3. Cranial Nerves (Dennis) Flashcards

1
Q

What cranial nerve provides taste sensation to the anterior two thirds of the tongue? Which provides sensation to the posterior one third of the tongue?

A

Anterior two thirds: facial nerve.

Posterior one third: glossopharyngeal nerve.

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2
Q

What is the function of the spinal accessory nerve?

A

Motor nerve to the sternocleidomastoid and trapezius.

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3
Q

What is the pathway for the fibers of the optic nerve into the brain?

A

Retina -> optic canal of the sphenoid bone -> optic chiasm -> optic tract -> thalamus -> optic radiations -> primary visual cortex.

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4
Q

What are the functions of the facial nerve?

A

Special visceral efferent motor innervation to the muscles of facial expression (pharyngeal arch 2).

General visceral efferent parasympathetic innervation to the lacrimal, and, as well as the submandibular and sublingual salivary glands.

Special visceral afferents bring taste from the anterior two thirds of tongue.

General somatic afferent sensation to the external acoustic meatus.

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5
Q

Where are the cell bodies found for CN IV?

A

Nucleus of the trochlear n. in the midbrain.

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6
Q

How do you test the oculomotor, trochlear, and abducens nerves?

A

Pupillary light reflex, accommodation, and extraocular muscle testing – e.g., can the patient move their eye in the motions of the innervated muscles?

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7
Q

What is the function of the trochlear nerve (CN IV)?

A

General somatic efferent motor innervation to the superior oblique muscle of the eye.

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8
Q

Where are the cell bodies found for CN XII?

A

Medulla.

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9
Q

Where are the cell bodies found for CN III?

A

Brainstem nucleus in the midbrain.

Visceral motor nucleus in the Edinger-Westphal nucleus (sends to the ciliary m. and sphincter pupillae m.)

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10
Q

Where are the cell bodies located for CN I?

A

Sensory nerve bodies in the olfactory epithelium.

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11
Q

Where are the cell bodies found for CN X?

A

Medulla.

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12
Q

What is the function of the mandibular division of the trigeminal nerve?

A

Sensation from the skin of the mandible, lower lip side of head (?), Mandibular teeth, TMJ joint, part of oral mucosa, anterior two thirds of tongue, motor innervation to the muscles of mastication (as well as the myelohyoid, anterior belly of the digastric, and the tensor tympani).

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13
Q

What is the function of the vestibulocochlear nerve?

A

Special somatic afferent senses of hearing and equilibrium.

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14
Q

What are the functions of the glossopharyngeal nerve?

A

General somatic afferent sensation from the ear and external auditory canal as well as the posterior one third of the tongue.

General visceral afferent from the oropharynx and carotid body.

Special visceral afferents supplying taste to the posterior one third of the tongue.

General visceral efferent parasympathetic’s to the parotid gland.

Special visceral efferent motor to the stylopharyngeus muscles of the pharyngeal arch 3.

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15
Q

Where are the cell bodies found for CN VI?

A

Nucleus of the abducent in the pons.

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16
Q

Where is the nucleus of the abducens located?

A

In the pons.

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17
Q

How do you test the trigeminal nerve?

A

Corneal reflex, check sensation of the cheek, check sensation of the chin, check the motor movements of the muscles of mastication. Click next

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18
Q

Where are the cell bodies found for CN V?

A

Substance of the pons.

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19
Q

What is the tract of the trochlear nerve?

A

Exits the dorsal surface of the midbrain -> pierces the dura mater at the margin of the tentorium cerebelli -> runs in the lateral wall the cavernous sinus -> enters the orbit via the superior orbital fissure.

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20
Q

Where are the cell bodies found for CN II?

A

Sensory nerve cell bodies in the retina.

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21
Q

What is the tract of the abducens nerve?

A

Emerges from the brainstem between the palms and the medulla -> traverses of the pontine cistern -> pierces of the dura covering the clivus -> runs in the cavernous sinus near the ICA -> enters the orbit by the superior orbital fissure.

22
Q

What is the only nerve to exit the dorsal surface of the midbrain?

A

Trochlear (CN IV).

23
Q

What is the tract of the facial nerve?

A

Emerges from the junction of the pons and medulla -> traverses the posterior cranial fossa and exits the skull by the internal acoustic meatus -> runs in the facial canal and exits via the styelomastoid foramen -> passes through the parotid gland.

24
Q

The motor portion of the trigeminal nerve exists within which branch?

A

V3 Mandibular

25
Q

What are the functions of the vagus nerve?

(6 things)

A

General somatic afferent fibers providing sensation to the external auditory canal and dura.

General visceral afferent providing sensory information from the viscera, pharynx, larynx, aortic arch, epiglottis, and base of the tongue.

Special visceral afferents providing taste from the epiglottis.

General visceral efferent providing parasympathetics to the viscera.

Special visceral efferent providing motor innervation to the constrictors of the pharynx, the palantine muscles, and the intrinsic muscle of the larynx (pharyngeal arches 4 and 6)

26
Q

How do you test the hypoglossal nerve?

A

Have the patient either push their tongue into their cheek, or stick their tongue out. When the tongue is stuck out, it will deviate to the side of the lesion.

27
Q

What is the function of the hypoglossal nerve?

A

General somatic efferent motor fibers to the intrinsic tongue muscles, styloglossus, hypoglossus, and genioglossus.

28
Q

How do you test the vestibulocochlear nerve?

A

Check proprioception of the head, check for Romberg’s sign - where the patient places feet together and extends arms at sides with their eyes closed to check for balance - check finger to nose pointing, and look for nice statements.

You can also do Webers test to check for conduction deafness.

29
Q

How do you test the olfactory nerve?

A

See if the patient can smell familiar smells.

30
Q

Where are the cell bodies found for CN XI?

A

Mostly in the spinal cord.

31
Q

What is the function of the maxillary division of the trigeminal nerve?

A

Sensation from the skin of the face, lower eyelid, cheek, upper lip, maxillary teeth, mucosa of nose, and maxillary sinus.

32
Q

What is the function, location, and tract of the olfactory nerve (CN I)?

A

Function: SVA – special sense of smell.

Location: olfactory organ.

Tract: cribiform plate to olfactory bulbs.

33
Q

Where are the cell bodies found for CN IX

A

Medulla.

34
Q

What are the six motor branches of the facial nerve?

A

Posterior auricular.

Temporal.

Zygomatic.

Buccal.

Marginal mandibular.

Cervical.

pA Tiny Zebra Bit My Cheek

35
Q

What is the pathway of the optic nerve?

A

The optic canal of the sphenoid bone.

36
Q

How do you test the glossopharyngeal nerve?

A

Check for the parotid reflex and for taste on the posterior one third of tongue. You can also check gag reflex, but this overlaps with the vagus.

37
Q

How do you test the spinal accessory nerve?

A

Motor only: check trapezius and SCM.

38
Q

What is the tract for the trigeminal nerve?

A

Both the motor and sensory portions emerge from the lateral aspect of the pons ->

V1 (Opthalmic): passes through the cavernous sinus and enters the orbit via the superior orbital fissure.

V2 (Maxillary): passes through the cavernous sinus and exits the skull by the foramen rotundum.

V3 Mandibular: exits the skull by the foramen ovale.

39
Q

What is the tract for the hypoglossal nerve?

A

Emerges from the medulla -> exits skull by the hypoglossal canal -> travels with the cervical plexus -> crosses the occipital artery -> enters the oral cavity

40
Q

How do you test the optic nerve?

A

Graded testing of visual acuity, pupillary light reflex, and blink reflex.

41
Q

What is the function of the ophthalmic division of the trigeminal nerve?

A

Sensation from the cornea, skin of forehead and scalp, upper eyelid, part of nose, and part of nasal cavity.

42
Q

Where are the cell bodies found for CN VIII?

A

Pons and Medulla (nucleus solitaris is in the medulla)

43
Q

Where are the cell bodies found for IX?

A

Medulla.

44
Q

How do you test the vagus nerve?

A

Test gag reflex (not specific), test posterior pharyngeal wall and edge of soft palate, test the swallowing reflex, test hoarseness with speech, check deviation of uvula.

45
Q

What are the functions of the trigeminal nerve?

A

Special visceral efferent (SVE) motor innervation to the muscles of mastication (derived from pharyngeal arch 1).

General somatic afferent sensory nerves to the face and scalp.

46
Q

What tract is followed by the oculomotor nerve?

A

Leave the midbrain -> pierces the dura lateral to diaphragma sellae -> runs in lateral wall of cavernous sinus -> enters orbit via superior orbital fissure.

47
Q

What are the functions of the oculomotor nerve (CN III)?

A

General somatic efferent motor innervation to:

Superior, medial, and inferior recti.

Inferior oblique.

Levator palpebrae superioris.

General visceral efferent carrying parasympathetic innervation to the pupil and ciliary muscle.

48
Q

Where are the cell bodies found for CN VII?

A

Branchial motor: pons.

Visceral motor: pons.

Special sensory: medulla.

49
Q

What is the function of the abducens nerve?

A

General somatic efferent innervation to the lateral rectus.

50
Q

How do you test the facial nerve?

A

Check the taste on the anterior 2/3 od the tongue, see if the patinet can wrinke their forehead or close their eye tightly, see if the patient can blow, whistle, smile, or suck on a straw, checkthe blink reflex, check the corneal reflex (also tests V1).

51
Q

What is the tract for the spinal accessory nerve?

A

Emerges from the spinal cord and enters the cranium via the foramen magnum -> then exits the skull through the jugular foramen.

52
Q

Which senses count as special visceral afferent, and which senses count as special somatic afferent?

A

Special somatic afferent: sight, hearing, balance. (CN II and VIII)

Special viceral afferent: taste and smell. (CN I, VII, IX, X)