Lecture Seven

Question 1

glossopharyngeal nerve originates from where?

Answer 1

CNS

Question 2

glossopharyngeal nerve breaks into two branches, what foramen do they both go through? one nerve goes directly where? the other goes where?

Answer 2

they both go through the jugular foramen, one branch goes to the stylopharyngeal muscle (in the neck) and continues on to the pharyngeal branches (taste and sensation post. 1/3 of tongue). The other branch goes back into the skull to tympanic canalicius (becoming the tympanic nerve) then passes through middle ear (tympanic plexus) then hiatus for lesser petrosal nerve (becomes lesser petrosal nerve) it then goes through foramen ovale (lesser petrosal= parasymp branch of the 9th nerve) then synapses in otic ganglion.

Question 3

the post ganglionic fibres of the glossopharyngeal nerve after synapsing in the otic ganglion travel with what? then what do they innervate?

Answer 3

the aurioculatemporal nerve (branch of the mandibular CNV3).
innervates the parotid gland.

Question 4

Giant cell Artheritis caused by?

Answer 4

systemic wide inflammation of arteries

Question 5

Giant cell artheritis can cause what?

Answer 5

irreversible blindness

Question 6

Giant cell Artheritis includes what symptoms? what is normally tested to diagnose?

Answer 6

scalp pain (pain when brushing hair), pain when chewing 
superficial temporal artery

Question 7

What are the four sensory branches of the mandibular nerve?

Answer 7

buccal, post auricular, inferior aveolar and lingual.

Question 8

which of the three branches of the trigem nerve are present in the cavernous sinus?

Answer 8

opthalamic and maxillary. NOT mandible

Question 9

What are the sensory branches of the maxillary nerve?

Answer 9

zygomatic and infraorbital

Question 10

Frontalis muscle: action? blood supply? innervated by?

Answer 10

wrinkles the forehead, supraorbital and supratrochlear artery, innervated by CN7

Question 11

Occipito frontalis muscle: action?, blood supply?, innervated by?

Answer 11

antagonist of frontalis, occipital artery, innervated by CN7 (post auricular branch).

Question 12

Corrugator Supercilli muscle: action? blood supply? innervated by?

Answer 12

brow down/medially (pulls eyebrows together), supraorbital and supratrochlear, innervated by CN7

Question 13

Orbicularis Oculi muscle: actions? what are the two different parts? blood supply? innervated by?

Answer 13

lid closure. 1. orbital (inner) 2. palpebral (outer) when both are constricted eye is shut tight, when only one is constricted eye shut gently.

Question 14

Two muscles located within the orbicularis Oculi muscle are?

Answer 14

1. Muscle of RIolan: keeps lids against eyeball

2. Horner’s muscle: attaches to lacrimal sac

Question 15

Orbicularis Orid muscle: action? blood supply? innervated by?

Answer 15

kissing muscle. facial artery. CN7 buccal branch

Question 16

Levator Labii Superioris muscle: action? blood supply? innervated by?

Answer 16

lifts upper lid. facial artery. zygomatic branch of CN7

Question 17

Levator Labii Superioris Aleque Nasi muscle: action? blood supply? innervated by?

Answer 17

wrinkles the nose “snarl”. facial artery and zygomatic branch of CN7

Question 18

RIsorius muscle: action? blood supply? innervated by?

Answer 18

“laughing muscle”. buccal branch of CN7 and facial artery.

Question 19

Buccinator muscle: action? blood supply? innervated by?

Answer 19

pulls back angle of mouth. facial artery, buccal branch of CN7.

Question 20

Depressor anguli oris muscle: action? blood supply? innervated by?

Answer 20

depresses angle of mouth. facial artery, buccal branch of CN7

Question 21

Depressor Labii Inferioris muscle: action? blood supply? innervated by?

Answer 21

lowers the lower lip, facial artery, buccal branch of CN7

Question 22

Mentalis muscle: action? blood supply? innervated by?

Answer 22

elevates and wrinkles skin of lower lip “quivers”. facial artery, buccal branch of CN7.

Question 23

the three muscles mentalis, depressor labii inferioris and depressor anguli oris all join what?

Answer 23

orbicularis oris.

Question 24

Playtsma muscle: action? blood supply? innervated by?

Answer 24

wrinkles skin of neck, CN7

Question 25

What are signs of CN7 paresis?

Answer 25

cannot puff out their cheek on affected side, food collects in the cheek like a hamster, saliva dribbles out.

Question 26

How is bells palsy formed? which nerve swells? what is a classic symptom? how long does it last? how can it be treated?

Answer 26

viral infection, CN 7 (it gets compressed as it swells when leaving the foramen).
facial muscles weaken
1-2 weeks
oral steroids (to reduce inflammation)

Question 27

name all the symptoms for bells palsy

Answer 27

blink reflex abnormal, earache, lacrimation (xs or deficient), loss of taste, sudden onset and palsy of CN7

Question 28

What three muscles are involved in jaw closing?

Answer 28

1. temporalis
2. masseter
3. medial pterygoid

Question 29

What one muscle is involved in jaw opening?

Answer 29

lateral pterygoid

Question 30

temporalis muscle:nerve supply? what nerve lies over this that we can see when people get angry? what is the blood supply?

Answer 30

CNV3, superficial temporal artery. superficial temporal artery.

Question 31

Medial pterygoid muscle: is the MPM muscle on each side works at the same time what happens to the jaw? what if they work oppositely?

Answer 31

same time= jaw closing

opposite= jaw grinding

Question 32

which muscles are more powerful jaw closing or opening? why?

Answer 32

closing. jaw opening is easer due to gravity affect.

Question 33

if lower face muscles alone were affected one might expect what?

Answer 33

a upper motor neuron lesion

Question 34

Masseter lies external to what muscle?

Answer 34

buccinator

Question 35

lateral pterygoid muscle: motor nerve supply from?

Answer 35

buccal branch of CNV3

Question 36

what two nerves both have a buccal branch what do they innervate?

Answer 36

CNV3 has a buccal branch which innervates motor muscles of mastication.
CN7 also has a buccal branch which innervates muscles of facial expression i.e. buccinator.

Question 37

a 45 year old man has weakness in muscles of mastication what could this suggest? if he also had hearing loss what could be a diagnosis?

Answer 37

motor branch of trigem is affected which is innervated by motor cortex in brain therefore may be an issue in brain.
due to acoustic neuroma (benign tumor) takes up space, causing compression on nerves (i.e CN8).

Question 38

the acoustic neuroma can impact which two nerves? what are some symptoms?

Answer 38

CN7/8

tingling facial pain, numbness and facial muscle weakness.