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Cranial nerves Flashcards

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1
Q

What are cranial nerves part of?

A

Peripheral nervous system

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2
Q

How many cranial nerves are there?

A

12 pairs

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3
Q

Where do cranial nerves arise?

A

Irregular intervals from the CNS

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4
Q

What do cranial nerves supply?

A

Head and neck except for vagus nerves which also supply structures in the thorax and abdomen

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5
Q

How are cranial nerves named?

A

Have a name and roman numeral which relates to there order

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6
Q

What kind of axons do cranial nerve carry?

A

some will be mixed but some are purely sensory or purely motor or autonomics (don’t all carry autonomic nerves)

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7
Q

What does the brain stem adjoin?

A

The brain to the spinal cord

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8
Q

What is the brainstem important for?

A

Cadio-respiratory functions and maintaining consciousness

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9
Q

Where are most of the cranial nerve nuclei?

A

in the brain stem

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10
Q

What is a nuclei?

A

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

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11
Q

Label the brain, midbrain, pons and medulla and how many CNs there are

A

2,2,4,4

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12
Q

What two Cranial nerves come from the forebrain?

A

Olfactory

Optic

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13
Q

What number is the olfactory nerve?

A

I

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14
Q

What does the olfactory nerve do?

A

special sensory

sense of smell (olfaction)

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15
Q

What is the route of the olfactory nerve?

A
  • Temporal lobe
  • Olfactory tract and bulb
  • Cribriform foramina (esmoid bone)
  • Through roof of nose to top of nasal cavity
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16
Q

How is the olfactory nerve tested?

A

Not usually tested- ask if lost sense of smell

Test one nostril at a time- uses smelling salts or whatever you have e.g. coffee

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17
Q

What is anosmia?

A

Losing sense of smell

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18
Q

What is the most common reason for losing your sense of smell?

A

Common cold

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19
Q

What can cause a loss of sense of smell?

A

Head injury

Intracranial tumours at base of frontal lobe

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20
Q

What is the number of the optic nerve?

A

II

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21
Q

What is the function of the optic nerve?

A

Special sense

Vision

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22
Q

Where does the optic nerve travel?

A
  • Visual cortex of the brain
  • Optic canal
  • Optic tract
  • Chiasm
  • Retina
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23
Q

How do you test the optic nerve?

A

Test one eye at a time

Visual tests

Testing pupil responses/reflexes

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24
Q

How can you see the optic nerve?

A

Use an opthalmoscope

Can see the optic disk- origin of optic nerve

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25
What is a papillodema?
If intracranial pressure raises, optic disc may swell due to extension of meinges the nerve carries
26
What will lesions fot the retina or optic nerve cause?
Visual disturbance affecting only one eye
27
Where will lesions causing visual defects in both eyes occur?
Chiasm or further back
28
What can cause compression of the optic chiasm?
Pituitary tumour
29
What is the function of the occulomotor nerve?
* Motor * Autonomic (parasympathetic) * Moves the eye * Opens eyelid * Control lens and pupil of eye * Innervates extra ocular muscles, LPS, Sphincter papillae, ciliary muscle
30
What is the number of the oculomotor nerve?
III
31
What happens to occulomotor nerve if intercranial pressure increases?
Uncus can slip over the edge of entorium cerebelli and squash the occulomotor nerve
32
What will happen if occulomotor nerve is squashed?
Will start autonomic parts of nerve being effected as they are on the outside So pupil will dilate and be blown then other things it does will be effected
33
How would you test the occulomotor nerve?
34
What are the cinical points of the occulomotor nerve?
35
What number is the trochlear nerve?
IV
36
What does the trochlear nerve supply?
1 Extra orbital muscle
37
What is special about the Trochlear nerve?
Emerges from the back of the brainstem
38
What are the two CN from the midbrain?
Oculomotor Trochlear
39
What are the 4 cranial nerves of the pons?
Trigeminal (V) Abducens (VI) Facial (VII) Vestibular (VIII)
40
What is the route of the occulomotor nerve and the trochlear nerve?
* Midbrain * Cavernous sinus * Superior orbital fissure * Orbit
41
What is the function of the trochlear nerve?
* Motor * Innervates 1 extra orbital muscle * Moves the eye
42
How would you test the trochlear nerve?
•Tests eye movement
43
What are the clinical signs of injury to the Trochlear?
* Diplopia (double vision)- rare and often subtle e.g. with a tilt of the head * From head injury or congenital palsies
44
What is the route of the Trigeminal?
* Pons * Branches- * Ophthalmic- superior orbital fissure and eye * Maxillary- foramen rotundum and cheek Mandibular- foramen ovale and jaw
45
What is the function and target tissue of the trigeminal nerve?
* Motor and Sensory * Sensory to cornea of the eye, and face * Sensation of 2/3 of tongue * Motor to muscles of mastication
46
How is the trigeminal nerve tested?
* Sensation on the face * Muscles of mastication * Corneal reflex
47
What is the pathology and injury of the trigeminal nerve?
* Main sensory nerve to skin of face and facial structures * Afferent limb of corneal reflex * Vulnerable in facial trauma * Shingles- trigeminal neuralgia
48
What is the route of the Abducens nerve?
* Bottom of pons * Cavernous sinus * Superior orbital fissure * orbit
49
What is the function of the Abducens?
* Motor * 1 muscle of the eye * Abducts eye- moves laterally
50
How would you test the Abducens?
* Eye movements * Diplopia (double vision)
51
What is the pathology and injury to the Abducens?
* Caused by increased intracranial pressure * Eye is stuck medially
52
What is the route of the facial nerve?
* Bottom of pons * Internal auditory meatus * Petrous bone * Gives off some branches in petrous bone * Exits base of skull then gives off branches
53
What is the function of the facial nerve?
* Motor, special sensory and autonomic parasympathetic * Motor- muscles of facial expression * Special sensory- taste to anterior 2/3 of tongue * Autonomic- lacrimal gland and salivary glands
54
How would you test the facial nerve?
* Muscles of facial expression movement * Corneal reflex * Taste
55
What is the injury and pathology of the facial nerve?
* Close relationship with vestibulocochlear nerve as both go through IAM * Close relationship to middle ear as goes through the petrous temporal bone * Close relationship to parotid gland * Idiopathic facial nerve palsy (bells palsy)
56
What is the route of the vestibulochochlear nerve?
* Pons * Internal auditory meatus * Petrous bone * Cochlea and inner ear * Primary auditory cortex (temporal lobe)
57
What is the function of the vestibulocochlear nerve?
* Special sensory * Conveys sense of hearing
58
What is the test for the vestbulocochlear nerve?
* Test hearing * Enquire about balance
59
What is the pathology and injury to the vestibulocochlear nerve?
* Hearing loss * Presbyacusis- old age related hearing loss * Semicircular canals vestibulocochlear nerve and brain nucleus can cause disturbance of balance and nystagmus * Acoustic neuroma- benign tumour involving the vestibulocochlear nerve- compression so causes hearing loss, tinnitus, vertigo and numbness pain or weakness down one half of the face
60
What is the route of the glossopharyngeal nerve?
* Medulla * Through jugular foramen * Descends through base of neck * To tongue and pharynx
61
What is the function of the glossopharyngeal nerve?
* General sensory, special sensory, autonomic and motor * General sensation of soft palate, tonsils and pharynx, middle ear and tympanic membrane, carotid body and sinus * Special sensory- Taste of posterior 1/3 of tongue * Autonomic innervation of parotid gland * Motor supplies one muscle- stylopharyngeaus
62
How would you test the glossopharyngeal nerve?
* Gag reflex * Taste not formally tested * Tested in conjunction with vagus nerve
63
What is the injury to the glossopharngeal nerve?
isolated lesions are rare
64
What is the route of the vagus nerve?
* Medulla * Through Jugular foramen * Descends through the neck in the carotid sheath * Gives off branches to the neck * Continue to thorax and gives branches * Into abdomen
65
What is the function of the vagus nerve?
* Sensory to lower pharynx and larynx * Motor- Muscles of soft palate, pharynx, and larynx (talking and eating) * Parasympathetic to thoracic and abdominal viscera
66
What is the test of the vagus nerve?
* Speech * Swallow and cough * Ahhhh and observe uvula * Gag reflex
67
What is the pathology and injury to the vagus nerve?
* Isolated lesions are rare * Deviation of uvula when soft palate elevated when saying ahhhh * Injury to recurrent laryngeal nerve branch can cause hoarseness and dysphonia
68
What is the route of the spinal accesory nerve?
* Medulla * Jugular foramen * Has a cranial and spinal route * Cranial joins the vagus – not important- this info is on spinal * Spinal goes through foramen magnum
69
What is the function of the spinal accessory nerve?
* Motor * Sternocleidomastoid and trapezius
70
How would you test the spinal accessory nerve?
* Shrug shoulders against resistance * Turn head against resistance
71
What is the injury and pathology for the spinal accessory nerve
* Spinal accessory nerve runs down through neck in posterior triangle * Susceptible to injury in this area e.g. in lymph nodes biopsies, surgery and stab wounds
72
What is the route of the hypoglossal nerve?
* From medulla * Through hypoglossal canal * To the tongue
73
What is the function of the hypoglossal nerve?
* Motor * Muscles of the tongue
74
How would you test the hypoglossal nerve?
•Inspect movement of the tongue
75
What is the injury and pathology of the hypoglossal nerve?
* Rare * Damage causes weakness and atrophy of the tongue muscles on ipsolateral side

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