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J Neuro > ANATOMY - cranial nerves > Flashcards

ANATOMY - cranial nerves Flashcards

1
Q

what does the PNS consist of

A

12 pairs of cranial nerves
31 pairs of spinal nerves
autonomic nerves - sympathetic and parasympathetic

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2
Q

where does CNS change to PNS

A

rootlets of nerves from spinal cord (before they become spinal nerves etc)

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3
Q

differentials of a problem with someones smell (3)

A

CNI injury
epilepsy
frontal lobe tumour (olfactory tract is below frontal lobe)

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4
Q

CNI name

A

olfactory nerve

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5
Q

CNI function

A

smell

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6
Q

CNI modality

A

sensory

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7
Q

CNI test

A

cover 1 nostril and test strong smells

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8
Q

CNI brain connection

A

cerebellum - temporal lobe olfactory areas

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9
Q

CNI cranial foraminae

A

cribiform plate of ethmoid bone

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10
Q

which lobe does CNI travel inferior to

hence … lobe tumour may affect smell

A

frontal lobe

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11
Q

what structure is in between the olfactory receptor cells and the olfactory tract

is the nerve PNS or CNS in this location

A

olfactory bulb

PNS, become CNS in the olfactory tract

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12
Q

CNII name

A

optic nerve

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13
Q

CNII function

A

sight

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14
Q

CNII tests (5)

A 
Snellen chart
visual fields 
ishihara chart (for colour blindness) 
light reflexes 
fundoscopy
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15
Q

CNII brain connection

A

cerebellum - occipital lobe

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16
Q

CNII cranial foraminae

A

optic canal

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17
Q

what surrounds the optic nerve and what is the significance of this

A

meninges and CSF (= optic sheath)

increased intracranial pressure = travels along optic sheath = papilloedema

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18
Q

which nerve may be affected by increased ICP

A

optic nerve

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19
Q

is CNII optic nerve CNS or PNS

A

CNS because encased in meninges

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20
Q

what type of tumours are significant for CNII and why

A

pituitary tumours

optic chiasm is directly above the pituitary

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21
Q

after the optic tract where do the APs synapse

A

lateral geniculate nucleus (LGN) of the thalamus

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22
Q

after synapsing at the LGN (lateral geniculate nucleus) of the thalamus, where do APs go

note: think of what signals go to LATERAL nucleus

A

occipital lobe

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23
Q

what type of APs synapse at the lateral geniculate nucleus (LGN) of the thalamus

A

visual

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24
Q

what type of APs synapse at the medial geniculate nucleus (MGN) of the thalamus

A

auditory

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25
Q

within the occipital lobe, where do APs form optic nerve go

A

primary visual cortex

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26
Q

what is the sulcus (in the occipital lobe) called in which 2 gyri (above and below) received visual information

A

calcarine sulcus

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27
Q

where do APs from the right upper visual field go (within the occipital lobe)

A

left occipital lobe
gyrus inferior to calcarine sulcus

remember: everything is opposites (R and L, sup and inf)

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28
Q

on the gyri above/below the calcarine sulcus, where does the fovea/macula send its info to (posterior or anterior)

A

posterior edge

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29
Q

what is meyers loop

A

‘loops’ the SUPERIOR visual field info from the lateral geniculate nucleus to the sulcus inferior to the calcarine gyrus in the occipital lobe

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30
Q

what visual field defect is the result of pituitary tumour

A

bitemporal hemianopia

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31
Q

what visual field defect is the result of L optic nerve (in front of chiasm) injury

A

L monocular blindness

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32
Q

what visual field defect is the result of R optic tract (behind optic chiasm) injury

A

L homonymous hemianopia

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33
Q

if a visual field defect has macula sparing, where is the problem

A

primary visual cortex (in occipital lobe)

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34
Q

CNIII name

A

oculomotor

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35
Q

CNIII function (specific)

A

eye movement - inferior oblique, inferior rectus, medial rectus, superior rectus (NOT lateral rectus or superior oblique bc of SO4 LR6 AO3)

levator palpebrae superioris

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36
Q

CNIII modality

A

motor

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37
Q

CNIII connection to brain

A

midbrain

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38
Q

CNIII cranial formainae

A

superior orbital fissure (SOF)

goes through with CN IV, CNV1 and CN VI too (all the extraocular eye muscles)

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39
Q

CNIII test

A

‘H’ eye movements

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40
Q

what is the mnemonic for remembering the nerves supply extraocular eye muscles

A

SO4 LR6 AO3

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41
Q

what does the superior branch of CNIII supply (3)

A

superior rectus
levator palpebrae superioris

ie - the 2 superior things!

plus PS to sphincter papillae and ciliary muscles

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42
Q

what does the inferior branch of CNIII supply (3)

A

inferior rectus
inferior oblique
medial rectus

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43
Q

what does CNIII palsy look like

A

down and out eyeball (only superior oblique and lateral rectus are working)

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44
Q

CNIV name

A

trochlear

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45
Q

CNIV function

A

eye movements - superior oblique, pulls eye down (and in)

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46
Q

CNIV modality

A

motor

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47
Q

CNIV test

A

‘H’ eye movements

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48
Q

CNIV brain connection

A

midbrain

dorsum of brain stem (diff from the others as all anterior)

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49
Q

CN IV cranial formainae

A

superior orbital fissure (SOF)

along with CN III, CNV1 and CNVI

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50
Q

how might someone with CN IV palsy present

A

head tilt - to compensate

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51
Q

which CN arises form the dorsum(back) of the brainstem

A

CN IV

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52
Q

which CN has the longest course, croses over etc = easily broken

A

CN IV

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53
Q

CNV name

A

trigeminal
div1 - ophthalmic
div2 - maxillary
div3 - mandibular

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54
Q

CNV function

A

sensory to face

motor- muscles of mastication

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55
Q

CNV modality

A

both sensory and motor

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56
Q

CNV brain connection

A

pons

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57
Q

CNV cranial foraminae

A

CNV1 - superior orbital fissure (SOF)
CNV2 - foramen rotundum
CNV3 - foramen ovale

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58
Q

CN V1 function

A

sensory - face above eyelids and bridge of nose, superior nasal cavity, cornea

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59
Q

CNV2 function

A

sensory - face between eyelids and crease of lips, ala of nose, maxillary teeth, inferior nasal cavity

60
Q

CNV3 function

A

sensory - face between crease of lips and jaw line (under jaw line and angle of mandible = great auricular nerve C2, 3), anterior 2/3 of tongue, mandibular teeth

motor - muscles of mastication (massester, temporalis, medial pterygoid, lateral pterygoid), tensor veli palatine, tensor tympani

61
Q

what is the sensory supply to the nasal cavity

A

V1-superior and anterior

V2-inferior and posterior

62
Q

what nerve gives sensory spply to angle of mandible

A

C2,3

63
Q

which nerve gives sensory supply to anterior 2/3 of tongue

A

CNV2

64
Q

what is the nasociliary branch a branch of

A

CNv1

65
Q

what is the significance of the nsociliary branch of V1 in singles

A

shingles can present with hutchisons sign (rash on tip of nose) THEN eye problems (corneal supply of V1)

66
Q

what notch odes CNV2 travel through that means it is susceptible to trauma damage

A

infraorbital notch

67
Q

which foramen is somatic sensory only

A

foramen rotundum

68
Q

which part of the face has dual nerve supply

A

forehead

69
Q

if there is an upper motor neurone (UMN) lesion in the nerves supplying the face, what will this present as

A

unilateral sensory loss but forehead sparing (as the forehead has a dual nerve supply so if one is cut off, there is still the nerve from the other side of the brain supplying it = not symptomatic)

70
Q

if there is a lower motor neurone (LMN) lesion in the nerves supplying the face, how will this present

A

unilateral sensory loss INCLUDING the forehead (as even though the forehead has a dual nerve supply, in a LMN both nerves that supply the same sid of the forehead have met and hence there will be no sensation in that side of the forehead)

71
Q

CNVI name

A

abducens

72
Q

CNVI function

A

eye movements - lateral rectus (LR6)

73
Q

CNVI modality

A

motor

74
Q

CNVI test

A

‘H’ eye movements

75
Q

CNV test

A

touch 6 areas of face (V1, V2, V3 bilaterally) with cotton wool, pin and tuning fork (for temp/vibration)

get them to open and close jaw with your hand on temporalis muscle (over temporal bone)

get them to open jaw with your hand underneath to give resistance (testing lateral pterygoid)

76
Q

CNVI brain connection

A

pons-medulla junction (most medial, CNVII and CNVIII come off here too)

77
Q

CNVI cranial foraminae

A

superior orbital fissure (SOF)

along with CNIII, CNIV and CNV1

78
Q

which nerves pass through the cavernous sinus

A

CNIII, CNIV, CNIV, CNV1 and CNV2

79
Q

which CN comes off the ponto-medullary junction most medially

which others come off here

A

CNVI

CNVII
CNVIII

80
Q

which part of the temporal bone does CNVI (abducens) travel over

A

petrous part

81
Q

CNVI palsy presentation

A

horizontal diplopia

82
Q

CNVII name

A

facial

83
Q

CNVII function

A

motor - muscle of facial expression, stapes bone in ear

chorda tympani branch - PS to sublingual and submandibular salivary glands

84
Q

CNVII modality

A

both - sensory and motor

85
Q

CNVII test

A

puff out cheeks
close eyes tightly
smile

86
Q

which CN is closely associated with CNVII

comes off same place in brain and goes through same cranial foraminae

A

CNVIII (vestibulocochlear)

both come of ponto-medullary junction
both go through the internal acoustic meatus

87
Q

which cavity does CNVII pass behind (and give off 1 branch to)

A

ear cavity

gives off a branch to supply to stapes bone

88
Q

after going through the internal acoutics meatus and passing behind the ear cavity (in the facial canal), which foramen does the facial nerve (CNVII) go through

A

stylomastoid foramen

89
Q

what are the 5 terminal branches of CNVII (after its given off branch to stape and chorda tympani branch)

what do they do

A 
temporal 
zygomatic 
buccal 
mandibular 
cervical

pneumonic - two zannibar buy motor car

supply muscles of facial expression

90
Q

muscles of facial expression (4)

A

frontalis (on forehead)
orbicularis occuli (around eyes)
orbicularis oris (around mouth)
elevators of lips

91
Q

which condition affects CN VII

A

bells palsy

92
Q

what cant someone with bells palsy do

A

puff out cheeks, close eyes tightly, smile etc

CNVII palsy

93
Q

which salivary gland is not supplied by chorda tympani branch of CNVII (though the nerve passes over it)

A

parotid gland

94
Q

which glands does chorda tympani branch of CNVII supply

A

sublingual and submandibular salivary glands

95
Q

which branch of CNVII passes over the tympanic membrane

what is the clinical significance of this

A

chorda TYMPANI

damage to tympanic membrane = may result in loss of taste/salivation

96
Q

CNVIII name

A

vestibulocochlear nerve

97
Q

CNVIII function

A

vestibular branch - balance

cochlear branch - hearing

98
Q

CNVIII test

A

rinnes and weber

99
Q

CNVIII cranial foraminae

A

internal acoustic meatus

100
Q

CNVIII brain connection

A

ponto-meduallry junction (with CNVI and CN VII)

101
Q

what are the 2 branches of CNVIII

A

cochlear

vestibular

102
Q

where does the info that travels in the vestibular branch of CNVIII arise

A

semi circular canals (anterior, posterior and lateral)

103
Q

CNIX name

A

glossopharyngeal nerve

104
Q

CNIX modality

A

both - sensory and motor

105
Q

CNIX brain connection

A

medulla

106
Q

CNIX function

A

sensory - pos 1/3 tongue, pharynx,

motor - stylopharyngeus

107
Q

CNIX brain connection

A

medulla (medial to CNX)

108
Q

which nerve supplies sensory to posterior 1/3 of tongue

A

CNIX glossopharyngeal

109
Q

CNIX test

A

gag reflex

110
Q

which nerve supplies eustachian tube and middle ear cavity (think about anatomy of eustachian tube)

A

CNIX glossopharyngeal

bc eustachian tube connects middle ear cavity to pharynx

111
Q

which nerve is significant in referred pain between throat and ear

A

CNIX glossopharyngeal

bc of connection between 2 cavities via eustachian tube

112
Q

CN X name

A

vagus

113
Q

CNX function

A

supplies lots of things between palate and midgut

114
Q

CNX cranial foraminae

A

jugular foramen

115
Q

CNX modality

A

both sensory and motor

116
Q

CNX test

A

say ‘ahhhhh’
swallow sip of water
hoarse voice?
cough

117
Q

within which sheath does the vagus nerve run

in relation to the other things in sheath, where does it run

A

carotid sheath

posterior to common carotid artery and internal jugular vein

118
Q

how do you differentiate between the vagus nerve CN X and the cervical ganglia in the carotid sheath

A

cervical ganglia have bulges

119
Q

what is the first branch of the vagus nerve

what do they supply

A

superior laryngeal nerves

larynx cricothyroid muscles (all other larynx muscles supplied by inferior laryngeal)

120
Q

what does the superior laryngeal nerve split into

A

internal and external superior laryngeal nerves

121
Q

what is the first branch of the vagus nerve

what does it supply

A

superior laryngeal nerves

larynx cricothyroid muscles (all other larynx muscles supplied by inferior laryngeal)

122
Q

what does the internal superior laryngeal nerve supply

A

mucosa above the vocal cords (bc mucosa is INTERNAL)

123
Q

what does the external superior laryngeal nerve supply

A

cricothyroid muscles of larynx (bc muscles are EXTERNAL)

124
Q

what does the inferior laryngeal nerve supply

A

all laryngeal muscles apart from the cricothyroid eg vocal cord muscles! important clinically

mucosa below the vocal cords

125
Q

what is the anastomosis between the inferior laryngeal nerve and the internal superior laryngeal nerve called

A

galens anastomosis

126
Q

where does the right vagus travel after being right to the oesophagus

A

posterior to oesophagus

laRP

127
Q

where does the left vagus travel after being left to the oeosphagus

A

anterior to the oesophagus

LArp

128
Q

where does the right recurrent laryngeal branch of the vagus go under

A

subclavian artery

129
Q

where does the left recurrent laryngeal branch of the vagus go under

A

arch of aorta

130
Q

what does the recurrent laryngeal branch of the vagus turn into

A

inferior laryngeal nerve (supplies half of larynx alongside the superior laryngeal nerve)

131
Q

how does recurrent laryngeal nerve damage present

A

change in/loss of voice (bc they control the vocal cords)

hoarseness if unilateral
aphonia if bilateral

132
Q

CNXI name

A

spinal accessory nerve

133
Q

CNXI modality

A

motor

134
Q

CNXI function

A

trapezius and sternocleidomastoid muscles

135
Q

CNXI test (2)

A

shrug shoulders

rotate head

136
Q

CNXI cranial foraminae

A

jugular foramen

137
Q

CNXI brain connection

A

spinal cord

138
Q

what is the route of the spinal accessory nerve

A

arises from cervical spine
enters cranial cavity via foramen magnum
exits cranial cavity via jugular foramen

139
Q

CNXII name

A

hypoglossal

140
Q

CNXII modality

A

motor

141
Q

CNXII function

A

extrinsic and intrinsic tongue muscles (apart from palatoglossus)

142
Q

CNXII test

A

stick out tongue

say ‘ahhh’

143
Q

CNXII cranial foraminae

A

hypoglossal canal

144
Q

which nerve supplies palatoglossus (diff form other tongue muscles)

A

CNX vagus

145
Q

which nerve supplies palatoglossus (diff form other tongue muscles)

A

CNX vagus

146
Q

pneumonic for names of cranial nerves in order

A

oh oh oh to touch and feel virgin girls vagina and hymen

147
Q

pneumonic for modality of cranial nerves in order

A

some say money matters but my brother says big boobs matter most

J Neuro (32 decks)

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