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Anatomy 6512 > CN's V and VII > Flashcards

CN's V and VII Flashcards

1
Q

Where does CN V exit the brainstem?

A

-Middle/lateral pons

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2
Q

Where does CN VII exit the brainstem?

A

-Cerebellar-pontine angle

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3
Q

CN V:

  1. Axon type(s)
  2. CNS origin or termination
  3. Peripheral origin or termination
A
  1. Somatic sensory
  2. Spinal and main sensory nuclei, Mesencephalic nucleus
  3. Skin and deep tissues of head, dura. Muscle spindles and other mechanoreceptors
  4. Brachial motor
  5. Trigeminal motor nucleus
  6. Muscles of mastication and 2 tensor muscles
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4
Q

What are the 3 segments of the spinal trigeminal nucleus and their boundaries?

A
  1. Oral nucleus: From main sensory nucelus to pontomedullary junction
  2. Interpolar nucleus: From pontomedullary junction to obey
  3. Caudal nucleus: From obex to spinal cord
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5
Q

What does Pars Oralis receive input from?

A

-Intraoral and perioral structures

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6
Q

What is Pars interpolaris proper involved in?

A

-Activation of trigemino-autonomic reflexes

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7
Q

What fibers target Pars Caudalis?

A
  • Those mediating pain, crude touch, temp.
  • Superficial structures like oral cavity and teeth
  • Deep structures like jaw muscles and TMJ
  • Convergence may be basis for referred pain
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8
Q

What is the function of the Spinal Mesencephalic nucleus?

A

-Proprioception for jaw muscles

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9
Q

Select the correct pair.
A) Main trigeminal sensory nucleus: Posterior column- medial lemniscus system for head
B) Spinal trigeminal nucleus: Pain and temperature for head
C) Spinal trigeminal tract: Contains descending fibers from cell bodies in trigeminal ganglion
D) Spinal mesencephalic nucleus: Proprioception for jaw muscles
E) All of the pairs above are correct

A

E

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10
Q

What is the somatotopic organization of the Pars Caudalis?

A

-“Onion Peel” organization- Rostral (oral) to caudal (peripheral face)

  • V3: Dorsal V2: Middle V1: Ventral
  • Fibers from center of face end near obey
  • Fibers from back of face end in upper cervical cord
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11
Q

Describe the onion skin distribution of sensory loss.

A

-The more caudal the spinal trigeminal injury, the larger the area around the mouth that is spared of sensory loss

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12
Q

What is a syrinx?

A

-A cavity that develops in the spinal cord and extends into the brainstem. It destroys pain and temperature out laterally (in circle)

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13
Q

What types of sensory fibers are found in the pulp?

A

-70-80% are A-delta (fast pain, thermal) and C (slow pain, itch, touch)

  • 20-30% are A-beta (spindle, touch, & pressure)
  • From inferior alveolar nerves
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14
Q

Where are the heaviest projections from tooth pulp fibers located?

A
  • Trigeminal main sensory nucleus

- Pars Oralis of Trigeminal spinal nucleus

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15
Q

Describe Trigeminal Neuralgia.

A
  • Brief, episodes of excruciating pain in distribution of one (can be more, rare) division of trigeminal nerve.
  • No sensory trouble between attacks
  • Often a tactile stimulus triggers the attack
  • Due to trigeminal compression of vessel, tumor, etc.
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16
Q

What is the result in Trigeminal neuralgia if they cut nerve root or introduce a lesion in trigeminal ganglion?

A

-Loss of all tactile and pain sensation

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17
Q

What is the result in Trigeminal neuralgia if they section spinal trigeminal tract slightly caudal to obey (remove afferents to caudal nucleus)?

A
  • Tractile sensation is intact (main sensory nucleus)
  • Abolishes pain sensation over half of the face
  • High mortality rate: compromise medullary cardiovascular and respiratory centers
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18
Q

Branches of what artery are most frequently involved in cases of Trigeminal neuralgia that are due to vascular cause?

A
  • Superior cerebellar artery

* Can slide a teflon between the nerve and artery to allow separation

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19
Q

Select the true statement.
A) Trigeminal neuralgia cases due to vascular causes are often attributed to branches of the posterior cerebellar artery
B) Trigeminal neuralgia attacks are often precipitated by a tactile stimulus
C) Trigeminal neuralgia patients experience severe pain between attacks
D) The somatotopic arrangement of fibers entering the main trigeminal sensory nucleus lead to the onion-skin pattern of sensory loss
E) None of the above are true

A

B

20
Q

Where do the fibers from trigeminal mesencephalic nucleus (cell bodies) terminate and what do they sense?

A
  • Terminate in either:
  • Trigeminal motor nucleus- jaw jerk reflex
  • Supratrigeminal nucleus- chewing movements

-Sense proprioception; spindles in mastication muscles, mechanoreceptors in gums, teeth and hard palate (controls occlusal vertical dimension-distance between mandible and maxilla)

21
Q

Where are the receptors for the Trigeminal mesencephalic nucleus?

A
  • Neuromuscular spindles of mastication mm.

- Pressure/tension receptors in periodontal ligaments

22
Q

Where do the cell bodies for the Trigeminal Mesencephalic nucleus originate?

A
  • Unipolar cell bodies (pseudo unipolar neurons)

- Trigeminal mesencephalic nucelus

23
Q

Where are the mesencephalic, main sensory, and motor nucleus of the Trigeminal nerve located?

A

-Midpons

24
Q

Where does the Spinal trigeminal nucleus span from?

A

-From pons-medullary junction to the brain stem

25
Q

What type of stretch receptors are in the Muscles of mastication? Suspensory, periodontal ligaments of teeth?

A

MOM- spindles

Periodontal ligaments- Ruffini endings

26
Q

Degree of myelination in fibers and homologue of what system for Trigeminal:

  1. Mesencephalic nucleus
  2. Main sensory nucleus
  3. Spinal nucleus
A
  1. Heavily myelinated, Posterior column-ML (proprioception)
  2. Heavily myelinated, Posterior column-ML (discriminative touch)
  3. Lightly myelinated, Anterolateral
    (pain, crude touch, temperature)
27
Q

Trigeminal motor nucleus:

  1. What type of fibers
  2. Where do fibers terminate
  3. Function
  4. Results of a lesion
A
  1. Brachial Motor
  2. Muscles of mastication
  3. Jaw closure
  4. Jaw closure weakened, opened jaw will deviate TOWARD side of lesion
28
Q

What is the function of the Supratrigeminal nucleus?

A

-Pattern generator for masticatory rhythm

actually part of reticular formation

29
Q

Jaw-Jerk Reflex:

  1. Type of reflex
  2. Afferent limb
  3. Efferent limb
A
  • Downward tap of chin, stretches masseter
    1. Monosynaptic reflex
    2. Mesencephalic V neuron innervating masseter (V3)
    3. Trigeminal motor nucleus
  • This reflex is enhanced by UMN damage*
30
Q

Select the true response:
A) Cell bodies sending fibers to masseter muscle spindles are located in the mesencephalic nucleus
B) Fibers from the trigeminal ganglion synapse in the main sensory nuclei
C) Fibers from the trigeminal ganglion synapse in the spinal trigeminal nucleus
D) Fibers from the trigeminal motor nucleus innervate muscles of mastication
E) All the above are true

A

E

31
Q

Facial Somatic Sensory axons:

  1. CNS origin/ termination
  2. Peripheral origin/ termination
A
  1. Spinal trigeminal nucleus, Geniculate ganglion

2. Skin of outer ear

32
Q

Facial Visceral Sensory axons:

  1. CNS origin/ termination
  2. Peripheral origin/ termination
A
  1. Nucleus of solitary tract, Geniculate ganglion

2. Taste buds anterior 2/3 of tongues, parts of nasal cavity, soft palate

33
Q

Facial Visceral Motor axons:

  1. CNS origin/ termination
  2. Peripheral origin/ termination
A
  1. Superior salivatory nucleus, submandibular and pterygopalatine ganglia
  2. Submandibular and sublingual glands, nasal and palatine glands, lacrimal glands
34
Q

Facial Brachial Motor axons:

  1. CNS origin/ termination
  2. Peripheral origin/ termination
A
  1. Facial motor nucleus

2. Muscles of facial expression, Stapedius (arch 2)

35
Q

Facial nerve functions include.
A) Innervation of Orbicularis oculi and Orbicularis oris muscles
B) Lubrication of the cornea
C) Produce saliva from submandibular gland
D) Sensory information from skin of outer ear
E) All the above

A

E

36
Q

Results of unilateral damage to corticobulbar pathway (in cerebral peduncle) with regard to facial motor nucleus.

A

-Inability to smile or bare teeth symmetrically (contralateral loss of innervation); but ability to wrinkle forehead is unaffected (innervated bilaterally)

37
Q

What is the most common cause of acute facial nerve paralysis?

A

Bell’s Palsy

38
Q

Symptoms of Bell’s Palsy.

A
  • Paresis of facial muscles above & below eye
  • Irritation of cornea
  • Often, affected eye cannot be closed
  • Hyperacusis (stapedius)
  • Reduced lacrimation and salivation
39
Q

What is the Corneal blink reflex? Afferent limb? Efferent limb? Test for?

A
  • Touch cornea and both eyes blink
  • Afferent limb: V1 to Spinal trigeminal tract
  • Efferent limb: VII elicited by bilateral projection from spinalV nucleus/reticular formation
  • Clinical test for V, VII and central connections
40
Q

Blink to light reflex:

  1. Receptor
  2. Afferent
  3. 1st synapse
  4. 2nd synapse
  5. Muscle
A
  1. Retina
  2. Optic Nerve
  3. Superior colliculus
  4. Facial nucleus
  5. Orbicularis Oculi
41
Q

Blink to noise reflex:

  1. Receptor
  2. Afferent
  3. 1st synapse
  4. 2nd synapse
  5. Muscle
A
  1. Cochlea
  2. Cochlear nucleus
  3. Inferior Colliculus
  4. Facial nucleus
  5. Orbicularis Oculi
42
Q

Sound attenuation relfex:

  1. Receptor
  2. Afferent
  3. 1st synapse
  4. 2nd synapse
  5. Muscle
A
  1. Cochlea
  2. Cochlear nucleus
  3. Superior olivary nucleus (pons)
  4. Facial nucleus
  5. Stapedius
43
Q

Select the correct pair.
A) The afferent limb of the jaw-jerk reflex is mesencephalic fibers; the efferent limb is motor of VII
B) The afferent limb of the blink to light reflex is cranial nerve II; the efferent limb is oculomotor nerve
C) The afferent limb of the sound attenuation reflex is the cochlear nucleus; the efferent limb is motor VII
D) The afferent limb of the jaw closing reflex is V; the efferent limb is VII
E) All of the above are correct pairs

A

C

44
Q

What is flavor due to?

A
  • Direct chemical stimulation of taste buds
  • Olfactory receptors respond to food vapors
  • Chemosensitive and somatosensory free nerve endings of VII (IX &X) in mucous membranes of oral cavity (response to temp. spiciness, texture of food)
45
Q

The average tongue has how many taste buds?

A

5,000

46
Q

When does Nervus Intermedius begin to align with CN VII?

A

-Distal to genu

47
Q

All input for taste goes to what nucleus?

A

-Nucleus of Solitary tract

Anatomy 6512 (9 decks)

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