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NB2 > Cranial Nerve V + CN VII > Flashcards

Cranial Nerve V + CN VII Flashcards

1
Q

What are the nuclei of CN V?

A

3 Sensory (Chief, mesencephalic, spinal) 1 Motor (trigeminal)

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2
Q

What is the attachment of CN V to the brain stem?

A

Laterally merging with middle cerebellar peduncle

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3
Q

What are the major branches of the trigeminal nerve?

A

Ophthalmic (sensory)
Maxillary (sensory)
Mandibular (sensory and motor)

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4
Q

What is the ganglia if the trigeminal nerve?

A

Trigeminal in posterior portion of cavernous sinus

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5
Q

Summarize the structure-functions of the trigeminal nerve

A

Sensory to the face and motor to the muscles of 1st pharyngeal arch
• Three sensory nuclei located throughout the brainstem

  • most serve as sensory nuclei for other cranial nerves as well
  • One motor nucleus located in the pons
  • Attaches to the lateral pons
  • Sensory ganglion (trigeminal/Gasserian/semilunar) located in Meckel’s cave (a space created in the cavernous dural venous sinus)
  • Has three divisions
  • Ophthalmic
  • Maxillary
  • Mandibular
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6
Q

Where is the sensory nucleus# of the trigeminal nerve?

A

Sensory ganglion (trigeminal/semilunar/gasserian) located in the middle cranial fossa lateral to the cavernous sinus

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7
Q

Where are the roots of the trigeminal nerve?

A

Attaches to the lateral portion of the pons

Situated close to the middle cerebellar peduncle

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8
Q

Describe the trigeminal ganglion

A
  • Pure sensory ganglion
  • Found in the middle cranial fossa
  • Along the lateral wall of the cavernous venous sinus

• Divides into 3 major divisions, each serves a ”3rd” of the face

  • Ophthalmic (CNV1)
  • Maxillary (CNV2)
  • Mandibular (CNV3), is joined by the motor root to form a single nerve
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9
Q

Describe the significance of the ophthalmic branch of the trigeminal nerve CN1

A

Sensory nerve of the orbit and surrounding area

Passes through superior orbital fissure Lateral wall of the cavernous sinus

▪Sensory supply to skin from the orbital fissure to the vertex
▪Central portion of the bridge of the nose
▪Cornea & Eyeball
▪Conjunctiva
▪Lacrimal gland
▪Ethmoid, frontal and sphenoid sinuses
▪Internal portion of nasal alae
▪Anterior-superior most portion of nasal septum

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10
Q

What does the ophthalmic nerve provide sensory nerve?

A

Sensory: Eye, Forehead, Part of Nasal Cavity, Paranasal Sinuses, Meninges (Dura mater)

Nasociliary:

Nasociliary

  • Gives anterior & posterior ethmoidal branches
  • Mediates corneal reflex
  • Receives sensory from eyeball
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11
Q

What does maxillary CN V2 do?

A

Sensory nerve of the pterygopalatine fossa, nose and surrounding area

Passes through foramen rotundum Lateral wall of the cavernous sinus

  • Communicates with the pterygopalatine ganglion
  • Continues into the infraorbital foramen and exits on the face
  • Sensory supply to skin below the orbit and lateral aspect of the nose
  • Maxillary sinus
  • Upper jaw teeth
  • Area over the lateral temple
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12
Q

Describe the sensory locations of the maxillary CN V2

A

Sensory: Cheek, Upper Lip, Lower Eyelid, Upper teeth, Part of Nasal Cavity, Paranasal Sinuses, Tympanic membrane, Meninges (Dura Mater)

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13
Q

What is the significance of the mandibular nerve?

A

Sensory nerve of the oral cavity, parotid gland and surrounding area

Passes through foramen ovale into the infratemporal fossa
Does NOT pass through the cavernous sinus

  • Sensory to the lower jaw teeth, area anterior to the ear and parotid gland
  • Sensory to the mucosa and skin of the cheek and chin
  • Motor to the muscles of mastication (temporalis, medial and lateral pterygoid and masseter), as well as anterior belly of digastric, tensor veli pallatini, tensor tympani and mylohyoid
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14
Q

What does the mandibular supply sensory to?

A

Sensory: Lower lip, Lower teeth, Chin, Anterior 2/3 of Tongue, Meninges (Dura
Mater), Temporomandibular joint

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15
Q

What does the mandibular nerve supply motor to?

A

Motor: Muscles of 1st pharyngeal arch • MAST MATT
• masseter
• temporalis
• 2 pterygoid muscles (medial & lateral) • mylohyoid
• anterior belly of the digastric
• tensor veli palatini
• tensor tympani

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16
Q

Describe innervation of the meninges by the trigeminal nerve

A

V1: falx cerebri, anterior cranial fossa and tentorium cerebelli
• V2: medial aspect of middle cranial fossa
• V3: lateral aspect of the middle cranial fossa
• Posterior cranial fossa is innervated by the cervical nerves

17
Q

How do we test the trigeminal nerve?

A 
• 1) Inspection • 2) Palpation
• Muscles of mastication
• 3) Touch areas of V1, V2, V3
• 4) Corneal reflex
• Touch the cornea and response will be to
close eye
• 2 Components
• V1 of CN V: Sensory to cornea of the eye • CN VII: Closes the eye
• 5) Jaw-jerk reflex
• Tests 2 components of V3 with reflex
hammer
• Sensory branch • Motor branch
18
Q

What’s the significance if herpes zoster-shingles?

A

The herpes zoster virus remains dormant in the cell bodies of the trigeminal nerve ganglion

Reactivated viruses follow the dermatomes innervated by the nerve
Consequences may include blindness

Usually unilateral

19
Q

What are the nuclei of the facial (VII) nerve?

A 
1 Special Sensory (nucleus solitaris)
1 Motor (facial)
1 parasympathetic (superior salivatory nucleus)
20
Q

Where does the facial nerve attach to the brainstem?

A

Ventrolateral to the Pontomedullary junction

21
Q

What are the major branches

A 
Greater petrosal (parasympathetic)
Chorda tympani (special sense and parasympathetic) 
Motor trunk (main portion will branch further)
22
Q

Where is the ganglia of the facial nerve?

A

Geniculate in petrous temporal bone

23
Q

Summarize facial nerve function

A

• Motor to muscles from second pharyngeal arch
• Special sensory to tongue – taste
• Parasympathetic to pterygopalatine and
submandibular ganglia

24
Q

Where are the nuclei of the facial nerve?

A

Nuclei:
• motor, located at the pontomedullary junction
• sensory, nucleus solitarius in the medulla oblongata
• parasympathetic, superior salivatory nucleus in the pons

25
Q

What is the route of the facial nerve?

A

• Attaches to the brainstem at the lateral aspect of the pontomedullary junction

• Sensory ganglion is located in the temporal bone and is named the geniculate
ganglion

• Exits the cranial cavity through the internal acoustic meatus

  • Travels through the temporal bone
    • via facial canal

• Main motor branch exits skull through the stylomastoid foramen & passes through the parotid gland

26
Q

What is the 2nd pharyngeal arch nerve?

A

Facial nerve

27
Q

What are the nuclei of the facial nerve?

A

one (1) sensory, one (1) parasympathetic &
one (1) motor nucleus
Also receives general sensory fibers from the spinal
trigeminal nucleus

28
Q

Where are the motor and sensory root of the facial nerve located?

A

Motors root and sensory root- attaches to pontomedullary junction

Situated close to the vestibulocochlear nerve

29
Q

What is the route of Great petrosal?

A

Greater petrosal

  • Parasympathetic fibers branch off at the location of the geniculate ganglion
  • Meets up with the deep petrosal nerve before entering the pterygoid canal
30
Q

What is the route of the Chorda tympani?

A

Chorda tympani
-special sensory fibers (to solitary nucleus) join the facial nerve after passing through the middle ear between the incus and stapes

  • The cell bodies are located in the geniculate ganglion
  • Receive its parasympathetic (efferent) fibers at the junction point
31
Q

What is the route of the facial nerve?

A

Passes through the internal acoustic meatus

Through the bone surrounding the inner ear

Forms geniculate ganglion

Gives the greater petrosal nerve

Passes through the facial canal, gives the nerve to stapedius
Continues and receives chorda tympani

Exits stylomastoid foramen

32
Q

What are the special fibers of the facial nerve?

A

Parasympathetic fibers arise from the superior salivatory nucleus
• attaches to brainstem in separate root– nervus intermedius

  • joins the facial nerve and exits cranial cavity via internal acoustic meatus • fibers pass through the geniculate ganglion (no synapse)
  • travels in the:
  • greater petrosal nerve that joins the sympathetic fibers from internal carotid plexus (deep petrosal nerve) to form the nerve of the pterygoid canal – goes to the pterygopalatine ganglion
  • chorda tympani nerve that “jumps onto” the lingual nerve in the infratemporal fossa and synapse in the submandibular ganglion
  • Special sensory fibers travel with the nervus intermedius to the brainstem and carries caries taste sensation from the anterior 2/3rd tongue to the solitary nucleus
33
Q

Describe the extracranial course of Facial nerve

A
  • Exits the stylomastoid foramen
  • MOTOR only at this point
  • Gives the posterior auricular and branches to the posterior belly of digastric and stylohyoid
  • Passes anteriorly into the parotid gland
  • Divides into two trunks which pass through the parotid at different depths
  • Because a portion of the nerve travels through the glandular tissue any infection or tumor growth will affect the nerve as well
34
Q

How is the facial nerve tested?

A
  • Crease up the forehead:
    • frontalis muscle
    • occipitalis muscle
  • Keep eyes closed against resistance:
    • orbicularis oculi
  • Reveal the teeth:
    * orbicularis oris
  • Puff out the cheeks or whistle:
    * buccinator
35
Q

What is the significance of facial lesions?

A

PNS(Lower motor lesions)

  1. All functions
  2. all functions
  3. parasympathetic to the nasal cavity, paranasal sinuses and lacrimal gland
  4. motor function and taste to the ant. 2/3 of tongue, parasympathetic to the submandibular and sublingual glands
  5. taste to ant. 2/3 of tongue and parasympathetic to sublingual and submandibular glands
  6. motor function to muscles of facial expression
36
Q

What is facial nerve “bells” palsy?

A

Any injury that presents risk to the facial nerve may result in paralysis of associated muscles. Infection, trauma, surgery, tumors.

37
Q

Contrast upper and lower motor lesions of the facial lesions?

A

UMN Lesion (within the cortex)
• Upper 1⁄2 side of the face is spared (“Upper spares upper”)
• Lower 1⁄2 side of the face is affected

LMN Lesion (within the brainstem/spinal cord)
• Upper and lower 1⁄2 side of the face is affected
• Complete palsy on one side of the face

NB2 (31 decks)

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