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Neuro Exam 3 > Review Cranial Nerves > Flashcards

Review Cranial Nerves Flashcards

(100 cards)

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1
Q

CN I

A

olfactory

-SVA - smell

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2
Q

olfactory bulb

A

where CN I synapses

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3
Q

anosmia

A

complete loss of smell

CN I lesion

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4
Q

CN I lesions

A

trauma - frontal lobe

sliding on cribriform plate shears the nerves

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5
Q

CN II

A

optic nerve

-SSA - vision

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6
Q

CN II problems

A

alterations in vision

change in intracranial pressure

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7
Q

testing CN II

A

fundoscope

visual field exam

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8
Q

pupillary light reflex

A

in by 2 out by 3

can also test CN II

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9
Q

papilledema

A

increased ICP

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10
Q

CN III

A

oculomotor
GSE - 5 of 7 extraocular eye muscles
GVE-P - to intraocular eye muscles (ciliary muscle and sphincter pupillae)

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11
Q

course of CN III

A

oculomotor and edinger westphal nuclei
-travel through superior orbital fissure

-superior division - superior rectus and levator palpebrae superioris

inferior division - medial rectus, inferior rectus, inferior oblique, and motor to ciliary ganglion

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12
Q

testing CN III

A

extraocular eye movements

make the “H”

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13
Q

accomodation reflex

A

in by 2, out by 3

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14
Q

CN III lesion pathology

A
  • uncal hernations
  • cavernous sinus pathology
  • aneurysm of posterior cerebral or superior cerebellar aa
  • compression against temporal bone - increased ICP
  • diabetic neuropathy
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15
Q

arteries near CN III

A

posterior cerebral a

superior cerebellar a

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16
Q

increased ICP

A

all cranial nerves can be affected

mostly CN II first

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17
Q

CN III lesion symptoms

A

paralysis extraocular - down and out
ptosis - cannot elevate eyelid
-paralysis sphincter - no pupil light reflex
-paralysis ciliary - no accomodation

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18
Q

cross section of CN III***

A

GSE - located centrally
GVE-P - fibers located peripherally

therefore, GVE-P affected first***

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19
Q

compression injuries of CN III***

A

damage to GVE-P

-loss of pupil constriction presents first

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20
Q

diabetic neuropathy in CN III***

A

sparing of GVE-P but GSE loses blood supply

pupillary sparing***

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21
Q

CN IV

A

trochlear nerve

GSE - superior oblique

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22
Q

course of trochlear nerve

A

only one to exit dorsal surface
-superior orbital fissure

innervates superior oblique

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23
Q

test CN IV

A

adduct eye and look down
-lesion cannot do this

extraocular movements

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24
Q

lesion to CN IV

A

neutral position - neutral position slightly elevated and adducte

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25
CN V
trigeminal nerve SVE - arch 1 derivatives GSA
26
arch 1 derivatives
muscles of mastication CN V innervation ``` temporalis masseter M/L pterygoid anterior belly digastric mylohyoid tensor tympani tensor veli palatini ```
27
GSA of trigeminal
``` face teeth oral cavity external ear paranasal sinuses nasal cavity eye and conjunctiva dura ```
28
course of trigeminal nerve
sensory and motor nucleus -trigeminal ganglion gives off: V1 - superior orbital fissure V2 - foramen rotundum to PPF V3 - foramen ovale to infratemporal fossa
29
V3
only one carrying the motor portion**
30
branches of trigeminal
route to distribute the autonomics
31
ophthalmic nerve
V1 - sensory to eye - suspends ciliary ganglion - supplies upper dermatome of face
32
maxillary nerve
V2 - sensory root to PPG - maxillary teeth - nasal cavities and paranasal sinuses - middle dermatome of face - upper lip, nostril, temple
33
mandibular nerve
V3 - suspends otic ganglion and submandibular - lower dermatome of face
34
testing CN V
test sensation to the face -in each dermatome can also test corneal reflex
35
corneal reflex
in by V1 (nasociliary branch) | out by VII
36
jaw jerk reflex
lightly tap mandible -response - mm. mastication contract afferent - V3 efferent - V3
37
symptoms of CN V lesion
hyperacusis - loss of SVE to tensor tympani deviation of jaw to side of lesion*** loss of sensory to face loss of corneal reflex
38
jaw towards or away from CN V lesion
towards lesion
39
CN VI
abducens | GSE - lateral rectus
40
course of CN VI
abducent nucleus - superior orbital fissure - innervates lateral rectus
41
within cavernous sinus**
internal carotid a | abducens nerve
42
walls of cavernous sinus**
maxillary nerve opthalmic nerve trochlear nerve oculomotor nerve
43
cavernous sinus infection**
first deficits is abducens - due to it being inside sinus cannot abduct eye
44
CN VII
``` facial nerve *SVE - arch 2 *GVE-P *SVA GVA - not clinically important GSA - ```
45
arch 2 muscles
SVE of CN VII mm facial expression posterior belly digastric stylogyoid stapedius
46
GVE-P of CN VII
greater petrosal: mucous of deep head lacrimal gland chorda tympani: SM/SL
47
SVA of CN VII
taste to anterior 2/3
48
course of CN VII
motor nucleus - SVE salivatory nucleus - GVE-P solitary nucleus - SVA (all taste)
49
solitary nucleus
all taste
50
geniculate ganglion
cell bodies for taste | -anterior 2/3 tongue
51
course of facial nerve
exits internal acoustic meatus -courses roof middle ear geniculate ganglion - near middle ear -exits stylomastoid foramen
52
greater petrosal nerve
first branch of facial nerve | -right at bend in middle ear - leaves hiatus for greater petrosal nerve (GVE-P)
53
chorda tympani
second branch of facial nerve - branches in middle ear - to oral cavity SVA and GVE-P
54
nerve to stapedius
third branch of facial nerve | -SVE to stapedius
55
at stylomastoid foramen
all SVE of facial nerve to mm of facial expression after exits foramen: Ten zebras bit my camel.
56
testing CN VII
test muscles of facial expression -use both upper and lower also corneal reflex taste anterior 2/3
57
belly palsy
``` lose all muscles of facial expression hyperacusis loss taste anterior 2/3 tongue dry, red eye dry nasal passages zerostomia ```
58
pathway of facial nerve**
know it
59
CN VIII
vestibulocochlear nerve SSA - hearing SSA - balance
60
course of CN VIII
exits internal acoustic meatus - with facial nerve - cochlear portion to cochlear duct (sound) - vestibular portion to vestibule (proprioception)
61
lesion of CN VIII
acoustic neuroma | -vertigo, hearing loss, tinnitus
62
acoustic neuroma
schwann cell tumor - usually benign - slow growing - lesion of CN VIII can also affect CN VII** - all components
63
tinnitus
ringing in ear
64
CN IX
glossopharyngeal nerve - SVE - arch 3 - GVE-P - SVA - GVA - GSA - not clinically important
65
arch 3 muscles
stylopharyngeus nerve - glossopharyngeus
66
GVE-P of glossopharyngeal
lesser petrosal to parotid gland
67
SVA of glossopharyngeal
taste to posterior 1/3 of tongue
68
GVA of glossopharyngeal **
``` most of pharynx auditory tube posterior 1/3 tongue middle ear carotid body carotid sinus ```
69
course of CN IX
solitary nucleus, nucleus ambiguus, inferior salivatory nucleus superior and inferior ganglia motor limb to otic ganglion exits at jugular foramen - associated with carotid sheath - course of sylopharyngeus into pharynx
70
tympanic branch of CN IX
GVE-P and GVA
71
GVA branch of tympanic
pain to inner ear** | -ear infection
72
carotid branch
of CN IX GVA - carotid body and sinus
73
stylopharyngeus n
of CN IX SVE
74
pharyngeal, tonsillar, lingual branches
GVA | SVA to tongue
75
gag reflex
in by 9 out by 10 afferent CN IX efferent CN X
76
lesion of CN IX
xerostomia - lose parotid pathay loss taste posterior 1/3 tongue lose gag reflex
77
CN X
``` vagus nerve SVE - arch 4 and 6 GVE-P SVA - not clinically important GVA GSA ```
78
SVE of CN X
to arch 4 and 6 muscles of palate (except tensor veli palatini) muscles of pharynx (except stylopharyngeus) larynx muscles esophagus skeletal m.
79
GVE-P of CN X
everything from neck down **not tested
80
GVA of CN X
general sensation to lower respiratory, thoracic viscera
81
GSA of CN X
external ear | -tympanic membrane and acoustic meatus (external)
82
nuclei of CN X
dorsal nucleus of vagus solitary nucleus nucleus ambiguus has superior and inferior ganglion
83
nucleus ambiguus
glossopharyngeal and vagus
84
meningeal nerve
branch of vagus GSA to meninges
85
auricular nerve
branch of vagus to mastoid formamen GSA to external ear
86
pharyngeal branches***
SVE and GVE-P branches of vagus -to pharyngeal plexus to constrictor mm of pharynx and palate PS to pharynx as well
87
superior laryngeal n***
of vagus SVE GVE-P GVA SVA internal and external branch** -know these**
88
recurrent laryngeal n***
of vagus SVE, GVE-P, GVA to everything except cricothyroid in larynx
89
lesions of vagus
usually lose single component
90
testing SVE of vagus
examine oral cavity | -pillars, arches - make sure contracting
91
uvula
deviates OPPOSITE lesion in vagus lesion
92
lesion of superior laryngeal n
lose cough reflex
93
CN XI
spinal accessory nerve GSE - to sternocleidomastoid and trapezius is actually cervical spinal nerve
94
test SCM
rotate head against resistance
95
test trap
raise shoulders
96
lesion of CN XI
drooping of shoulder | -usually SCM okay, but lose trapezius
97
CN XII
hypoglossal nerve GSE to tongue all intrinsic and extrinsic muscles of tongue -except palatoglossus
98
course of CN XII
hypoglossal canal to tongue
99
test CN XII
protrude tongue | -look for atrophy
100
tongue
points TOWARD side of lesion

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