Flashcards in Cranial nerves Deck (82)
What are the three divisions of the trigeminal nerve?
V1 - Opthalmic
V2 - Maxillary
Which is the only branch of the trigeminal nerve to have a motor component?
What part of the brain does the trigeminal nerve attach to?
What formania does CN V1 leave the skull via?
Superior orbital fissure
What formania does CN V2 leave the skull via?
What formania does CN V3 nleave the skull via?
What does CN V1 supply?
Sensory input to
- the upper eyelid
- the cornea
- Skin of the root/tip/bridge of the nose
What does CN V2 supply?
Sensory input to
- Skin of the lower eyelid
- Skin over maxilla
- Skin of the ala of the nose
- Skin/mucosa of the upper lip
What does CN V3 supply? (sensory only)
- Skin over TMJ (NOT the angle of the mandible)
What nerve supplies the skin over the angle of the mandible and some of the external ear?
Great auricular nerve(C2, 3)
What is the great auricular nerve a sensory branch of?
The cervical plexus
What is the deep sensory territory of CN V1?
- bones & soft tissues of the orbit (except the orbital floor & lower eyelid)
- the upper anterior nasal cavity
- all paranasal sinuses (except the antrum)
- the anterior & posterior cranial fossae
What is the deep sensory territory of CN V2?
- the lower posterior nasal cavity
- the maxilla & maxillary sinus (antrum)
- the floor of the nasal cavity/palate
- the maxillary teeth & associated soft tissues (gingivae & mucosae)
What is the deep sensory territory of CN V3?
- the middle cranial fossa
- the mandible
- the anterior 2/3rds of the tongue
- the floor of the mouth
- the buccal mucosa
- the mandibular teeth & associated soft tissues
What 6 muscles does the motor branch on CN V3 supply?
What nerve forms the first part of the afferent limb of the bilnk/corneal reflex?
Long ciliary nerve
What nerve are you testing when you ask the patient to open their jaw against resistance?
Where does the facial nerve connect to the CNS?
What two foramina in the base of the skull does the facial nerve leave via?
Internal accoustic meatus
What structure does the facial nerve divide on top of?
The parotid gland
What does the chorda tympani supply?
- taste buds of the anterior 2/3rds of the tongue
- parasympathetic supply to the submandibular & sublingual salivary glands (salivation)
What nerve is the lingual nerve a branch of?
What are the four muscles of facial expression?
Elevators of lips
Where does the glossopharyngeal nerve connect to the brain?
Lateral aspect of the superior medulla oblongata
through which base of skull foramen does the glossopharyngeal nerve leave teh brain?
What do the glossopharyngeal nerve give a general sensory supply to?
the posterior 1/3rd of the tongue
the mucosa of most of the nasopharynx
the mucosa of all of the oropharynx
the mucosa of some of the laryngopharynx (some overlap with CN X territory)
the palatine tonsil
the eustachian tube
the middle ear cavity
What do the glossopharyngeal nerves give a special sensory supply to?
The vallate papillae on the posterior third of teh tongue
What does the glossopharyngeal nerve give parasympathetic supply to?
Parotid salivary gland
What does the glossopharyngeal nerve give visceral afferent supply to?
Carotid sinus baroreceptors and carotid body chemoreceptors
What muscle does the glossopharyngeal nerve give somatic motor supply to?
Where abouts of the brain does the vagus nerve connect?
Lateral aspect of the medulla oblongata
Where does the vagus nerve exit the base of the skull?
Where does the spinal accessory nerve attach to the CNS?
Attached via cervical spinal nerves anterior rootlets to the spinal cord
How does the spinal accessory nerve get into the brain?
Through the foramen magnum
Where does the hypoglossal nerve connect with CNS?
Lateral to the pyramids of the medulla oblongata
Where does CN XII leave the base of skull?
How do you clinically test the functioning of the trigeminal nerve?
1. Sensory branches tested by lightly tounching the fact with a bit of cotton wool:
V1 - Forehead. Corneal reflex should also be examined by lightly touching the cornea with cotton wool. The patient should shit their eyes.
V2 - Cheek
V3 - Jawline
- Ask patient to clench their teeth together and feel the bulk if the masseter and temporalis muscles
- Ask the patient to clench their mouth against resistance
- Perform the "jaw jerk" test; you should see protrusion of the jaw when the chin is hit with a tendon hammer
Hiw do you test the function of teh facial nerve clinically?
Ask patient to:
- Crease forehead
- Close their eyes and keep them closed against resistance
- Puff out cheeks
- Reveal their teeth
How do you test the function of the vestibulocochlear nerve?
Rinne and weber test
How you test the functioning o the glossopharyngeal nerve?
By initiating the gag reflex
How do you clinically test the vagus nerves?
- Ask patient to speak
- Ask the patient to say ahhh and look for deviation of the uvula
What two muscles doe the spinal accessory nerve give motor supply to?
How do you test the functioning of the spinal accessory nerve?
- Get the patient to shrug their shoulders against resistance
- Get the patient to turn their head against resistance
How do you test the functioning of the hypoglossal nerve?
Ask the patient to stick their tongue out (look for deviations and signs of wasting)
What does the hyopglossal nerve innervate?
Motor supply to the muscles of the tongue
Which is the only cranial nerve to exit the brain posteriorly?
CN IV - Trochlear
What cranial nerve does not synapse in the thalamus before heading up to the cortex?
Where exactly in the midbrain does the occulomotor nerve originate?
The third nerve nucleus at the level of the superior colliculus
What structure is the third nerve nucleus located lateral to?
The cerebral aqueduct
What nucleus of the trigeminal nerve receives the signals of proprioception from the chewing muscles?
What nucleus of the trigeminal nerve receives general sensation of pain, touch and position?
Trigeminal sensory nuclei
What nucleus of the trigeminal nerve is responsible for discriminitive touch and vibration?
Pontine trigeminal nucleus (Principal nucleus)
Which part of the trigeminal nucleus is responsible for pain and temperature?
Which part of the trigeminal nucleus forms a long column of neurons that stretched from the midbrain to the upper 2 segments of the cervical spinal cord?
Which is the only site of the CNS where the cell bodies are primary afferent neurones?
What are the three parts of the trigeminal nucleus?
Spinal trigeminal nucleus
What motor nucleus is responsible for the jaw jerk reflex?
Trigeminal motor nucleus
Where are the cell bodies for the afferent fibres of the facial nerve found?
Whereabouts in the brain does the motor component of the facial nerve arise from?
Facial nerve nucleus in the pons
What nerve contains the sensory and parasympathetic fibres of the facial nerve before they join with the motor root?
What are the three different nucleus's of the facial nerve?
Facial motor nucleus
Superior salivatory nucleus
What nucleus holds the cell bodies of the facial nerve responsible for taste?
Where would you find the nucleus ambiguus?
Medullary reticular formation
Does the nucleus ambiguus hold motor or sensry neurones?
What nucleus contains the cell bodies of the nerves that innervate the muscle of the soft palate, pharynx and larynx?
What nerve nucleus contains the parasympathetic fibres of the glossopharyngeal nerve?
Inferior salivatory nucleus
What nerve nucleus hold the cell bodies for nerve of taste?
What vagus nerve nucleus contains the cell bodies of the parasympathetic neurones?
What three cranial nerves does the solitary nucleus have cell bodies of?
What two cranial nerves do the salivatory nuclei have cell bodies of?
What two cranial nerves does the nucleus ambiguus have cell bodies of?
(Cranial part of spinal accessory)
What nucleus deals with taste and general visceral sensations?
Which nucleus extends in a V shape for upper to lower medulla?
The solitary nucleus
Where does the corticobulbar tract originate?
The primary motor cortex
Is the corticobulbar tract made of white or grey matter?
What makes up the corticobulbar tract?
The upper motor neurones of cranial nerves V, VII, X, XII
What muscle groups does the corticobulbar tract supply?
Muscles of the face, head and neck
Which part of the corticobulbar system only has unilateral (as opposed to bilateral) innervation?
Lower half of the facial nerve
Where do the inputs to the cranial nerves containing parasympathetic efferents (VII, IX, X) arise from?
What does the reticular formation do?
Connects the spinal cord, cerebrum and cerebellum and mediates the overall level of cosciuosness
Give 6 functions of the reticular formation
1. Integrate cranial nerve reflexes.
2. Participate in conduction and modulation of pain
3. Influence voluntary movement
4. Regulate autonomic activity
5. Integrate basic functions, such as respiration and sleep
6. Activation of the cerebral cortex; major component of the ascending reticular activating system