Cranial Nerves Flashcards
Give the saying for cranial nerves for sensory and motor
Some
Say
Money
Matters
But
My
Brother
Says
Big
Brains
Matter
More
List cranial nerves in order
Olfactory1
Optic 2
Oculomotor 3
Trochlear 4
Trigeminal 5
Abducens 6
Facial 7
Vastibulocochlear 8
Glossopharyngeal 9
Vagus 10
Accessory 11
Hypoglossal 12
What is the olfactory nerve
Sensory nerve which function is olfaction
Olfactoey bulb
Cribiform plate
Olfactory cortex
Problem (anosima which is loss of smell)
Common in head trauma, Parkinson’s (lewy body accumulation) alzheimers (degen), MS (demlyination of olfactory process)
frontal lobe tumour
chronic upper airway infections
Smell coffe or vanilla one nostril at a time
What is the optic nerve
Sensory for vision
Retinol ganglion cells-
Optic canal
Optic chiasm
Optic radiation
Teach eye
Vision problem
Response to light
Use the Snellen chart from 6 metres away
What is oculomotor nerve
Motor
Pubic constrictor
Mid brain
Superior orbital fissure
Extraocular muscles
Problem- dilated pupil diplopia espeically in brain haemorhage
Check dilation, constrictions dn follow my finger
Place hand in middle of pt face to asses separate eyes
you want to make them look up/medially, look up to the corner of the room then laterally, down/laterally and medially.
Outcome: myasthenia Gravis relates to the loss of function in cranial nerve 3,4,6.
stroke, diabetic ischemia,Papilledema, tumour, meneingitis, gullian- barre syndrome
What is the trochlear nerves for sensory
Motor
Superior oblique muscle
Problem is vertical diplopia ( especially looking down, walking downstairs)
Ocular Hypertropia (affected eye is higher than the normal eye).
Check pt look up then down and eyes together vertical and medial!
Head tilt toward the affected side → worsening hypertropia (due to loss of intorsion from the superior oblique).
Head tilt to the opposite side → improvement (because the normal superior oblique compensates).
head trauma, stroke, tumour, cerebral aneurysms, MS, Guillian barre syndrome,
What is the trigeminal nerve
Sensory
Touch, pain, temp, jt position, vibration for face, mouth, 2/3 tongue
Mastication (motor)
Pons
Sup orbital fissure v1- ophthalmic
Foremen rotundum V2- maxillary
Forman ovals V3- mandibular
Trigeminal neuralgia- one sided face px loss of reflex
Stroke can affect
MS
Shingles
Check out- sensation touch temp, forehand cheek chin, clench jaw
Test: cotton wool and sharp object on the 3 layers of the face and the coldness of a tuning fork.
Jaw reflex or assess chewing
What is abduscens nerve
Motor
Lateral Rectus muscle- abduction
Abduscens nucleus- sup orbital fissure- lateral Rectus muscle
Problem- pt will have lateral gaze palsy (can’t abduct eye)
Outcome: if the patient can’t turn their eye lateral it is called abducens paresis.
What is the facial nerve
Sensory and motor
Branchial motor for facial expression
Parasympathetic for lacrimal glands and salivary g;ands expect parotid
Visceral sensory taste from ant 2/3 tongue
Sensory near auditory meat us
Problem- Bell’s palsy LMN lesion
Motor-Can’t close eyes, copy faces, swallow properly
Pons- internal acoustic meatus- styloid mastoid foremen
Lesion to midbrain- unable to close eyes or move eyeballs, can’t make E sound. Trauma/ stroke UMN
What is the vestibulocochlear nerve 8
Sensory for hearing and vestibular sensation
Problem is balance and hearing. Vertigo
Balance and hearing tests
Pons-internal acoustic meatus- cochlear and vestibular branches
Webbers test= tuning fork p[;aced on centre superior skill, allow bone conduction to be assessed. Ask if can hear in both ears and when stop
Rhine’s test is placing tuning for on mastoid process ask pt to identify when sound stops
Finger rub test
Normal is air condition 2x as long as bone
problems can be MS, Aucotist trauma, tumour or infections
What is the glossopharyngeal nerves for sensory 9
Motor and sensory
Swallowing
Parasympathetic to parotid gland
, posterior 1/3 sensation taste tongue
Sensation from middle ear
Midbrain origin
Problem- loss of gag reflex
Dysphagia (difficulty to swallow)
Hoarse voice due to a muscle motor function
Can be caused by a stroke
tumours
neuralgia stabbing pain in the throat, tongue, or ear, often triggered by swallowing or speaking. It is caused by irritation or compression of the glossopharyngeal nerve, sometimes by blood vessels pressing on the nerve.
MS
diabets
Ask if you can taste
What is the vagus nerve 10
Sensory and motor
Swallowing, speech, parasympathetic for heart, lungs and digestive tract
Origin medulla- jugular foramen - thoracic- abdomen
Problem- dysphagia, dystarthia caused by vagus nerve palsy where the nervee loses some function
vagus nerve injury or compression, stroke, tumour, MS, Gillian barre syndrome
Ask pt to open their mouth wide and say ‘AHHH’ looks for tonsil movin and swallow
What is the spinal accessory nerves
Moore
Originates c1-c5 unlike all others
Jugular foramen- upper traps SCM
Problem- struggle to shrug or elevate shoulder/ rotate head due to trauma, i.e. whiplash, tumours, infections, stroke
Check- resisted movement, rotation and elevation
Resist shoulder shrug
What is hypoglossal nerve
Somatic Motor
Intrinsic muscles of the tongue
Medulla- exit through hypoglossal canal- intrinsic and exterinsic tongue muscles
Check- open mouth bring tongue forward
Problem is deviation of tongue to one side caused by hypoglossal nerve palsy
, stroke, tumours, trauma, polio, infections
Ask pt to stick their tongue out if it deviated can be ipsilateral issue
Tongue toi side of mouth and asses the strength
What pathology can cause CN issues
LMN lesion from trauma like a slap,
ear infection,
Bell’s palsy
UMNL like stroke
SOL
Tumour
If difficult swallowing and saying AAA where is the issue
9,10
If difficulty to stick tongue out what is the issue?
12
If difficulty to move eyes lateral what is the issue?
Abduscens 6
If difficulty to smell what is the issue?
Olfactory 1
If difficulty to feel face, and have a jaw jerk reflex what is the issue?
Trigeminal 5
If difficulty to shrug shoulders what is the issue?
11 accessory
If difficulty open eyelids and eye movement, reaction with pupil to what is the issue?
Oculomotr 3
If difficulty to move eyes down or medial what is the issue?
Trochlear 4
If difficulty to make faces what is the issue?
Facial nerve 7
