Cranial Nerves Flashcards by Sheryl O'Hare

Trigeminal nerve - which component is motor (CN V1, V2 or V3) ?

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Trigeminal nerve - which component is Sensory (CN V1, V2 or V3) ?

V1, V2, V3

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Ophthalmic division of trigeminal nerve

CN V1

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Maxillary division of trigeminal nerve

CN V2

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Mandibular division of trigeminal nerve

CN V3

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Which CN’s carry parasympathetics ?

CN III, VII, IX, X

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Which CNs connect with the forebrain?

CN I

CN II

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Which CNs connect with the midbrain?

CN III

CN IV

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What is the only CN to connect directly with the pons?

CN V

CN V1, V2, V3

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Which CNs connect at the junction between pons and medulla?

CN VI
CN VII
CN VIII

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Which CNs connect with the medulla?

CN IX
CN X
CN XII

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Which CNs connect with the SC ?

CN XI

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CN I - function

Smell (special sensory)

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CN I - base of skull foraminae

Cribriform plate of ethmoid bone

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CN I is the only nerve in the anterior cranial fossa. True or false?

True

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CN I - where is it found intracranially

Olfactory bulb

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CN I - testing

Ask patient to smell a familiar strong smell whilst covering contralateral nostril

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A frontal lobe tumour would not affect CN I. True or false?

False

- it could

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CN II - function

Vision

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CN II - base of skull foramina

Optic canal

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CN II is in the anterior cranial fossa. True or false?

False

- middle

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CN II - intracranial part

Optic nerve -> optic chiasma -> optic tract

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CN II - connection with CNS

Diencephalon

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CN II - testing

Acuity (snellen chart )
Colour (ishihara plate)
Fields (4 quadrants)
Reflexes
Fundoscopy

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CN III - function

``` Eye movement (MR, SR, IR, IO, LPS) Pupil constriction (parasympathetic) ```

CN III - base of skull foramina

Superior orbital fissure

CN III - testing

Eye movements | Pupil response to light

CN IV - function

Supplies SO eye muscle

CN IV - base of skull foramina

Superior orbital fissure

Which CNs travel towards the orbit in the lateral wall of the cavernous sinus?

CN III, IV, VI

What is the only CN that arises posterior from the brain?

CN IV

CN IV has a very short course. True or false?

False | - very long course

CN V1 - base of skull foramina

Superior orbital fissure

CN V2 - base of skull foramina

Foramen rotundum

CN V3 - base of skull foramina

Foramen ovale

CN V1 - functions

``` Supply sensation to: Forehead Upper eyelid Cornea Conjunctiva Skin of the root/bridge/ tip of nose ``` ``` Deep sensory territory: Bones and soft tissues of orbit Upper anterior nasal cavity Paranasal sinuses (apart from maxillary sinus) Anterior and posterior cranial fossae ```

CN V2 - functions

``` Supply sensation to: Central part of face Lower eyelid Skin over maxilla Skin over ala of nose Skin of upper lip ``` ``` Deep sensory territory: Lower posterior nasal cavity Maxilla and maxillary sinus Floor of nasal cavity/palate Maxillary teeth ```

CN V3 - sensory functions

Supply sensation to: Skin over mandible and TMJ Chin ``` Deep sensory territory: Mandible Anterior 2/3rds tongue Floor of mouth Buccal mucosa Mandibular teeth ```

What supplies the skin over the angle of the mandible?

Greater auricular nerve (C2,3)

CN V3 - motor functions

Muscles of mastication

Name the jaw opening muscle(s)?

Lateral pterygoid

Name the jaw closing muscle(s) ?

Medial pterygoid Masseter Temporalis

CN V - testing sensation

Ask patient to close eyes Gently brush skin in each dermatome with a fine tip of cotton wool Tell patient to tell you when they feel skin being touched Compare 2 sides

CN V - motor component testing

Palpate strength of contraction of the master and temporals by asking patient to clench teeth ask patient to open jaw against resistance

What is the role of pontine trigeminal nucleus ?

Discriminative touch, vibration

What is the role of spinal nucleus?

Pain, temperature

CN VI - function

Supplies lateral rectus extraocular muscle

Which CN is most medial within the pontomedullary junction: CN VI, CN VII, CN VIII ?

CN VI

CN VI - base of skull foramina

Superior orbital fissure

CN VII - function

Special sensory - taste to anterior 2/3rds of tongue Motor - supplies muscles of facial expression - stapedius

CN VII is in the posterior cranial fossa. True or false?

True

CN VII - base of skull foramina (in)

Internal acoustic meatus

CN VII - base of skull foramina (out)

Stylomastoid foramen

What is the chorda tympani?

Branch of CN VII which passes through between incus and malleus

What is the function of the chorda tympani?

Provides taste sensation to the anterior 2/3rds of the tongue Parasympathetic supply to the submandibular and sublingual salivary glands

Which nerve does the chorda tympani join (hitch a ride with)?

Lingual nerve

If a patient looses function of CN VII but retains normal sound, it is more likely to be a fracture where?

Stylomastoid foramen

CN VII - testing

Test muscles of facial expression: - raise eyebrows - close eyes tight - smile - puff out cheeks and hold air - whistle

The branches of CN VII that supply muscles of facial expression can be split into fibres that supply muscles in the upper face and fibres that supply muscles in the lower face. true or false?

True

Fibres that control the lower face all cross over to the contralateral facial nerve at the brainstem. True or false?

True

Fibres that control the upper face all cross over to the contralateral facial nerve at the brainstem. True or false?

False - half of the fibres cross to contralateral facial nerve - half of the fibres remain on the same side and contribute to ipsilateral facial nerve

Eyes and forehead (upper face) receives innervation from both cerebral hemispheres. True or false?

True

Lower face receives innervation from both cerebral hemispheres. True or false?

False | - innervation from the contralateral hemisphere

Lesions that damage the motor cortex (e.g. acute ischemic stroke) will result in contralateral facial weakness of the lower face only, with preservation of the muscles of the upper face on both sides. True or false?

True

Lesions that damage the facial nerve in the brainstem or after it exits the brainstem "peripheral lesions" result in what facial weakness?

Ipsilateral facial weakness involving both upper and lower face.

CN VIII - function

Hearing and balance

CN VIII - base of skull foramina

Internal acoustic meatus

CN VIII - testing

Rinnie and Weber

CN IX - sensory function

Special sensory - taste ``` General sensory - posterior 1/3rd tongue - mucosa of most naso and oropharynx - mucosa of some laryngopharynx - palatine tonsil eustachian tube middle ear cavity - gag reflex ```

CN IX - motor function

Stylopharyngeus

CN IX - parasympathetic function

Parotid gland

CN IX - base of skull foraminae

Jugular foramen

CN IX nuclei - location

Upper medulla

CN IX - what are the 4 components of the nuclei

Solitary nucleus Spinal trigeminal nucleus Inferior salivatory nucleus Nucleus ambiguous

CN IX nuclei - what is the gustatory nucleus which receives taste information ?

Solitary nucleus

CN IX nuclei - what is the nucleus related to the stylopharyngeus muscle ?

Nucleus ambiguous

CN IX nuclei - what is the nucleus related to parasympathetics

Inferior salivatory nucleus

CN IX nuclei - what is the nucleus which has a small region of somatosensation associated with the ear?

Spinal trigeminal nucleus

CN X - sensory function

Pain, temperature from the pharynx, larynx, trachea, oesophagus, thoracic and abdominal viscera Taste

CN X - motor function

Muscle of the pharynx and larynx

CN X - base of skull foramina

Jugular foramen

CN X - what does it travel within ?

Carotid sheath

Right CN X is found on the lateral aspect of the aortic arch. True or false?

False | - lateral aspect of the trachea

Left CN X is found on the lateral aspect of the aortic arch. True or false?

True

CN X - testing

Get the patient to say ahhh which tests the muscles of the palate Look for uvula in the midline

CN X - in CNX pathology, uvula deviated TOWARDS/AWAY from the side of dysfunction ?

Away from

CN X nuclei - 4 components

Dorsal motor nucleus Solitary nucleus Spinal trigeminal nucleus Nucleus ambiguous

CN XI - function

Motor supply to - trapezius - Sternocleidomastoid

CN XI - base of skull foramina

jugular foramen

CN XI - testing

Shrug shoulders

CN XII - function

Muscles of the tongue | - apart from palatoglossus

CN XII - base of skull foramen

Hypoglossal canal

At which level does the CN XII turn anteriorly towards the lateral aspect of the tongue?

at the hyoid

CN XII - testing

Ask patient to stick tongue out and check it is in midline

CN XII pathology means tongue tip will point TOWARDS/AWAY from the side of the damaged nerve?

Towards

Solitary nucleus is located in the medulla. True or false?

True

Solitary nucleus function

Taste (gustatory nucleus) and visceral sensory information

Which CNs are involved in the solitary nucleus ?

CN VII , CN IX , CN X

Superior and inferior salivatory nuclei - which CN are involved?

CN VII , CN IX

Nucleus ambiguous is located in the pons. True or false?

False | - medulla

What is the function of nucleus ambiguous ?

Motor efferents to muscles of pharynx, larynx and upper oesophagus

Which CNs are involved in nucleus ambiguous?

CN IX, CN X

Which part of the pyramidal tract is motor to cranial nerves?

Corticobulbar tract

What is the reticular formation?

Network of loosely aggregated cells with cell bodies, axons and dendrites intermingling in the central core of the brainstem

What kind of Diplopia would be seen in 4th nerve palsy? | Horizontal or vertical

Vertical | - exacerbated when looking down (eg reading, walking down stairs)

When facial nerve supplies which ear structure Malleolus Incus Stapedius

Stapedius

A VI nerve palsy will cause vertical/horizontal Diplopia?

Horizontal

Which cranial nerves are involved in corneal reflex Afferent limb Efferent limb

Afferent: CNV1 Efferent: CNVII

Which cranial nerves are involved in afferent and efferent limb of jaw jerk reflex

Afferent and efferent both CNV3

Which cranial nerves are involved in gag reflex

Afferent: CNIX Efferent: CNX

Pupillary light reflex cranial nerves

Afferent CNII | Efferent CNIII

Lacrimation reflex cranial nerve involvement

Afferent: CNV1 Efferent: CNVII

CN IV palsy will make affected eye deviate upwards/downwards and rotated inwards/outwards when patient looks straight ahead?

Upwards | Outwards

Cranial Nerves Flashcards

(113 cards)