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Cranial nerves Flashcards

1
Q

Which three structures make up the brain stem?

A

Midbrain, pons and medulla

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2
Q

Which part of the brain are the first and second cranial nerves extensions of?

A

Forebrain - there is no sheath surrounding them but CSF instead

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3
Q

Where do nerves 3-7 originate from?

A

Brainstem

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4
Q

Which nerves are purely sensory?

A

1,2,8

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5
Q

Which nerves are purely motor?

A

3,4,6,11,12

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6
Q

Which nervous system controls the cranial nerves?

A

Autonomic

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7
Q

What does the olfactory nerve do?

A

Smell

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8
Q

Where does the olfactory nerve emerge?

A

Cribriform plate

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9
Q

How to test the olfactory plate

A

Change in sense of smell

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10
Q

Injury to olfactory nerve

A

Unilateral/bilateral anosmia

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11
Q

Function of optic nerve

A

Vision and pupil reflex

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12
Q

Where does optic nerve emerge?

A

Optic canal

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13
Q

How to test optic nerve

A

Snellen chart

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14
Q

Injury to optic nerve

A

Ipsilateral blindness

Pituitary tumour = tunnel vision

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15
Q

Function of oculomotor nerve

A

MR, IR, SR, IO

Upper eyelid

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16
Q

Where does the oculomotor nerve exit?

A

Superior orbital fissure

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17
Q

How to test oculomotor nerve

A

‘H’ movement

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18
Q

Injury to oculomotor nerve

A

Ptosis, double vision, divergent quint, dilated pupils

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19
Q

Function of trochlear nerve

A

Superior oblique muscle

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20
Q

Where does trochlear nerve exit?

A

Superior orbital fissure

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21
Q

How to test trochlear nerve

A

Follow finger - bring the eye to the nose and back down

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22
Q

Injury to trochlear nerve

A

Nystagmus (involuntary eye movement)
Diplopia
Vision converging

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23
Q

What are the three branches of the trigeminal nerve?

A

Ophthalmic
Maxillary
Mandibular

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24
Q

Function of ophthalmic branch of trigeminal nerve

A

Sensory function of scalp forehead and nose

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25
Where does the ophthalmic branch of trigeminal nerve exit the skull?
Superior orbital fissure
26
How to test trigeminal nerve
Corneal light reflex with VII Assess light touch/pin prick for sensory Corneal reflex tested using wisp of wool Clench jaw and open against my hand
27
Injury of trigeminal nerve
Ipsilateral anesthesia Paralysis of ipsilateral muscles of mastication Carcinoma tongue (lingual nerve) cause severe earache
28
Function of maxillary branch of trigeminal nerve
Sensory: Cheeks, lower eyelid, nasal mucosa, upper lip, upper teeth, palate
29
Where does the maxillary branch of trigeminal nerve exit the skull?
Foramen rotundum
30
Function of mandibular branch of trigeminal nerve?
Sensory: anterior 2/3 tongue, skin over mandible and lower teeth Motor: mastication
31
Where does the mandibular branch of the trigeminal nerve exit the skull?
Foramen vale
32
What are the three divisions of the ophthalmic branch of the trigeminal nerve?
Frontal (supraorbital and supratrochlear), lacrimal and nasociliary (eyeball, cornea and conjunctiva)
33
What nerve can be damaged when the anterior cranial fossa is damaged?
Olfactory
34
Symptoms of temporal lobe epilepsy
Olfactory hallucinations
35
Symptoms of frontal lobe tumour
Unilateral anosmia
36
Can the optic nerve regenerate after division?
No
37
What happens in the optic chiasma?
Nerves from each eye are shared
38
Symptoms of retinal/optic lesions
Ipsilateral blindness
39
What does AFRO stand for?
Acuity Fields Reflexes Opthalmoscopy
40
What is the MR?
Medial rectus
41
What is the IR?
Inferior rectus
42
What is the SO?
Superior oblique
43
What is the IO?
Inferior oblique
44
Path of oculomotor nerve
Brain - cavernous sinus - extrinsic ocular muscles
45
What is ptosis?
Drooping of upper eyelid
46
Function of abducens
Motor of lateral rectus
47
Where does abducens exit skull?
Superior orbital fissure
48
How to test abducens
Follow penlight with eye to all 4 quadrants
49
Injury to abducens
Nystagmus, diplopia, convergence of vision
50
Functions of facial nerve
Sensory: taste to anterior 2/3 of tongue Motor: facial muscles, crying (lachrymal gland), salivating (sublingual and submandibular) and tasting (chorda tympani)
51
Where does facial nerve exit skull?
Internal acoustic meatus
52
How to test facial nerve
``` Raising eyebrows – temporal Scrunching eyes – zygomatic Blow cheeks – buccal Show teeth – mandibular Resist these motions and assess power ```
53
Injury to facial nerve
Ramsay-Hunt syndrome: herpes zoster oticus – shingles affects facial nerve involving geniculate ganglion Shingles rash, facial paralysis, hearing loss Altered taste perception, saliva and tear production
54
Function of vestibulocochlear nerve
Hearing and balance
55
Where does the vestibulocochlear nerve exit the skull?
Internal acoustic meatus
56
How to test vestibulocochlear nerve
Obscure pt’s ear canal and eyes | Whisper letter and number and ask pt to repeat
57
Injury to vestibulocochlear nerve
Hearing loss, vertigo, false sense of motion
58
Function of glossopharyngeal nerve
Sensory: posterior third of tongue, pharynx, middle ear Motor: stylopharyngeus (palate) Autonomic: salivary glands
59
Where does glossopharyngeal nerve exit skull?
Jugular foramen
60
How to test glossopharyngeal nerve
Sensory part of gag reflex with vagus Ask to cough and swallow water Say ahhhhh – look for
61
Injury to glossopharyngeal nerve
Sensory loss of pharynx Loss of taste and sensation to posterior 1/3 of tongue Pharangeal weakness, loss of saliva Rarely isolated – usually involves X
62
Function of vagus nerve
Sensory: tympanic membrane, external auditory canal, ear Motor: palate, pharynx, larynx Autonomic: afferents from carotid baroreceptors
63
Where does vagus nerve exit skull?
Jugular foramen
64
How to test vagus nerve
Pt’s voice quality Ask them to say ahhhhh – note elevation of soft palate and uvula Gag reflex
65
Injury to vagus nerve
Stridor – noisy breathing Aspiration – inhale into airway Dys/aphonia – difficulty speaking If recurrent laryngeal nerve damaged after surgery, cricothyroid muscle still works and can tense muscles in larynx
66
Function of spinal accessory nerve
Motor: sternocleideomastoid and trapezius, shrug shoulders
67
Where does spinal accessory nerve exit skull?
Jugular foramen
68
How to test spinal accessory nerve
Ask pt to shrug shoulders and turn face against your hands
69
Injury of spinal accessory nerve
Weakness of trapezius - winged scapula
70
Function of hypoglossal nerve
Intrinsic and extrinsic tongue muscles except palatoglossus
71
Where does hypoglossal nerve exit skull?
Hypoglossal canal
72
How to test hypoglossal nerve
Stick out tongue, note fasciculation, deviation and abnormality in muscle Push against mouth to test resistance
73
Injury to hypoglossal nerve
Atrophy of tongue on affected side Ipsilateral paralysis, wasting and deviation when pushed to affected side UMN lesion in corticobulbar palsy = bilateral paralysis with no wasting
74
What are the 5 branches of the facial nerve?
``` Temporal Zygomatic Buccal Mandibular Cervical ```
75
Function of utricle
Horizontal movement
76
Function of saccule
Linear acceleration and gravity

Nervous system (24 decks)

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