lecture 16: CN V and VII Flashcards

1
Q

what are the 3 divisions of the trigeminal n

A

opthlamaic
maxillary
madinbular

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2
Q

is trigeminal mixed, sensory or motor

A

mixed

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3
Q

where does the trigeminal n emerge from the pons

A

lateral aspect of the pons

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4
Q

what is the only branch of the trigeminal n that carries motor fibers

A

only C V3 (mandibular)

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5
Q

true or false: only the only C V3 (mandibular) carries sensory fibers

A

false, motor fibers

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6
Q

in the trigeminal n, most primary sensory neurons cell bodies (pseudounipolar) are located where

A

in trigeminal ganglion

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7
Q

where is the trigeminal ganglion located

A

near pons

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8
Q

what is the dermatome distribution of the opthlamaic n

A

cornea, skin of forehead, scalp, eyelid, anterior nose, anterior nasal cavity mucosa, mucosa of paranasal sinuses

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9
Q

what foramen foes the ophthalmic n exit thru

A

superior orbital fissure

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10
Q

what foramen foes the maxillary n exit thru

A

foramen rotundum

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11
Q

what foramen foes the mandibular n exit thru

A

foramen ovale

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12
Q

what is the dermatome distribution of the maxillary n

A

skin of the face over maxilla (upper lip, cheek), maxillary teeth, posterior nasal cavity mucosa, maxillary sinus and palate

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13
Q

what is the dermatome distribution of the mandibular n

A

skin of the face over the mandible and sides of face, mandibular teeth, temporomadinular joint, oral mucusa, anterior 2.3 of tongu

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14
Q

what muscle does the mandibulary n innervate

A

muscles of mastication
=temporalis, masseter, medial and lateral pterygoids

tensr tympani

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15
Q

true or false: all 3 divisions of the trigeminal n carry all somatosensory modalities

A

true

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16
Q

what are the two trigeminal n nuclei

A

sensory trigeminal n (somatic sensory)

motor trigeminal nucleus (brainchian motor)

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17
Q

what are the 3 parts of the sensory trigeminal nucleus

A

mesencephalic nucleus (midbrain/pons), chief nucleus (pons), spinal nucleus (pons to c3)

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18
Q

the sensory trigeminal nucleus extends from where to where

A

midbrain to upper cervical spine

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19
Q

where is the mesencephalic nucleus (of sensory trigeminal nucleus) located

A

midbrain/pons

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20
Q

where is the chief nucleus (of sensory trigeminal nucleus located )

A

pons

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21
Q

true or false: the chief nucleus carries only branchial motor

A

false, sensory info

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22
Q

where is the spinal nucleus (of sensory trigeminal nucleus) located

A

(pons to c3)

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23
Q

spinal trigeminal nucleus receives what type of info

A

pain and temperature (spinothalamic pathway)

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24
Q

the spinal nucleus of the trigeminal n is continuous with BLANK in the spinal cord

A

dorsal column (since spinothalamic info is thru dorsal horns)

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25
Q

the spinal trigeminal tract is continuous with what in the spinal cord

A

dorsolateral tract

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26
Q

what is the function of the spinal trigeminal tract

A

acts as an elevator to allow information/axons to ascent or descent

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27
Q

what somatosensoation does the spinal nucleus receive

A

pain and temperate

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28
Q

what somatosensoation does the chief sensory nucleus receive

A

rfine touch and vibration (DCML)

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29
Q

true or false: the chief nucleus receives rfine touch and vibration (DCML)

A

true

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30
Q

true or false: the trigeminal tract only carries information from the spinal nucleus

A

fALSE, from all 3 trigeminal sensory nuclei

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31
Q

what information does the mesenphealic nucleus receive

A

non concious proprioception

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32
Q

what pathway is the mesencephalic nucleus equivalent to

A

spinocerebellar pathway

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33
Q

why is the mesephalic nucleus unique

A

since it contains cell bodies of primary sensory neurons (only knwoncause of primary sensory neurones with cell bodies in CNS)

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34
Q

most primary sensory neuron cell bodies of the trigeminal n are located in the trigeminal ganglion, except what exception

A

mesencephalic nucleus

contains cell bodies of primary sensory neurons (only knwoncause of primary sensory neurones with cell bodies in CNS)

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35
Q

be able to locate the different sensory and branchial motor nuclei i the brainstem

A
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36
Q

where is the motor trigeminal nucleus located

A

in the pons at the level where CN V emerges

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37
Q

why is the motor trigeminal nucleus considered branchial motor

A

since the muscles of mastication are derived from pharyngeal arches which lead to branchial motor (not somatic)

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38
Q

explain the ascending trigeminal pathway carrying fine touch, vibration and concious proprioceptions

A

1) primary sensory neuron in trigeminal ganglion
2) synapse with secondary sensory neuron in the chief nucleus of CN V
3) decussation
4) ascends in trigeminal nucleus
5) synapse with tertiary sensory neuron in the VPM of thalamus
6) internal capsule (genu)
7) to primary somatosensory cortex in most lateral area for head and neck

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39
Q

the trigeminal ganglion for fine touch vibration is equivalent to what in the DCML pathway

A

dorsal root ganglion

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40
Q

the chief nucleus of the CNV is equvileant to what in the DCML

A

nucleus cuneatus/gracilis

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41
Q

fine touch vibration and concious proprioception of trigemianl ascending pathway ascends as trigeminal leminscus is analogous to what in the DCML

A

medial lemiscus

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42
Q

what is the equivalent to the medial lemniscus in the trigeminal ascending pathway for fine touch, vibration etc

A

trigeminal leminscus

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43
Q

where does the synapse happen between secondary and tertiary neurons in the trigeminal ascending pathways

A

VPM of thalamus

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44
Q

what part of the internal capsule do fibers from the trigeminal ascending pathways

A

genu

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45
Q

explain the ascending trigeminal pathway carrying pain, temp, crude touch, pressure

A

1) primary sensory neuron in trigeminal ganglion
2) descend in spinal trigeminal tract
3) synapse with secondary sensory neuron in spinal trigeminal nucleus
4) decussation
5) ascends in trigeminothalamic tract
6) synapse with tertiary sensory neuron in the VPM of thalamus
6) internal capsule (genu)
7) to primary somatosensory cortex in most lateral area for head and neck

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46
Q

the spinal trigeminal tract is equivalent to what in the spinothalamic pathway

A

posterolateral tract

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47
Q

true or false” the spinal trigeminal nucleus is equivlanr to the anterior horn in the SC

A

false, the dorsal horn

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48
Q

true or false, there is no UMN control of trigeminal motor pathways

A

false, there is

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49
Q

explain the pathway of UMN control of corticonuclear fibers for trigeminal patway

A

1) UMN in primary motor cortex (pre central gyrus facial area)
2) corona radiata
3) internal capsule (genu)
4) cerebral peduncle
5) synapse with LMN bilaterally in motor trigeminal nuclei
=going to muscles of mastication

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50
Q

true or false, in UMN control of trigeminal motor, uMN synapse with LMN unilaterally in motor trigeminal nuclei

A

false, bilaterally

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51
Q

lesion to an UMN/corticonuclear tract of trigeminal motor pathway, will a unilateral lesion have a little or big effect

A

little because there is bilateral UMN control

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52
Q

is the jaw jerk reflex mono or poly synaptic reflex

A

mono (non conious therefore the primary sensory neon is actually located in the brainstem already=no need for interneours0

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53
Q

explain the jaw jerk reflex

A

1) stimulus = tap chin (stimulate the proprioceptors/muscle spindles in masseter, temporals etc)

2) afferent limb = sensory signals travel via V3 to motor nucleus of CN V via central process (sensory cell bodies in mesenphelaic nucleus of CN V9

3) synapse = in motor nucleus of CN V

4) efferent limb = motor signals travel via V3 to extrafusal fibers of muscles of masticuated

5) response = mandible elevates (close jaw)

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54
Q

explain the afferent limb of the jaw jerk reflex

A

sensory signals travel via V3 to the motor nucleus of the CN V

(cell bodies in mesenphalic nucleus of CN V)

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55
Q

where dos the synapse happen for the jaw jerk reflex

A

in motor nucleus of the CN V

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56
Q

true or false, the only branch of the trigeminal n involved in the jaw jerk reflex is the mandibular branch

A

true

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57
Q

explain the efferent limb of the jaw jerk reflex

A

motor signals travel via V3 to extrafusal fibers of muscles of mastication

58
Q

in the jaw jerk reflex: motor signals travel via V3 to extrafusal fibers of what

A

of muscles of mastication

59
Q

what is the response of the jaw jerk relfex

A

mandible elevates (close jaw)

60
Q

true or false: the facial nerve is sensory only

A

false, mixed

61
Q

where does the facial n emerge in brainstem

A

pontomedullar junction (lateral)

62
Q

where does the facial n excite the skull

A

via internal acoustic meatus

63
Q

after exited thru the internal acoustic meatus, where does the facial n travel trhru

A

facial canal

64
Q

what makes up the facial n

A

motor root and nervus intermedius (sensory)

65
Q

where are the cell bodies of the primary sensory neurons of the facial n located

A

geniculate ganglion

66
Q

true or false: the cell bodies of the primary sensory neurons of the facial n are located in denticulate ganglion

A

false, geniculate

67
Q

explain the parasumpathic cell body location for the facial n

A

preganglionic parasympathetic cell bodies located in superior salivatory nuclei and the axons synapse either in pterygopalatine ganglion (for lacrimal gland)
or submandibular ganglion (for submandibular and sublingual glands)

68
Q

where does the preganglionic parasympathetic neurons synapse in for the lacrimal gland

A

pterygopalatine ganglion

69
Q

where does the preganglionic parasympathetic neurons synapse in for the submandibular and sublingual gland

A

submandibular ganglion

70
Q

the facial cranial n excite the facial canal via what

A

stylomastoid foramen

71
Q

what are the motor branches of the facial n

A

temporal
zygomatic
buccal
mandibular
cervical

72
Q

how many facial n nuclei are there

A

4

73
Q

in what aspect of the brainstem are the facial n nuclei located

A

in the caudal aspect of the pons

74
Q

what its he somatic sensory nuclei of the facial n

A

sensory trigmeinal nucleus

specifically cheif trigeminal nucleus and spinal trigmeninal sensory nuc

75
Q

infromation from what area for the facial n is carried to the trigeminal sensory nucleus

A

sensory info of skin of external ear

76
Q

what its the branchial motor nuclei of the facial n

A

facial motor nucleus

77
Q

true or false: facial motor nucleus is branchial motor

A

tre=ue because it is derived muscles of facial expression are derived from pharyngeal arches

78
Q

facial motor nucleus provides motor innervate to what

A

muscles of facial expression and 3 others

79
Q

explain the passage of fibres from facial motor nucleus in relation to another nucleus

A

fibers loop around abducens nucleus, then exit ventrally

80
Q

what is the clinical significance of the fact that facial motor fibers loop around abducens nucleus, then exit ventrally

A

abducens nucleus will often be associated with facial motor issues as well

81
Q

what is the visceral motor nucleus of the facial n

A

superior salivary nucleus

82
Q

the superior salivatoruy nucleus is associated with what in olfaction

A

associated with the salivary reflex in response to appetizing smells

83
Q

preganglionic parasympathetic fibers from pterygopalatine ganglion synapsen in what nucleus

A

superior salivary nucleus (carries info from lacrimal gland to minor salivary gland)

84
Q

preganglionic parasympathetic fibers from submandibular ganglion synapsen in what nucleus

A

superior salivatory nucleus (carries info from submandibular and sublingual gland

85
Q

true or false, the facial n nuclei nucleus solitaires is a special sensory nucleus

A

true

86
Q

why is the nucleus solitaires of the facial n special

A

since it a nucleus that has 2 parts that carries different modalities

(normally, nucleus oney carries 1 modality)

87
Q

nucleus solitaires carries taste sensation from what

A

anterior 2/3 of tongue

88
Q

explain the UMN control via corticonuclear fibres of the facial nuclei

A

1) UMN in primary motor cortex (pre central gyrus in facial area)
2) corona radiata
3) internal capsule (genu)
4) cerebral peduncle
5) synapse with LMN in facial motor nuclie
=bilaterally for upper face
=contralaterally for lower face

89
Q

true or false, in UMN for facial nucleus, the synapse with LMN in facial motor nucleus is
=bilaterally for lower face
=contralaterally for upper face

A

false,
=bilaterally for upper face
=contralaterally for lower face

90
Q

explain the effect of a LMN lesion for facial n

A

results in complete paralysis of ipsilateral side of face (bells palsy) (upper and lower)
eliminating all branchial motor innervation to the face

91
Q

explain the effect of a UMN (central.supranucleus) lesion for facial

A

results in paralysis of lower half of face on the contralateral side

92
Q

true or false: lesion to a LMN of facial n results in paralysis of lower half of face on the contralateral side

A

false, thats for UMN

93
Q

explain why a facial UMN lesion results in paralysis of lower half of face on the contralateral side

A

theupper half would still be receiving innevation from the contralateral side

94
Q

know crocodile tear kinda

A
95
Q

which of these is a polysynaptic reflex: corneal blind or jaw jerk

A

corneal

96
Q

the corneal blink reflex is polysynaptic or mono synapstic

A

poly

97
Q

the corneal blink reflexv receives what type of stimulus

A

nociceptive stimulus (in cornea)

98
Q

explain the corneal blind reflex

A

1) sensory fibers (CN V1) synapsen in spinal part of sensory trigeminal nucleus
2) interneurons project to facial motor nuclei bilaterally
3) motor fibers (CN VII) from facial motor nuclei innervate orbiculares occult
4) response= blink
5) direct and consensual responses

99
Q

add slides about hyperacusis

A
100
Q

the trigemianl n is associated with what brainstem nuclei type

A

branchial motor
somatic sensory

101
Q

what is the branchial motor nuclei called for the trigeminal n

A

motor trigeminal nucleus

102
Q

what is the somatic sensory nuclei called for the trigeminal n

A

sensory trigeminal nuclei

103
Q

what are the associated foramen of the trigeminal n

A

V1 = superior orbital fissure
V2= foramen rotundem
V3= foramen ovale

104
Q

what is the function of the branchial motor of trigeminal n

A

to muscles of mastication, and tensor tympani

105
Q

the facial n is associated with what brainstem nuclei type

A

branchial motor
visceral motor
somatic sensoru
special sensoru

106
Q

what is the branchial motor nuclei called for the facial n

A

facial motor n

107
Q

what is the visceral motor nuclei called for the facial n

A

superior salivator nucleus

108
Q

what is the speficicsomatic sensory nuclei of the trigeminal sensory nuclei used for the facial n

A

spinal and chief sensory trigeminal nuclei

109
Q

what is the special sensory nuclei called for the facial n

A

nucleus solitaris

110
Q

what are the associated foramen for the facial n

A

internal acoustic meatus (anf facial canal and stlomastoid foramen)

111
Q

the branchial motor of the facial n goes to

A

muscles of facial expression,. strapedius, stylohyoid, posterior digastic

112
Q

the visceral motor of the facial n goes to

A

lacrimal, submandibular, sublingual glands

glands of nose/soft palate

113
Q

the somatic sensory of the facial n carriesinfo from where

A

skin of external ear

114
Q

whatis the special sensaton associated with nucleus solitaris

A

taste from anterior 2/3 of the tongue and soft palate

115
Q

what is hyperacusis

A

unsuall intolerance or sensitive to sound. Tensory tympani or stapedius damaged/no innervation which is usually used to dampen sound waves

116
Q

what are the two muscles involved in hyperacusis issues

A

tensor tympani
stapedius

117
Q

what is the function of the tensor tympani

A

pull on the malleus which tenses the tympanic membrane (lessens \dampens vibrations to inner ear)

118
Q

what innervates the tensor tympani

A

trigeminal n (mandibular branch)

119
Q

what is the function of the stapedius m

A

pull on the stapes (prevent excessive movement) decrease vibrations going into oval window

120
Q

what inneravtes the stapedius

A

facial

121
Q

what is 2 examples of lesions that could result in hyperacuisis

A

lesion to mandibular n
lesion to facial n

122
Q

where are the 1 neuron cell bodies in the spinal cord for DCML

A

dorsal root

123
Q

where are the 1 neuron cell bodies in trigeminal for DCML

A

trigeminal gangion

124
Q

what are the central processes (axons) of primary neurons for the DCML in SC

A

dorsal column (fasciculus cuneatus and gracilis)

125
Q

what are the central processes (axons) of primary neurons for the DCML in trigeminal n

A

trigeminal n

126
Q

where is the synapse between primary and secondary neurons in DCML of SC

A

nucleus cuneatus and gracilis

127
Q

where is the synapse between primary and secondary neurons in DCML of trigmeinal

A

chief trigeminal sensory nucleus

128
Q

what is the decussation of 2 neuron called in DCML of SC

A

internal artucate fibers

129
Q

what are the ascending secondary neuron axons of the DCML of SC called

A

medial lemnisuc

130
Q

what are the ascending secondary neuron axons of the DCML of trigmeinal n called

A

trigeminal lemnisuc

131
Q

what is the thalamic nucleus of the DCML in SC

A

VPL

132
Q

what is the thalamic nucleus of the DCML in trigeminal

A

VPM

133
Q

what is the destination i the primary somatosensory cortex for the DCCML in SC

A

to primary somato sensory cortex (post central gyrus most medial, superior and superior lateral)

134
Q

what is the destination i the primary somatosensory cortex for the DCCML in trigmeinal n

A

to primary somato sensory cortex (lateral)

135
Q

where are the primary neuron cell bodies in the ST pathway of SC

A

dorsal root ganglion

136
Q

where are the primary neuron cell bodies in the ST pathway of trigmeinal n

A

trigeminal ganglion

137
Q

where do the central processes (axons) of the primary neurons go in the ST pathway of the SC

A

dorsolaltearl tract

138
Q

where do the central processes (axons) of the primary neurons go in the ST pathway of the trigeminal

A

spinal trigeminal tract

139
Q

where does the decussation of secondary neurons occur in the ST pathway of SC

A

anterior white commissure

140
Q

what are the ascending secondary neuron axons of the ST pathway in SC called

A

spinothalamic tract = becomes spinal lemniscus in the brainstem

141
Q

where do the central processes (axons) of the primary neurons go in the ST pathway of the trgimeninal n

A

spinaltrigeminal tract