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Y3 Neurology Anatomy > Anatomy 4: Anatomy of Cranial Nerves > Flashcards

Anatomy 4: Anatomy of Cranial Nerves Flashcards

1
Q

For CNI, give it’s extracranial and intracranial course and connection with CNS (if applicable)

A

In olfactory mucosa in nasal cavity
Synapse in olfactory bulb, and pass to olfactory tract
NO CONNECTION

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2
Q

Outline how you would go about testing CNI

A

Smell while covering contralateral side`

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3
Q

For CNII, give it’s extracranial and intracranial course and connection with CNS (if applicable)

A

Neurones of retina travel posteriorly via optic nerve to the orbit
Pass from the optic chiasm to the optic tract
Diencephalon

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4
Q

Outline how you would go about testing CNII

A 
Visual acuity (Snellen)
Colour (Ishihara plates)
Fields (4 quadrants)
Reflexes (Pupillary light reflexes)
Fundoscopy
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5
Q

For CNIII, give it’s extracranial and intracranial course and connection with CNS (if applicable)

A

SOF into orbit and supply all extraocular muscles except 2, PSs synapse in ciliary ganglion
Lateral wall of cavernous sinus (orbit)
Mesencephalon (midbrain)

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6
Q

Outline how you would go about testing CNIII

A

Light reflexes via a torch (PS)

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7
Q

For CNIV, give it’s extracranial and intracranial course and connection with CNS (if applicable)

A

SOF into orbit and supply SO muscle
Lateral wall of cavernous sinus (orbit)
Mesencephalon (midbrain)

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8
Q

Outline how you would go about testing CNIV

A

H test (in and down)

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9
Q

For CNVI, give it’s extracranial and intracranial course and connection with CNS (if applicable)

A

SOF into orbit and supply LR muscle
Cavernous sinus to orbit
Pontomedullary junction

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10
Q

Outline how you would go about testing CNVI

A

H test (out)

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11
Q

For CNVIII, give it’s extracranial and intracranial course and connection with CNS (if applicable)

A

Axons from cochlear and vestibular apparatus
Posteromedially from IAM to PM junction
Pontomedullary junction

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12
Q

Outline how you would go about testing CNVIII

A

Rinnie and Weber tests

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13
Q

For CNXI, give it’s extracranial and intracranial course and connection with CNS (if applicable)

A

Axons supply SCMD, travel across posterior triangle to trapezius
Foramen magnum to jugular foramen
Cervical spinal cord

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14
Q

Outline how you would go about testing CNXI

A 
Shrug shoulders (and resist) - TRAPEZIUS
Turn head to flex neck (and resist) - SCMD
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15
Q

For CNXII, give it’s extracranial and intracranial course and connection with CNS (if applicable)

A

Descends lateral to carotid sheath (at hyoid turns anteriorly to tongue)
Pass anteriorly to hypoglossal canal
Many rootlets lateral to pyramids of medulla

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16
Q

Outline how you would go about testing CNXII

A

Stick tongue out and move side-side

Tip of tongue will point towards side of pathology

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17
Q

For CNV, give it’s extracranial and intracranial course and connection with CNS (if applicable)

A

Sensory passes superficial to deep structures of face posteriorly to foramen
Motor from CNV3 travels from f. ovale to skeletal muscle

Inferior to tentorium cerebelli

Pons!

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18
Q

Give the superficial sensory divisions for the trigeminal supply to the face

A

CNVI: upper eyelid to tip of nose to forehead
CNV2: Lower eyelid to upper lip and nostril
CNV3: Lower lip and chin to TMJ/ mandible (except angle)

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19
Q

What gives sensory supply to the angle of mandible, and what are the roots of this nerve?

A

Great auricular nerve (C2, C3)

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20
Q

Give the deep sensory divisions for the trigeminal supply to the face

A

CNV1: orbit (not floor or lower eyelid), upper anterior nasal cavity, paranasal sinuses (not maxillary), anterior and posterior CF

CNV2: lower posterior nasal cavity, maxillary sinus, maxilla, floor of nasal cavity/ palate, maxillary teeth, soft tissues

CNV3: Middle CF, mandible A 2/3 of tongue, floor of mouth, buccal mucosa, mandibular teeth

21
Q

Outline how you would go about testing the sensory divisons of CNV

A

Close eyes
Cotton wool - ‘Say when you feel me touching you’
Compare sides

22
Q

Which nerve is the 1st part of afferent limb of blink/ corneal reflex?

A

Long ciliary nerve

23
Q

Outline how you would go about testing the motor division of CNV

A

Palpate strength of masseter (clench teeth)

Open jaw against resistance

24
Q

For CNVII, give it’s extracranial and intracranial course and connection with CNS (if applicable)

A

Somatic motor fibres to parotid gland and then facial expression muscles (1 out of 5)
Directly to IAM
Pontomedullary junction

25
Q

The facial canal is located within what part of the temporal bone?

A

Petrous part

26
Q

What is the function of chorda tympani, a branch of CNVII?

A

Taste to A 2/3 of tongue

PS to submandibular and sublingual glands (salvation)

27
Q

What is the tiniest SkM in the body?

A

Stapedius

28
Q

What is the role of the stapedius muscle, and what happens when you damage it?

A

Reduces stapes movement to dampen down excessive noise

Hyperacuisis

29
Q

Outline how you would go about testing CNVII

A

Test the muscles of facial expression - raise eyebrows, close eyes tightly, smile, puff out cheeks and hold air

30
Q

List the muscles of facial expression

A

Frontalis
Orbicularis oculi
Elevators of lips
Orbicularis oris

31
Q

For CNIX, give it’s extracranial and intracranial course and connection with CNS (if applicable)

A

Descends in pharynx in mouth to stylopharyngeus, parotid gland, pharyngeal muscosa, carotid body and sinus, posterior 1/3 of tongue

Directly to jugular foramen

Medulla oblongata

32
Q

Outline how you would go about testing CNIX

A

Elicit afferent limb of gag reflex

33
Q

What is the only muscle supplied by CNIX

A

Stylopharyngeus

34
Q

Which muscles are supplied with motor innervation from CNV?

A

Tensor tympani
Tensor veli palatini
1 pair of jaw closing muscles - lateral pterygoid
3 pairs of jaw opening muscles - masseter, temporalis, medial pterygoid

35
Q

For CNX, give it’s extracranial and intracranial course and connection with CNS (if applicable)

A

Structures between pallate and midgut
Directly into jugular foramen
Medulla oblongata

36
Q

Why is pain often referred from pharynx to ear and vice versa?

A

Both supplied by glosopharyngeal nerve

37
Q

What two vessels is the carotid sheath located between? Which CN runs in the carotid sheath?

A

CCA and IJV

Vagus nerve

38
Q

The left recurrent laryngeal nerve, branch of CNX, passes under…

A

Arch of aorta

39
Q

The right recurrent laryngeal nerve, branch of CNX, passes under…

A

Right subclavian artery

40
Q

Outline the route taken by both vagus nerves from the chest to abdomen

A 
RIGHT: Lateral aspect of trachea
LEFT: Lateral aspect of aortic arch
Pass posterior to lung root on oesophagus
Pass through diaphragm with oesophagus
Pass onto surface of stomach
Branches and travels to organs
41
Q

List the branches of the vagus nerve in the abdomen

A 
Celiac and superior mesenteric ganglia
Foregut
Renal
Midgut (on mesenteries)
Splenic
Pancreatic
42
Q

What vertebral level do the oesophagus and vagus nerve pass through the diaphragm?

A

T10

43
Q

Where do the vagus nerves very last PS axons pass onto?

A

Splenic flexure of colon

44
Q

Outline how you would go about testing CNX

A

MUSCLES OF PALATE (motor) - Say ‘aaah’ - uvula deviates to side that is functioning
PHARYNGEAL MUSCLES - Swallow water and see if they splutter
LARYNGEAL MUSCLES - Listen to speech and see if any hoarseness

45
Q

Which CN is the only nerve to exit the brainstem posteriorly?

A

Trochlear nerve - EXIT POSTERIOR MIDBRAIN AT JUNCTION WITH PONS

46
Q

If a patient has reduced sensation unilaterally on the face, including the forehead and lip, what does this suggest? Why?

A

More likely involves peripheral facial nerve (Bell’s palsy) than a central lesion (forehead sparing)

There is bilateral innervation of the upper facial nerve

47
Q

Which cranial nerves are located within the cavernous sinus and can be damaged in thrombosis?

A

III, IV, VI, V2, V1

48
Q

Outline the ‘rule of 4’ for cranial nerves

A

4 above the pons (1-4)
4 at the pons (5-8)
4 in medulla (9-12)

Y3 Neurology Anatomy (12 decks)

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