Cranial Nerves Flashcards
How many cranial nerves are there?
12 pairs
Why are they prone to compression?
- Inflammation due to soft nerves pressing on hard bone
- Tumours causing compression
- Fractures of bone
What is the difference between visceral ad general sensory innervation?
- Visceral - not usually conscious; afferent inputs from pharynx, larynx, heart, lung, gut etc
- General - person is aware of it; afferent inputs (i.e. touch, temp, pain) from skin and mucous membranes
What are the three different sensory innervations?
Visceral, general and special sensory
What are the special sensory nerve important for?
Taste, smell, vision, hearing and balance
Describe where the cell body is on a sensory (afferent) fibre
Cell bodies outside on the CNS - i.e. in spinal nerve they are in dorsal root ganglions
Where is the cell body of a somatic motor (efferent) fibre?
Cell body is in the ventricle of the brain, travelling all the way out to the periphery to skeletal muscle
Where is the cell body of an autonomic motor (efferent) fibre?
Cell body in the CNS but also autonomic ganglia as there is a preganglion and postganglionic fibre
From CN I to XII, what is the order of the cranial nerves?
- Olfactory (CN I)
- Optic (CN II)
- Oculomotor (CN III)
- Trochlear (CN VI)
- Trigeminal (CN V)
- Abducent (CN VI)
- Facial (CN VII)
- Vestibulocochlear (CN VIII)
- Glossopharyngeal (CN IX)
- Vagus (CN X)
- Accessory (CN XI)
- Hypoglossal (CN XII)
What is the component and the pathway of the olfactory nerve (CN I)?
- Special sense - smell
- Receptors in olfactory epithelium of nasal cavity, olfactory nerve fibres pass through foraminifera in cribriform plate of ethmoid bone and enter olfactory bulb in the anterior cranial fossa
What can occur if the the cribriform plate fractures?
May tear the olfactory nerve passing through it causing anosmia (loss of smell)
What is the component and pathway of the optic nerve (CN II)?
- Special sensory - vision
- Enters via optic canal, nerves join to form optic chiasm, fibres from medial (nasal) half of each retina cross to form optic tract
Name some clinical applications that occur with damage to the optic nerve (CN II)
- 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 and right nasal fields (left homonymous hemianopsia)
What are the components of the occulomotor nerve (CN III)?
- Somatic motor - extraocular muscles (superior, medial & inferior rectus and inferior oblique) and eyelid (levator palpebrae superioris)
- Visceral motor - parasympathetic to pupil causing constriction and to ciliary muscle causing accommodation of the lens
What is the pathway of the oculomotor nerve (CN III)?
Emerges from midbrain and exits via superior orbital fissure
What is the clinical application of the oculomotor nerve?
- Drooping of upper eyelid (ptosis)
- Eyeball abducted and pointing down (as it doesn’t innervate LR and SO)
- No pupillary reflex
- No accommodation of the lens
What is the component and pathway of the trochlear nerve?
- Somatic motor - extraocular muscle (superior oblique depresses eye)
- Emerges from dorsal surface of the mid brain and exits via the superior orbital fissure
What can occur with damage to the trochlear nerve?
Diplopia when looking down (as SO adducts and depresses)
What is diplopia?
Double vision
What is the component and pathway of the abducent nerve (CN VI)?
- Somatic motor - extraocular muscle (lateral rectus abducts eye)
- Emerges between pons and medulla and exits exits via the superior orbital fissure
What can occur if the abducent nerve is damaged?
Medial deviation of the affected eye causing diplopia
What is the component and pathway of the ophthalmic dividision of the trigeminal nerve (CN VI)?
- General sensory - from cornea, forehead, scalp, eyelids, nose and mucosa of nasal cavity and sinuses
- Emerges from the pons, travels through the trigeminal ganglion and exits via the superior orbital fissure
What is the component and pathway of the maxillary dividision of the trigeminal nerve (CN VII)?
- General sensory - from face over maxilla, maxillary teeth, temperomandibular joint, mucosa of nose, maxillary sinuses and palate
- Emerges from the pons, travels through the trigeminal ganglion and exits via the foramen rotundum
What is the component of the mandibular dividision of the trigeminal nerve (CN VIII)?
- General sensory - from face over mandible, mandibular teeth, temperomandibular joint, mucosa of mouth and anterior 2/3rds of tongue
- Somatic motor - muscles of mastication, part of digastric, tensor veli palatinin and tensor tympani