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HNN > Cranial Nerves VII-XII > Flashcards

Cranial Nerves VII-XII Flashcards

(60 cards)

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1
Q

What is cranial nerve VII?

A

Facial nerve

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2
Q

Outline the facial nerve

A

Cranial nerve VII - arises from pons
- muscles of facial expression + stapedius
- special sensory to anterior 2/3 tongue (taste)
- parasympathetic to lacrimal, nasal + salivary glands (except parotid)

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3
Q

How do you test the facial nerve VII?

A

Test muscles of facial expression

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4
Q

Signs and symptoms of facial nerve VII lesions

A
  • Unilateral facial droop - whole half
  • Loss/change in taste to anterior 2/3 of tongue
  • Dry eye/mouth
  • Hyperacusis - normal sounds are too loud to hear
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5
Q

What is the pathway of the facial nerve?

A
  • from pons into internal acoustic meatus
  • into petrous bone + gives off 3 branches (greater petrosal nerve, nerve to stapedius + chorda tympani)
  • emerges through base of skull via stylomastoid foramen
  • extra cranial branches TZBMC
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6
Q

What does the facial nerve branch into in the petrous bone?

A

Greater petrosal nerve
Nerve to stapedius
Chorda tympani

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7
Q

Function of the greater petrosal nerve

A

Parasympathics to lacrimal and nasal glands

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8
Q

What are the functions of chorda tympani (branch of facial nerve)?

A
  • taste to anterior 2/3 tongue
  • parasympathics to salivary gland
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9
Q

Causes of facial nerve VII lesions

A
  • lesions in/around internal acoustic meatus
  • posterior cranial fossa tumours
  • basal skull fracture involving petrous bone
  • middle ear disease
  • inflammation in facial canal > facial nerve palsy e.g. Bell’s palsy, Ramsay-Hunt syndrome
  • parotid disease
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10
Q

What two structures does the facial nerve have a close relation to?

A

Middle ear cavity
Parotid gland

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11
Q

What is cranial nerve VIII?

A

Vestibulocochlear nerve

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12
Q

Outline the vestibulocochlear nerve

A

Cranial nerve VIII - arises from pons
- special sensory to cochlea (hearing)
- vestibular system for balance

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13
Q

What is cranial nerve IX?

A

Glossopharyngeal nerve

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14
Q

What is cranial nerve X?

A

Vagus nerve

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15
Q

Pathway of the glossopharyngeal IX + vagus X nerve

A
  • arise from medulla
  • run through posterior cranial fossa
  • exit through jugular foramen
  • enter carotid sheath
  • glossopharyngeal IX exits proximally
  • vagus X continues inferiorly down neck
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16
Q

Outline the glossopharyngeal nerve

A

Cranial nerve IX - arises from medulla
- mainly sensory to oropharynx, posterior 1/3 of tongue (sensation + taste) + middle ear cavity
- sensation to carotid sinus + carotid body
- parasympathetic to parotid gland

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17
Q

Outline the vagus nerve

A

Cranial nerve X - arises from medulla
- muscles of larynx/pharynx + soft palate
- parasympathetic to thoracic + abdominal viscera
- general sensation to lower pharynx + larynx

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18
Q

How do you test the glossopharyngeal nerve IX?

A

Gag reflex

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19
Q

How do you test the vagus nerve?

A

Speech
Cough
Soft palate movement
Uvula position
Swallow

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20
Q

Signs and symptoms of vagus nerve lesions

A
  • difficulties with speech
  • changes in voice
  • dysphagia
  • weak cough
  • deviated uvula
  • nasal regurgitation
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21
Q

What is cranial nerve XI?

A

Accessory nerve

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22
Q

What is cranial nerve XII?

A

Hypoglossal nerve

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23
Q

Outline the accessory nerve

A

Cranial nerve XI - arises from medulla
- motor innervation to trapezius + sternocleidomastoid

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24
Q

How do you test the accessory nerve XI?

A

Test actions of SCM + trapezius
- SCM: turn head against resistance
- trapezius: shrug shoulders

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25
Signs and symptoms of accessory nerve XI lesions
Winged scapula
26
Causes of accessory nerve lesions
- injuries, surgery or pathology involving posterior triangle - posterior cranial fossa tumours - base of skull fractures
27
Pathway of accessory nerve XI
- arises from **medulla** - through **posterior cranial fossa** - entered carotid sheath - exits + head toward posterior triangle
28
Outline hypoglossal nerve
Cranial nerve XII - arises from medulla - innervation to all muscles of tongue (except stylopharngeus)
29
How do you test the hypoglossal nerve XII?
Tongue movements Appearance of tongue
30
Signs and symptoms of hypoglossal nerve XII lesions
Weakness + atrophy of tongue on ipsilateral side *‘Lick your wound’*
31
Pathway of vestibulocohlear nerve VIII
- arises from **pons** - passes through **internal acoustic meatus** - through petrous bone to inner ear target tissues
32
How do you test the vestibulocochlear nerve?
Gross hearing tests - whisper/finger rub Asking about balance
33
Signs and symptoms of vestibulocochlear nerve VIII lesions
- hearing loss +/- tinnitus - dizziness (vertigo) - balance issues
34
Causes of vestibulocochlear nerve VIII lesions
- vestibular schwannoma (non cancerous inner ear tumour) - occlusion of labyrinthine artery - base of skull fracture involving petrous bone
35
Mnemonic to remember the cranial nerve
**O**h **O**h **O**h **T**o **T**ouch **A**nd **F**eel **V**irgin **G**irls **V**agina **A**h **H**eaven - **O**lfactory - **O**ptic - **O**culomotor - **T**rochlear - **T**rigeminal - **A**bducens - **F**acial - **V**estibulocochlear - **G**lossopharyngeal - **V**agus - **A**ccessory - **H**ypoglossal
36
What is Ramsay Hunt syndrome?
Shingles outbreak which effects facial nerve near the ears (facial nerve) Herpes zoster
37
What is the mnemonic to remember where cranial nerves are motor, sensory or both?
**S**ome **S**ay **M**arry **M**oney **B**ut **M**y **B**rother **S**ays **B**ig **B**rains **M**atter **M**ore
38
How does the olfactory nerve pass through the skull?
Cribriform foramina
39
How does the optic nerve pass through the skull?
Optic canal
40
How does the Oculomotor nerve pass through the skull?
Superior orbital fissure + through cavernous sinus
41
How does the trochlear nerve pass through the skull?
Superior orbital fissure + through cavernous sinus
42
How does the ophthalmic division of the trigeminal nerve pass through the skull?
Superior orbital fissure + cavernous sinus
43
How does the maxillary division of the trigeminal nerve pass through the skull?
Foramen rotundum
44
How does the mandibular division of the trigeminal nerve pass through the skull?
Foramen ovale
45
How does the abducens nerve pass through the skull?
Superior orbital fissure
46
How does the facial nerve pass through the skull?
Internal acoustic meatus Then stylomastoid foramen after branching
47
How does the vestibulocochlear nerve pass through the skull?
Internal acoustic meatus
48
How does the glossopharyngeal nerve pass through the skull?
Jugular foramen
49
How does the vagus nerve pass through the skull?
Jugular foramen
50
How does the accessory nerve pass through the skull?
Jugular foramen
51
How does the hypoglossal nerve pass through the skull?
Hypoglossal canal
52
Anterior 2/3rd of the tongue: - general sensation - taste - motor
Anterior 2/3rd of the tongue: - **general sensation**: trigeminal - **taste**: facial - **motor**: hypoglossal
53
Posterior 1/3rd of tongue: - general sensation - taste - motor
Posterior 1/3rd of tongue: - **general sensation**: glossopharyngeal - **taste**: glossopharyngeal - **motor**: hypoglossal
54
What is hyperacusis?
Normal sounds are too loud to here
55
What is the only cranial nerve that comes off the brainstem dorsally?
Trochlear
56
What are the afferent and efferent limb of gag reflex?
- **afferent**: glossopharngeal IX - **efferent**: vagus X
57
Differentiate between shingles + Ramsay hunt syndrome
**Shingles** - red rash on nose + forehead (trigeminal nerve) **Ramsay hunt syndrome** - red vesicles on ears (facial nerve)
58
What causes trigeminal shingles?
Reactivation of varicella zoster virus within trigeminal ganglion
59
Managment of trigeminal shingles
IV aciclovir
60
Mnemonic to remember the cranial holes for each cranial nerve
**Cocks Often Smell Really Offensive If Just Handled** - **C**ribiform foramina: I - **O**ptic canal: II - **S**uperior orbital fissure: III, IV, Va + VI - **R**otundum: Vb - **O**vale: Vc - **I**nternal auditory meatus; VII + VIII - **J**ugular foramen: XI, X + XI - **H**ypoglossal canal: XII

HNN (24 decks)

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