Nerves

Question 1

Greater occipital nerve

Answer 1

Sensory Branch of dorsal ramus of C2
Emerges from between C1 and C2, inferior to obliquus capitis inferior
Sensation from the back of the head

Question 2

Least (3rd) occipital nerve

Answer 2

Sensory branch of dorsal ramus of C3
Inferior to greater occipital nerve
Sensation from posterior of head and neck

Question 3

How does the vagus nerve (CN X) travel through the neck?

Answer 3

Between the common carotid artery and internal jugular vein within the carotid sheath

Question 4

How does the hypoglossal nerve (CN XII) travel through the neck?

Answer 4

Deep to posterior belly of digastric - between internal carotid artery and internal jugular vein - crosses over external carotid artery to loop anteriorly - dives between mylohyoid and hyoglossus muscles (traveling with lingual artery)

Question 5

Where is the cervical portion of the sympathetic trunk found?

Answer 5

Deep to contents of carotid sheath

Against pre-vertebral muscles

Question 6

Name the ganglia typically found in the cervical portion of the sympathetic trunk

Answer 6

Superior
Middle
Inferior
Vertebral

Question 7

Cervicothoracic (stellate) ganglion

Answer 7

The common fusing of the inferior cervical ganglion and the first thoracic ganglion of the sympathetic trunk
Typically posterior to subclavian artery

Question 8

Ansa subclavia

Answer 8

Thin loop of sympathetic fibers that travel anterior to subclavian artery
Connect stellate ganglion to vertebral ganglion

Question 9

Carotid plexus

Answer 9

Sympathetics traveling above superior cervical ganglion

Travel with the carotid vessels

Question 10

Superior cervical gangion

Answer 10

Sympathetics to head

Question 11

Middle cervical ganglion

Answer 11

Sympathetics to heart and lungs

Question 12

Inferior cervical ganglion

Answer 12

Sympathetics to heart and lungs

Question 13

Horner’s syndrome

Answer 13

Lesion of sympathetic trunk in neck
Causes: stroke, neck trauma, carotid artery injury, Pancoast tumors (top of lungs), cluster headaches
Symptoms:
- miosis (contraction of pupil)
- ptosis (drooping of eyelid)
- anhidrosis (decreased sweating face/neck)

Question 14

Branchial fistula

Answer 14

Abnormal canal resulting from the persistence of remnants of the 2nd pharyngeal pouch
Passes through subcutaneous tissue, platysma, fascia of neck to enter carotid sheath
Passes between internal and external carotid arteries to tonsillary sinus
Usually travels along anterior of SCM
Saliva may drip from fistula - infection

Question 15

How does the brachial plexus course through the neck?

Answer 15

Travels between anterior and middle scalene - between clavicle and first rib

Question 16

How does the phrenic nerve course through the neck?

Answer 16

C3, C4, C5

Runs anteriorly to anterior scalene - enters thorax - runs along pericardium - diaphragm

Question 17

How does the accessory nerve (CN XI) course through the neck?

Answer 17

C1-C6
Enters skull through foramen magnum - leaves skull through jugular foramen - deep to levator scapulae to trapezius
Innervates SCM and trapezius

Question 18

How does the olfactory nerve (CN I) pass through the skull?

Answer 18

Olfactory foramina (ethmoid bone)

Question 19

How does the optic nerve (CN II) pass through the skull?

Answer 19

Optic canal (sphenoid bone)

Question 20

How does the oculomotor nerve (CN III) pass through the skull?

Answer 20

Superior orbital fissure (sphenoid bone)

Question 21

How does the trochlear nerve (CN IV) pass through the skull?

Answer 21

Superior orbital fissure (sphenoid bone)

Question 22

How does the opthalmic division of the trigeminal nerve (CN V-1) pass through the skull?

Answer 22

Superior orbital fissure (sphenoid bone)

Question 23

How does the abducens nerve (CN VI) pass through the skull?

Answer 23

Superior orbital fissure (sphenoid bone)

Question 24

Which nerves pass through the superior orbital fissure of the sphenoid bone?

Answer 24

Oculomotor (III)
Trochlear (IV)
Opthalmic division of trigeminal (V1)
Adbucens (VI)

Question 25

How does the maxillary division of the trigeminal nerve (CN V2) pass through the skull?

Answer 25

Foramen rotundum (sphenoid bone)

Question 26

How does the mandibular division of the trigeminal nerve (CN V3) pass through the skull?

Answer 26

Foramen ovale (sphenoid bone)

Question 27

How does the facial nerve (CN VII) pass through the skull?

Answer 27

Internal auditory meatus (temporal bone)

Question 28

How does the vestibulocochlear nerve (CN VIII) pass through the skull?

Answer 28

Internal auditory meatus (temporal bone)

Question 29

Which nerves pass through the internal auditory meatus of the temporal bone?

Answer 29

Facial (VII) | Vestibulocochlear (VIII)

Question 30

How does the glossopharyngeal nerve (CN IX) pass through the skull?

Answer 30

Jugular foramen (between temporal and occipital bones)

Question 31

How does the vagus nerve (CN X) pass through the skull?

Answer 31

Jugular foramen (between the temporal and occipital bones)

Question 32

How does the accessory nerve (CN XI) pass through the skull?

Answer 32

Jugular foramen (between temporal and occipital bones)

Question 33

Which nerves pass through the jugular foramen between the temporal and occipital bones?

Answer 33

Glossopharyngeal (IX) Vagus (X) Accessory (XI)

Question 34

How does the hypoglossal nerve (CN XII) pass through the skull?

Answer 34

Hypoglossal foramen (occipital bone)

Question 35

Anosmia

Answer 35

Loss of sense of smell | Can be caused by fracture of ethmoid bone

Question 36

The medial retina of the eye receives information from the _______ and projects to the ______ of the brain

Answer 36

The medial retina of the eye receives information from the LATERAL and projects to the OPPOSITE side of the brain

Question 37

The lateral retina of the eye receives information from the ________ and projects onto the _______ of the brain

Answer 37

The lateral retina of the eye receives information from the MEDIAL and projects onto the SAME SIDE of the brain

Question 38

Trigeminal ganglion

Answer 38

Cell bodes of the unipolar sensory neurons of all 3 divisions of the trigeminal nerve (V) In middle cranial fossa

Question 39

Facial motor nucleus

Answer 39

Cell bodies of the neurons that innervate the muscles of facial expression In brainstem One on right and left sides Have superior and inferior halves

Question 40

The right facial motor nucleus innervates the muscles of facial expression on the _____ side of the face (and vice versa)

Answer 40

Right

Question 41

Superior half of facial motor nucleus

Answer 41

Innervate muscles on superior half of face Receives input from the cerebral cortex on BOTH sides of the brain (contralateral and ipsilateral) - Receives most of it’s activation from the contralateral side

Question 42

Inferior half of facial motor nucleus

Answer 42

Innervate muscles on the inferior part of face | Receives input from cerebral cortex on CONTRALATERAL side of brain

Question 43

Lower motor neuron lesion

Answer 43

Lesion in neuron AFTER facial motor nucleus | Results in paralysis of muscles of facial expression on the same side as the lesion

Question 44

Upper motor neuron lesion

Answer 44

Lesion of the axons coming from the cerebral cortex towards the contralateral facial motor nuclei - BEFORE they cross to the ipsilateral facial motor nuclei NO activation of the contralateral inferior motor nucleus - paralysis of the inferior facial muscles on the opposite side of the lesion Activation of superior motor nuclei on BOTH sides decreased, but mostly affects side contralateral to lesion - results in weakness of the superior facial muscles on BOTH sides

Question 45

Bell’s Palsy

Answer 45

Inflammation of the facial nerve | Lower motor neuron lesion

Question 46

What kind of lesion commonly result from a stroke?

Answer 46

Upper motor neuron lesion

Question 47

Name the cutaneous nerve branches of the opthalmic division of the trigeminal nerve (V1)

Answer 47

``` Supraorbital Supratrochlear Infratrochlear External nasal Palpebral ```

Question 48

Name the cutaneous nerve branches of the maxillary division of the trigeminal nerve (V2)

Answer 48

Infraorbital Zygomaticotemporal Zygomaticofacial

Question 49

Name the cutaneous nerve branches of the mandibular division of the trigeminal nerve (V3)

Answer 49

Mental Buccal Auriculotemporal

Question 50

Trigeminal neuralgia

Answer 50

Demyelination of the axons of the sensory nerves of trigeminal (V) Middle aged, elderly Sudden attacks of severe facial pain in response to otherwise painless stimuli Lead to depression and suicide - psychological changes Usually caused by pressure on sensory root of nerve near brainstem by artery

Question 51

Herpes zoster

Answer 51

Viral infection that can cause lesions in cranial ganglia 20% cases in trigeminal (V) Eruption of vesicles following course of affected nerve Can affect any division - usually opthalmic (V1) - corneal ulceration and scarring Aka shingles