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Sem 3 > Case 5 > Flashcards

Case 5 Flashcards

1
Q

what is the first cranial nerve?

A

Olfactory

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2
Q

Where do the axons of the olfactory nerve extend to?

A

The olfactory bulb in the inferior surface of the frontal lobe

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3
Q

What are the sensory receptors for the olfactory nerve?

A

Olfactory mucosa in the upper nasal cavity.

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4
Q

where does the olfactory nerve leave the skull?

A

Cribiform plate of ethmoid bone

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5
Q

What is the second cranial nerve?

A

Optic nerve

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6
Q

Why is the optic nerve considered part of the CNS?

A

As its fibres are mylinated by oligodenrocytes of the CNS rather than schwann cells.

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7
Q

What would a doctor test to screen for lesions of the second optic nerve?

A

Pupillary reflexes.

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8
Q

What does the optic nerve innervate?

A

Retina of the eye

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9
Q

what is the third cranial nerve?

A

Oculomotor

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10
Q

What muscles are innervated by CN III

A

Superior, Inferior, Medial rectus

Inferior oblique

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11
Q

What structures are controlled parasympathetically by CN III?

A
  • Levator palprebrae superiorsis (keeps eyelid open)
  • Smooth muscle of iris (controld pupil dilation)
  • ciliary muscle (controlls accommodation)
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12
Q

What are the roles of the oculomotor (III) nerve?

A

Control of eye movements, constriction of the pupil and keeping the eyelids open.

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13
Q

What are the two nuclei of the oculomotor (III) nerve?

A

Oculomotor nucleus

Edinger westphal nucleus.

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14
Q

How might a doctor test the occulomotor (III) nerve? What other two nerves would be tested at the same time?

A

The patient would be asked to to hold their head still and follow with their eyes a pen light or finger being moved in H pattern. This nerve is tested at the same time as the trochlear nerve (IV) and the abducens nerve (VI).

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15
Q

What is the fourth cranial nerve?

A

Troclear

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16
Q

what does CN IV innervate?

A

Superior oblique

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17
Q

What type of nerve is the trochlear nerve (IV)?

A

Motor nerve (somatic efferent nerve)

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18
Q

What are some of the unique features of the trochlear nerve?

A
  • smallest number of axons,
  • greatest intracranial length
  • exits from the dorsal aspect of the midbrain
  • the only cranial nerve that decussates before innervating its target
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19
Q

When do the majority of cranial nerve fibres decussate what is the one exception to this?

A

The majority of cranial nerves decussate after innervating their targets the trochlear nerve is the exception as it decussates before its target.

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20
Q

Where does the trochlear nerve (IV) leave the midbrain?

A

The dorsal aspect of the midbrain, caudal to the inferior colliculus.

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21
Q

Where does the the trochlear nerve (IV) enter the eye?

A

Superior orbital fissure

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22
Q

what is the fifth cranial nerve?

A

Trigeminal

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23
Q

Where do the three branches of the trigeminal nerve (V) converge? What is the alternate name for this?

A

Trigeminal ganglion

Semilunar ganglion

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24
Q

What is the trigeminal/semilunar ganglion the cranial equivalent for of the spinal nerves?

A

The dorsal root ganglion.

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25
Q

Where are the cell bodies of the motor fibres of the trigeminal nerve (V) found?

A

The trigeminal motor nucleus located deep within the pons.

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26
Q

What brainstem nucleus does pain and temperature project to?

A

Spinal trigeminal nucleus in the midbrain

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27
Q

What brainstem nucleus does touch and pressure project to?

A

Principal trigeminal nucleus in the pons

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28
Q

What nerves, apart from sensory axons of the trigemnal nerve, terminate in the trigeminal/semilunar ganglion? What does this mean is contained within the trigeminal/semilunar ganglion?

A

Sensory fibers of the facial (VII), glossopharyngeal (IX) and vagus (X) nerves, this means that an entire sensory map of the face is contained within the trigeminal nucleus.

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29
Q

what is the sixth cranial nerve?

A

Abducens nerve

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30
Q

What does CN VI innervate?

A

Lateral rectus.

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31
Q

Where does the abducens nerve (VI) leave the brainstem?

A

Caudal pons - junction between the pons and medulla.

pontomedullary junction.

32
Q

What artery does the abducens nerve run alongside after it enters the cavernous sinus?

A

The internal carotid

33
Q

Where does the abducens nerve (VI) enter the orbit?

A

superior orbital fissure

34
Q

What is a test for the abducens nerve?

A

Hold an object in front of the patient and ask them to follow it with their eyes if they cannot abduct their eye their is likely an abnormality

35
Q

What is the seventh cranial nerve?

A

Facial nerve

36
Q

Where does the facial nerve enter the the brainstem?

A

Ventrolateral aspect of the caudal pons at the pontomedullary junction.
Cerebellopontine angle.

37
Q

The facial nerve (VII) splits into two roots what is the difference between the two?

A

Lateral root contains sensory and parasympathetic fibres whereas the more medial roots contains motor fibres

38
Q

What does the lateral root of the facial nerve contain?

A

Sensory and parasympathetic fibres.

39
Q

What does the medial root of the facial nerve contain?

A

Motor fibres

40
Q

What is the motor root of the facial nerve called?

A

Facial nerve proper

41
Q

What is the medial root of the facial nerve called?

A

Nervus intermedius

42
Q

Where do the cell bodies of the primary afferents of the facial nerves lie within?

A

Geniculate ganglion within the facial canal of the petrous temporal bone.

43
Q

Where do the central processes of the taste fibres terminate?

A

the rostral part of the nucleus solitarius of the medulla.

44
Q

Where do the motor fibres of the facial nerve (VII) originate?

A

The caudal pontine tegmentum, in the facial motor nucleus.

45
Q

Where do the preganglionic parasympathetic fibres of the facial nerve originate from?

A

Superior salivatory nucleus

46
Q

what do the postganglionic parasympathetic fibres from the facial nerve (VII) innervate?

A
  • lacrimal gland
  • nose, palate and pharynx mucosa
  • submandibular and sublingual salivary glands.
47
Q

What does the greater petroseal nerve innervate (branch of facial nerve) (parasympathetic)

A
  • lacrimal gland

- nose, palate and pharynx mucosa

48
Q

What does the chorda tympani nerve innervate (branch of facial nerve) (parasympathetic)

A
  • submandibular and sublingual salivary glands.
49
Q

What portion of the tongue does the facial nerve (VII) innervate in respect to taste?

A

anterior 2/3

50
Q

What differs in upper motor neuron lesions and lower motor neuron lesions of the face?

A

With an upper motor neuron lesion only the lower side of the face on the opposite side to the lesion will be effected whereas in lower motor neuron lesions there will be upper and lower facial weakness the same side as the lesion.

51
Q

What is the eighth cranial nerve?

A

Vestibulocochlear nerve

52
Q

Where does the vestibulocochlear nerve (VIII) enter the brainstem?

A

The cerebellopontine angle.

53
Q

What nuclei does the vestibular nucleus connect with to help co-ordinate eye movements?

A

The abducens (VI), the trochlear (IV) and occulomotor (III) nerves.

54
Q

What is the ninth cranial nerve?

A

glossopharyngeal nerve

55
Q

Is the glossopharyngeal (IX) nerve a predominately sensory or motor nerve?

A

Mostly sensory but contains preganglionic parasympathetic and some motor fibres.

56
Q

What gland does the glossopharyngeal nerve innervate?

A

Parotid salivary gland

57
Q

Where does the Glossopharyngeal (IX) nerve link to the brainstem?

A

Lateral to the olive in the rostral medulla.

58
Q

Where does the glossopharyngeal (IX) nerve carry sensation from?

A
  • Oropharynx tastebuds
  • Posterior 1/3 tongue
  • Eustation tube and middle ear
  • Chemoreceptors and baroreceptors in carotid body and sinus
59
Q

Where do taste fibres from the glossopharyngeal nerve (IX) terminate?

A

nucleus ambiguus

60
Q

What is the tenth cranial nerve?

A

Vagus

61
Q

Where does the Vagus nerve attach to the brainstem?

A

Lateral aspect of the medulla immediately caudal to the glossopharyngeal nerve (IX)

62
Q

Where do the sensory afferent nerve fibres of the Vagus nerve (X) carry information from?

A
  • Pharynx, larynx, oesophagus
  • tympanic membrane, external acoustic meatus and part of the concha of the external ear,
  • chemoreceptors in aortic bodies and baroreceptors in the aortic arch
  • distributed through the thoracic and abdominal viscera
63
Q

Where do the motor fibres of the vagus nerve (X) arise from?

A

Nucleus ambiguus

64
Q

What are the muscles innervated by the motor aspects of the vagus nerve (X) responsible for?

A

speech and swallowing

65
Q

What are the three signs of someone with a Vagus nerve lesion?

A
  • Difficulty swallowing
  • lose the gag reflex
  • their uvula would be deviated away from the side of the lesion.
66
Q

What is the eleventh nerve?

A

Accessory

67
Q

What type of nerve is the accessory nerve (XI)?

A

Purely motor.

68
Q

Which cranial nerve allows a person to shrug their shoulders?

A

The accessory nerve (XI)

69
Q

What muscles does the accessory nerve innervate?

A

Trapezius and sternocleidomastoid

70
Q

What are the two parts of the accessory nerve (XI)

A

It emerges from the lateral aspect of the medulla, The fibres from it originate from the caudal part of the nucleus ambiguus.

71
Q

What does the cranial aspect of the accessory nerve fuse with at the level of the jugular foramen?

A

The vagus nerve (X)

72
Q

Where does the the spinal aspect of the accessory nerve arise from where does it leave the spinal cord?

A

It arises from motor neurons located in the ventral horn of the spinal grey matter at C1-C5 and leave the cord via a series of rootlets at the lateral aspects of the cord.

73
Q

Where does the spinal aspect of the accessory nerve enter and leave the skull?

A

Enters at the foramen magnum and leaves via the jugular foramen

74
Q

What is the twelfth cranial nerve?

A

Hypoglossal

75
Q

What type of nerve is the hypoglossal nerve (XII) ?

A

Purely motor

76
Q

How would you test the hypoglossal nerve?

A

Ask a patient to stick their tongue out straight if it deviates to one side then that side most likely has a hypoglossal lesion.

Sem 3 (6 decks)

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