Exam 2 Flashcards by Brad Francis

The vestibulocochelar nerve is purely a ____ nerve

Composed of how many nerves?

Sensory

Vestibular and chochlear

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The vestibular nerve terminates _____

Which consists of how many parts?

What are they?

Vestibular nuclear complex

Superior, Medial, Lateral Inferior

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Vestibular nerve fibers arise from cell bodies located in ______

This has how many parts?

They are?

Vestibular Ganglion

Superior and Inferior

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The cochlear nerve terminates in what two places?

Axons of which ganglion compose the cochlear nerve?

Anterior and Posterior cochlear nuclei

Axons from the spiral ganglion

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Peripheral processes of the cochlear nerve extend from spiral ganglion to _____

Axons from these cell bodies carry in cochlear nerve and terminate in two cochlear nuclei located where?

Axons then cross other side of brainstem and synapse where?

From which axons form what?

Spiral organ (organ of corti)

Posterior, superior MO, lateral to vestibular nuclei

Trapezoid nuclei

Lateral lemniscus

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Peripheral processes from vestibular ganglion extend to what three inner ear structures?

Central processes convey info to vestibuar nuclei located where?

Most fibers terminate where? Some will travel directly to cerebellum by way of what?

Saccule, Utricle, Semicircular canals

in the MO on floor of rhomboid fossa

Medial vestibular nucleus (schwalbe)

Some by way of inferior cerebellar peduncle

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Vestibulocochlear nerve Apparent Origin

Travels in the posterior cranial fossa to the _______ which it enters with facial nerve

Cerebellopontine Angle

Internal Acoustic Meatus

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The cochlear nerve carries how many fibers?

Traverses the IAM then leaves temporal bone and reaches the ____ ganglion of the cochlea

30-40 thousand

Spiral ganglion

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Vestibular nerve carries how many fibers?

Approaches ear divides into sup and inf branches. Which branch is smaller?

What are they composed of?

What do they supply?

20,000

Inferior (8000 fibers)

Inferior - saccular nerve and posterior ampullary

Superior - lateral and anterior ampullary nerves

Inferior - saccule and posterior ampullary crest

Superior - lateral and anterior semicircular canals

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What supplies the utricle?

What is Voits nerve?

Branch from lateral ampullary nerve and a branch off superior branch.

Branch off of superior branch that sends directly to saccule

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Clinical of CN VIII

Acousitc Neuroma

Tinnitus

Cochlear implants

Vestibular disesase

Vestibular schuanoma - hear, balance vertigo

Ringing ear, sign of Menieres disease

Sensory neural hear loss

Equilibrium and vertigo prob, dizzy

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What is the diff diagnosis for cervicogenic vertigo?

Swivel chair, hold head still and move in chair should cause vertigo

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What type of fibers does the Glossopharyngeal nerve carry?

Motor, Sensory, Autonomic (para).

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CN IX motor to ____

Sensory from ___

Taste info from ____

Parasympathetic leading to _____

Stylopharyngeus

Pharynx

Posterior tongue

Parotid gland

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The motor fibers in CN IX arise from cell bodies located in the _____ part of the _______

Preganglionic para fibers arise from ________

Afferent fibers terminate in _______

Two periph ganglia ____ and ____ are associated with CN IX. Which is smaller

Superior part of Nucleus Ambiguus

Salivatory nucleus

Solitary nucleus

Superior and Inferior

Superior ganglion is smaller

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What are the three sensory pathways for CN IX?

General, Taste, Visceral afferent

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Info from nasopharynx, oropharynx, posterior tongue, uvula, and palatine tonsils and tympanic cavity is which sensory pathway of CN IX?

Cell bodies of these neurons are located where?

The fibers synapse in which nucleus?

General sensory

Inferior ganglion

Spinal nucleus of trigeminal nerve

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Taste info from the posterior tongue is carried from neurons from the ____ganglion.

Axons from these cells synapse in the superior part of _____ nucleus

Some incoming fibers from this ganglion synapse in inferior part of the nucleus and they carry ______ info to the _____ and _____

Inferior ganglion

Solitary

Visceral afferent

Carotid sinus and body

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CN IX motor pathway the _____ contributes LMN to three CN.

Nucleus ambiguus

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Parasympathetic pathway CN IX

_____ nucleus gives rise to pre gang para axons.

Fibers synapse in ____ganglion from which _____ fibers arise to supply which three glands?

Inferior salvatory

Otic
Postganglionic

Parotid, buccal, inferior labial glands

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AO of CN IX

Nerve exits via ___

___ ganglion located inside cranium and ____ ganglion is outside

Superior lateral M.O.

Jugular foramen

Superior

Inferior

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The tympanic nerve arises from the _____ ganglion.

Carries which types of fibers?

Carried through _____ into the tympanic cavity.

Receives postganglionic sympathetic fibers from superior cervical ganglion to form ____

Inferior

Pregang para, and sensory

Tympanic Canaliculus

Tympanic Plexus

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The tympanic plexus carries somatosensory info from what three things?

Tympanic cavity

Pharyngotympanic tube

Mastoid air cells

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Pregang parasymp fibers pass through tympanic plexus and reform as ______ nerve which travels through _____ canal to the otic ganglion

Lesser petrosal nerve

Lesser Petrosal canal

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Postganglionic parasympathetic fibers from otic ganglion are carried in which branch of trigimenial and to what three glands?

Mandibular Parotid, Buccal and inferior labial

The ___ branch of CN IX ascend from below and enters the nerve at inferior ganglion. Carries afferent info from _____ in carotid body and _____ in carotid sinus Similar info may be carried in what nerve

Carotid branch Chemoreceptors Baroreceptors Vagus

____ branches of CN IX convey sensory info from mucosa of pharynx. ____ branch of CN IX leave glossopharyngeal nerve to supply which muscle?

Pharyngeal Muscular

Which two CN IX branches reach the oral cavity? Which one conveys sensory info from palatine tonsils and oral mucosa? Which carries general sensory and taste info from tongue posterior

Tonsillar Lingual

Describe the Vagus nerve

Mixed Carries Parasymp sensory Carry some taste from epiglottal region Longest Most important parasymp nerve

Apparent origin of CN X Motor fibers cell bodies located in ____ which receives info from both cerebral hemispheres

Lateral MO Nucleus Ambiguus

Pregang para fibers of CN X arise from ____ It receives info indirectly from ____ and ____ Incoming somatic sensory infor terminates in _____ nucleus of CN V Taste and viscerosensory info terminates in nucleus of _____ _____

Posterior (dorsal) nucleus of vagus Hypothalmus and carotid sinus Spinal Solitary tract

Two peripheral ganglia associated with vagus nerve?? What is important about them? AKA names for them?

Superior and Inferior NOT same ones for glossopharyngeal nerve. ``` Superior = Jugular Inferior = Nodose ```

What are the three Sensory pathways of CN X?

Somatic sensory Taste Visceral sensory

CN X info from dura, auricle, EAC, lateral tympanic membrane, mucosa of pharynx, to spinal nucleus of trigeminal Info from epiglottis carried in superior part of nucleus of solitary tract by neurons in inferior gang Info carried from larynx and laryngopharynx, visera in thoracic/abdominal cavities, pressure receptors in aortic arch and chemoreceptors in para-aoritc body

Somatic sensory Taste Visceral

_____ info carried to inferior part of nucleus for solitary tract by neurons in inferior ganglion. (vagus nerve)

Visceral sensory

AO of vagus nerve Exit skull via ____ A meningeal branch supplies dura of _______ fossa

Lateral MO Jugular foramen Posterior cranial fossa

Jugular foramen is compartmentalized by a ______ The glosspharyngeal nerve travels ____ to this The vagus nerve and accessory nerve travel ____ to this

Fibrous septum Posterior Anterior

Which ganglion of CN X is larger and more cylindrically shaped? (superior or inferior) Where are they located?

Inferior - inferior to jugular foramen Superior is smaller and located in the jugular foramen

The auricular branch of Vagus is given off at the ____ ganglion. Couses through the ____ and ______ to reach the EAM Carries sensory info from meatus and small portion of ____

Superior Mastoid canaliculus and tympanomastoid fissure auricle

What are the three branches of vagus given off in the neck?

Pharyngeal Branches to carotid Superior laryngeal Internal laryngeal External laryngeal Recurrent Laryngeal Superior and inferior cervical cardiac branches

Pharyngeal branch and branches to the carotid of vagus are given off of the ____ ganglion Superior laryngeal branch given off where??? Recurrent laryngeal comes off?? Superior and inferior cervial cardiac branches given off where?

Inferior Inferior to inferior ganglion Left side - vagus b4 passes in front of aortic arch Right side - passes posterior under subclavian artery Superior - leave vagus and travel with great vessels to cardiac plexus Inferior - same except come off recurrent laryngeal

Vagus nerve enters thorax, passes posterior to root of _______ lung and contribute to _____ plexus Then ___ vagus passes posteriorly over esophagus and ____ vagus goes anterior. Both contribute to ____ plexus

Ipsilateral Pulmonary Right Left Esophageal

Which of the Pulmonary plexuses is larger? Both carry ____ info ____ receives sympathetic fibers from cervical sympathetic ganglia _____ receive sympathetic fibers from thoracic ganglia

Posterior Sympathetic Anterior Posterior

The ____ vagus nerve enters abdominal cavity through esophageal opening and becomes _____ Sends branches to _____ stomach and terminates in a large celiac branch that sends branches to which organs? Vagal supply to the organs through which three plexuses

Right Posterior vagal trunk Posterior Duodenum, liver, kidneys, SI, proximal 2/3 colon Celiac, superior mesenteric, renal

The ____ vagus becomes the anterior vagal trunk . Sends branches to where?

Left Stomach, liver, pancreas, superior duodenum

Three clinical considerations of Vagus nerve?

Bilateral Transection Fatal Lesion in vault or close to skull Widespread problem Damage to recurrent laryngeal Speech hoarseness or volume problems

CN XI is an exclusively ____ nerve Its two roots contribute LMN that supply which muscles?

Motor SCM, Trap, Soft palate, pharynx, and larynx muslces

Cell bodies of CN XI located in ____ and contribute axons to the ____ root of the nerve Spinal nucleus of accessory nerve is found where? Expends from level of foramen magnum inferiorly to what cord level?

Nucleus ambiguous Cranial root Anterior horn of gray matter C5 or C6

AO of cranial root of CN 11 Combines briefly with spinal root before exit skull through ____ Fibers then separate and join ____ nerve at ____ ganglion

Lateral MO Jugular foramen Vagus Inferior

Once cranial root fibers are carried in vagus nerve they distribute to ____ plexus along with external and recurrent laryngeal nerves Contribute motor supply to laryngeal muscles other than _____

Pharyngeal Cricothyroid

AO of spinal root of CN 11 Combine w anterior and posterior rootlets to form a trunk that will ascend between _____ and ____ Enter skull through ____

Lateral Cervical cord denticulate ligaments and posterior rootlets Foramen magnum

Spinal root passes laterally to combine with cranial root and passes through _____ Then goes deep to ______ muscle sending fibers Then traverses ___ triangle and goes deep to trap

Jugular foramen SCM Posterior

Where else might Trapezius receive motor supply besides CN 11?

Cervical plexus supplies lower 2/thirds of muscle

What happens if there is interruption of the spinal portion of CN 11? Two other clinical things?

Loss of motor supply to SCM and trap. Right side loss no turn head left Trap and Brachial plexus damage Spasmodic torticollis

Hypoglossal nerve is exclusively ____ Supplies intrinsic and extrinsic muscles of tongue except ______ Formed by axons with cell bodies in which nucleus? Located where?

Motor, Palatoglossus Nucleus of hypoglossal nerve Floor or rhomboid fossa

AO of hypoglossal nerve Forms two bundles which exit skull via Descends forming a loop to reach base of ____ Fibers distribute into terminal branches supplying the ____

Between pyramid and olive of MO Hypoglossal canal Tongue Tongue

Some fibers from ___ and ____ cervical nerves travel with but are not incorporated with hypoglossal nerve. These fibers separate from hypoglossal nerve to form ______ Some fibers continue with hypoglossal and ultimately supply ____ and ____ Lingual branches are given off to supply three things

first and second Superior root of ansa cervicallis Geniohyoid, thyrohyoid Hypoglossus, genioglossus, styloglossus

Main clinical consideration for hypoglossal nerve? Lesion side deviate where? Larynx could deviate where?

Hemiatrophy of tongue Lesion left tongue deviates LEFT To good side during swallow

How many Spinal nerve pairs are there?

31 ``` 8 12 5 5 1 ```

Roots off the spinal cord separate into number of rootlets that attach to the cord at the _____-

Posterolateral Sulcus

What two places are spinal ganglia typically located? 3 Exceptions?

Inside or just medial to the IVF C1 and C2 - vertebral arches Sacral gang - within Vert Canal Coccygel - inside dura matter

Before combining to form mixed spinal nerve a ____ branch is given off. It is present at ___ spinal levels Re enter vert canal through IVF and devices into ____, ____, and ____ branches Provides somatosensory and sympathetic supply to dura, vessels, periosteum, ligaments in which portions of canal

Meningeal (sinuvertebral) ALL Ascending, descending, transverse Anterior and Lateral

What two things do the mixed spinal nerves divide into?

Posterior and Anterior Rami

Splits into lateral and medial branches (except C1) Smaller rams (except C1, S4 S5) Motor innervation to deep back Sensory to skin along spine

Posterior Dorsal Ramus

Motor innervation to anterior and lateral trunk muscles Motor inneration to skeletal musles in extremiteis Contribute to great plexuses Sensory innfervation to skin of extremities and anterior lateral trunk

Anterior Ventral Ramus

Where are sympathetic chain communicans located? What carries mylenated axons from cell bodies found in lateral horn cells at cord level T1-L2? What carries unmylenated post gang sump fibers from cell bodies located in sympathetic chain to spinal nerve, located in each spinal nerve!

At or just medial to bifurcation of mixed spinal nerve White rams communicants Gray ramus communicans

What is the cervical plexus formed by? Nerve roots form a series of _____ _____ Communicate with which cranial nerves?

Anterior (primary) rami of C1-C4 Communicating loops 10 - 12

Fibers from inferior vagal ganglion communicate with loop formed by which roots of cervical plexus>? Fibers from which nerve carry proprioceptive info and communicate with C2,C3 and C4 loop? SCM to ____ Trap to ___ and ____

C1 and C2 Spinal accessory C2 C3 and C4

The _____ nerve communicates with C1 fibers that later separate to become superior root of ansa cervicalis. C1 supply thyrohyoid and geniohyoid remain with the nerve.

Hypoglossal nerve

What three gray rami communicans go with superior cervical ganglion?

Vasomotor, Sudomotor, Pilomotor

Superficial branches of the cervical plexus are all _____ Lesser occipital nerve carries fibers from C2 to supply skin on superior 1/3 of the ____ and skin behind it. May be implicated in cases of ______ _____

Sensory Auricle Cervicogenic Headache

Great auricular nerve carries fibers from ___ and ___ Enter parotid gland and divide into ___ and ___ branches ____ branch combines with facial nerve to supply skin over parotid ____ branch supplies skin over mastoid process

C2 and C3 Anterior and Posterior Anterior Posterior

Transverse cutaneous nerve of neck carries fibers from C_ & C_ Divides into ___ and ____ branches Both of them supply what muscle?

2 and 3 Ascending and descending Platysma

The trunks of cervical plexus from C_ and C_ combine to form trunk giving rise to medial, intermediate, and lateral _______ nerves ____ supplies skin inferior to sternal clavicle to inferior rib2 ____supplies skin over deltoid and pec major to inferior rib 2 ___supplies skin over superior and lateral shoulder

C3 and C4 Supraclaviclular Medial Intermediate Lateral

Deep branches of cervical plexus are divided into ____ and ____ ____ ____ passes through posterior triangle ____ ____ passes through anterior triangle

Medial and Lateral series Lateral Series Medial Series

What are the two branches off of the lateral series of deep branch of cervical plexus?

Spinal accessory nerve ``` Muscular branches SCM (C234) Trap (C2, maybe 3) Levator scap (C34) Middle scalene (C34) ```

What are the 4 major branches off of the medial series of cervical plexus branch?

Communicating branches Muscular Branches from C2 and C2 Phrenic nerve

Look at last part of notes!!!

Shit

Look at diagrams!

Shit

What are two clinical considerations of Cervical plexus?

Subluxation Spinal cord injuries.

Exam 2 Flashcards

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