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3.2 Neuroanatomy > Anatomy of Cranial Nerves > Flashcards

Anatomy of Cranial Nerves Flashcards

1
Q

What is the function and modality of cranial nerve I?

A

Olfactory nerve- smell

Special sensory

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2
Q

Where is the extra cranial part of CN I?

A

Lays within olfactory mucosa in nasal cavity

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3
Q

What is the cranial foramina of CN I?

A

Cribriform plate of the ethmoid bone

Lies within anterior cranial fossa

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4
Q

Where is the intracranial part of CN I where is connects with the CNS?

A

Olfactory nerves synapse in the olfactory bulb

Then pass through the olfactory tract to cortical areas

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5
Q

What is the function and modality of CN II?

A

Optic nerve- vision

Special sensory

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6
Q

Where is the extra cranial part of CN II?

A

Neurons of retina travel posteriorly via optic nerve from posterior hemisphere of eye through orbit

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7
Q

What is the cranial foramina for CN II?

A

Optic canal in middle cranial fossa

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8
Q

Where is the intracranial part of CN II?

A

Optic nerve passes around pituitary stalk to optic chasm to form the optic tract

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9
Q

Where does CN II connect with the CNS?

A

Diencephalon

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10
Q

What are the only 2 structures running through the optic canal?

A

Optic nerve and ophthalmic artery

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11
Q

How is CN I clinically tested?

A

Not routinely tested!

Can ask patient to smell familiar smell whilst covering contralateral nostril

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12
Q

How is CN II clinically tested?

A 
5 ways:
Acuity (Snellen chart)
Colour (Ishihara plates for colour blindness)
Fields (Four quadrants)
Reflexes (Pupillary light reflexes)
Fundoscopy
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13
Q

What is the function and modality of CN III?

A 
Oculomotor nerve
Eye movement (motor)
Pupil constriction (parasympathetic)
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14
Q

Where does CN III connect with the CNS?

A

Midbrain (mesencephalon)

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15
Q

Where is the intracranial part of CN III?

A

Towards the orbit in the lateral wall of the cavernous sinus

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16
Q

What is the cranial foramina for CN III?

A

Superior orbital tissue (SOF)

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17
Q

What is the extra cranial part of CN III?

A

Passed from SOF into orbit to supply all extra ocular muscles except 2
Parasympathetic part synapses in ciliary ganglion

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18
Q

What is the function and modality of CN IV?

A 
Trochlear nerve
Eye movement (Motor)
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19
Q

Where does CN IV connect with the CNS?

A

Midbrain (mesencephalon)

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20
Q

Where is the intracranial part of CN IV?

A

Nerve travels towards the orbit in the lateral wall of the cavernous sinus

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21
Q

What is the cranial foramina for CN IV?

A

Superior orbital fissure (SOF)

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22
Q

Where is the extra cranial part of CN IV?

A

Passes through SOF into orbit and supplies only superior oblique muscle

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23
Q

What is the function and modality of CN VI?

A 
Abducent nerve
Eye movement (motor)
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24
Q

Where does CN VI connect with the CNS?

A

Pontomedullary junction

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25
Q

Where is the intracranial part of CN VI?

A

Travels towards orbit within cavernous sinus

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26
Q

What is the cranial foramina for CN VI?

A

Superior orbital fissure (SOF)

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27
Q

Where is the extra cranial part of CN IV?

A

Passes through SOF into orbit and supplies only lateral rectus

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28
Q

How are eye movements tested?

A

The ‘H’ test

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29
Q

What is the function and modality of CN VIII?

A

Vestibulocochlear nerve

Hearing and balance (special sensory)

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30
Q

Where is the extra cranial part of CN VIII?

A

Axons from cochlear and vestibular apparatus

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31
Q

What is the cranial foramina for CN VIII?

A

Internal acoustic meatus

In posterior cranial fossa

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32
Q

Where is the intracranial part of CN VIII?

A

Travels posteromedially from internal acoustic to pontomedullary junction

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33
Q

Where does CN VIII connect with the CNS?

A

Pontomedullary junction

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34
Q

How do you clinically test VIII?

A

Rinne and Weber test

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35
Q

What is the function and modality of CN XI?

A

Spinal accessory nerve

Motor- sternocleidomastoid and trapezius muscle

36
Q

Where does CN XI connect with the CNS?

A

Cervical spinal cord

37
Q

Where is the intracranial part of CN XI?

A

Ascends through foramen magnum then travels towards jugular foramen in posterior cranial fossa

38
Q

What is the cranial foramina for CN XI?

A

Jugular foramen in posterior cranial fossa

39
Q

Where is the extra cranial part of CN XI?

A

Axons supply SCM on deep surface, then continue across posterior triangle to supply trapezius

40
Q

How do you clinically test XI?

A

Ask patient to shrug shoulder

Ask patient to turn head to flex neck and turn towards the opposite side

41
Q

What is the function and modality of CN XII?

A

Hypoglossal nerve

Motor ( all muscles of the tongue except palatoglossus)

42
Q

Where does CN XII connect with the CNS?

A

Via rootlets lateral to pyramids of medulla oblongata

43
Q

Where is the intracranial part of CN XII?

A

Passes anteriorly to hypoglossal canal

44
Q

What is the cranial foramina for CN XII?

A

Hypoglossal canal in posterior cranial fossa

45
Q

Where is the extra cranial part of CN XII?

A

Descends lateral to carotid sheath

At level of hyoid it turns anteriorly towards lateral aspect of tongue

46
Q

How do you clinically test XII?

A

Ask patient to stick tongue straight out

Tongue tip will point towards side of injured nerve

47
Q

Which cranial nerves are more complex?

A

Trigeminal
Facial
Glossopharyngeal
Vagus

48
Q

What are the 3 divisions of CN V (Trigeminal) and what are their modalities?

A

CNV1- Ophthalmic- Sensory
CNV2- Maxillary- Sensory
CNV3- Mandibular- Sensory and Motor

49
Q

Where does CN V connect with the CNS?

A

Pons (laterally)

50
Q

Where is the intracranial part of CN V?

A

Inferior to edge of tentorium cerebella between posterior and middle cranial fossae

51
Q

What are the cranial foramina for the 3 divisions of CN V?

A

CN V1- Superior orbital fissure
CNV2- Foramen rotundum
CNV3- Foramen ovale

52
Q

Where is the extra cranial part of CN XII?

A

Sensory axons from all 3 divisions- from superficial and deep facial structures posteriorly towards respective cranial foramen

Motor axons- from CNV3 flow from foramen ovale towards skeletal muscle they supply

53
Q

What areas of the face does CNV1 supply?

A

Upper eyelid
Cornea
All the conjunctiva
Skin of root/bridge/tip of nose

54
Q

What areas of the face does CNV2 supply?

A

Skin of lower eyelid
Skin of maxilla
Skin of ala of nose
Skin/mucosa of upper lip

55
Q

What areas of the face does CNV3 supply?

A

Skin over mandible and TMJ

56
Q

What are the motor functions of CNV3 mandibular nerve?

A

Innervation of 3 pairs of jaw closing muscles- master, temporalis and medial pterygoid

Innervation of 1 pair of jaw opening muscles- lateral pterygoid

Tensor veli palatini and tensor tympani

57
Q

How do you clinically test CNV?

A

Sensory: ask patient to close eyes and gently brush skin in each dermatome with fine top of cotton wool, compare both sides
Motor: Palpate strength of contraction of masseter & temporalis by asking patient to clench teeth
Ask patient to open jaw against resistance

58
Q

What is the function and modality of CN VII?

A

Facial nerve- special sensory (taste), motor and parasympathetic

59
Q

Where does CN VII connect with the CNS?

A

Anterolateral at pontomedullary junction

60
Q

What is the cranial foramina for CN VII?

A

Temporal bone
Internal acoustic meatus (in)
Stylomastoid foramen (out)

61
Q

Where is the extra cranial part of CN VII?

A

Most somatic motor axons pass into parotid gland then into 1 of 5 branches that supply muscles of facial expression

62
Q

Where is the course of the facial nerve in the base of skull?

A

Through the petrous part of temporal bone

63
Q

What does the branch of CN VII (chorda tympani) innervate?

A

Taste buds on anterior 2/3rds of tongue

Parasympathetic supply to submandibular & sublingual glands (salivation)

64
Q

Which muscle in the inner ear is innervated by CN VII?

A

Stapedius muscle

Reduces stapes movement to protect the internal ear from excessive noise

65
Q

The chorda tympani joins the lingual nerve (CNV3) to innervate what?

A

Anterior 2/3rds of tongue and parasympathetic fibres to glands of submandibular and sublingual

66
Q

How do you clinically test CN VII?

A 
Ask patient to:
Raise eyebrows (frontalis)
Close eyes tightly (orbicularis oculi)
Smile (elevators of lips)
Puff out cheeks and hold air (orbicularis oris)
67
Q

What is the function and modality of CN IX?

A 
Glossopharyngeal nerve
Special sensory (Taste)
Sensory
Motor
Visceral afferent
Parasympathetic
68
Q

Where does CN IX connect with the CNS?

A

Lateral aspect of superior medulla oblongata

69
Q

What is the cranial foramina for CN IX?

A

Jugular foramen

70
Q

Where is the extra cranial part of CN IX?

A 
Descends towards pharynx and mouth
To stylopharyngeus muscle
To parotid gland
From pharyngeal mucosa
From carotid body and sinus
From posterior 1/3rd of tongue
71
Q

Where is the intracranial part of CN IX?

A

Directly towards jugular foramen in posterior cranial fossa

72
Q

Which areas does CN IX innervate in general sensory?

A 
Posterior 1/3rd of tongue
Mucosa of most of nasopharynx and oropharynx
Mucosa of some of laryngopharynx
Palatine tonsil
Eustachian tube
Middle ear cavity
73
Q

CN IX innervates what with special sensory?

A

Vallate papillae (taste buds) of posterior 1/3rd of tongue

74
Q

CN IX innervates what with visceral afferent?

A

Carotid sinus baroreceptors

Carotid body chemoreceptors

75
Q

CN IX innervates what with somatic motor?

A

Stylopharyngeus

76
Q

CN IX innervate what with parasympathetic?

A

Secretomotor to parotid gland (salivary)

77
Q

How do you clinically test CN IX?

A

Gag reflex in general sensory

Referred pain from pharynx to ear and vice versa

78
Q

What is the function and modality of CN X?

A

Vagus nerve

Sensory, motor, visceral afferent and parasympathetic

79
Q

Where does CN X connect with the CNS?

A

Lateral aspect of medulla oblongata

Immediately inferior to CN IX

80
Q

Where is the intracranial part of CN X?

A

Directly towards jugular foramen in the posterior cranial fossa

81
Q

What is the cranial foramina for CN X?

A

Jugular foramen

82
Q

Where is the extra cranial part of CN X?

A

Axons supply lots of structures between the palate and the midgut

83
Q

Which anatomical structures lie close to the CN X in the neck?

A

CN X runs within the carotid sheath

Posterior to and between the common carotid artery and internal jugular vein

84
Q

Which anatomical structures lie close to the CN X in the thorax?

A

CN X runs inferiorly into the thorax then gives off the recurrent laryngeal nerve to turn back superiorly to supply the muscles of the larynx.

85
Q

Which anatomical structures lie close to the left and right recurrent laryngeal nerves?

A 
Left= curves under arch of aorta
Right= curves under right subclavian artery
86
Q

Which anatomical structures lie close to CN X in the abdomen?

A

Both CNs X pass onto surface of stomach

Vagus nerves very last parasympathetic axons pass to the splenic flexure of the colon

87
Q

How do you clinically test CN X?

A

Ask patient to say ‘ahhhh”- muscles of palate- uvula should lift straight in the midline
Unilateral pathology will pull uvula away from non-functioning side

Ask patient to swallow water- splutter may suggest abnormal swallow

Listen to speech- hoarseness may suggest abnormal function of laryngeal muscles

3.2 Neuroanatomy (10 decks)

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