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Anatomy Test 4 > Cranial Nerves > Flashcards

Cranial Nerves Flashcards

1
Q

which cranial nerves are purely motor?

A

CN IV–trochlear, CN VI–abducens, CN XI–accessory, CN XII–hypoglossal

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2
Q

which cranial nerves are purely sensory?

A

CN I–olfactory, CN II–optic, CN VIII–vestibulocochlear, V1—opthalamic division, V2–maxillary division

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3
Q

which cranial nerves are motor and sensory?

A

mandibular division V3

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4
Q

which cranial nerves are motor, sensory, parasympathetic?

A

CN VII–facial, CN IX–glossopharyngeal, CN X–vagus

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5
Q

which cranial nerves are motor and parasympathetic?

A

CN III-oculomotor

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6
Q

What is the general function the olfactory nerve I?

A

special sense of smell

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7
Q

what is the general function of the optic nerve II?

A

special sense of sight

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8
Q

what is the general function of the oculomotor nerve III?

A

motor to selected extraocular muscles; parasympathetic to ciliary and sphincter pupillae mm via ciliary ganglion

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9
Q

what is the general function of the trochlear nerve IV?

A

motor to superior oblique extraocular muscle

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10
Q

what is the general function of the trigeminal nerve V?

A

VI: sensory to the orbit and forehead
V2: sensory to upper jaw and region
V3: sensory to lower jaw and region; anterior 2/3 of tongue general sensation
V3: motor to muscles of mastication, tensor tympani, tensor palati, anterior belly of digastric and mylohyoid

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11
Q

what is the general function of the abducens nerve VI?

A

motor to the lateral rectus extraocular muscle

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12
Q

what is the general function of the facial nerve VII?

A

motor to the muscles of facial expression, stapedius, stylohyoid and posterior belly of the digastric;
carries special sense of taste fibers to anterior 2/3 tongue; parasympathetic to sublingual and submandibular glands via submandibular gangion; parasympathetic to lacrimal gland via pterygopalatine (sphenopalatine) ganglion.

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13
Q

what is the general function of the vestibulocochlear nerve VIII?

A

special sense of hearing, balance, and acceleration

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14
Q

what is the general function of the glossopharyngeal nerve IX

A

motor to the stylopharyngeus m; sensory from the middle ear, soft palate, tonsils/pharynx, carotid sinus/body and tongue; parasympathetic to parotid gland via otic ganglion
Taste to posterior 1/3

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15
Q

what is the general function of the vagus nerve X?

A

parasympathetic to thorax and most of the abdomen;
motor to pharynx, larynx and soft palate (fibers of XI), upper esophagus;
sensory from external acoustic meats, larynx, thorax, esophagus and digestive tract
Taste from epiglottis and palate

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16
Q

what is the general function of the accessory nerve XI?

A

cranial fibers distributed via CN X to pharynx (motor); spinal fibers (motor) to the SCM and trapezius

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17
Q

what is the general function of the hypoglossal nerve XII?

A

motor to muscles of the tongue except the palatoglossus (XI via X)

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18
Q

how would you clinically test the olfactory nerve? I

A

test the sense of the smell in each nostril (smelling salts)

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19
Q

how would you clinically test the optic nerve? II

A

any changes in eye sight

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20
Q

how would you clinically test the oculomotor nerve? III

A

in complete paralysis of III, eye cannot be moved up, down or inward; at rest, the eye gazes laterally (external strabismus); ptosis due to paralyzed levator papebrae superioris; dilated pupil (paralysis of sphincter and unopposed action of dilator–sympathetic).

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21
Q

how would you clinically test the trochlear nerve? IV

A

double vision looking straight forward due to paralysis of Superior oblique; inability to depress the eye while abducted; inability to intort the eye, so pt presents with their head tilted to attempt to maintain a vertical axis to the affected eye to minimize double vision

22
Q

how would you clinically test the V1 branch of CN V?

A

touch skin of forehead (sensory)

23
Q

how would you clinically test the V2 branch of CN V?

A

touch skin of cheek/upper lip (sensory)

24
Q

how would you clinically test the V3 branch of CN V?

A

touch skin of lower lip/chin (sensory) and ask them to clench their teeth (motor for temporalis, massester and medial pterygoid mm.)

25
Q

how would you clinically test the abducens nerve? VI

A

ask them to turn their eye laterally (which they cannot because of unopposed action caused by medial strabismus)

26
Q

how would you clinically test the facial nerve VII?

A

show teeth by separating lips with teeth clenched; taste on each 1/2 of anterior 2/3 of tongue

27
Q

how would you clinically test the vestibulocochlear nerve? VIII

A

patient will have vertigo and may not be able to hear

28
Q

how would you clinically test the glossopharyngeal nerve? IX

A

test general sensation and taste on posterior 1/3 of tongue

29
Q

how would you clinically test the vagus nerve? X

A

touch lateral wall of pharynx with tongue depressor to initiate gag reflex

30
Q

how would you clinically test the accessory nerve? XI

A

ask them to shrug (trapezius) and to rotate head in one direct against pressure (SCM)

31
Q

how would you clinically test the hypoglossal nerve? XII

A

ask them to stick out tongue; it should deviate to the side of the affected nerve as that side will atrophy

32
Q

what is the only cranial nerve to exit the dorsal aspect of the brainstem?

A

trochlear nerve (IV)

33
Q

what are the four autonomic ganglia of the head? which division of the ANS synapse in these ganglia?

A

Ciliary, Pterygopalatine, submandibular, otic;

preganglionic parasympathetic fibers

34
Q

Which cranial nerves supply preganglionic parasympathetic fibers to each ganglia?

A

Ciliary–III, Pterygopalatine and submandibular–VII, and Otic–IX

35
Q

what are the rules of the autonomics of the head. how to pre- and post-ganglionic fibers reach their targets? parasympathetic and sympathetic?

A

ALL ganglia in the head are parasympathetic; Preganglionic parasympathetic fibers reach their target ganglia via branches of CN III, VII or IX;
Postganglionic parasympathetic fibers reach their end organs by hitch-hiking along branches of CN V.
Preganglionic sympathetic fibers arise in T1-T4; Postganglionic sympathetic fibers arise from the superior cervical ganglion and reach their target end organs via branches of the internal and external carotid arteries.

36
Q

what is the exception of innervation relating to the tongue?

A

All the muscles of the tongue are innervated by the hypoglossal nerve (XII) except the palatoglossus which is innervated by CN XI via X.

37
Q

what is the exception of innervation relating to the soft palate?

A

All of the muscles of the soft palate are innervated by the cranial part of the accessory nerve reaching the pharyngeal plexus via the vagus nerve (XI via X) except the tensor palati, which is innervated by V3.

38
Q

what is the exception of innervation relating to the pharynx?

A

All of the muscles of the pharynx are innervated by CN XI via X except the stylopharyngeus which gets its motor innervation via CN IX.

39
Q

what is the exception of innervation relating to the larynx?

A

All of the muscles of the larynx are innervated by the recurrent laryngeal nerve except for the cricothyroid, which is innervated by the external laryngeal nerve.

40
Q

what is the exception of innervation relating to the vocal fold?

A

Sensory innervation above the vocal fold is by the internal laryngeal nerve while below the fold the recurrent laryngeal nerve is responsible.

41
Q

Name the foramen though which the CN leaves the cranial cavity and foramen by which it exits on the face or skull (if required):
Olfactory nerve
Optic
Oculomotor

A

I: enters via cribiform plate of the ethmoid
II: optic canal
III: superior orbital fissure

42
Q

Name the foramen though which the CN leaves the cranial cavity and foramen by which it exits on the face or skull (if required):
Trochlear
Trigeminal
Abducens

A

IV: SOF
V1: SOF, V2: Foramen rotundum, V3: foramen ovale
VI: SOF

43
Q

Name the foramen though which the CN leaves the cranial cavity and foramen by which it exits on the face or skull (if required):
Facial
Vestibulocochlear
Glossopharyngeal

A

VII: internal acoustic meatus
VIII: internal acoustic meatus
IX: jugular foramen

44
Q

Name the foramen though which the CN leaves the cranial cavity and foramen by which it exits on the face or skull (if required):
Vagus
Accessory
Hypoglossal

A

X: jugular foramen
XI: jugular foramen
XII: hypoglossal canal

45
Q

Which cranial nerves are associated with the cavernous sinus and why is this clinically important?

A

III, IV, V1, V2 (possibly), VI. they become involved in cavernous sinus syndrome.

46
Q

What is cavernous sinus syndrome? Which CN is affected first?

A

infection thrombi pass to the cavernous sinus and lodge there and cause eventual paralysis of the eye–affecting the nerves of the extraocular mm. CN VI is affected first as it passes thru the cavernous sinus (the others are embedded in the lateral dural wall so are affected later.

47
Q

What is the anatomical basis for Horner’s syndrome?

A

Postganglionic SYMPATHETIC fibers arising from their superior cervical ganglion that hitch-hike along the carotid aa to their target organs are disrupted. Pupillary constriction results from paralysis of the dilator pupillae m. Ptsosi is the result of paralysis of the superior tarsal m. Vasodilation and dry face are due to the lack of sympathetic innervation to the blood vessels and glands of the skin of the face.

48
Q

What specific structures compose the pharyngeal plexus?

A

Cranial accessory fibers of CN XI distributed by the vagus nerce (XI via X); and fibers of the glossopharyngeal nerve (IX); and postganglionic sympathetic fibers

49
Q

what is the modalities of the pharyngeal plexus

A

motor, sensory, sympathetic

50
Q

what are the primary functions of the pharyngeal plexus?

A

motor to the pharyngeal constrictors/soft palate, and sensory to the mucosa of the pharynx

Anatomy Test 4 (8 decks)

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