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MB3 Neurology > Cranial nerve anatomy > Flashcards

Cranial nerve anatomy Flashcards

1
Q

Foramen of CN I

A

Cribiform plate of ethmoid bone

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2
Q

Foramen of CN II

A

Optic canal

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3
Q

Foramen of CN III

A

Superior orbital fissure

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4
Q

Foramen of CN IV

A

Superior orbital fisure

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5
Q

Foramen of CN V

A

V1 - Superior orbital fissure
V2 - foramen rotundum
V3 - foramen ovale

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6
Q

Foramen of CN VI

A

Superior orbital fissure

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7
Q

Foramen of CN VII

A

Internal acoustic meatus

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8
Q

Foramen of CN VIII

A

Internal acoustic meatus

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9
Q

Foramen of CN IX

A

Jugular foramen

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10
Q

Foramen of CN X

A

Jugular foramen

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11
Q

Foramen of CN XI

A

Jugular foramen

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12
Q

Foramen of CN XII

A

Hypoglossal canal

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13
Q

Intracranial route of the trigeminal nerve?

A

Inferior to edge of tentorium cerebelli between posterior/middle cranial fossa

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14
Q

Extracranial route of the trigeminal nerve

A

Sensory axons from all 3 divisions course from superficial and deep structures posteriorly back towards respective skull formaninae
Motor of V3 from foramen ovale to skeletal muscles supplied

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15
Q

CNV1 sensory innervation

A 
Upper eyelid 
Cornea 
Conjunctiva 
Skin of foot, bridge and tip of nose 
Upper anterior nasal cavity and paranasal sinuses 
Anterior and posterior cranial fossae
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16
Q

CNV2 sensory innervation

A 
Skin of lower eyelid 
Skin over maxilla 
Ala of nose
Skin and mucosa upper lip
Maxillary teeth and soft tissues 
Floor of nasal cavity and palate 
Maxillary sinuses 
Lower posterior nasal cavity
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17
Q

CNV3 sensory innervation

A 
Skin over mandible and TMJ apart from angle of mandible 
Middle cranial fossa
Mandible 
Anterior 2/3 tongue 
Floor of mouth 
Buccal mucosa 
Mandibular teeth
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18
Q

True/false - the great auricular nerve is a branch of a division of the trigeminal nerve
Also what does it supply?

A

False - it is C2,3 nerve roots of cervical plexus

supplies skin over angle of mandible and part of ear

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19
Q

Motor innervation from trigmeninal nerve?

A 
Tensor veli palatini
tensor tympani 
masseter
temporalis 
medial/lateral pterygoid 
mylohyoid 
anterior belly digastric
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20
Q

Where is the facial nerve connected to the CNS

A

pontomedullary junction

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21
Q

describe the path of the facial nerve

A

Directly to IAM and passes through temporal bone and out SM foramen
Passes through facial canal and meets geniculate ganglion to give off GP nerve
carries through facial canal to give off chorda tympani
last remaining is all motor

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22
Q

what does most of the somatic motor supply pass through but not supply and what are the 5 branches of the facial nerve supplying motor innervation

A 
parotid gland 
to zanzibar by motor car 
Temporal 
Zygomatic 
Buccal 
Mandibular 
Cervical
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23
Q

what does the chorda tympani supply and what nerve does it connect with

A

lingual nerve of CNV3
SS ant 2/3 tongue
parasympathetic for secretomotor submandibular and sublingual glands
stapedius muscle

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24
Q

where does chorda tympani pass in relation to the middle ear cavity

A

medial to handle of malleus

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25
Q

what are th muscles of facil expression supplied by the facial nerve

A

frontalis
orbicularis oculi
elevators of lips
orbicularis oris

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26
Q

where does the glossopharyngeal nerve connect to CNS

A

lateral superior medulla oblongata

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27
Q

general sensory actions of CNIX

A 
posterior 1/3 tongue
mucosa nasopharynx and oropharynx and some to laryngopharynx 
palatine tonsil
eustachian tube 
middle ear
28
Q

special sensory actions of CNIX

A

vallate papillae to post 1/3 tongue

29
Q

visceral afferent actions of CNIX

A

carotid baroreceptoe and carotid body chemoreceptors

30
Q

parasympathetic secretomotor actions of CNIX

A

parotid gland

31
Q

somatic motor actions of CNIX

A

stylopharyngeus muscle

32
Q

where is the vagus nerve connected to CNS

A

lateral aspect medulla oblongata inferior to IX

33
Q

describe the path of the vagus nerve up to the abdomen

A

passes to jugular foramen
descends in carotid sheath and gives off branches to larynx, pharynx, cardiopulmonary plexuses
gives off recurrent laryngeal
the right lies lateral on trachea and left of the laterla aspect aortic arch

34
Q

describe the path of the vagus nerve within the abdomen

A

pass through on surface of oesophagus as a plexus and become anterior and posteiror vagal trunks in the abdominal cavity
branches to celiac and SM ganglion
gives off splenic, pancreatic, renal and foregut and midgut branches
last axons are at the splenic flexure of the colon

35
Q

sensory testing of CNV

A

patient to close eyes
touch V1 areas as upper eyelid and tip of nose
touch V2 areas as lower eyelid, cheek, upper lip and nostril
Touch V3 areas as lower lip, chin, low cheek

36
Q

motor testing CNV

A

Palpate strength and contraction of masseter and temporalis by asking patient to clench jaw
ask patient to open jaw against resistance

37
Q

testing of muscles of facial expression?

A

puff out cheeky, close eyes tight, frown, smile

38
Q

clinical testing of vagus nerve?

A

say ah - uvula should lift in midline
swallow small sip water
listen for hoarseness
assess cough

39
Q

true/false - pathology of the uvula pulls it towards the non functioning side

A

false - away from the non functioning side

40
Q

describe path and innervation of the spinal accessory nerve

A

connected to CNS by cervical spine nerve anterior rootlets
ascends through foramen magnum and exits jugular foramen
SCM and trapezius

41
Q

testing of the spinal accessory nerve

A

shrug shoulders

turn head and look up

42
Q

describe path and innervation of the hypoglossal nerve

A

via rootlets lateral to medullary pyramids
anterior to hypoglossal canal
descends in neck lateral to carotid sheath
anterior towards tongue at level of hyoid
most muscles of tongue

43
Q

testing of the hypoglossal nerve

A

stick tongue straight out

44
Q

true/false - injury to the hypoglossal nerve causes the tongue to deviate to the unaffected side

A

false - it deviates to the affected side

45
Q

describe the path of special sensory smell to the brain by CN I

A

nerves are in contact with outside world
pick up stimulus and is trnasmitted back to synapse in olfactory bulb and form olfactory tract
then directly connects with posterior inferior frontal and anteromedial temporal lobe

46
Q

function of the 3rd CN

A

motor to SR, IR, IO, MR

parasympathetic to ciliary muscle and sphincter pupillae

47
Q

describe where the origin of oculomotor nerve is

A

found in the superior colliculus of medial midbrain
oculomotor nucleus
parasympathetic supplied sy edinger westphal
pass out interpeduncular fossa to form CN 3

48
Q

describe where the origin of the trochlear nerve is

A

close to midline of midbrain at inferior colliculus
trochlear nucleus with motor
crosses midline and exits posteriorly

49
Q

describe where the origin of the abducent nerve is

A

close to midline and exits abducent nucleus at the pontomedullary junction

50
Q

describe where the origin of the hypoglossal nerve is

A

lowest part of pons and upper medulla at hypoglossal nucleus

51
Q

describe the origin and pathway of the spinal accessory nerve and its exception

A

arises from cervical spinal cord from accessory nucleus in anterior horn comes together and arcs through jugular foramen and out by the jugular foramen
accessory fibres called cranial accessory are actually part of the vagus nerve and originate from vagal nuclei

52
Q

where does the motor supply of the trigeminal nerve originate

A

trigeminal motor nucleus, close to pontine terminal nucleus

53
Q

where is the trigeminal sensory nucleus located and what sections is it split into

A

from midbrain, through pons and medulla to upper 2 segments cervical spinal cord
mesencephalic nucleus
pontine terminal nucleus
Spinal nucleus

54
Q

what trigeminal sensory info reaches the mesencephalic nucleus

A

proprioception regarding tough

55
Q

what trigmeninal sensory info reaches the pontine terminal nucleus

A

discriminative touch and vibration

56
Q

what trigeminal sensory info reaches the spinal nucleus

A

pain and temperature

57
Q

what is the ventral trigeminothalamic tract

A

connect thalamus to trigeminal nuclei and further connection to higher centres in cortex
most fibres cross midline but not all

58
Q

facial nerve, what are the nuclei associated with it and why

A

facial motor nucleus - motor to face
solitary - taste sensation
salivatory - parasympathetics
some facial axons for sensory ear arrive at spinal trigeminal nuclei

59
Q

glossopharyngeal nerve, what nuclei is it associated with and why

A

post 1/3 taste and touch arrives at solitary nucleus, and carotid baroreceptors/chemoreceptors
general sensory from pharynx and post 1/3 tongue and ear arrive spinal trigeminal nucleus
motor to stylopharyngeal originates from nucleus ambiguous
inferior salivatory provides parasympthetic

60
Q

what nuclei are associated with the vagus nerve and why

A

dorsal motor nucleus - parasympathetic
solitary nucleus receives taste and visceral info from aortic arch baroreceptors
spinal trigeminal receives sensory from ear, upper oesophagus and lower pharynx
nucleus ambiguous delivers motor info to pharynx/larynx and parasympathetic to heart

61
Q

what is arnolds reflex

A

sensory stimulation in ear leads to cough

entry of sensory ear info to spinal trigeminal being misinterpreted to solitary tract and prokoking cough

62
Q

where does input to cranial nerves with parasympathetic efferent come from

A

hypothalamus mainly

63
Q

what is the corticobulbar tract, what nerves does it implicate and where does it pass

A

part of the pyramidal tract that passes from primary motor cortex, through itnernal capsule to nuclei of CN V, VII, XI, XII

64
Q

describe the bilateral input of the corticobulbar tract and how this can demonstrate differences in bells palsy and stroke

A

input to the facial nucleus is only bilateral to the upper section of the muscles of the face
the lower part are contralaterally controlled
fully paralysis of one side of the face implicates a facial nerve palsy, but stroke of the face would only implicate the lower half of a facial palsy

65
Q

what is the reticular formation and what does it do

A 
network of cells with bodies, axons, dendrites in central core brainstem 
integrates CN reflex
conduction and modulation pain 
autonomic regulation 
basic functyion
66
Q

how does the reticular formation activate the central cortex

A

ascending reticular activating system

67
Q

a bilateral lesion of the brainstem reticular formation at or above the upper pons leads to what

A

irreversible coma

MB3 Neurology (19 decks)

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