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Cranial nerves Flashcards

1
Q

What are cranial nerves part of?

A

Peripheral nervous system

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2
Q

How many cranial nerves are there?

A

12 pairs

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3
Q

Where do cranial nerves arise?

A

Irregular intervals from the CNS

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4
Q

What do cranial nerves supply?

A

Head and neck except for vagus nerves which also supply structures in the thorax and abdomen

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5
Q

How are cranial nerves named?

A

Have a name and roman numeral which relates to there order

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6
Q

What kind of axons do cranial nerve carry?

A

some will be mixed but some are purely sensory or purely motor or autonomics (don’t all carry autonomic nerves)

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7
Q

What does the brain stem adjoin?

A

The brain to the spinal cord

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8
Q

What is the brainstem important for?

A

Cadio-respiratory functions and maintaining consciousness

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9
Q

Where are most of the cranial nerve nuclei?

A

in the brain stem

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10
Q

What is a nuclei?

A

Collection of the cell bodies of nerve fibres that make up the whole cranial nerve

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11
Q

Label the brain, midbrain, pons and medulla and how many CNs there are

A

2,2,4,4

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12
Q

What two Cranial nerves come from the forebrain?

A

Olfactory

Optic

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13
Q

What number is the olfactory nerve?

A

I

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14
Q

What does the olfactory nerve do?

A

special sensory

sense of smell (olfaction)

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15
Q

What is the route of the olfactory nerve?

A
  • Temporal lobe
  • Olfactory tract and bulb
  • Cribriform foramina (esmoid bone)
  • Through roof of nose to top of nasal cavity
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16
Q

How is the olfactory nerve tested?

A

Not usually tested- ask if lost sense of smell

Test one nostril at a time- uses smelling salts or whatever you have e.g. coffee

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17
Q

What is anosmia?

A

Losing sense of smell

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18
Q

What is the most common reason for losing your sense of smell?

A

Common cold

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19
Q

What can cause a loss of sense of smell?

A

Head injury

Intracranial tumours at base of frontal lobe

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20
Q

What is the number of the optic nerve?

A

II

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21
Q

What is the function of the optic nerve?

A

Special sense

Vision

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22
Q

Where does the optic nerve travel?

A
  • Visual cortex of the brain
  • Optic canal
  • Optic tract
  • Chiasm
  • Retina
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23
Q

How do you test the optic nerve?

A

Test one eye at a time

Visual tests

Testing pupil responses/reflexes

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24
Q

How can you see the optic nerve?

A

Use an opthalmoscope

Can see the optic disk- origin of optic nerve

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25
Q

What is a papillodema?

A

If intracranial pressure raises, optic disc may swell due to extension of meinges the nerve carries

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26
Q

What will lesions fot the retina or optic nerve cause?

A

Visual disturbance affecting only one eye

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27
Q

Where will lesions causing visual defects in both eyes occur?

A

Chiasm or further back

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28
Q

What can cause compression of the optic chiasm?

A

Pituitary tumour

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29
Q

What is the function of the occulomotor nerve?

A
  • Motor
  • Autonomic (parasympathetic)
  • Moves the eye
  • Opens eyelid
  • Control lens and pupil of eye
  • Innervates extra ocular muscles, LPS, Sphincter papillae, ciliary muscle
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30
Q

What is the number of the oculomotor nerve?

A

III

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31
Q

What happens to occulomotor nerve if intercranial pressure increases?

A

Uncus can slip over the edge of entorium cerebelli and squash the occulomotor nerve

32
Q

What will happen if occulomotor nerve is squashed?

A

Will start autonomic parts of nerve being effected as they are on the outside

So pupil will dilate and be blown

then other things it does will be effected

33
Q

How would you test the occulomotor nerve?

34
Q

What are the cinical points of the occulomotor nerve?

35
Q

What number is the trochlear nerve?

36
Q

What does the trochlear nerve supply?

A

1 Extra orbital muscle

37
Q

What is special about the Trochlear nerve?

A

Emerges from the back of the brainstem

38
Q

What are the two CN from the midbrain?

A

Oculomotor

Trochlear

39
Q

What are the 4 cranial nerves of the pons?

A

Trigeminal (V)

Abducens (VI)

Facial (VII)

Vestibular (VIII)

40
Q

What is the route of the occulomotor nerve and the trochlear nerve?

A
  • Midbrain
  • Cavernous sinus
  • Superior orbital fissure
  • Orbit
41
Q

What is the function of the trochlear nerve?

A
  • Motor
  • Innervates 1 extra orbital muscle
  • Moves the eye
42
Q

How would you test the trochlear nerve?

A

•Tests eye movement

43
Q

What are the clinical signs of injury to the Trochlear?

A
  • Diplopia (double vision)- rare and often subtle e.g. with a tilt of the head
  • From head injury or congenital palsies
44
Q

What is the route of the Trigeminal?

A
  • Pons
  • Branches-
  • Ophthalmic- superior orbital fissure and eye
  • Maxillary- foramen rotundum and cheek

Mandibular- foramen ovale and jaw

45
Q

What is the function and target tissue of the trigeminal nerve?

A
  • Motor and Sensory
  • Sensory to cornea of the eye, and face
  • Sensation of 2/3 of tongue
  • Motor to muscles of mastication
46
Q

How is the trigeminal nerve tested?

A
  • Sensation on the face
  • Muscles of mastication
  • Corneal reflex
47
Q

What is the pathology and injury of the trigeminal nerve?

A
  • Main sensory nerve to skin of face and facial structures
  • Afferent limb of corneal reflex
  • Vulnerable in facial trauma
  • Shingles- trigeminal neuralgia
48
Q

What is the route of the Abducens nerve?

A
  • Bottom of pons
  • Cavernous sinus
  • Superior orbital fissure
  • orbit
49
Q

What is the function of the Abducens?

A
  • Motor
  • 1 muscle of the eye
  • Abducts eye- moves laterally
50
Q

How would you test the Abducens?

A
  • Eye movements
  • Diplopia (double vision)
51
Q

What is the pathology and injury to the Abducens?

A
  • Caused by increased intracranial pressure
  • Eye is stuck medially
52
Q

What is the route of the facial nerve?

A
  • Bottom of pons
  • Internal auditory meatus
  • Petrous bone
  • Gives off some branches in petrous bone
  • Exits base of skull then gives off branches
53
Q

What is the function of the facial nerve?

A
  • Motor, special sensory and autonomic parasympathetic
  • Motor- muscles of facial expression
  • Special sensory- taste to anterior 2/3 of tongue
  • Autonomic- lacrimal gland and salivary glands
54
Q

How would you test the facial nerve?

A
  • Muscles of facial expression movement
  • Corneal reflex
  • Taste
55
Q

What is the injury and pathology of the facial nerve?

A
  • Close relationship with vestibulocochlear nerve as both go through IAM
  • Close relationship to middle ear as goes through the petrous temporal bone
  • Close relationship to parotid gland
  • Idiopathic facial nerve palsy (bells palsy)
56
Q

What is the route of the vestibulochochlear nerve?

A
  • Pons
  • Internal auditory meatus
  • Petrous bone
  • Cochlea and inner ear
  • Primary auditory cortex (temporal lobe)
57
Q

What is the function of the vestibulocochlear nerve?

A
  • Special sensory
  • Conveys sense of hearing
58
Q

What is the test for the vestbulocochlear nerve?

A
  • Test hearing
  • Enquire about balance
59
Q

What is the pathology and injury to the vestibulocochlear nerve?

A
  • Hearing loss
  • Presbyacusis- old age related hearing loss
  • Semicircular canals vestibulocochlear nerve and brain nucleus can cause disturbance of balance and nystagmus
  • Acoustic neuroma- benign tumour involving the vestibulocochlear nerve- compression so causes hearing loss, tinnitus, vertigo and numbness pain or weakness down one half of the face
60
Q

What is the route of the glossopharyngeal nerve?

A
  • Medulla
  • Through jugular foramen
  • Descends through base of neck
  • To tongue and pharynx
61
Q

What is the function of the glossopharyngeal nerve?

A
  • General sensory, special sensory, autonomic and motor
  • General sensation of soft palate, tonsils and pharynx, middle ear and tympanic membrane, carotid body and sinus
  • Special sensory- Taste of posterior 1/3 of tongue
  • Autonomic innervation of parotid gland
  • Motor supplies one muscle- stylopharyngeaus
62
Q

How would you test the glossopharyngeal nerve?

A
  • Gag reflex
  • Taste not formally tested
  • Tested in conjunction with vagus nerve
63
Q

What is the injury to the glossopharngeal nerve?

A

isolated lesions are rare

64
Q

What is the route of the vagus nerve?

A
  • Medulla
  • Through Jugular foramen
  • Descends through the neck in the carotid sheath
  • Gives off branches to the neck
  • Continue to thorax and gives branches
  • Into abdomen
65
Q

What is the function of the vagus nerve?

A
  • Sensory to lower pharynx and larynx
  • Motor- Muscles of soft palate, pharynx, and larynx (talking and eating)
  • Parasympathetic to thoracic and abdominal viscera
66
Q

What is the test of the vagus nerve?

A
  • Speech
  • Swallow and cough
  • Ahhhh and observe uvula
  • Gag reflex
67
Q

What is the pathology and injury to the vagus nerve?

A
  • Isolated lesions are rare
  • Deviation of uvula when soft palate elevated when saying ahhhh
  • Injury to recurrent laryngeal nerve branch can cause hoarseness and dysphonia
68
Q

What is the route of the spinal accesory nerve?

A
  • Medulla
  • Jugular foramen
  • Has a cranial and spinal route
  • Cranial joins the vagus – not important- this info is on spinal
  • Spinal goes through foramen magnum
69
Q

What is the function of the spinal accessory nerve?

A
  • Motor
  • Sternocleidomastoid and trapezius
70
Q

How would you test the spinal accessory nerve?

A
  • Shrug shoulders against resistance
  • Turn head against resistance
71
Q

What is the injury and pathology for the spinal accessory nerve

A
  • Spinal accessory nerve runs down through neck in posterior triangle
  • Susceptible to injury in this area e.g. in lymph nodes biopsies, surgery and stab wounds
72
Q

What is the route of the hypoglossal nerve?

A
  • From medulla
  • Through hypoglossal canal
  • To the tongue
73
Q

What is the function of the hypoglossal nerve?

A
  • Motor
  • Muscles of the tongue
74
Q

How would you test the hypoglossal nerve?

A

•Inspect movement of the tongue

75
Q

What is the injury and pathology of the hypoglossal nerve?

A
  • Rare
  • Damage causes weakness and atrophy of the tongue muscles on ipsolateral side

Head And Neck (18 decks)

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