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Anatomy > Cranial Nerves > Flashcards

Cranial Nerves Flashcards

1
Q

cranial nerves

A
  • Bundles of sensory, motor, or mixed fibers that innervate muscles or glands
  • They emerge through foramina or fissures in the cranium
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2
Q

motor CN

A

CN III – oculomotor
CN IV – trochlear
CN VI – abducent
CN XI – accessory
CN XII – hypoglossal

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3
Q

sensory CN

A

CN I – olfactory
CN II – optic
CN VIII – vestibulocochlear

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4
Q

mixed CN

A

CN V – trigeminal
CN VII – facial
CN X – vagus
CN XI – glossopharyngeal

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5
Q

CN I

A
  • Olfactory
  • Type: special sensory
  • Course: olfactory receptors on olfactory mucosa -> CN I arise through the foramina of the cribriform plate -> synapse on olfactory bulb -> axons of secondary nerve cells (mitral cells) become olfactory tract
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6
Q

CN II

A
  • Optic
  • Type: special sensory
  • Course: axons of 3rd order nerve cells in the retina (retinal ganglion cells) project back to the brain forming the optic nerve (CN II) ->enters cranium through the optic canal -> form the optic chiasm -> posterior to the chiasm becomes the optic tract
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7
Q

CN III

A
  • Oculomotor
  • Type: somatic motor and visceral motor (parasympathetic fibers)
  • Course: runs anteriorly in the lateral wall of the cavernous sinus -> enters the orbit through the superior orbital fissure -> branches out into superior and inferior divisions
  • Innervation
    • Superior division
      • Levator palpebrae superioris
      • Superior rectus
    • Inferior division
      • Medial rectus
      • Inferior rectus
      • Inferior oblique
    • Parasympathetic fibers (via short ciliary nerves of ciliary ganglion)
      • sphincter pupillae m. (constriction of pupil)
      • ciliary m. (accomodation of lens; for distance or close vision)
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8
Q

CN IV

A
  • Trochlear
  • Type: somatic motor
  • Smallest cranial nerve, with longest intracranial course
  • Course: runs anteriorly in the lateral wall of the cavernous sinus -> enters the orbit through the superior orbital fissure
  • Innervation
  • Superior oblique m. (uses a pulley or trochlea to redirect its line of action, giving name to CN IV)
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9
Q

CN VI

A
  • Abducent
  • Type: somatic motor
  • Course: runs through the cavernous sinus parallel and inferior to internal carotid artery -> enters the orbit through the superior orbital fissure
  • Innervation
  • Lateral rectus m (abducts the eye)
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10
Q

CN V

A
  • trigeminal
  • Type: somatic sensory and somatic motor
  • Principal somatic sensory nerve of the head (face, teeth, mouth, nasal cavity, and dura mater of cranial cavity). Motor root is distributed exclusively via the mandibular division (CN V3)
  • Branches or divisions
    • Ophthalmic (CN V1)
    • Maxillary (CN V2)
    • Mandibular (CN V3)
  • Opthalmic & maxillary ONLY SENSORY
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11
Q

CN V1

A
  • Ophthalmic
  • Type: sensory only
  • Course: runs anteriorly in the lateral wall of the cavernous sinus -> enters the orbit through the superior orbital fissure
  • Branches
    • Lacrimal n.
    • Frontal n.
    • Nasociliary n.
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12
Q

Lacrimal n.

A
  • runs anteriorly along lateral aspect of orbit
  • Supply: upper eyelid (sensory)
  • Supply: lacrimal gland (parasympathetic fiber from the pterygopalatine ganglion via the zygomatic n. of CN V2)
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13
Q

Frontal n.

A
  • runs anteriorly in the center of orbit
  • Supraorbital n. (exits through supraorbital foramen)
  • Supratrochlear n. (medial to supraorbital n.)
  • Supply: forehead, anterior scalp, and upper eyelid
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14
Q

Nasociliary n.

A
  • runs anteriorly along medial wall of orbit
  • Sensory root of ciliary ganglion: sensory fibers from the eyeball pass through
  • the ciliary ganglion and join the nasociliary n.
  • Long ciliary nerve: supply iris and cornea. Contains sympathetic fibers to
  • the dilator pupillae m.
  • Infratrochlear nerve: supplies skin of eyelid, side of nose, conjunctiva,
  • and lacrimal sac
  • Anterior & Posterior ethmoidal nerves: supply ethmoid and sphenoid
  • air sinuses and part of nasal cavity
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15
Q
A
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16
Q

CN V2

A
  • Maxillary
  • Type: sensory only
  • Course: goes through lateral wall of the cavernous sinus -> exits cranium via foramen rotundum -> travel in the pterygopalatine fossa
  • Major nerves and their branches:
    • Zygomatic n
    • Infraorbital n
    • Nasal branches
    • Pterygopalatine ganglion branches
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17
Q

Zygomatic nerve

A
  • Zygomaticofacial nerve: skin of upper cheek
  • Zygomaticotemporal nerve: skin over side of forehead. Carries communicating branch to lacrimal nerve
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18
Q

Infraorbital nerve

A
  • (exits through infraorbital foramen)
  • Supply: upper teeth, lower eyelid, upper lip, and part of nasal vestibule
  • Posterior superior alveolar nerve: molar teeth and associated gum area
  • Anterior & Middle superior alveolar: premolar, canine, and incisive teeth and associated gum
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19
Q

Nasal branches

A
  • Posterior superior and inferior lateral nasal nerves
  • Nasopalatine nerve
  • Supply walls and septum of nasal cavity
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20
Q

Pterygopalatine ganglion branches

A
  • Ganglion located inferior to the maxillary nerve in the pterygopalatine fossa
  • Receives parasympathetic fibers via the greater petrosal nerve from the Facial nerve (CN VII)
  • Greater & Lesser palatine nerve: enter nasal cavity and supply palate mucosa and glands
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21
Q
A
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22
Q

CN V3

A
  • Mandibular
  • Type: sensory and motor
  • Course: exits cranium via foramen ovale
  • Branches:
  • Motor
  • Sensory
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23
Q

Motor branch of Mandibular CN V3

A
  • Muscles of mastication (temporalis, masseter, & lateral and medial pterygoid)
  • Tensor veli palatini: in palate, tenses soft palate(when swallowing opens and covers nasal cavity)
  • Tensor tympani: in tympanic cavity, dampens sounds (reduce damage to ear)
  • Mylohyoid and anterior belly of digastric via mylohyoid nerve
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24
Q

Sensory branch of Mandibular CN V3

A
  • Auriculotemporal nerve: auricle, TMJ, and anterior temporal region
    • Parotid branches: parasympathetic fibers from the glossopharyngeal nerve (CN IX) via the lesser petrosal nerve -> otic ganglion->auriculotemporal n.
  • Buccal nerve: skin over buccinator m. (cheeks) and internal mucosa membrane of the same area
  • Lingual nerve: sensation to anterior 2/3rd of tongue
    • Submandibular ganglion branches: visceral fibers from the facial nerve (CN VII) via chorda tympani nerve join the lingual nerve posteriorly to reach the submandibular ganglion
    • Supply submandibular and sublingual glands and carry taste fibers from anterior 2/3rd of tongue
  • Inferior alveolar nerve: enters mandibular foramen -> runs anteriorly in the body of mandible -> emerges through the mental foramen as the mental nerve
    • Supply: mandibular teeth (IAN); skin of chin, and skin and mucosa of lower lip (MN)
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25
Q

*Parasympathetic ganglia and CNs

A
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26
Q

3 parasympathetic ganglia associated with the trigeminal nerve

A
  • Pterygopalatine ganglion (from CN VII -> CN V2)
  • Submandibular ganglion (CN VII -> lingual nerve of CN V3)
  • Otic ganglion (CN IX -> auriculotemporal n. of CN V3)
27
Q

cavernous sinus and associated structures

A
28
Q

CN VIII

A
  • Facial
  • Type: somatic and visceral motor and sensory
  • Course: enters cranium through internal acoustic meatus  runs in facial canal (geniculate nucleus)  exits cranium through stylomastoid foramen
  • Clinical: lesions lead to facial paralysis
  • Branches:
    • Sensory:
      • Geniculate ganglion (also carries taste)
    • Motor:
      • Stapedius n.
      • Post. auricular n.
      • Temporal branches
      • Zygomatic branch
      • Buccal branch
      • Mandibular branch
      • Cervical branch
29
Q

Geniculate ganglion

A
  • sensory
  • Greater petrosal nerve: from geniculate ganglion -> to pterygopalatine ganglion (CN V2 in the pterygopalatine fossa) -> via the zygomatic nerve to lacrimal nerve (CN V1) to lacrimal gland
  • Chorda tympani through petrotympanic fissure to submandibular ganglion via the lingual nerve (CN V3) -> to sublingual and submandibular glands. It also carries taste (special sensory) fibers from anterior 2/3rd of tongue
30
Q

Stapedius nerve

A

to stapedius muscle in middle ear. Before coming out of stylomastoid foramen

31
Q

Posterior auricular n.

A
  • runs posterior to auricle
  • Muscles of auricle and occipitalis m.
  • Posterior belly of digastric, stylohyoid m.
32
Q

5 motor branches of CN VII that innervate the mm of facial expression after getting into the parotid gland

A
  1. temporal branches
  2. zygmatic branch
  3. buchal branch
  4. mandibular branch
  5. cervical branch
33
Q

Temporal branches

A

Course: superior to parotid gland -> crosses zygomatic arch -> to temporal and frontal regions of scalp

34
Q

Zygomatic branch

A

Course: anterior to parotid gland -> innervates muscles as it goes forward on the upper cheek

35
Q

Buccal branch

A

Course: medially through cheek
Innervate: buccinator. This is motor, remember that CN V3 has a buccal branch as well, but it is sensory

36
Q

Mandibular branch

A

Course: along lower border of mandible, innervates muscles on its course

37
Q

Cervical branch

A

Course: courses inferiorly to innervate the platysma

38
Q

*CN VII Facial

A
39
Q

CN VIII

A
  • Vestibulocochlear
  • Type: special sensory (hearing and equilibrium and motion)
  • Course: Enters the internal auditory meatus with the facial nerve divides in two parts:
  • Divisions:
    • Cochlear
    • Vestibular
40
Q

cochlear division of CN VIII

A

Cochlear: to the cochlear or organ of hearing

41
Q

vestibular division of CN VIII

A

Vestibular: to the semicircular canal for balance and equilibrium

42
Q

*CN VIII vestibulocochlear

A
43
Q

CN IX

A
  • Glossopharyngeal
  • Type: somatic, visceral, and special sensory (taste) & somatic and visceral motor
  • Course: exits cranium through anterior aspect of the jugular foramen. At this foramen the CN IX has two ganglia
  • Branches
    • Somatic motor
      • Stylopharyngeous m.
    • Somatic sensory
      • Tympanic nerve
      • Carotid sinus nerve
      • Pharyngeal and tonsillar nerves
      • Lingual nerve
    • Visceral motor
      • Lesser petrosal nerve to otic ganglion
44
Q

Stylopharyngeous m.

A

somatic motor branch of CN IX

45
Q

Tympanic nerve

A
  • somatic sensory branch of CN IX
  • sensory to middle ear (affected during ear infection)
46
Q

Carotid sinus nerve

A
  • somatic sensory branch of CN IX
  • sensory to carotid sinus (barorec.) and body (chemorec.)
47
Q

Pharyngeal and tonsillar nerves

A
  • somatic sensory branch of CN IX
  • sensory to pharynx, palatine tonsils, and soft palate
48
Q

Lingual nerve

A
  • somatic sensory branch of CN IX
  • sensory and taste (special sensory) to posterior 1/3rd of tongue
49
Q

Lesser petrosal nerve to otic ganglion

A
  • visceral motor branch of CN IX
  • (associated with CN V3) -> auriculotemporal nerve -> to parotid gland
50
Q

*CN IX Glossopharyngeal

A
51
Q

CN X

A
  • vagus
  • Type: somatic, special, and visceral sensory & somatic and visceral motor
  • Course: exits cranium through middle aspect of jugular foramen between CN IX and XI and travels inferiorly in the neck in the carotid sheath
  • Branches:
    • meningeal branch
    • auricular branch
    • pharyngeal branch
    • sup. laryngeal n.
    • cardiac branches
    • recurrent laryngeal n.
52
Q

Meningeal branch

A
  • sensory branch of CN X
  • sensory to dura mater of posterior cranial fossa, rest of dura mater (CN V)
53
Q

Auricular branch

A
  • branch of CN X
  • tympanic membrane, part of ear canal, and auricle
54
Q

Pharyngeal branch

A
  • motor and sensory branch of CN X
  • motor to pharyngeal mm., except stylopharyngeous (CN IX) & to soft palate, except tensor veli palatini (CN V3). Sensory to lower pharynx, rest of pharynx (CN IX)
55
Q

Superior laryngeal nerve

A
  • branch of CN X
  • Internal laryngeal n.: sensory to larynx (above vocal folds), and soft palate. Taste to root of tongue and epiglottis
  • External laryngeal n.: motor to cricothyroid m.
56
Q

Cardiac branches

A
  • branch of CN X
  • visceral motor and sensory to heart and lungs
57
Q

Recurrent laryngeal nerve

A
  • branch of CN X
  • Course: goes inferiorly, wraps around subclavian artery (R) & around aortic arch (L)  ascends in the neck in the groove between the trachea and esophagus
  • Motor to laryngeal mm., except for cricothyroid. Clinical relevance: damage to this nerve could lead to lack of voice production
  • Sensory to larynx (below focal folds)
58
Q

*CN X vagus

A
59
Q

CN XI

A
  • Accessory
  • Type: somatic motor only
  • Course: ascends along upper cervical cord -> enters skull through FM -> loops around and exit cranial cavity through posterior part of jugular foramen
  • Innervates: SCM & trapezius mm.
60
Q

*CN XI accessory

A
61
Q

CN XII

A
  • Hypoglossal
  • Type: somatic motor
  • Course: Exits cranium through hypoglossal canal -> goes anteriorly between ECA and IJV -> runs deep to posterior belly of digastric and stylohyoid mm. to enter the submandibular triangle
  • Superior root of Ansa cervicalis runs with hypoglossal n. and provides motor innervation to thyrohyoid and geniohyoid mm.
  • Innervate: intrinsic and extrinsic tongue muscles
62
Q

*CN XII Hypoglossal

A
63
Q

innervation of the tongue

A
  • CN V3 (anterior 2/3rd of tongue  sensation)
  • CN VII (anterior 2/3rd via chorda tympani and lingual  taste)
  • CN IX (posterior 1/3rd sensation and taste)
  • CN X (taste to root of tongue and epiglottis)
  • CN XII (motor to extrinsic and intrinsic m.)
  • Clinical relevance: these functions can be used clinically to test the integrity of these nerves

Anatomy (10 decks)

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