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Block 3 - Resp > Anatomy - Cranial Nerves > Flashcards

Anatomy - Cranial Nerves Flashcards

1
Q

Three nerves for the eye

A
  • Oculomotor (III)
  • Trochlear (IV)
  • Abducent (VI)
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2
Q

Oculomotor nerve course

A
  • from brainstem, in between the two pillars
  • lies upon circle of willins
  • to cavernous sinus (on lateral wall)
  • through superior orbital fissure
  • gives off motor nerves
  • parasympathetic goes through ciliary ganglion
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3
Q

Through which foramina does the oculomotor nerve exit?

A

Superior orbital fissure

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4
Q

What ganglion does the parasympathetic part of oculomotor go through

A

Ciliary Ganglion

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5
Q

What does the parasympathetic fibers of the oculomotor nerve innervate

A
  • Ciliaris

- sphincter pupillae

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6
Q

What do the motor fibers of the oculomotor nerve innervate

A
  • Most muscles of the eye except SO and LR
  • LPS
  • MR
  • SR
  • IO
  • IR
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7
Q

Clinical issues with the oculomotor nerve

A
  • hemmorage near circle of willis, aneurysms
  • pupil dilation: mydriasis
  • no pupillary reflex
  • no accomodation
  • lateral squint: down-out
  • diplopia: double vision
  • ptosis: because LPS is damaged
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8
Q

Trochlear nerve course

A
  • only cranial nerve that crosses to the other side in the periphery
  • goes through cavernous sinus on lateral wall
  • exits skull through the orbital fissure
  • along the superior eyelid
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9
Q

What type of fibers does the trochlear nerve have

A
  • only motor
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10
Q

What fissure does the trochlear nerve exit by

A
  • Superior orbital fissure
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11
Q

What does the trochlear nerve innervate

A
  • Superior oblique
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12
Q

Clinical issues for the trochlear nerve

A
  • rise in intracranial pressure
  • slight lateral squint (extortio) - patients may try to correct this by tilting their head to one side. This is because the inferio oblique is rising the eye and SO cant contradict it
  • weak eye depression when adducted
  • diplopia
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13
Q

Abducent nerve course (VI)

A
  • stupid
  • down then hits sphenoid bone, goes back up
  • goes through cavernous sinus next to internal carotid
  • exits via superior orbital fissure
  • innervates lateral rectus
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14
Q

What fissure does the abducent nerve use to exit the skull?

A
  • the superior orbital fissure
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15
Q

What does the motor fibers of abducent nerve innervate?

A
  • lateral rectus
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16
Q

What type of fibers does the abducent nerve have?

A
  • motor only
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17
Q

Clinical issues with abducent nerve

A
  • carotid dilation, pathology, rICP

- medial squint: esotropia: diplopia

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18
Q

Two cranial nerves for the face area

A
  • Trigeminal (V)

- Facial (VII)

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19
Q

Trigeminal nerve three parts

A
  • ophtalmic: V1
  • Maxillary: V2
  • Mandibular: V3

V1 and V2 are purely snesory
V3 is sensory but has a motor component

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20
Q

Trigeminal nerve course

  • where does the trigeminal nerve exit?
  • where does it form a swelling
  • Where does V1 go through?
  • Where does V2 go through?
  • where does V3 go through?
A
  • Exit midbrain through Merkel’s cave
  • forms a swelling over the petrous temporal bone and then fibers separate
  • V1 through superior orbital fissure
  • V2 through foramen rotundum
  • V3 through foramen ovale
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21
Q

What is the sensory innervztion of V1

A
  • scalp
  • forehead
  • sinus
  • eyelids
  • nose
  • nasal cavity
  • eye
  • HEAD BLOOD VESSELS
  • MENINGES (particularly dura)
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22
Q

What is the sensory innervation of V2

A
  • upper teeth
  • palate, sinus
  • cheek
  • upper lip
  • nose
  • nasal cavity
  • oral cavity
  • pharynx
23
Q

What is the sensory innervation of V3

A
  • Lower teeth,
  • tongue
  • lower lip
  • chin
  • jaw
  • ear
24
Q

What is the motor innervation of V3

A
  • Mastication muscles
  • TVP
  • Tensor tympanic
  • mylohyoid
  • ant digastric
25
Q

Clinical issues of trigeminal

A
  • sensory face loss: neuralgia, shingles
  • mastication issues: jaw deviation
  • headaches: artery dilation/pathology, visceral issues, rICP
26
Q

Facial nerve course

  • where does it exit?
  • where does the ganglion form
  • what structures does it pass
A
  • exits via internal acoustic meatus
  • forms a swelling at facial sensory gnaglion and then first division
  • second division after tympanic cavity
27
Q

First division of facial nerve:4 courses

A

1) parasympathetic fiber goes above petrous temporal bone, through trigeminal ganglion. Synapse into pterygopalatine ganglion and post-ganglionic fiber go to lacrimal gland
2) motor fiber to stapediues
3) sensory fibers to ear, auricle
4) some parasympathetic and motor fibers continue

28
Q

Second division of facial nerve

  • what fissures do motor fibers and parasympathetic fibers go through?
  • what is the ganglion that the parasympathetic fibers synapse to, and where do post-ganglion neurons go to?
A
  • after the first division: goes through tympanic cavity and then further divide
  • Motor fibers continue down over mastoid process through stylomastoid foramen and parotid gland
  • parasympathetic fiber go through petrotympanic fissure and take advantage of chorda tympani (lingual nerves to send fibers to V3 lingual) - synapse into submandinbular ganglion and post ganglionic fibers innervate submandibular gland and sublingual gland. This is also the path for taste nerves that go to anterior 2/3 of tongue
29
Q

What do the fibers of facial nerve innervate?

  • parasympathetic
  • sensory
  • taste
  • motor
A
  • Parasympathetic: lacrimal gland, submandibular/sublingual gland
  • Sensory: ear
  • Taste: anterior 2/3 of tonghe
  • motor: muscles of facial expression + stapedius, stylohyoid, post digastric
30
Q

Clinical issues with facial nerve

A
  • intracranial: sensory/visceral issues ( + hyperacusis), Motor (bell’s palsy): middle ear infection/shingles
  • extracranial: motor (Bell’s palsy): Parotid tumour/infections/ mastoid trauma
31
Q

NErve that innervates ear

A
  • Vestibulo cochlear
32
Q

Cochlear nerve: function

A
  • Sensory: hearing, frequency maps
33
Q

Cochlear nerve: Clinical issues

A
  • abscess/tymour, internal acoustic meatus, inner ear damage
  • hearing loss: Rinne and Weber test to distinguish between sensorineural and conductive
  • tinnitus
34
Q

What foramina does the vestibulocochlear nerve use to exist brainstem?

A
  • internal acoustic meatus
35
Q

VEstibular nerve function

A
  • sensory
  • balance
  • posture: position, movement
  • ocular (head eye together, stable retinal moves)
36
Q

Clinical issues with vestibular nerve

A
  • Posture: balance loss, unsteady (without eyes)
  • ocular: no eye-head moves, nystagmus
  • visceral issues: vertigo, vomit, nausea
  • will always fall towards sign of lesion
37
Q

Innervation of mouth 3 nerves

A
  • glossopharyngeal
  • vagus
  • hypoglossal
38
Q

Glossopharyngeal nerve (IX) course

  • foramen to leave brainstem
  • swelling
  • 5 branches off
A
  • leave brainstem through jugular foramen
  • swelling at glossopharyngeal sensory ganglion
  • 1st branch off: parasympathetic fiber to parotid gland and sensory fiber to middle ear
  • 2nd branch off: sensory fiber to carotid body
  • 3rd branch off: motor nerve to stylopharyngeus
  • 4th branch off: sensory and taste to posterior 1/3 of tongue
  • 5th branch: sensory to oropharynx
39
Q

Parasympathetic fibers of glossopharyngeal

  • above which bone?
  • synapse to which ganglion?
  • what do postganglionic fibers innervate
A
  • go above petrous temporal bone
  • synapse into otic ganglion
  • post ganglionic fiber go to parotid gland
40
Q

Sensory fibers of glossopharyngeal nerve

A
  • oropharynx
  • posterior 1/3 of tongue
  • carotid body
41
Q

Taste fibers of glossopharyngeal nerve

A
  • posterior 1/3 of tongue
42
Q
  • Motor fibers of glossopharyngeal
A
  • stylopharyngeus
43
Q

CLinical issues of glossopharyngeal

A
  • sensory-visceral issues
  • no gag reflex
  • rare
44
Q

What foramina does the vagus nerve use to exit midbrain

A
  • jugular foramen

Then form vagus sensory ganglion

45
Q

Divisions of vagus nerve: sensory

A
  • one to aorta/baroreceptors
  • two separate fibers to vocal folds (posterior and superior)
  • laryngopharynx
  • thorax/ upper GIT
46
Q

Taste fibers of vagus

A
  • to larynx
47
Q
  • parasynmpathetic fibers of vagus
A
  • go through carotid sheath with IJV and CCA an then synapse into thorax/abdomen ganglia
  • post ganglioninc fiber innervate thorax and upper GIT
48
Q

Motor branches of vagus nerve

A
  • pharyngeal plexus (middle constrictor)
  • muscles of palate (except TVP)
  • muscles of pharync (except stylopharyngeus)
  • Cricothyroideus and cricopharyngeus
  • all laryngeal muscles except cricothyroideus
49
Q

Clinical issues with vagus nerve

A
  • sensory-visceral issues
  • dysphonia: recurrent laryngeal is damaged - cant contract cricothyroideus
  • dysphagia: problem swallowing because constrictors are not working
  • dyspalatia; problems with palate
50
Q

Hypoglossal nerve: course

A
  • exit midbrain through hypoglossal canal

- crosses carotid around the loop of lingual

51
Q

Hypoglossal nerve: innervation

A
  • only motor: tongue
  • hyoglossus
  • all glossal muscles except palatoglossus
52
Q

Clinical issues with hypoglossal nerve

A
  • nearly always unilateral

- glossal palsy: ask to stick tongue out: deviation to the right (side of lesion)

53
Q

Accessory nerve: neck nnervation

  • what spinal levels
  • what foramen
  • what muscles
A
  • at spinal cord level C1-6
  • exit through jugular foramen
  • separates into to innervate SCM and trapexius
54
Q

Accessory nerve clinical issues

A
  • shoulder/head movement
  • viral infection?
  • difficulty turning to opposite side of lesion and shrugging shoulder

Block 3 - Resp (44 decks)

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