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AHNNA > 5. Cranial Nerves VII-XII > Flashcards

5. Cranial Nerves VII-XII Flashcards

1
Q

What is CNVII?

A

Facial (motor, special sensory taste, parasympathetic)

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2
Q

Where does the facial nerve originate?

A

Pons

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3
Q

What are the target tissues of CNVII?

A

Muscles of facial expression
Taste from anterior 2/3 of tongue
Glands - lacrimal, salivary, mucosal (nose)

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4
Q

What are the signs and symptoms of damage to facial nerve supplying muscles of facial expression?

A

Unilateral facial droop

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5
Q

What can damage the CNVII?

A
  • Lesions in/around internal acoustic meatus and posterior cranial fossa
  • Basal skull fracture (involving petrous bone)
  • Middle ear disease
  • Inflammation in facial canal - facial nerve palsy
  • Parotid disease
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6
Q

What is the difference in presentation between Bell’s palsy and Ramsay-Hunt syndrome?

A

Both have facial weakness

Ramsay-Hunt has rash/vesicles on ear as well

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7
Q

What is the route of the facial nerve?

A

Passes through internal acoustic meatus
Runs into petrous bone and gives off 3 branches
Then runs through facial canal
Then merges through base of skill via stylomastoid foramen
Then gives of muscles of facial expression

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8
Q

What does the greater petrosal nerve supply?

A

Lacrimal gland
Nasal
Oral/palatal mucosal glands
(Parasympathetic)

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9
Q

Where does the greater petrosal nerve branch off the facial nerve?

A

At the geniculate ganglion

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10
Q

What is the second branch off the facial nerve?

A

Nerve to stapedius

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11
Q

What is the third branch of the facial nerve?

A

(Sensory)

Chorda tympani

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12
Q

How can you tell the difference in appearance between a stroke and Bell’s palsy?

A

Can raise eyebrows with stroke due to dual cortical input to upper part of face

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13
Q

What is CNVIII?

A

Vestibulocochlear (special sensory)

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14
Q

Where does CNVIII originate?

A

Pons

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15
Q

How do you test CNVIII?

A

Gross bedside hearing tests (whisper/finger rub) and tuning fork test

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16
Q

What do patients with damage to CNVIII present with?

A

Hearing loss
Dizziness (vertigo)
Tinnitus

17
Q

What can affect the CNVIII?

A

Vestibular schwannoma (and other posterior cranial fossa tumours)
Occlusion of labyrinthine artery
Base of skull fracture (involving petrous bone)
Brainstem lesions

18
Q

What are the symptoms and signs of vestibular schwannoma?

A

Unilateral hearing loss
Tinnitus
Vertigo
Numbness, pain or weakness down one half of face

19
Q

What is the pathway of CNIX and CNX?

A

Medulla
Run through posterior cranial fossa
Exit through jugular foramen
Enter into carotid sheath

20
Q

What is CNIX?

A

Glossopharyngeal nerve

21
Q

What is CNX?

A

Vagus nerve

22
Q

What are the target tissues of the glossopharyngeal nerve?

A 
Mainly sensory (oropharynx/tonsils)
Posterior 1/3 tongue 
1 swallowing muscle 
Parasympathetic to parotid gland 
Afferent from carotid sinus and body
23
Q

What are the target tissues of the vagus nerve?

A

Motor and sensory
Muscles of larynx/pharynx - including soft palate
Sensory (larynx/laryngopharynx)
Parasympathetic to many tissues

24
Q

What may patients present with if they have pathology with glossopharyngeal or vagus nerve?

A

Difficult with swallowing
Weak cough
Difficulties with speech or changes in voice

25
Q

How can you test the CNIX and CNX?

A

Speech, swallow, cough
Soft palate movement and uvula position (CNX)
Gag reflex (IX and X)

26
Q

What can cause damage to CNIX and CNX?

A

Recurrent laryngeal nerve branch of CNX
Pathology involving carotid sheath structures
Posterior cranial fossa tumours
Brainstem lesions

27
Q

What is CNXI?

A

Accessory nerve

28
Q

What is CNXII?

A

Hypoglossal nerve (motor)

29
Q

What are the pathways of the CNXI and CNXII?

A

Arise from medulla
Run through posterior cranial fossa
Enter into aortic sheath
Hypoglossal exits and travels towards tongue
Accessory exits and heads towards posterior triangle

30
Q

What is hypoglossal nerve responsible for?

A

Tongue movements and protrusion

31
Q

What can affect the hypoglossal nerve?

A

Surgery/pathology in proximity to or involving upper carotid sheath, internal and external carotid artery
Posterior cranial fossa tumours
Brainstem lesions involving hypoglossal nucleus

32
Q

What muscle protrudes tongue?

A

Genioglossus

33
Q

What s the gemioglossus innervated by?

A

CNXII

34
Q

What are the target tissues of CNXI?

A

SCM

Trapezius

35
Q

What can damage the accessory nerve?

A

Injuries, surgery or pathology involving posterior triangle
Posterior cranial fossa tumours
Base of skull lesions
Brainstem lesions

36
Q

Where does accessory nerve emerge?

A

Deep to posterior border of SCM to enter posterior triangle

Runs superficially in posterior triangle to reach trapezius

AHNNA (18 decks)

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