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809 - Exam Block 2 > Cranial Nerves 4 - Herring > Flashcards

Cranial Nerves 4 - Herring Flashcards

1
Q

Only composed of special sensory fibers for vision

A

CN II

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2
Q

1st order cell bodies for vision of CN II = ____________ of the inner layer of the eyeball

A

Retinal ganglion cells

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3
Q

Right and left optic nerves unite in the cranial cavity to form the

A

optic chiasm

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4
Q

Some central processes of CN II, cross to the other side (decussate); others do not = this forms the ___________

A

optic tracts

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5
Q

Optic tracts of CN II continue to 2nd-order cell
bodies in the ___________ of
the thalamus (primary pathway) and SYNAPSE here as well

A

lateral geniculate nucleus

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6
Q

Axons from the 2nd order cell bodies of CN II project to the _________ which is for getting visual stimulus back to the occipital lobe

A

occipital cortex

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7
Q

Lesions of CN II present with a __________ of visual field defects

A

RANGE

We can have complete blindness from one or both eyes

Loss of only a portion of
the visual field in each eye
* Due to the mix of
some fibers crossing
and others not
crossing at the optic
chiasm

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8
Q

Each cranial nerve reflex will have a ________ limb & a _________ limb

A

sensory ; motor

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9
Q

For the most part, 2nd order sensory neurons of CN II project to the __________ limb

A

motor

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10
Q

Regarding pupillary light reflex, sensory CN II senses

A

light

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11
Q

Regarding pupillary light reflex, CN III is _______ and sends parasympathetic to the _________ muscle

A

motor ; constrictor pupillae muscle

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12
Q

What is the smallest cranial nerve

A

CN IV

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13
Q

Where are the somatic motor LMNs of CN IV located

A

trochlear nucleus

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14
Q

Axons of LMNs of CN IV decussate within the

A

brainstem

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15
Q

Axons of LMNs of CN IV decussate within the brainstem then exit on its ___________ surface which is the ONLY CN TO DO SO

A

dorsal

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16
Q

Axons from the right trochlear nucleus form the ______ trochlear nerve

A

left

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17
Q

What muscle is the peripheral target of CN IV

A

superior oblique muscle

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18
Q

Regarding a lesion of CN IV, someone would be unable to look ________ when the pupil (eye) is adducted

A

down

Results in diplopia when both eyes (pupils) are looking down in the medial position (going
down stairs, reading)

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19
Q

CN IV nerve lesion =

A

ipsilateral pupil presentation

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20
Q

CN IV - Trochlear nucleus lesion =

A

contralateral pupil presentation

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21
Q

Where are the LMNs of CN VI

A

Abducens nucleus

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22
Q

What muscle is the peripheral target of CN VI

A

lateral rectus muscle

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23
Q

Lesion of CN VI

A

Unable to ABDUCT the eye during clinical (“H-pattern”) testing

Results in diplopia when looking toward the affected side

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24
Q

regarding a lesion to CN VI or left abducens nucleus, when a patient is asked to look to the left, what happens?

A

The patient’s left eye stays straight and the patient’s right eye looks left (double vision)

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25
Q

regarding a lesion to CN VI or left abducens nucleus, when a patient is asked to look to the right, what happens?

A

both eyes look to the right (normal vision) because it’s the left lateral rectus muscle that is damaged which is not used when looking to the right

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26
Q

What is the primary cranial nerve for somatic motor innervation to the extra-ocular muscles & levator palpebrae superioris

Except lateral rectus muscle (CN VI) and superior oblique (CN IV)

A

CN III

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27
Q

CN III has ____________
fibers to 2 of the 3 intrinsic
muscles of the eye

A

Preganglionic parasympathetic

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28
Q

Regarding somatic motor for CN III, where are the LMNs

A

oculomotor nucleus

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29
Q

axons of LMNs of CN III form the _______ nerve

A

oculomotor nerve

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30
Q

Where are the preGPS cell bodies of CN III located

A

Edinger-Westphal (accessory
oculomotor) nucleus

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31
Q

Where are the postganglionic parasympathetic cell
bodies of CN III located

A

Ciliary ganglion

32
Q

Postganglionic parasympathetic fibers
(axons) of CN III hitch a ride on a branch of CN V, which branch?

A

V1

33
Q

What are the 4 peripheral targets of CN III

A

Extraocular muscules
Levator palpebrae superioris
Sphincter pupillae
ciliary muscles (lens)

34
Q

Lesion to CN III - the eye (pupil) has what 3 symptoms in the anatomical position (when patient attempts to look straight ahead):

A

Dilated pupil

Ptosis (droopiness) of upper eyelid

Pupil is directed “down & out” (resulting in diplopia)

** this is because we have lost 4 of the 6 muscles **

35
Q

What is the primary cranial nerve for somatic sensory (pain, temperature, proprioception, & touch) innervation from the head

A

CN V

36
Q

CN V is somatic motor to what 2 muscles

A

muscles of mastication

pharyngeal arch 1 muscles

37
Q

Regarding somatic sensory for CN V, the 1st order cell bodies for touch, pain, & temp are located in the

A

trigeminal ganglion

38
Q

The peripheral processes of CN V form 3 divisions, what are they

A

CN V1
CN V2
CN V3

39
Q

Which branch of CN V is somatic motor

A

CN V3 (mandibular)

40
Q

Central processes forming the trigeminal nerve project to different nuclei (2nd order cell bodies) - what are they?

A

Main / chief / principal nucleus

Spinal trigeminal nucleus

41
Q

Discriminative touch of CN V goes to what nucleus

A

Main / chief / principal nucleus

42
Q

Pain and temperature for CN V goes to what nucleus

A

Spinal trigeminal nucleus

43
Q

For CN V, 2nd order cell bodies primarily send their axons to 3rd order cell bodies located in the

A

VPM of the thalamus

44
Q

For CN V, 3rd order cell bodies project to the inferolateral portion of the

A

postcentral gyrus

45
Q

For CN V, where are the 1st order cell bodies for proprioception

A

Mesencephalic nucleus

46
Q

For somatic motor of CN V, where are the UMNs located

A

Cell bodies located in the precentral gyrus

47
Q

For CN V somatic motor, UMNs axons project BILATERALLY through the _________ tract

A

corticonuclear / corticobulbar

48
Q

The somatic motor LMNs of CN V are located in what nucleus

A

trigeminal motor nucleus

49
Q

The axons of LMNs of CN V contribute to CN V and follow what branch of CN V

A

mandibular (CN V3)

50
Q

What are the sensory from (pain, temp, touch) peripheral targets of CN V1

A

Skin at & superior to the eyes

Eyeball (including cornea)

** basically skin of the forehead and eyeball **

51
Q

Lesion of CN V1 =

A

Decreased (or abnormal) sensations of pain, temperature, & touch from area of distribution

** lose sensory from forehead and eyeball **

52
Q

Peripheral targets of V3 = Sensory (pain, temp, touch) from

A

Skin along the region of the mandible

Anterior 2/3rd tongue

External ear

53
Q

Peripheral targets of V3 = Somatic motor to what 2 muscles

A

muscles of mastication

pharyngeal arch 1 muscles

54
Q

CN V3 passes through _________ to reach __________ ganglion

A

foramen ovale

trigeminal

55
Q

Sensory lesion to CN V3

A

Decreased (or abnormal) sensations of pain, temperature, & touch from area of distribution

** mandible and anterior 2/3 tongue **

56
Q

Motor lesion to CN V3

A

Deviation of mandible to side of the lesion during mouth opening

** lose motor to ipsilateral muscles of mastication **

57
Q

Sensory corneal reflex is from what CN

A

V1 (somatic sensory from eyeball)

** this is to close eyelid/blink **

58
Q

Motor corneal reflex is from what CN

A

CN VII (somatic motor to orbicularis oculi & visceral motor parasympathetic to lacrimal gland for tear production)

59
Q

Signs & Symptoms of impacted CN V1 & CN V2 from Cavernous Sinus Thrombosis

A

sensory deficits for forehead, eyeball, and cheek

60
Q

Regarding Sympathetic Pathway to the Head - where are the preganglionic sympathetic cell
bodies

A

T1 - T4

61
Q

Regarding Sympathetic Pathway to the Head - where are the postganglionic sympathetic cell bodies

A

Superior Cervical Ganglion

62
Q

Postganglionic sympathetic fibers from the superior cervical ganglion form

A

cephalic arterial rami

63
Q

After postGS fibers form cephalic arterial rami, they reach their target organs by forming a plexuses, but to now get to the EYE, they follow what artery

A

ophthalmic artery

64
Q

If we lost sympathetics in the head, what would we see

A

Flushed face due to vasodilation as we have lost VASOCONSTRICTION from the smooth muscle of arteries

No more sweating because we have lost innervation to our sweat glands

Dry mouth because we have lost innervation to our salivary glands

Constricted pupil because we have lost innervation to the dilator pupillae muscle

Ptosis because we have lost innervation the superior tarsal muscle BUT we still have the levator palpebrae muscle so it’s only slight ptosis

65
Q

Signs/symptoms of Oculosympathetic Palsy / Horner’s Syndrome

A

Slight ptosis of the upper eyelid

Constricted pupil

Vasodilation

Decreased sweating

66
Q

Central processes of what cell bodies form CN II (optic nerve)

A

retinal ganglion cells

67
Q

if sensory CN II is damaged, we will have no ____________

A

constriction

68
Q

if right side motor CN III is damaged, what will we see

A

nothing will happen on the right side but we will have the expected response on the left side

69
Q

what can we expect to see if we accidentally impair CN II during a dental injection

A

temporary complete or partial blindness

70
Q

the axons of the right abducens nucleus forms the _____ abducens nerve

A

right

71
Q

if you damage CN III as it travels between the brainstem and superior orbital fissure, you damage what 2 fibers?

A

preGPS fibers

somatic motor fibers

72
Q

Cavernous Sinus Thrombosis can impact what CNs?

A

3, 4, 6, V1 and V2

73
Q

What 3 signs/symptoms can you expect to see with cavernous sinus thrombosis

A

Fixed pupil (can’t move because we lost all the nerves innervating the muscles to move the eye)

Pupil unresponsive to light changes (due to loss of both parasympathetic innervation (CN III) and sympathetic innervation (traveling on ICA)

Ptosis of the upper eyelid (because lost innervation to it)

74
Q

What signs/symptoms can we expect to see from a misplaced dental injection to CN III?

A

Ptosis of upper eyelid (because we lost innervation to levator palpebrae superioris)

Pupil in down and out position at rest (because we lost innervation to 4 out of the 6 muscles)

Can’t do H pattern

75
Q

Proprioception of CN V goes to what nucleus

A

Mesencephalic nucleus

809 - Exam Block 2 (14 decks)

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