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Neurology > Cranial nerves > Flashcards

Cranial nerves Flashcards

1
Q

How many cranial nerves are there?

A

12 pairs

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2
Q

What do parasympathetic nerves innervate?

A

Glands, smooth muscle

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3
Q

Is there any sympathetic outflow from the skull?

A

No

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4
Q

What nerve fibres are present in olfactory nerve?

A

Special sensory

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5
Q

What nerve fibres are present in optic nerve?

A

Special sensory

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6
Q

What nerve fibres are present in oculomotor nerve?

A

Motor

Parasympathetic

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7
Q

What nerve fibres are present in trochlear nerve?

A

Motor

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8
Q

What nerve fibres are present in trigeminal nerve?

A

Motor

Sensory

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9
Q

What nerve fibres are present in abducens nerve?

A

Motor

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10
Q

What nerve fibres are present in facial nerve?

A

Motor
Sensory
Parasympathic

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11
Q

What nerve fibres are present in vestibulocochlear nerve?

A

Special sensory

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12
Q

What nerve fibres are present in glossopharyngeal nerve?

A

Sensory
Motor
Parasympathetic

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13
Q

What nerve fibres are present in vagus nerve?

A

Sensory
Motor
Parasympathetic

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14
Q

What nerve fibres are present in spinal accessory nerve?

A

Motor

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15
Q

What nerve fibres are present in hypoglossal nerve?

A

Motor

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16
Q

Where does the olfactory nerve fibres pass through the skull?

A

Cribiform plate of ethmoid

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17
Q

What is the name for lost sense of smell?

A

Anosmia

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18
Q

An increase in ICP can result in which eye condition?

A

Papillodema

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19
Q

A lesion at the optic chiasm will result in what type of visual field loss?

A

Bitemporal hemianopsia

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20
Q

A lesion at the right optic tract will result in what type of visual field loss?

A

left homonymous hemianopsia

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21
Q

Which foramen does the optic nerve pass through?

A

Optic foramen

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22
Q

Where do the retinal nerve fibres synapse?

A

Lateral geniculate body

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23
Q

Where does the oculomotor nerve originate?

A

Midbrain

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24
Q

Where does the oculomotor emerge from the skull?

A

Superior orbital fissure

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25
Q

What does the oculomotor supply in the eye?

A 
Extraocular muscles & eyelid
Constricts pupil (circular muscles) & accommodates lens (ciliary muscle)
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26
Q

If the oculomotor is lesioned, what will be observed?

A

Ptosis (eyelid drooping)
Eyeball abducted and pointing down
No pupillary reflex
No accommodation

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27
Q

Where does the trochlear nerve exit the skull?

A

Superior orbital fissure

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28
Q

What does the trochlear nerve supply?

A

Superior oblique (turns eye down)

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29
Q

What happens is the trochlear nerve is lesioned?

A

Diplopia (On looking down)

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30
Q

Where does the abducent nerve originate?

A

Pons

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31
Q

Where does the abducent nerve exit the skull?

A

Superior oblique fissure

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32
Q

What does the abducent nerve supply?

A

Lateral rectus muscle

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33
Q

If the abducens nerve is lesioned what happens?

A

Medial deviation of eye causing diplopia

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34
Q

Where does the trigeminal emerge from?

A

Pons

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35
Q

Where does the trigeminal (ophthalmic) nerve exit the skull?

A

Superior orbital fissure

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36
Q

What does V1 supply?

A

Sensory to cornea, forehead, scalp, eyelids & mucosa of nasal sinuses

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37
Q

Where does the V2 division of the trigeminal nerve exit the skull?

A

Foramen rotundum

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38
Q

What does the V2 nerve supply?

A

Sense to the face of maxilla, teeth, TMJ joint & mucosa of maxillary sinuses

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39
Q

Where does the V3 branch of trigeminal nerve exit the skull?

A

Foramen ovale

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40
Q

What does the V3 branch of the trigeminal supply?

A

Sense to mandible, mucosa of mouth & anterior 2/3rds of tongue
Muscles of mastication

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41
Q

If the trigeminal nerve is lesioned what are the clinical signs?

A

Paralysis of muscles of mastication
loss of corneal reflex
loss of face sensation
trigeminal neuralgia

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42
Q

Where does the facial nerve originate?

A

Pontomedullary junction

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43
Q

Where does the facial nerve travel?

A

Internal acoustic meatus and out via the stylomastoid foramen

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44
Q

What does the facial nerve supply?

A

Muscles of facial expression
Innervation of submandibular & submental salivary glands
taste to anterior 2/3rd of tongue
General sensory - external acoustic meatus

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45
Q

If the facial nerve is lesioned what clinical signs can be observed?

A

Bell’s palsy (cannot close eyelid, drooping of mouth)

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46
Q

What nerve is the most frequently injured?

A

Facial nerve

47
Q

Where does the vestibulocochlear nerve originate?

A

Pontomedullary junction

48
Q

Where does the vestibulocochlear nerve exit the skull?

A

Internal acoustic meatus

49
Q

What are the clinical signs observed with a lesion of nerve VIII?

A

Tinnitus
Deafness
Vertigo
Nystagmus (involuntary rapid eye movements )

50
Q

Where does the glossopharyngeal nerve originate?

A

Medulla

51
Q

Where does the glossopharyngeal nerve exit the skull?

A

Jugular foramen

52
Q

What does the glossopharnygeal nerve supply?

A

Taste posterior 1/3rd of tongue
sensation for middle ear & posterior oral cavity
innervation of parotid gland
stylopharyngeus innervation

53
Q

When the glossopharyngeal nerve is lesioned, what are the clinical signs?

A

Loss of gag reflex & taste from back of tongue

54
Q

Where does the vagus nerve exit the skull?

A

Jugular foramen

55
Q

What does the vagus nerve supply?

A

Taste for epiglottis
parasympathetic innervation of pharynx, larynx, trachea, bronchi, heart & gut
Motor control to the pharynx, larynx, palate & oesophagus

56
Q

What are some of the branches of vagus nerve?

A

Recurrent laryngeal nerve

57
Q

What clinical signs will be observed if the vagus nerve is lesioned?

A

Difficulty swallowing

Hoarse voice

58
Q

Where does the spinal accessory nerve exit the skull?

A

Jugular foramen

59
Q

What does the spinal accessory nerve supply?

A

Sternocleidomastoid & trapezius

60
Q

If the spinal accessory nerve is lesioned, what clinical signs will be observed?

A

Weakness in turning head & shrugging shoulder

61
Q

Where does the hypoglossal nerve exit the skull?

A

Hypoglossal canal

62
Q

What does the hypoglossal nerve supply?

A

Muscles of tongue

63
Q

What clinical signs will be observed if the hypoglossal nerve is lesioned?

A

Deviation of tongue to affected side

Paralysis & muscle atrophy of tongue

64
Q

Which nerves are required for taste?

A

Facial
Glossopharyngeal
Vagus

65
Q

Which nerves are required for movements of face?

A

Facial

66
Q

Which nerves are required for chewing?

A

V3

67
Q

Which nerves are required for swallowing?

A

Glossopharyngeal

Accessory

68
Q

Which nerves are required for movements of vocal cords?

A

Vagus

69
Q

Which nerves have visceral sensory input?

A

Vagus

Glossopharyngeal (carotid body & sinus)

70
Q

What are the functions of the cranial nerves?

A

Special senses
Ordinary sensation
Autonomic
Motor control

71
Q

Which are the nerves of special sense?

A

I - olfaction
II - vision
XII, IX, X - taste
VIII - hearing

72
Q

What nerves supply sensation to the ear?

A

VII & IX

73
Q

Which nerve supplies muscles of mastication?

A

Trigeminal (mandibular branch)

74
Q

Which nerve supplies muscles of facial expression?

A

Facial

75
Q

Which nerve supplies muscles of pharynx & larynx?

A

Vagus

76
Q

Which nerves supplies SCM & trapezuis?

A

Accessory spinal

77
Q

Which nerves carry parasympathetic innervation?

A

III, VII, IX, X

78
Q

What does parasympathetic activity in III nerve mediate ?

A

Pupillary constriction

79
Q

What does parasympathetic activity in VII nerve mediate ?

A

Submandibular & Sublingual salivary gland

80
Q

What does parasympathetic activity in IX nerve mediate ?

A

Parotid salivary gland

81
Q

What does parasympathetic activity in X nerve mediate ?

A

Organs of abdomen & thorax

82
Q

What nerves are involved in the pupillary reflex?

A

II - AFFERENT

III- Efferent

83
Q

What nerves are involved in the corneal reflex?

A

V- Afferent

VII- efferent

84
Q

What nerves are involved in the jaw jerk reflex?

A

V - afferent & efferent

85
Q

What nerves are involved in the GAG reflex?

A

IX afferent

X efferent

86
Q

Which cranial nerve nuclei are found in the midbrain?

A

III, IV

87
Q

Which cranial nerve nuclei are found in the pons?

A

V, VI, VII

88
Q

Which cranial nerve nuclei are found in the pontomedullary junction?

A

VIII

89
Q

Which cranial nerve nuclei are found in the medulla?

A

IX, X, XI, XII

90
Q

How can cranial nerves be damage?

A

Ischaemia
Crossing sub-arachnoid space (eg. meningitis)
Outside skull, eg tumours

91
Q

What is the pathology behind optic neuritis? What disease is it associated with?

A

Demyelination of the optic nerve

MS

92
Q

What are the signs of optic neuritis?

A 
Monocular vision loss
Pain on eye movement 
Reduced visual acuity 
Reduced colour vision 
Swelling of optic disc
93
Q

What can cause dilated pupils?

A 
Dim light 
Young 
3rd nerve palsy 
"Mydriatic" eye drops 
Amphetamine & cocaine
Brainstem death (Bilateral)
94
Q

What cause pupils to constrict?

A 
Old age
Bright light 
Miotic eye drops
Opiate overdose
Horner's syndrome (sympathetic plexus)
95
Q

What are the microvascular causes of 3rd nerve palsy?

What are the symptoms?

A

Diabetes & hypertension

Painless & pupil spared

96
Q

What are the compressive causes of 3rd nerve palsy?

What are the symptoms?

A

Posterior communicating artery aneurysm
Raised ICP

Painful & pupil affected

97
Q

What are the causes of 6th nerve palsy?

A

Meningitis
Raised ICP
Diabetes

98
Q

Trigeminal neuralgia presents as painful attacks due to the compression of which nerve?

A

V

99
Q

What is Bell’s Palsy?

A

Idiopathic facial (VII) nerve palsy

100
Q

What is observed with Bell/s palsy?

A

Unilateral facial weakness

Inability to close eye

101
Q

What are some of the LMN causes of facial nerve palsy?

A

Bell’s palsy

Lymes diseae

102
Q

What are some of the UMN causes of facial nerve palsy?

A

Stroke

Tumour

103
Q

What will be the signs of UMN facial palsy?

A

The forehead will be spared

104
Q

What will be the signs of LMN facial palsy?

A

The whole side of the face will be affected including forehead

105
Q

What are the symptoms of vestibular neuronitis?

A

Sudden onset of vertigo
Vomiting
Gradual recovery

106
Q

What is dysarthria?

A

Slurred speech

Disordered articulation

107
Q

What is dysphonia?

A

Loss of volume of speech

108
Q

What is dysphagia?

A

Difficulty swallowing

109
Q

What is the difference between bulbar palsy & pseudo bulbar palsy?

A 
Pseudobulbar = UMN
Bulbar = LMN
110
Q

What is the pathology of Pseudobulbar palsy?

A

Bilateral vascular lesion of the internal capsule

111
Q

What are some of the symptoms/ signs of pseudo bulbar palsy?

A 
Dysarthria 
Dysphonia
Dysphagia
Spastic immobile tongue
Brisk jaw & gag reflex
112
Q

What nerves does bulbar palsy affect?

A

IX-XII

113
Q

Where is the lesion in bulbar palsy?

A

Bilateral lesion of LMN in brainstem

114
Q

What are some of the symptoms/ signs of bulbar palsy?

A

Dysarthria
Dysphonia
Dysphagia
Wasted, fasciulcating tongue

Neurology (16 decks)

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