ANATOMY - cranial nerves Flashcards
(147 cards)
1
Q
what does the PNS consist of
A
12 pairs of cranial nerves
31 pairs of spinal nerves
autonomic nerves - sympathetic and parasympathetic
2
Q
where does CNS change to PNS
A
rootlets of nerves from spinal cord (before they become spinal nerves etc)
3
Q
differentials of a problem with someones smell (3)
A
CNI injury
epilepsy
frontal lobe tumour (olfactory tract is below frontal lobe)
4
Q
CNI name
A
olfactory nerve
5
Q
CNI function
A
smell
6
Q
CNI modality
A
sensory
7
Q
CNI test
A
cover 1 nostril and test strong smells
8
Q
CNI brain connection
A
cerebellum - temporal lobe olfactory areas
9
Q
CNI cranial foraminae
A
cribiform plate of ethmoid bone
10
Q
which lobe does CNI travel inferior to
hence … lobe tumour may affect smell
A
frontal lobe
11
Q
what structure is in between the olfactory receptor cells and the olfactory tract
is the nerve PNS or CNS in this location
A
olfactory bulb
PNS, become CNS in the olfactory tract
12
Q
CNII name
A
optic nerve
13
Q
CNII function
A
sight
14
Q
CNII tests (5)
A
Snellen chart visual fields ishihara chart (for colour blindness) light reflexes fundoscopy
15
Q
CNII brain connection
A
cerebellum - occipital lobe
16
Q
CNII cranial foraminae
A
optic canal
17
Q
what surrounds the optic nerve and what is the significance of this
A
meninges and CSF (= optic sheath)
increased intracranial pressure = travels along optic sheath = papilloedema
18
Q
which nerve may be affected by increased ICP
A
optic nerve
19
Q
is CNII optic nerve CNS or PNS
A
CNS because encased in meninges
20
Q
what type of tumours are significant for CNII and why
A
pituitary tumours
optic chiasm is directly above the pituitary
21
Q
after the optic tract where do the APs synapse
A
lateral geniculate nucleus (LGN) of the thalamus
22
Q
after synapsing at the LGN (lateral geniculate nucleus) of the thalamus, where do APs go
note: think of what signals go to LATERAL nucleus
A
occipital lobe
23
Q
what type of APs synapse at the lateral geniculate nucleus (LGN) of the thalamus
A
visual
24
Q
what type of APs synapse at the medial geniculate nucleus (MGN) of the thalamus
A
auditory
25
within the occipital lobe, where do APs form optic nerve go
primary visual cortex
26
what is the sulcus (in the occipital lobe) called in which 2 gyri (above and below) received visual information
calcarine sulcus
27
where do APs from the right upper visual field go (within the occipital lobe)
left occipital lobe
gyrus inferior to calcarine sulcus
remember: everything is opposites (R and L, sup and inf)
28
on the gyri above/below the calcarine sulcus, where does the fovea/macula send its info to (posterior or anterior)
posterior edge
29
what is meyers loop
'loops' the SUPERIOR visual field info from the lateral geniculate nucleus to the sulcus inferior to the calcarine gyrus in the occipital lobe
30
what visual field defect is the result of pituitary tumour
bitemporal hemianopia
31
what visual field defect is the result of L optic nerve (in front of chiasm) injury
L monocular blindness
32
what visual field defect is the result of R optic tract (behind optic chiasm) injury
L homonymous hemianopia
33
if a visual field defect has macula sparing, where is the problem
primary visual cortex (in occipital lobe)
34
CNIII name
oculomotor
35
CNIII function (specific)
eye movement - inferior oblique, inferior rectus, medial rectus, superior rectus (NOT lateral rectus or superior oblique bc of SO4 LR6 AO3)
levator palpebrae superioris
36
CNIII modality
motor
37
CNIII connection to brain
midbrain
38
CNIII cranial formainae
superior orbital fissure (SOF)
goes through with CN IV, CNV1 and CN VI too (all the extraocular eye muscles)
39
CNIII test
'H' eye movements
40
what is the mnemonic for remembering the nerves supply extraocular eye muscles
SO4 LR6 AO3
41
what does the superior branch of CNIII supply (3)
superior rectus
levator palpebrae superioris
ie - the 2 superior things!
plus PS to sphincter papillae and ciliary muscles
42
what does the inferior branch of CNIII supply (3)
inferior rectus
inferior oblique
medial rectus
43
what does CNIII palsy look like
down and out eyeball (only superior oblique and lateral rectus are working)
44
CNIV name
trochlear
45
CNIV function
eye movements - superior oblique, pulls eye down (and in)
46
CNIV modality
motor
47
CNIV test
'H' eye movements
48
CNIV brain connection
midbrain
| dorsum of brain stem (diff from the others as all anterior)
49
CN IV cranial formainae
superior orbital fissure (SOF)
along with CN III, CNV1 and CNVI
50
how might someone with CN IV palsy present
head tilt - to compensate
51
which CN arises form the dorsum(back) of the brainstem
CN IV
52
which CN has the longest course, croses over etc = easily broken
CN IV
53
CNV name
trigeminal
div1 - ophthalmic
div2 - maxillary
div3 - mandibular
54
CNV function
sensory to face
| motor- muscles of mastication
55
CNV modality
both sensory and motor
56
CNV brain connection
pons
57
CNV cranial foraminae
CNV1 - superior orbital fissure (SOF)
CNV2 - foramen rotundum
CNV3 - foramen ovale
58
CN V1 function
sensory - face above eyelids and bridge of nose, superior nasal cavity, cornea
59
CNV2 function
sensory - face between eyelids and crease of lips, ala of nose, maxillary teeth, inferior nasal cavity
60
CNV3 function
sensory - face between crease of lips and jaw line (under jaw line and angle of mandible = great auricular nerve C2, 3), anterior 2/3 of tongue, mandibular teeth
motor - muscles of mastication (massester, temporalis, medial pterygoid, lateral pterygoid), tensor veli palatine, tensor tympani
61
what is the sensory supply to the nasal cavity
V1-superior and anterior
| V2-inferior and posterior
62
what nerve gives sensory spply to angle of mandible
C2,3
63
which nerve gives sensory supply to anterior 2/3 of tongue
CNV2
64
what is the nasociliary branch a branch of
CNv1
65
what is the significance of the nsociliary branch of V1 in singles
shingles can present with hutchisons sign (rash on tip of nose) THEN eye problems (corneal supply of V1)
66
what notch odes CNV2 travel through that means it is susceptible to trauma damage
infraorbital notch
67
which foramen is somatic sensory only
foramen rotundum
68
which part of the face has dual nerve supply
forehead
69
if there is an upper motor neurone (UMN) lesion in the nerves supplying the face, what will this present as
unilateral sensory loss but forehead sparing (as the forehead has a dual nerve supply so if one is cut off, there is still the nerve from the other side of the brain supplying it = not symptomatic)
70
if there is a lower motor neurone (LMN) lesion in the nerves supplying the face, how will this present
unilateral sensory loss INCLUDING the forehead (as even though the forehead has a dual nerve supply, in a LMN both nerves that supply the same sid of the forehead have met and hence there will be no sensation in that side of the forehead)
71
CNVI name
abducens
72
CNVI function
eye movements - lateral rectus (LR6)
73
CNVI modality
motor
74
CNVI test
'H' eye movements
75
CNV test
touch 6 areas of face (V1, V2, V3 bilaterally) with cotton wool, pin and tuning fork (for temp/vibration)
get them to open and close jaw with your hand on temporalis muscle (over temporal bone)
get them to open jaw with your hand underneath to give resistance (testing lateral pterygoid)
76
CNVI brain connection
pons-medulla junction (most medial, CNVII and CNVIII come off here too)
77
CNVI cranial foraminae
superior orbital fissure (SOF)
along with CNIII, CNIV and CNV1
78
which nerves pass through the cavernous sinus
CNIII, CNIV, CNIV, CNV1 and CNV2
79
which CN comes off the ponto-medullary junction most medially
which others come off here
CNVI
CNVII
CNVIII
80
which part of the temporal bone does CNVI (abducens) travel over
petrous part
81
CNVI palsy presentation
horizontal diplopia
82
CNVII name
facial
83
CNVII function
motor - muscle of facial expression, stapes bone in ear
chorda tympani branch - PS to sublingual and submandibular salivary glands
84
CNVII modality
both - sensory and motor
85
CNVII test
puff out cheeks
close eyes tightly
smile
86
which CN is closely associated with CNVII
comes off same place in brain and goes through same cranial foraminae
CNVIII (vestibulocochlear)
both come of ponto-medullary junction
both go through the internal acoustic meatus
87
which cavity does CNVII pass behind (and give off 1 branch to)
ear cavity
gives off a branch to supply to stapes bone
88
after going through the internal acoutics meatus and passing behind the ear cavity (in the facial canal), which foramen does the facial nerve (CNVII) go through
stylomastoid foramen
89
what are the 5 terminal branches of CNVII (after its given off branch to stape and chorda tympani branch)
what do they do
```
temporal
zygomatic
buccal
mandibular
cervical
```
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supply muscles of facial expression
90
muscles of facial expression (4)
frontalis (on forehead)
orbicularis occuli (around eyes)
orbicularis oris (around mouth)
elevators of lips
91
which condition affects CN VII
bells palsy
92
what cant someone with bells palsy do
puff out cheeks, close eyes tightly, smile etc
| CNVII palsy
93
which salivary gland is not supplied by chorda tympani branch of CNVII (though the nerve passes over it)
parotid gland
94
which glands does chorda tympani branch of CNVII supply
sublingual and submandibular salivary glands
95
which branch of CNVII passes over the tympanic membrane
what is the clinical significance of this
chorda TYMPANI
damage to tympanic membrane = may result in loss of taste/salivation
96
CNVIII name
vestibulocochlear nerve
97
CNVIII function
vestibular branch - balance
| cochlear branch - hearing
98
CNVIII test
rinnes and weber
99
CNVIII cranial foraminae
internal acoustic meatus
100
CNVIII brain connection
ponto-meduallry junction (with CNVI and CN VII)
101
what are the 2 branches of CNVIII
cochlear
| vestibular
102
where does the info that travels in the vestibular branch of CNVIII arise
semi circular canals (anterior, posterior and lateral)
103
CNIX name
glossopharyngeal nerve
104
CNIX modality
both - sensory and motor
105
CNIX brain connection
medulla
106
CNIX function
sensory - pos 1/3 tongue, pharynx,
motor - stylopharyngeus
107
CNIX brain connection
medulla (medial to CNX)
108
which nerve supplies sensory to posterior 1/3 of tongue
CNIX glossopharyngeal
109
CNIX test
gag reflex
110
which nerve supplies eustachian tube and middle ear cavity (think about anatomy of eustachian tube)
CNIX glossopharyngeal
bc eustachian tube connects middle ear cavity to pharynx
111
which nerve is significant in referred pain between throat and ear
CNIX glossopharyngeal
bc of connection between 2 cavities via eustachian tube
112
CN X name
vagus
113
CNX function
supplies lots of things between palate and midgut
114
CNX cranial foraminae
jugular foramen
115
CNX modality
both sensory and motor
116
CNX test
say 'ahhhhh'
swallow sip of water
hoarse voice?
cough
117
within which sheath does the vagus nerve run
in relation to the other things in sheath, where does it run
carotid sheath
posterior to common carotid artery and internal jugular vein
118
how do you differentiate between the vagus nerve CN X and the cervical ganglia in the carotid sheath
cervical ganglia have bulges
119
what is the first branch of the vagus nerve
what do they supply
superior laryngeal nerves
larynx cricothyroid muscles (all other larynx muscles supplied by inferior laryngeal)
120
what does the superior laryngeal nerve split into
internal and external superior laryngeal nerves
121
what is the first branch of the vagus nerve
what does it supply
superior laryngeal nerves
larynx cricothyroid muscles (all other larynx muscles supplied by inferior laryngeal)
122
what does the internal superior laryngeal nerve supply
mucosa above the vocal cords (bc mucosa is INTERNAL)
123
what does the external superior laryngeal nerve supply
cricothyroid muscles of larynx (bc muscles are EXTERNAL)
124
what does the inferior laryngeal nerve supply
all laryngeal muscles apart from the cricothyroid eg vocal cord muscles! important clinically
mucosa below the vocal cords
125
what is the anastomosis between the inferior laryngeal nerve and the internal superior laryngeal nerve called
galens anastomosis
126
where does the right vagus travel after being right to the oesophagus
posterior to oesophagus
laRP
127
where does the left vagus travel after being left to the oeosphagus
anterior to the oesophagus
LArp
128
where does the right recurrent laryngeal branch of the vagus go under
subclavian artery
129
where does the left recurrent laryngeal branch of the vagus go under
arch of aorta
130
what does the recurrent laryngeal branch of the vagus turn into
inferior laryngeal nerve (supplies half of larynx alongside the superior laryngeal nerve)
131
how does recurrent laryngeal nerve damage present
change in/loss of voice (bc they control the vocal cords)
hoarseness if unilateral
aphonia if bilateral
132
CNXI name
spinal accessory nerve
133
CNXI modality
motor
134
CNXI function
trapezius and sternocleidomastoid muscles
135
CNXI test (2)
shrug shoulders
| rotate head
136
CNXI cranial foraminae
jugular foramen
137
CNXI brain connection
spinal cord
138
what is the route of the spinal accessory nerve
arises from cervical spine
enters cranial cavity via foramen magnum
exits cranial cavity via jugular foramen
139
CNXII name
hypoglossal
140
CNXII modality
motor
141
CNXII function
extrinsic and intrinsic tongue muscles (apart from palatoglossus)
142
CNXII test
stick out tongue
| say 'ahhh'
143
CNXII cranial foraminae
hypoglossal canal
144
which nerve supplies palatoglossus (diff form other tongue muscles)
CNX vagus
145
which nerve supplies palatoglossus (diff form other tongue muscles)
CNX vagus
146
pneumonic for names of cranial nerves in order
oh oh oh to touch and feel virgin girls vagina and hymen
147
pneumonic for modality of cranial nerves in order
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