lecture 16: CN V and VII Flashcards

1
Q

what are the 3 divisions of the trigeminal n

A

opthlamaic
maxillary
madinbular

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2
Q

is trigeminal mixed, sensory or motor

A

mixed

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3
Q

where does the trigeminal n emerge from the pons

A

lateral aspect of the pons

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4
Q

what is the only branch of the trigeminal n that carries motor fibers

A

only C V3 (mandibular)

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5
Q

true or false: only the only C V3 (mandibular) carries sensory fibers

A

false, motor fibers

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6
Q

in the trigeminal n, most primary sensory neurons cell bodies (pseudounipolar) are located where

A

in trigeminal ganglion

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7
Q

where is the trigeminal ganglion located

A

near pons

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8
Q

what is the dermatome distribution of the opthlamaic n

A

cornea, skin of forehead, scalp, eyelid, anterior nose, anterior nasal cavity mucosa, mucosa of paranasal sinuses

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9
Q

what foramen foes the ophthalmic n exit thru

A

superior orbital fissure

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10
Q

what foramen foes the maxillary n exit thru

A

foramen rotundum

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11
Q

what foramen foes the mandibular n exit thru

A

foramen ovale

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12
Q

what is the dermatome distribution of the maxillary n

A

skin of the face over maxilla (upper lip, cheek), maxillary teeth, posterior nasal cavity mucosa, maxillary sinus and palate

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13
Q

what is the dermatome distribution of the mandibular n

A

skin of the face over the mandible and sides of face, mandibular teeth, temporomadinular joint, oral mucusa, anterior 2.3 of tongu

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14
Q

what is the innervates the masseter

A

opthlamaic n

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15
Q

what is the innervates the termporalis

A

maxillary

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16
Q

what is the innervates the medial and lateral pteryhoids

A

mandibular

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17
Q

what muscle does the ophthalmic n innervate

A

masseter

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18
Q

what muscle does the maxillary n innervate

A

temporalis

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19
Q

what muscle does the mandibulary n innervate

A

medial and lateral pterygoids

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20
Q

true or false: all 3 divisions of the trigeminal n carry all somatosensory modalities

A

true

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21
Q

what are the two trigeminal n nuclei

A

sensory trigeminal n (somatic sensory)

motor trigeminal nucleus (brainchian motor)

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22
Q

what are the 3 parts of the sensory trigeminal nucleus

A

mesencephalic nucleus (midbrain/pons), chief nucleus (pons), spinal nucleus (pons to c3)

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23
Q

the sensory trigeminal nucleus extends from where to where

A

midbrain to upper cervical spine

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24
Q

where is the mesencephalic nucleus (of sensory trigeminal nucleus) located

A

midbrain/pons

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25
Q

where is the chief nucleus (of sensory trigeminal nucleus located )

A

pons

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26
Q

true or false: the chief nucleus carries only branchial motor

A

false, sensory info

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27
Q

where is the spinal nucleus (of sensory trigeminal nucleus) located

A

(pons to c3)

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28
Q

spinal trigeminal nucleus receives what type of info

A

pain and temperature (spinothalamic pathway)

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29
Q

the spinal nucleus of the trigeminal n is continuous with BLANK in the spinal cord

A

dorsal column (since spinothalamic info is thru dorsal horns)

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30
Q

the spinal trigeminal tract is continuous with what in the spinal cord

A

dorsolateral tract

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31
Q

what is the function of the spinal trigeminal tract

A

acts as an elevator to allow information/axons to ascent or descent

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32
Q

what somatosensoation does the spinal nucleus receive

A

pain and temperate

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33
Q

what somatosensoation does the chief sensory nucleus receive

A

rfine touch and vibration (DCML)

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34
Q

true or false: the chief nucleus receives rfine touch and vibration (DCML)

A

true

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35
Q

true or false: the trigeminal tract only carries information from the spinal nucleus

A

fALSE, from all 3 trigeminal sensory nuclei

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36
Q

what information does the mesenphealic nucleus receive

A

non concious proprioception

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37
Q

what pathway is the mesencephalic nucleus equivalent to

A

spinocerebellar pathway

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38
Q

why is the mesephalic nucleus unique

A

since it contains cell bodies of primary sensory neurons (only knwoncause of primary sensory neurones with cell bodies in CNS)

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39
Q

most primary sensory neuron cell bodies of the trigeminal n are located in the trigeminal ganglion, except what exception

A

mesencephalic nucleus

contains cell bodies of primary sensory neurons (only knwoncause of primary sensory neurones with cell bodies in CNS)

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40
Q

be able to locate the different sensory and branchial motor nuclei i the brainstem

A
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41
Q

where is the motor trigeminal nucleus located

A

in the pons at the level where CN V emerges

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42
Q

why is the motor trigeminal nucleus considered branchial motor

A

since the muscles of mastication are derived from pharyngeal arches which lead to branchial motor (not somatic)

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43
Q

explain the ascending trigeminal pathway carrying fine touch, vibration and concious proprioceptions

A

1) primary sensory neuron in trigeminal ganglion
2) synapse with secondary sensory neuron in the chief nucleus of CN V
3) decussation
4) ascends in trigeminal nucleus
5) synapse with tertiary sensory neuron in the VPM of thalamus
6) internal capsule (genu)
7) to primary somatosensory cortex in most lateral area for head and neck

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44
Q

the trigeminal ganglion for fine touch vibration is equivalent to what in the DCML pathway

A

dorsal root ganglion

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45
Q

the chief nucleus of the CN is equvileant to what in the DCML

A

dorsal horn

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46
Q

fine touch vibration and concious proprioception of trigemianl ascending pathway ascends as trigeminal leminscus is analogous to what in the DCML

A

medial lemiscus

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47
Q

what is the equivalent to the medial lemniscus in the trigeminal ascending pathway for fine touch, vibration etc

A

trigeminal leminscus

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48
Q

where does the synapse happen between secondary and tertiary neurons in the trigeminal ascending pathways

A

VPM of thalamus

49
Q

what part of the internal capsule do fibers from the trigeminal ascending pathways

A

genu

50
Q

explain the ascending trigeminal pathway carrying pain, temp, crude touch, pressure

A

1) primary sensory neuron in trigeminal ganglion
2) descend in spinal trigeminal tract
3) synapse with secondary sensory neuron in spinal trigeminal nucleus
4) decussation
5) ascends in trigeminothalamic tract
6) synapse with tertiary sensory neuron in the VPM of thalamus
6) internal capsule (genu)
7) to primary somatosensory cortex in most lateral area for head and neck

51
Q

the spinal trigeminal tract is equivalent to what in the spinothalamic pathway

A

posterolateral tract

52
Q

true or false” the spinal trigeminal nucleus is equivlanr to the anterior horn in the SC

A

false, the dorsal horn

53
Q

true or false, there is no UMN control of trigeminal motor pathways

A

false, there is

54
Q

explain the pathway of UMN control of corticonuclear fibers

A

1) UMN in primary motor cortex (pre central gyrus facial area)
2) corona radiata
3) internal capsule (genu)
4) cerebral peduncle
5) synapse with LMN bilaterally in motor trigeminal nuclei
=going to muscles of mastication

55
Q

true or false, in UMN control of trigeminal motor, uMN synapse with LMN unilaterally in motor trigeminal nuclei

A

false, bilaterally

56
Q

lesion to an UMN/corticonuclear tract of trigeminal motor pathway, will a unilateral lesion have a little or big effect

A

little because there is bilateral UMN control

57
Q

is the jaw jerk reflex mono or poly synaptic reflex

A

mono (non conious therefore the primary sensory neon is actually located in the brainstem already=no need for interneours0

58
Q

explain the jaw jerk reflex

A

1) stimulus = tap chin (stimulate the proprioceptors/muscle spindles in masseter, temporals etc)

2) afferent limb = sensory signals travel via V3 to motor nucleus of CN V via central process (sensory cell bodies in mesenphelaic nucleus of CN V9

3) synapse = in motor nucleus of CN V

4) efferent limb = motor signals travel via V3 to extrafusal fibers of muscles of masticuated

5) response = mandible elevates (close jaw)

59
Q

explain the afferent limb of the jaw jerk reflex

A

sensory signals travel via V3 to the motor nucleus of the CN V

(cell bodies in mesenphalic nucleus of CN V)

60
Q

where dos the synapse happen for the jaw jerk reflex

A

in motor nucleus of the CN V

61
Q

true or false, the only branch of the trigeminal n involved in the jaw jerk reflex is the mandibular branch

A

true

62
Q

explain the efferent limb of the jaw jerk reflex

A

motor signals travel via V3 to extrafusal fibers of muscles of mastication

63
Q

in the jaw jerk reflex: motor signals travel via V3 to extrafusal fibers of what

A

of muscles of mastication

64
Q

what is the response of the jaw jerk relfex

A

mandible elevates (close jaw)

65
Q

true or false: the facial nerve is sensory only

A

false, mixed

66
Q

where does the facial n emerge

A

pontomedullar junction (lateral)

67
Q

where does the facial n excite the skull

A

via internal acoustic meatus

68
Q

after exited thru the internal acoustic meatus, where does the facial n travel trhru

A

facial canal

69
Q

what makes up the facial n

A

motor root and nervus intermedius (sensory)

70
Q

where are the cell bodies of the primary sensory neurons of the facial n located

A

geniculate ganglion

71
Q

true or false: the cell bodies of the primary sensory neurons of the facial n are located in denticulate ganglion

A

false, geniculate

72
Q

explain the parasumpathic cell body location for the facial n

A

preganglionic parasympathetic neurons synapse in pterygopalatine ganglion (for lacrimal gland)
or submandibular ganglion (for submandibular and sublingual glands)

73
Q

where does the preganglionic parasympathetic neurons synapse in for the lacrimal gland

A

pterygopalatine ganglion

74
Q

where does the preganglionic parasympathetic neurons synapse in for the submandibular and sublingual gland

A

submandibular ganglion

75
Q

the facial cranial n excite the facial canal via what

A

stylomastoid foramen

76
Q

what are the motor branches of the facial n

A

temporal
zygomatic
buccal
mandibular
cervical

77
Q

how many facial n nuclei are there

A

4

78
Q

in what aspect of the brainstem are the facial n nuclei located

A

in the caudal aspect of the pons

79
Q

what its he somatic sensory nuclei of the facial n

A

sensory trigmeinal nucleus

80
Q

what does the sensory trigmeinal nucleus innervate

A

sensory info of skin of external ear

81
Q

what its the branchial motor nuclei of the facial n

A

facial motor nucleus

82
Q

true or false: facial motor nucleus is branchial motor

A

tre=ue because it is derived muscles of facial expression are derived from pharyngeal arches

83
Q

facial motor nucleus provides motor innervate to what

A

muscles of facial expression and 3 others

84
Q

explain the passage of fibres from facial motor nucleus in relation to another nucleus

A

fibers loop around abducens nucleus, then exit ventrally

85
Q

what is the clinical significance of the fact that facial motor fibers loop around abducens nucleus, then exit ventrally

A

abducens nucleus will often be associated with facial motor issues as well

86
Q

what is the visceral motor nucleus of the facial n

A

superior salivary nucleus

87
Q

the superior salivatoruy nucleus is associated with what in olfaction

A

associated with the salivary reflex in response to appetizing smells

88
Q

preganglionic parasympathetic fibers from pterygopalatine ganglion synapsen in what nucleus

A

superior salivary nucleus (carries info from lacrimal gland to minor salivary gland)

89
Q

preganglionic parasympathetic fibers from submandibular ganglion synapsen in what nucleus

A

superior salivatory nucleus (carries info from submandibular and sublingual gland

90
Q

true or false, the facial n nuclei nucleus solitaires is a special sensory nucleus

A

true

91
Q

why is the nucleus solitaires of the facial n special

A

since it a nucleus that has 2 parts that carries different modalities

(normally, nucleus oney carries 1 modality)

92
Q

nucleus solitaires carries taste sensation from what

A

anterior 2/3 of tongue

93
Q

explain the UMN control via corticonuclear fibres of the facial nuclei

A

1) UMN in primary motor cortex (pre central gyrus in facial area)
2) corona radiata
3) internal capsule (genu)
4) cerebral peduncle
5) synapse with LMN in facial motor nuclie
=bilaterally for upper face
=contralaterally for lower face

94
Q

true or false, in UMN for facial nucleus, the synapse with LMN in facial motor nucleus is
=bilaterally for lower face
=contralaterally for upper face

A

false,
=bilaterally for upper face
=contralaterally for lower face

95
Q

explain the effect of a LMN lesion for facial n

A

results in complete paralysis of ipsilateral side of face (bells palsy) (upper and lower)
eliminating all branchial motor innervation to the face

96
Q

explain the effect of a UMN (central.supranucleus) lesion for facial

A

results in paralysis of lower half of face on the contralateral side

97
Q

true or false: lesion to a LMN of facial n results in paralysis of lower half of face on the contralateral side

A

false, thats for UMN

98
Q

explain why a facial UMN lesion results in paralysis of lower half of face on the contralateral side

A

because upper half is innervated by contralateral side

but lower face only gets ipsialtearl innervation only

99
Q

know crocodile tear kinda

A
100
Q

which of these is a polysynaptic reflex: corneal blind or jaw jerk

A

corneal

101
Q

the corneal blink reflex is polysynaptic or mono synapstic

A

poly

102
Q

the corneal blink reflexv receives what type of stimulus

A

nociceptive stimulus (in cornea)

103
Q

explain the corneal blind reflex

A

1) sensory fibers (CN V1) synapsen in spinal part of sensory trigeminal nucleus
2) interneurons project to facial motor nuclei bilaterally
3) motor fibers (CN VII) from facial motor nuclei innervate orbiculares occult
4) response= blink
5) direct and consensual responses

104
Q

add slides about hyperacusis

A
105
Q

the trigemianl n is associated with what brainstem nuclei type

A

branchial motor
somatic sensory

106
Q

what is the branchial motor nuclei called for the trigeminal n

A

motor trigeminal nucleus

107
Q

what is the somatic sensory nuclei called for the trigeminal n

A

sensory trigeminal nuclei

108
Q

what are the associated foramen of the trigeminal n

A

V1 = superior orbital fissure
V2= foramen rotundem
V3= foramen ovale

109
Q

what is the function of the branchial motor of trigeminal n

A

to muscles of mastication, mylohyoid, anterior gastric, tensor vela palatini, tensor tympani

110
Q

the facial n is associated with what brainstem nuclei type

A

branchial motor
visceral motor
somatic sensoru
special sensoru

111
Q

what is the branchial motor nuclei called for the facial n

A

facial motor n

112
Q

what is the visceral motor nuclei called for the trigeminal n

A

superior salivator nucleus

113
Q

what is the somatic sensory nuclei called for the facial n

A

spinal and chief sensory trigeminal nuclei

114
Q

what is the special sensory nuclei called for the facial n

A

nucleus solitaris

115
Q

what are the associated foramen for the facial n

A

internal acoustic meatus (anf facial canal and stlomastoid foramen)

116
Q

the branchial motor of the facial n goes to

A

muscles of facial expression,. strapedius, stylohyoid, posterior digastic

117
Q

the visceral motor of the facial n goes to

A

lacrimal, submandibular, sublingual glands

glands of nose/soft palate

118
Q

the somatic sensory of the facial n goes to

A

skin of external ear

119
Q

the special sensory of the facial n goes to

A

taste from anterior 2/3 of the tongue and soft palate