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Cranial Nerves > Cranial Nerves > Flashcards

Cranial Nerves Flashcards

1
Q

What kind of nerve is CN V? (Trigeminal)

A

Motor & Sensory

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2
Q

CN V’s primary motor function is…

A

Chewing

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3
Q

What muscles do CN V innervate?

A

Muscles to close jaw: masseter, temporalis, medial pterygoid

Muscles to open jaw: lateral pterygoid, ant. belly of digastric, mylohyoid

Tensory veli palatini to close VP/tense velum

Tensory tympani to tense tympanic membrane

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4
Q

What is sensory purpose of CN V?

A

Pain & tactile from forehead, eyes, nose, lips, maxilla, mandible, teeth, cheeks, gums, cheeks, palate and max. sinus & anterior 2/3 of tongue

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5
Q

Other CN V functions (aside from chewing)

A
  • mastication
  • articulation
  • hyolaryngeal elevation
  • tensing/closing of of soft palate
  • sensation to face, teeth, gums and ant 2/3 of tongue
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6
Q

How to test CN V

A
  • Palpate Masseter muscles as patient bites down
  • Can patient close jaw against mod. resistance?
  • Can patient open jaw freely against resistance?
  • Check to see if jaw deviates towards side of weak lateral pterygoid
  • Can patient lateralize jaw against resistance? (weakness is expressed as difficulty moving in opposite direction)
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7
Q

No significant motor deficits due to innervation

A

Unilateral UMN damage

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8
Q

Mandible deviates to the side of paralysis/paresis during opening; muscle hypotonia and atrophy; impaired hyolaryngeal elevation…

A

LMN damage

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9
Q

Hypertonia, slow movements, restricted haw opening/closing, reduced hyolaryngeal elevation are signs of…

A

bilateral UMN damage

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10
Q

Hypotonia, significant impaired jaw opening/closing, and significant impaired hyolaryngeal elevation are signs of…

A

bilateral LMN damage

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11
Q

CN V sensory testing

A

-assess light touch on face (3 divisions); check right & left
- ophthalmic branch = stroke above eyebrows
-maxillary branch = stroke upper lip or central cheek; gums or hard/soft palate
- mandibular branch = stroke between lower lip and chin; floor of mouth, lower gums, ant. 2/3 of tongue

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12
Q

What kind of nerve is CN VII? (Facial)

A

Motor & Sensory

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13
Q

What muscles does CN VII innervate? (motor)

A
  • muscles of facial expression
    -platysma, stylohyoid, stapedius, and post. belly of digastric
  • also lacrimal, submandibular, and sublingual glands (visceral motor)
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14
Q

Sensory aspects of CN VII?

A

-Taste for ant. 2/3 of tongue, floor of mouth, and soft/hard palates
- tactile of external ear and auditory meatus

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15
Q

What are the functions of CN VII?

A

Movements of facial expression, supporting hyolaryngeal elevation, saliva and tear production, and tase of ant. 2/3 of tongue

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16
Q

Motor testing of CN VII

A
  • Facial symmetry: look for flattening of nasolabial fold, lower face droop, smooth forehead
  • Motor Function of upper and lower face: can patient wrinkle forehead, close eyes tightly, spread lips (smile), keep lips compressed against resistance (pucker), or keep cheeks puffed to resistance
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17
Q

Unilateral UMN of CN VII looks like…

A

Contralateral lower face weakness. No upper face weakness as it is bilaterally innervated.

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18
Q

Bilateral UMN damage looks like…

A

spastic paralysis of whole face.

19
Q

Sensory testing of CN VII

A

test taste on each side of tongue = salty, sour, bitter, sweet

20
Q

What kind of nerve is CN IX (glossopharyngeal)?

A

Motor and Sensory

21
Q

What muscle does CN IX innervate?

A

Stylopharyngeus muscle (helps elevate larynx and pharynx)

22
Q

Sensory innervation of CN IX…

A

General sensation for post 1/3 of the tongue, soft palate, fauces, tonsils, and adenoids. Also taste of post. 1/3 of the tongue.

23
Q

CN IX is important to trigger what part of swallow?

A

Pharyngeal stage

24
Q

What nerve is responsible for gag reflex (sensory)?

A

CN IX
* can also test gag reflex to test sensory aspect of this nerve

25
Q

What is the most complex cranial nerve?

A

Vagus Nerve (CN X)

26
Q

What are the branches of CN X?

A
  • Laryngeal branch (recurrent and superior: internal and external)

-Pharyngeal branch

27
Q

Laryngeal branch: recurrent laryngeal nerve

A
  • innervates all intrinsic laryngeal muscles (except cricothyroid)
  • general sensation to true VFs and immediately below VFs
28
Q

Laryngeal branch: superior laryngeal nerve

A

internal = sensory info from mucous membranes of epiglottis, base of tongue, aryepiglottal folds, and inner surface of larynx (above true VFs)

external = innervates cricothyroid muscle

29
Q

Pharyngeal branch

A

Motor innervation for muscles of pharynx and soft palate

30
Q

What is the motor function of Vagus nerve?

A

Voice production, VP closure, and swallowing

31
Q

What is the sensory function of Vagus nerve?

A

Sensory innervation to base of tongue which plays big role in triggering pharyngeal phase of swallow; above & below VFs to trigger cough reflex; rest of pharynx to allow detection of flood/liquid residue after swallow

32
Q

Motor testing of Vagus Nerve

A

Observe palate at rest – look for asymmetry; observe palatal movement during production of “ah”; test gag reflex; check vocal quality (weakness can result in hypophonia); check glottal coup & voluntary cough (blurred attack?)

33
Q

Bilateral UMN damage of CN V is characterized by…

A

a strained-strangled vocal quality & will often result in hypernasality

34
Q

Unilateral LMN damage of CN V will result in …

A

ipsilateral signs of palatal weakness or VF paresis/paralysis

35
Q

CN XI is what kind of nerve? (accessory)

A

Motor only

36
Q

CN XI innervates what muscles?

A

palatal muscles, sternocleidomastoid and trapezius

37
Q

CN XII is what kind of nerve? (Hypoglossal)

A

Motor only

38
Q

What muscles does CN XII innervate?

A

intrinsic muscles of tongue and 3 extrinsic tongue muscles (genioglossus, hyoglossus, styloglossus)

39
Q

What are the functions of CN XII?

A

Articulation, oral stage of swallowing, and innervates 1 muscle of pharyngeal stage (geniohyoid = elevation of larynx during swallow)

40
Q

Motor testing of CN XII

A

-observe tongue at rest and look for atrophy, fasciculations and tremor or random movements.
- protrude tongue - look for range of motion and symmetry (tongue will deviate towards weak side)
- push tongue inside cheek against resistance - if patient pushes weakly against left cheek, then weakness is on right side
-rapid alternating tongue movements (side to side)

41
Q

What muscles does CN VII innervate? (motor)

A
  • muscles of facial expression
    -platysma, stylohyoid, stapedius, and post. belly of digastric
  • also lacrimal, submandibular, and sublingual glands (visceral motor)
42
Q

Unilateral UMN damage of CN XII results in …
Unilateral LMN damage of CN XII results in…

A

contralateral weakness

ipsilateral weakness

43
Q

Bilateral UMN or LMN damage of CN XII…

A

weakness on both sides

Bilateral UMN damage often presents w/ reduced ROM and slow movements

Cranial Nerves (1 decks)

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