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Neuro MTC > Cranial nerves > Flashcards

Cranial nerves Flashcards

1
Q

What are the cranial nerves?

A
  • Olfactory
  • Optic
  • Oculomotor
  • Trochlear
  • Trigeminal (VI,2,3)
  • Abducens
  • Facial
  • Vestibulocochlear
  • Glossopharyngeal
  • Vagus
  • Accessory
  • Hypoglossal
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2
Q

what consistency are nerves?

A

soft and squishy

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3
Q

what are the different fibres that the nerves may contain? (x5)

A
  • somatic motor ie striated muscle
  • visceral motor ie cranial division of parasympathetic supply innervates smooth muscle and glands
  • visceral sensory ie afferent inputs from pharynx, larynx, heart, lung, gut etc
  • general sensory - afferent inputs (eg touch, temperature, pain) from skin & mucous membranes
  • special sensory – taste, smell, vision, hearing & balance
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4
Q

Is each nerve sensory/motor/ or both?

A
  • Olfactory (CNI) –sensory (smell)
  • Optic (CNII) –sensory (vision)
  • Oculomotor (CNIII) –motor (eye movement)
  • Trochlear (CNIV) –motor (eye movement)
  • Trigeminal (CNV) –mixed (V1&2=sensory, V3= sensorimotor)
  • Abducent (CNVI) –motor (eye movement)
  • Facial (CNVII)–mixed
  • Vestibulocochlear (CNVIII) –sensory (hearing & balance)
  • Glossopharyngeal (CNIX) –mixed
  • Vagus (CNX) –mixed
  • Accessory (CNXI) –motor
  • Hypoglossal (CNXII) -motor (tongue)
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5
Q

Olfactory nerve:

  • pathway
  • components
  • clinical application
A
  • pathway
  • receptors in olfactory epithelium of nasal cavity,

olfactory nerve fibres pass through foramina

in cribriform plate of ethmoid bone and enter

olfactory bulb in the anterior cranial fossa

  • Components

special sensory –> smell

  • Clinical application

Fractured cribriform plate may tear olfactory nerve fibres causing anosmia

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6
Q

Optic nerve:

  • pathway
  • components
  • clinical application
A
  • Pathway
  • enters via optic canal, nerves join to form optic chiasm, fibres from medial (nasal) half of each retina cross to form optic tract
  • Components
  • special sensory –> vision
  • Clinical application
  • increase in CSF pressure can cause papilloedema
  • section of right optic nerve causes blindness through right eye
  • section of optic chiasm causes loss of peripheral vision (bitemporal hemianopsia)
  • section of right optic tract causes blindness in left temporal & right nasal fields (left homonymous hemianopsia)
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7
Q

Oculomotor nerve:

  • pathway
  • components
  • clinical application
A
  • Pathway
  • emerges from midbrain and exits via superior orbital fissure
  • Components
  • somatic motor –> extraocular muscles (superior, medial & inferior rectus & inferior oblique) and eyelid (levator palpebrae superioris)
  • visceral motor –> parasympathetic to pupil causing constriction and to ciliary muscle causing accommodation of the lens
  • Clinical application
  • drooping of upper eyelid (ptosis)
  • eyeball abducted and pointed down
  • no pupillary reflex
  • no accommodation of lens
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8
Q

Trochlear nerve:

  • pathway
  • components
  • clinical application
A
  • Pathway

emerges from dorsal surface of the mid brain and exits via the superior orbital fissure

  • Components

somatic motor –extraocular muscle –> SO

  • Clinical application
  • diplopia when looking down
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9
Q

Trigeminal VI (opthalmic) nerve:

  • pathway
  • components
  • clinical application
A
  • Pathway

Emerges from the pons, travels through trigeminal ganglion & exits via superior orbital fissure

  • Components

General sensory- from cornea, forehead, scalp, eyelids, nose and mucosa of nasal cavity & sinuses

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10
Q

Trigeminal V2 (maxillary) nerve:

  • pathway
  • components
  • clinical application
A
  • Pathway

Emerges from the pons, travels through the trigeminal ganglion & exits via the foramen rotundum

  • Components

General sensory – from face over maxilla, maxillary teeth, TM joint, mucosa of nose, maxillary sinuses and palate

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11
Q

Trigeminal V3 (mandibular) nerve:

  • pathway
  • components
  • clinical application
A
  • Pathway
  • emerges from the pons, travels through the trigeminal ganglion & exits via foramen ovale
  • Components
  • general sensory –> from the face over mandible, mandibular teeth, TM joint, mucosa of mouth & anterior 2/3 of tongue
  • somatic motor–> muscles of mastication, part of digastric, tensor veli palatini & tensor tympani
  • Clinical application
  • paralysis of muscles of mastication
  • loss of corneal or sneezing reflex
  • trigeminal neuralgia
  • loss of sensation in the face
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12
Q

Abducens nerve:

  • pathway
  • components
  • clinical application
A
  • Pathway
  • emerges between pons & medulla & exits via superior orbital fissure
  • Components
  • somatic motor –> lateral rectus muscle (abducts eye)
  • Clinical application
  • medial deviation of the affected eye causing diplopia
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13
Q

Facial nerve:

  • pathway
  • components
  • clinical application
A
  • Pathway
  • emerges between pons & medulla & exits via internal acoustic meatus, facial canal & stylomastoid foramen
  • Components

somatic motor – muscles of facial expression & scalp, stapedius of middle ear, part of digastric muscle

visceral motor- parasympathetic innervation of submandibular & sublingual salivary glands, lacrimal glands, glands of nose & palate

special sensory- taste from anterior 2/3 of tongue & soft palate

general sensory- from external acoustic meatus

  • Clinical application
  • most frequently injured – due to long pathway through bone
  • Bell’s palsy- cannot frown, close eyelid, or bare teeth
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14
Q

Vestibulocochlear nerve:

  • pathway
  • components
  • clinical application
A
  • Pathway
  • emerges from between pons & medulla and exits via

internal acoustic meatus, dividing into vestibular

and cochlear nerves

  • Components
  • special sensory –> vestibular sensation from semi-circular ducts, utricle, saccule, gives sense of position & movement
  • hearing from spiral organ
  • Clinical application
  • tinnitus (ringing of ears)
  • deafness (conductive vs sensorineural)
  • vertigo (loss of balance)
  • nystagmus (involuntary rapid eye movements)
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15
Q

Glossopharyngeal (rememer tongue and pharynx) nerve:

  • pathway
  • components
  • clinical application
A
  • pathway
  • emerges from medulla & exits via jugular foramen
  • components
  • special sensory–> taste from posterior 3rd of tongue
  • general sensory –> sensation from middle ear & posterior oral cavity
  • visceral sensory –> sensation from carotid body & carotid sinus
  • visceral motor –> parasympathetic innervation of parotid gland
  • somatic motor –> to stylopharyngeus, helps with swallowing
  • clinical application
  • loss of gag reflex and taste from back of tongue
  • associated with injuries to CNs X & XI – jugular foramen syndrome
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16
Q

Vagus nerve:

  • pathway
  • components
  • clinical application
A
  • Pathway

Emerges from medulla and exits via jugular foramen, then goes everywhere

  • Components
  • special sensory –> taste from epiglottis and

palate

-general sensory –> sensation from auricle,

external acoustic meatus

-visceral sensory –> from pharynx, larynx, trachea,

bronchi, heart, oesophagus, stomach, intestine

-visceral motor –> parasympathetic innervation

to muscle in bronchi, gut and heart

-somatic motor –> to pharynx, larynx, palate and

oesophagus

  • Clinical application
  • damage to pharyngeal branches causes difficulty swallowing
  • damage to laryngeal branches causes difficulty in speaking
17
Q

Accessory nerve:

  • pathway
  • components
  • clinical application
A
  • pathway
  • small cranial (medulla) & large spinal roots exit via

jugular foramen

  • components
  • somatic motor –> striated muscle of soft palate, pharynx, larynx, sternocleidomastoid & trapezius
  • clinical application
  • weakness in turning head & shrugging shoulder
18
Q

Hypoglossal nerve:

  • pathway
  • components
  • clinical application
A
  • pathway
  • emerges from the medulla and exits through the

hypoglossal canal

  • components
  • somatic motor –> to muscles of tongue
  • clinical application
  • vulnerable to damage during tonsillectomy
  • causes paralysis & atrophy of ipsilateral half of
    tongue. Tip deviates towards affected side.

Neuro MTC (5 decks)

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