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BMS100 Clin Phys > Clin Phys 6 > Flashcards

Clin Phys 6 Flashcards

1
Q

What are cranial nerves?

A

nerves that “emerge from the brain” and exit via skull foramina

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2
Q

What do cranial nerves carry?

A
  • special sensory info: special senses (sight, sound, taste, smell, “balance)
  • somatic motor info: somatic motor = skeletal muscles w/ voluntary control
  • somatic sensory info: somatic sensory = sensations that we can perceive OTHER THAN special senses
  • motor & sensory info to/from structures that we cannot control or perceive: ANS —> glands/organs or from organs
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3
Q

Where does CN I project to?

A

cortex

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4
Q

Where does CN II project to?

A

thalamus

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5
Q

Where are nuclei of CN III and IV found?

A

midbrain

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6
Q

Where are nuclei of CN V, VI, VII, VIII found?

A

pons

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7
Q

Where are nuclei of CN IX, X, XI, XII found?

A

mostly in the medulla

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8
Q

What is the name of CN I?

A

olfactory nerve

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9
Q

What is the function of CN I?

A

sense of smell

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10
Q

What is the pathway of CN I?

A

from superior part of nasal cavity –> olfactory bulb –> many different locations in temporal and frontal lobes

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11
Q

What is the skull entry/exit point for olfactory nerve?

A

cribriform plate (ethmoid)

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12
Q

How do we test CN I?

A

ask pt to identify a couple of distinctive smells (eyes closed if necessary) - ex., coffee, peppermint

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13
Q

What is it called if the CN I is no longer function?

A

anosmia

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14
Q

What is the name for CN II?

A

optic nerve

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15
Q

What is the function of CN II?

A

vision

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16
Q

What is the pathway of CN II?

A

from retina (back of eye) –> thalamus –> occipital lobe (cortex)

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17
Q

What is the skull entry/exit point for CN II?

A

optic foramen

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18
Q

How do we test CN II?

A
  • the Snellen eye chart (central vision)
  • Peripheral field tests (peripheral vision)
  • observation of back of the eye - retina (ophthalmoscope)
  • pupillary movements, rapid involuntary eye movements
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19
Q

What is the main function of CN III, IV, VI?

A

eye movements (somatic motor)

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20
Q

What is the name for CN III?

A

oculomotor

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21
Q

What is the name for CN IV?

A

trochlear

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22
Q

What is the name for CN VI?

A

abducens

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23
Q

What is the pathway of CN III?

A

midbrain –> muscles around the eye –> projects to pupillary muscles (dilation, constriction) & elevator palpebral superioris muscle

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24
Q

What is the specific function of CN III?

A

most eye movements and control of pupils

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25
Q

What is the pathway of CN IV?

A

midbrain –> superior oblique

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26
Q

What is the specific function of CN IV?

A

directs gaze down and outwards

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27
Q

What is the pathway of CN VI?

A

pons –> lateral rectus

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28
Q

What is the specific function of CN VI?

A

directs gaze laterally (abducts eyeball)

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29
Q

What is the entry/exit point for CN III, IV, VI?

A

superior orbital fissure

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30
Q

How do we test CN III, IV, VI?

A
  1. Ask t to “follow your finger w/ their eyes”
  2. Move your finger so that you draw a big “H” in the air in front of them
    • eyes SHOULD smoothly follow finger
  3. Shine a light into the pt’s eyes & hold an object close to pt’s eyes
    • pupils SHOULD constrict in response
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31
Q

What is the name of CN V?

A

trigeminal nerve

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32
Q

What are the 2 major functions of CN V?

A

somatic sensation and somatic motor

33
Q

What cranial nerve is in charge of sensation over the face, tongue, scalp, nasal cavity and cornea?

A

CN V

34
Q

What is the cornea?

A

clear, tough outer part of eye that overlies the iris

35
Q

What is the entry/exit point of CN V?

A

exits from pons, leaves skull through:
- superior orbital fissure: cornea, forehead, scalp, eyelids, nasal mucosa (upper face, scalp)
- foramen rotunda: face over the maxillary part of the face, including maxillary teeth (mid-face)
- foramen vale: lower jaw, proprioception for tongue (lower face, mouth - NOT TASTE)

36
Q

What cranial nerve is in charge of motor function for muscles of mastication (chewing) and some neck, middle ear muscles?

A

CN V

37
Q

What are the main muscles associated with CN V?

A

temporalis, maseters, pterygoids

38
Q

Where does CN V exit?

A

foramen ovale

39
Q

How do we test CN V?

A
  1. Sensory: sharp, dull, & light touch over the face
  2. Strength of jaw clenching & movements of jaw
40
Q

What is the name for CN VII?

A

facial nerve

41
Q

What are the 4 main functions of CN VII?

A
  1. Facial movements OTHER THAN the tongue, eye muscles, & muscles of mastication (somatic motor)
    • controls the most muscles
  2. Taste from anterior 2/3 of the tongue (taste)
  3. Autonomic motor input to glans (“autonomic” motor) - salivary & tears, nasal glands (nasal secretions)
  4. Somatic sensation from ear canal (somatic sensory)
42
Q

What is the exit/entry point for CN VII?

A

stylomastoid foramen

43
Q

What is the pathway for CN VII?

A

Exits/enters the pons —> passes through the internal acoustic meatus & facial canal, exits through the stylomastoid foramen

44
Q

How do you test CN VII?

A

ask pt to use their facial muscles

45
Q

What is the name of CN VIII?

A

vestibulocochlear

46
Q

What is the pathway of the hearing apparatus (CN VIII)?

A

Sound waves enter the ear canal –> vibration of tympanic membrane –> Movements of tiny bones in middle ear (malleus, incus, stapes) - act as levers to increase amplitude of sound –> Vibrations transmitted from stapes to cochlea within inner ear –> vibrations in cochlear fluid move hairs in the cochlea –> Hairs transduce vibrations into electrical impulses –> Electrical impulses are carried by CN VIII

47
Q

What is the function of CN VIII?

A

hearing and balance

48
Q

What is the pathway of CN VIII?

A

inner ear –> internal acoustic meatus –> pons –> thalamus and synapses in temporal lobe for perception of sound

49
Q

How do you test hearing function of CN VIII?

A
  • whisper to pt to test for auditory acuity
  • tuning forks: allows you to tell if there’s problem with the nerve or ear canal (—> ear drum —> cochlea pathway)
    • tuning forks are heard by conduction of tuning fork vibration through bones of skull
    • if you “hear” tuning fork better when it’s sending vibrations through your skull (vs. Being held up by ear) —> have problem w/ ear canal, ear drum, or tiny bones in middle ear
50
Q

How do you test balance function of CN VIII?

A
  • motion-detecting apparatus of ear feeds important info to cerebellum (vestibular apparatus)
  • IF this is COMPROMISED —> balance is impaired
  • have pt stand w/ eyes closed (falls over) or with abnormalities in gait (veers to one side)
  • nausea, rapid, involuntary eye movements (nystagmus)
51
Q

What is the entry/exit point for CN VIII?

A

internal acoustic meatus

52
Q

What is the name of CN IX?

A

glossopharyngeal

53
Q

What are the main functions of CN IX?

A
  1. Swallowing: somatic motor
  2. Sensation from pharynx, part of external ear (somatic sensory) & from chemoreceptors/ baroreceptors in carotid body (“autonomic sensory”)
  3. Taste from posterior 1/3 of tongue (special sensory)
  4. Innervation of parotid salivary gland (“autonomic motor”)
54
Q

Where does CN IX enter/exit and project to/leaves?

A

entry/exit: julgular foramen
projects to/leaves: medulla

55
Q

How do you test CN IX?

A
  • stimulate posterior aspect of pharynx (gag reflex)
  • soft palate & tongue elevate (CN X) when stimulation is detected (CN IX)
  • NOT the best*
56
Q

What is the name of CN X?

A

Vagus

57
Q

What is the main functions of CN X?

A
  • Pharyngeal muscles: swallowing (somatic motor)
  • laryngeal muscles: vocal cords (somatic motor)
  • parasympathetic nervous system input to the lungs, heart, liver, GI tract (“autonomic motor”)
    • “rest & digest” aspect of ANS
  • sensation from organs it impacts (“autonomic sensory”)
  • sensation from pharynx & external ear (“somatic sensory”)
  • sensory input from aortic baroreceptors & chemoreceptors (“autonomic sensory”)
58
Q

How do you test CN X?

A
  • listen to pt’s voice: if hoarse —> may be due to damage of vagus motor input to vocal cords
  • ask pt to say “ahhh” —> elevation of palate is part of somatic function of CN X
59
Q

What is the name of CN XI?

A

accessory

60
Q

What is the function of CN XI?

A

innervation of sternocleidomastoid & trapezius (somatic motor)

61
Q

What is the entry/exit points of CN XI?

A

entry: foramen magnum
exit: jugular foramen

62
Q

How do you test CN XI?

A
  • turning head against resistance
  • shrugging shoulders
63
Q

Which CN is not a “true” CN?

A

CN XI: accessory

64
Q

What is the name of CN XII?

A

hypoglossal

65
Q

What is the function of hypoglossal?

A

innervation of tongue
- key for speech & swallowing

66
Q

What is the pathway of CN XII?

A

exits medulla and passes through hypoglossal canal

67
Q

How do you test CN XII?

A
  • ask pt to stick out their tongue and move it slide-to-slide
  • if tongue is deviated or pt can’t follow these instructions —> DAMAGE to nerve, medulla, or motor cortex
68
Q

The special senses carried via cranial nerves will eventually project to the ___.

A

cortex

69
Q

What sensory function is the occipital lobe responsible for?

A

vision

70
Q

What sensory function is the temporal lobe responsible for?

A

sound

71
Q

What sensory function is the inferior-lateral frontal lobes responsible for?

A

taste and smell

72
Q

What are the special senses?

A

vision, smell, hearing, touch, taste

73
Q

The other senses (pain, touch, vibration, proprioception, temp) project to __-__ __.

A

post-central gyrus

74
Q

What sensory function is the dorsal column-medial lemniscal system responsible for?

A

touch, vibration, proprioception

75
Q

What sensory function is the spinothalamic tract responsible for?

A

pain and temperature

76
Q

What is the pathway of the dorsal column-medial lemniscal system?

A
  • neurons that receive sensory input (first order neuron’s) send their axons to dorsal horn (grey matter) and then project into dorsal columns (white matter)
  • these axons stay on same side until they enter medulla —> enter medulla —> synapse on another neuron
  • next neuron (second-order neuron) crosses to other side of medulla, and then synapses with another neuron in thalamus (third order neuron) —> projects to post-central gyrus
77
Q

What is the pathway of the spinothalamic tract?

A

neurons that receive sensory input (first order neurons) send their axons to the dorsal horn (grey matter) —> synapse w/ another cell in dorsal horn (second-order neuron)
- axon of second-order neuron crosses over in the grey matter —> send its axon up to the brain in the lateral & anterior white matter of spinal cord
- second-order neuron synapses w/ another neuron in the thalamus (third-order neuron) —> synapses w/ a neuron in post- central gyrus

78
Q

What are dermatomes used for?

A

testing sensation

79
Q

How do you test dermatomes?

A
  • sharp: splintered wooden tongue depressor or cotton swab
    • spinothalamic tract
  • dull or soft: cotton swab
    • dorsal column-medial lemniscal
  • vibration sense: tuning fork on bony prominence
    • dorsal column-medial lemniscal

BMS100 Clin Phys (8 decks)

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