Cranial Nerves and Autonomics Part II Flashcards
What are the 3 responsibilities of Vagus?
motor, sensory and autonomics
What are the two sections of motor in vagus?
pharyngeal muscles and laryngeal muscles
what is included in the pharyngeal muscles?
pharyngeal constrictors, levator veli palatini, palatopharyngeus, salpingopharyngeus
what is included in the laryngeal muscles?
cricothyroid arytenoids, vocalis and thyroarytenoid, cricoarytenoids
what are pharyngeal muscles primarily responsible for?
swallowing and manipulate palate
what are the laryngeal muscles primarily responsible for?
vocalization, tenses and manipulates vocal folds, closes larynx during swallowing or hiccups
what are the 2 sections of sensory?
cutaneous sensory and taste
what is included in the cutaneous sensory?
external acoustic meatus, inferior larynx, pharynx and epiglottis
what is included in taste?
epiglottis and diffused taste-like sensors throughout the gut tube
what is included in the autonomics section?
sympathetics and parasympathetics
what is included in the sympathetics of vagus?
below head
what is included in parasympathetics of vagus?
thyroid gland, thoracic organs, external genitalia, foregut, midgut, pharyngeal muscles, laryngeal muscles, aortic bodies
what branch does vagus give off while in the jugular foramen?
auricular branch
what does the auricular branch provide cutaneous innervation to?
over the inferior-anterior edges of external auditory canal
all of the branchial arch nerves have cutaneous responsibilities where?
in and around ear
what 3 branches does vagus give off once it is in the neck?
pharyngeal branch and superior laryngeal and inferior cervical cardiac
describe the pharyngeal branch
innervates the pharyngeal constrictors, palatopharyngeus, salpingopharyngeus and pharyngeal mucosa
describe the superior laryngeal branch
only cranial nerve branch that runs medial to internal carotid, splits into internal and external laryngeal nerves
*what is the only muscle that does not get motor innervation by recurrent laryngeal but instead external laryngeal?
cricothyroid
describe internal laryngeal
general sensation to supraglottic larynx and tastebuds on the epiglottis, parasympathetics to superior larynx
describe external laryngeal
innervates inferior pharyngeal constrictor and cricothyroid
What does the recurrent laryngeal nerve do?
sensory and parasympathetics to infraglottic larynx, once passing under inferior pharyngeal constrictor it becomes inferior laryngeal nerve
what does inferior laryngeal do?
motor to all intrinsic laryngeal muscles
where does vagus run?
between carotid and internal jugular vein
all branches of vagus course which way
anteriorly off of the main vagal stalks
what is the exception to the above?
some of the pharyngeal plexus branches fan out to form a web of nerve fibers over the back of the pharyngeal constrictors that get innervation from the plexus
what structures are lateral to external carotid and lateral to internal carotid?
hypoglossal
what structures are medial to external carotid and lateral to internal carotid?
main trunk of glossopharyngeal and pharyngeal branch of vagus
what structure is medial to both external and internal carotid?
superior laryngeal nerve
what structures are parallel to both external and internal carotid?
carotid nerve, main trunk of vagus and sympathetic trunk
what is within the carotid sheath at the base of the skull?
internal jugular, internal carotid, vagus nerve, accessory nerve, glossopharyngeal nerve
what is in the carotid sheath at C2?
internal jugular, internal and external carotid, vagus nerve, ansa cervicalis is embedded on top of the sheet
what is in the carotid sheet at C4?
internal jugular, common carotid, vagus nerve, ansa cervicalis at bottom, phrenic at C3-C5 and sympathetic trunk both on top
what helps open the eustachin tube?
salpingopharyngeus
how is the pterygomandibular raphe a landmark?
everything in front is innervated by facial and trigeminal, everything behind it is innervated by glossopharyngeal and vagus
vagus has carotid and aortic bodies that monitor what?
blood pressure and blood oxygen content
what are the 3 responsibilities of trigeminal?
motor, sensory and autonomics
what 2 sections are included in motor for trigeminal?
muscles of mastication and tensors of head and neck
what is included in muscles of mastication?
medial and lateral pterygoid, anterior belly of digastric, mylohyoid, temporalis, masseter
what is included in the tensors of the head and neck?
tensor veli palatini, tensor tympani
what 2 sections of sensory does trigeminal have?
cutaneous sensory and taste
what is included in cutaneous sensory?
face, eyes, orbit, cornea, anterior 2/3 of tongue, teeth, palate, inner cheeks, superior pinna, dura and meninges
what is included in taste for trigeminal?
trigeminal DOES NOT directly do any taste, it carriers taste fibers for facial to tongue and palate
what is included in the autonomics section for trigeminal?
sympathetic and carrying parasympathetics
what is included in sympathetics?
distributed among branches
what is included in carrying sympathetics?
trigeminal DOES NOT have its own parasympathetics, it carries parasympatheics for facial, oculomotor and glossopharyngeal
what are the 3 major division of trigeminal?
ophthalmic, maxillary and mandibular
where does trigeminal pass off brain stem?
Meckle’s cave
describe the opthalamic division of trigeminal
picks up post synaptic membranes from carotid plexus in cavernous sinus and distributes it over its nerves including to intrinsic muscles of eye
what are the 3 major branches of the opthalamic division of trigeminal?
frontal, lacrimal and naociliary
describe nasociliary
picks up post synaptic parasympathetics via zygomatic nerve from facial for paranasal mucosa and nasal mucosa
describe lacrimal
picks up postsynaptic parasympathetics via zygomatic nerve from facial for lacrimal gland
what does the opthalamic division of trigeminal provide sensory innervation over?
upper face, scalp, outer nose, eye, lacrimal gland and lacrimal aparatus
what are the 3 main branches of the maxillary division?
zygomatic, infraorbital and posterior superior alveolar
describe the the maxillary division
picks up post synaptic sympathetics from pterygopalatine ganglion via deep petrosal nerve through nerve of pterygoid canal
picks up post synaptic parasympathetics from facial via pterygopalatine ganglion, passes both parasympathetic and sympathetic to nasal mucosa, palatal mucosa, maxillary sinus via its nerves, carries taste for facial from palate via ptergopalatine ganglion through greater petrosal
zygomatic hands parasympathetic for lacrimal gland to lacrimal nerve
what does the maxillary division provide sensory over?
palate, midface, some of internal nose, upper lip, inferiolateral orbit, anterior temple and upper teeth
describe the mandibular divison
carries post synaptic sympathetics to areas it covers via maxillary artery/meningeal artery
carries post synaptic parasympathetic from glossopharyngeal to buccal mucosa via buccal nerve and parotid gland via auriculotemporal nerve
quickly divides into many nerves upon leaving foramen ovale
carries parasympathetic and taste from facial via chorda tympani on the lingual nerve
what does the mandibular division provide sensory over?
over lower portion of face, jaw, lower teeth, lower lip, upper ear and posterior temple area
what does the mandibular division provide motor innervation for?
major jaw openers and closers (mandible), tensor veli palatini and tensor tympani
what is stern’s law in regards to the motor innervation for mandibular division?
if the muscle has ‘gloss’ in it is innervated by hypoglossal unless
the muscle has ‘palat-‘ in it which means it is innervated by vagus unless
it had tensor in the name which means it is innervated by the mandibular division of trigeminal
what are the parasympathetic ganglia of the head and neck?
ciliary, sphenopalatine, otic and submandibular
what are the 2 types of sensory ganglia in the head and neck?
somatosensory and viscerosensory
what are the somatosensory ganglia?
trigemina, geniculate, vestibular, cochlear, superior and jugular
what are the viscerosensory ganglia?
geniculate, petrosal and nodose
which parasympathetic ganglia does the intrinsic muscles of neck?
ciliary
what parasympathetic ganglia does glands?
otic, sphenopalatine, submandibular
describe the pathway of oculomotor nerve to intrinsic eye muscles
oculomotor, ciliary ganglion, short ciliary nerves, intrinsic eye muscles
describe the route of facial nerve to lacrimal gland
facial nerve, greater petrosal, nerve of pterygoid canal, pterygopalatine ganglion, (maxillary division) zygomatic nerve, communicating branch, lacrimal nerve, lacrimal gland
describe the route of glossopharyngeal to parotid gland
glossopharyngeal, tympanic, tympanic plexus, lesser petrosal, synapse on otic ganglia, (mandibular) auriculotemporal, parotid gland
describe the route of facial to submandibular gland
facial nerve, chorda tympani, (mandibular) lingual, submandibular ganglion, submandibular gland
describe the route of facial to sublingual gland
facial nerve, chorda tympani, lingual nerve, submandibular ganglion, lingual nerve, sublingual gland
describe the ciliary ganglion
seated behind eye above optic nerve, parasympathetic from oculomotor for intrinsic eyes muscles synapse, pass via short ciliary nerve to eye
Sympathetics pass to intrinsic eye muscles via branches of nasociliary from carotid plexus
describe the pterygopalatine ganglion
seated in pterygopalatine fossa, parasympathetics from greater petrosal nerve synapse and passed via trigeminal to lacrimal gland, palatal mucosa and nasal mucose
describe the otic ganglion
seated in infratemporal fossa attached to mandibular division of trigeminal, parasympathetics lesser petrosal synapse then passed to parotid gland, buccal and pharyngeal mucosa
describe the submandibular ganglion
seated off of lingual nerve just above submandibular gland, parasympathetics from chorda tympani via lingual nerve synapse passed via lingual to submandibular and sublingual salivary glands
what are the 2 types of ganglia for trigeminal?
parasympathetics: motor to glands and mucosa
somatosensory: general sensation for face, nasal, oral and orbital cavities
what does the geniculate ganglion do?
both general sensation and taste
how many ganglia are in facial?
1
how many ganglia are in trigeminal?
2
how many ganglia are in vestibulocochlear?
2
describe the cochlear ganglion
several sensing sound waves
describe the vestibular ganglion
one sensing angular acceleration and positioning
how many ganglia in glossopharyngeal?
2
describe the glossopharyngeal ganglia
parasympathetics are motor to glands and mucosa
somatosensory are general sensation for tongue and ear
visceral sensation is for taste, blood pressure and blood oxygen content
how many ganglia for vagus?
2
where does vagus send fibers to?
enteric ganglia of gut tube
describe enteric ganglia
parasympathetic ganglia of lower body
describe somatosensory and visceral ganglia
somatosensory: general sensation
visceral ganglia: tase, blood pressure and blood oxygen content
what is the hiccup nerve?
vagus
vagus does parasympathetic below the neck except for?
cloacally derived organs
what nerve is responsible for vocalization?
vagus
what does superior laryngeal split into and where?
superior cervical carotid branch before carotids, internal laryngeal through thyrohyoid membrane and external laryngeal to cricothyroid
what branches off of vagus near clavicle?
recurrent laryngeal
how does recurrent laryngeal travel?
loops around clavicle up along esophagus and trachea underneath thyroid and inferior pharyngeal constrictor
what cranial nerve contributes only sensory fibers to pharyngeal plexus?
glossopharyngeal
what cranial nerve contributes both motor and sensory to pharyngeal plexus?
vagus
what innervates superior and middle pharyngeal constrictors?
pharyngeal branch of vagus
what innervates inferior pharyngeal constrictors?
external laryngeal
what elevate the soft palate?
levator veli palatini
what muscles are responsible for voice function>
posterior and lateral cricoarytenoid
what muscle attaches to torbus tubarius and what does it do?
salpingopharyngeus, closes eustachin tube
nasociliary nerve travels where in the orbti?
medial wall
oculomotor splits into superior and inferior where?
superior orbital fissure
what provides sensation for cornea?
nasociliary branch of trigeminal
where is the submandibular ganglion located?
suspended inferior to lingual nerve
where does the opthalamic division of trigeminal go and what does it do after leaving Meckel’s cave?
into cavernous sinus to pick up postsynaptic sympathetics to internal carotid
what branches of opthalamic of trigeminal enter the orbit outside of the common tendinous ring?
frontal and lacrimal
what branches of the opthalamic of trigeminal enter orbit through common tendinous ring?
nasociliary
what branch of nasociliary bypasses ciliary ganglion and where does it go?
long ciliary n, directly to eye
whar are the branches of nasociliary nerve?
long ciliary, internal nasal and infratrochlear
what happens to the internal nasal branch of nasociliary?
branches into external nasal on to of nose then enters nose
what happens to the frontal branch of the opthalamic division of trigeminal?
splits into supratrochlear and supraorbital for general sensation of forehead
where does the maxillary division of trigeminal travel from meckel’s cave?
along middle cranial fossa through foramen routndum into infratemporal fossa
before entering infraorbital fissure, maxillary gives off what branch and what does it do?
posterior superior alveolar punches into maxilla for general sensation of upper teeth
at the infraorbital fissure, the maxillary division branches into what?
zygomatic and infraorbital branchees
where does infraorbital nerve go?
runs along middle orbital floor to infraorbital canal within maxillary bone
what infraorbital nerve do?
general sensation of mid face below eye, branches toward superior alveolar plexus for general sensation of upper jaw and teeth
where does zygomatic nerve go and what does it do?
runs along lateral floor of orbit and punches through zygomatic bone for cheek sensation
where is the pterygopalatine ganglion located?
suspended below infraorbital nerve
from the pterygopalatine ganglion, what does trigeminal branch into?
greater and lesser palatine, nasopalatine
where does nasopalatine nerve travel?
through sphenopalatine into nose
mandibular division of trigeminal branches into what and where?
mastication branches, buccal, lingual, inferior alveolar and auriculotemporal and foramen ovale
what branch does inferior alveolar give off?
nerve to mylohyoid
what does inferior alveolar nerve do?
general sensation of teeth and jaw, exits mental foramen to give general sensation to face below mouth
what does auriculotemporal do and where does it go?
splits around middle meningeal artery to give general sensation to ear, carries parasympathetics from otic ganglion to parotid glands
what does lateral pterygoid do?
pulls mandible forward to open mouth
what does medial pterygoid do?
elevates mandible to close mouth
what muscle tenses malleus during speech and yawning??
tensor tympani
