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Neurology-Week 2 > Cranial Nerves > Flashcards

Cranial Nerves Flashcards

1
Q

Main attachment site of the cranial nerves

A

Brainstem

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2
Q

Cranial nerves have both Sensory and Motor components (True or False)

A

False: some have only 1, while others can have both

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3
Q

Not all of the Cranial Nerves attach to the Brainstem. What are the 2 exceptions

A

CN I: directly to Brain

CN II: Diencephalon

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4
Q

Which cranial nerves attach directly to the Midbrain

A

CN 3 and 4 (Oculomotor and Trochlear)

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5
Q

Cranial nerve (3/4) has it’s nucleus in the Superior Colliculi of the Midbrain

A

CN 3 (Oculomotor)

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6
Q

Cranial nerve (3/4) has it’s nucleus in the Inferior Colliculi of the Midbrain

A

CN 4 (Trochlear)

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7
Q

Which cranial nerve attaches to the Pons

A

CN 5 (Trigeminal)

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8
Q

Which cranial nerves are at the Pontomedullary Junction of the brainstem?

A

CN 6, 7 and 8 (Abducens, Facial and Vestibulocochlear)

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9
Q

Which cranial nerve sits between the medullary olive and pyramids

A

CN 12 (Hypoglossal)

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10
Q

A cranial nerve’s nuclei will generally be located at the same level of the brainstem that it attaches (True or False)

A

True

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11
Q

What are the mixed Motor/Sensory cranial nerves (4 total)

A

CN 5,7,9,10

CN V (Trigeminal)
CN VII (Facial)
CN IX (Glossopharyngeal)
CN X (Vagus)
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12
Q

What are the pure Sensory Cranial nerves (3 total)

A

CN 1,2,8

CN I (Olfactory)
CN II (Optic)
CN VIII (Vestibulocochlear)
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13
Q

What are the pure Motor Cranial Nerves (5 total)

A

CN 3,4,6,11,12

CN III (Oculomotor)
CN IV (Trochlear)
CN VI (Abducens)
CN XI (Accessory)
CN XII (Hypoglossal)
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14
Q

Cranial nerve; connects straight to Brain; special sensory for smell; also sends info to old parts of brain for emotional, feeding and sexual circuits;

A

Olfactory (CN I)

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15
Q

Cranial nerve; exits the Diencephalon; special sensory for vision; sends to Optic Chiasm where crossing occurs; continues to Optic tract to Lateral Geniculate Nucleus and Visual Cortex;

A

Optic (CN II)

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16
Q

Pattern of signaling from the Optic nerve to Visual cortex

A

Optic Nerve–> Optic Chiasm (crosses)–> Optic Tract–> Lateral Geniculate Nucleus (Thalamus)–> Primary Visual Cortex (Occipital lobe)

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17
Q

Cranial nerve; arises from the Midbrain; provides motor innervation to 4/6 eye muscles and is responsible for the movement of the eyeball; also conveys PARASYMPATHETIC to the Ciliary Ganglion and innervate ciliary muscle (for accommodation) and constrictor pupillary muscle (for pupil constriction).

A

Oculomotor (CN III)

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18
Q

Special nuclei for the Oculomotor nerve in the Midbrain (2 total)

A 
Oculomotor nucleus (motor)
Edinger-Westphal nucleus (parasympathetic)
  • Together = oculomotor complex
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19
Q

The Oculomotor nerve works to (constrict/dilate) the pupil via the Ciliary Ganglion

A

Constrict (parasympathetic)

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20
Q

Damage to the Oculomotor nerve causes what characteristic findings?

  • Oculomotor Nerve Palsy
A

3 D’s

  • Droopy eyelid (ptosis)
  • Dilation (pupil)
  • Down & Outward
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21
Q

Cranial nerve; arises from the DORSAL midbrain; motor innervation of the Superior Oblique eye muscle (allows complex downward motion);

A

Trochlear (IV)

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22
Q

The Trochlear nerve is the only cranial nerve to exit the brainstem dorsally and decussate (hence innervate contralateral superior oblique muscle) (True or False)

A

True

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23
Q

Damage to the Trochlear nerve causes what characteristic findings?

*Trochlear Nerve Palsy

A

Eyeball positioned upward with tilting/rotation of head AWAY from the lesion (to reduce double vision or vertical diplopia)

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24
Q

Cranial nerve; arises from the Pons; SENSORY for the face, eye/orbit, nasal, oral, and meninges; MOTOR for masseter and tympanic muscles; has three subdivisions (Ophthalmic, Maxillary, and Mandibular)

A

Trigeminal (CN V)

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25
Q

The Trigeminal nerve is responsible for (motor/sensory) of the cornea reflex

A

Sensory (facial nerve controls motor of eyelid closing)

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26
Q

Damage to the Trigeminal nerve will result in abnormal Corneal Reflex (True or False)

A

True (Trigeminal senses and signals motor Facial nerve to close eyelid)

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27
Q

Trigeminal nerve has what 2 nuclei?

A
  1. Trigeminal Motor Nucleus
  2. Trigeminal Sensory Nucleus (2 parts)
    - Principal trigeminal nucleus (located in pons; receives touch/pressure)
    - Spinal trigeminal nucleus (located in medulla; receives pain and temperature)
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28
Q

Cranial nerve; motor innervation for the Lateral Rectus eye muscle (moves eyeball laterally or abduction); attaches to Pontomedullary junction medially

A

Abducens (CN VI)

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29
Q

Sign that the Abducens cranial nerve has been damaged

*Abducens Nerve Palsy

A

Eye stays midline when patient tries to move laterally (innervates the Lateral Rectus eye muscle)

  • Esotropia (inward turn of the eye when relaxed)
30
Q

Cranial nerve; attaches to Pontomedullary junction; 3 nuclei
1. SENSORY for the anterior 2/3rds of the tongue (for taste)

  1. MOTOR for facial muscles (facial expression) and Stapedius muscle (for tension of ossicles)
  2. Parasympathetic for salivary and lacrimal glands (via submandibular and pterygopalatine ganglia)
A

Facial (CN VII)

31
Q

The facial nerve provides (sensory/motor) for the face

A

Motor

*Trigeminal does sensory

32
Q

3 Nuclei of Facial Nerve

A
  1. Facial Motor Nucleus
  2. Superior Salivatory Nucleus (parasympathatic)
  3. Solitary Nucleus (Taste sensation)
33
Q

The Facial nerve works to (relax/constrict) the Orbicularis oculi muscle

A

Constrict

34
Q

Damage of the LMN (lower motor neuron) of the Facial nerve will result in (contra/ipsi)lateral weakness of (entire/lower) half of the face

A

Ipsilateral; entire half of face

  • Bell’s Palsy
35
Q

Damage of the UMN (upper motor neuron) of the Facial nerve will result in (contra/ipsi)lateral weakness of (entire/lower) half of the face

A

Contralateral; Lower half (each upper half is bilaterally innervated)

36
Q

Nerves involved with Corneal Reflex (eyelid closing in response to stroking) (2 total)

A
  1. Trigeminal (afferent limb; senses the cornea stroke)

2. Facial (efferent limb; contracts orbicularis oculi to blink)

37
Q

Cranial nerve; sensory for hearing and propriception of head/balance; attaches to Pontomedullary junction laterally; 2 nuclei

A

Vestibulocochlear (CN VIII)

38
Q

2 nuclei of CN 8

A
  1. Vestibular nuclei (equilibrium)

2. Cochlear nuclei (hearing)

39
Q

Signs of Vestibulocochlear nerve damage

A

Ipsilateral loss of hearing, NYSTAGMUS, vertigo, nausea

40
Q

Cranial nerve; attaches to medulla lateral to olive; 4 nuclei

  1. SENSORY for eustachian tube, middle ear, PHARYNX (gag reflex), carotid body, sinus, and posterior 1/3 of tongue (taste)
  2. MOTOR for Stylopharyngeous (swallowing)
  3. PARASYMPATHETIC for salivary glands (via Otic Ganglion)
A

Glossopharyngeal (IX)

41
Q

4 nuclei of CN 9

A
  1. Solitarius Nucleus (taste sensation; sensation of carotid body/sinus)
  2. Trigeminal sensory nucleus (sensation to ears, pharynx)
  3. Ambiguus Nucleus (motor)
  4. Inferior Salivatory Nucleus (parasympathetic)
42
Q

What Cranial nerves might be damaged if the Gag reflex is abnormal

A

Glossopharyngeal (CN IX)

Vagus (CN X)

43
Q

Cranial nerve; attaches to medulla lateral to olive; 4 nuclei

  1. SENSORY for pharynx, larynx, external ear, aortic arch, and thoracic/abdominal viscera
  2. MOTOR (speech & swallowing) for soft palate, pharynx, and larynx
  3. PARYSYMPATHETIC for cardiovascular, respiratory, and GI systems
A

Vagus (CN X)

44
Q

4 nuclei of CN 10

A
  1. Solitarius Nucleus (chemo/baroreception; visceral sensation)
  2. Trigeminal sensory nucleus (sensation to ears, pharynx, larynx)
  3. Ambiguus Nucleus (motor)
  4. Dorsal Motor Nucleus of Vagus (parasympathetic)
    * Same nuclei to CN 9 except DMNV!
45
Q

Pattern of signaling during a Gag Reflex

A

Stroke pharynx–> Glossopharyngeal (sensory)–> Trigeminal nuclei (sensory)–> motor Ambiguus nucleus (motor)–> Vagus (causing pharyngeal muscles to contract)

46
Q

During the gag reflex, cranial nerve ________ serves as the sensory/afferent limb while cranial nerve __________ serves as the motor/efferent limb.

A

Glossopharyngeal (IX) –> sensation of oropharynx

Vagus (X) –> contraction of pharyngeal muscles

47
Q

Cranial nerve; motor innervation of the Sternocleidomastoid (SCM) and Trapezius; attaches to LATERAL medulla and LATERAL UPPER cervical spinal cord; has 2 roots but spinal root is the one that innervates SCM and Trapezius

A

Spinal Accessory (CN XI)

48
Q

Signs of Accessory nerve damage

A

Weak shoulder shrug

Weak head turn to opposite side of lesion

49
Q

Cranial nerve; motor innervation to ALL tongue muscles; attaches to Medulla between Olive and Pyramid; Hypoglossal nucleus

A

Hypoglossal (CN XII)

50
Q

Damage to the Hypoglossal nerve causes the tongue to deviate (toward/away from) lesion

A

Toward (ipsilateral; intact side overpowers the weak side)

51
Q

Pattern to the Ascending/Sensory tract for cranial nerves

A

Neuron #1: cell body in CN ganglion
Neuron #2: decussates
Neuron #3: cell body in Thalamus (VPM) to Postcentral gyrus (where primary sensory cortex is located)

52
Q

Sensory cranial nerves go to the thalamic (VPM/VPL) nucleus

A

VPM

*VPL is for the other sensory tracts we learned earlier

53
Q 
Mechanosensory stimuli (fine touch, vibration, pressure) 
from head/face will utilize what nucleus and tract?
A

Main/Principle trigeminal sensory nucleus

Dorsal Trigeminothalamic Tract

54
Q

Pain and temperature from head/face will utilize what nucleus and tract?

A

Spinal trigeminal nucleus

Ventral Trigemniothalamic tract

55
Q

Sensory loss via the cranial nerves will be (contra/ipsi)lateral

A

Ipsilateral!!

56
Q

Injury to the cranial NERVE will result in (contra/ipsi)lateral loss of function and is usually due to (trauma/vascular loss)

A

Ipsilateral; trauma

57
Q

Injury to the cranial nerve NUCLEI will result in (conta/ipsi)lateral loss of function and is usually due to (trauma/vascular loss)

A

Ipsilateral; vascular loss

58
Q

Pathway for the Corticobulbar tract (Descending/motor tract for cranial nerves)

A

Neuron #1: Precentral gyrus or primary motor cortex (UMN)

Neuron #2: Cranial nerve nuclei (LMN)

59
Q

Bell’s Palsy (ipsilateral entire half of face paralysis) is caused by UMN/LMN damage

A

LMN

60
Q

Facial paralysis only in the lower faces muscles is caused by UMN/LMN damage

A

UMN

61
Q

Cranial nerve (3/7) opens and raises the eyelid via the Levator Palpebrae (skeletal) and Superior Tarsal (smooth)

A

CN 3 (Oculomotor)

62
Q

If a patient’s uvula is deviated to the left, which CN nerve is impacted and on which side?

A

CN X (Vagus); Right side (contralateral)

63
Q

If a patient has a midline uvula but an absent gag reflex, which cranial nerve is impacted?

A

CN IX (Glossopharyngeal)

64
Q

What four CNs convey parasympathetic nerves in addition to carrying motor and/or sensory nerves?

A
  1. CN 3 (Oculomotor)
  2. CN 7 (Facial)
  3. CN 9 (Glossopharyngeal)
  4. CN 10 (Vagus)
65
Q

Ascending and descending tracts (DCML, STT, CST, hypothalamospinal tracts) are found in white/gray matter of brainstem

A

white matter

66
Q

Nuclei associated with ascending tracts (gracile & cuneate), inferior olivary nucleus, and cranial nerve nuclei are found in white/gray matter of brainstem

A

gray matter

67
Q

Three nuclei with ODD names

A
  1. Edinger-Westphal nucleus
  2. Ambiguus Nucleus
  3. Solitary Nucleus
68
Q

What is the condition that can arise due to compression, degeneration or inflammation of the CN 5 that is characterized by recurring episodes of intense stabbing, severe, excoriating pain from the jaw?

A

Trigeminal Neuralgia (aka. Tic Douloureux)

  • due to maxillary and mandibular branch compression/degneration
69
Q

What is the most common ocular motor paralysis in adults?

A

Abducens (CN6) Nerve Palsy

70
Q

What tumor can arise from Schwann cells and affect vestibulocochlear nerve and cause symptoms like hearing loss, tinnitus, loss of balance, etc.?

A

Vestibular Schwannoma (aka. acoustic neuroma)

71
Q

Cranial nerve nuclei that are motor are located more Medially/Laterally in the brainstem

A

Medially

72
Q

Cranial nerve nuclei that are sensory are located more Medially/Laterally in the brainstem

A

Laterally

Neurology-Week 2 (5 decks)

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