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Anatomy Week 16 > Cranial Nerve Review > Flashcards

Cranial Nerve Review Flashcards

1
Q

What are the parasympathetic targets in the head?

A
  • Constrictor Pupillae m.
  • Ciliary Smooth m.
  • Salivary Glands (submandibular, parotid, sublingual, minor salivary)
  • Lacrimal Glands
  • Mucous glands (nasal cavity and hard palate)
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2
Q

What 3 cranial nn. carry parasympathetic fibers destined for the head?

A

3, 7, 10 (Vagus does parasympathetic below the head)

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3
Q

What are the 4 terminal motor ganglia of the head?

- Nerves associated?

A

C3 - Ciliary
O9 - Otic
P7 - Pterygopalatine
S7 - Submandibular

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4
Q

How do parasympathetic postganglionics in the head generally reach their targets?

A
  • Hitchhike on one of the 3 divisions of trigeminal n.

note: In V3, lingual has both pre and post ganglionic fibers riding along

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5
Q

CN III:
Preganglionic - Cell Bodies, Fibers?
Postgaglionic - Cell Bodies, Fibers?

A

Preganglionic:

  • Cell bodies = Midbrain
  • Fibers = CN III (lower?)

Postganglionic:

  • Cell bodies = Ciliary Ganglia
  • Fibers = Ciliary Nn. (short?)
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6
Q

What are the targets of CN III?

A

Eyeball:

  • Ciliary mm.
  • Contrictor pupillae
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7
Q

CN VII:
Preganglionic - Cell Bodies, Fibers?
Postgaglionic - Cell Bodies, Fibers?

A

Preganglionic:

  • Cell bodies (1) = Pons
  • Fibers (1) = Greater Petrosal n.
  • Cell bodies (2) = Pons
  • Fibers (2) = Chorda Tympani n., Lingual n. (V3)

Postganglionic:

  • Cell bodies (1) = Pterygopalatine ganglion
  • Fibers (1) = Travel with V2 branches
  • Cell bodies (2) = Submandibular ganglion
  • Fibers (2) = Lingual n. (V3)
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8
Q

CN VII main targets?

A

Greater Petrosal = Lacrimal Gland

Chorda Tympani = Submandibular and Salivary Glands

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9
Q

CN IX:
Preganglionic - Cell Bodies, Fibers?
Postgaglionic - Cell Bodies, Fibers?

A

Preganglionic:

  • Cell bodies = Medulla
  • Fibers = Tympanic n. –> Lesser petrosal n.

Postganglionic:

  • Cell bodies = Otic Ganglion
  • Fibers = Auriculotemporal n. (V3)
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10
Q

CN IX main parasympathetic target?

A

Parotid Gland

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11
Q

What fiber types are carried by the chorda tympani n.?

A
  • GVE: PREganglionic PARAsympathetic

- SA: Taste fibers

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12
Q

Where do Chorda Tympani Taste fibers go?

A
  • Anterior 2/3 of the tongue
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13
Q

In what space does Chorda Tympani join the lingual n.?

A
  • Infratemporal Fossa
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14
Q

Describe the path of Chorda Tympani GVE fibers

A

GVE:
- Bypass Geniculate in Facial Canal (btwn IAM and EAM)
- Pass out into middle ear:
Medial side of Tympanic membrane over malleous
- Exits via Petrotympanic Fissure

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15
Q

Where are the POSTganglionic sympathetics found that complement the parasympathetic functions of Chorda Tympani (CN VII)?

A

Hitchhike via Facial a., Lingual a.

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16
Q

Path of tympanic n.?

- Continuous with?

A
  1. Through Jugular Foramen
  2. Back up through Tympanic Canaliculis (btwn JF and CC)
  3. Leaves middle ear to become the lesser petrosal n.
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17
Q

Path of Lesser Petrosal n.?

- Terminates where?

A
  • out of HLPN
  • along GLPN
  • THROUGH Forament Ovale
  • Terminates in Otic Ganglion
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18
Q

What is the major functional different between the tympanic n. and the lesser petrosal n.?

A

Tympanic = GSA AND GVE

Lesser Petrosal = GVE ONLY

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19
Q

What preganglionic fiber innervates the lacrimal gland?

A
  • Greater Petrosal n. (CN VII)
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20
Q

T or F: all branches of CN VII must enter through IAM

A

True

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21
Q

Describe the path of the greater petrosal n.

A
  • Exits Facial Cavity via HGPN
  • Travels in GGPN
  • Join Deep PN
  • Enters Pterygoid Canal
  • Terminates in PP ganglion
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22
Q

What fibers do Postganglionics of the greater petrosal n. (CN VII) travel on to get to their targets?
- Be specific

A
  • Zygomatic (V2, GSA)

- Lacrimal (V1, GSA)

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23
Q

T or F: the greater petrosal n. only carries preganglionic GVE fibers.

A

FALSE, carries SA taste fibers to the soft palate too

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24
Q

What is the major functional difference between the greater petrosal n. and the nerve of the pterygoid canal?

A
  • Greater Petrosal = GVE (parasymp, Pregang.) and SA (taste)

- N. of Pterygoid Canal = GVE (SYMPATHETIC POSTgang.; parasymp, Pregang.) and SA (taste)

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25
Q

Most Postganglionic Sympathetic fibers reach targets in the head via branches of the carotid, what are 2 exceptions to this rule?

A
  1. Sympathetics in Deep PN and N. of Pterygoid Canal

2. Short and Long ciliary nn.

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26
Q

Where do Preganglionic Fibers traveling to the Ciliary Ganglia exit the skull?

A
  • Superior Orbital Fissure
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27
Q

What branch from CN III conducts ONLY parasympathetic fibers to the ciliary ganglia?

A
  • Parasympathetic Motor Root of CN III
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28
Q

What POSTganglionic Fibers carry info to the Globe?

- Are Parasympathetic fibers the only fibers?

A

Short Ciliary n.

Fiber Types:
- POSTganglionic sympathetic and parasympathetic

  • GSA fibers
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29
Q

What are the SYMPATHETIC targets in the head?

A 
Sweat Glands
Vascular Smooth mm. 
2 Smooth mm. of the eye:
1. Superior Tarsal m. 
2. Dilator Pupillae m.
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30
Q

Where are the PRE and POST ganglionic cell bodies for the parasympathetics in the head?

A

PREganglionic Cell bodies:
- Lateral Horn of Spinal Cord Gray Matter (T1 and T2)

POSTganglionic Cell bodies:
- Superior Cervical Ganglion

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31
Q

What cranial nn. are purely sensory?

A

1, 2, and 8

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32
Q

CN I:

  • ganglion
  • Exits Skull via??
  • function
A

NO associated ganglion

Exits via:
- Cribiform Foramina

Function:
- SA (olfaction)

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33
Q

CN II:

  • ganglion
  • Exits Skull via??
  • function
A

NO associated ganglion

Exits via:
- Optic Canal

Function:
- Sight

34
Q

CN VIII:

  • ganglion
  • Exits Skull via??
  • Function
A

Spiral and Vesibular Ganglia

Exits via:
- External Acoustic Meatus

Function:
- Audition/Equilbrium

35
Q

What cranial n are purely motor?

A

3, 4, 6, 11, 12

36
Q

CN IV:

  • Exits skull via?
  • Muscle Innervated?
A

Superior Orbital Fissue

Innervates Superior Oblique

37
Q

CN IV lesion:

  • symptoms?
  • Test?
A

Weakness in:

  • Depression
  • Adduction??
  • Intorsion

Test:
- Look Medially and Down

38
Q

CN VI:

  • Exits skull via?
  • Muscle Innervated?
A

Superior Orbital Fissure

Muscle: Lateral Rectus

39
Q

CN VI Lesion:

  • Syptoms?
  • test?
A

Weakness:
- Abduction

Test:
- Look laterally

40
Q

You encounter a patient whose eye do not dilate in the absence of light. What nerve is responsible for this finding?
- Cell body location?

A

This is a loss of sympathetic tone

  • Postganglionic cell bodies = Superior Cervical Ganglion
  • Preganglionic cell bodies = T1 and T2 lateral Horn

NOTE: Sympathetics travel to dilator pupillae muscle via long and short ciliary nn.

41
Q

You tell a patient to keep their eyes closed while you try to pull it open. What cranial nn. are you testing?

A
  • Motor Branches of Facial n. (VII)

Note: Closing the eye/keeping the eye closed is a facial n. function

42
Q

You test a patient for the gag reflex and it is absent, what two nerves could possibly be at fault?
- how to differentiate

A

No Gag Reflex:

  • Glossopharyngeal (IX) = afferent
  • Vagus (X) = Efferent

Differentiate with Uvula Deviation Test (say Ahh)

43
Q

What are the contents of the cavernous sinus?

A

Lateral Wall:
CNs: III, IV, V1, V2

Middle of Cavernous:
CN VI
Opthalmic Artery

44
Q

In what area would a tumor result in BOTH loss of Balance AND Facial expression?

A

Internal Acoustic Meatus

45
Q

What structures are located medially and superiorly to the cavernous sinus?

A
  • Optic Chiasm

- Pituitary

46
Q

CN XI:

  • How does it get to and exit the skull
  • What is its function
  • Fiber type
A

Fiber Type = GSE ONLY

Function - SCM and Trapezuis

Enters Skull via Foramen Magnum
Exits Skull via Jugular Foramen

47
Q

How would a lesion in CN XI present?

- test

A
  • Shoulder Drooping or Inability to Flex or Rotate the Neck ON AFFECTED SIDE

Test: Have the patient elevate shoulders against force

48
Q

Where could you find CN XI in the body?

A
  • Deep to upper ~1/3 of SCM

- Deep to Trapezius

49
Q

Describe the path of CN XII relative to:

  • Digastric m.
  • Hyoglossus m.
A

Digastric:
- Deep to the digastric near its inferior tendon

Hyoglossus:
Enters submandibular triangle on the external surface of hyoglossus

50
Q

What is innervated by CN XII?

- how to test for lesion?

A

ALL of intrinsic tongue mm.
3/4 Extrinsic tongue mm. (except palatoglossus - X)

Ask patient to stick tongue out in order to test

51
Q

CN III

  • Fiber types
  • 2 branches
  • Function
A

Fiber type: GSE, GVE

Superior and Inferior

Function:
Superior - Levator Palpebrae, Superior Rectus
Inferior - Lower Rectus, Medial Rectus, Inferior Oblique

52
Q

CN III

  • Symptoms
  • tests
A

GVE symptoms:
- Dilated pupil

GSE:

  • SEVERE Ptosis
  • Diplopia (double vision)
  • External Stabismus (eye moves down and laterally)

Test:
Most commonly = pupillary Light Reflex

53
Q

V1 (ophthalmic)

  • Associated foramen/fissure
  • Main Branches (3)
  • Function (GSA, GVE etc.)
  • GSA, etc?
A

Superior Orbital Fissure

Branches:

  • Nasociliary
  • Frontal
  • Lacrimal

Function (GSA):
- Skin on Forehead and Scalp

54
Q

V2 (maxillary)

  • Associated foramen/fissure
  • Main Branches (8)
  • Function
  • GSA, etc?
A

Foramen Rotundum

Branches:

  • Zygomatic
  • Infraorbital
  • Posterior Superior Alveolar
  • Greater Palatine
  • Lesser Palatine
  • Nasopalatine
  • Lateral Nasal Branches
  • Pharyngeal

Function (GSA):

  • Maxilla Skin
  • Maxillary Teeth
55
Q

V3

  • Associated foramen/fissure
  • Main Branches (8)
  • Function
  • GSA, etc?
A

Foramen Ovale

Branches:

  • MAST-MATT = motor
  • Auriculotemporal, Inferior Alveolar, Lingual, Buccal = sensory

Function (GSA, BE):

  • MAST-MATT = BE
  • GSA - mandible, mandibular teeth and gingiva, parotid capsule, floor of the mouth
56
Q

V1 lesion

-symptoms

A

General Loss of Sensation on Forehead and Scalp

57
Q

V2 lesion

-symptoms

A

Loss of Sensation to the maxilla and maxillary teeth

58
Q

V3 lesion

- symptoms

A

GSA:
- Mandible, Parotid Capsule, Lower Teeth, Gingiva

BE:

  • weakness in Chewing
  • Jaw Deviation TO SIDE OF LESION
59
Q

CN III

  • symptoms
  • test
A

symptoms:

  • Dilated pupil
  • Ptosis (levator palpebrae sup.)
  • Diploia (double vision)
  • External Stabismus (eye looks down and out)

Test:
- Light Reflex test is most common

60
Q

What are the mixed cranial nn.?

A

V, VII, IX , X

61
Q

CN VII

  • Functions (4)
  • What does each function do?
A

BE, GVE, GSA, SA

BE: Facial mm., Stapedius, Stylohyoid, Post. Digastric

GVE: Submandibular, Sublingual, Lacrimal

GSA: External Ear

SA: Taste anterior 2/3 Tongue, SOFT PALATE

62
Q

Why is external Stabimus a symptom of CN III lesion?

A
  • Superior Oblique (IV) and Lateral Rectus (VI) pull on the eye unopposed
63
Q

What part of CN VII carries taste (SA) fibers to the soft palate?

A

Greater Petrosal (NOT chorda tymp.)

64
Q

What type of cell bodies can be found in the geniculate ganglion?

A

GSA and SA cell bodies

65
Q

What fibers exit the Stylomastiod Foramen?

A

GSA:
- To external Ear

BE:
- To all mm. of VII except Stapedius

NOTE: NO SA and NO GVE

66
Q

CN VII lesion

- symptoms

A
  • Facial Paralysis on affected side
  • Taste loss on anterior 2/3 tongue
  • Dry eye
  • Dry Mouth
67
Q

CN VII Tests

A
  • Ask patient to smile or raise their eyebrows
68
Q

CN IX:

  • Function
  • Where?
A

BE, GVE, GSA, GVA, SA

BE - Stylopharngeus
GVE - Parotid
GSA - Posterior Tongue, Palatine Tonsils, Oropharynx, Mucosa of middle ear, Auditory Tube
GVA- Carotid Body and Sinus
SA - Posterior 1/3 of tongue
69
Q

Specifically what nerve innervates Stylopharyngeus?

A

N. to Stylopharyngeus

70
Q

CN IX lesion

- Symptoms

A

Symptoms

  • No gag reflex (IX or X)
  • Dry Mouth (no parotid)
71
Q

What would Dry mouth in addition to gag reflex confirm?

A
  • A lesion in CN IX NOT CN X
72
Q

CN X

- functions

A

BE, GVE, GSA, GVA, SA

73
Q

BE and GVE component of CN X.

A

BE:

mm. of Arches 4-6
- mm. of larynx
- mm. of pharynx (except stylopharyngeus)
- mm. of Palate (except Tensor Veli Palatini)

GVE:
Smooth mm. and glands trachea and esophagus

74
Q

GSA, GVA, SA component of CN X.

A

GSA:

  • Posterior ear
  • EAM
  • Lower 1/3 of Pharyngeal mucosa
  • Esophagus
  • laryngeal mucosa
  • root of the tongue

GVA:
- Carotid Body

SA:
- Base of the tongue and Epiglottis

75
Q

Ganglia associated with CN X?

A

Superior and Inferior Ganglia of X

76
Q

Fiber type and function of the following CN X branches:

  • Auricular n.
  • Meningeal n.
  • Sinus n.
A

Auricular n. (GSA) - External Ear

Meningeal n. (GSA) - Dura in POSTERIOR cranial fossa

Sinus n. (GVA) - carotid body

77
Q

What CNs are responsible for innervation of the dura?

A
  • CN V3 (meningeal b.)

- CN X (meningeal b.)

78
Q

Fiber Type and Function of the following CN X branches:

  • Internal Branch of Superior Laryngeal
  • Ext. Branch of Superior Laryngeal
A

IBSL (GSA/GVE):

  • mucosa laryngopharynx to vocal folds - GSA
  • Root of Epiglottis - GSA
  • Glands of the pharynx - GVE
  • Root of Tongue and Epiglottis = SA

EBSL (BE):
- Cricothyroid m.

79
Q

Fiber Type and Function of the following CN X branches:

  • Pharyngeal Branch
  • Recurrent (inferior) Laryngeal n.
A

Pharygeal Branch (BE):

  • Palatoglossus
  • All mm. of Pharynx (except stylopharygeus)
  • All soft palate mm. (except tensor Veli Palatini)
Recurrent Laryg (BE/GSA):
- Mucosal Lining of Larynx Below Vocal Folds
80
Q

CN X lesion

- symptoms

A
  • Dysphagia
  • Hoarsness
  • No Gag Reflex
  • No Cough Reflex
  • Drooping Palate
81
Q

CN X tests

A
  1. Say Ahh - Uvula deviates to side opposite of lesion
  2. Listen to Speech
  3. Evaluate Swallowing and Gag Reflex

Anatomy Week 16 (12 decks)

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