Cranial Nerves and Autonomics Flashcards
List the cranial nerves in order, and the foramen or passage they pass through if relevant
Olfactory- cribriform plate Optic- optic canal Oculomotor- superior orbital fissure Trochlear- superior orbital fissure Trigeminal- superior orbital fissure Abducens- superior orbital fissure Facial- internal acoustic meatus Vestibulocochlear- internal acoustic meatus Glossopharyngeal- jugular foramen Vagus- jugular foramen Accessory- jugular foramen Hypoglossal- hypoglossal canal Oh once one takes the anatomy final very good vacations are heavenly
List the different divisions of the trigeminal nerve and the foramen they pass through
Opthalmic division- superior orbital fissure
Maxillary division- foramen rotundum
Mandibular division- foramen ovale
Structures derived from first (mandibular) pharyngeal arch
Trigeminal nerve Muscles of mastication Mylohyoid and anterior belly of digastric Tensor tympani Malleus/incus
Structures derived from second (hyoid) pharyngeal arch
Facial nerve Muscles of facial expression Stapedius Stylohyoid Posterior belly of digastric Stapes Lesser cornu and upper part of body of hyoid
Structures derived from the third pharyngeal arch
Glossopharyngeal nerve
Stylopharyngeus
Greater cornu and lower part of body of hyoid
Structures derived from fourth and sixth pharyngeal arch
Superior laryngeal branch and recurrent laryngeal branch of vagus nerve
Cricothyroid
Levator veli palatine
Constrictors and intrinsic muscles of pharynx
Striated muscles of esophagus
Thyroid/cricoid/arytenoid cartilages and other cartilages
All sympathetic fibers are
Postganglionic fibers arising from the superior cervical ganglion of the sympathetic trunk
They travel on vessels to the structures that they innervate
Preganglionic sympathetic fibers in the head arise from and synapse
Nuclei in the brain stem and synapse at 4 ganglia in the head
Ciliary, pterygopalatine, otic and submandibular
Preganglionic parasympathetic fibers in the head are carried by which cranial nerves
VII facial
IX glossopharyngeal
X vagus
Postganglionic fibers piggy back on which nerve
A branch of the trigeminal nerve
Oculomotor nerve innervates
4 extrinsic eye muscles, levator palpebrae superioris (elevates eyelid)
Pupil constrictor muscle
Contracts ciliary muscle to help with near sight
Trochlear nerve innervates and what happens if damaged
Superior oblique eye muscle
Diplopia
Affected eye is higher and deviated medially
Trigeminal nerve innervates (sensory)
Anterior scalp Nasal cavity Entire face Most of oral cavity, teeth Anterior 2/3 tongue Part of auricle
Trigeminal nerve innervates which muscles
Mastication muscles Mylohyoid Anterior belly of digastric Tensor tympani Tensor veli palatini
Abducens nerve innervates and what happens if injured
Lateral rectus eye muscle
Diplopia
Adducted eye
-May develop in association with meningitis and subarachnoid hemmorhage
Facial nerve innervates
Taste to anterior 2/3 of tongue Muscles of facial expression Posterior belly of digastric Stylohyoid Stapedius Lacrimal gland, submandibular/sublingual glands
Vestibulocochlear nerve innervates
Responsible for hearing/equilibrium
Glossopharyngeal nerve innervates
Touch and taste to posterior 1/3 of tongue, visceral sensory to carotid bodies
Stylopharyngeus
Parotid salivary gland
Vagus nerve innervates (sensory)
Visceral sensory afferent from pharynx, larynx, carotid bodies, heart, lungs, most abdominal organs
General sensory afferent from EAC, external eardrum, pharynx, larynx, posterior meninges and posterior ear
Vagus nerve innervates (muscle, parasympathetic motor)
SME-Most pharyngeal muscles, laryngeal muscles, palatoglossus
VE-Smooth muscle and glands of heart, lungs, larynx, pharynx and most abdominal organs
Accessory nerve innervates
Trapezius
Sternocleidomastoid
Hypoglossal nerve innervates
Intrinsic and extrinsic tongue muscles
What is the only nervous tissue known to regenerate
Olfactory
Optic tracts travel to which nucleus in the brain
Lateral geniculate nucleus of thalamus, and then to occipital lobe
Complete lesion of right optic nerve
Blindness of right eye
Right perichiasmal area lesion
Right nasal hemianopia (blindness in the medial half of right eye field of vision)
Midline chiasmal lesion
Bipolar hemianopia (blindness in lateral half of field of vision of both eyes)
Lesion or pressure on right optic tract
Left homonymous hemianopia (blindness in left side of field of vision bilaterally)
Lower right optic radiations lesion
Left homonymous inferior quadrantanopia (blindness in inferior left quadrant of field of vision bilaterally)
Upper right optic radiations lesion
Left homonymous superior quadrantanopia (blindness in superior left quadrant of field of vision bilaterally)
Right occipital lobe lesion
Left homonymous hemianopia (blindness in left side of field of vision bilaterally)
Origin and path of oculomotor nerve
Edinger westphal (VE) and oculomotor nuclei (SE) in mesencephalon Parasympathetic fibers travel to ciliary ganglion (only nerve synapsing here) and postganglionic fibers then travel to iris and ciliary muscle
Origin of trochlear nerve
Trochlear nucleus
Origin of abducens nerve
Pontine (abducens) nucleus
Right oculomotor nerve palsy
Causes right eye to gaze downward and outward, dilated pupil, eyelid needs to be manually elevated due to ptosis
Diplopia
Pupil dilation- Mydriasis
Left abducent nerve palsy
Left eye will not abduct
Origin of trigeminal nerve
Pons
Origin of facial nerve and where do fibers synapse
Pontine trigeminal nucleus (GSA)
Nucleus solitaries (SSA)
Motor nucleus of facial nerve (SME)
Superior salivatory nucleus (VE)
GSA and SSA fibers synapse at the geniculate ganglion of the facial nerve
VE fibers synapse at pterygopalatine and submandibular ganglion
Visceral parasympathetic motor to submandibular and sublingual glands
Chorda tympani branch arises from facial nerve just superior to stylomastoid foramen
Chorda tympani crosses tympanic cavity medial to malleus
Chorda tympani passes through petrotympanic fissure to join the lingual nerve from CN V3 in infratemporal fossa
Parasympathetic fibers of chorda tympani synapse in submandibular ganglion, postsynaptic fibers follow arteries to glands
Visceral/parasympathetic motor to lacrimal gland
Greater petrosal nerve arises from facial nerve at geniculate ganglion and emerges from superior surface of petrous temporal bone to enter middle cranial fossa
Greater petrosal nerve joins deep petrosal nerve at foramen lacerum to form nerve of pterygoid canal
Nerve of pterygoid canal travels through pterygoid canal and enters pterygopalatine fossa
Parasympathetic fibers from nerve of pterygoid canal in pterygopalatine fossa synapse in pterygopalatine ganglion
Postsynaptic parasympathetic fibers from this ganglion innervate lacrimal gland via zygomatic branch of CN V2 and lacrimal nerve (branch of CN V1)
Pathway of vestibulocochlear nerve
Sensory cell bodies of vestibular branch are in vestibular ganglion
Sensory cell bodies of cochlear branch are in spiral ganglion
These branches merge, and together enter cranial cavity through internal auditory canal and travel to junction of pons and medulla oblongata
Where do motor fibers of glossopharyngeal nerve originate
Medulla oblongata
Pathway of glossopharyngeal nerve
Sensory fibers travel from posterior 1/3 of tongue and carotid bodies along nerve through the inferior or superior ganglion into the jugular foramen and then to pons
Somatic motor fibers leave cranium via jugular foramen and travel to stylopharyngeus
Visceral/parasympathetic motor to parotid gland
Tympanic nerve arises from glossopharyngeal nerve
Tympanic nerve enters tympanic plexus, which gives rise to the lesser petrosal nerve
Lesser petrosal nerve enters cranial vault and then exits via foramen ovale
Parasympathetic fibers synapse in otic ganglion, postsynaptic fibers pass to parotid gland via branches of auriculotemporal nerve (CN V3)
Origin and pathway of vagus nerve
Motor nuclei in medulla oblongata
Leaves cranium via jugular foramen before traveling and branching extensively in neck, thorax and abdomen; sensory neuron cell bodies are located in superior and inferior ganglia associated with the nerve
Spinal accessory nerve origin and pathway
Cranial root- motor nuclei in medulla oblongata
Spinal root- motor nuclei in spinal cord
Spinal root travels superiorly to enter skull through foramen magnum, there, cranial and spinal roots merge and leave skull via jugular foramen. Then cranial root splits to travel with vagus nerve and spinal root travels to sternocleidomastoid and trapezius
Hypoglossal nerve origin and pathway
Hypoglossal nucleus in medulla oblongata
Leaves cranium via hypoglossal canal; travels inferior to mandible and to inferior surface of tongue
Branches of ophthalmic (V1) section of trigeminal nerve
Lacrimal
Frontal
Nasociliary
Meningeal (from tentorium cerebelli)
Branches of maxillary V2 section of trigeminal nerve
Zygomatic Infraorbital Superior alveolar Nasociliary Palatine Meningeal
Branches of mandibular V3 section of trigeminal nerve- sensory
Buccal Lingual Inferior alveolar Auriculotemporal Meningeal (spinous)
Branches of mandibular V3 section of trigeminal nerve- motor
Medial pterygoid- tensor veli palatini, tensory tympani Lateral pterygoid Masseteric Mylohyoid -nerve to mylohyoid -nerve to anterior belly of digastric
