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B3 CAI > Cranial Nerves > Flashcards

Cranial Nerves Flashcards

1
Q

What is CN I?

A

The olfactory nerve

Responsible for smell from nasal mucosa

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2
Q

How does CN I exit the skull?

A

Cribriform plate

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3
Q

What fibre type does CN I carry?

A

Special sensory - olfaction

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4
Q

What symptoms present with damage to CN I?

A
  • Anosmia (loss of sense of smell)
  • Parosmia (distortion of smell)
  • Olfactory Hallucination
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5
Q

What is CN II?

A

The optic nerve

Responsible for vision from retina

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6
Q

What fibre type(s) does CN II carry?

A

Special sensory - vision

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7
Q

What does CN II innervate?

A

The retina

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8
Q

How does CN II exit the skull?

A

The optic canal

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9
Q

How can you test CN II?

A
  • Visual acuity
  • Fundoscopy
  • Pupil light reflex
  • Accommodation and visual fields
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10
Q

Give examples of conditions that could cause issues with the retina

A
  • Papilloedema
  • Retinopathy
  • Emboli
  • Haemorrhage
  • Scar
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11
Q

What is the principal of the consensual light reflex?

A

Shining light in one eye should make both pupils contract

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12
Q

What does the Pupillary light reflex test?

A

The function of the retina, CN II, the midbrain and CN III

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13
Q

What is CN III?

A

The oculomotor nerve

Responsible for motor to superior rectus, inferior rectus, medial rectus, inferior oblique and levator palpebrae superiororis

Also responsible for parasympathetics to sphincter pupillae and cilliary muscle (constricts pupil and helps with accommodation of lens)

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14
Q

What fibre type(s) does CN III carry and where do they synapse?

A

Somatic motor - Oculomotor nucleus (CN III motor nucleus midbrain)

Visceral motor - Edinger-Westphal nucleus in the midbrain

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15
Q

How does CN III exit the skull?

A

Via the Superior Orbital Fissure

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16
Q

Does the oculomotor nerve pass through the cavernous sinus?

A

Yes

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17
Q

What is the cavernous sinus?

A

A venous sinus (2 pockets of venous blood) on either side of the sella turcia (the saddle where the pituitary gland sits)

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18
Q

Describe CN III fibres route from their brainstem nuclei

A

Both motor and parasympathetic fibres exit the brainstem together via the interpeduncular fossa, they then pass through the cavernous sinus and the superior orbital fissue to the eye

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19
Q

Give examples of lesions that can damage CN III

A
  • Midbrain lesions
  • Interpeduncular fossa lesions
  • SCA or PCA aneurysm
  • Cavernous sinus lesions
  • Ischaemia
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20
Q

What would be the clinical presentation of a CN III lesion?

A
  • Dilated pupil unresponsive to light and accommodation
  • Complete ptosis on affected side
  • Eye is down and out
  • Diplopia
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21
Q

What is CN IV?

A

Trochlear nerve

Responsible for motor to superior oblique (turns eye down and out)

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22
Q

What fibre type(s) does CN IV carry?

A

Somatic motor

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23
Q

Where does CN IV synapse?

A

The midbrain, trochlear nerve nucleus

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24
Q

How does CN IV exit the skull?

A

Via the superior orbital fissure

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25
Q

What does CN IV provide innervation to?

A

Motor to the superior oblique muscle

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26
Q

How would damage to CN IV present?

A

A resting eye that has an upward deviation and extorsion (outward rotation)

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27
Q

What is CN VI?

A

The abducens nerve

Responsible for motor to lateral rectus (turns eye laterally)

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28
Q

What fibre type(s) does CN VI carry?

A

Somatic motor

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29
Q

Where does CN VI synapse?

A

The pons, abducens nucleus

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30
Q

How does CN VI exit the skull?

A

Via the superior orbital fissure

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31
Q

Outline the route taken by CN VI from its nucleus in the brainstem

A

CN VI emerges from the pontomedullar junction, passes along the base of the skull, turns up into the cavernous sinus (next to the internal carotid artery) and then through the superior orbital fissure

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32
Q

How would a lesion to CN VI present?

A

A resting eye in an adducted position, no lateral movement of the eye. Patient will also experience horizontal diplopia

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33
Q

What is the name of CN V?

A

Trigeminal nerve

34
Q

What are the 3 divisions of CN V?

A

V1 or a; Opthalmic

  • responsible for sensation from cornea, forehead skin, scalp, eyelids, nose, mucosa of nasal cavity, paranasal sinuses (except maxillary), frontal dura

V2 or b: Maxillary

  • responsible for sensation from skin of face over maxillar, upper lip, maxillary teeth, mucosa of nosem maxillary sinuses, palate, dura

V3 or c: Mandibular

  • responsible for sensation from skin over mandible, lower lip, side of head, mandibular teeth, TMJ,

mouth muvosa, anterior 2/3 tongue.

  • responsible for motor to muscles of mastication
35
Q

What fibre type(s) does the Opthalmic division of CN V carry?

A

Somatic sensory

36
Q

Where does the opthalmic division of CN V synapse?

A

On the sensory nucleus of CN V

37
Q

How does the Opthalmic division of CN V exit the skull?

A

Superior Orbital Fissure

38
Q

What fibre type(s) does the Maxillary division of CN V carry?

A

Somatic sensory

39
Q

How does the Maxillary division of CN V exit the skull?

A

Via the Foramen Rotundum

40
Q

What fibre type(s) does the Mandibular division of CN V carry?

A

Somatic sensory

Somatic motor

41
Q

How does the Mandibular division of CN V exit the skull?

A

Via the Foramen Ovale

42
Q

What two divisions of the trigeminal nerve pass through the cavernous sinus?

A

Opthalmic division and maxillary division

43
Q

What virus can reside in the trigeminal ganglion?

A

Herpes Zoster (manifests as shingles in the immunocompromised)

44
Q

What are the 3 large sensory territories of CN V?

A
  • Supraorbital
  • Infraorbital
  • Mental
45
Q

What does the mandibular division of CN V branch off into?

A
  • The lingual nerve
  • The inferior alveolar nerve
46
Q

How does the motor component of CN V travel from the brainstem?

A

The motor nerve component of CN V comes from a small motor only nucleus in the Pons

These fibres exit next to the sensory trigeminal nerve fibres from the lateral pons, and accompany the mandibular division to the muscles of mastication (Temporalis, Masseter, Pterygoids)

47
Q

What is CN VII?

A

The facial nerve

Responsible for motor to muscles of facial expression, stapedius, stylohyoid, post digastric

Also responsible for parasympathetics to lacrimal gland and submandibular/sublingual glands

Responsible for sensation from EAM skin

Also responsible for taste from anterior 2/3 tongue

48
Q

What fibre type(s) does CN VII carry and where do they synapse?

A

Somatic motor - Motor nucleus of CN VII

Visceral motor - Superior salivatory nucleus

Somatic sensory - Spinal nucleus of CN V (hitchhikes)

Special sensory - Chorda tympani -> Nucleus solitarius

49
Q

How does CN VII exit the skull?

A

CN VII travels via the internal acoustic meatus and through the facial canal before exiting the skull via the sylomastoid foramen

50
Q

Describe the route CN VII takes from the brainstem

A

It exits the brainstem via the lateral pontomedullary junction and with CN VIII passes into the internal acoustic meatus. It then passes through the facial canal, running close to the middle ear, before exiting the skill via the stylomastoid foramen

51
Q

What does the greater petrosal nerve from CN VII innervate?

A

Provide parasympathetic innervation to the lacrimal gland and salivary glands

52
Q

What does the stapedius nerve from CN VII innervate?

A

The stapes muscle, protects the ears from loud noises

53
Q

What does the posterior auricular nerve innervate?

A

Sensory to skin around the ear

54
Q

After exiting the stylomastoid foramen, CN VII enters the parotid gland where it forms a plexus and gives off 5 major branches. What are these branches?

A
  • Temporal
  • Zygomatic
  • Buccal
  • Marginal mandibular
  • Cervical

To Zanzibar By Motor Car

55
Q

What is CN VIII?

A

The vestibulocochlear nerve

Responsible for vestibular sensation from inner ear - for head position and movement

Also responsible for hearing

56
Q

What fibre type(s) does CN VIII carry?

A

Special sensory

Vestibular - balance

Cochlear - hearing

57
Q

Where does CN VIII synapse?

A

The vestibulocochlear nucleus at the pontomedullary junction

58
Q

How does CN VIII exit the skull?

A

Via the internal acoustic meatus

59
Q

What is CN IX?

A

The Glossopharyngeal nerve

Responsible for motor to stylopharyngeus

Also responsible for parasympathetics to parotid gland

Responsible for sensation from external ear, pharynx, middle ear, carotid body and sinus

Also responsible for taste posterior 1/3 tongue

60
Q

What fibre type(s) does CN IX carry and where do they synapse?

A

Somatic motor - Nucleus ambiguus

Visceral motor - Inferior salivatory nucleus

Somatic sensory - Spinal nucleus of CN V (hitchhikes)

Visceral sensory - Nucleus solitarius

Special sensory - Nucleus solitarius

61
Q

How does CN IX exit the skull?

A

Via the jugular foramen

62
Q

What is CN X?

A

The vagus nerve

Responsible for motor to constrictor muscles of pharynx, intrinsic larynx, palate and upper 1/3rd of oesophagus

Also responsible for parasympathetics to smooth muscle of trachea, bronchi, GI tract and cardiac muscle

Responsible for sensation from auricle, EAM, pharynx, larynx, dura of posterior cranial fossa, trachea, bronchi, heart, lungs, GI tract

Also responsible for taste from epiglottis and palate

63
Q

What fibre type(s) does CN X carry and where do they synapse?

A

Somatic motor - Nucleus ambiguus

Visceral motor - Dorsal vagal nucleus

Somatic sensory - Spinal nucleus of CN V (hitchhikes)

Visceral sensory - Nucleus solitarius

Special sensory - Nucleus solitarius

64
Q

How does CN X exit the skull?

A

Via the jugular foramen

65
Q

What cranial nerves are you assessing in a gag reflex test?

A
  • Glossopharyngeal (CN IX) - Sensory
  • Vagus (CN X) - Motor
66
Q

What is CN XI?

A

The accessory nerve

Cranial part - responsible for minor contribution to CN X innervation of larynx

Spinal part - responsible for motor to SCM and trapezius

67
Q

What fibre type(s) does CN XI carry?

A

Somatic motor

Cranial part and Spinal part

68
Q

How does CN XI leave the skull?

A

The jugular foramen

69
Q

How would you test the function of the sternocleidomastoid?

A

Axial rotation of the head against resistance

70
Q

How would you test the function of the trapezius?

A

Shrug the shoulders against resistance

71
Q

What is CN XII?

A

The hypoglossal nerve

Responsible for motor to the intrinsic and extrinsic muscles of the tongue (except the palatoglossus)

72
Q

What fibre type(s) does CN XII carry and where do they synapse?

A

Somatic motor - motor nucleus of CN XII

73
Q

How does CN XII exit the skull?

A

The hypoglossal canal

74
Q

How do you test the function of CN XII?

A

Ask patient to protrude the tongue, if CN XII is lesioned the tongue will deviate towards the weak side

75
Q

Which cranial nerves provide parasympathetic innervation?

A

CN X, IX, VII, III

(1973)

76
Q

How can you determine whether damage to a CN will lead to loss of a single function or loss of all functions?

A

Loss of single function: lesion in brainstem nuclei
Loss of all functions: damage to nerve itself (after it has emerged from brainstem)

77
Q

Which bones make up the skull floor?

A
78
Q

What does corneal reflex test?

A

sensory of CN VI and motor of CN VII

79
Q

If a patient has sensation but unilateral or no contraction of soft palate, what is the problem?

A

CN X lesion - motor loss

80
Q

If a patient has no sensation and therefore no setting off the gag reflex when touching a side, what is the problem?

A

CN IX lesion - sensory loss

B3 CAI (13 decks)

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