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Cranial Nerves Flashcards

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1
Q

Cranial nerves are part of which NS?

A

Peripheral

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2
Q

How many pairs of cranial nerves do we have?

A

12

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3
Q

Where is the brain stem?

A

Attaching the brain to the spinal cord

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4
Q

What are the 3 parts of the brainstem?

A

Midbrain
Pons
Medulla

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5
Q

Define nerve nuclei

A

Collections of cell bodies of nerve fibres that make up the whole cranial nerve

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6
Q

How many cranial nerves come from each section?

A

2 forebrain
2 midbrain
4 pons
4 medulla

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7
Q

What is CNI and where does it come from?

A

Olfactory nerve

Forebrain

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8
Q

What type of nerve is CNI?

A

Special sensory only

Sense of smell

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9
Q

Describe the route of CNI

A

Olfactory tract comes from forebrain
To olfactory bulb on top of cribriform plate
Olfactory nerves dangle through cribriform foramina
Sense of smell to very top of nasal cavity

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10
Q

How do we test CNI?

A

Smelling salts under one nostril at a time

Not commonly tested

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11
Q

What is the clinical term for loss of sense of smell?

A

Anosmia

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12
Q

What is the commonest cause of anosmia?

A

A cold

URTI

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13
Q

What is CNII and where does it come from?

A

Optic nerve

Forebrain

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14
Q

What type of nerve fibres at in CNII?

A

Special sensory only

Eyesight

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15
Q

Describe the route of CNII from retina

A

Optic nerves run back from eyes to meet at the optic chiasm

Optic tracts take signals from chiasm to forebrain

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16
Q

What is the danger close to the optic chiasm?

A

Very close to pituitary gland
Tumours etc can squash chiasm
Present with problem in both eyes most likely

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17
Q

What is CNIII and where does it come from?

A

Oculomotor

Midbrain

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18
Q

Describe the route of CNIII

A

Midbrain - through cavernous sinus

Through the superior orbital fissure into the orbit

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19
Q

What nerve fibres are carried for CNIII?

A 
Motor (mainly) 
Some autonomics (PNS) - to muscles controlling the pupil
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20
Q

What does the motor part of CNIII innervate?

A

4 out of the 6 extra-ocular muscles

And levator palpebrae superioris of the eyelid

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21
Q

How do we test CNIII?

A

Inspection of eyelids and pupils
Eye movements
Pupillary light reflexes

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22
Q

What will an eye look like with a CNIII lesion?

A

Down and out
Severe ptosis
Pupil dilation

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23
Q

Give some causes of CNIII lesions

A

Raised ICP
Aneurysms
Cavernous sinus thrombosis
Diabetes/hypertension

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24
Q

Why are the autonomics on CNIII easily damaged?

A

PNS fibres run on the periphery of the nerve
Therefore any squashing of the nerve damages these fibres first
Dilated pupils

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25
What is CNIV and where does it come from?
Trochlear nerve | Dorsal aspect of midbrain
26
Which CN has the longest intracranial route?
Trochlear
27
Which hole does CNIV pass through?
Superior orbital fissure
28
What type of fibres are on CNIV?
Motor only
29
What does CNIV supply?
One extra-ocular muscle: superior oblique
30
Which direction does superior oblique muscle make you look?
Down and out
31
Why can CNIV lesions be easy to miss?
Patient can compensate with a slight tilt to their head
32
With a CNIV palsy, when will the double vision be worst?
When looking down
33
What is CNV and where does it come from?
Trigeminal | Pons
34
How many branches does CNV have and name them?
3 divisions Ophthalmic Maxillary Mandibular
35
Through which holes do the branches of CNV pass?
Ophthalmic - SOF Maxillary - foramen rotundum Mandibular - foramen ovale
36
What fibres are carried on CNV?
Sensory | Motor
37
What is the main sensory nerve of the face?
Trigeminal (V)
38
Where does CNV supply sensory to?
Face Inside mouth, nasal cavity and sinuses Cornea
39
What does the motor branch of CNV innervate?
Muscles of mastication
40
What runs through the infra-orbital foramen?
Infra-orbital nerve - a branch of the maxillary part of the trigeminal
41
What runs through the mental foramen?
Mental nerve - a branch of the mandibular part of the trigeminal
42
What is CNVI and where does it come from?
Abducens | Pons (junction between pons and medulla therefore can get squashed easily)
43
Describe the course of CNVI
Pons Through cavernous sinus to the SOF Into the orbit
44
What type of fibres are on CNVI?
Purely motor
45
What does CNVI supply?
Motor to one extra-ocular muscle - lateral rectus
46
What is CNVII and where does it come from?
Facial | Pons
47
Describe the route of CNVII
Very complex From pons, through internal acoustic meatus, through petrous part of the temporal bone Out at the stylomastoid foramen Gives off 5 branches which pass through parotid gland
48
What types of fibres are carried on CNVII?
Motor Special sensory Autonomic
49
What does the motor part of CNVII supply?
Muscles of facial expression
50
What does the special sensory part of VII supply?
Anterior 2/3 tongue taste
51
What does the autonomic part of VII supply?
PNS to lacrimal and salivary glands
52
Facial nerve has a close relationship with which other nerve?
Vestibulocochlear nerve (VIII)
53
What is CNVIII and where does it come from?
Vestibulocochlear nerve | Pons
54
Describe the route of CNVIII
From pons through IAM Terminates inside the ear (petrous part of temporal bone) Gives branches to semicircular canals and cochlear
55
What types of fibres are carried on CNVIII?
Special sensory | Hearing and balance
56
What is an acoustic neuroma?
A benign tumour that grows on VIII | Can cause complications
57
What is CNIX and where does it come from?
Glossopharyngeal | From medulla
58
What fibres are carried on IX?
Sensory Special sensory Motor Autonomic
59
Where does IX supply general sensation to?
Soft palate Tonsils Oropharynx Tympanic membrane
60
Where does IX supply special sense to?
Taste | Posterior 1/3 tongue
61
Where does IX send autonomic fibres to?
Parotid gland
62
Where does the motor supply to IX go?
Stylopharyngeus muscle
63
How do we test IX?
In conjunction with X Gag reflex Taste (posterior 1/3)
64
What is CNX and where does it come from?
Vagus | Medulla
65
What fibres are carried on X?
Sensory Autonomic Motor
66
Where does X supply general sensation to?
Laryngopharynx Larynx Small part of ear
67
Where does X supply motor to?
Muscles of soft palate Pharynx Larynx
68
Where does X send autonomic to?
PNS to thoracic and abdo viscera
69
How do we test X?
Noting speech Swallow Cough Gag reflex
70
How will a X lesion present?
Deviation of uvula when soft palate is raised
71
What do the right and left recurrent laryngeal nerves branch around?
``` Right = R subclavian artery Left = arch of the aorta ```
72
What is CNXI and where does it come from?
Accessory | Medulla
73
What fibres are on XI?
Motor only
74
What does XI supply?
Motor to SCM and trapezius
75
How do we test XI?
Shrug shoulders and turn head against resistance
76
Where is XI susceptible to injury?
Posterior triangle
77
What is CNXII and where does it come form?
Hypoglossal | Medulla
78
What fibres are on XII?
Purely motor
79
What does XII supply?
Motor to all the muscles of the tongue
80
Describe the route of XII
From medulla Passes through hypoglossal canal Runs medial to angle of mandible Crosses internal and external carotid arteries in the neck
81
Describe Bell's palsy
Facial nerve palsy Temporary weakness/paralysis of muscle in one side of face Often due to nerve inflammation eg. Viral infection
82
Which nerves run through the cavernous sinus?
Oculomotor Trochlear Abducens Ophthalmic and maxillary branches of trigeminal (V1 and V2)

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