Cranial Nerves and Autonomics (Wright) Flashcards

1
Q

What are the somatic motor nerves?

A

III Oculomotor: all extraocular eye muscles (except superior oblique and lateral rectus)

IV Trochlear: superior oblique

VI Abducens: lateral rectus

XII Hypoglossal: intrinsic and extrinsic tongue muscles except palatoglossus

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2
Q

What are the branchial motor nerves?

A

V Masticator: muscles of mastication

VII Facial: muscles of facial expression

IX, X Ambiguus: muscles of pharynx and larynx

XI Accessory: trapezius and sternomastoid

“5, 7, 9, 10, 11”

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3
Q

What are the visceral motor (parasympathetic) nerves?

A

III Edinger-Westphal: ciliary muscle, constrictor pupillae

VII Superior Salivatory: all glands of the head except the integ. and paratid

IX Inferior Salivatory: parotid gland

X Dorsal Vagus: all thoracic viscera and abdominal viscera to the splenic flexure

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4
Q

What are the visceral sensory nerves?

A

IX, X solitarius: visceral afferent info necessary for visceral reflexes, nausea, NOT pain

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5
Q

What are the general sensory nerves?

A

V, VII, IX, X trigeminal: pain, temp, touch, proprioception from head, neck, sinuses, meninges

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6
Q

What are the special sensory nerves?

A

I olfactory bulb: smell

II retina: vision

VII, IX gustatory : taste

VIII vestibular : balance

VIII cochlear: hearing

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7
Q

Derivatives of the first (mandibular) pharyngeal arch

A

N: trigeminal nerve

M: mastication, mylohyoid and anterior belly of diagastric, tensor tympani, tensor veli palatini

B: malleus and incus

L: anterior L. of malleus, sphenomandibular L.

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8
Q

Derivatives of the second (hyoid) arch?

A

N: Facial N.

M: muscles of expression, sapedius, stylohoid, posterior belly of digastric

B: stapes, styloid process, lesser cornu of hyoid, upper part of hyoid

L: stylohyoid L.

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9
Q

Derivatives of the third pharyngeal arch?

A

N: Glossopharyngeal

M: stylopharyngeus

B: greater cornu of hyoid, lower part of hyoid

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10
Q

Derivatives of the fourth and sixth pharyngeal arch?

A

N: Superior laryngeal branch of vagus, recurrent laryngeal branch of vagus

M: cricothyroid, levator veli palatini, constrictors of pharynx, instrinsic M. of larynx, striated muscles of esophagus

B: thyroid, cricoid, arytenoid, corniculate, cuneiform cartilages

“nerves and muscles of larynx, pharynx muscles, striated esophagus muscles, all the thyroid/pharyngeal cartilages)

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11
Q

General Rules concerning Autonomics of the Head

A

all sympathetic fibers are postsynaptic and rise off the superior cericval ganglion of the sympathetic trunk

they travel on vessels to the structures that they innervate (deep petorsal nerve)

presynaptic parasymapthetics come off the nuclei in the brain stem and synapse in the head (ciliary, pterygopalatine, otic and submandibualr ganglions)

all postsynaptic fibers “piggy back” on a branch of the trigeminal N. to arrive at the structure they innervate

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12
Q

Olfactory N

A
  • CN I
  • smell to brain, only type to regenerate
  • originates in the bipolar neurons in olfactory mucosa of nasal cavity
  • trabels through cribiform plate of ethmoid and synsapses in olfactory bulbs, in anterior cranial fossa
  • Anosmia (loss of smell)
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13
Q

Optic N.

A
  • vision to brain
  • originates in retina
  • enters cranium via optic foramen of sphenoid bone, uniting at optic chiasm. Optic tracts travel to lateral genicualate nucleus of thalamus, forwarding info to occipical lobe
  • Anopsia (visual deficit)
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14
Q

Olfactory nerve component is?

A

special sensory

sensation of smell

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15
Q

the optic nerve component is?

A

special sensory

conveys visual info from retina

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16
Q

oculomotor component?

A

general somatic efferent: supplies levaotr palpebrae superioris, superior rectus, medial rectus, inferior recuts, inferior oblique muscle of the eye

general visceral efferent: parasymapthetic supply to constrictor pupillae and ciliary muscles via ciliary ganglion

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17
Q

Oculomotor N.

A
  • innervation of upper eyelid and 4/6 extrinsic eye muscles
  • Somatic: eye muscles
  • Parasympathetic: constric pupil, contract ciliary muscle of lens
  • originates at Edinger-Westphal nuclei in mesencephalon
  • leaves cranium via superior orbital fissure and travels to eye
  • ptosis, paralysis, strabismus, diplopoa, diff. focusing eye
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18
Q

Trochlear N. component and function

A

general somatic efferent

supplies the superior oblique muscle of the eye

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19
Q

What is the component and function of the trochlear N?

A

general somatic efferent

supplies the superior oblique muscle of the eye (inferior/lateral movement of eye)

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20
Q

Trochlear N.

A
  • muscle that is being innervated acts as a pulley
  • somatic: innervates superior oblique m.
  • originates at trochlear nucleus within mesencephalon
  • leaves cranium via superior orbital fissure and travels to superior oblique muscle
  • strabismus, diplopia
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21
Q

What is the component and funciton of the Abducens N?

A

general somatic efferent

supplies lateral rectus M. of the eye

eye abduction

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22
Q

Abducens N.

A
  • pulls eye laterally (ABduct)
  • somatic: innervates lateral rectus
  • originates at the pontine (abducens) nucleus in pons
  • leaves cranium through superior orbital fissure and travels to lateral rectus M.
  • limited ABduction, diplopia
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23
Q

Trigeminal N. branchial motor component and function

A

special visceral efferent

masticator muscles, tensory tympani, tensor veli palatini, mylohyoid, anterior belly digastric

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24
Q

trigeminal N. general sensory component and function

A

general somatic afferent

from face and scalp as far as top of head, conjunctiva, bulb of eye, mucous membranes of paranasal sinues, nasal and oral cavities, tongue & teeth, external TM, meninges of anterior and middle cranial fossa

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25
Q

Trigeminal N.

A
  • three divisions, V1, V2, V3 (sensory and motor)
  • sensory and somatic
  • originates in the pons
  • trigeminal neuralgia caused by inflammation in sensory components (v1 +2) causing intense pulsating pain for minutes to hours
26
Q

Pathway of V1

A

sensory fibers enter cranium via superior orbital fissure and travel to trigeminal ganglion, before entering pons

27
Q

pathway of V2

A

sensory fibers enter cranium via foramen rotundum and travel to trigeminal ganglion, before entering pons

28
Q

Pathway of V3

A

motor fibers leave pons and exit cranium via foramen ovale to supply muscles

sensory fibers travel through foramen ovale to trigeminal ganglion before entering pons

29
Q

structures innervated by Ophthalmic V1 of the trigeminal nerve

A

Lacrimal

Frontal (supratrochlear and supraorbital)

Nasalciliary (long/short, infratrochlear, ethmoidal)

meningeal branch (from tentorium cerebelli)

30
Q

Structures innervated by Maxillary V2

A

Zygomatic

Infraorbital (external nasal and superior labial)

Superior alveolar

Palatine (orbital, greater and lesser, posteiror superior nasal, pharyngeal)

Meningeal (anterior and middle cranial fossa)

31
Q

structures innervated by Mandibular V3

A

Sensory:

buccal

lingual

inferior alveolar

auriculotemporal

menigeal

Motor:

meidal pterygoid (tensor palatini and tympani)

lateral pterygoid

masseteric

deep temporal

mylohyoid (nerve to it and anterior belly of digastric)

32
Q

What is the branchial motor component and function of the facial N?

A

special visceral efferent

supply:

stapedius, stylohyoid, post. belly of digastric, muscles of facial expression, including buccinator, platysmna, occipitalis M.

33
Q

What is the visceral motor component of the facial N?

A

general visceral efferent

Supply:

stimulate lacrimal, submandibular, sublingual glands and mucous membranes of nose, hard and soft palates

34
Q

What is the general sensory component and function of the facial N?

A

general somatic afferent

supply:

skin of ear, behind ear

35
Q

What is the special sensory component of the facial N?

A

special afferent

taste and anterior 2/3 of tongue and hard and soft pallates

36
Q

Facial N.

A
  • innervates muscles of facial expression
  • sensory, somatic, parasympathetic
  • originates in the nuclei of the pons
  • pathway: sensory travel from the tongue via chorda tympani through foramen to enter skull and synapses with geniculate ganglion. Somatic motor fibers leave the pons and enter temporal bone thru internal auditory canal, prkect thry temporal bone and emerge thru stylomastoid foramen to supply muscles. Parasympathetic motor fibers leave pons and enter internal auditory canal, leave greater petrosal nerve or chorda tympani and travel to autonomic ganglion before innervating glands
  • dry eye/mouth, loss of taste, bell’s palsy.
37
Q

Vestibulocochlear Nerve component and function

A

special sensory/afferent

supplies: auditory cochlea, balance

38
Q

Vestibulocochlear N.

A
  • equilibrium and hearing
  • sensory
  • vestibular branch originates from hair cells in the inner ear
  • cochlear branch originates in the cochlea of the inner ear
  • pathway: sensory cell bodies from vestibular ganglion or spiral ganglion merge and enter cranial cavity thru internal auditory canal and travel to junction of pons and the medulla oblongata
  • lesions include loss of balance, n/v/dizziness, loss of hearing
39
Q

branchial motor components of the glossopharyngeal nerve

A

special visceral efferent

supplies striated muscle, stylopharyngeus

40
Q

Visceral motor component of the glossopharyngeal nerve

A

general visceral efferent

supplies the otic ganglion, sends fibers to stimulate the parotid gland

41
Q

visceral sensory component and function of the glossopharyngeal n.

A

general visceral afferent

sensation from carotid body and sinus

42
Q

general sensory component and function of the glossopharyngeal n.

A

general somatic afferent

general sensation to posterior 1/3 of tongue, skin on external ear and internal TM

43
Q

Special sensory component and function of glossopharyngeal N.

A

special afferent

taste of posterior 1/3 of tongue

44
Q

Glossopharyngeal N.

A
  • taste of posterior 1/3 of tongue, 1 pharynx muscle, parotid gland
  • sensory, somatic, parasympathetic
  • sensory originates on taste buds of tongue and carotid bodies, motor originates in nuclei of medulla oblongata
  • sensory travels along the inferior or superior ganglion into the jugular foramen and travels to pons. somatic motor leaves cranium via jugular foramen and tarvels to stylopharyneus. Parasympathetic motor travel to otic ganglion and then to parotid gland
  • dry mouth, loss of taste in back of tongue
45
Q

branchial motor component and function of the vagus n.

A

special visceral efferent

striated muscle of phrarynx, tongue, larynx. (except stylopharyngeus, tensor veli palatini)

46
Q

visceral motor component of the vagus n.

A

general visceral efferent

smooth muscle of glands of the pharynx, larnx, thoracic and abd. viscera

47
Q

visceral sensory component and function of the vagus n.

A

visceral afferent

from larynx, trachea, esophagus, thoracic and abd. viscera in aortic arch

48
Q

general sensory component of the vagus n.

A

general somatic afferent

from skin on back of ear and exteranl acoustic mearus, external TM and pharynx

49
Q

Vagus N.

A
  • innervates structures of head and neck and in thoracic and abd. cavities
  • sensory, somatic, parasympathetic
  • originates in the motor nuclei of the medulla oblongata
  • leaves cranium via jugular foramen before branching. Sensory neuron cell bodies located in superior and inferior ganglia assocaited with the nerve
  • hoarsness, monotone, loss of voice, diff. swallowing, GI issues
50
Q

branchial motor component of the spinal accessory nerve

A

special viscera efferent

supplies SCM and trap

51
Q

Spinal accesory nerve

A
  • innervates trap and SCM
  • somatic
  • spinal root origin: motor nuclei in spinal cord
  • enter skull thru foramen magnum, cranial and spinal roots merge and leave the skull via jugualr foramen, split to travel with vagus
  • trap and SCM paralysis, diff. shrugging shoulder, turning head contralaterally
52
Q

hypoglossal nerve somatic motor component and function

A

general somatic efferent

supplies intrinsic and extrinsic muscles of the tongue except the palatoglossus (which is vagus)

53
Q

hypoglossal n.

A
  • innervates intrinsic and extrinsic tongue muscles
  • somatic
  • originates in the hypoglossal nucleus in the medulla oblongata
  • leaves cranium via hypoglossal cana, travels to mandible and below tongue
  • speech/swallowing issues, tongue deviation toward lesioned side
54
Q

Visceral motor (parasympathetic) pathway the lacrimal gland

A

greater petrosal n. from CN VII at geniculate ganglion emerges from superior surface of petrous part of temporal bone to enter middle cranial fossa

greater petrosal n. joins deep petrosal n. (sympathetic) at foramen lacerum to form nerve of pterygoid canal

nerve of pterygoid canal travels thru pterygoid canal and enters pterygopalatine fossa

parasympathetic fibers from nerve of pterygoid canal in ptergopalatine fossa synapse in ptergopalatine ganglion

postsynaptic parasympathetic fibers from this ganglion innervate lacrimal gland via zygomatic branch of CN V2 and lacrimal nerve branch (from CN V1)

55
Q

Visceral (parasympathetic) motor to submandibular and sublingual glands pathway

A

the chorda tympani branch arises from CN VII just superior to stylomastoid foramen

the chorda tympani crosses tympnaic cavity medial to handle of malleus

the chorda tympani passes thru petrotympanic fissure between tympanic and petrous parts of the temporal bone to join the lingual nerve (CN V3) in the infratemporal fossa

Parasympathetic fibers of chorda tympani synapse in submandibular ganglion; post-synaptic fibers follow arteries to glands

56
Q

Shingles and the Trigeminal n.

A

tingles follow tracts, stop at crown (E distribution)

57
Q

Left Abducent (CN VI) nerve palsy

A

right eye is normal and will abduct/adduct at will

left eye will not move, stays forward facing

58
Q

right oculomotor (CN III) nerve palsy

A

right eye: downward and outward gaze, dilated pupil, eyelid manually elevated due to ptosis

left eye: normal

no antagnoist to pull straight forward

59
Q

motion of oculomotor N.

A

moves eye upward and inward

60
Q

eye motion of Trochlear N. and Abducent N.

A

Downward and Outward

61
Q

know cranial nerve nuclei picture

A