Brainstem & Cranial Nerves Flashcards
1
Q
CN III passes in the interpeduncular fossa between these two arteries
A
PCA and SCA
2
Q
This cranial nerve may be affected by aneurysm of Posterior communicating artery
A
CN III
3
Q
Uncal herniation affects this cranial nerve
A
CN III
4
Q
Type of fibers of CN III that are initially involved during compression
A
Parasympathetic fibers
5
Q
In CN III, do parasympathetic or somatomotor fibers utilize ciliary ganglion and are situated peripherally?
A
Parasympathetic
6
Q
In CN III, are parasympathetic or somatomotor fibers located centrally?
A
Somatomotor
7
Q
Type of fibers in CN III that are initially affected by ischemia
A
Somatomotor
8
Q
CN III is in the midbrain at the level of this
A
Superior colliculus
9
Q
Nucleus of CN III that supplies the preganglionic parasympathetic innervation
A
Edinger-Westphal (GVE)
10
Q
Most CN III motor neurons project ipsilaterally, with the exception of this muscle, which receives contralateral innervation
A
Superior rectus
11
Q
Most CN III motor neurons project ipsilaterally, with the exception of this muscle, which has neurons distributed to both sides of the brain (bilateral distribution)
A
Levator palpebrae superioris (LPS)
12
Q
Complete palsy of this nerve results in an eye that is down and out
A
CN III
13
Q
Pupil that is fixed and dilated with loss of accommodation results when parasympathetic fibers of this nerve are involved
A
CN III
14
Q
Ischemia preferentially affects this type of fibers of CN III
A
Somatic motor
15
Q
Compression lesions affect this type of fibers of CN III
A
Parasympathetic
16
Q
A transtentorial herniation results in increased pressure that forces the uncus to compress this nerve
A
CN III
17
Q
This cranial nerve is affected in a transtentorial herniation
A
CN III
18
Q
Diabetes mellitus most commonly affects this cranial nerve
A
CN III
(spares pupilloconstrictors)
19
Q
CN IV nucleus is in the midbrain at the level of this
A
Inferior colliculus
20
Q
CN IV decussates in this location
A
Superior (anterior) medullary velum
21
Q
CN IV exits the contralateral side of this part of the midbrain
A
Dorsal
22
Q
CN IV innervates this muscle
A
Superior oblique muscle
23
Q
Complete palsy of this cranial nerve results in vertical strabismus, with the eye deviated upward and slightly inward
A
CN IV
24
Q
Lesion to this cranial nerve results in vertical diplopia maximum on downward gaze, resulting in difficulty going downstairs and reading
A
CN IV
25
A patient who tilts their head to the contralateral side of the paretic muscle to decrease diplopia may have lesion to this cranial nerve
CN IV
26
Abducens nucleus is in the dorsal pontine tegmentum at the level of this
Lower pons
27
CN VI emerges at this junction near midline
Pontomedullary junction
28
CN VI nucleus underlies this
Facial colliculus (elevated area on the floor of the 4th ventricle)
29
This cranial nerve nucleus underlies the facial colliculus (of the floor of the 4th ventricle)
CN VI
30
Lesion of this cranial nerve causes impaired ipsilateral lateral gaze
CN VI
31
Patients with unilateral palsy of this nerve have horizontal diplopia, worse in the direction of the paretic LR muscle
CN VI
32
A peripheral lesion of this cranial nerve causes impaired lateral gaze (= horizontal diplopia)
Ex: right side lesion of nerve impairs rightward gaze of right eye only
CN VI
33
A nuclear lesion of this cranial nerve impairs ipsilateral gaze of both eyes
Ex: right-sided lesion of nucleus impairs rightward gaze of both eyes
CN VI
34
Caudal basilar pontine lesion causes this
Alternating hemiplegia
35
The abducens nuclear complex contains interneurons projecting via this tract, to the contralateral oculomotor nucleus (innervating the contralateral middle rectus muscle)
Medial longitudinal fasciculus (MLF)
36
The abducens nuclear complex contains interneurons projecting via the medial longitudinal fasciculus, to the contralateral oculomotor nucleus (innervating this muscle)
Contralateral middle rectus muscle
37
Syndrome where unilateral pontine lesion may result in a loss of medial and lateral voluntary eye movement on the side of the lesion and a loss of medial horizontal eye movement on the contralateral side
One and a half syndrome
38
A unilateral pontine lesion may result in this syndrome involving CN VI
One and a half syndrome
39
These 5 cranial nerves lie on the lateral wall of the cavernous sinus
CN III, IV, VI, and V1 and V2
40
This cranial nerve is adjacent to the cavernous portion of the internal carotid artery, making it vulnerable to aneurysm
CN VI
41
CN VI is vulnerable to aneurysm to this artery
Internal carotid
42
This cranial nerve is vulnerable to aneurysm of internal carotid artery
CN VI
43
This cranial nerve does not enter the cavernous sinus but rather leaves the cranial base through the foramen ovale
CN V3
44
This describes the large sensory root of CN V
Portio major
45
This describes the smaller motor root of CN V
Portio minor
46
CN V1 enters the orbit through this
Superior orbital fissure
47
This branch of CN V supplies the orbit and upper face
CN V1
48
CN V2 passes through this
Foramen rotundum
49
This branch of CN V provides sensory supply to midface and upper teeth
CN V2
50
CN V3 passes through this
Foramen ovale
51
Branch of CN V that supplies sensory to lower face, lower teeth, and anterior 2/3 of tongue, as well as motor to muscles of mastication
CN V3
52
What is the function of the CN V chief sensory nucleus?
Discriminative touch, vibration, conscious proprioception
53
Which CN V nucleus is responsible for Discriminative touch, vibration, conscious proprioception?
Chief sensory nucleus
54
Where is the CN V chief sensory nucleus located?
In the pons
55
What is the function of the CN V spinal nucleus?
Pain and temperature
56
Which CN V nucleus is responsible for pain and temperature?
Spinal nucleus
57
The CN V spinal nucleus extends caudally from the pons to this level
C2 spinal segment
58
CN V spinal nucleus merges with this
Substantia gelatinosa
59
This nucleus merges with the substantia gelatinosa
CN V spinal nucleus
60
The spinal nucleus receives input from these 4 cranial nerves
CN V, VII, IX, and X
61
Onion-skin pattern of facial sensory loss may occur when this nerve is affected
CN V (spinal nucleus)
62
The CN V mesencephalic nucleus extends from pons cranially to this
Superior colliculus in midbrain
63
The CN V mesencephalic nucleus extends from this cranially to the superior colliculus in midbrain
Pons
64
Nucleus of CN V that contains primary sensory neurons involved in proprioception of masticatory muscles and TMJ
Mesencephalic nucleus
65
What is the function of the CN V Mesencephalic nucleus?
Primary sensory involved in proprioception (of masticatory muscles and TMJ)
66
Nucleus of CN V that provides sensory for jaw jerk
Mesencephalic nucleus
67
What nucleus provides sensory for jaw jerk?
CN V Mesencephalic nucleus
68
Nucleus of CN V that provides motor for jaw jerk
Motor nucleus
69
Lesions to this cranial nerve result in the jaw deviating to the paralyzed side when opened
Due to lack of contraction of ipsilateral masticatory muscles
CN V
70
Partial deafness to low-pitched sounds
Hypacusis
71
Hypacusis due to paralysis of tensor tympani can occur with lesion to this cranial nerve
CN V
72
Bilateral loss of corneal reflex occurs due to lesion of this cranial nerve
CN V
73
CN VII axons loop around this, forming the genu of the facial nerve and facial colliculus
CN VI nucleus
74
What forms the genu of the facial nerve?
CN VII axons looping around the CN VI nucleus
(facial colliculus is formed by this genu)
75
After emerging from the pons, the motor division and nervus intermedius of CN VII enter this
The internal acoustic canal (in petrous temporal bone)
76
Is central facial palsy caused by a UMN or LMN lesion?
UMN
Affects the muscles of contralateral lower face
77
Does central facial palsy (supra-nuclear palsy) affect the muscles of the ipsilateral or contralateral lower face?
Contralateral
78
Is Bell's palsy an UMN or LMN lesion?
LMN
Flaccid paralysis of the ipsilateral muscles of facial expression
79
Is Bell's palsy a flaccid paralysis of the ipsilateral or contralateral muscles of facial expression?
Ipsilateral
80
UMN lesion of CN VII affecting the muscles of contralateral lower face
Central facial palsy
81
Flaccid paralysis of the ipsilateral muscles of facial expression due to LMN lesion to CN VII
Bell's palsy
82
Lesion to this cranial nerve causes loss of taste from the anterior 2/3 of the tongue
CN VII
83
Hyperacusis occurs in CN VII lesion due to paralysis of this
Stapedius
84
Hyperacusis due to stapedius paralysis occurs after lesion to this cranial nerve
CN VII
85
Paroxysmal otalgia attributed to vascular (usually AICA) compression of nervus intermedius of CN VII
Geniculate neuralgia
86
Geniculate neuralgia is paroxysmal otalgia attributed to vascular (usually AICA) compression of this
Nervus intermedius of CN VII
87
Geniculate neuralgia is paroxysmal otalgia compression of nervus intermedius of CN VI by this
Vascular - usually anterior inferior cerebellar artery (AICA)
88
What artery usually causes Geniculate neuralgia?
Anterior inferior cerebellar artery (AICA)
89
Geniculate neuralgia is paroxysmal otalgia attributed to vascular (usually AICA) compression of this component of CN VII
Nervus intermedius
90
Geniculate neuralgia is paroxysmal otalgia attributed to vascular (usually AICA) compression of nervus intermedius, a component of this cranial nerve
CN VII
91
Condition where lacrimation occurs during eating due to a CN VII lesion proximal to the geniculate ganglion
Crocodile tear syndrome
92
Crocodile tear syndrome is when lacrimation occurs during eating due to a lesion to this
CN VII (proximal to the geniculate ganglion)
93
Crocodile tear syndrome is when lacrimation occurs during eating due to a lesion to CN VII proximal to this
Geniculate ganglion
94
This is responsible for the afferent corneal reflex
CN V principal sensory nucleus
95
This is responsible for the efferent corneal reflex
CN VII motor nucleus
96
Lesion to this cranial nerve results in both direct and indirect (bilateral) corneal reflex loss
CN V
97
Lesion to this cranial nerve results in unilateral abolition of corneal reflux
CN VII
98
CN IX leaves the medulla at this
Postolivary sulcus
99
CN IX sends off this branch before exiting the skull through the jugular foramen
Tympanic branch to middle ear
100
Parasympathetic preganglionic fibers from this in the rostral medulla travel with CN IX and join the tympanic nerve to enter the tympanic plexus (no synapse here), from which the lesser petrosal nerve (LPN) arises
Salivatory nucleus
101
Parasympathetic preganglionic fibers from inferior salivatory nucleus in rostral medulla travel with CN IX and join this nerve to enter the tympanic plexus (no synapse here), from which the lesser petrosal nerve (LPN) arises
Tympanic nerve
102
Parasympathetic preganglionic fibers from inferior salivatory nucleus in rostral medulla travel with CN IX and join the tympanic nerve to enter the tympanic plexus (no synapse here), from which this nerve arises
Lesser petrosal nerve
103
Lesser petrosal nerve is a branch of CN IX that reenters cranium through a small canal in petrous temporal bone, then travels back out through foramen ovale to synapse in this
Optic ganglion
104
Lesser petrosal nerve is a branch of this
CN IX
105
Postganglionic fibers of CN IX travel with this nerve branch from CN V3 to parotid gland to cause salivation
Auriculotemporal nerve
106
Unilateral UMN lesions of this cranial nerve cause no deficit as there is bilateral corticobulbar innervation of the nucleus ambiguus
CN IX
107
Lesion to this cranial nerve causes ipsilateral loss of sensation over soft palate, posterior one third of tongue, and nasopharynx; loss of tase from posterior tongue
CN IX
108
Condition causing paroxymsal excruciating otalgia, often associated with swallowing, coughing, chewing, yawning
Most commonly due to vascular compression by PICA
Glossopharyngeal neuralgia
109
Glossopharyngeal neuralgia is most commonly due to vascular compression by this artery
PICA
110
This is a well documented complication of parotid surgery and is also known as auriculotemporal syndrome
Frey's syndrome
111
Loss of palatal reflex occurs due to lesion of this cranial nerve
CN IX
112
Does this describe nuclear or supranuclear palsy to CN X:
unilateral vagal injury may result in failure of palatal elevation, uvular deviation away from the lesion, dysphagia, dysarthria, vocal cord paralysis with hoarseness, and dysphonia
Nuclear
113
Does this describe nuclear or supranuclear palsy to CN X:
If unilateral, no or minor deficit (bilateral corticobulbar input to nucleus ambiguus)
Supranuclear
114
Uvula deviation away from the lesion is caused by lesion to this cranial nerve
CN X (nuclear lesion)
115
Vocal cord paralysis with hoarseness is seen in lesion to this cranial nerve
CN X (nuclear lesion)
116
Bilateral UMN or LMN lesions may result in severe dysfunction of CN IX and X and associated severe dysphagia?
UMN
117
Bilateral UMN lesions may result in severe dysfunction of CN IX and X, and this distinct syndrome characterized by severe dysphagia, spastic dysarthria, and loss of emotional control with pathologic crying
Pseudobulbar palsy
118
Cranial nerve that provides afferent to GAG reflex
CN IX (to caudal nucleus solitarius)
119
Cranial nerve that provides efferent to GAG reflex
CN X (to pharyngeal muscles)
120
Aortic aneurysms and tumors of the neck and thorax frequently compress this cranial nerve
CN X
121
Does a nuclear or supranuclear lesion to CN XI cause ipsilateral SCM and trapezius palsy?
Nuclear
122
Does a nuclear or supranuclear lesion to CN XI cause ipsilateral SCM and contralateral trapezius palsy?
Supranuclear
123
Does nuclear CN XI lesion cause ipsilateral or contralateral SCM and trapezius palsy?
Ipsilateral (for both muscles)
124
Does supranuclear CN XI lesion cause ipsilateral or contralateral SCM and trapezius palsy?
Ipsilateral SCM
Contralateral trapezius
125
CN XII emerges from the medulla at this
Pre-olivary (anterior lateral) sulcus
126
Cranial nerve that supplies all the intrinsic muscles of the tongue and all of the extrinsic muscles of the tongue except palatoglossus
CN XII
127
Does this describe a nuclear or supranuclear lesion to CN XII:
tongue deviates toward the opposite side of the lesion; spastic
Supranuclear
128
Does this describe a nuclear or supranuclear lesion to CN XII:
tongue deviates toward same side of lesion; fasciculation and atrophy
Nuclear
129
In a nuclear CN XII lesion, which way does the tongue deviate?
Towards same side as lesion
130
In a supranuclear CN XII lesion, which way does the tongue deviate?
Towards the opposite side of the lesion
