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ETA 5: HEAD & NECK > 4: Cranial Nerves & Autonomics of the H & N > Flashcards

4: Cranial Nerves & Autonomics of the H & N Flashcards

1
Q

What are the 5 fibre types of Cranial Nerve?

A
  1. Motor fibres to voluntary (striated) muscle
  2. Motor fibres innervating involuntary muscles and glands
  3. Sensory (afferent) fibres: General transmission from skin and mucus membrane
  4. Sensory (afferent) fibres carrying sensation from viscera
  5. Sensory (afferent) fibres transmit unique SPECIAL sensory sensation
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2
Q

What fibre type is the Olfactory Nerve (CN 1)?

A

Special Sensory (5)

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3
Q

What does the Olfactory Nerve (CN 1) control?

A

Sense of smell

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4
Q

Where does the Olfactory Nerve (CN 1) originate?

A

Cerebrum

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5
Q

What is the Cranial exit of the Olfactory nerve (CN 1)?

A

Cribriform plate

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6
Q

How is the Olfactory Nerve (CN 1) tested?

A

Testing smelling

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7
Q

What fibre type is the Optic Nerve (CN 2)?

A

Special Sensory (5)

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8
Q

What is the origin of the Optic Nerve (CN 2)?

A

Cerebrum

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9
Q

What is the cranial exit of the Optic nerve (CN 2)?

A

Optic canal

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10
Q

What is the function of the Optic nerve (CN 2)?

A

Vision

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11
Q

How is the Optic nerve (CN 2) tested?

A

Pupil responses to light

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12
Q

What fibre type is the Occulomotor Nerve (CN 3)?

A

Motor (1) & (2)

To Voluntory + Invol muscles

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13
Q

What is the origin of the Occulomotor Nerve (CN 3)?

A

Midbrain of brainstem

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14
Q

What is the cranial exit of the Occulomotor Nerve (CN 3)?

A

Superior Orbital Fissure

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15
Q

What is the function of the Occulomotor Nerve (CN 3)? ( 2 things)

A
  1. Motor (1 Vol): Extrinsic eye muscles & levator palpebrae
  2. Motor (2 Invol): Pupillary sphincter
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16
Q

How is the Occulomotor Nerve tested?

A

Test movements of eye

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17
Q

What fibre type is the Trochlear Nerve (CN 4)?

A

Motor (1 Vol)

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18
Q

What is the origin of the Trochlear Nerve (CN 4)?

A

Midbrain of brainstem

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19
Q

What is the cranial exit of the Trochlear Nerve (CN 4)?

A

Superior orbital fissure

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20
Q

What is the function of the Trochlear Nerve (CN 4)?

A

Sup oblique muscle of eye

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21
Q

How is the Trochlear Nerve (CN 4) tested?

A

Test movements of eye

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22
Q

What is the fibre type of the Trigeminal Opthalmic Nerve (CN V1)?

A

Motor (2 Invol)

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23
Q

What is the origin of the Trigeminal Opthalmic Nerve (CN V1)?

A

Pons

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24
Q

What is the cranial exit of the Trigeminal Opthalmic Nerve (CN V1)?

A

Sup orbital fissure

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25
Q

What is the function of the Trigeminal Opthalmic Nerve (CN V1)?

A

Scalp, forehead and nose

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26
Q

What is the fibre type of the Trigeminal Maxillary Nerve (CN V2)?

A

Motor (2 Invol)

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27
Q

What is the origin of the Trigeminal Maxillary Nerve (CN V2)?

A

Pons

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28
Q

What is the cranial exit of the Trigeminal Maxillary Nerve (CN V2)?

A

Foramen rotundum

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29
Q

What is the function of the Trigeminal Maxillary Nerve (CN V2)? (6 things)

A
  1. Cheeks
  2. lower eyelid
  3. Nasal mucosa
  4. Upper lip
  5. upper teeth
  6. palate
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30
Q

What is the fibre type of the Trigeminal Mandibular Nerve (CN V3)?

A

Motor (2 Invol)

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31
Q

What is the origin of the Trigeminal Mandibular Nerve (CN V3)?

A

Pons

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32
Q

What is the cranial exit of the Trigeminal Mandibular Nerve (CN V3)?

A

Foramen ovale

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33
Q

What are the functions of the Trigeminal Mandibular Nerve (CN V3)? (4 things)

A
  1. Ant 2/3 tongue
  2. Skin over mandible
  3. lower teeth
  4. muscles of mastication
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34
Q

What is the fibre type of the Abducens Nerve (CN 6)?

A

Motor (1 Vol)

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35
Q

What is the origin of the Abducens Nerve (CN 6)?

A

Pontine - Medulla junction

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36
Q

What is the cranial exit of the Abducens Nerve (CN 6)?

A

Sup orbital fissure

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37
Q

What is the function of the Abducens Nerve (CN 6)?

A

Lactal rectus

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38
Q

How is the Abducens Nerve (CN 6) tested?

A

Test movements of eye

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39
Q

What is the fibre type of the Facial Nerve (CN 7)?

A

All

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40
Q

What is the origin of the Facial Nerve (CN 7)?

A

Pontine - Medulla junction

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41
Q

What is the cranial exit of the Facial Nerve (CN 7)?

A

Internal acoustic meatus

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42
Q

What is the function of the Facial Nerve (CN 7)? (6 things)

A
  1. Part of external ear sensation
  2. Muscles of facial expression
  3. Mucous glands of mouth + nose
  4. Taste from ant 2/3 tongue
  5. Palate
  6. Lacrimal / submandibular / sublingual glands
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43
Q

How is the Facial Nerve (CN 7) tested? (3 things)

A
  1. Raise eyebrows
  2. Close eyes vs resistance
  3. Puff cheeks and reveal teeth
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44
Q

What is the fibre type of the Vestibulocochlear Nerve (CN 8)?

A

Sensory (5)

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45
Q

What is the origin of the Vestibulocochlear Nerve (CN 8)?

A

Pontine - medulla junction

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46
Q

What is the cranial exit of the Vestibulocochlear Nerve (CN 8)?

A

Internal acoustic meatus

47
Q

What is the function of the Vestibulocochlear Nerve (CN 8)?

A

Hearing & balance

48
Q

How is the Vestibulocochlear Nerve (CN 8) tested?

A

Rinne’s Test

  • tuning fork on mastoid / ear
  • Should be louder @ EAR
49
Q

What is the fibre type of the Glossopharyngeal Nerve (CN 9)?

A

All of them

50
Q

What is the origin of the Glossopharyngeal Nerve (CN 9)?

A

Medulla oblongata

51
Q

What is the cranial exit of the Glossopharyngeal Nerve (CN 9)?

A

Jugular foramen

52
Q

What is the function of the Glossopharyngeal Nerve (CN 9)? (6 things)

A
  1. Ext ear
  2. Middle ear cavity
  3. Stylophayngeus
  4. Parotid gland
  5. Taste and sensation of post 1/3 tongue
  6. Carotid body & Sinus
53
Q

How is the Glossopharyngeal Nerve (CN 9) tested?

A

Gag reflex

54
Q

What is the fibre type of the Vagus Nerve (CN 10)?

A

All of them

55
Q

What is the origin of the Vagus Nerve (CN 10)?

A

Medulla oblongata

56
Q

What is the cranial exit of the Vagus Nerve (CN 10)?

A

Jugular foramen

57
Q

What is the function of the Vagus Nerve (CN 10)? (4 things)

A
  1. Ext ear
  2. Taste from epiglottis region of tongue
  3. Larynx + pharynx
  4. Thoracic + abdominal viscera (organs)
58
Q

How is the Vagus Nerve (CN 10) tested?

A

Patient says aaah, check uvula (hanging tonsil thingy at back of throat) before and after

59
Q

What is the fibre type of the Spinal Accessory Nerve (CN 11)?

A

Motor (1 Vol) & (2 Invol)

60
Q

What is the origin of the Spinal Accessory Nerve (CN 11)?

A

Medulla oblongata

61
Q

What is the cranial exit of the Spinal Accessory Nerve (CN 11)?

A

Jugular foramen

62
Q

What is the function of the Spinal Accessory Nerve (CN 11)? (2 things)

A
  1. Trapezius
  2. SCM
63
Q

How is the Spinal Accessory Nerve (CN 11) tested?

A

Get patient to shrug shoulder and turn head vs resistance

64
Q

What is the fibre type of the Hypoglossal Nerve (CN 12)?

A

Motor (1)

65
Q

What is the origin of the Hypoglossal Nerve (CN 12)?

A

Medulla oblongata

66
Q

What is the cranial exit of the Hypoglossal Nerve (CN 12)?

A

Hypoglossal canal

67
Q

What is the function of the Hypoglossal Nerve (CN 12)?

A

Instrinsic + Extrinsic tongue muscles

68
Q

How is the Hypoglossal Nerve (CN 12) tested?

A

Stick tongue out

if tongue deviates to one side = weaking of muscle on one side

69
Q

What are the causes and consequences of CN 1 damage? (1:3 things)

A

Cause

cribriform plate

Consequences

  1. Anosmia (loss of smell)
  2. Rhinorrhoea (CSF leak from nose)
  3. Meningitis
70
Q

What are the causes and consequences of CN 2 damage? (1:2 things)

A

Cause

optic canal

Consequences

  1. Loss of pupillary constriction
  2. Raised Intracranial pressure / blood loss from central artery of retina → pressure on optic pathway → pupilloedema (optic disc swelling) → visual defects
71
Q

What are the causes and consequences of CN 3 damage? (3:3 things)

A

Causes

  1. Cavernous sinus thrombosis
  2. Aneurysm of post cerebral / sup cerebellar artery
  3. Raised intracranial pressure

Consequences

  1. Dipoplia (double vision)
  2. Ptosis (drooping eye lid)
  3. Dilated pupil with NO pupillary light reflex
72
Q

What are the consequences of CN 4 damage? (2 things)

A

Consequences

  • Eyeball adducted and sup rotated
  • Dipoplia (double vision)
73
Q

What are the causes and consequences of CN 5 damage? (6:4 things)

A

Causes

  1. Trauma
  2. Tumour
  3. Aneurysm
  4. Meningeal infections
  5. Herpes zoster infection
  6. Trigeminal neuralgia (fx sensory root of CN V)

Consequences

  1. Muscles of mastication paralysis
  2. NO sensation to face
  3. NO corneal & sneezing reflexes
  4. Excruciating pain to max and mand divisions of nerve (if trigeminal neuralgia)
74
Q

What are the causes and consequences of CN 6 damage? (4:2 things)

A

Causes

  1. Raised intracranial pressure
  2. Aneurysm to cerebral arterial ring @ brain base
  3. Increased pressure in cavernous sinus from atherosclerotic changes
  4. Septic thrombus in cavernous sinus

Consequences

  1. Eye adduction
  2. Dipoplia (double vision)
75
Q

What are the causes and consequences of CN 7 damage? (2:2 things)

A

Causes

  1. Knife / gun injury
  2. # temporal bone

Consequences

  1. Facial nerve palsy
  2. Inf face musclular paralysis on contralateral side
76
Q

What are the causes and consequences of CN 8 damage? (3:3 things)

A

Causes

  1. Skull #
  2. Ear infection
  3. Central lesions

Consequences

  1. Vertigo (everything spinning)
  2. Tinnitus (ringing ears)
  3. Hearing impairement
77
Q

What are the consequences of CN 9 damage? (3 things)

A

Consequences

  1. Dysphagia (difficulty swallowing)
  2. Blood pressure problems
  3. Parotid gland secretion problems
78
Q

What are the causes and consequences of CN 10 damage? (4:4 things)

A

Causes

  1. Arch of aorta aneurysm
  2. Thyroid / larynx cancer
  3. Enlarged mediastinal lymph nodes
  4. Thyroid surgery

Consequences

  1. Dysphagia (difficulty swallowing)
  2. Inspiratory stridor (breath in → collapse of tissue above vocal cords)
  3. Hoarseness
  4. Loss of cricothyroid muscle → aphonia
79
Q

What are the causes and consequences of CN 11 damage? (1:1 things)

A

Causes

  1. Surgery

Consequences

  1. NO SCM / trapezius innervation
80
Q

What are the consequences of CN 12 damage? (2 things)

A

Consequences

  1. Tongue atrophy (wasting)
  2. Tongue deviating to paralysed side of tongue
81
Q

Where do PS nerves originate?

A

Cranial sacral source

82
Q

What is the outflow of PS nerves provided by?

A

CN 3, 7, 9, 10

S2-4

83
Q

Where do S NS nerves originate from?

A

Thoracolumbar region

84
Q

What is the outflow of S NS nerves provided by?

A

T1 - L2

85
Q

How do S NS nerves send fibres to tissue?

A

Nerves synapse with Pre-ganglionic neurone → post synaptic neurones → send fibres to target tissue

86
Q

How do Symphathetic Post ganglionic fibres reach their targets in H & N?

A

By “hitch-hiking” on arterial system

87
Q

Where is the Superior Cervical Ganglion?

A

@ level of C1 & C2

88
Q

How do the post-synaptic fibres of the Superior Cervical Ganglion travel?

A

“Hitch-hike” on Internal & External Carotid Arteries

89
Q

What do the Post-synaptic fibres of the Superior Cervical Ganglion innervate?

A

Trigeminal dermatomes

90
Q

Where is the Middle Cervical Ganglion?

A

@ level of C6

91
Q

How do the post-synaptic fibres of the Middle Cervical Ganglion travel?

A

“Hitch-hike” on inferior thyroid artery

92
Q

What do the post-synaptic fibres of the Middle Cervical Ganglion innervate? (4 things)

A
  1. Trachea
  2. Lower oesophagus
  3. Lower larynx
  4. Laryngopharynx
93
Q

Where is the Inferior Cervical Ganglion?

A

@ level of C7

94
Q

How do the post-synaptic fibres of the Inferior Cervical Ganglion travel?

A

“Hitch-hike” on Vertebral artery

95
Q

Where do PS pre-ganglionic axons synapse? (2 things)

A
  1. Autonomic ganglia

OR

  1. Walls of target organ
96
Q

What are the 4 PS ganglia and their associated CN?

A
  1. Ciliary ganglion: CN 3
  2. Pterygopalatine g: CN 7
  3. Submandibular g: CN 7
  4. Otic g: CN 9
97
Q

Where does the Ciliary ganglion lie?

A

Orbital cavity

98
Q

What is the route of the PS fibres of the Ciliary ganglion?

A

CN3 → Ciliary muscle + Pupillae of iris

99
Q

What is the route of the Symp fibres of the Ciliary ganglion?

A

Sup Cervical Ganglion → Dilator pupillae + eye blood vessels

100
Q

What is the route of the Sensory fibres of the Ciliary ganglion?

A

Pass through eyeball uninterrupted

101
Q

Where does the Pterygopalatine ganglion lie?

A

Pterygopalatine fossa

102
Q

What is the route of the PS fibres of the Pterygopalatine ganglion?

A

Greater petrosal nerve → Lacrimal gland

103
Q

What is the route of the Symp fibres of the Pterygopalatine ganglion?

A

Sup Cervical Ganglion – ICA plexus →

  1. Blood vessels of nasal cavity
  2. Palate
  3. Superior parts of pharnyx
104
Q

What is the route of the Sensory fibres of the Pterygopalatine ganglion?

A

From Maxillar n

passed uninterrupted

105
Q

Where does the Submandibular ganglion lie?

A

Surface of hypoglossus muscle

106
Q

What is the route of the PS fibres of the Submandibular ganglion?

A

CN 12 – chorda tympani branch →

  1. Unite with lingual nerve
  2. Supplies submandibular and sublingual
107
Q

What is the route of the Symp fibres of the Submandibular ganglion?

A

Sup Cervical Ganglion – CN 12 plexus → submandibular & sublingual nerve

108
Q

What is the route of the Sensory fibres of the Submandibular ganglion?

A

From lingual nerve

passes uninterrupted

109
Q

Where does the Otic ganglion lie?

A

Inf to foramen ovale

110
Q

What is the route of the PS fibres of the Otic ganglion?

A

CN 9 →

  1. Parotid gland
  2. Post 1/2 of tongue
111
Q

What is the route of the Symp fibres of the Otic ganglion?

A

Sup Cervical Ganglion → Parotid gland

112
Q

What is the route of the Sensory fibres of the Otic ganglion?

A

To post 1/3 tongue

113
Q
A
114
Q
A

ETA 5: HEAD & NECK (4 decks)

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