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Neuroscience I > Cranial Nerves and Craniofacial Autonomics > Flashcards

Cranial Nerves and Craniofacial Autonomics Flashcards

1
Q

Cervical plexus:

  • Superficial branches
  • what are the four nerves, innervations
A
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2
Q

Dermatomes of neck

A
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3
Q

what exits the jugular foramen?

A
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4
Q

Vernet’s syndrome

-result of what type of fracture, what nerves paralyzed, common “signs”

A
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5
Q

Collet’s or Sicard’s syndrome

  • injury to what space?
  • paralysis of what nerves?
  • what foramen do they come out of
A

9-11 come out of jugular foramen, 12 comes out of hypoglossal canal

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6
Q

Ansa Cervicalis:

  • formed by anterior rami of?
  • where is it normally found?
  • superior root relationship?
  • superior root inn, vs inferior root inn
  • muscles it innervates
A
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7
Q

Branches of external carotid artery

A
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8
Q
A
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9
Q

Left vagus N branches

A
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10
Q
A
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11
Q

anterolateral view of cervical plexus name branches

A
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12
Q

branches of right vagus nerve

A
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13
Q

nerves and arteries with anterior scalene intact

A
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14
Q

Phrenic nerve:

  • spinal levels
  • relationship to anterior scalene, IJV, prevertebral fascia
  • what crosses it anteriorly?
  • relationship to subclavian vein in root of neck
A
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15
Q

Phrenic nerve problems:

  • unilateral paralysis vs bilateral symptoms
  • phrenic neuralgia causes, symptoms, complications
A
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16
Q

Muscular branches of cervical nerves and their spinal cord segments

A
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17
Q

Nuchal rigidity:

-Symptoms, causes

A
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18
Q

Brachial Plexus:

  • spinal levels
  • course
  • postganglionic fibers from where?
  • spasms of anterior scalene cause
  • Erb-duchenne vs Klumpke?
A
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19
Q

FYI

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20
Q
A

Relevant Anatomy

Brainstem:

Midbrain.

Pons

Medulla

Cervical spinal cord.

Sulcus limitans divides each half of the brainstem into:

The medial-lying Motor/Efferent division, derived from the basal plate.

The lateral-lying Sensory/Afferent division, derived from the alar plate.

OVERVIEW OF THE POSITIONS OF THE CRANIAL NERVE NUCLEI

Medial half of the motor division: General Somatic Efferent cell column – supply striated muscle with volitional actions - * we’ll see that this set of CNs activates midline musculature, which helps us remember that they all lie in midline.*

CN 3 in the superior midbrain

CN 4 in the inferior midbrain

CN 6 in the pons

CN 12 spanning the height of the medulla

CN 11 in the cervical spinal cord

Next to them, the parasympathetic motor nuclei, the General Visceral Efferent cell column, which supply visceral musculature – remember “REST and DIGEST” as hint for their functions.

CN 3 (small subnucleus) in the superior midbrain

CN 7 (small subnucleus) in the inferior pons

CN 9 (small subnucleus) in the superior medulla

CN 10 in the medulla (large nucleus)

In the lateral motor area, the Special Visceral Efferent cell column, which is analogous to the General Visceral Efferent column in that it supplies striated muscles with volitional control but is derived from special embryological origins: the pharyngeal arches.

CN 5 in the mid pons

CN 7 in the inferior pons

CNs 9 and 10 spanning the height of the medulla

Charles Judson Herrick’s early 1900s observations about the role of these cranial nerves in the gill arches of fish provides insight into their purpose in humans. Whereas fish use these nerves to coordinate jaw movements that pump water across their gills for oxygen transfer; as we’ll see humans use them for chewing (CN 5), facial expression (CN 7), speaking and swallowing (CNs 9 and 10).

In the medial sensory region, draw, the sole nucleus of the Special Visceral Afferent/General Visceral Afferent cell column:

Nucleus of CNs 7, 9, and 10 spans the height of the medulla.

As it’s cell column suggests, this provides numerous functions, which are, again, special in that they are derived from the embryological pharyngeal arches.

Lateral to this, draw the sole nucleus of the Special Sensory Afferent cell column.

CN 8 from the pons into the medulla.

We’ll see that this nucleus supplies one of the special senses.

At the lateral edge of the brainstem, the General Somatic Afferent cell column, which is really just one nucleus CN 5, spanning the brainstem into the upper cervical spinal cord, but this nucleus has important subnuclei:

A large midbrain/pontine component,

A small pontine component

A long component from the pons into the cervical spinal cord.

KEY CRANIAL NERVE FUNCTIONS

CNs 3, 4, 6, 12, 11, and CN 8 — the most straightforward.

The oculomotor complex supplies CN 3, which innervates several extraocular muscles:

The medial, superior, and inferior recti

Levator palpebrae, which raises the eyelid when looking up

Inferior oblique.

The Edinger-Westphal CN 3 subnucleus produces pupillary constriction.

The trochlear nucleus of CN 4 innervates the superior oblique.

The abducens nucleus of CN 6 innervates the lateral rectus.

The hypoglossal nucleus of CN 12 provides tongue protrusion.

The spinal accessory nucleus of CN 11 provides head turn.

The vestibulocochlear nucleus of CN 8 provides hearing and balance; hearing is one of the special senses. CNs 1 and 2 are part of this group of special sensory afferent nuclei, but lie superior to the brainstem, so we exclude them here.

The subnuclei of cranial nerves 5, 7, 9, and 10 — they are numerous and complex.

The superior salivatory nucleus of CN 7 provides lacrimation and salivation, amongst other facial secretions.

The inferior salivatory nucleus of CN 9

The dorsal motor nucleus of the vagus nerve, CN 10.

We bundle the actions of CNs 9 and 10 later: they are most easily remembered together.

The motor trigeminal nucleus of CN 5, which provides mastication.

The sensory subnuclei of CN 5 all play a role in facial sensation.

The mesencephalic trigeminal nucleus spans from the midbrain to the upper pons,

The principal sensory trigeminal nucleus is restricted to the mid pons,

The spinal trigeminal nucleus spans from the mid pons to the upper cervical spinal cord.

CN 7 forms the facial nucleus, which provides facial strength and comprises part of the solitary tract nucleus, along with CNs 9 and 10 the CN 7 component receives taste sensation from the anterior two-thirds of the tongue.

CNs 9 and 10 comprise nucleus ambiguus.

The functions of CNs 9 and 10.

Both are involved in cardio-pulmonary function, swallowing

CN 9 helps in salivation (it innervates the otic ganglion, which supplies the parotid gland)

CN 10 is instrumental to gut motility.

For completeness, the spinal trigeminal nucleus also receives CNs 7, 9, and 10, which provide clinically insignificant sensory coverage from the external ear.

One simplistic way to recall this rostral–caudal organization is to imagine that you are a primordial fish swimming through the great sea. First, you smell food (cranial nerve 1, the olfactory nerve); then, you visualize it (cranial nerve 2, the optic nerve); next, you fix your eyes on it, for which you use your extraocular eye muscles — innervated by cranial nerve 3 (the oculomotor nerve), cranial nerve 4 (the trochlear nerve), and cranial nerve 6 (the abducens nerve); you chew the food using cranial nerve 5 (the trigeminal nerve) and then taste it and smile using cranial nerve 7 (the facial nerve). Then, you listen for predators with cranial nerve 8 (the vestibulocochlear nerve) while you swallow the meal with cranial nerves 9 (the glossopharyngeal nerve) and 10 (the vagus nerve); you lick your lips with cranial nerve 12 (the hypoglossal nerve); and toss your head from side to side with cranial nerve 11 (the accessory nerve).

For reference, according to the simplest, most common definition, the first pharyngeal arch derives cranial nerve 5, the second pharyngeal arch derives cranial nerve 7, the third pharyngeal arch derives cranial nerve 9, and the fourth and sixth pharyngeal arches derive cranial nerve 10.

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21
Q

GSA fibers convey what type of sensations?

  • what structures do they innervate?
  • primarily which CN
A

sharp highly localized sensations, innervate structures of ectodermal origin

-trigeminal

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22
Q

GVA fibers

  • innervate what structures
  • type of sensation
A

innervate endodermal origin structures (gut)

dull, aching, burning, poorly localized sensation

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23
Q

GSE fibers:

-what do they innvervate

A

-myotomic origin structures

*in the head only myotomic origin are muscles of the tongue, and extraocular muscles.

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24
Q

GVE fibers come from?

innervate what?

parasympathetic or symparthetic?

-which CNs

A

Components of the ANS and innervate smooth muscle and glands. they can be either sympathetic or parasympathetic

*there are no preganglionic parasympathetic fibers in any of the spinal nerves.*

CN III, VII, IX, X

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25
Q

SVA, SVE, SSA

  • senses associated
  • CNs
A
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26
Q

Trigeminal Sensory Nuclei (GSA)

  • sensations for what
  • what CNs
  • subnuclei of V
A
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27
Q

Solitary Nucleus (SVA and GVA)

  • sensory for what parts of body?
  • SVA receives taste from what?
  • visceral reflexes?
A
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28
Q

GSE column:

-nuclei, CNs, and what they innervate

A
29
Q

GVE parasympathetic column:

-nuclei, CNs, and they do

A
30
Q

Lesions to vagus, accessory, glossopharyngeal, hypoglossal produce what symptoms

A
31
Q

What part of SVE column innervates the SCM/Trap

-what does the nucleus ambiguus exit the brainstem with? anastomose with?

A
  • Spinal root from C5-C1 comes out of accessory nucleus is the part that goes to the SCM and Trap
  • part that comes out of the nucleus ambiguus exits brainstem w/cranial portion of accessory nerve (11) and merges with vagus nerve (10) at jugular foramen
32
Q

Sympathetic trunk relationship to common carotid, longus colli, and capitus muscle?

-what is it embedded in?

A
33
Q

Preganglionic sympathetic fibers in the head

-where are they?

A
34
Q

Preganglionic Sympathetic Fibers

  • in head and neck where do they originate from?
  • what part of column
  • exit via? going which direction?
A
35
Q

Postganglionic Sympathetic Fibers:

  • originate from?
  • where do they usually form on?
  • innervate what?
A
36
Q

Study this

A
37
Q

External carotid plexus:

  • consists of?
  • continuous with?
A
38
Q

Superior Cervical Ganglion:

  • location
  • receives preganglionic fibers from?
  • what does it send out?
A

chain of 3-4 ganglia

  • superior cervical
  • middle cervical
  • vertebral ganglion
  • inferior cervical ganglion
  • stellate ganglion
39
Q

Internal Carotid Plexus:

  • formed from?
  • branches from internal carotid plexus and what they do
A
40
Q

Horners syndrome

  • causes
  • signs/symptoms
A
41
Q

Cranial parasympathetic Nervous system:

  • preganglionic neurons
  • postganglionic neurons
A
42
Q

innervation to the submandibular and sublingual glands

  • preganglionic sympathetic fibers found where, postganglionic sympathetics get to glands how?
  • what sends preganglionic parasympathetic to the submandibular ganglion? via which nerve? postganglionic fibers come from?
A
43
Q

ANS to Parotid Gland:

  • preganglionic sympathetic origin.
  • postganglionic sympathetic reach the gland how?
  • preganglionic parasympathetic fibers come from? where are they sent to? via which nerve?
  • how to postganglionic parasympathetics reach the parotid?
A
44
Q

Pupillary constriction and thickening of the lense (near vision) are what type of response?

-what is accomodation

A

they are parasympathetic responses

accomodation is a cortically mediated response, coordinated changes in muscles, lense, to focus eye

45
Q

Trigeminal Nerve

  • divisions, their foramens
  • what parts of column, subnuclei
  • branches of V1, V2, V3
A

Opthalmic, Maxillary, Mandibular

Standing Room Only: Spinosum, rotundum, ovale

Mandibular portion (V3) has a SVE nucleus in the lateral most motor column before the sulcus limitans

lateral most sensory (GSA) midbrain/pons has a mesencephalic nucleus that extends from midbrain through pons. There is a small pontine principal sensory nuclei. And there is a large spinal nucleus spanning from the pons through medulla and into the cervical spinal cord w/ contributions from 7,9,10

46
Q

Parasympathetic relationship of trigeminal nerve

A

Otic and submandibular parasympathetic ganglions are accompanied V3 and their secretomotor fibers are distributed to the major and minor salivary glands.

47
Q

Opthalmic division branches

somatic sensory innervation

A
48
Q

Maxillary division branches

-somatic sensory

A
49
Q

Mandibular division branches, foramen, somatic sensory, somatic motor

A
50
Q

Trigeminal Nerve Palsy:

signs, which side?

-neuralgia characterized by what saying

A
51
Q

How does the corneal reflex work

A
52
Q

Facial Nerve branches: what mm do they supply

-foramen

Temporal

zygomatic

buccal

mandibular

cervical

A

CN 7 goes through Int. Acoustic meatus

53
Q

CN 7 palsy

lose what reflex, taste in what part of tongue, sound issue?

A
54
Q

Bell’s Palsy is a mononeuropathy of what?

A
55
Q

foramen of CN 8

A

internal acoustic meatus

56
Q

CN IX

  • foramen
  • branches
  • taste
  • gland
  • carotid body/sinus
  • important muscle
A

remember that CN IX does carotid sinus hemodynamics whereas vagus does aortic arch hemodynamics

57
Q

CN IX palsy

A
58
Q

CN X nuclei and their functions

A
59
Q

CN X palsy

  • what happens to voice
  • lose what reflex
  • lose sensation where
  • which way does uvula go
  • hemodynamic affects?
A
60
Q

CN XII

  • foramen
  • function
  • palsy
A

hypoglossal canal

61
Q

V1

A
62
Q

V2

A
63
Q

V3

A
64
Q

Study this

A
65
Q
A
66
Q

Submandibular. sublingual parasympathetic innervation

  • role of chorda tympani, where its from, joins up with what?
  • where does this synapse
A
67
Q

Parasympathetics of the lacrimal gland

  • greater petrosal nerve from where? at what ganglion?
  • deep petrosal coming out where, meets with what?
  • how to postsynpatic parasympathetics get to lacrimal gland what nerve/branch?
A
68
Q

Parasympathetics to the parotid gland:

-1,2,3,4,5,6

A

Neuroscience I (14 decks)

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