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HNN > Cranial Nerves VII-XII > Flashcards

Cranial Nerves VII-XII Flashcards

1
Q

What is cranial nerve VII?

A

Facial nerve

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2
Q

Outline the facial nerve

A

Cranial nerve VII - arises from pons
- muscles of facial expression + stapedius
- special sensory to anterior 2/3 tongue (taste)
- parasympathetic to lacrimal, nasal + salivary glands (except parotid)

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3
Q

How do you test the facial nerve VII?

A

Test muscles of facial expression

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4
Q

Signs and symptoms of facial nerve VII lesions

A
  • Unilateral facial droop - whole half
  • Loss/change in taste to anterior 2/3 of tongue
  • Dry eye/mouth
  • Hyperacusis - normal sounds are too loud to hear
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5
Q

What is the pathway of the facial nerve?

A
  • from pons into internal acoustic meatus
  • into petrous bone + gives off 3 branches (greater petrosal nerve, nerve to stapedius + chorda tympani)
  • emerges through base of skull via stylomastoid foramen
  • extra cranial branches TZBMC
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6
Q

What does the facial nerve branch into in the petrous bone?

A

Greater petrosal nerve
Nerve to stapedius
Chorda tympani

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7
Q

Function of the greater petrosal nerve

A

Parasympathics to lacrimal and nasal glands

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8
Q

What are the functions of chorda tympani (branch of facial nerve)?

A
  • taste to anterior 2/3 tongue
  • parasympathics to salivary gland
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9
Q

Causes of facial nerve VII lesions

A
  • lesions in/around internal acoustic meatus
  • posterior cranial fossa tumours
  • basal skull fracture involving petrous bone
  • middle ear disease
  • inflammation in facial canal > facial nerve palsy e.g. Bell’s palsy, Ramsay-Hunt syndrome
  • parotid disease
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10
Q

What two structures does the facial nerve have a close relation to?

A

Middle ear cavity
Parotid gland

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11
Q

What is cranial nerve VIII?

A

Vestibulocochlear nerve

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12
Q

Outline the vestibulocochlear nerve

A

Cranial nerve VIII - arises from pons
- special sensory to cochlea (hearing)
- vestibular system for balance

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13
Q

What is cranial nerve IX?

A

Glossopharyngeal nerve

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14
Q

What is cranial nerve X?

A

Vagus nerve

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15
Q

Pathway of the glossopharyngeal IX + vagus X nerve

A
  • arise from medulla
  • run through posterior cranial fossa
  • exit through jugular foramen
  • enter carotid sheath
  • glossopharyngeal IX exits proximally
  • vagus X continues inferiorly down neck
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16
Q

Outline the glossopharyngeal nerve

A

Cranial nerve IX - arises from medulla
- mainly sensory to oropharynx, posterior 1/3 of tongue (sensation + taste) + middle ear cavity
- sensation to carotid sinus + carotid body
- parasympathetic to parotid gland

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17
Q

Outline the vagus nerve

A

Cranial nerve X - arises from medulla
- muscles of larynx/pharynx + soft palate
- parasympathetic to thoracic + abdominal viscera
- general sensation to lower pharynx + larynx

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18
Q

How do you test the glossopharyngeal nerve IX?

A

Gag reflex

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19
Q

How do you test the vagus nerve?

A

Speech
Cough
Soft palate movement
Uvula position
Swallow

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20
Q

Signs and symptoms of vagus nerve lesions

A
  • difficulties with speech
  • changes in voice
  • dysphagia
  • weak cough
  • deviated uvula
  • nasal regurgitation
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21
Q

What is cranial nerve XI?

A

Accessory nerve

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22
Q

What is cranial nerve XII?

A

Hypoglossal nerve

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23
Q

Outline the accessory nerve

A

Cranial nerve XI - arises from medulla
- motor innervation to trapezius + sternocleidomastoid

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24
Q

How do you test the accessory nerve XI?

A

Test actions of SCM + trapezius
- SCM: turn head against resistance
- trapezius: shrug shoulders

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25
Q

Signs and symptoms of accessory nerve XI lesions

A

Winged scapula

26
Q

Causes of accessory nerve lesions

A
  • injuries, surgery or pathology involving posterior triangle
  • posterior cranial fossa tumours
  • base of skull fractures
27
Q

Pathway of accessory nerve XI

A
  • arises from medulla
  • through posterior cranial fossa
  • entered carotid sheath
  • exits + head toward posterior triangle
28
Q

Outline hypoglossal nerve

A

Cranial nerve XII - arises from medulla
- innervation to all muscles of tongue (except stylopharngeus)

29
Q

How do you test the hypoglossal nerve XII?

A

Tongue movements
Appearance of tongue

30
Q

Signs and symptoms of hypoglossal nerve XII lesions

A

Weakness + atrophy of tongue on ipsilateral side
‘Lick your wound’

31
Q

Pathway of vestibulocohlear nerve VIII

A
  • arises from pons
  • passes through internal acoustic meatus
  • through petrous bone to inner ear target tissues
32
Q

How do you test the vestibulocochlear nerve?

A

Gross hearing tests - whisper/finger rub
Asking about balance

33
Q

Signs and symptoms of vestibulocochlear nerve VIII lesions

A
  • hearing loss +/- tinnitus
  • dizziness (vertigo)
  • balance issues
34
Q

Causes of vestibulocochlear nerve VIII lesions

A
  • vestibular schwannoma (non cancerous inner ear tumour)
  • occlusion of labyrinthine artery
  • base of skull fracture involving petrous bone
35
Q

Mnemonic to remember the cranial nerve

A

Oh Oh Oh To Touch And Feel Virgin Girls Vagina Ah Heaven

  • Olfactory
  • Optic
  • Oculomotor
  • Trochlear
  • Trigeminal
  • Abducens
  • Facial
  • Vestibulocochlear
  • Glossopharyngeal
  • Vagus
  • Accessory
  • Hypoglossal
36
Q

What is Ramsay Hunt syndrome?

A

Shingles outbreak which effects facial nerve near the ears (facial nerve)

Herpes zoster

37
Q

What is the mnemonic to remember where cranial nerves are motor, sensory or both?

A

Some Say Marry Money But My Brother Says Big Brains Matter More

38
Q

How does the olfactory nerve pass through the skull?

A

Cribriform foramina

39
Q

How does the optic nerve pass through the skull?

A

Optic canal

40
Q

How does the Oculomotor nerve pass through the skull?

A

Superior orbital fissure
+ through cavernous sinus

41
Q

How does the trochlear nerve pass through the skull?

A

Superior orbital fissure
+ through cavernous sinus

42
Q

How does the ophthalmic division of the trigeminal nerve pass through the skull?

A

Superior orbital fissure
+ cavernous sinus

43
Q

How does the maxillary division of the trigeminal nerve pass through the skull?

A

Foramen rotundum

44
Q

How does the mandibular division of the trigeminal nerve pass through the skull?

A

Foramen ovale

45
Q

How does the abducens nerve pass through the skull?

A

Superior orbital fissure

46
Q

How does the facial nerve pass through the skull?

A

Internal acoustic meatus
Then stylomastoid foramen after branching

47
Q

How does the vestibulocochlear nerve pass through the skull?

A

Internal acoustic meatus

48
Q

How does the glossopharyngeal nerve pass through the skull?

A

Jugular foramen

49
Q

How does the vagus nerve pass through the skull?

A

Jugular foramen

50
Q

How does the accessory nerve pass through the skull?

A

Jugular foramen

51
Q

How does the hypoglossal nerve pass through the skull?

A

Hypoglossal canal

52
Q

Anterior 2/3rd of the tongue:
- general sensation
- taste
- motor

A

Anterior 2/3rd of the tongue:
- general sensation: trigeminal
- taste: facial
- motor: hypoglossal

53
Q

Posterior 1/3rd of tongue:
- general sensation
- taste
- motor

A

Posterior 1/3rd of tongue:
- general sensation: glossopharyngeal
- taste: glossopharyngeal
- motor: hypoglossal

54
Q

What is hyperacusis?

A

Normal sounds are too loud to here

55
Q

What is the only cranial nerve that comes off the brainstem dorsally?

A

Trochlear

56
Q

What are the afferent and efferent limb of gag reflex?

A
  • afferent: glossopharngeal IX
  • efferent: vagus X
57
Q

Differentiate between shingles + Ramsay hunt syndrome

A

Shingles - red rash on nose + forehead (trigeminal nerve)
Ramsay hunt syndrome - red vesicles on ears (facial nerve)

58
Q

What causes trigeminal shingles?

A

Reactivation of varicella zoster virus within trigeminal ganglion

59
Q

Managment of trigeminal shingles

A

IV aciclovir

60
Q

Mnemonic to remember the cranial holes for each cranial nerve

A

Cocks Often Smell Really Offensive If Just Handled
- Cribiform foramina: I
- Optic canal: II
- Superior orbital fissure: III, IV, Va + VI
- Rotundum: Vb
- Ovale: Vc
- Internal auditory meatus; VII + VIII
- Jugular foramen: XI, X + XI
- Hypoglossal canal: XII

HNN (24 decks)

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