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Neuro Exam 1 > Cranial Nerves > Flashcards

Cranial Nerves Flashcards

1
Q

What type of nerve fibers convey impusles from the skin and skeletal muscle spindles?

A

General somatic afferents (somatic sensation aka general sensory)

[GSA]

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2
Q

What type of nerve fibers convey impulses from the viscera and blood vessels?

A

General visceral afferents (visceral sensation)

[GVA]

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3
Q

What type of nerve fibers innervate the smooth muscle of the viscera, intraocular mm, heart, salivary glands, etc.?

A

General visceral efferents (visceromotor function)

[GVE]

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4
Q

What type of nerve fibers innervate skeletal muscles?

A

General somatic efferents (somatomotor function)

[GSE]

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5
Q

What special type of nerve fibers conduct impulses from the retina and from the auditory and vestibular apparatus?

A

Special somatic afferents

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6
Q

What special type of nerve fibers conduct impulses from the taste buds of the tongue and from the olfactory mucosa?

A

Special visceral afferents (special sensory)

[SSA]

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7
Q

What special type of nerve fibers innervate skeletal muscles derived from the branchial arches?

A

Special visceral efferents (branchial motor)

[SVE]

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8
Q

4 cranial nerves are located ______ the pons, including I, II, III, and IV.

4 cranial nerves are located in the ______, including V, VI, VII, and VIII.

4 cranial nerves are located in the ______, including IX, X, XI, and XII.

A

Above

Pons

Medulla

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9
Q

What 4 cranial nerve nuclei are located medially?

A

III, IV, VI, XII

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10
Q

Modality(-ies) and associated function of CN I

A

Special sensory afferent: smell

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11
Q

Modality(-ies) and associated function of CN II

A

Special sensory afferent: visual info from retina

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12
Q

Modality(-ies) and associated function of CN III

A

Somatic motor (efferent): innervates levator palpebrae superioris, superior rectus, medial rectus, inferior rectus, and inferior oblique mm.

Parasympathetic motor (visceral efferent): innervates constrictor pupillae and ciliary mm.

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13
Q

Modality(-ies) and associated functions of CN IV

A

Somatic motor (efferent): innervation of superior oblique m. of the eye

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14
Q

Modality(-ies) and associated function of CN VI

A

Somatic motor (efferent): innervates lateral rectus m. of the eye

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15
Q

Modality(-ies) and associated functions of CN V

A

General sensory (afferent): general sensation from face and anterior scalp as far posteriorly as apex of the head, conjunctivae, bulb of the eye, mucous membranes of paranasal sinsuses, and nasal and oral cavities including the tongue and teeth, part of the external aspect of the TM, and from meninges of the anterior and middle cranial fossae

Branchial motor (efferent): innervates muscles of mastication — masseter, temporalis, medial and lateral pterygoid, tensor tympani, tensores veli palatini, mylohyoid, and anterior belly of the digastric mm.

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16
Q

Modality(-ies) and associated functions of CN VII

A

General sensory (afferent): sensation from variable area of pinna/auricle, external acoustic meatus, external TM, and small area of skin behind ear

Special sensory (afferent): taste from anterior 2/3 tongue and soft palate

Branchial motor (efferent): innervates muscles of facial expression

Parasympathetic motor (visceral efferent): stimulates lacrimal, submandibular, and sublingual glands as well as oral, nasal, and pharyngeal mucosal glands

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17
Q

Modality(-ies) and associated functions of CN VIII

A

Special sensory (afferent): balance (via vestibular nucleus), hearing (via cochlear nucleus)

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18
Q

Modality(-ies) and associated functions of CN IX

A

General sensory (afferent): sensation from posterior 1/3 tongue, tonsil, soft palate, fauces, uvula, mucosa of internal TM and cavity, mastoid air cells, auditory tube, upper pharynx

Visceral sensory (afferent): subconscious sensations from carotid body and carotid sinus

Special sensory (afferent): taste from posterior 1/3 tongue

Branchial motor (efferent): innervation of stylopharyngeus m.

Parasympathetic motor (visceral efferent): innervates parotid gland, controls blood vessels in carotid body and BP in carotid sinus

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19
Q

Modality(-ies) and associated functions of CN X

A

General sensory (afferent): general sensation from posterior meninges, concha, skin at back of ear and in external acoustic meatus, part of external TM, pharynx, larynx

Visceral sensory (afferent): sensation from lower pharynx, larynx, trachea, esophagus, thoracic and abdominal viscera, stretch receptors of aortic arch, chemoreceptors in aortic bodies

Branchial motor (efferent): innervates via pharyngeal plexus the pharyngeal constrictors, levator palati, salpingopharyngeus, palatopharyngeus, palatoglossus, and intrinsic mm of larynx

Parasympathetic motor (visceral efferent): smooth muscle and glands of pharynx, thoracic and abdominal viscera, cardiac muscle, aortic bodies

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20
Q

Modality(-ies) and associated functions of CN XI

A

Branchial motor (efferent): innervate sternomastoid and upper fibers of trapezius

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21
Q

Modality(-ies) and associated function of CN XII

A

Somatic motor (efferent): innervates 3/4 extrinsic mm of the tongue: genioglossus, styloglossus, hyoglossus, and ALL intrinsic mm of the tongue

[innervation of palatoglossus is with CN X]

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22
Q

Primary branches of CN V

A

V1 = ophthalmic

V2 = maxillary

V3 = mandibular

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23
Q

Primary branches of V1: ophthalmic

A

Lacrimal
Frontal
Nasociliary
Meningeal

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24
Q

Primary branches of V2: maxillary

A 
Zygomatic
Infraorbital
Superior alveolar
Nasociliary
Palatine
Meningeal
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25
Q

Primary branches of mandibular V3

A 
Buccal
Lingual
Inferior alveolar
Auriculotemporal
Meningeal
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26
Q

Which primary branch of CN V is the only one with branchial motor function? What are its sub-branches?

A

Mandibular (V3)

Sub-branches:
Medial pterygoid
Lateral pterygoid
Masseteric
Deep temporal
Mylohyoid
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27
Q

Cells of origin of CN I

A

Olfactory bulb

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28
Q

Cells of origin of CN II

A

Retinal photoreceptors

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29
Q

Nuclei associated with CN III

A

Oculomotor nucleus (SME)

Edinger-Westphal nucleus (VME)

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30
Q

Nucleus associated with CN IV

A

Trochlear nucleus

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31
Q

Nucleus associated with CN VI

A

Abducens nucleus

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32
Q

Nucleus and ganglion associated with CN V in terms of general sensory afferent innervation

A

Trigeminal nucleus

Trigeminal ganglion

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33
Q

Nucleus associated with CN V in terms of branchial motor efferent innervation

A

Masticator nucleus

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34
Q

What nuclei (and their associated ganglia) are associated with CN VII

A

GSA: Pontine trigeminal nucleus and spinal trigeminal nucleus (pain) + Geniculate ganglion

SSA: Nucleus solitarius + geniculate ganglion (taste buds)

BME: motor nucleus of CN VII

VME: superior salivatory nucleus + pterygopalatine and submandibular ganglia

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35
Q

Nuclei associated with CN VIII

A

Vestibular nucleus + vestibular ganglion and hair cells

Cochlear nucleus + spiral ganglion + cochlear hair cells

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36
Q

What nuclei (and their associated ganglia) are associated with CN IX?

A

GSA: spinal trigeminal nucleus + superior glossopharyngeal ganglion

VSA: nucleus of tractus solitarius + inferior glossopharyngeal ganglion

SSA: nucleus of tractus solitarius + inferior glossopharyngeal ganglion (taste buds)

BME: nucleus ambiguus

VME: inferior salivatory nucleus + otic ganglion
Nucleus ambiguus

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37
Q

What nuclei (and their associated ganglia) are associated with CN X

A

GSA: spinal trigeminal nucleus + superior vagal ganglion

VSA: nucleus of tractus solitarius + inferior vagal ganglion

BME: nucleus ambiguus

VME: dorsal vagal motor nucleus, nucleus ambiguus

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38
Q

What nucleus is associated with CN XI?

A

Accessory nucleus

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39
Q

What nucleus is associated with CN XII?

A

Hypoglossal nucleus

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40
Q

What 4 cranial nerves have general sensory (afferent) modality?

A

CN V
CN VII
CN IX
CN X

[all via trigeminal nucleus]

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41
Q

What 2 cranial nerves have visceral sensory (afferent) modality?

A

CN IX
CN X

[both via nucleus solitarius]

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42
Q

What 4 cranial nerves have special sensory (afferent) modality?

A 
CN I
CN II
CN VII
CN VIII
CN IX
43
Q

What 4 cranial nerves have somatic motor (efferent) modality?

A

CN III
CN IV
CN VI
CN XII

44
Q

What 5 cranial nerves have branchial motor (efferent) modality?

A 
CN V
CN VII
CN IX
CN X
CN XI
45
Q

What 4 cranial nerves have parasympathetic (visceral) motor modality?

A

CN III
CN VII
CN IX
CN X

46
Q

Pathway of CN I

A

Cribriform plate of ethmoid bone, synapses in olfactor bulb —> piriform cortex

47
Q

Injury to CN I may cause ____, or loss of sense of smell

48
Q

T/F: afferent fibers of CN I travel to the thalamus

49
Q

Pathway of CN II

A

Optic canal of sphenoid bone

50
Q

The optic n. arises from the _____ of the brain

A

Diencephalon

51
Q

What 3 CN’s innervate ocular muscles? These 3 nerves all pass through what hole in the skull?

A

CN III: oculomotor n.
CN IV: trochlear n.
CN VI: abducens n.

All pass through the superior orbital fissure

52
Q

The oculomotor n. moves the eye via 4 muscles:

Superior rectus m.
Medial rectus m.
Inferior rectus m.
Inferior oblique m.

How do each of the above muscles move the eye?

A

Superior rectus = moves eye up

Medial rectus = moves eye medially

Inferior rectus = moves eye down

Inferior oblique = superior rotation

53
Q

What muscle, innervated by the oculomotor nerve, elevates the eyelid?

A

Levator palpebrae m.

54
Q

The oculomotor n. provides parasympathetic innervation to the sphincter pupillae m. and the ciliary m. What is the difference in function of these 2 muscles?

A

Sphincter pupillae = pupillary constriction

Ciliary m. = near vision

55
Q

The oculomotor n. innervates the superior rectus, medial rectus, inferior rectus, and inferior oblique. The other two muscles of the eye are innervated by what 2 cranial nn?

A

Superior oblique = CN IV

Lateral rectus m. = CN VI

56
Q

What would be the result of oculomotor nerve palsy on the right side?

A

Right eye would exhibit downward and outward gaze, dilated pupil, and ptosis

57
Q

What is the smallest cranial n.?

A

Trochlear (IV)

58
Q

The trochlear n (IV) innervates the superior oblique m. of the eye. What is the action of this m?

A

Turns eye down/in

59
Q

What would be the result of CN IV palsy? How do people compensate?

A

Strabismus and diplopia

Eye tilted outward and unable to look down/in

Head tilts AWAY from affected side to compensate

60
Q

The abducens n (VI) innervates the lateral rectus m. What would be the effect of an abducens n. palsy?

A

Diplopia

Inability to laterally move the affected eye

61
Q

What is the largest cranial n.?

A

Trigeminal (V)

62
Q

What would be the result of a trigeminal n. (V) palsy?

A

Numb face (sensory)

Weak jaw (motor) — deviates TOWARDS affected side

63
Q

Clinical manifestations of trigeminal neuralgia

A

Recurrent, sudden sharp pains

Tic douloureux (painful tic) — pains are so intense they cause wincing

64
Q

The corneal reflex can be elicited by touching the eye with a Q-tip. The input is sensed by CN ______, and is transmitted to CN ____ bilaterally

The latter is what causes you to blink

A

V (V1)

VII

65
Q

What CN has dual upper motor neuron innervation?

A

Facial n.

Somatic (branchial) motor for muscles of facial expression

Visceral (parasympathetic) motor for lacrimal gland, sublingual gland, and submandibular gland

Upper part of the face receives innervation from both sides of the brain

Lower part of the face receives innervation only from contralateral side of the brain

66
Q

What branches of the facial nerve contribute to the muscles of facial expression?

A 
Temporal n.
Zygomatic n.
Buccal n.
Mandibular n.
Cervical n.
67
Q

What would be the result of CN VII palsy?

A

Loss of corneal reflex (motor output)

Loss of taste anterior 2/3

Hyperacusis (stapedius paralysis leading to intolerance of sound)

68
Q

Idiopathic mononeuropathy of CN VII leading to sudden onset of facial paralysis, usually resolving in weeks to months

A

Bell’s Palsy

69
Q

What happens with lesions to the cochlear portion of CN VIII?

A

Loss of hearing, tinnitus

70
Q

What happens with lesions to the vestibular portion of CN VIII?

A

Vertigo, nystagmus, vomiting, nausea

71
Q

What are the 6 branches of the glossopharyngeal n.?

A 
Tympanic n.
Branch to carotid sinus
Branch to stylopharyngeus m.
Tonsillar branches
Lingual branches
Pharyngeal branches
72
Q

The stylopharyngeus is the only striated muscle that is innervated by the glossopharyngeal n. What is the action of this m?

A

Elevates pharynx for swallowing/gagging

73
Q

Damage to the glossopharyngeal n. may lead to CN IX palsy and/or associated hemodynamic effects. Describe these

A

CN IX palsy = loss of gag reflex, loss of taste in posterior 1/3 tongue, loss of sensation upper pharynx

Hemodynamic effects = tricks body into thinking BP is low, resulting in unopposed sympathetic response —> increased BP and vasoconstriction

74
Q

What nerve contributes to taste in the supra-epiglottic region?

75
Q

Someone complaining of dysphagia may have an issue with what n?

76
Q

What are the 3 vagal nuclei and their modalities/functions?

A

nucleus Solitarius = visceral Sensory info (e.g., taste, baroreceptors, gut distention)

nucleus aMbiguus = Motor innervation of pharynx, larynx, upper esophagus

Dorsal motor nucleus = sends autonomic (parasympathetic) fibers to heart, lungs, upper GI

77
Q

Effects of Vagus n. palsy

A 
Hoarseness, dysphagia, dysarthria
Loss of gag reflex
Loss of sensation pharynx and larynx
Weak side of palate collapse (lower)
Uvula deviates AWAY from affected side
78
Q

Hemodynamic effects of vagus n. damage

A

Unopposed sympathetic stimulation of the heart, resulting in increased HR, BP, etc.

79
Q

What is the most common cause of syncope?

A

Vasovagal syncope — triggered by vagus n. —> increase parasympathetic outflow, decreasing HR and BP which leads to fainting

[many things can trigger the vagus n. into this response including hot weather, prolonged standing, pain, sight of blood, etc.]

80
Q

What would be the effects of accessory n. palsy?

A

Difficulty turning head toward normal side (SCM) and shoulder droop (affected side)

81
Q

What would be the result of hypoglossal n. palsy?

A

Protrusion of tongue TOWARD the affected side

82
Q

The tongue receives motor, taste, and general sensory from what CNs?

A

Motor: hypoglossal (XII)

Taste: anterior 2/3 from facial (VII), posterior 1/3 from glossopharyngeal (IX), tongue root from vagus (X)

General sensory: anterior 2/3 from mandibular branch of trigeminal (V3), posterior 1/3 from glossopharyngeal (IX), tongue root from vagus (X)

83
Q

The _____ ____ separates the innervation of the anterior 2/3 from the posterior 1/3 of the tongue

A

Terminal sulcus

84
Q

What provides afferent and efferent output for corneal reflex?

A

Afferent = V1

Output = VII (blinking)

85
Q

What provides afferent and efferent output for lacrimation reflex?

A

Afferent = V1

Efferent = VII (tearing)

86
Q

What effect does a damaged V1 have on the lacrimation reflex?

A

No reflex tears can be produced but you can still produce emotional tears

87
Q

What provides afferent and efferent output for gag reflex?

A

Afferent = IX

Efferent = X (gagging)

88
Q

What provides afferent and efferent output for jaw jerk reflex?

A

Afferent = V3

Efferent = V3 (trigeminal reflex)

[place finger on pt’s chin and tap finger, jaw will jerk upwards]

89
Q

What provides afferent and efferent output for pupillary reflex?

A

Afferent = II

Efferent = III (constrict pupil)

90
Q

List all CN’s

A 
I: Olfactory
II: Optic
III: Oculomotor
IV: Trochlear
V: Trigeminal
VI: Abducens
VII: Facial
VIII: Vestibulocochlear
IX: Glossopharyngeal
X: Vagus
XI: Accessory
XII: Hypoglossal
91
Q

List modalities of all cranial nerves in terms of sensory, motor, or both

A

[Some Say Marry Money But My Brother Says Big Boobs Matter Most]

I: Olfactory = Sensory
II: Optic = Sensory
III: Oculomotor = Motor
IV: Trochlear = Motor
V: Trigeminal = Both
VI: Abducens = Motor
VII: Facial = Both
VIII: Vestibulocochlear = Sensory
IX: Glossopharyngeal = Both
X: Vagus = Both
XI: Accessory = Motor
XII: Hypoglossal = Motor
92
Q

What CN(s) is/are associated with the anterior cranial fossa?

93
Q

What CN(s) is/are associated with the middle cranial fossa (through sphenoid bone)?

A

CN II

CN III
CN IV
CN VI
CN V1

CN V2

CN V3

94
Q

What CN(s) is/are associated with the posterior cranial fossa (through temporal or occipital bone)?

A

CN VII
CN VIII

CN IX
CN X
CN XI

CN XII

95
Q

What CNs pass through the optic canal?

96
Q

CN II passes through the optic canal with what vessel?

A

Opthalmic a.

97
Q

What CN’s pass through the superior orbital fissure?

A

CN III
CN IV
CN VI
CN V1

98
Q

What CN passes through the foramen rotundum?

99
Q

What CN passes through the foramen ovale?

100
Q

What vessel passes through the foramen spinosum?

A

Middle meningeal a.

101
Q

What CNs pass through the internal auditory meatus?

A

CN VII

CN VIII

102
Q

What CNs pass through the jugular foramen?

A

CN IX
CN X
CN XI

103
Q

CN’s IX, X, and XI pass through the jugular foramen with what vessel?

A

Jugular v.

104
Q

What CN passes through the hypoglossal canal?

Neuro Exam 1 (17 decks)

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