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Head and Neck > 6) Cranial Nerves > Flashcards

6) Cranial Nerves Flashcards

1
Q

How many cranial nerves are there?

Are they part of the CNS or PNS?

A

12

Part of peripheral nervous system

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2
Q

What are the 3 parts of the brainstem?

A

Mid-brain, pons and medulla oblongata

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3
Q

What is the role of the brainstem?

A

Regulation of cardio-respiratory functions and maintaining consciousness

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4
Q

What is cranial nerve I?

A

Olfactory nerve

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5
Q

What is the function of CN I?

A

Sense of smell

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6
Q

How would you test CN I?

A

Test one nostril at a time using smelling salts

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7
Q

What can damage to the olfactory nerve result in?

A

Anosmia (loss of sense of smell)

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8
Q

What are the causes of anosmia?

A

URTI
Head injury e.g. basilar skull fracture
Neurodegenerative conditions e.g. Parkinson’s and Alzheimer’s

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9
Q

Describe the route of CN I:

A

Through foramina of cribriform plate onto olfactory mucosa in roof of nose

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10
Q

What is cranial nerve II?

A

Optic nerve

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11
Q

What is the function of CN II?

A

Vision

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12
Q

How would you test CN II?

A 
Test one eye at a time 
Visual tests (acuity and fields) and puplis
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13
Q

Describe the route of CN II:

A

Crossover at optic chiasm, through optic canal to retina

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14
Q

What visual problems can a pituitary adenoma cause and why?

A

Bilateral visual problems due to compression of optic chiasm

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15
Q

Which cranial nerves arise from the forebrain?

A

Olfactory and optic nerves

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16
Q

What is cranial nerve III?

A

Oculomotor nerve

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17
Q

What are the functions of CN III?

A

Innervate extra-ocular nerves (4/6)

PSNS to pupil causes constriction

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18
Q

How would you test CN III?

A

Eye movements

Pupillary light reflexes

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19
Q

Describe the route of CN III:

A

Through cavernous sinus and superior orbital fissure into orbit

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20
Q

How does damage to the oculomotor nerve present?

A

Diplopia (double vision) and eye is in down and out position (blown pupil)
Due to damage to PSNS before cranial nerve

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21
Q

What are the causes of oculomotor nerve lesions?

A

Raised intracranial pressure
Aneurysms
Cavernous sinus thrombosis
Diabetes/hypertension (pupil sparing)

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22
Q

What is cranial nerve IV?

A

Trochlear nerve

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23
Q

What is the function of CN IV?

A

Innervation of extra-ocular muscle - superior oblique

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24
Q

How would you test CN IV?

A

Patient follows finger and reports double vision

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25
Q

Describe the route of CN IV:

A

Arises from dorsal aspect of brainstem and travels through cavernous sinus and superior orbital fissure

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26
Q

How does damage to the trochlear nerve present?

A

Diplopia, worse on downward gaze

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27
Q

What are the causes of trochlear nerve lesions?

A

Head injury
Raise ICP, stretching nerve
Congenital palsies

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28
Q

What is cranial nerve V?

A

Trigeminal nerve

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29
Q

What are the functions of CN V?

A

Innervate muscles of mastication

Main sensory to face

30
Q

How would you test CN V?

A

Sensation to face
Muscles of mastication
Corneal reflex

31
Q

Describe the route of CN V:

A

V1 ophthalmic - superior orbital fissure
V2 maxillary - foramen rotundum
V3 mandibular - foramen ovale

32
Q

What can cause trigeminal nerve lesions?

A

Trigeminal neuralgia

Shingles

33
Q

How does damage to the trigeminal nerve present?

A

Absent corneal reflex
Absent sensation
Weakness/wasting of muscles of mastication

34
Q

What nerves can be damaged through facial trauma?

Hint: from trigeminal nerve

A

Intra-orbital (V2) and mental (V3)

Travel superficially

35
Q

What is cranial nerve VI?

A

Abducens nerve

36
Q

What is the function of CN VI?

A

Innervation of extra-ocular muscle - lateral rectus

37
Q

How would you test CN VI?

A

Patient follows finger and reports double vision

38
Q

Describe the route of CN VI:

A

Through cavernous sinus and superior orbital fissure into orbit

39
Q

What can cause damage to abducens nerve?

A

Nerve can be easily stretched in raised ICP due to running under surface of pons

40
Q

How does damage to abducens nerve present?

A

Diplopia

Eye can’t be abducted past midline

41
Q

What nerves arise from the midbrain?

A

Oculomotor and trochlear nerves

42
Q

What nerves arise from the pons?

A

Trigeminal, abducens, facial and vestibulocochlear nerves

43
Q

What nerves arise from the medulla oblongata?

A

Glossopharyngeal, vagus, spinal accessory and hypoglossal nerves

44
Q

What is cranial nerve VII?

A

Facial nerve

45
Q

What are the functions of CN VII?

A

Muscles of facial expression
Anterior 2/3rd of tongue (taste)
PSNS to lacrimal and salivary glands

46
Q

How would you test CN VII?

A

Muscles of facial expression

47
Q

Describe the route of CN VII:

A

Through petrous part of temporal bone via internal acoustic meatus, gives off branches and travels through stylomastoid foramen to give off terminal branches

48
Q

What can cause damage to facial nerve and how does it present?

A

Bell’s palsy
Parotid tumours
Ipsilateral paralysis of muscles

49
Q

What is cranial nerve VIII?

A

Vestibulocochlear nerve

50
Q

What are the functions of CN VIII?

A

Hearing and balance

51
Q

How would you test CN VIII?

A

Hearing test

Rinne’s and Weber’s test

52
Q

Describe the route of CN VIII:

A

Through internal acoustic meatus and terminates in ear

53
Q

What is an acoustic neuroma?

A

Benign tumour growing on nerve

54
Q

How does damage to vestibulocochlear nerve present?

A

Hearing loss

Vertigo/tinnitus

55
Q

What is cranial nerve IX?

A

Glossopharyngeal nerve

56
Q

What are the functions of CN IX?

A

Sensation or soft palate, tonsils and oropharynx
Taste and sensation of posterior 1/3rd of tongue
Sensory from carotid body and sinus
Autonomic to parotid gland
Innervates stylopharyngeus

57
Q

How would you test CN IX?

A

Gag reflex

58
Q

Describe the route of CN IX:

A

Through jugular foramen

59
Q

What is cranial nerve X?

A

Vagus nerve

60
Q

What are the functions of CN X?

A

Sensory to laryngopharynx and larynx
Innervates muscles of soft palate, pharynx and larynx
PSNS to thoracic and abdominal viscera

61
Q

How does damage to the vagus nerve present?

A

Deviation of uvula when soft palate is elevated (say Aaah)

Recurrent laryngeal branch - hoarseness and dysphonia

62
Q

What is cranial nerve XI?

A

Spinal accessory nerve

63
Q

What are the functions of CN XI?

A

Innervate SCM and trapezius

64
Q

How would you test CN XI?

A

Shrug shoulder

Turn head against resistance

65
Q

Describe the route of CN XI:

A

Through jugular foramen

66
Q

What anatomical area does the spinal accessory nerve run through and how can it be damaged?

A

Posterior triangle

Lymph node biopsies and stab wounds

67
Q

What is cranial nerve XII?

A

Hypoglossal nerve

68
Q

What are the functions of CN XII?

A

Innervate muscles of the tongue

69
Q

How would you test CN XII?

A

Inspection and movement of the tongue

70
Q

Describe the route of CN XII:

A

Through hypoglossal canal

71
Q

How does damage to the hypoglossal nerve present?

A

Weakness and atrophy of the tongue muscles on same side

Head and Neck (17 decks)

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