and branches to the ___ and __ upper teeth.

A
  • Palatine
  • Maxillary
  • Middle
  • Anterior
30
Q

Mandibular Nerve (CN V3)

A
  • Inferior and largest division of the Trigeminal N
  • Passes through the Foramen Ovale
  • Has 3 sensory brancehs taht supply the area of skin of the mandible
  • Supplies the motor fibers to the muscles of mastication
  • Only division of CN V that carries motor fibers
31
Q

What are the 3 sensory branches of the Mandibular Nerve?

A
  • Auriculotemporal
  • Buccal
  • Mental
32
Q

En route to the skin, the Auriculotemporal N passes deep to the __ ___, conveying secretomotor fibers to it from the ___ ___

A
  • Parotid Gland
  • Otic Ganglion
33
Q

Great Auricular Nerve

A
  • Anterior rami C2-3
  • Ascends vertically across the SCM, posterior to the External Jugular Vein
  • Innervates skin overlying the angle of mandible and inferior lobe of auricle; parotid sheath
34
Q

Lesser Occipital Nerve

A
  • Anterior Ramus C2
  • Follows posterior border of SCM, ascends posterior to auricle
  • Innervates scalp posterior to the auricle
35
Q

Greater Occipital Nerve

A
  • Posterior Ramus C2
  • Pierces trapezius
  • Innervates scalp occipital region
36
Q

CN VII emerges from the cranium via:

A

Stylomastoid Foramen

37
Q

What are the 6 branches of the Facial Nerve (CN VII)?

A

(1) Posterior Auricle
(2) Cervical
(3) Marginal Mandibular
(4) Buccal
(5) Zygomatic
(6) Temporal

38
Q

Facial Nerve has __, __, and ___ components

A

Motor, Sensory, Parasympathetic

39
Q

Does the Facial Nerve have cutaneous innervation?

A

Nope

40
Q

What does the motor component of the Facial N supply?

A
  • Muscles of facial expression
  • Superficial muscles of the neck (Platysma)
  • Auricular muscles
  • Scalp muscles
41
Q

Parasympathetic (Visceral Motor) to Lacrimal Gland

A

(1) Greater Petrosal N arises from CN VII
(2) Greater Petrosal N joints the Depp Petrosal N (sympathetic) at the Foramen Lacerum to form the N to the Pterygoid Canal
(3) N of Pterygoid Canal travels thru Pterygoid Canal and enters Pterygopalatine Fossa
(4) Parasympathetic fibers from N of Pterygopalatine Canal synapse in Pterygopalatine Ganglin in Pterygopalatine Fossa
(5) Postsynaptic parasympathetic fibers from this ganglion innervate the Lacrimal Gland via the Zygomatic branch of CN V2 and the Lacrimal N (branch of V1)

42
Q

Parasympathetic (Visceral Motor) to Submandibular and Sublingual Gladns

A

(1) Chorda Tympani branch arises from CN VII
(2) Chorda Tympani passes through the Petrotympanic Fissure between the petrous parts of the temporal bone to join the Lingual N (CN V3) in the infratemporal fossa
(3) Parasympathetic fibers of the Chorda Tympani synapse in the Submandibular Ganglion; postsynaptic fibers follow arteries to glands

NE Exam 1 (14 decks)

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