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Mod 10 Cranial Nerves Flashcards

1
Q

Where are sensory nuclei of CNs lie in the brain and where do motor nuclei lie?

A

sensory: lateral
motor: medial

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2
Q

What makes CN I (olfactory) special?

A

does not:
- synapse in thalamus before reaching cerebral cortex
- attach brainstem
- have DRG equivalent

is: part of CNS

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3
Q

What forms the olfactory bulb?

A

bipolar neurons

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4
Q

What type of neurons fill the olfactory tract?

A

secondary neurons

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5
Q

How do you evaluate CN I in clinic?

A

test each nostril separately with familiar scent
- can have affect on olfaction, emotion, and memory

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6
Q

What is anosmia?

A

the inability to smell that may occur from a common cold, COVID, trauma, or PD and Alzheimer’s

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7
Q

What type of cell axons form the optic nerve?

A

retinal ganglion cell axons

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8
Q

Which CNs are components of the CNS?

A

olfactory and optic

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9
Q

How does the fact that CN II is part of the CNS have affect when it comes to diseases of the CNS?

A

patients with MS typically experience visual deficits first which can indicate MS

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10
Q

What are the ways to evaluate CN II in clinic?

A
  • snellin chart
  • quadrant testing
  • pupillary light reflex (afferent limb)
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11
Q

How does CN III have a visceral motor function?

A

edinger - westfall nucleus is parasympathetic pre-ganglionic nucleus that control the iris sphincter muscle and ciliary muscle

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12
Q

Which eye muscles does CN III innervate?

A
  • levator palpebrae superioris
  • medial rectus
  • inferior oblique
  • inferior rectus
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13
Q

What is the pupillary light reflex?

A

shine light in the eyes
- consensual response: pupil constriction in opposite eye (CN II)
- direct response: pupil constriction in same eye (CN III)

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14
Q

What is anisocoria?

A

denotes pupillary size inequality

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15
Q

How would damage to CN II affect the pupillary light reflex?

A

no relay to the lateral geniculate nucleus so opposite CN III cannot fire

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16
Q

How would damage to CN III affect the pupillary light reflex?

A

no ipsilateral contraction due to the nerve not being able to accept the relayed communication from CN II

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17
Q

What is a good way to remember which extra ocular muscles are innervated by a CN?

A

SO4, LR6, the rest are 3

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18
Q

Where does CN III emerge from?

A

midbrain

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19
Q

What is the role of CN IV?

A

innervates superior oblique muscle

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20
Q

What is unique about CN IV?

A

axons leaving the trochlear nucleus cross midline to innervate contralateral superior oblique muscles

only CN to exit dorsal brainstem

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21
Q

What function is CN III?

A

somatic motor and visceral motor

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22
Q

What is the function of CN IV?

A

somatic motor

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23
Q

What is the function of CN VI?

A

somatic motor

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24
Q

Where is the abducens nucleus located?

A

caudal pons

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25
What does CN VI do?
innervates lateral rectus muscles
26
How do you evaluate CN III, IV, and VI function in clinic?
H test - smoothness - convergence/divergence - pupillary light reflex
27
What is opthalmoplegia?
disorder of eye movement causing the paralysis of one or more of the extra ocular muscles
28
What is strabismus?
disorder of eye movement causing the inability to direct both eyes to the same object
29
What is the difference between lateral and medial strabismus?
lateral: CN III paralysis (stuck lateral) medial: CN VI paralysis (stuck medial)
30
What is diplopia?
disorder if eye movement causing double vision
31
What is ptosis?
disorder of eye movement causing weakness of levator palpebrae superioris muscle
32
What is the function of CN V?
general sensory and branchial motor
33
What are the three divisions of the trigeminal nerve?
- ophthalmic (V1) - maxillary (V2) - mandibular (V3)
34
Where are the trigeminal nerve sensory nuclei located in the brain?
large and located in the midbrain, pons, medulla, and cervical spinal cord
35
Where are the trigeminal nerve motor nuclei located?
pons
36
What does CN V do?
sensory innervation of face and head, motor innervation to muscles of mastication, small branch to tensor tympani
37
What is the main sensory nucleus of CN V role?
fine touch, pressure, vibration
38
What is the spinal nucleus of CN V role?
nociception and temperature
39
What is the mesencephalic nucleus of CN V role?
jaw proprioception (jaw reflex efferent limb)
40
What is the motor nucleus of CN V role?
muscles of mastication and tensor tympani
41
What is the motor pathway and UMN/LMN of the face?
corticobulbar tract UMN: primary cerebral cortex LMN: motor nucleus CN V
42
What is the fine touch, pressure, and vibration pathway of the face?
trigeminal pathway
43
What is the proprioception pathway of the face?
trigeminal pathway
44
What is the nociception and temperature pathway of the face?
trigeminal pathway
45
Where do the primary afferents of the trigeminal system terminate?
main trigeminal sensory, spinal nucleus, and mesencephalic nucleus
46
How do you evaluate the trigeminal nerve in clinic?
sensory test for DCML and STT (light touch, sharp, dull) palpate MoM and resist jaw opening
47
What is herpes zoster opthalmicus?
inflammatory and infectious disease that causes 2-3 days of severe pain along V1 distribution with rash soon after could cause corneal damage
48
What is the function of the facial nerve?
general sensory special sensory branchial motor parasympathetic motor
49
Where do CN VII nuclei lie?
pons and medulla
50
What does the facial nerve do?
innervate sensory of ext ear, anterior 2/3 tongue for taste, muscles of facial expression, stapedius, lacrimal, submandibular, and sublingual glands
51
How do we evaluate CN VII in clinic?
special sensory: ask about taste branchial motor: muscles of facial expression
52
What is Bell's palsy?
most common disease of CN VII caused by herpes simplex virus paralysis of facial muscles, and impaired corneal blink reflex
53
What is important to remember about Bell's palsy and how it affects facial muscles?
UMN weakness: more observable in lower facial muscles LMN weakness: more observable in both upper and lower facial muscles
54
What is the function of CN VIII?
special sensory
55
What does CN VIII do?
conveys vestibular and cochlear info
56
Where is CN VIII nuclei located?
caudal pons and rostral medulla
57
How do we clinically evaluate CN VIII?
- finger rub or whisper test - Romberg/sharpened romberg
58
Where does CN VIII enter the brainstem?
rostral medulla
59
What is the function of CN IX?
- general sensory - special sensory - visceral sensory - branchial motor - visceral motor
60
Where are the nuclei of CN IX?
rostral medulla
61
Where does CN IX attach to the brainstem?
causal medulla
62
What is the function of the vagus nerve?
- general sensory - special sensory - branchial motor - visceral motor
63
Where are the nuclei of CN X located?
mid medulla
64
How do you clinically evaluate CN IX and X?
- soft palate movement ("ah") - observe swallow - observation of vocal quality
65
What can lesions of CN IX and X cause?
hoarseness of speech and difficulty swallowing
66
What side does the uvula deflect if damage to CN IX?
deflect to unaffected side
67
What is the function of CN XI?
branchial motor
68
Where are the nuclei of CN XI located?
medulla and cervical spinal cord
69
What does CN XI do?
SCM and traps
70
How do we clinically evaluate CN XI?
shoulder shrug test and resisted head turning
71
What is the function of CN XII?
somatic motor
72
Where are the nuclei of CN XII located?
medulla
73
What does CN XII do?
intrinsic and extrinsic muscles of the tongue
74
How do we clinically evaluate CN XII?
- protrusion and speech articulation - "late night downtown" - lick the lesion (goes toward affected side

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