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Neuro > Cranial Nerves (Motor) > Flashcards

Cranial Nerves (Motor) Flashcards

1
Q

Name and Location of Motor Nuclei for the Trigeminal Nerve.

A

Motor Nucleus V

mid pons level

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2
Q

Name and Location of Motor Nuclei for the Facial Nerve.

A

Facial Nucleus

mid pons level

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3
Q

What do the facial nucleus axons create on the floor of the 4th ventricle?

A

Facial Colliculus (bulge)

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4
Q

Name and Location of Motor Nuclei for the Glossophayngeal Nerve.

A

Nucleus Ambiguus

near junction of pons and lateral medulla

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5
Q

What is interesting about the motor fibers of X?

A

some fibers go through proximal portion of CN XI before rejoining the CN X

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6
Q

Name and Location of Motor Nuclei for the Vagus Nerve.

A

Nucleus Ambiguus

near junction of pons and lateral medulla

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7
Q

Name and Location of Motor Nuclei for the Accessory Nerve.

A

Spinal Accessory Nucleus

(Intermediolateral gray area between dorsal and ventral roots of C1-C5)→

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8
Q

How do the fibers of the Accessory enter the calvarium?

A

Ascend in the spinal cord and enter through the foramen magnum

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9
Q

Name and Location of Motor Nuclei for the Hypoglossal Nerve.

A

Hypoglossal Nucleus

near midline in mid to posterior medulla

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10
Q

Brainstem exit of CN V.

A

Middle of anterior pons

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11
Q

Brainstem exit of CN VII.

A

Cerebellopontine Angle: after passing dorsal medially and looping over abducens nucleus

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12
Q

Brainstem exit of CN IX.

A

Junction between pons and medulla

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13
Q

Brainstem Exit of X.

A

Between interior olive and inferior cerebellar peduncle

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14
Q

Brainstem exit of XI.

A

Lower medulla and upper spinal cord.

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15
Q

Brainstem exit of XII.

A

Ventrally between the inferior olive and the pyramid

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16
Q

Calvaria exit of CN V.

A

V3 exits the foramen ovale

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17
Q

Calvaria exit of CN VII.

A

Auditory canal→ facial canal→ exit via stylomastoid foramen

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18
Q

Calvaria exit of CN IX.

A

Jugular foramen

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19
Q

Calvaria exit of CN X.

A

Jugular Foramen

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20
Q

Calvaria exit of CN XI.

A

Jugular Foramen

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21
Q

Calvaria exit of CN XII.

A

Hypoglossal foramen (posterior aspect of petrous temporal bone)

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22
Q

Motor Targets of CN V

A

Masseter and Temporalis- muscles of mastication
Tensor tympani muscle- dampens sound
Tensor Veli Palatini- opens eustacian tube
Mylohyoid- elevates hyoid bone
Anterior Belly of Digastric- elevates hyoid bone

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23
Q

Motor Targets of CN VII

A

Muscles of facial expression

Stapedius muscle- dampens sound

24
Q

Motor Target of CN IX

A

Stylopharyngeus muscle- raise pharynx when talking or swallowing

25
Q

Motor Targets of CN X

A

Pharyngeal and Palate Muscle- swallow, gagging

Laryngeal Muscle- voice

26
Q

Motor Targets of CN XI

A

SCM- head turning in opposite direction

Trapezius- elevation of shoulders

27
Q

Motor Targets of CN XII

A

Intrinsic tongue muscles

28
Q

Location of the GVE nucleus for Nervus Intermedius (CN VII)

A

Superior Salivatory

near midline of the rostral medulla

29
Q

Location of the GVE nucleus for CN IX

A

Inferior Salivatory

mid-portion of pons

30
Q

Location of the GVE nucleus for CN X

A

Dorsal Motor Nucleus of X

near midline of the medulla

31
Q

Parasympathetic Target for the Nervus Intermedius (CN VII)

A

Sphenopalatine and Submandibular ganglia → Lacrimal and all salivary glands except parotid

32
Q

Parasympathetic Target for CN IX

A

Lesser petrosal nerve→ Otic Ganglion→ Parotid Gland

33
Q

Parasympathetic Target for CN X

A

Intermural ganglia → Heart (slow HR), lung, and GI tract (increase digestion)

34
Q

What type of lesion causes unilateral weakness of jaw closure, reduced jaw jerk, and atrophy of the temporalis and masseter muscles? What nerve?

A

unilateral LMN lesion of CN V or its nucleus

35
Q

Why do unilateral UMN lesions to CN V not cause the symptoms that LMN lesions do?

A

UMN input to trigeminal motor nuclei is largely bilateral

36
Q

What type of lesion (commonly caused by a stroke) results in weakness of contralateral lower facial muscles (spares forehead)?

A

unilateral UMN lesion to CN VII

37
Q

Why do UMN lesions of CN VII spare the forehead?

A

UMN input to CN VII is largely bilateral for forehead muscles but unilateral for lower face

38
Q

What type of lesion may produce some dysphagia (difficulty swallowing)?

A

unilateral UMN lesion to CN IX

39
Q

In what type of CN XII lesion does the tongue deviate away from the lesion?

A

unilateral UMN lesion

40
Q

Why do UMN CN XII lesions cause the tongue to point away from the lesion?

A

Corticobulbar fibers from motor cortex cross over to control contralateral genioglossus (others get bilateral innervation)

41
Q

What type of lesion causes ipsilateral weakness of lower face and forehead muscles + possible ipsilateral hyperacusis and dry eye?

A

unilateral LMN lesion of CN VII or its nucleus

42
Q

What is a common cause of LMN lesions to CN VII?

A

Bell’s Palsy

43
Q

What type of lesion causes weakness of contralateral shoulder elevation and weakness of ipsilateral SCM muscle (turning head away from lesion)?

A

unilateral UMN lesion of CN XI

44
Q

Why do UMN lesions to CN XI affect the trapezius and SCM of different sides?

A

UMNs for the SCM descend ipsilaterally to the spinal accessory nucleus while the UMNs for the trapezius muscle cross the midline in the pyramidal decussation to synapse in the contralateral spinal accessory nucleus

45
Q

What type of lesion causes hoarseness, dysphagia, inability to elevate palate on ipsilateral side as well as a reduced gag reflex?

A

unilateral LMN lesion to CN X or its nucleus

46
Q

Why do UMN lesions to CN X not cause the same symptoms as LMN lesions?

A

Substantial bilateral upper motor neuron innervation of CN X nuclei

47
Q

What would you expect to see with a unilateral LMN lesion to CN XI?

A

Weakness and atrophy of both muscles ipsilateral to lesion—weakness elevating the shoulder and turning head away from lesion side.

48
Q

What would you expect to see with a unilateral LMN lesion to CN XII?

A

Tongue protrusion towards the side of the lesion, unilateral atrophy and fasciculations

49
Q

How do you test for CN V?

A

Test by having patient bite down on tongue depressor and test jaw strength; palpate masseter and temporalis bilaterally.

50
Q

What does the “jaw jerk reflex” test for?

A

assess function of motor nucleus of V and mesencephalic nucleus as well as the third branch of the trigeminal nerve (mandibular) carrying the fibers

51
Q

What is the “jaw jerk reflex”?

A
  • Chin tapped (stimulate proprioceptors)
  • Project to mesencephalic nucleus and synapse
  • Fibers leave as interneuron and synapse on motor nucleus of V
  • Motors fibers occlude jaw (masseter contracts
52
Q

How do you test for CN VII?

A

Test by having patient wrinkle forehead, close eyes tightly, and show you their teeth. Look for symmetric furrowing of forehead, ability to symmetrically close eyes, and symmetric retraction of the corners of the mouth.

53
Q

How do you test for CN IX and X?

A

Integrity tested via the gag reflex ( IX carries afferent/sensory arm of the reflex but shares efferent part of the reflex with CN X). Stimulate reflex by gently touching posterior pharynx on left and right side separately and watching for the motor, or gag response and elevation of soft palate

54
Q

After synapsing in the nucleus solitarius, where do the secondary neurons from the Gag Reflex go?

A

secondary fibers project to the nucleus ambiguous where they synapse so that visceral efferents (traveling with the vagus nerve) can reach the pharynx and mediate the gag reflex

55
Q

How do you test for CN XI?

A

Test by getting patient to raise shoulder and look in opposite directions bilaterally.

56
Q

How do you test for CN XII?

A

Test by getting patient to stick tongue out (make sure it is sticking straight out at midline)

Neuro (10 decks)

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