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AAA PA: Clinical Anatomy > Lecture Module 2: Head, > Flashcards

Lecture Module 2: Head, Flashcards

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1
Q

What are the categories of the bones of the skull?

A
  • Cranial bones (8)
    – Paired: temporal & parietal bones
    – Unpaired: frontal, occipital, sphenoid, ethmoid bone
  • Facial bones (14):
    – Paired: nasal, lacrimal, palatine, inferior nasal concha, zygomatic, maxilla
    – Unpaired: mandible & vomer
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2
Q

What is important about the ethmoid bone?

A
  • Crist Galli (steeple): separated olfactory bulbs & anterior attachment of falx cerebri
  • Cribriform plate
  • Superior/Middle nasal concha/turbinate
  • Perpendicular plate of the E.B.
  • Ethmoidal cells of ethmoidal sinus (make mucous)
  • Olfactory foramina
  • Lateral masses,
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3
Q

What are the “holes” in the bony orbits of the skull?

A
  • Optic foramen (canal)
  • Superior orbital fissure: CN III, CNIV, CN VI & CN V1 (Opthalmic division)
  • Inferior orbital fissure
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4
Q

What is the use of nasal conchae?

A
  • Inc surface area of the cavity
  • Rapid warming & humidification of air through the lungs
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5
Q

What are the sinuses and what is their purpose?

A
  • Frontal, ethmoid, sphenoidal, maxillary
  • Produce mucus: coat & lubricate nasal passages
  • Voice resonance
  • In X-ray of sinuses decreased blackness indicates sinusitis
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6
Q

What are the aspects of the sphenoid bone?

A
  • Optic canal
  • Sphenoid sinus
  • Foramen rotundum
  • Lesser wing
  • Greater wing
  • Superior orbital fissure
  • Body
  • Pterygoid processes: involved with chewing (w/ masseter muscle)
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7
Q

What is the function of the facial bones?

A
  • Face framework
  • Cavities for senses
  • Openings for air and food passage
  • Hold teeth in place
  • Anchor face muscles
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8
Q

What are aspects of the facial bones? (Nasal, Maxilla, Mandible, Zygomatic, Lacrimal, Palatine, Conchae, Nasal septum)

A
  • Nasal: form nose bridge (rest cartilage)
  • Maxilla: 2 fuse, hold teeth, anterior hard palate, all facial bones joint to maxilla but mandible
  • Mandible: only movable join tin skull, lower teeth, articulate w/ temporal bones (condylar process), form chin + coronoid process, mental foramen
  • Zygomatic: form lateral orbit
  • Lacrimal: medial orbit w/ groove tear drainage to nasal cavity
  • Palatine: posterior plate, fuse fail –> cleft palate
  • Conchae (turbinates): warm, humidify, filter air & inc surface area
  • Nasal septum: Perpendicular plate of the E.B. + Vomer
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9
Q

What are the cranial sutures?

A
  • Coronal
  • Lambdoid (lambda point)
  • Squamous
  • Fuse ~2 yrs
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10
Q

What is important about the fontanels?

A
  • Anterior & posterior
  • Depressed: dehydration
  • Bulging: meningitis
  • Craniosynostosis when sutures fuse too early
    Multiple fractures crossing suture lines suspicious for child abuse
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11
Q

What are the lobes and landmarks of the cerebral hemispheres?

A
  • Medulla oblongata
  • Pons
  • Cerebellum
  • Occipital lobe
    – occipital pole
  • Temporal lobe
    – temporal pole (end)
  • Lateral sulcus (b/w F & T)
  • Frontal lobe
    – frontal pole
  • Central sulcus
    – Postcentral gyrus: Somatosensory cortex - sensory paths terminate
    – Precentral gyrus: Primary motor cortex - motor paths beginning
  • Parietal lobe
  • Longitudinal cerebral fissure
    ALL Grey Matter - outside of cerebral cortex
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12
Q

Where would damage be to affect the insular cortex? What would be the symptoms?

A
  • Deep to frontal & temporal lobes
  • Axon passage–cortical & subcortical connection–to integrate information (sensory, emotional, motivational, cognitive)
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13
Q

Where would the damage of the telencephalon be? The symptoms?

A
  • Damage to the cerebral cortex & basal ganglia
  • Problems with voluntary movements, olfaction, language, speech, sensory processing, learning & memory, reasoning, problem solving
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14
Q

A patient has injury to the diencephalon what parts of the brain are affected?

A
  • Thalamus, hypothalamus, Pineal gland
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15
Q

A patient has injury to the brainstem what parts of the brain are affected?

A
  • Midbrain
  • Pons
  • Medulla oblongata
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16
Q

What structures are visible in a median sagittal cross section of the brain?

A
  • Cerebrum
  • Corpus callosum
  • Septum pellucidum
  • Thalamus (wall of third ventricle)
  • Pineal body
  • Hypothalamus
  • Brainstem
    – Midbrain
    – Pons
    – Medulla oblongata
  • Cerebral aqueduct
  • Cerebellum
  • 4th ventricle
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17
Q

A patient has with stained damage to their midbrain. What deficits will they exhibit?

A
  • Superior colliculus: primarily visual integration
  • Inferior colliculus: primarily auditory integration
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18
Q

A patient has cerebellar damage, what are the structures that are affected?

A
  • Arbor vitae (white matter)
  • Cerebellar cortex/folia (gray matter)
  • Cerebellar peduncles
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19
Q

A patient has damaged their brainstem. What structures/functions are you concerned about?

A

All ascending & descending tracts (pass through brainstem)
- Midbrain: Substantia nigra, contains neuronal cell bodies in CNS
- Pons: (anterior protrusion of brainstem, same horizontal plane as 4th ventricle & cerebellum)
- Medulla oblongata: Motor tracts decussate at pyramids, vital reflex centers (HR, RR, vasoconstriction)
– CST & PCML (then enter medial leminiscus)
- Reticular formation:
– Net-like intermingling of gray & white matter
– Ascending: RAS (reticular activating system)
– Descending: helps regulate muscle tone

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20
Q

A patient is having difficulty with memory, what brain structures may be affected?

A
  • Hippocampus (primary for memory) where memory begins
  • Mammillary body: recollective memory: info transmitted here from hippocampus through fornix
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21
Q

A patient is exhibiting uncontrolled movement? What is a potential Dx and what is affected?

A
  • Gradual loss of neurons w/i substantia nigra (pars compacta): produce dopamine –> subconscious movement, cognitive behaviors, & reward
  • Dx: Parkinson’s disease
  • sn (pars reticula): inhibitory GABA
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22
Q

What are the types of peduncles?

A
  • Cerebral: conduct nerve impulses from motor areas in cerebral cortex to spinal cord, medulla & pons
  • Cerebellar: communication & connection, between cerebellum & brainstem, myelinated motor axon tracks
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23
Q

What are the extensions of the Dura?

A
  • Falx cerebri: between cerebral hemispheres
  • Falx cerebelli: between cerebellum hemispheres
  • Tentorium cerebelli: b/w cerebrum & cerebellum
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24
Q

What is important about the reticular formation?

A
  • Extends through medulla, pons, midbrain, & thalamus
  • Contains: clusters of neuronal cell bodies interspaced w/ small bundles of myelinated axons
  • Ascending: RAS: consciousness, wakefulness, arousal
  • Descending portion: muscle tone
  • Receives auditory, visual, sensory information –> RAS
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25
What is the function of the thalamus?
- **Central relay station for afferent (sensory) fibers** - Skin, skeletal muscle (touch, vibration, 2-point discrimination, proprioception, pain, temp) *NOT Smell
26
What is the composition and function of the hypothalamus?
- It has many nuclei - Major regulator of homeostasis 1. Ctrl pituitary gland & production of hormones 2. Regulate eating & drinking 3. Ctrl body temp
27
What are the aspects of the cerebellum?
- Key for skeletal muscle **coordination, tone, posture, balance** - Impairment --> **ataxia** (loss of orderly movements) -- uses sensory input to modulate & coordinate 1. Inability to coordinate muscular movements 2. unsteady walk 3. Difficulty w/ fine motor tasks 4. Change in speech pattern - uncoordinated speech muscles - Blindfolded ppl w/ ataxia cannot touch nose b/c cannot coordinate movement w/ sense of where body part located
28
What are the functions associated with the lobes of the cerebellum?
- Anterior lobe: **unconscious proprioception** - Posterior lobe: movement initiation, planning & **motor coordination** esp inhib involuntary movement via inhibitory GABA - Flocculonodular lobe: **head & eye movements, vestibular**
29
What are the aspects of the Cerebrum?
- Cerebral cortex: see when look at brain, gray matter, insula - hides - Cerebral white matter: -- connect diff regions of brain, includes -- corpus callosum - Basal ganglia: - Limbic System: -- "emotional Brain" (memory, reward/punishment) -- Found near inner "border" the cerebrum -- Key structures: **amygdala, fornix, hippocampus**
30
What are the aspects of the cerebral white matter?
- Myelinated axons running from -- Gyri to gyri: **association tracts** (same cerebral hemisphere) -- Gyri to opposite hemisphere: **commissural tracts** -- Gyri to spinal cord: **projection tracts**
31
What are the aspects of the basal ganglia?
- gray matter deep w/i brain - collection of neuronal cell bodies - connects to other brain regions: thalamus, cerebral cortex, subcortical areas involved w/ movement -- Coordinate & modulate **motor movements** (muscle tone, arm swinging) - **Subconscious ctrl ("fine-tuning") voluntary movements** -- Initiate wanted movements, suppress unwanted, muscle tone, regulate nonmotor process -- Choose actions to execution - Globus pallidus & putamen: lateral to thalamus lentiform nucleus - Caudate nucleus
32
What are the aspects of the limbic system?
- Hippocampus: Memory - Fornix: Connect hippocampus w/ other subcortical areas - Amygdala: manage & processes emotions (ie fear). Regulates autonomic & endocrine functions w/ resulting release of hormones (F/F) - Primary role **Emotions**: pain, pleasure, docility, affection, & anger + Olfaction & memory - Simulation: range intense pain --> extreme pleasure
33
What are the aspects of the internal capsule?
- Two-way tract transmit info to & from cerebral cortex - **Communication b/w cerebral cortex & brainstem** - **Nearly all info in & out cerebral cortex passes through** -- **External capsule** to frontal & parietal lobes -- **Extreme capsule** to insular cortex
34
What is the function and path of CSF?
- Functions 1. **Protection** (cushion) 2. **Buoyancy** (weight X compress CN toots & blood vessels against internal cranium) - **Formed: network of capillaries "choroid plexuses" w/i brain ventricles** by **ependymal cell** - **absorbed**: back into blood by arachnoid villi (granulations) mostly via **superior sagittal sinus**
35
What are the sinuses of the brain?
**dural venous sinuses: b/w periosteal (superficial) & meningeal (deep) layers of dura mater** -- blood from cerebral veins & CSF -- **mainly empty into internal jugular vein** - **Superior sagittal: lies** in attached border of **falx cerebri** -- **begin @ crista galli, end near internal occipital protuberance** @ **confluence of sinuses** (meet superior sagittal, occipital, & transverse sinuses) -- (receives superior cerebral veins & communicate w/) **lateral venous lacunae** (drains superior cerebral veins)
36
What are the ventricles of the brain?
- Lateral ventricles (choroid plexus @ inferior portion of superior enlargement) -- Interventricular foramen (flow to third) - Third ventricle -- cerebral aqueduct (flow to fourth) - Fourth ventricle -- Lateral, median aperture, central canal (flow from fourth)  (CSF made in each)
37
What can cause intercranial pressure and what can it cause?
- Causes: tumors, infections (meningitis), trauma, bleeds (hematomas/hemorrhages), inc production CSF vol - Brain herniation: inc BP, irreg/slow HR, severe headache, cardiac arrest, LOC, loss of brainstem reflexes (blinking, gagging, & pupil light reaction), respiratory arrest
38
What are the types of intracranial bleeds?
- Epidural - Subdural - Intracerebral (parenchymal) - Subarachnoid
39
What is hydrocephalus?
- "water on the brain" - too much CSF: inc production, dec resorption - Tx: VP shunt (ventricles to abd cavity)
40
What is the arterial blood supply to the brain?
Brachiocephalic - Right subclavian -- Vertebral a.: cervical pt, atlantic pt, intracranial pts - Common carotid artery -- internal carotid a. & external carotid a. (@bifurcation)
41
What are the aspects of the circle of willis?
- Vertebral - Basilar - Posterior cerebral - Posterior communicating - Internal carotid - Middle cerebral - Anterior cerebral - Anterior communicating
42
What are the cortical vascular territories?
- Anterior cerebral a.: medial cerebrum (external--medial frontal & parietal--& internal) - Middle cerebral a: lateral cerebral cortex (lateral frontal, superior temporal, lateral parietal) - Posterior cerebral a.: inf. temporal, occipital
43
What are the divisions of the nervous system?
- CNS - PNS -- Sensory: Somatic & visceral sensory -- Motor division: Somatic & autonomic (Sympathetic/parasympathetic)
44
What are the important aspects of the autonomic nervous system?
- Motor innervation to smooth/cardiac muscle & glands - Maintain homeostasis in response to external stimuli (F/F, R&D) - Preganglionic & postganglionic neurons - Sympathetic Autonomic Nervous System (SANS) -- **"Thoracolumbar"** T1-L2 (preganglionic near sympathetic trunk) - Parasympathetic Autonomic Nervous System (PANS) -- **"Craniosacral"** CN & S2-S4 (preganglionic synapse near effector organs)
45
What are ganglia, nucleus, nerve, tract, decussate, synapse, contralateral, and ipsilateral?
- Ganglia: collection of somas in PNS - Nucleus: collection of somas in CNS - Nerve: collection of axons in PNS - Tract: collection of axons in CNS - Decussate: cross over midline - Synapse: b/w neuron & neuron/muscle/gland - Contralateral: opposite side body - Ipsilateral: same side of body
46
What are the afferent tracts of the PNS?
- TYPE of stimuli & location --> three ascending tracts 1. Posterior Column Medial Lemniscus 2. Spinothalamic Tract (part of anterolateral) 3. Trigeminothalamic tract
47
What are the motor tracts of the PNS?
1. **Corticospinal tract (CST)**: brain --> spinal cord --> body (trunk & limbs) -- **anterior & lateral divisions** 2. **Corticobulbar Tract (CBT)**: brain --> brainstem --> CN --> head & neck
48
What are the important functions & structures of the spinal cord?
- Integrate reflexes - Carry white matter tracts (ascending & descending) - Gray matter houses cell bodies of neurons - Structures: gray matter, dorsal/ventral horn, central canal, anterior white commissure
49
What are the common aspects of the ascending tracts?
- AKA Somatosensory tracts - Info in skin/skeletal muscles, & joints to primary somatosensory cortex - 3 neuron cascade 1. first order neuron: pseudounipolar; axon: receptor --> spinal cord/brainstem, soma: dorsal root ganglion 2. Secondary order neuron: multipolar; axon: spinal cord/brainstem --> thalamus; soma: gray matter of sc/b nuceli 3. Third order neuron: multipolar; axon: thalamus --> somatosensory cortex; soma: thalamus
50
What are the aspects of the posterior column medial lemniscus tract?
- Touch, pressure, vibration & proprioception - Pathway 1. FON: receptor --> **sc**, soma: DRG, 2. Axons **FON --> medulla via posterior columns** 3. synapse w/ SON 4. SON **decussate** & enter **medial lemniscus** --> thalamus 5. synapse w/ TON 6. TON --> primary somatosensory cortex
51
What are the aspects of the spinothalamic tract?
- Pain, temperature, itch, tickle (+ deep pressure) (Anterolateral pathway) 1. FON --> **sc & synapse SON**; soma in DRG 2. SON decussate --> thalamus as **spinothalamic tract** *Takes ~2 spinal levels fully decussate* 3. SON synapse w/ TON --> primary somatosensory cortex
52
What are the aspects of the trigeminothalamic tract?
- CN V (trigeminal) all sensory info face, head, oral/nasal cavity 1. FON face/nasal&oral cavity/teeth --> **pons** through **CN V**; soma in **trigeminal ganglion** 2. **some** FON axons synapse w/ SON in **Pons, others descend** to **medulla** to synapse w/ SON 3. SON decussate & ascend as **trigeminothalamic tract** to thalamus 4. SON synapse w/ TON axons to primary somatosensory cortex
53
What is the somatosensory homunculus? **Stroke deficits**
- In parietal lobe - post central gurus - Somatotopic organization: -- lower limb medial: anterior cerebral artery supply -- upper limb medial: middle cerebral artery supply
54
What are the control, names, and common neuron cascade of the descending tracts?
- Ctrl limb & trunk + head & face muscles - Pathways -- Corticospinal tract: anterior & lateral division s -- Corticobulbar tract - 2 neuron cascade : 1. Upper motor neuron: multipolar - axons: precentral gurus to brainstem/spinal cord; soma in cerebral cortex 2. Lower motor neuron: multipolar; axons: brainstem/sc to skeletal muscle; soma: anterior gray horn or brainstem nuclei
55
What is the primary motor cortex homunculus? **Consider stroke deficits**
- Found: frontal lobe - precentral gyrus - Somatotopic organization -- Lower limb medially: anterior cerebral artery supply -- Upper limb & face laterally: medial cerebral artery supply here
56
What are the two corticospinal tracts?
- Anterior (10%) -- UMN decussate @ synapse level w/ LMN & exits as spinal nerve -- Travel anterior funiculus -- Innervates axial muscles & proximal limbs - Lateral (80%) -- UMN decussate in pyramids -- Travel lateral funiculus -- Innervates distal limbs - Pathway: 1. UMN primary motor cortex form corticospinal tracts descend through *internal capsule & cerebral peduncles* 2. m. pyramids 80% decussate & (3) descend to synapse w/ LMN @ exit level 10% form **anterior corticospinal tract in anterior white funiculus** decussate in **anterior white commissure** synapsing w/ LMN @ exit level
57
What are the features of upper and lower motor lesions?
- Site: -- UMN: Cerebral hemispheres, cerebellum brainstem, spinal cord -- LMN: Anterior horn cell, nerve roots, peripheral nerves, neuromuscular jct, muscles - Muscle weakness -- UMN: quad/hemi/di/paraplegia -- LMN: proximal (myopathy) distal (neuropathy) - Muscle tone -- UMN: spasticity, rigidity (contralateral) -- LMN: flaccid, hypotonia - Fasiculations: -- UMN: absent -- LMN: Present (esp tongue) - Tendon reflexes -- UMN: hyperreflexia -- LMN: hypo/areflexia - Abdominal reflexes -- UMN: absent -- LMN: present - Sensory loss -- UMN: cortical sensation (stereognosis, graphesthesia) -- LMN: Peripheral sensations - Babinski sign & Clonus -- UMN: present -- LMN: absent
58
What is the Babinski reflex?
- Upward movement of toes & fanning other toes - Children: normal - Adults: UMN lesion
59
What is clonus?
- Abnormal reflex response involving involuntary & rhythmic muscle contractions - Indicate UMN lesion
60
What is ALS?
- Amyotrophic lateral sclerosis - both motor neuron groups gradually deteriorate - Neurons cannot send signals - Muscles cannot function UMN: positive Babinski, inc deep tendon reflexes, slow/rapid alternating movements, lack coordination, balance, stiffness w/ upper & lower extremity movement LMN: diff squatting & rise from chair, foot drop, muscle atropy (upper & lower extremities
61
Patient presents with loss of pain and temp sensation in right lower limb. - What pathway may be lesioned? Sensation modality lost? Pt also lost motor function of left lower limb w/ hyperreflexia - What tract not working? - Where injured?
- Pain & temp: spinothalamic - Motor: corticospinal tract - Hyperreflexia; Upper motor neuron injury - Somewhere lumbar region on left side
62
What is the corticobulbar pathway?
- Descending somatic motor tract for some CN innervating skeletal muscles - UMN travel from primary motor cortex to specific nuclei in brainstem - CN = LMN - CN V, VII, IX, X, XI, XII receive bilateral input (mostly) 1. Axons of UMN from primary motor cortex to *internal capsule* and *cerebral peduncles* 2. UMN innervate nuclei bilaterally (X decussation) & terminate in motor nuclei of CN in brain stem (V, VII, IX, XI, XII)
63
What are the indirect motor pathways?
AKA extrapyramidal pathways - Conduct impulses for **involuntary movements:** for **posture balance, & muscle tone** - Special info from other tracks to ensure right position, affected by psychology medications - Vestibulospinal (CN VII) - Reticulospinal (reticular formation) - Rubrospinal (red nucleus) - Tectospinal: (superior colliculus)
64
Where are the sensory and motor tracks in the spinal cord?
- Ascending: -- posterior columns in posterior white tract -- Spinothalamic in anterior/lateral white tract - Descending -- Lateral corticospinal tract: lateral/posterior tract -- Anterior corticospinal tract: anterior tract
65
What is Brown Sequard Syndrome?
- AKA: Hemisected cord syndrome - Loss of voluntary motor function (CST) & tactile sensation (PCML) on inferior ipsilateral side as spinal cord damage - Loss of pain & temp sensation (STT) on inferior contralateral
66
What are the potential functional components of cranial nerves?
- Motor fibers -- To voluntary (striated) muscle -- To involuntary (smooth) muscle or glands: parasympathetic ANS - Sensory fibers -- general sensation: touch, pressure, heat cold from skin & mucous membranes -- viscera: carotid body & sinus, pharynx, larynx, trachea, bronchi, lungs, heart, & GI -- Special sensory fibers: taste, smell, vision, hearing - CN fibers connect to CN nuclei (sensory terminate, motor originate) -- mostly in or adjacent to brainstem
67
Notes for CN identification on brain:
- CN III, VI both medial - CN IV: tiny on brain - CN V: big - CN VIII: more than one - CN X: multiple, - CN XI: coming from foramen magnum - CN XII: off of medulla
68
What are the skull openings for the cranial nerves?
- Cribriform foramina: CN I - Optic canal: CN II - Superior orbital fissure: CN III, IV, V1, VI - Foramen rotundum: CN V2 - Foramen ovale: CN V3 - Internal acoustic meatus: CN VII, VIII - Jugular foramen: CN IX, X, XII - Hypoglossal canal: CN XII (Cranial Nerves ppt, slide 7)
69
What are the aspects of CN I?
- Olfactory, Sensory, Smell, special afferent - **olfactory cilia** stimulated by odors - **olfactory nerves pass through cribriform palate synapse with** mitral cells of **olfactory bulbs** & **travel along olfactory tracts to olfactory cortex in temporal lobe**
70
What are the aspects of CN II?
- Optic, sensory, vision, special afferent - **photoreceptor cells** (rods & cones) contain **rhodopsin** (protein) in retina, physical energy (light) concerted to electrical signals **optical stimuli transmitted** by bipolar neurons to **retinal ganglion cells** - axons come together at **optic disk** = beginning **optic nerve** - Exits through optic canal to middle cranial fossa to optic chiasm - Half of each retina decussate at chiasm then form optic tract with half not decussate - Terminate in **lateral geniculate nuclei of thalamus** then axons to **visual cortex of occipital lobe**
71
What are the aspects of CN III?
- Oculomotor, motor, eye movement + open eyelid & ctrl pupil - Functions: 1. **Somatic motor innervation: superior, medial, & inferior recti, inferior oblique & levator palpebrae superioris** (superior eyelid) 2. **Parasympathetic innervation**: **ciliary ganglion** to smooth muscle of sphincter pupillae (pupil & ciliary muscle construction)
72
What are the aspects of CN IV?
- Trochlear, motor, eye movement - **Superior oblique muscle**
73
What are the aspects of CN VI?
- Abducens, motor, eye movement - **lateral rectus muscle**
74
What is damage to the oculomotor nerve?
- Oculomotor nerve palsy - Unable to open eye + Upward & downward gaze minimal - Loss pupillary constriction
75
What are the aspects of CN V?
- Trigeminal, both, sensation: facial skin & teeth, Motor: chewing - Functions: 1. Sensory: head (face, teeth, mouth, nasal cavity, upper & lower jaw) 2. Motor: muscles of mastication - 3 divisions 1. Ophthalmic nerve (V1): superior orbital fissure, S (upper eyelid, eye, lacrimal glands, upper nasal cavity, forehead, anterior scalp) 2. Maxillary nerve (V2): foramen rotundum, S (nose mucosa, palate, pharynx, upper teeth & lip, lower eyelid) 3. Mandibular nerve (V2) foramen ovale: B (anterior **2/3 tongue** (NOT taste) cheek & mucosa, lower teeth, mandible skin & head anterior of ear) (Mylohyoid, digastric, tensor veli palatini, tensor tympani)
76
What is a pathology of the trigeminal nerve?
**Neuralgia** - 1+ branches by inflammation or lesions. - C: Sharp, cutting, tearing, - Hx: More common >60 - First sign MS, DM, Vit B12 deficiency (damages nerves)
77
What are the aspects of CN VII?
- Facial, both, S: taste (anterior 2/3), M: facial expressions, tears & spit - **Motor neurons**: exit through stylomastoid foramen innervate (middle ear, facial, scalp, neck muscles) **muscles of facial expression** + stylohyoid, digastric, & stapedius muscles - **Special sensory neurons: anterior 2/3 tongue** enter temporal bone join facial nerve via **chorda tympani** then **genicular ganglion** in pons then to thalamus then **gustatory area cerebral cortex** - **Parasympathetic motor preganglionic neurons** through **greater petrosal nerve & chorda tympani** end in **pterygopalatine & submandibular ganglion** + lacrimal, sublingual, & submandibular glands
78
What is a pathology of the facial nerve?
- CN VII - Face drooping & inability to close eye on affected side. Loss of muscle tone of facial expression - Bell's palsy
79
What are the aspects of CN VIII?
- Vestibulocochlear nerve, Sensory, hearing& equilibrium - Function: **special sensory hearing, equilibrium & motion** - Vestibular nerve extends to **inner ear **utricle & saccule** (linear acceleration & gravity) & **ampullae of semicircular ducts** (rotational acceleration) - Cochlear nerve to **spiral ganglion** --> auditory cortex
80
What are the aspects of CN IX?
- Glossopharyngeal nerve, both, taste (post 1/3), swallowing - **Special sensory: taste post 1/3 tongue** - **Somatic sensory: tympanic cavity of middle ear** touch, pain, thermal. + **lingual & pharyngeal branch** (gag reflex) - **Visceral sensory** 1. **Baroreceptors**: (pressure) carotid sinus 2. **Chemoreceptors** (blood O2 & CO2) in carotid bodies (near carotid a. bifurcation) & aortic bodies (near aortic arch)  - **Somatic motor**: **stylopharyngeus muscle** - exit through jugular foramen - **Parasympathetic motor neurons**: stim **parotid gland** secrete saliva
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What are the aspects of CN X?
- Vagus, both, monitor BP, O2, CO2, & GI/thoracic viscera; swallowing, coughing, voice, slows HR, digestive juices - **Somatic motor**: soft palate, pharynx, intrinsic laryngeal muscle, palatoglossus - **Visceral (para)**: motor to thoracic & abdominal viscera - **Somatic sensory**: inf pharynx & larynx **cough reflex** - **Visceral sensory**: thoracic & abd organs - **special sensory**: taste from tongue root & epiglottis
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What are the aspects of CN XI?
- Spinal Accessory Nerve, Motor, head & shoulder movement - **Somatic motor: sternocleidomastoid & trapezius muscles**
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What are the aspects of CN XII?
- Hypoglossal nerve, motor, tongue movement - **Somatic motor: intrinsic & extrinsic tongue muscles** - Exit cranium through **hypoglossal canal** - Pathology; tongue deviation, atrophy, fasciculations (muscle twitches)
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What structures does the neck contain?
- Muscles - Glands: **thyroid gland** is middle of anterior aspect - Arteries: **Carotid** a. - Veins: **Jugular** - Nerves - Lymphatics: **cervical lymph nodes** - Trachea, Esophagus, Cervical vertebrae
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What are the aspects of the hyoid bone?
- Not articulate with any other - Suspended from styloid process of temporal bones by ligaments & muscles - *Supports the tongue - & attachment site tongue, neck, & pharynx muscles
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AAA PA: Clinical Anatomy (3 decks)

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