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C&M Neuroanatomy > Week 3 Lecture 7: Cranial nerves > Flashcards

Week 3 Lecture 7: Cranial nerves Flashcards

1
Q

Which cranial nerves emerge from the brainstem?

A
  • 3-12 so they are therefore part of our CNS.

- CN I and II are not true peripheral cranial nerves - they are part of the CNS

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2
Q

For each fibre type within a cranial nerve, there is a corresponding ______ in the brain stem

A

nucleus

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3
Q

Which two fibres (and therefore two nuclei) form the oculomotor nerve?

A
  1. Oculomotor nucleus: somatic motor fibres to extraocular muscles
  2. Edinger-westphal nucleus - visceral motor (autonomic) fibres to provide parasympathetic information to the sphincter pupillae and ciliary muscles
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4
Q

Cranial nerve nuclei are scattered throughout brainstem. Where are sensory and motor nuclei located?

A

Located within the tegmentum of the brainstem:
sensory nuclei - located lateral
motor nuclei - located medial

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5
Q

Explain what type of fibre types travel to:

  1. skin of face
  2. tongue
  3. eye muscles
  4. neck muscles
  5. salivary glands
  6. organs
A
  1. sensory
  2. taste sense
  3. motor
  4. motor
  5. visceral motor
  6. visceral sensory
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6
Q

What is visceral motor information?

A
  • autonomic division of CNS

- represents motor innervation of smooth muscle, cardiac muscle and gland cells

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7
Q

What is a nucleus?

A

a functional group of neurones within the CNS

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8
Q

Which cranial nerves are found in:

  1. the midbrain
  2. the pons
  3. the medulla
A
  1. CN III and IV
  2. CN V, VI, VII, VIII
  3. CN IX, X, XI, XII
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9
Q

How many cranial nerves are:

  1. purely motor
  2. purely sensory
  3. mixed
A
  1. 5
  2. 3
  3. mixed
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10
Q

How do sensory nerve nuclei work?

A

receive information from fibres entering brainstem in cranial nerves which synapse here, and nuclei then send fibres to appropriate higher centre

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11
Q

How do motor nerve nuclei work?

A

receive motor information from higher centre which synapse and give rise to motor fibres that leave the brainstem in cranial nerves

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12
Q

Where is cranial nerve 1 and 2 derived from?

A

forebrain (not the brainstem)

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13
Q

Where is CN I (Olfactory nerve) located?

A

from the nasal mucosa, CN I merges with olfactory tracts and bulbs which are extensions of the telencephalon

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14
Q

What foramina does CN I use to exit the brainstem?

A

cribriform plate of ethmoid bone

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15
Q

What is the function of CN I and how do we test its function?

A

Function: special sensory - smell
Test: offer a familiar smelling item e.g orange

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16
Q

What is anosmia?

A

inability to smell

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17
Q

Where is CN II (optic nerves) located?

A
  • emerge from retina
  • travel through optic canal to cranial cavity, to optic chiasma
  • optic tracts then carry visual information to the thalamus
  • thalamus relay the information to the primary visual cortex
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18
Q

Which structure do all our sensory modalities go through? (except smell)

A

thalamus

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19
Q

Which foramina does CN II use to exit the brainstem?

A

optic canals

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20
Q

What is the function of CN II and how do we test its function?

A 
function - vision
test - various visual tests e.g fundoscopy
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21
Q

Where is CN III (oculomotor) found?

A

pontomesencephalic junction then emerges anteriorly in between the cerebral peduncles

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22
Q

Which foramina does CN III use to exit the brainstem?

A

Superior orbital fissure

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23
Q

What are the functions of CN III?

A
  • somatic motor to four extra ocular muscles

- visceral (parasympathetic) motor to ciliary muscle and sphincter pupillae

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24
Q

What is CN IV and where is it located?

A

trochlear nerve

location: dorsal midbrain

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25
Q

What is the function of CN IV?

A

Somatic motor to superior oblique

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26
Q

Which foramina does CN IV use to exit the brainstem?

A

superior orbital fissure

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27
Q

Which is cranial nerve VI, where is it located and which foramen does it travel through?

A
  • abducens
  • located in pontomedullary junction
  • exits the brainstem via the superior orbital fossa (same as CN III, CN IV)
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28
Q

What is the function of cranial nerve VI?

A

Somatic motor supply to lateral rectus

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29
Q

How do we test the function of CN III, IV and VI?

A

follow finger (H) test

30
Q

What is the pneumonic to remember the innervation of the extraocular muscles

A

LR6SO4AO3
Lateral rectus - CN VI
Superior oblique - CN IV
All others - CN III

31
Q

Which muscles are responsible for moving the eyelid up and to the right/left?

A

inferior oblique and superior rectus

32
Q

What muscles are responsible for moving the eyelids left and right

A

lateral and medial rectus

33
Q

What muscles are responsible for moving the eyelids down and to the right?

A

superior oblique and inferior rectus

34
Q

Which muscle is responsible for closing of the eyelid?

A

orbicularis oculi

35
Q

Which muscles are responsible for opening the eyelid?

A
  • Levator palpebrae superioris opens the eyelid

- superior tarsal muscle keeps it open

36
Q

Which muscle:

  1. dilates pupil
  2. constricts pupil
  3. changes shape of lens
A
  1. dilators of iris
  2. sphincter pupillae
  3. ciliary muscle
37
Q

What are the 3 branches of the trigeminal nerve and where are they located?

A

V1- Ophthalmic division
V2 - Maxillary division
V3 - Mandibular division
location - pons

38
Q

Which foramina does each branch of CN V use to exit the brainstem?

A

v1 - enters superior orbital fissure to make its way to orbit
v2- foramen rotundum
v3- foramen ovale

39
Q

what is the function of the ophthalmic division of the trigeminal nerve and how do we test its function?

A

somatic sensation from upper face (above eye but includes the upper eyelid)
test - cotton wool bud on forehead

40
Q

what is the function of the maxillary division of the trigeminal nerve and how do we test its function?

A

somatic sensation from middle face (between eye and mouth)

test - cotton wool bud on cheek

41
Q

What are the functions of the mandibular division of the trigeminal nerve?

A
  • somatic sensation from lower face mandible and anterior 2/3 tongue
  • brachial (somatic) motor to muscles of mastication, anterior belly of digastric, tensor tympani, others
42
Q

How do we test the function of the mandibular branch of the trigeminal nerve?

A

-cotton wool bud on jaw
-clench teeth
protrude jaw
-move side to side against resistance (testing pterygoids)
-jaw-jerk reflex

43
Q

What are the 4 ganglia of the head and neck that are associated with the trigeminal nerve?

A
  1. ciliary
  2. pterygopalatine
  3. submandibular
  4. otic
44
Q

What is a ganglia?

A
  • function like relay stations
  • one nerve enters and another exits
  • contains cell bodies and glial cells supported by connective tissues
45
Q

What is CN VII and where is it located?

A
  • facial nerve

- located in the cerebellopontine angle

46
Q

Which foramina does CN VII use to enter and exit the brainstem?

A

enters at Internal acoustic meatus

exits at the stylomastoid foramen

47
Q

What are the functions of the facial nerve?

A
  • brachial motor to muscles of facial expression, stapedius muscle, posterior belly of digastric
  • taste to anterior 2/3rd of tongue
  • somatic sensory to skin of ear
  • visceral motor (parasympathetic) to all glands except parotid e.g lacrimal
48
Q

Which branch of the facial nerve supplies the anterior 2/3rds of tongue?

A

chorda tympani

49
Q

Which nerve helps to protect structures of ear when we hear loud music?

A

facial nerve

50
Q

How would we test the function of CN VII?

A

Facial movements, taste, salivation

51
Q

What is CN VIII and where is it found?

A
  • vestibulocochlear

- location: cerebellopontine angle

52
Q

Which foramina does CN VIII use to exit the brainstem?

A

Internal acoustic meatus (IAM)

53
Q

What is the function of CN VIII?

A

Special sensory - hearing and balance

54
Q

How can we test the function of CN VIII?

A

Bedside hearing tests (Rinne’s and Weber’s test)

55
Q

Why are CN VII and CN VIII closely linked?

A

emerge closely together and use the same foramen (internal acoustic meatus)

56
Q

What is CN IX and where is it located?

A
  • glossopharyngeal

- location: posterolateral sulcus of medulla, lateral to olives

57
Q

Which foramina does CN IX use to exit the brainstem?

A

Jugular foramen

58
Q

What are the functions of CN IX?

A
  • brachial motor for swallowing (pharynx)
  • visceral motor (parasympathetic) to parotid gland
  • special sensory for taste to posterior 1/3 of tongue
  • somatic sensory to middle ear, pharynx, posterior 1/3rd tongue
  • visceral sensation from carotid body and carotid sinus monitoring O2 and BP
59
Q

What is the test for CN IX?

A

gag reflex

60
Q

Where is CN X located?

A
  • vagus nerve

- location: posterolateral sulcus of medulla, lateral to olives

61
Q

Which foramina does CN X use to exit the brainstem?

A

Jugular foramen

62
Q

What is the function of CN X?

A
  • brachial motor to muscles of pharynx and larynx, muscles of soft palate (uvula)
  • visceral motor (parasympathetic) to thoracic and GI tract and visceral sensory
  • special sensory taste from epiglottis and palate
  • somatic sensation from epiglottis, skin of external ear, larynx
63
Q

How can we test the function of CN X?

A

Speaking, movement of uvula

64
Q

What structures monitor oxygenation and blood pressure and is innervated by CN IX?

A

Carotid body and sinus

65
Q

What is CN XI and where is it located?

A
  • accessory

- location: caudal medulla and rostral spinal cord

66
Q

Which foramina does CN XI use to exit the brainstem?

A

Jugular foramen

67
Q

What is the function of CN XI?

A

Somatic motor to sternocleidomastoid and trapezius

68
Q

How do we test for CN XI?

A

Shrug shoulder and rotate head against resistance

69
Q

What is CN XII and where is it located?

A
  • hypoglossal

- anterolateral sulcus (between pyramid and olives)

70
Q

Which foramina does CN XII use to exit the brainstem?

A

Hypoglossal canal

71
Q

What is the function of CN XII and how do we test that function

A 
function - somatic motor to muscles of tongue 
test - protrude tongue
72
Q

What would injury to the hypoglossal nerve cause?

A

deviation of the tongue toward the paralysed side

C&M Neuroanatomy (44 decks)

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