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Neurology SOH > Cranial Nerves > Flashcards

Cranial Nerves Flashcards

1
Q

Trigeminal nerve - which component is motor (CN V1, V2 or V3) ?

A

V3

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2
Q

Trigeminal nerve - which component is Sensory (CN V1, V2 or V3) ?

A

V1, V2, V3

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3
Q

Ophthalmic division of trigeminal nerve

A

CN V1

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4
Q

Maxillary division of trigeminal nerve

A

CN V2

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5
Q

Mandibular division of trigeminal nerve

A

CN V3

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6
Q

Which CN’s carry parasympathetics ?

A

CN III, VII, IX, X

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7
Q

Which CNs connect with the forebrain?

A

CN I

CN II

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8
Q

Which CNs connect with the midbrain?

A

CN III

CN IV

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9
Q

What is the only CN to connect directly with the pons?

A

CN V

CN V1, V2, V3

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10
Q

Which CNs connect at the junction between pons and medulla?

A

CN VI
CN VII
CN VIII

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11
Q

Which CNs connect with the medulla?

A

CN IX
CN X
CN XII

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12
Q

Which CNs connect with the SC ?

A

CN XI

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13
Q

CN I - function

A

Smell (special sensory)

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14
Q

CN I - base of skull foraminae

A

Cribriform plate of ethmoid bone

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15
Q

CN I is the only nerve in the anterior cranial fossa. True or false?

A

True

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16
Q

CN I - where is it found intracranially

A

Olfactory bulb

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17
Q

CN I - testing

A

Ask patient to smell a familiar strong smell whilst covering contralateral nostril

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18
Q

A frontal lobe tumour would not affect CN I. True or false?

A

False

- it could

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19
Q

CN II - function

A

Vision

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20
Q

CN II - base of skull foramina

A

Optic canal

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21
Q

CN II is in the anterior cranial fossa. True or false?

A

False

- middle

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22
Q

CN II - intracranial part

A

Optic nerve -> optic chiasma -> optic tract

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23
Q

CN II - connection with CNS

A

Diencephalon

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24
Q

CN II - testing

A 
Acuity (snellen chart )
Colour (ishihara plate)
Fields (4 quadrants)
Reflexes
Fundoscopy
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25
Q

CN III - function

A 
Eye movement (MR, SR, IR, IO, LPS)
Pupil constriction (parasympathetic)
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26
Q

CN III - base of skull foramina

A

Superior orbital fissure

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27
Q

CN III - testing

A

Eye movements

Pupil response to light

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28
Q

CN IV - function

A

Supplies SO eye muscle

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29
Q

CN IV - base of skull foramina

A

Superior orbital fissure

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30
Q

Which CNs travel towards the orbit in the lateral wall of the cavernous sinus?

A

CN III, IV, VI

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31
Q

What is the only CN that arises posterior from the brain?

A

CN IV

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32
Q

CN IV has a very short course. True or false?

A

False

- very long course

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33
Q

CN V1 - base of skull foramina

A

Superior orbital fissure

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34
Q

CN V2 - base of skull foramina

A

Foramen rotundum

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35
Q

CN V3 - base of skull foramina

A

Foramen ovale

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36
Q

CN V1 - functions

A 
Supply sensation to: 
Forehead
Upper eyelid
Cornea 
Conjunctiva 
Skin of the root/bridge/ tip of nose
Deep sensory territory:
Bones and soft tissues of orbit
Upper anterior nasal cavity
Paranasal sinuses (apart from maxillary sinus) 
Anterior and posterior cranial fossae
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37
Q

CN V2 - functions

A 
Supply sensation to: 
Central part of face 
Lower eyelid
Skin over maxilla
Skin over ala of nose 
Skin of upper lip 
Deep sensory territory:
Lower posterior nasal cavity 
Maxilla and maxillary sinus 
Floor of nasal cavity/palate 
Maxillary teeth
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38
Q

CN V3 - sensory functions

A

Supply sensation to:
Skin over mandible and TMJ
Chin

Deep sensory territory:
Mandible 
Anterior 2/3rds tongue 
Floor of mouth
Buccal mucosa
Mandibular teeth
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39
Q

What supplies the skin over the angle of the mandible?

A

Greater auricular nerve (C2,3)

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40
Q

CN V3 - motor functions

A

Muscles of mastication

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41
Q

Name the jaw opening muscle(s)?

A

Lateral pterygoid

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42
Q

Name the jaw closing muscle(s) ?

A

Medial pterygoid
Masseter
Temporalis

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43
Q

CN V - testing sensation

A

Ask patient to close eyes
Gently brush skin in each dermatome with a fine tip of cotton wool
Tell patient to tell you when they feel skin being touched
Compare 2 sides

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44
Q

CN V - motor component testing

A

Palpate strength of contraction of the master and temporals by asking patient to clench teeth

ask patient to open jaw against resistance

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45
Q

What is the role of pontine trigeminal nucleus ?

A

Discriminative touch, vibration

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46
Q

What is the role of spinal nucleus?

A

Pain, temperature

47
Q

CN VI - function

A

Supplies lateral rectus extraocular muscle

48
Q

Which CN is most medial within the pontomedullary junction: CN VI, CN VII, CN VIII ?

49
Q

CN VI - base of skull foramina

A

Superior orbital fissure

50
Q

CN VII - function

A

Special sensory
- taste to anterior 2/3rds of tongue

Motor

  • supplies muscles of facial expression
  • stapedius
51
Q

CN VII is in the posterior cranial fossa. True or false?

52
Q

CN VII - base of skull foramina (in)

A

Internal acoustic meatus

53
Q

CN VII - base of skull foramina (out)

A

Stylomastoid foramen

54
Q

What is the chorda tympani?

A

Branch of CN VII which passes through between incus and malleus

55
Q

What is the function of the chorda tympani?

A

Provides taste sensation to the anterior 2/3rds of the tongue

Parasympathetic supply to the submandibular and sublingual salivary glands

56
Q

Which nerve does the chorda tympani join (hitch a ride with)?

A

Lingual nerve

57
Q

If a patient looses function of CN VII but retains normal sound, it is more likely to be a fracture where?

A

Stylomastoid foramen

58
Q

CN VII - testing

A

Test muscles of facial expression:

  • raise eyebrows
  • close eyes tight
  • smile
  • puff out cheeks and hold air
  • whistle
59
Q

The branches of CN VII that supply muscles of facial expression can be split into fibres that supply muscles in the upper face and fibres that supply muscles in the lower face. true or false?

60
Q

Fibres that control the lower face all cross over to the contralateral facial nerve at the brainstem. True or false?

61
Q

Fibres that control the upper face all cross over to the contralateral facial nerve at the brainstem. True or false?

A

False

  • half of the fibres cross to contralateral facial nerve
  • half of the fibres remain on the same side and contribute to ipsilateral facial nerve
62
Q

Eyes and forehead (upper face) receives innervation from both cerebral hemispheres. True or false?

63
Q

Lower face receives innervation from both cerebral hemispheres. True or false?

A

False

- innervation from the contralateral hemisphere

64
Q

Lesions that damage the motor cortex (e.g. acute ischemic stroke) will result in contralateral facial weakness of the lower face only, with preservation of the muscles of the upper face on both sides. True or false?

65
Q

Lesions that damage the facial nerve in the brainstem or after it exits the brainstem “peripheral lesions” result in what facial weakness?

A

Ipsilateral facial weakness involving both upper and lower face.

66
Q

CN VIII - function

A

Hearing and balance

67
Q

CN VIII - base of skull foramina

A

Internal acoustic meatus

68
Q

CN VIII - testing

A

Rinnie and Weber

69
Q

CN IX - sensory function

A

Special sensory
- taste

General sensory
- posterior 1/3rd tongue 
- mucosa of most naso and oropharynx
- mucosa of some laryngopharynx
- palatine tonsil
eustachian tube 
middle ear cavity 
- gag reflex
70
Q

CN IX - motor function

A

Stylopharyngeus

71
Q

CN IX - parasympathetic function

A

Parotid gland

72
Q

CN IX - base of skull foraminae

A

Jugular foramen

73
Q

CN IX nuclei - location

A

Upper medulla

74
Q

CN IX - what are the 4 components of the nuclei

A

Solitary nucleus
Spinal trigeminal nucleus
Inferior salivatory nucleus
Nucleus ambiguous

75
Q

CN IX nuclei - what is the gustatory nucleus which receives taste information ?

A

Solitary nucleus

76
Q

CN IX nuclei - what is the nucleus related to the stylopharyngeus muscle ?

A

Nucleus ambiguous

77
Q

CN IX nuclei - what is the nucleus related to parasympathetics

A

Inferior salivatory nucleus

78
Q

CN IX nuclei - what is the nucleus which has a small region of somatosensation associated with the ear?

A

Spinal trigeminal nucleus

79
Q

CN X - sensory function

A

Pain, temperature from the pharynx, larynx, trachea, oesophagus, thoracic and abdominal viscera
Taste

80
Q

CN X - motor function

A

Muscle of the pharynx and larynx

81
Q

CN X - base of skull foramina

A

Jugular foramen

82
Q

CN X - what does it travel within ?

A

Carotid sheath

83
Q

Right CN X is found on the lateral aspect of the aortic arch. True or false?

A

False

- lateral aspect of the trachea

84
Q

Left CN X is found on the lateral aspect of the aortic arch. True or false?

85
Q

CN X - testing

A

Get the patient to say ahhh which tests the muscles of the palate
Look for uvula in the midline

86
Q

CN X - in CNX pathology, uvula deviated TOWARDS/AWAY from the side of dysfunction ?

87
Q

CN X nuclei - 4 components

A

Dorsal motor nucleus
Solitary nucleus
Spinal trigeminal nucleus
Nucleus ambiguous

88
Q

CN XI - function

A

Motor supply to

  • trapezius
  • Sternocleidomastoid
89
Q

CN XI - base of skull foramina

A

jugular foramen

90
Q

CN XI - testing

A

Shrug shoulders

91
Q

CN XII - function

A

Muscles of the tongue

- apart from palatoglossus

92
Q

CN XII - base of skull foramen

A

Hypoglossal canal

93
Q

At which level does the CN XII turn anteriorly towards the lateral aspect of the tongue?

A

at the hyoid

94
Q

CN XII - testing

A

Ask patient to stick tongue out and check it is in midline

95
Q

CN XII pathology means tongue tip will point TOWARDS/AWAY from the side of the damaged nerve?

96
Q

Solitary nucleus is located in the medulla. True or false?

97
Q

Solitary nucleus function

A

Taste (gustatory nucleus) and visceral sensory information

98
Q

Which CNs are involved in the solitary nucleus ?

A

CN VII , CN IX , CN X

99
Q

Superior and inferior salivatory nuclei - which CN are involved?

A

CN VII , CN IX

100
Q

Nucleus ambiguous is located in the pons. True or false?

A

False

- medulla

101
Q

What is the function of nucleus ambiguous ?

A

Motor efferents to muscles of pharynx, larynx and upper oesophagus

102
Q

Which CNs are involved in nucleus ambiguous?

A

CN IX, CN X

103
Q

Which part of the pyramidal tract is motor to cranial nerves?

A

Corticobulbar tract

104
Q

What is the reticular formation?

A

Network of loosely aggregated cells with cell bodies, axons and dendrites intermingling in the central core of the brainstem

105
Q

What kind of Diplopia would be seen in 4th nerve palsy?

Horizontal or vertical

A

Vertical

- exacerbated when looking down (eg reading, walking down stairs)

106
Q

When facial nerve supplies which ear structure
Malleolus
Incus
Stapedius

107
Q

A VI nerve palsy will cause vertical/horizontal Diplopia?

A

Horizontal

108
Q

Which cranial nerves are involved in corneal reflex
Afferent limb
Efferent limb

A

Afferent: CNV1
Efferent: CNVII

109
Q

Which cranial nerves are involved in afferent and efferent limb of jaw jerk reflex

A

Afferent and efferent both CNV3

110
Q

Which cranial nerves are involved in gag reflex

A

Afferent: CNIX
Efferent: CNX

111
Q

Pupillary light reflex cranial nerves

A

Afferent CNII

Efferent CNIII

112
Q

Lacrimation reflex cranial nerve involvement

A

Afferent: CNV1
Efferent: CNVII

113
Q

CN IV palsy will make affected eye deviate upwards/downwards and rotated inwards/outwards when patient looks straight ahead?

A

Upwards

Outwards

Neurology SOH (31 decks)

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