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Neurology > Cranial Nerves > Flashcards

Cranial Nerves Flashcards

1
Q

Function of CN1

A

Special sensory

Smell - assists with taste (not important)

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2
Q

Course of CN1

A

Olfactory bulb - Olfactory tract

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3
Q

Pathology of CN1

A

URTI
Compression = Meningioma
Fracture of anterior cranial fossa - check for CSF leakage

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4
Q

Clinical testing for CN1

A

Ask for anosmia - ‘‘Have you had any recent change in your sense of smell’’

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5
Q

CN2 exit

A

Optic canal

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6
Q

CN2 pathology

A

Blindness
Reduced visual acuity
Loss of colour vision

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7
Q

Clinical testing of CN2

A 
Visual fields
Visual acuity - Snellen chart 
Colour vision - ishihara plates 
Pupillary reflexes - RAPD etc 
Fundoscopy
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8
Q

Function of CN3

A

Somatic motor & PSNS (parasympathetic nervous system?)

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9
Q

CN3 exit

A

superior orbital fissure

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10
Q

What muscles does CN3 supply in the eye?

A

Superior, Medial & Inferior rectus

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11
Q

What other things do CN3 supply?

A

Levator palpabrae superioris - damage to this results in a droopy eyelid
(as part of being PSNS) - ciliary muscles, sphincter pupillae - they will lose the ability to constrict their pupil

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12
Q

What causes CN3 to become damaged

A

Raised ICP
Aneurysm of post cerebral artery
Diabetes, MS

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13
Q

Clinical signs of CN3 pathology

A

Eyeball ‘down & out’
Ptosis
Dilated pupil

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14
Q

Clinical testing of CN3

A

H test

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15
Q

CN4 function

A

somatic motor

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16
Q

CN4 exit

A

Superior orbital fissure

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17
Q

What muscle does CN4 supply

A

Superior oblique

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18
Q

What causes CN4 to become damaged?

A

Raised ICP

Cavernous sinus

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19
Q

Signs of CN4 pathology

A

Vertical diplopia - exacerbated when looking down

Head tilt away from affected side

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20
Q

CN6 function

A

Somatic motor

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21
Q

CN6 exit

A

Superior orbital fissure

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22
Q

CN6 supplies what?

A

Lateral rectus

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23
Q

What causes CN6 to become damaged?

A

Raised ICP

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24
Q

CN6 pathology signs

A

Horizontal diplopia
Abducted eye can’t be abducted past midline
Compensatory turning of head

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25
Q

CN5 divisions and their exits

A

V1 - ophthalmic - sup orbital fissure
V2 - Maxillary - Foramen rotundum
V3 - Mandibular - Foramen ovale

26
Q

What are V1 and V2 associated with

A

cavernous sinus

27
Q

CN5 function

A

somatic sensory and motor

Motor = V3 only

28
Q

V3 sensory supply

A

2/3 tongue (NOTE - not the taste, just the sensation. Taste of ant 2/3 is by CN7)
Tensor tympani

29
Q

What causes CN5 to become damaged?

A

Trigeminal neuralgia - usually V2,3

Herpes zoster

30
Q

CN5 signs of pathology

A

Loss of sensation
Jaw deviates towards lesion when opening mouth
Hutchinson’s sign

31
Q

CN5 clinical testing

A

Sensation - cotton wool, pin prick etc
Motor - mastication, open mouth
Reflexes - Corneal reflex, jaw jerk

32
Q

How to remember what is in the cavernous sinus?

A 
OTOM CAT 
O - Oculomotor nerve (CN3)
T - Trochlear nerve (CN4) 
O - Ophthalmic nerve (CNV1) 
M - Maxillary nerve (CNV2)

C A - Internal Carotid Artery
T - Junction point

33
Q

CN7 Function

A

B for BOTH somatic and sensory
Facial muscles (motor)
Anterior 2/3 taste sensation of tongue (special sensory)
Small area around concha of auricle (sensory)

It also has a PARASYMPATHETIC supply to lots of GLANDS:
Lacrimal (parasympathetic)
Submandibular and sublingual gland (parasympathetic)
Nasal, palatine & pharyngeal mucous glands (parasympathetic)

34
Q

CN7 exit

A

Internal acoustic meatus

35
Q

CN7 nerve - explain the course of the nerve

A

2 roots come from the pons
Travel through internal acoustic meatus

Within the temporal bone, enter facial canal
2 roots fuse to form facial nerve
Nerve forms geniculate ganglion
Gives out greater petrosal nerve, nerve to stapedius, chorda tympani

Exits cranium via stylomastoid foramen
After exit, nerve turns superiorly and runs anterior to outer ear
Gives off posterior auricular nerve and more motor branches (belly of digastric muscle & stylohyoid muscle)
Main trunk passes through parotid and splits into 5 branches within the gland

36
Q

What causes CN 7 to become damaged?

What are the clinical signs?

A

Reduced salivation
Loss of taste for ant. 2/3rds of tongue
Hyperacusis
Lacrimal fluid production

Any parotid gland pathology (e.g. tumours)
Herpes infection of facial nerve

Compression during forceps delivery (underdeveloped mastoid process)

Bell’s palsy

37
Q

CN7 clinical testing

A

Facial asymmetry

Motor - raise eyebrows, purse lips, show teeth, puff out cheeks

38
Q

CN8 function

A

Hearing (cochlear fibres)

Balance (vestibular fibres)

39
Q

Course of CN8

A

Cochlear arises from ventral & dorsal cochlear nuclei in inferior cerebellar peduncle

Vestibular arises from vestibular nuclei complex in pons & medulla

Both combine in pons

40
Q

CN8 exit

A

Internal acoustic meatus

41
Q

CN8 pathology

A

2 high yield conditions:

Vestibular neuritis - inflammation of vestibular nerve
Symptoms = vertigo, nystagmus, loss of equilibrium

Labyrinthitis - inflammation of membranous labyrinth
Symptoms = hearing loss, tinnitus, vertigo, nystagmus

42
Q

CN8 clinical testing

A

Rinne’s & Weber’s

43
Q

CN9 function

A

Orophyranx (sensory)
Carotid body & sinus (sensory)
Posterior 1/3 tongue (sensory & special sensory/taste)
Middle ear cavity & eustachian tube (sensory)
Parotid gland (parasympathetic) **CNVII passes through but doesn’t innervate
Stylopharyngeus (motor)

44
Q

Course of CN9

A

Originates from medulla oblongata

Exits via jugular foramen

45
Q

What nerve does CN9 give rise to?

A

Carotid sinus nerve

46
Q

Pathology signs when CN9 is damaged

A

loss of gag reflex

47
Q

Clinical testing for CN9

A

Open mouth and say ahh
Inspect palate for any uvula deviation
Assess speech, cough, swallow

48
Q

CN10 sensory function

A

Internal laryngeal n –> Laryngopharynx, Larynx

Vagus n. –> heart, GI tract

49
Q

CN10 special sensory function

A

Taste –> root of tongue & epiglottis

50
Q

CN10 motor function

A

Pharyngeal branch of vagus n:
Sup, mid, inf pharyngeal constrictor muscles
Palatopharyngeus
Salpingopharyngeus

Recurrent laryngeal n:
All the arytenoids, vocalis

External branch of sup laryngeal n:
Cricothyroid

51
Q

Parasympathetic function of CN10

A

Heart & GI tract (oesophagus up to splenic flexure)
Heart - lowers HR
GI - stimulates smooth muscle contraction, secretions. (remember REST & DIGEST)

52
Q

Course of CN10

A

Originates in medulla oblongata
Exits via jugular foramen
In neck passes into carotid sheath
R & L vagus n. travel separately at neck base level

At neck, several branches arise. One to remember is R recurrent laryngeal n.
This nerve hooks underneath R subclavian artery

53
Q

Where does the L recurrent laryngeal nerve hook under?

A

Arch of aorta

54
Q

What causes damage to CN10

A

Vasovagal syncope
Carotid massage
Dysphonia/aphonia (Cancer/injury)

55
Q

Function of CN11

A

Sternocleidomastoid (motor)

Trapezius (motor)

56
Q

Course of CN11

A 
2 parts:
Cranial part:
Medulla oblongata 
Exits via jugular foramen 
Combines with vagus nerve

Spinal part:
Enters via foramen magnum
Exits via jugular foramen

57
Q

Symptoms of pathology of CN11

A

muscle wasting, inability to rotate head/weakness in shrugging

58
Q

CN12 function

A

Intrinsic & Extrinsic muscles of tongue (motor)

59
Q

Course of CN12

A

Medulla oblongata

Exits via hypoglossal canal

60
Q

Clinical testing of CN12

A

Check tongue for fasiculations

Stick tongue out and check for deviations

Neurology (15 decks)

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