1 - Zill - Cranial Nerves Flashcards by John Castillo

Somatic Motor spinal nerves

Voluntary skeletal muscles–derived from somites

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Somatic Sensory spinal nerves

Precise sensation to skin joints, muscle, tendon receptors (in head, also nasal and oral cavities)

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Visceral Motor spinal nerves

(Efferents)

Autonomics - smooth muscles (including arrector pilae muscles of skin), blood vessels; secretomotor to glands

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Visceral Sensory spinal nerves

Imprecise sensation from gut, blood vessels, glands, internal organs (in head, pharynx which is rostral end of gut)

In your throat, you have no precise sensation or feelings

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Classifications of Innervation found Only in Cranial Nerves

Special Senses: Vision, hearing, balance (vestibular apparatus)

Chemical Senses: Taste and smell

Branchiomotor: Voluntary skeletal muscles from branchial arches

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Somatic Nervous Systems:

Somatic Motor

Somatic Sensory

Somatic Motor (Efferents) - Voluntary activities (limb, eye movements, walking; Conscious Actions

Somatic Sensory (Afferents) - Sensory neurons that innervate skin, provide precise conscious sensation of touch, pressure, pain, sense of body position (prioception)

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Two Groups of Somatic Motor in Head?

Eye Muscles - Extraocular muscles that move eye (and lift upper eyelid)
Muscles of Tongue

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Somatic Sensory in Head

Mostly CRANIAL NERVE V - precise sensation sensory to skin, also oral cavity, nasal cavity

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Visceral Motor

Parasympathetic and Sympathetic Efferents

Control smooth and cardiac muscle, glands, and internal organs–largely unconscious actions

Mostly Smooth Muscle

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Visceral Sensory

Afferents - sensory neurons that innervate internal organs, blood vessels, only provide imprecise localization of sensation and dull sense of pressure, pain, etc

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Outflow of Parasympathetics vs Sympathetics

Parasympathetics - Cranio-Sacral outflow - in Cranial Nerves (3, 7, 9, 10)

- - -

Sympathetics - not in cranial nerves - come from spinal cord - Thoraco Lumbar outflow

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Cranial Nerves:

1-12

1 - Olfactory

2 - Optic

3 - Oculomotor

4 - Trochlear

5 - Trigeminal

6 - Abducens

7 - Fascial

8 - Vestibulo-cochlear

9 - Glossopharyngeal

10 - Vagus

11 - Accessory

12 - Hypoglossal

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What forms extrinsic muscles of eye?

Cranial nerves?

Preotic somites

Cranial Nerves:

3 - Oculomotor

4 - Trochlear

6 - Abducens

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What forms muscles of tongue?

Cranial nerves?

Occipital Somites

Cranial Nerve 12 - Hypoglossal

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Somatic Sensory in Head?

Almost all Trigeminal V

*Exception: Skin of outer ear (7, 9, 10)

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Bell’s Palsy

Lesion in Cranial Nerve 7

Paralysis of Facial Muscles

In recovery, patients may complain of earaches

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Trigeminal borders?

V1 - Forehead, upper eye, bridge of nose

V2 - Lower eye, nostrol, to upper lip

V3 - Lower lip to chin, cheek

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Location of cell bodies of sensory neurons in Trigeminal Nerve?

Location of cell bodies of sensory neurons in Cranial Nerve 7?

Trigeminal (Semilunar) Ganglion

Geniculate Ganglion

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Preganglionic vs Postganglionic Neuron differences in Sympathetics and Parasympathetics?

Sympathetics - Ganglia close to vertebrae

Parasympathetic - Ganglia close to target organ

Where do Sympathetics originate from?

Not in cranial nerves

Come from spinal cord - Thoraco-lumbar outflow

What is the path of sympathetics to head?

What is the highest ganglia in the chain?

Preganglionic neuron (1) in spinal cord leaves and ascends sympathetic chain
Postganglionic Neuron (2) in Superior Cervical Ganglia
Joins Plexus on Internal and External Carotid Arteries in Unnamed Branches

- - - -

Highest ganglia = Superior Cervical Ganglia

Ciliary Ganglion

Parasympathetics - Cranial Nerve 3

Sphincter Pupillae M.

Ciliary M.

Pterygopalatine Ganglion

Parasympathetics - Cranial Nerve 7

Lacrimal Gland

Mucous Glands of Oral and Nasal Cavities

Palate

Submandibular Ganglion

Parasympathetics - Cranial Nerve 7

Submandibular Gland

Sublingual Gland

Otic Ganglion

Sympathetics - **Cranial Nerve 9** Parotid Gland (in front of ears) **Mumps**

Pre-ganglionic Neurons with Cranial Nerve X (Parasympathetics)

**Vagus** Heart Lungs Gut proximal to left colic flexure Kidney

Innervation of Pharynx

**Visceral Sensory =** Imprecise, "Popcorn Stories" ## Footnote **Naso - 7** **Oro - 9** **Laryngo - 10**

Special Sense Nerve of Eye

Cranial Nerve 2 - Optic Nerve

Special Senses - Nerves of Ear

Cranial Nerve 8 - Vestibulocochlear (Auditory) a) Cochlea - hearing b) Semicircular Canals (vestibular apparatus) - balance

Special Senses - Taste and Smell

Smell - Cranial Nerve 1 - Olfactory Nerve Taste - Cranial Nerves: 10 - Vagus (ant. to epiglottis) 9 - Glossopharyngeal (post. 1/3 tongue) 7 - Facial (ant. 2/3 of tongue)

Origin of branchiomotor nerves? Order of development?

Branchial Arches - - - 5 - 7 - 9 - 10 - 11

Branchiomotor: V

All in V3 Muscles of Mastication mylohyoid tensor tympani tensor palati anterior belly of digastric

Branchiomotor: 7 (Facial)

Muscles of facial expression stylohyoid posterior belly of digastric stapedius

Branchiomotor: 9 (Glossopharyngeal)

Stylopharyngeus

Branchiomotor: 10 (Vagus)

All muscles of pharynx (except stylopharyngeus) Muscles of larynx All muscles of palate (except tensor palati)

Branchiomotor: 11 (Accessory)

Sternocleidomastoid trapezius

Bell's Palsy ear symptoms?

Due to Cranial Nerve 7, your own voice is not dampened and hearing your **own** voice can be too loud

Test for Cranial Nerve 10

Have the patient say "Ahhhh!"

Cranial Nerve # - Role

1 - Olfactory - Smell 2 - Optic - Vision 3 - Oculomotor - Eye Movements; **Parasympathetics to eye smooth muscles** 4 - Trochlear - Eye Movements 5 - Trigeminal - Sensory nerve to skin, pain, temperature touch to oral and nasal cavities, (outer ear) 6 - Abducens - Eye Movements 7 - Facial - Muscles of Facial Expressions, taste, **parasympathetics** 8 - Vestibulo-Cochlear - Hearing & Balance 9 - Glossopharyngeal - Sensory to pharynx, back of tongue (gag reflex) 10 - Vagus - Motor to pharynx (most), larynx (voice box), soft palate, **parasympathetics to thorax**, **abdomen** 11 - Accessory - Motor to sternocleidomastoid, trapezius 12 - Hypoglossal - Motor to muscles of tongue

Somatic Motor Cranial Nerves

Voluntary muscle form somites Eye: 3, 4, 6 Tongue: 12

Somatic Sensory Cranial Nerve

Precise Sensory - skin, nasal/oral cavity, joint position, muscles 5 (V1, V2, V3) Bell's Palsy to ear ache - 7, 9, 10

Visceral Motor Cranial Nerves

Autonomics - Parasympathetics 3, 7, 9, 10

Visceral Sensory Cranial Nerves

Imprescise sensory (blood vessels, organs, **pharynx**) Pharynx: 7, 9, 10 (popcorn) Middle ear: 9

Special Senses Cranial Nerves

Vision - 2 Hearing and Balance - 8

Chemical Senses Cranial Nerves

Smell - 1 Taste - 7, 9, 10

Branchiomotor Cranial Nerves

Voluntary skeletal muscle from Branchial Arches 5, 7, 9, 10, 11 **Memorize Incantation**