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Neuroanatomy and Physiology > 7 - Cranial Nerves (Exam 2) > Flashcards

7 - Cranial Nerves (Exam 2) Flashcards

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1
Q

What are 3 ways we can assess the health of CN II?

A
  1. Visual acuity testing
  2. Visual field testing
  3. Pupil evaluation
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2
Q

Which cranial nerve is most likely to be affected by increased intracranial pressure and why?

A

CN VI
CN VI runs over the petrous ridge of the temporal bone, uncal herniation of the temporal lobe due to raised ICP may compress CN VI on the sharp petrous ridge

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3
Q

You have a patient who is unable to smile or frown with the left side of their mouth, but is able to raise both eyebrows and close both eyes. What is the most likely site of the lesion causing this problem and why?

A

Right motor cortex

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4
Q

Which cranial nerves have only sensory components?

A 
CN I - olfactory
CN II - optic
CN V1 - trigeminal (ophthalmic)
CN V2 - trigeminal (maxillary)
CN VIII - vestibulocochlear
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5
Q

Which cranial nerves have only motor components?

A 
CN III - oculomotor
CN IV - trochlear
CN VI - abducens
CN XI - accessory
CN XII - hypoglossal
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6
Q

Which cranial nerves have both sensory and motor components?

A

CN V3 - trigeminal (mandibular)
CN VII - facial
CN IX - glossopharyngeal
CN X - vagus

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7
Q

When dealing with an orbital fracture, which cranial nerve will most likely be affected and why?

A

CN V2

Due to its location under the very fragile orbit

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8
Q

Which cranial nerves make up the ocular group?

A

CN II - optic
CN III - oculomotor
CN IV - trochlear
CN VI - abducens

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9
Q

Which cranial nerves make up the sensory group?

A

CN I - olfactory
CN V - trigeminal
CN VIII - vestibulocochlear
CN IX - glossopharyngeal

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10
Q

Which cranial nerves make up the motor group?

A

CN VII - facial
CN X - vagus
CN XI - accessory
CN XII - hypoglossal

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11
Q

Which 2 cranial nerves originate in the midbrain?

A
  1. CN III

2. CN IV

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12
Q

Which 4 cranial nerves originate in the pons?

A
  1. CN V
  2. CN VI
  3. CN VII
  4. CN VIII
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13
Q

Which 4 cranial nerves originate in the medulla oblongata?

A
  1. CN IX
  2. CN X
  3. CN XI
  4. CN XII
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14
Q

Which 2 cranial nerves aren’t actually cranial nerves?

A
  1. CN I

2. CN II

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15
Q

What opening in the skull does CN II go through?

A

Optic canal

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16
Q

What is the afferent pupil pathway?

A
  1. Retina
  2. Optic nerve (CN II)
  3. Optic chiasm
  4. Optic tract
  5. Pretectal nucleus
  6. Edinger-Westphal nucleus
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17
Q

What is the efferent pupil pathway?

A
  1. Edinger-Westphal nucleus
  2. Oculomotor nerve, superior division (CN III)
  3. Ciliary ganglion
  4. Sphincter muscle
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18
Q

Where are the 2 hemi-decussations in the afferent pupil pathway?

A
  1. At the optic chiasm

2. At the pretectal nucleus

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19
Q

What is a cause of RAPD?

A

Unilateral/ asymmetrical damage

Affected eye does not dilate directly, but does consensually

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20
Q

What is Light-Near dissociation?

A

Pupils do not respond to light, but do to accomodation

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21
Q

How are light fibers and accommodative fibers different?

A

Lightfibers travel from pretectal nucleus to EW nucleus

Acc. fibers travel from frontal eye fields to EW nucleus

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22
Q

What structure is the link between head movements and eye movements?

A

Superior colliculi

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23
Q

Which opening in the skull does CN III go through?

A

Superior orbital fissure

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24
Q

Does CN III provide sympathetic or parasympathetic pupil/ accommodation innervation?

A

Parasympathetic
Pupil constriction
Accommodation to near

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25
What muscle does CN III innervate in addition to the 4 EOMs it innervates?
Superior palpebral levator
26
What contributes fibers to CN III to assist with innervation of both levator muscles?
Central caudal nucleus (CCN)
27
What is the group of nerve cells that innervate the EOMs?
Main Motor Nucleus
28
What 3 places does the main motor nucleus receive information from?
1. Both cerebral hemispheres 2. Superior colliculus/ pretectal nuclei 3. Medial longitudinal fasciculus (MLF)
29
What muscles receive innervation from the superior division of CN III?
Superior rectus | Superior palpebral levator
30
What muscles receive innervation from the inferior division of CN III?
Medial Rectus Inferior Rectus Inferior Oblique Parasympathetic pupil fibers
31
Where is the division of rami for CN III?
Superior orbital fissure
32
What EOM does CN IV innervate?
Superior oblique
33
What opening in the skull does CN IV go through?
Superior orbital fissure
34
What is the function of the superior oblique muscle?
Moves the eye down and out
35
When do nerve fibers from CN IV decussate?
Immediately after exiting dorsal aspect of midbrain
36
What 3 places does the trochlear nucleus receive information from?
1. Both cerebral hemispheres 2. Superior colliculus 3. Medial longitudinal fasciculus
37
What is the longest and thinnest cranial nerve?
CN IV
38
What opening in the skull does CN VI go through?
Superior orbital fissure
39
What EOM does CN VI innervate?
Lateral rectus
40
What 4 places does the abducens nucleus receive information from?
1. MLF (links medial and lateral rectus) 2. Both cerebral hemispheres 3. Superior colliculus 4. CN VI
41
What nerve fibers wrap around the abducens nucleus?
CN VII
42
What is significant about the path of CN VI?
Travels over the petrous ridge of the temporal bone
43
Should you dilate patients with symptoms of a CN VI palsy and why?
Yes | View the optic nerve heads, look for disc edema
44
What nuclei does the medial longitudinal fasciculus connect?
CN VIII CN VI - lateral rectus CN III - medial rectus
45
What is a basic summary of what the MLF does?
Links eye movements with vestibular control apparati | yoked muscles
46
Where are the openings in the skull for CN I?
Openings in cribiform plate of the ethmoid bone
47
What type of neurons are olfactory receptors?
Bipolar neurons
48
What is V1 of CN V?
Ophthalmic nerve
49
What is V2 of CN V?
Maxillary nerve
50
What is V3 of CN V?
Mandibular nerve
51
CN V is sensory with the exception of 1 division. What is that division that carries both sensory and motor innervation?
V3 - mandibular nerve
52
What is the acronym for openings in the skull of the branches of CN V?
Standing Room Only V1 - Superior orbital fissure V2 - foramen Rotundum V3 - foramen Ovale
53
Where is the main sensory nucleus of CN V located?
Posterior pons | Lateral to motor nucleus
54
Where is the spinal nucleus of CN V located?
Medulla oblongata and cervical spinal cord
55
Where is the motor nucleus of CN V located?
Pons | Medial to main sensory nucleus
56
What types of sensations does the main sensory nucleus of CN V recognize?
Touch | Pressure
57
What types of sensations does the spinal nucleus of CN V recognize?
Pain | Temperature
58
What type of sensation does the mesencephalic nucleus of CN V recognize?
Proprioceptive
59
What does the motor nucleus of CN V provide innervation to?
The muscles of mastication
60
What are the 4 nuclei of CN V?
1. Main sensory nucleus 2. Spinal nucleus 3. Mesencephalic nucleus 4. Motor nucleus
61
Where does the large ganglion of CN V rest?
Meckel cave
62
What areas does CN V1 provide sensory innervation to?
``` Forehead Scalp Upper eyelid Cornea Bridge of nose Tip of nose Mucous membranes of paranasal sinuses/ cavities ```
63
Where does CN V1 enter the orbit?
Superior orbital fissure
64
What is the acronym for the three branches of CN V1 and what are the 3 branches?
NFL Nasociliary nerve Frontal nerve Lacrimal nerve
65
What is Hutchinson's sign?
Vesicles present on the tip of the nose | Likely to see ocular involvement with shingles
66
What areas does the CN V2 provide sensory innervation to?
Skin of cheek Teeth of upper jaw Mucous membrane of nose, maxillary sinus, palate
67
Where does CN V2 enter the orbit?
Inferior orbital fissure
68
Which branch of CN V2 is most at risk of being damaged by an orbital fracture and why?
Infraorbital branch | Orbital floor is easily broken and can cause damage to the infraorbital branch that runs underneath
69
What area of the face does the infraorbital branch of CN V2 provide sensory innervation to?
The lower eyelid
70
Where is the opening in the skull for CN VIII?
Internal acoustic meatus
71
What is the function of the cochlear division of CN VIII?
Hearing
72
What is the function of the vestibular division of CN VIII?
Position/ movement of head | Balance
73
Where are the 4 vestibular nuclei found, and what are they called?
``` Found in the pons Medial Lateral Superior Inferior ```
74
Where are the 2 cochlear nuclei found, and what are they called?
Found in the pons Posterior Anterior
75
Where do a small amount of fibers that bypass the vestibular nuclei pass to?
The cerebellum
76
Where is the opening in the skull for CN IX?
Jugular foramen
77
Where are the three main nuclei for CN IX housed?
Medulla oblongata
78
What organs does CN X provide parasympathetic innervation to?
``` Lungs Heart Esophagus Stomach Small intestine Large intestine ```
79
Where is the opening in the skull for CN X?
Jugular foramen
80
Are the paths of the left and right CN X mirrored?
No | very different as the organs of the thorax and abdomen are not mirrored
81
Where are the nuclei for CN X housed?
Medulla oblongata
82
Where are the openings in the skull for CN VII?
Internal acoustic meatus Facial canal Stylomastoid foramen
83
What are the 3 nuclei of CN VII?
1. Main motor nucleus 2. Parasympathetic nuclei 3. Sensory nucleus
84
What nucleus do the motor fibers of CN VII wrap around?
CN VI nucleus
85
How is an upper motor neuron (UMN) lesion of CN VII differentiated from a lower motor neuron (LMN) lesion of CN VII?
UMN lesion results in contralateral bottom 1/2 of face losing innervation LMN lesion results in ipsilateral hemiparesis (down midline of face)
86
What is another name for a LMN lesion and what are 2 possible causes?
Bell's Palsy 1. Inner ear infection 2. Herpes simplex 1
87
What is the function of the accessory nerve?
Shrugs the shoulders
88
Where is the opening in the skull for CN XI?
Jugular foramen
89
Where is the opening in the skull for CN XII?
Hypoglossal canal
90
What does CN XII innervate?
Muscles of the tongue

Neuroanatomy and Physiology (9 decks)

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