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HD/BB > Cranial nerves > Flashcards

Cranial nerves Flashcards

1
Q

How many extraoccular muscles are there? name them and the nerves which innovate them

A 
6
4 rectus muscles 
superior, medial, inferior (oculomotor) 
Lateral (abducens)
2 oblique muscles 
Superior (trochlear)
Inferior (oculomotor)
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2
Q

What is the origin and attachment of the rectus muscles?

A

Origin- common tendinouse ring

Attachment- sclera

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3
Q

Where do the oblique muscles attach?

A

Behind the equator

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4
Q

What does the suprior oblique muscle hook around?

A

fibrocartilaginous pulley (trochlear)

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5
Q

What is the action of the superior and inferior oblique muscle?

A

Superior- Down and intorsion (inward rotation)

Inferior- up and extorsion (outward rotation)

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6
Q

What Is the parasympathetic nervous pathway of the oculormotor nerve?

A

Pre-synaptic fibers travel to the ciliary ganglion

Post-synaptic fibers innervate the sphincter pupillae and ciliary muscles

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7
Q

What is the sympathetic innervation to the eye?

A

Sympathetic fibres go from the carotid plexus to the dilator pupillae blood vessels of the eye

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8
Q

What is the primary action of the medial, lateral, inferior and superior rectus muscles?

A

Medial- adduction
lateral- abduction
Superior- elevate
inferior- depress

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9
Q

What are the symptoms of an oculomotor palsy?

A 
ptosis (lev palpebrae)
Stabismus (eyes not aligned)
Dyplopia (double vision)
Dilated pupil 
Down and out due to the unapposed action of superior oblique (down)
out (lateral rectus)
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10
Q

What cause cause an oculomotor palsy?

A

Ischemic event from diabetes and hypertension

aneurysm at the junction of internal carotid and posterior communicating arteries

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11
Q

What are the is the cause and symptoms of a trochela pasly?

A

Paralysis of superior oblique
Hardest to diagnose but also rarest.
Patients attempt to minimise diplopia by tilting head away from paralyzed eye
Eyes move up and in

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12
Q

What is the cause and symptoms of an abducens pasly?

A

Paralysis of lateral rectus
Effected eye cannot abduct

Goes through cavernous sinus – abducens palsy can be a sign of raised intracranial pressure

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13
Q

What is the name of the intermediate facial nerve? What are the categories of its function?

A

nervus intermedius– special sensory, and parasympathetic

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14
Q

What are the muscles of facial expression?

A

post belly digastric, stylohyoid, stapedius

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15
Q

What is bells palsy? What is the potential cause?

A

Facial muscle paralysis LMN injury

swelling of nerve in facial canal

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16
Q

Explain the concept of for-head sparing

A

a patient with forehead sparing (i.e. no involvement to the occipitofrontalis muscle) will have a UMN origin to the palsy, due to the bilateral innervation of the forehead muscle).
UMN- stroke
LMN- bells palsy-forhead will crease

17
Q

What are the symptoms of bells palsy? State the inhibited branch of the facial nerve causing each symptom

A

Droopy eye lid (can not close eyes), (temporal and zygomatic branches)

Facial paralysis

Hyperacusis (increased sensitivity to sound) (nerve to stapedius)

Metallic taste (chorda tympani)

Reduced lacrimation (greater petrosal nerve)

Droopy corner of the mouth
dry mouth

18
Q

What are the branches of the vagus nerve in the neck?

A

Auricular nerve
external acoustic meatus and tympanic membrane

Pharyngeal nerves – pharyngeal plexus
muscles and mucous membranes

Superior laryngeal nerve –
sensory to laryngeal mucosa above vocal folds, motor to cricothyroideus

Right recurrent laryngeal nerve – loops under RSCA
sensory to mucosa below folds, motor to all intrinsic laryngeal muscles (excluding cricothyroideus)

Left recurrent larnygeal – loops under the aortic arch

19
Q

What is the parasympathetic innervation to the intrinsic eye muscles?

A

Ocularmotor nerve, ciliary ganglion, opthalmic branch of trigeminal

20
Q

What is the parasympathetic innervation to the lacrimal gland, nasal cavity, maxillary sinus ans palate?

A

Facial nerve
Pterygopalatine ganglion branch
maxillary trigeminal

21
Q

What is the parasympathetic innervation to the submandibular and sublingual glands?

A

facial nerve
Submandibular ganglion
mandibular trigeminal

22
Q

What is the parasympathetic innervation to the parotid gland?

A

glosso nerve
otic ganglion
mandibular trigeminal

23
Q

List the nerves found in the …

A

3, 4, 5, 6

24
Q

What is the consequnce of damage to the olfactory nerve?

A

Anosmia

25
Q

What will be effected if the optic nerve is damaged?

A

Visual field defects

Pupillary light reflex issues

26
Q

What will be effected if the trigeminal nerve is damaged?

A

Corneal blink reflex
Sensory innervation over opthalmic, maxillary and mandibular divisions
Loss of motor function
Jaw deviates to side of lesion

27
Q

What will be effected if the Facial Nerve is damaged?

A

Lower Motor Neuron Lesion – ipsilateral facial weakness
- bells palsy

Upper Motor Neuron Lesion – contralateral facial weakness, forhead sparing, stroke

28
Q

What will be effected if the Vestibulocochlear is damaged?

A

dolls eye- Vestibulo-ocular reflex

29
Q

What will be effected if the vagus is damaged?

A

Vagus UMN unilateral damage- Minimal effect on swallowing – bilateral innervation
Vagus UMN bilateral damage
Paralysis of vocal folds
swallowing difficult

Vagus LMN unilateral damage
Palate drops, vocal fold paralysis, weak pharynx – difficulty swallowing
Vagus LMN bilateral damage
Usually not compatible with life

30
Q

What can cause a Vagus UMN bilateral damage?

A

TIA- can effect this- casues aspiration neumonia

31
Q

Symptoms of damage to midbrain

A

Ptosis (drooping of the upper eyelid)
Diplopia (double vision)
Dilated pupils
Inability to gaze up, down or inward

32
Q

Symptoms of daWallenberg’s Syndrome) – ataxia, inability to swallow, hoarse voice)
mage to pons

A

Facial sensation loss CN 5
Corneal reflex loss CN IN5 OUT 7
Facial muscle drooping
Inability to gaze outwards (abduction)- CN 6

33
Q

Symptoms of damage to medulla

A 
Difficulty swallowing
Loss of gag and cough reflex- TONGUE PERTRUSION , respiratory changes 
Vomiting
Tongue protrusion (deviate towards)
Respiratory pattern changes.

(Wallenberg’s Syndrome) – ataxia, inability to swallow, hoarse voice)

HD/BB (7 decks)

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