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Cranial Nerves Flashcards

(60 cards)

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1
Q

Function of CN1

A

Special sensory

Smell - assists with taste (not important)

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2
Q

Course of CN1

A

Olfactory bulb - Olfactory tract

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3
Q

Pathology of CN1

A

URTI
Compression = Meningioma
Fracture of anterior cranial fossa - check for CSF leakage

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4
Q

Clinical testing for CN1

A

Ask for anosmia - ‘‘Have you had any recent change in your sense of smell’’

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5
Q

CN2 exit

A

Optic canal

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6
Q

CN2 pathology

A

Blindness
Reduced visual acuity
Loss of colour vision

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7
Q

Clinical testing of CN2

A 
Visual fields
Visual acuity - Snellen chart 
Colour vision - ishihara plates 
Pupillary reflexes - RAPD etc 
Fundoscopy
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8
Q

Function of CN3

A

Somatic motor & PSNS (parasympathetic nervous system?)

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9
Q

CN3 exit

A

superior orbital fissure

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10
Q

What muscles does CN3 supply in the eye?

A

Superior, Medial & Inferior rectus

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11
Q

What other things do CN3 supply?

A

Levator palpabrae superioris - damage to this results in a droopy eyelid
(as part of being PSNS) - ciliary muscles, sphincter pupillae - they will lose the ability to constrict their pupil

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12
Q

What causes CN3 to become damaged

A

Raised ICP
Aneurysm of post cerebral artery
Diabetes, MS

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13
Q

Clinical signs of CN3 pathology

A

Eyeball ‘down & out’
Ptosis
Dilated pupil

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14
Q

Clinical testing of CN3

A

H test

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15
Q

CN4 function

A

somatic motor

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16
Q

CN4 exit

A

Superior orbital fissure

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17
Q

What muscle does CN4 supply

A

Superior oblique

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18
Q

What causes CN4 to become damaged?

A

Raised ICP

Cavernous sinus

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19
Q

Signs of CN4 pathology

A

Vertical diplopia - exacerbated when looking down

Head tilt away from affected side

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20
Q

CN6 function

A

Somatic motor

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21
Q

CN6 exit

A

Superior orbital fissure

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22
Q

CN6 supplies what?

A

Lateral rectus

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23
Q

What causes CN6 to become damaged?

A

Raised ICP

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24
Q

CN6 pathology signs

A

Horizontal diplopia
Abducted eye can’t be abducted past midline
Compensatory turning of head

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25
CN5 divisions and their exits
V1 - ophthalmic - sup orbital fissure V2 - Maxillary - Foramen rotundum V3 - Mandibular - Foramen ovale
26
What are V1 and V2 associated with
cavernous sinus
27
CN5 function
somatic sensory and motor | Motor = V3 only
28
V3 sensory supply
2/3 tongue (NOTE - not the taste, just the sensation. Taste of ant 2/3 is by CN7) Tensor tympani
29
What causes CN5 to become damaged?
Trigeminal neuralgia - usually V2,3 | Herpes zoster
30
CN5 signs of pathology
Loss of sensation Jaw deviates towards lesion when opening mouth Hutchinson's sign
31
CN5 clinical testing
Sensation - cotton wool, pin prick etc Motor - mastication, open mouth Reflexes - Corneal reflex, jaw jerk
32
How to remember what is in the cavernous sinus?
``` OTOM CAT O - Oculomotor nerve (CN3) T - Trochlear nerve (CN4) O - Ophthalmic nerve (CNV1) M - Maxillary nerve (CNV2) ``` C A - Internal Carotid Artery T - Junction point
33
CN7 Function
B for BOTH somatic and sensory Facial muscles (motor) Anterior 2/3 taste sensation of tongue (special sensory) Small area around concha of auricle (sensory) It also has a PARASYMPATHETIC supply to lots of GLANDS: Lacrimal (parasympathetic) Submandibular and sublingual gland (parasympathetic) Nasal, palatine & pharyngeal mucous glands (parasympathetic)
34
CN7 exit
Internal acoustic meatus
35
CN7 nerve - explain the course of the nerve
2 roots come from the pons Travel through internal acoustic meatus Within the temporal bone, enter facial canal 2 roots fuse to form facial nerve Nerve forms geniculate ganglion Gives out greater petrosal nerve, nerve to stapedius, chorda tympani Exits cranium via stylomastoid foramen After exit, nerve turns superiorly and runs anterior to outer ear Gives off posterior auricular nerve and more motor branches (belly of digastric muscle & stylohyoid muscle) Main trunk passes through parotid and splits into 5 branches within the gland
36
What causes CN 7 to become damaged? | What are the clinical signs?
Reduced salivation Loss of taste for ant. 2/3rds of tongue Hyperacusis Lacrimal fluid production Any parotid gland pathology (e.g. tumours) Herpes infection of facial nerve Compression during forceps delivery (underdeveloped mastoid process) Bell's palsy
37
CN7 clinical testing
Facial asymmetry | Motor - raise eyebrows, purse lips, show teeth, puff out cheeks
38
CN8 function
Hearing (cochlear fibres) | Balance (vestibular fibres)
39
Course of CN8
Cochlear arises from ventral & dorsal cochlear nuclei in inferior cerebellar peduncle Vestibular arises from vestibular nuclei complex in pons & medulla Both combine in pons
40
CN8 exit
Internal acoustic meatus
41
CN8 pathology
2 high yield conditions: Vestibular neuritis - inflammation of vestibular nerve Symptoms = vertigo, nystagmus, loss of equilibrium Labyrinthitis - inflammation of membranous labyrinth Symptoms = hearing loss, tinnitus, vertigo, nystagmus
42
CN8 clinical testing
Rinne's & Weber's
43
CN9 function
Orophyranx (sensory) Carotid body & sinus (sensory) Posterior 1/3 tongue (sensory & special sensory/taste) Middle ear cavity & eustachian tube (sensory) Parotid gland (parasympathetic) **CNVII passes through but doesn't innervate Stylopharyngeus (motor)
44
Course of CN9
Originates from medulla oblongata | Exits via jugular foramen
45
What nerve does CN9 give rise to?
Carotid sinus nerve
46
Pathology signs when CN9 is damaged
loss of gag reflex
47
Clinical testing for CN9
Open mouth and say ahh Inspect palate for any uvula deviation Assess speech, cough, swallow
48
CN10 sensory function
Internal laryngeal n --> Laryngopharynx, Larynx Vagus n. --> heart, GI tract
49
CN10 special sensory function
Taste --> root of tongue & epiglottis
50
CN10 motor function
Pharyngeal branch of vagus n: Sup, mid, inf pharyngeal constrictor muscles Palatopharyngeus Salpingopharyngeus Recurrent laryngeal n: All the arytenoids, vocalis External branch of sup laryngeal n: Cricothyroid
51
Parasympathetic function of CN10
Heart & GI tract (oesophagus up to splenic flexure) Heart - lowers HR GI - stimulates smooth muscle contraction, secretions. (remember REST & DIGEST)
52
Course of CN10
Originates in medulla oblongata Exits via jugular foramen In neck passes into carotid sheath R & L vagus n. travel separately at neck base level At neck, several branches arise. One to remember is R recurrent laryngeal n. This nerve hooks underneath R subclavian artery
53
Where does the L recurrent laryngeal nerve hook under?
Arch of aorta
54
What causes damage to CN10
Vasovagal syncope Carotid massage Dysphonia/aphonia (Cancer/injury)
55
Function of CN11
Sternocleidomastoid (motor) | Trapezius (motor)
56
Course of CN11
``` 2 parts: Cranial part: Medulla oblongata Exits via jugular foramen Combines with vagus nerve ``` Spinal part: Enters via foramen magnum Exits via jugular foramen
57
Symptoms of pathology of CN11
muscle wasting, inability to rotate head/weakness in shrugging
58
CN12 function
Intrinsic & Extrinsic muscles of tongue (motor)
59
Course of CN12
Medulla oblongata | Exits via hypoglossal canal
60
Clinical testing of CN12
Check tongue for fasiculations | Stick tongue out and check for deviations

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