Cranial Nerves Flashcards

0
Q

XII

A

hypoglossal
GSE - intrinsic muscles of the tongue

extrinsic muscles of tongue - hypoglossus, palatoglossus, genioglossus

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1
Q

hypoglossal XII

A
  • motor nerve - tongue protrusion
  • nucleus located - midline of medulla
  • axons pass anterior in medulla with lateral aspect of medial lemniscus and pyramid - continue thru hypoglossal canal
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2
Q

XII blood supply

A

hypoglossal

branches from anterior spinal artery

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3
Q

XII lower motor neuron injury

A

tongue will deviate toward side of the injury

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4
Q

occlusion of anterior spinal artery

A
  • paralysis of genioglossus muscle with deviation of the tongue towards the weak side of protrusion
  • contra hemiparesis of limbs (pyramidal tract)
  • contra loss deep sensation (medial lemniscus)
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5
Q

XII upper motor neuron injury

A
  • inferior part of primary motor area

- tongue deviate away from side of lesion

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6
Q

spinal accessory XI

A

motor nerve

from caudal medulla and motor neurons of cervical segments of SC

axons exit lateral aspect of cord

ascend to enter cranial cavity via foramen magnum

exits skull thru jugular foramen

innervates SCM & trapezius

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7
Q

CNs that exit skull via jugular forament

A

spinal accessory XI
vagus X
glossopharyngeal IX

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8
Q

XI lesion

A
  • ipsi trapezius paralysis (drooping shoulder ipsi)

- ipsi SCM paralysis (difficulty turning head contra)

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9
Q

vagus X

A

nuclei located in medulla (intermediate b/w midline & lateral aspect of medulla)

exits cranial cavity via jugular foramen

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10
Q

X parasympathetic

A
heart
trachea
lungs
esophagus
stomach
intestines
spleen
liver
pancreas
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11
Q

X motor

A
  • pharyngeal muscles (speech volume & swallowing)

- laryngeal muscles, palatine muscles, skeletal muscles in upper half of esophagus

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12
Q

X sensory

A
  • general visceral from heart, lungs, gut
  • pharynx
  • meninges (dura of posterior cranial fossa)
  • external auditory meatus
  • taste sensation from the base of the tongue
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13
Q

X unilateral lesion

A

dysphagia

dysarthria (reduced speech)

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14
Q

X bilateral lesion

A

rare and life threatening

  • aphonia (no sound)
  • aphagia (no swallow)
  • dyspnea (SOB)
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15
Q

glossopharyngeal IX

A

shares motor and sensory nuclei with other nerves:

-solitary nucleus and nucleus ambiguus in medulla

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16
Q

IX parasympathetic

A

parotid gland (salivation)

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17
Q

IX motor

A

stylopharyngeus muscles (swallowing and gag reflex)

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18
Q

IX sensory

A
  • parotid gland
  • middle ear
  • external auditory meatus
  • pharynx
  • taste from posterior 1/3 tongue
  • visceral sensation (chemoreceptors & baroreceptors in carotid body)
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19
Q

IX parasympathetic function

A

reduced salivation

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20
Q

IX motor function

A

impairments with gag reflexes

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21
Q

IX sensory function

A
  • responds to changes in BP, blood gasses
  • mediates taste receptors from posterior 1/3 of tongue
  • somatosensory info from external ear, tympanic membrane, posterior 1/3 of tongue
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22
Q

IX lesion

A

rare
occurs with damage to vagus and accessory fibers in jugular foramen

  • loss of taste sensation posterior 1/3 tongue
  • loss gag reflex on side of lesion
23
Q

vestibulocochlear VIII

A

most lateral of CN in brainstem at pons-medualla junction

travels with facial nerve

2 portions that for 1 nerve as they enter brainstem

24
Q

2 portions of vestibulocochlear VIII

A

cochlear

vestibular

25
Q

cochlear portion VIII

A

hearing

info from cochlea

26
Q

vestibular portion VIII

A

balance

sensory info from utricle and saccule and ampullae of semicircular canals

27
Q

VIII lesion common causes

A

acoustic neuroma - small growth on nerve impinges on hearing

trigeminal neuroma - on trigeminal but presses on VIII

28
Q

VIII lesions

A
  • hearing loss
  • tinnitus
  • vertigo
  • dizziness
  • nystagmus
  • nausea & vomiting
  • ataxia
  • unsteadiness
29
Q

facial VII

A

nucleus located in pons just rostral to pons-medulla junction

motor fibers arch around abducent nucleus to exit brainstem then merges with parasympathetic fibers and joining vestibulocochlear nerve

30
Q

VII motor

A

muscles of facial expression

closing during eye-blink reflexes

31
Q

VII sensory

A
  • taste from anterior 2/3 tongue
  • sensation from back of external ear
  • sensation from external auditory canal
  • muscus membrane of the palate and nasopharynx
32
Q

VII parasympathetic

A
  • hard and soft palates
  • nasal cavity paranasal sinuses
  • salivary glands (except parotid)
  • lacrimal
33
Q

VII upper motor neuron lesion

A
  • facial muscle paralysis on 1/4 of face (contra lower)
  • decreased salivation
  • decreased taste sensation from anterior 2/3 tongue
  • decreased tear fluid production
34
Q

VII lower motor neuron

A

Bell’s palsy

  • paralysis of facial muscles for upper and lower face ipsi
  • decreased mucus and saliva output ipsi
  • temporary
35
Q

abducens VI

A

motor nerve - horizontal eye movements (abducting)

nucleus near midline of pons

motor function - ipsi lateral rectus muscle

36
Q

VI lesion

A

paralysis of ipsi lateral rectus muscle - inability to abduct ipsi eye

37
Q

trigeminal V

A

sensory and motor

all sensation from face and mouth is transmitted by trigeminal nerve

3 branches

motor nucleus located in midline of pons

sensory nucleus forms continuous cell columns (main sensory n and spinal n) extending from rostral levels of the midbrain to spinal cord-medulla junction

38
Q

3 branches of V

A

opthalamic
maxillary
mandibular

39
Q

V sensory

A
  • external ear
  • facial sensation
  • sensation from mouth (upper and lower teeth, lining of oral cavity, lining of pharynx & larynx)
  • muscle spindle of the muscles of mastication and extraocular muscles
40
Q

V motor

A
  • muscles of mastication
  • jaw jerk reflex (stretch reflex)
  • corneal reflex (blink in response to touching cornea)
41
Q

V travels

A
  • sensory info from face travels thru CN V

- runs parallel to medial lemniscus system and synapses in thalamus

42
Q

V lesion

A

sensory & motor signs

trigeminal neuralgia

43
Q

trigeminal neuralgia

A

bouts of intense facial pain that last from a few seconds to several minutes or hours

44
Q

trochlear IV

A

motor nerve

located near midline of midbrain

45
Q

IV unique among CNs

A

exits brainstem dorsally

crosses on way out

46
Q

IV function

A
  • contra superior oblique muscle

- moves contra eye downward & outward

47
Q

IV lesion

A

inability to move the contra eye outward and downward

48
Q

oculomotor III

A

located in rostral half of midbrain

49
Q

III motor

A
  • extrinsic eye muscles: superior rectus, inferior rectus, medial rectus, inferior oblique
  • functions in most eye movements
50
Q

III parasympathetic

A
  • pupillary constrictor muscle

- ciliary muscle of lens

51
Q

III lesion

A

-paralysis of external ocular muscles (eye pulled outward and downward (spared lateral rectus & external oblique muscle)

  • dilated pupil
  • diplopia - double vision
52
Q

optic II

A

special sensory afferent
-vision

terminates in diencephalon

goes to lateral geniculate nucleus of thalamus

53
Q

olfactory I

A

special sensory afferent

smell within nasal cavity

projects to olfactory bulb (to limbic system)

54
Q

I lesion

A

anosmia - loss of sense of smell
-due to - head injury, viral infection, tumors

patients sometimes complain of loss of taste when it’s actually olfaction

55
Q

I and II

A

of brainstem