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Brainstem And Cranial Nerves Flashcards

1
Q

Brainstem contains nuclie controlling…

A 
CN 
LOC
Cerebellar circuits
Muscle tone
Posture
CP
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2
Q

Midbrain rectus

A

Superior colliculus

Inferior colliculus

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3
Q

Floor of 4th ventricle

A

Facial colliculus

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4
Q

CN IV on brainstem

A

Exits dorsally

Travels laterally around midbrain

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5
Q

CN I olfactory nerve pathway

A

Special chemoreceptors detect odor —> axons via short olfactory nerves through cribiform plate —> synapse on olfactory bulb—> sensory info relayed vial olfactory tracts to primary olfactory cortex in temp lobe

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6
Q

CN I Anosmia

A

Los of olfaction

Unilateral - not noticeable because compensation

Bilateral - c/o decreased tasted

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7
Q

CN I anosmia casued by

A 
Head trauma
Viral infection
Nasal obstruction 
Neurodegenerative disease
Intracranial lesion at base of frontal lobe
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8
Q

CN II pathway

A

Optic nerve

Carries visual info form retinal to LGN to extrageniculate pathways and PVS

Optic nerve - anterior to chiasm
Optic tract - posterior to chiasm

Travels from orbit to intracranial vanity via optic canal

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9
Q

Control of extraocular muscles

A

CN III
CN IV
CN VI

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10
Q

CN III extraocular

A

Levator palpebrae superior (elevates eyelid)

PS fibers - pupillary constrictor muscles, ciliary muscles (near vision)

All other extraocular muscles besides LR and SO

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11
Q

CN IV extraocular

A

Superior oblique

Intorsion and depression

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12
Q

CN VI extraocular

A

Lateral rectus (abduction)

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13
Q

CN III course

A

Exits centrally at interprendulcar fossa —> preganglionic PS synapse in ciliary ganglion in orbit —> postganglionic PS continue to pupillary constrictor muscles and ciliary muscles of lens in orbit

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14
Q

CN IV exits

A

Dorsally at inferior tectum

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15
Q

CN VI exits

A

Centrally at pontomedullary junction

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16
Q

CN V facial sensation

A

Touch, pain, temp, joint position, vibration

Face, mouth, ant 2/3 tongue, nasal sinuses, cornea, meninges

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17
Q

CN V muscles of mastication

A

Just know they’ve innervates by this

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18
Q

Major branches of CN V

A

Ophthalmic division V1
Maxillary division V2
Mandibular division V3

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19
Q

CN V nuclei are primarily in

20
Q

CN V course

A

Exits ventrolateral pons and then enters small fossa

Ophthalmic division - enters cavernous sinus to texit at superior orbital fissue

Maxillary division - exits via foramen rotundum

Mandibular division - exits via foramen ovale

21
Q

CN V incoming sensory info synapses - mesensephalic trigeminal nucleus

A

In midbrain

Proprioception
Jaw jerk reflex
Cross and ascend via msesncephalic trigeminal tract

22
Q

CN V incoming sensory info synapses - chief trigeminal sensory nurcleus

A

In pons

Fine/discriminative touch and dental pressures

Cross and ascend via trigeminal leminisucus —> VPM—> PSC

23
Q

CN V incoming sensory info synapses - spinal trigeminal nucleus

A

In pons and medulla

Pain, temp, crude touch

Cross and ascend via trigeminothalamic tract —> VPM —> PSC

24
Q

CN V motor fx

A

UMN control to CN motor nucleus is bilateral

25
Unilateral lesion to cortex or corticobulbar tract
No deficit in jaw movement
26
Lesion to LMN CN V
Ipsilateral jaw weakness | Deviation toward side of lesion (weak side)
27
Trigeminal neuralgia
** most common CN V disorder Brief severe pain lasting from seconds to a few minutes Cause is unknown • Most often in V2 or V3 sensory distribution • Painful episodes triggered by chewing, shaving, etc. •Facial sensation is normal on exam • Initial treatment is with medications
28
Lesion to the nerve of CN V sensor nucleus
Ipsilateral loss of facial sensations (primary sensory fibers do not cross before entering the nucleus)
29
Lesion to ascending tracts (CN V) or face area of PSC
Contralateral loss of facial sensation (fibers cross after exiting the nucleus)
30
Jaw jerk reflex
CN V Tap on the chin with the mouth slightly open • The reflex is minimal or absent in normal individuals • The response is the jaw jerking slightly forward or absence of movement • Bilateral UMN lesions could cause hyperactive (brisk) jaw jerk reflex
31
Monosynpatic pathway CN V
Sensory axons heading to the mesencephalic trigeminal nucleus also send axons to synapse on the trigeminal motor nucleus • Motor axons from trigeminal motor nucleus travel via V3 to the muscles of mastication
32
CN VII: muscles
Of facial expression
33
CN VII PS fibers
Lacrimal glands and salivary glands
34
CV NII taste
Ant 2/3 of tongue
35
CN VII sensation
Small area near external auditory meatus
36
CN VII nucleus
In lower pons Fibers loop dorsally around CN VI nucleus at floor of 4th ventricle to form facial colliculus
37
CN VII pathway
Course of CN VII: Nerve exits brainstem ventrolaterally at the pontomedullary junction in a region called the cerebellopontine angle Enters internal auditory meatus to travel in auditory canal along with CN VIII CN VII turns inferior to enter the facial canal and travels to the stylomastoid foramen to exit the skull • Geniculate ganglion are located where CN VII turns (primary sensory neurons for taste and sensation) Divides into five major branches to control muscles of facial expression
38
CN VII decides into
Temporal, zygomatic, buccal, mandibular, and cervical branches
39
Two branches of CN VII form superior salivatory nucleus
Greater petrosal nerve | Chorda tympani
40
CN VII taste
anterior 2/3 of tongue • Primary sensory neurons synapse in nucleus solitarius (gustatory nucleus) (green) • Ascend via Central tegmental tract- > VPM -> Cortical taste area (PSC, fronto-parietal operculum, and insula) • Taste projects to bilateral cortical taste areas
41
Lesion to ipsilateral CN VII
Cause weakness of the ispislateral half of face
42
CN VII UMN facial weakness
LMNs to forehead and eye muscles get bilateral innervation from cortex (red UMNs- A) LMNs to muscles below eye get contralateral innervation only from cortex (purple UMNs- A)
43
Lesion to contralateral PMC cause 9CN VII)
LMNs to forehead and eye muscles get bilateral innervation from cortex (red UMNs- A) LMNs to muscles below eye get contralateral innervation only from cortex (purple UMNs- A)
44
Bell’s palsy
Most common CN VII disorder Unilateral facial weakness of the LMN type • Severe cases- eye will not close, loss of salivation, lacrimation, and taste from ipsilateral anterior 2/3 of the tongue • Cause unknown, can be from viral, inflammatory, or immune disorder • 80% recover neural control of facial muscles within 3 weeks-2 months • Recommended treatment is 10 days of oral steroids after onset
45
CN VII corneal reflex
Afferent- Sensation to the cornea of the eye is from CN V • Efferent- Innervation to facial muscles is from CN VII (including obicularis oculi) • Eye closure in response to lightly touching the cornea

Neuro Anatomy (22 decks)

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