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Neurology > Cranial Nerves > Flashcards

Cranial Nerves Flashcards

1
Q

Describe the locations of the cell bodies for various types of cranial nerve fibres

A

Sensory fibres - Ganglia outside the CNS (think pseudounipolar neurons)
- Some special sensory fibres use bipolar neurons (e.g. olfactory mucosa or retinal fibres)

Somatic Motor Fibres have cell bodies withing the CNS (Think Multipolar)

Autonomic Motor fibres have cells bodies within the CNS and then synapse outwith the CNS.

  • Either pre-vertebral ganglia (sympathetic)
  • Or Intramural Ganglia (Parasympathetic)
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2
Q

Describe the pathway and components of Cranial Nerve I:

A
  • Olfactory Nerve
  • Purely Special Sensory (smell)

Fibres start in receptors in the olfactory epithelium of the nasal cavity

  • -> Pass through foramina in the cribriform plate of the ethmoid
  • -> Enters the olfactory bulb in the anterior cranial fossa
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3
Q

Whats the clinical relevance of the 1st cranial nerve?

A

If you fracture the cribriform plate you can tear the olfactory nerve fibres leading to anosmia

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4
Q

Describe the pathway and components of the 2nd cranial nerve:

A
  • Optic Nerve
  • Purely Special Sensory (Vision)
  • Retinal Nerve Fibres
  • > Optic Disc -> Optic Nerve (in optic canal)
  • > Fibres mix at the optic chiasm and nasal fibres swap sides
  • > So temporal fibres and contralateral nasal fibres of each side form optic tracts
  • > Synapse at LGB
  • > Form Right and Left Optic Radiations
  • > Feed into the left and right Primary Visual Cortex
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5
Q

Whats the clinical relevance of Cr N II:

A

Papilloedema (Optic Disc Swelling
- Due to increased Intracranial Pressure

Right Optic Nerve Damage
-> Blindness in right eye

Middle Optic Chiasm damage

  • > Knocks out both sides of nasal fibres
  • > Loss of temporal visual fields (Bitemporal Heminopia)

Right Optic Tract Damage
-> Blindness in Left Temporal and Right Nasal visual fields ( Left Hemonymous Hemianopia)

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6
Q

What could cause damage to the optic chiasm?

A

Pressure from a Pituitary Tumour

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7
Q

What are the components of the 3rd cranial nerve?

A

Oculomotor:

  • Somatic Motor supply to most of the extraocular muscles
  • Autonomic Motor (parasympathetic) to the constrictor pupillae and the ciliaris muscle
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8
Q

What extraocular muscles arnt supplied by the oculomotor nerve?

A
  • Sup Oblique (Cranial Nerve IV - Trochlear)

- Lateral Rectus (Cranial Nerve VI - Abducens)

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9
Q

Whats the pathway of the 3rd cranial nerve?

A
  • Arises from midbrain

- Emerges throught he superior orbital fissure

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10
Q

Whats the clinical relevance of the oculomotor nerve?

A

Ptosis
- Loss of somatic innervation to the levator palpebrae Superioris

Eyeball Abducted & Depressed:
- Due to loss of innervation to the extraocular muscles so the sup oblique depresses it and the lateral rectus abducts it

Loss of pupillary reflex
- Loss of autonomic motor innervation

No lens accomadation
- Loss of autonomic motor innervation

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11
Q

What are the components of the 4th cranial nerve?

A

Its Purely Somatic Motor to the superior oblique

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12
Q

Describe the pathway of the 4th cranial nerve?

A

Comes from the midbrain and emerges through the superior orbital fissure
The only Cr N to arise from the posterior surface of the brainstem

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13
Q

Clinical relevance of the trochlear nerve?

A

Lose innervation to the sup oblique so when you look down one eye doesnt depress properly leading to diplopia

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14
Q

Describe the pathway of the 5th cranial nerve

A

Emerges from pons and forms the trigeminal ganglion, then it divides into the 3 branches:

  • Ophthalmic exits via Sup Orbital Fissure
  • Maxillary exits through Foramen Rotundum
  • Mandibular Exits through the Foramen Ovale
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15
Q

Whats the components of the trigeminal nerve branches?

A

Ophthalmic:
- General Sensory to cornea/eyelid/scalp/nose/nasal&sinus mucosa

Maxillary:
- General Sensory to face, upper teeth, TM joint, palate and nose

Mandibular:

  • General Sensory to face, lower teeth, TM joint, mouth mucosa & ant 2/3rds of tongue
  • Somatic Motor to muscles of mastication, digastric, tensor veli palatine & Tensor Tympani
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16
Q

Whats the clinical relevance of the trigeminal nerve?

A
  • Paralysed Muscles of mastication
  • Loss of corneal or sneezing reflex
  • Loss of facial sensation
  • Trigeminal Neuralgia
17
Q

Describe the pathway, components and clinical relevance of the 6th cranial nerve?

A
  • Abducens
  • Emerges from between pons & Medulla then out via the Sup Orbital Fissure
  • Contains purely somatic motor nerves to the lateral rectus
  • Loss of this nerve leads to medial deviation of the eye and diplopia
18
Q

What are the components of the facial nerve?

A

Somatic Motor
- Muscles of facial expression, stapedius & Digastric

Autonomic Motor

  • Salivary Glands (not parotid)
  • Lacrimal glands
  • Other glands in the nose/palate

Special Sensory:
- Taste to Ant 2/3rds of tongue

General Sensory
- External Acoustic Meatus

19
Q

Whats the pathway of the facial nerve?

A

Emerges from between Pons & Medulla

Then exits via the internal acoustic meatus through the facial canal and out stylomastoid foramen.

20
Q

Whats the clinical relevance of Cranial Nerve VII

A
  • Its the most commonly injured due to its long external path
  • Damage leads to facial palsies
    E.g. Bell’s Palsy where you cant frown, close your eyelid or bare teeth on one side
21
Q

Whats the pathway of the 8th cranial nerve?

A

Vestibulocochlear nerve
Emerges from between Pons and Medulla
Exits through internal acoutis meatus
Divides into Vestibular and Cochlear nerves in the middle ear

22
Q

What are the components of the vestibulocochlear nerve?

A

Special Sensory:
- Vestibular Sensation from semi-circular ducts, utricle & Saccule

  • Hearing from the cochlea
23
Q

Clinical relavance of the 8th cranial nerve?

A
  • Tinnitus
  • Sensorineural deafness
  • Vertigo
  • Nystagmus
24
Q

Describe the pathway of the glossopharyngeal nerve?

A

Emerges from the medulla

Exits via the jugular foramen

25
Q

What are the components of the 9th cranial nerve?

A
  • Special Sensory to post 3rd of the tongue
  • General Sensory to the middle ear and post oral cavity/post 3rd of tongue
  • Visceral Sensory to carotid body/sinus
  • Autonomic motor to the parotid gland
  • Somatic Motor to the Stylopharyngeus (swallowing)
26
Q

Clinical application of cranial nerve 9?

A
  • Loss of gag reflex & taste from back of tongue

- Associated with X & XI injuries (Jugular Foramen Syndrome)

27
Q

PAthway of the 10th cranial nerve?

A

Vagus exits the medulla and passes through the jugular foramen

28
Q

Components of the Vagus Nerve?

A

Special Sensory (Taste) to epiglottis and palate
General Sensory to auricle and EAM
Visceral Sensory to pharynx and below
Autonomic motor to bronchi, gut and heart
Somatic Motor to swallowing muscles and speaking muscles. (pharynx, larynx & Oesophagus)

29
Q

Clinical relevance of Cr N X?

A
  • Difficulty swallowing if you damage the pharyngeal branches
  • Difficulty speaking/hoarseness if you damage the laryngeal branches
  • Jugular Foramen Syndrome (Damage to IX/X/XI)
30
Q

What are the components of the 11th cranial nerve?

A

Somatic Motor to soft palate, pharynx and larynx muscles. Also the SCM and Trapezius

31
Q

Describe the pathway of the Accessory Nerve:

A

Has both medullary and spinal roots, the spinal roots ass up into the skull.
It all exits via the jugular foramen

32
Q

Clinical relevance of the accessory nerve?

A

Weakness when shrugging or turning the head

33
Q

What are the components of the hypoglossal nerve?

A

Somatic motor to the tongue muscles

34
Q

Describe the pathway of the hypoglossal nerve?

A
  • Emerges from medulla

- Exits via hypoglossal canal (in the wall of the foramen magnum)

35
Q

Whats the clinical relevance of the 12th cranial nerve?

A
  • Damaged in a tonsillectomy

- Paralyses the ipsilateral side of the tongue, the tip also deviates towards the affected side

36
Q

What foramen do the various cranial nerves exit?

A 
I - Foramina in the Cribriform plate
II - Optic Canal
III - Sup Orbital Fissure
IV - Sup Orbital Fissure
V1 - Sup Orbital Fissure
V2 - Foramen Rotundum
V3 - Foramen Ovale
VI - Sup Orbital Fissure
VII - Internal Auditory Meatus -> Stylomastoid foramen
VIII - Internal Auditory Meatus
IX - Jugular Foramen
X - Jugular Foramen
XI - Jugular Foramen
XII - Hypoglossal Canal

Neurology (50 decks)

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