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Head and Neck Anatomy > Summary and Revision of the Intracranial Region, Orbit, Eye and Ear > Flashcards

Summary and Revision of the Intracranial Region, Orbit, Eye and Ear Flashcards

1
Q

What is the 1st cranial nerve?

A

This is the olfactory nerve.

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2
Q

What is the 2nd cranial nerve?

A

This is the optic nerve.

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3
Q

What is the 3rd cranial nerve?

A

The oculomotor nerve.

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4
Q

What is the 4th cranial nerve?

A

The trochlear nerve.

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5
Q

What is the 5th cranial nerve?

A

Trigeminal nerve.

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6
Q

What is the 6th cranial nerve?

A

The abducent nerve.

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7
Q

What is the 7th cranial nerve?

A

The facial nerve.

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8
Q

What is the 8th cranial nerve?

A

The vestibulocochlear nerve.

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9
Q

Which cranial nerve is considered as an extension of the brain?

A

The olfactory nerve and the bulb.

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10
Q

How many olfactory nerve bundles pass to the olfactor bulb?

A

About 20 bundles.

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11
Q

How do the olfactory nerve bundles pass to the olfactory bulb?

A

They pass to the olfactory bulb through the cribriform plate of the ethmoid in the anterior cranial fossa from the roof of the nose.

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12
Q

What do the olfactory nerves innervate?

A

They innervate the upper part of the nasal cavity.

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13
Q

What is anosmia?

A

This is when there is loss of sensation of smell.

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14
Q

What can anosmis tell us?

A

It can tell us that there is a fracture involving the cribriform plate or it may indicate a neuroma or meningoma compressing the olfactory bulb or tract.

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15
Q

When is anosmia common?

A

It is common after a cold or upper respiratory tract infection.

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16
Q

How can we test the olfactory nerve?

A

By asking the patient to identify a strong smell such as coffee or chocolate through each nostril in turn is a way of testing the olfactory nerve.

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17
Q

What are the optic nerves concerned with?

A

They are concerned with vision.

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18
Q

What is the path of the optic nerve?

A
  • pass from the back of the eye through the orbit
  • pass through the optic canal in the sphenoid bone.
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19
Q

What is the path of nerve impulses from the lateral part of the retina?

A

They run to the visual cortex of the same side.

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20
Q

What is the path of nerve impulses from the nasal side of the retina?

A

They cross to the other side in the optic chiasma.

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21
Q

Where is the optic chiasma?

A

This lies in front of the pituitary stalk and between the terminal parts of both internal carotid arteries.

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22
Q

When do we get bitemporal hemianopia?

A

We can get this when a pituitary tumour presses on the centre of the optic chiasma.

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23
Q

What happens to the nasal parts of the retina in bitemporal hemianopia?

A

Thr nasal parts of the retina recieve light from the temporal fields and in this case they become insensitive to light.

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24
Q

When do we get nasal hemianopia?

A

This is when there is pressure to the side of hte optic chiasma.

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25
Q

What do we have to make sure that we do when there are visual field defects?

A

These defects need to be described and plotted with care for each eye when testing the optic nerve.

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26
Q

What does the oculomotor nerve supply?

A

It supplies most of the extrinsic muscles of the eye?

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27
Q

What does the oculomotor nerve not supply?

A
  • lateral rectus
  • superior oblique
  • involuntary part of the levator palpebrae superioris muscle
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28
Q

Describe the path of the lateral rectus muscle.

A
  • passes from front of the midbrain between posterior cerebral and superior cerebellar arteries
  • into the cleft of dura between free edge of tentorium and the dura over the petroclinoid ligament
  • runs forwards in the lateral wall of the cavernous sinus and through the superior orbital fissure within the tendinous ring to enter the orbit.
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29
Q

How can we test the muscles that are supplied the oculomotor nerve?

A

We can ask the subject to look from side to side and then to look up and down with the eye placed alternately medially and laterally.

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30
Q

Describe the trochlear nerve.

A

This is a small thread like nerve.

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31
Q

Where does the trochlear nerve arise from?

A

It arises from the back of the midbrain.

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32
Q

How does the trochlear nerve enter the dura of the lateral wall of the cavernous sinus?

A
  • runs forwards under the free edge of the tentorium
  • passes beneath and lateral to the 3rd nerve to enter the dura of the lateral wall of the cavernous sinus.
33
Q

How does the trochlear nerve enter the orbit?

A

It enters the orbit through the outer part of the superior orbital fissure outside the tendinous ring.

34
Q

What does the trochlear nerve supply?

A

After it enters the orbit, it supplies the superior oblique muscle.

35
Q

How can we test the trochlear nerve>

A

By asking the patient to look downwards and then downwards.

36
Q

Describe the path of trigeminal nerve?

A
  • This leaves the anterolateral surface of the pons
  • passes forwards to petrous crest
  • runs over the petrous crest with an extension of the dura and arachnoid from the posterior cranial fossa.
37
Q

Where is the sensory trigeminal ganglion?

A

This in a depression on the apex of the petrous bone in Meckels cave.

38
Q

How many sensory division of the trigeminal nerve are there?

A

There are 3 large sensory division of the ganglion

39
Q

What does the motor part of the trigeminal nerve go on to join?

A

It joins the mandibular division which is the 3rd division of the trigeminal nerve.

40
Q

What is the first division of the trigeminal nerve?

A

This is the opthalmic division.

41
Q

What does the opthalmic divison run through?

A

It runs through the lateral wall of the cavernous sinus.

42
Q

What does the opthalmic division divide into?

A
  • frontal
  • lacrimal
  • nasociliary

branches

43
Q

What are the branches of the opthalmic division of the trigeminal nerve sensory to?

A
  • conjunctiva
  • skin of upper eyelid
  • bridge of nose
  • forehead
  • short and long ciliary branches supply the cornea and the sclera.
44
Q

What is the second division of the trigeminal nerve?

A

This is the maxillary division.

45
Q

Where does the maxillary division run?

A

It also runs in the lateral wall of the cavernous sinus.

46
Q

What is the maxillary division the sensory nerve to?

A
  • mid face
  • nasal cavity
  • palate
  • lower eyelid and associated conjuctiva via infraorbital nerve
47
Q

How can the sensory branches of the different division of the trigeminal nerves be tested?

A

They can be tested for touch, temperature and pressure and pain over the dermatomes on the skin of the forehead and face.

48
Q

Where does the abducent nerve leave the brain from?

A

It leaves the brain from the lower aspect of the pons

49
Q

What does the abducent nerve do before it pierces the dura?

A

It runs a long way up the clivus.

50
Q

What is the course of the abducent nerve after it pierces the dura?

A

It runs under the petroclinoid ligament and into the cavernous sinus.

51
Q

What is a negative consequence of the fact that abducent nerve has such a long course?

A

Because of its long course, it is more susceptible to injury.

52
Q

What does the abducent nerve accompany through cavernous sinus?

A

It accompanies the internal carotid artery.

53
Q

How does the abducent nerve enter the orbit?

A

It enters the orbit through the superior orbital fissure within the fibrous ring.

54
Q

What does the abducent nerve supply?

A

It supplies the lateral rectus muscle.

55
Q

How can we test the lateral rectus muscle?

A

By asking the subject to follow and look at an object that is held out to the edge of the temporal field of view with the eye of the same side.

56
Q

Where does the facial nerve emerge from?

A

It emerges from between the pons and the medulla.

57
Q

After the facial nerve emerges from between the pons and medulla, where does it pass laterally to?

A

It passes laterally to the internal acoustic meatus.

58
Q

What is the facial nerve destined to supply?

A

It will eventually supply the muscles of facial expression.

59
Q

Where does the facial nerve go immediately after it passes into the internal acoustic meatus?

A

It continues laterally in the internal acoustic meatus until it approaches the medial wall of the middle ear cavity.

60
Q

What is the ganglion of the sensory root called?

A

This is called the geniculate ganglion.

61
Q

What does the geniculate ganglion contain?

A

It contains cell bodies of the sensory nerve fibres of the facial nerve.

62
Q

What is the path of the facial nerve after the geniculate ganglion?

A
  • turns posteriorly at the genu in a bony canal
  • runs towards the posterior wall of the middle ear cavity
  • travels down the posterior wall of the middle ear cavity in its bony canal.
  • leaves the skull through the stylomastoid foramen.
63
Q

Close to the geniculate ganglion, what does the facial nerve give off?

A

It gives off the greater superficial petrosal nerve.

64
Q

What branch does the facial nerve give off in the middle ear cavity?

A

It gives off a branch to the stapedius muscle.

65
Q

What does the facial nerve give off just before it leaves the skull through the stylomastoid foramen?

A

It gives off the chorda tympani.

66
Q

What is the path of the chorda tympani?

A

It runs forwards over the handle of the malleus and the tympanic membrane.

67
Q

How does the facial nerve leave the skull?

A

It leaves the skull base through the petrotympanic fissure.

68
Q

What happens to the facial nerve immediately after it leaves the skull base?

A

It joins the lingual nerve.

69
Q

What is the vestibulocochlear nerve the nerve of?

A

It is the nerve of hearing and balance.

70
Q

Where does the vestibulocochlear nerve emerge?

A

It emerges close to the facial nerve between the pons and the medulla.

71
Q

After the vestibulocochlear nerve emerges between the pons and the medulla where does it pass into?

A

It passes into the internal acoustic meatus.

72
Q

In the internal acoustic meatus, what does the facial nerve run with?

A

It runs with the facial nerve and the labrynthine artery.

73
Q

What is the labrynthine artery?

A

This is an end artery like the central artery of the retina.

74
Q

While passing through the internal acoustic meatus where is the vestibulocochlear nerve heading towards?

A

It is heading towards the cochlea and vestibular apparatus.

75
Q

Where do the nerve fibres in the cochlear division of the vestibulocochlear nerve have their sensory ganglia?

A

In the modiolus of the cochlea.

76
Q

Where do the nerve fibres of the vestibular division have their sensory ganglia?

A

They have their sensory ganglia in the internal acoustic meatus.

77
Q

What is a test for vestibular function?

A

Ask the subject to stand with their feet together and close their eyes.

If there is a recent vestibular lesion then the subject will sway and fall to the side.

78
Q

How can we test for hearing impairment?

A
  • tests are complicated but we can use a tuning fork to distinguish between sensorineural deafness and deafness due to conduction between the external auditory meatus and the footplate of the stapes.
  • air conducted sound is larger than bone conducted sound.
  • if sound conduction pathway is damaged then conduction is better than air conduction
  • we can distinguish between the 2 types of deafness by placing a tuning fork first on the mastoid process and then beside the ear

Head and Neck Anatomy (36 decks)

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