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BMS100 Clin Phys > Clin Phys 6 > Flashcards

Clin Phys 6 Flashcards

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1
Q

What are cranial nerves?

A

nerves that “emerge from the brain” and exit via skull foramina

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2
Q

What do cranial nerves carry?

A
  • special sensory info: special senses (sight, sound, taste, smell, “balance)
  • somatic motor info: somatic motor = skeletal muscles w/ voluntary control
  • somatic sensory info: somatic sensory = sensations that we can perceive OTHER THAN special senses
  • motor & sensory info to/from structures that we cannot control or perceive: ANS —> glands/organs or from organs
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3
Q

Where does CN I project to?

A

cortex

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4
Q

Where does CN II project to?

A

thalamus

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5
Q

Where are nuclei of CN III and IV found?

A

midbrain

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6
Q

Where are nuclei of CN V, VI, VII, VIII found?

A

pons

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7
Q

Where are nuclei of CN IX, X, XI, XII found?

A

mostly in the medulla

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8
Q

What is the name of CN I?

A

olfactory nerve

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9
Q

What is the function of CN I?

A

sense of smell

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10
Q

What is the pathway of CN I?

A

from superior part of nasal cavity –> olfactory bulb –> many different locations in temporal and frontal lobes

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11
Q

What is the skull entry/exit point for olfactory nerve?

A

cribriform plate (ethmoid)

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12
Q

How do we test CN I?

A

ask pt to identify a couple of distinctive smells (eyes closed if necessary) - ex., coffee, peppermint

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13
Q

What is it called if the CN I is no longer function?

A

anosmia

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14
Q

What is the name for CN II?

A

optic nerve

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15
Q

What is the function of CN II?

A

vision

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16
Q

What is the pathway of CN II?

A

from retina (back of eye) –> thalamus –> occipital lobe (cortex)

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17
Q

What is the skull entry/exit point for CN II?

A

optic foramen

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18
Q

How do we test CN II?

A
  • the Snellen eye chart (central vision)
  • Peripheral field tests (peripheral vision)
  • observation of back of the eye - retina (ophthalmoscope)
  • pupillary movements, rapid involuntary eye movements
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19
Q

What is the main function of CN III, IV, VI?

A

eye movements (somatic motor)

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20
Q

What is the name for CN III?

A

oculomotor

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21
Q

What is the name for CN IV?

A

trochlear

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22
Q

What is the name for CN VI?

A

abducens

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23
Q

What is the pathway of CN III?

A

midbrain –> muscles around the eye –> projects to pupillary muscles (dilation, constriction) & elevator palpebral superioris muscle

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24
Q

What is the specific function of CN III?

A

most eye movements and control of pupils

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25
What is the pathway of CN IV?
midbrain --> superior oblique
26
What is the specific function of CN IV?
directs gaze down and outwards
27
What is the pathway of CN VI?
pons --> lateral rectus
28
What is the specific function of CN VI?
directs gaze laterally (abducts eyeball)
29
What is the entry/exit point for CN III, IV, VI?
superior orbital fissure
30
How do we test CN III, IV, VI?
1. Ask t to “follow your finger w/ their eyes" 2. Move your finger so that you draw a big “H” in the air in front of them - eyes SHOULD smoothly follow finger 3. Shine a light into the pt’s eyes & hold an object close to pt’s eyes - pupils SHOULD constrict in response
31
What is the name of CN V?
trigeminal nerve
32
What are the 2 major functions of CN V?
somatic sensation and somatic motor
33
What cranial nerve is in charge of sensation over the face, tongue, scalp, nasal cavity and cornea?
CN V
34
What is the cornea?
clear, tough outer part of eye that overlies the iris
35
What is the entry/exit point of CN V?
exits from pons, leaves skull through: - superior orbital fissure: cornea, forehead, scalp, eyelids, nasal mucosa (upper face, scalp) - foramen rotunda: face over the maxillary part of the face, including maxillary teeth (mid-face) - foramen vale: lower jaw, proprioception for tongue (lower face, mouth - NOT TASTE)
36
What cranial nerve is in charge of motor function for muscles of mastication (chewing) and some neck, middle ear muscles?
CN V
37
What are the main muscles associated with CN V?
temporalis, maseters, pterygoids
38
Where does CN V exit?
foramen ovale
39
How do we test CN V?
1. Sensory: sharp, dull, & light touch over the face 2. Strength of jaw clenching & movements of jaw
40
What is the name for CN VII?
facial nerve
41
What are the 4 main functions of CN VII?
1. Facial movements OTHER THAN the tongue, eye muscles, & muscles of mastication (somatic motor) - controls the most muscles 2. Taste from anterior 2/3 of the tongue (taste) 3. Autonomic motor input to glans (“autonomic” motor) - salivary & tears, nasal glands (nasal secretions) 4. Somatic sensation from ear canal (somatic sensory)
42
What is the exit/entry point for CN VII?
stylomastoid foramen
43
What is the pathway for CN VII?
Exits/enters the pons —> passes through the internal acoustic meatus & facial canal, exits through the stylomastoid foramen
44
How do you test CN VII?
ask pt to use their facial muscles
45
What is the name of CN VIII?
vestibulocochlear
46
What is the pathway of the hearing apparatus (CN VIII)?
Sound waves enter the ear canal --> vibration of tympanic membrane --> Movements of tiny bones in middle ear (malleus, incus, stapes) - act as levers to increase amplitude of sound --> Vibrations transmitted from stapes to cochlea within inner ear --> vibrations in cochlear fluid move hairs in the cochlea --> Hairs transduce vibrations into electrical impulses --> Electrical impulses are carried by CN VIII
47
What is the function of CN VIII?
hearing and balance
48
What is the pathway of CN VIII?
inner ear --> internal acoustic meatus --> pons --> thalamus and synapses in temporal lobe for perception of sound
49
How do you test hearing function of CN VIII?
- whisper to pt to test for auditory acuity - tuning forks: allows you to tell if there’s problem with the nerve or ear canal (—> ear drum —> cochlea pathway) - tuning forks are heard by conduction of tuning fork vibration through bones of skull - if you “hear” tuning fork better when it’s sending vibrations through your skull (vs. Being held up by ear) —> have problem w/ ear canal, ear drum, or tiny bones in middle ear
50
How do you test balance function of CN VIII?
- motion-detecting apparatus of ear feeds important info to cerebellum (vestibular apparatus) - IF this is COMPROMISED —> balance is impaired - have pt stand w/ eyes closed (falls over) or with abnormalities in gait (veers to one side) - nausea, rapid, involuntary eye movements (nystagmus)
51
What is the entry/exit point for CN VIII?
internal acoustic meatus
52
What is the name of CN IX?
glossopharyngeal
53
What are the main functions of CN IX?
1. Swallowing: somatic motor 2. Sensation from pharynx, part of external ear (somatic sensory) & from chemoreceptors/ baroreceptors in carotid body (“autonomic sensory”) 3. Taste from posterior 1/3 of tongue (special sensory) 4. Innervation of parotid salivary gland (“autonomic motor”)
54
Where does CN IX enter/exit and project to/leaves?
entry/exit: julgular foramen projects to/leaves: medulla
55
How do you test CN IX?
- stimulate posterior aspect of pharynx (gag reflex) - soft palate & tongue elevate (CN X) when stimulation is detected (CN IX) - NOT the best*
56
What is the name of CN X?
Vagus
57
What is the main functions of CN X?
- Pharyngeal muscles: swallowing (somatic motor) - laryngeal muscles: vocal cords (somatic motor) - parasympathetic nervous system input to the lungs, heart, liver, GI tract (“autonomic motor”) - “rest & digest” aspect of ANS - sensation from organs it impacts (“autonomic sensory”) - sensation from pharynx & external ear (“somatic sensory”) - sensory input from aortic baroreceptors & chemoreceptors (“autonomic sensory”)
58
How do you test CN X?
- listen to pt’s voice: if hoarse —> may be due to damage of vagus motor input to vocal cords - ask pt to say “ahhh” —> elevation of palate is part of somatic function of CN X
59
What is the name of CN XI?
accessory
60
What is the function of CN XI?
innervation of sternocleidomastoid & trapezius (somatic motor)
61
What is the entry/exit points of CN XI?
entry: foramen magnum exit: jugular foramen
62
How do you test CN XI?
- turning head against resistance - shrugging shoulders
63
Which CN is not a "true" CN?
CN XI: accessory
64
What is the name of CN XII?
hypoglossal
65
What is the function of hypoglossal?
innervation of tongue - key for speech & swallowing
66
What is the pathway of CN XII?
exits medulla and passes through hypoglossal canal
67
How do you test CN XII?
- ask pt to stick out their tongue and move it slide-to-slide - if tongue is deviated or pt can’t follow these instructions —> DAMAGE to nerve, medulla, or motor cortex
68
The special senses carried via cranial nerves will eventually project to the ___.
cortex
69
What sensory function is the occipital lobe responsible for?
vision
70
What sensory function is the temporal lobe responsible for?
sound
71
What sensory function is the inferior-lateral frontal lobes responsible for?
taste and smell
72
What are the special senses?
vision, smell, hearing, touch, taste
73
The other senses (pain, touch, vibration, proprioception, temp) project to __-__ __.
post-central gyrus
74
What sensory function is the dorsal column-medial lemniscal system responsible for?
touch, vibration, proprioception
75
What sensory function is the spinothalamic tract responsible for?
pain and temperature
76
What is the pathway of the dorsal column-medial lemniscal system?
- neurons that receive sensory input (first order neuron’s) send their axons to dorsal horn (grey matter) and then project into dorsal columns (white matter) - these axons stay on same side until they enter medulla —> enter medulla —> synapse on another neuron - next neuron (second-order neuron) crosses to other side of medulla, and then synapses with another neuron in thalamus (third order neuron) —> projects to post-central gyrus
77
What is the pathway of the spinothalamic tract?
neurons that receive sensory input (first order neurons) send their axons to the dorsal horn (grey matter) —> synapse w/ another cell in dorsal horn (second-order neuron) - axon of second-order neuron crosses over in the grey matter —> send its axon up to the brain in the lateral & anterior white matter of spinal cord - second-order neuron synapses w/ another neuron in the thalamus (third-order neuron) —> synapses w/ a neuron in post- central gyrus
78
What are dermatomes used for?
testing sensation
79
How do you test dermatomes?
- sharp: splintered wooden tongue depressor or cotton swab - spinothalamic tract - dull or soft: cotton swab - dorsal column-medial lemniscal - vibration sense: tuning fork on bony prominence - dorsal column-medial lemniscal

BMS100 Clin Phys (8 decks)

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