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Post Midterm Anatomy > Cranial Nerves > Flashcards

Cranial Nerves Flashcards

1
Q

CN I

A
  • Olfactory Nerve
  • arise from olfactory epithelium (upper 1/3 of nasal cavity)
  • pass through cribriform plate (ethmoid bone), terminate in primary olfactory cortex
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2
Q

CN I tests

A

Olfactory N
•test patency of nostril
•have them smell something like coffee, lemon extract, alcohol swab
•Anosmia-multiple causes including TBI

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3
Q

Nerves involved in vision

A

CNs II, III, IV, VI

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4
Q

CN II

A
  • Optic nerve
  • pass through optic canals (sphenoid bone), travel in optic tracts and converge at optic chiasm
  • continue and synapse at thalamus; from there, optic radiation fibers run to visual cortex
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5
Q

CN III

A
  • occular motor nerve
  • extend from ventral midbrain
  • sperior orbital fissure (spenoid bone)
  • somatic motor to eyelid and 4 external ocular muscles (Middle rectus (look medial), superior rectus (look up and out), inferor recuts (look down and out), inferior oblique (look up and in))
  • PSNS motor to sphincter muscles of iris–>dialate–>from ciliary ganglion
  • lesion would cause pt to be unable to open eyelid, eye would face down and out as SR, LR are unopposed
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6
Q

CN IV

A
  • Trochlear n
  • emerge from dorsal midbrain (only CN on dorsal side of midbrain)
  • superior orbital fissures (sphenoid bone)
  • innervate superior oblique muscle (down and in)
  • longest and thinest of the cranial nerves (easily compressed)
  • impairment leads to eye resting looking up)
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7
Q

CN VI

A
  • Abducens
  • leave from inferior pons; superior orbital fissure (spenoid bone)
  • innervate lateral rectus muscle (abducts the eye)
  • impairment–>eye appears normal when looking forward, but pt is unable to move eye to the imparied side
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8
Q

Eye exam sequence

A

(1. History)
2. Inspection
3. Visual Acuity (eye chart)
4. fisual fields (confrontation)
5. ocular alignment
6. pupillary examination
7. opthalmoscopy

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9
Q

Visual field defects

A
  • one eye blindness-leison to optic nerve
  • bitemporal anop(s)ia-often caused by pituitary tumor (which sits just superior to optic chiasm)–>loose vision on lateral/temporal sides of both eyes
  • hemianop(s)ia–>lesion in optic tract–>loose vision on the same side of both eyes
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10
Q

Extra-occular motor exam

A

•have pateint follow something to make a figure 8 shape–>if they get diplopia (double vision) with a certain movement is a positive test

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11
Q

Pupillary reflexes

A
  • Afferent limb: CNII; Efferent limb: CN III, PS componenet
  • light reflex: shine light in eye–>ipislateral iris constricts (direct light reflex), and contralateral iris constricts (consensual reflex)
  • accomodation reflx (for near objects)–>attempt to focus on close object, pupil constrics (pupillary constrictor muscle), lends “rounds up” (ciliary muscles) for increase refraction
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12
Q

CN V

A 
Trigeminal N
•originates from ventral pons
•V1: Ophthalmic S
•V2: Maxillary S
•V3: Mandibular S & M
•trigeminal ganglion (sensory) in a dural cave (Meckle's)
•passes through cavernous sinus
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13
Q

V1

A
  • Opthalmic n
  • superior orbital fissure (sphenoid)–>orbit–>superior orbital notch (frontal bone)
  • Sensory to eye, forehead, nasal cavity
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14
Q

V2

A
  • Maxillary n
  • foramen rotundum (shpenoid)–>maxillary sinus (in body of maxilla)–>infraorbital foramen (maxilla)
  • sensory to cheek, upper lip, teeth adn nasal avity
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15
Q

V3

A
  • Mandibular n
  • forament ovale (sphenoid bone)–>mandibular foramen (mandible)–>mental foramen (mandible)
  • motor to muscles of MASTication (masseter, temporalis, pterygoids)
  • motor to MATT muscles (mylohyoid, ant. digastric, tensor tympani, tensor veli palatini)
  • sensory to lower lip, teeth, chin & tounge (touch)
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16
Q

CN VII

A
  • Facial Nerve
  • Exit cranial cavity w/ CN VIII through internal auditory meatus; exit skull through stylomastoid foramen (both temporal bone)
  • 5 somatic efferent brances for muscles of facial expression (temporal, zygomatic, buccal, mandibular, cervial)
  • chorda tympani–>through stylomastoid foramen: taste to ant 2/3 of tounge (special sense); PSNS to submandibular, sublingual salivary, and lacrimal glands
17
Q

Testing CN V

A
  • Inspection
  • Palpation of masseter/temporalis
  • test sensation V1, V2, V3
  • corneal reflex (touch cornea) (afferent is V1)
  • Jaw jerk (both branches should be V3)
18
Q

Testing CN VII

A
  • observe facial syymmetry
  • forehead wrinkling, eyelid closure, whistle/pucker
  • blink/corneal reflex (VII motor)
19
Q

Tic douloureux

A
  • trigeminal neuralgia
  • most excruciating pain known (suicide disease)
  • inflammation of nerve
  • in severe cases, never ablated–>lead to loss of function of muscles of mastication and others
20
Q

Bell’s Palsy

A
  • Palsy of CN VII
  • paralysis of facial muscles on affected side, loss of taste sensation
  • caused by HSV-I infection of soma of CN VII neurons
  • lower eyelid droops and eye cannot be closed (dry eye)
  • condition may disappear spontaneously without treatment, some people respond to steroid treatment
  • temporary or permanent
21
Q

CN VIII

A
  • Vestibulocochlear nerve
  • 2 division: cochlear (hearing) and vestibular (balance) (only special sense)
  • pass trough internal auditory meatus (temporal bone)
  • enter brainstem at pons-medulla border
22
Q

Testing CN VIII

A

•Cochlear

  • acuity: whisper test, finger rub, hx
  • rinne (the one on the side), weber (the one on the forehead)

•Vestibular-balance idk, didn’t say

23
Q

CN IX

A

•Glossopharyngeal n
•emerge from lateral medulla
•exit via jugular foramen (temporal and occipital bones)
-motor: to stylopharyngeus & PSNS to parotid
-sensory: taste and general sesory from tounge and pharynx
-Parasympathetic: to parotid
-Visceral afferent: from carotid body

24
Q

CN X

A

•Vagus n
•emerge from lateral medulla
•exit via jugular foramen (temporal and occipital bones) within carotid sheath
-general sensation from larynx and part of laryngopharynx and a small part of ext auditory meatus (temporal bone)
-visceral afferents from esophagus, foregut, midgut, bronchi, lungs, heart, and carotid body
-parasympathetic for smooth muscles and glads of larynx, parynx, airway, foregut adn midgut
-motor for pharynx (except stylopharyngeus), larynx, platoglossus, and muscles of soft palate (except tensor veli palatini)
-taste from epiglottis

25
Q

Test CN IX and X

A
  • asses dysphonia
  • “say ahh” asses uvula deviation, will go toward affected side
  • gag reflex
26
Q

CN XI

A
  • (Spinal) accessory nerve
  • 2 roots, one from spinal cord (C1-C4) enters cranium through foramen magnum (occipital bone); one root comes from medulla
  • Leave cranium via jugular foramen (temporal and occipital bones)
  • motor nerve: some fibers to larynx, pharynx, and soft palate; innervates trapezius and sternocleidomastoid
27
Q

Test CN XI

A
  • turn head against resistance: SCM turns head to contralateral side
  • Shoulder shrug–>trapezius
28
Q

Testing CN XII

A
  • assess speech–>yellow lorry
  • stick out tounge (deviation/strength)
  • Right XII thrusts tounge to left so if weak tongue would deviate to affected side
29
Q

CN XII

A
  • hypoglossal
  • arrise from medulla and exit via hypoglossal canal (occipital bone)
  • innervates extrinsic and intrinsic (4 & 4) muscles of tounge–>swallowing and speech

Post Midterm Anatomy (10 decks)

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