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NE Exam 1 > Cranial Nerves & Autonomics > Flashcards

Cranial Nerves & Autonomics Flashcards

1
Q

Which Cranial Nerves pass through the Cribriform Plate?

A

Olfactory N. (CN I)

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2
Q

Which Cranial Nerves pass through the Optic Canal?

A

Optic N. (CN II)

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3
Q

Which Cranial Nerves pass through the Superior Orbital Fissure?

A

Occulomotor N. (CN III)
Trochlear N. (CN IV)
Ophthalmic Division of Trigeminal N. (CN V - V1)
Abducens N. (CN VI)

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4
Q

Which Cranial Nerves pass through the Foramen Rotundum?

A

Maxillary Division of Trigeminal N. (CN V - V2)

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5
Q

Which Cranial Nerves pass through the Foramen Ovale?

A

Mandibular Division of Trigeminal N. (CN V - V3)

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6
Q

Which Cranial Nerves pass through the Internal Acoustic Meatus?

A

Facial N. (CN VII)

Vestibulocochlear N. (CN VIII)

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7
Q

Which Cranial Nerves pass through the Jugular Foramen?

A

Glossopharyngeal N. (CN IX)
Vagus N. (CN X)
Spinal Accessory N. (CN XI)

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8
Q

Which Cranial Nerves pass through the Hypoglossal Canal?

A

Hypoglossal N. (CN XII)

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9
Q

What are the nuclei of CN I (Olfactory)? Modality?

A

Mitral cells of Olfactory Bulb – SVA (Special Sensory)

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10
Q

What are the nuclei of CN II (Optic)? Modality?

A

Ganglion cells of Retina – SSA (Special Sensory)

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11
Q

What are the nuclei of CN III (Oculomotor)? Modality?

A

Oculomotor – GSE (Somatic Motor)

Edinger Westphal – GVE (Visceral Motor - Parasympathetic)

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12
Q

What are the nuclei of CN IV (Trochlear)? Modality?

A

Trochlear – GSE (Somatic Motor)

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13
Q

What are the nuclei of CN V (Trigeminal)? Modality?

A

Masticator – SVE (Branchial Motor)

Trigeminal – GSA (General Sensory)

***Remember, SVE is Branchial Motor which means these nuclei innervate all muscles derived from Branchial (Pharyngeal) Arches!

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14
Q

What are the nuclei of CN VI (Abducens)? Modality?

A

Abducens – GSE (Somatic Motor)

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15
Q

What are the nuclei of CN VII (Facial)? Modality?

A

Facial – SVE (Branchial Motor)

Trigeminal – GSA (General Sensory)

Superior Salivatory – GVE (Visceral Motor - Parasympathetic)

Gustatory – SVA (Special Sensory)

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16
Q

What are the nuclei of CN VIII (Vestibulocochlear)? Modality?

A

Vestibular – SSA (Special Sensory)

Cochlear – SSA (Special Sensory)

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17
Q

What is the difference between the special sensory modalities SSA and SVA?

A

SSA is for special “body” senses – Vision, Balance, Hearing

SVA is for special “ingestion” senses – Smell, Taste

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18
Q

What are the nuclei for CN IX (Glossopharyngeal)? Modality?

A

Ambiguus – SVE (Branchial Motor)

Inferior Salivatory – GVE (Visceral Motor - Parasympathetic)

Solitarius – GVA (Visceral Sensory)

Trigeminal – GSA (General Sensory)

Gustatory – SVA (Special Sensory)

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19
Q

What are the nuclei for CN X (Vagus)? Modality?

A

Solitarius – GVA (Visceral Sensory)

Ambiguus – SVE (Branchial Motor)

Dorsal Vagus – GVE (Visceral Motor - Parasympathetic)

Trigeminal – GSA (General Sensory)

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20
Q

What are the nuclei for CN XI (Spinal Accessory)? Modality?

A

Accessory – SVE (Branchial Motor)

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21
Q

What are the nuclei for CN XII (Hypoglossal)? Modality?

A

Hypoglossal – GSE (Somatic Motor)

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22
Q

In the autonomics of the head, all sympathetic fibers are (PREGANGLIONIC/POSTGANGLIONIC) arising from the superior cervical ganglion (C1, 2, 3, 4) of the sympathetic trunk. They travel on vessels to the structures that they innervate.

A

Postganglionic

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23
Q

In the autonomics of the head, this nerve is the only nerve that is postganglionic but parasympathetic.

A

Deep Petrosal N.

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24
Q

In the autonomics of the head, preganglionic parasympathetic fibers arise from nuclei in the brain stem and synapse at 4 ganglia in the head, which are…

A

Ciliary
Pterygopalatine
Otic
Submandibular

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25
Q

Preganglionic parasympathetics are carried by which cranial nerves?

A

III, VII, IX, X

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26
Q

In the autonomics of the head, all parasympathetic postganglionic fibers “piggy back” on a branch of the _________ nerve to arrive at the structure that they innervate.

A

Trigeminal (CN V)

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27
Q

What is the function of CN I (Olfactory)?

A

Smell (olfaction)

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28
Q

What is the function of CN II (Optic)?

A

Vision

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29
Q

What is the function of CN III (Oculomotor)?

A

Somatic Motor (GSE) – Supplies the Levator Palpebrae Superioris to elevate eyelid, and the four extrinsic eye muscles (Superior Rectus, Medial Rectus, Inferior Rectus, and Inferior Oblique) to move eyeball.

Visceral Motor (GVE) – Provides parasympathetic supply to Constrictor Pupillae to make pupil constrict and Ciliary muscles to make lens of eye more spherical (for near vision).

30
Q

What can happen if CN I (Olfactory) is damaged?

A

Anosmia (partial or total loss of smell)

31
Q

What can happen if CN II (Optic) is damaged?

A

Anopsia (visual defects)

32
Q

What can happen if CN III (Oculomotor) is damaged?

A 
Ptosis 
Paralysis of eye muscles 
Lead to strabismus (eyes not in parallel/deviated)
Diplopia (double vision) 
Focusing difficulty
33
Q

What is the function of CN IV (Trochlear)?

A

Supplies one extrinsic eye muscle (Superior Oblique) to move eyeball inferiorly and laterally.

34
Q

What can happen if CN IV (Trochlear) is damaged?

A

Paralysis of Superior Oblique
Lead to strabismus (eye not in parallel/ deviated)
Diplopia (double vision)

35
Q

What is the function of CN VI (Abducens)?

A

Supplies one extrinsic eye muscle (Lateral Rectus) for eye abduction.

36
Q

What can happen if CN VI (Abducens) is damaged?

A

Paralysis of Lateral Rectus limits lateral movement of eye

Diplopia (double vision)

37
Q

If my left eye is normal, but my right eye has a downward and outward gaze, dilated pupil, and the eyelid has to be manually elevated due to ptosis, what is wrong?

A

Right Oculomotor (CN III) Nerve Palsy

***Eye gaze is down and outward because Superior Oblique and Lateral Rectus both still work!

***Pupils dilated because parasympathetic component of Constrictor Pupillae not working!

***Eyelid manually raised because Levator Palpebrae Superioris not working (raises eyelid)!

38
Q

If my right eye is normal, but my left eye will not abduct, what is wrong?

A

Left Abducens (CN VI) Nerve Palsy

***Will not abduct because Lateral Rectus won’t work!

39
Q

The Trigeminal N. (CN V) has three divisions, which are…

A

Ophthalmic (V1)
Maxillary (V2)
Mandibular (V3)

40
Q

What is the branchial motor (SVE) function of the Trigeminal N. (CN V)?

A

Innervates:

Muscles of mastication (Temporalis, Masseter, Lateral and Medial Pterygoids)
Mylohyoid
Anterior Belly of Digastric
Tensor Tympani
Tensor Veli Palatini
41
Q

What is the general sensory (GSA) function of the Trigeminal N. (CN V)?

A

V1 – Conducts sensory impulses form cornea, nose, forehead, anterior scalp

V2 – Conducts sensory impulse from nasal mucosa, palate, gums, cheek

V3 – Conducts sensory impulses from anterior 2/3 of tongue, skin of chin, lower jaw, lower teeth

42
Q

If there is tingling due to herpes zoster (shingles and chicken pox) on the top of my nose, in what area will the lesions appear?

A

They will appear on the top of the nose, which is in the area of the Ophthalmic branch (V1) of Trigeminal N.

***Wherever there is tingling on the face, it corresponds with a certain branch of the Trigeminal N. and the lesions will appear in that area.

43
Q

What are the branches of the Ophthalmic (V1) N.?

A

Lacrimal
Frontal
Nasociliary
Meningeal branch

44
Q

What are the branches of the Maxillary (V2) N.?

A 
Zygomatic
Infraorbital 
Superior Alveolar 
Palatine
Meningeal
45
Q

What are the branches of the Mandibular (V3) N.?

A 
Buccal
Lingual
Inferior Alveolar
Auriculotemporal 
Meningeal (spinosus)
46
Q

What are the branches of the Mandibular (V3) N. that are involved with the muscles of mastication?

A

Medial Pterygoid (Innervates Tensor Veli Palatini and Tensor Tympani)

Lateral Pterygoid

Masseteric

Deep Temporal

Mylohyoid (innervates Mylohyoid and Anterior Belly of Digastric)

47
Q

What is the sensory function (SVA, GSA) of the Facial N. (CN VII)?

A

Taste from anterior 2/3 of the tongue

48
Q

What is the branchial motor function (SVE) of the Facial N. (CN VII)?

A

Five major motor branches innervate muscles of facial expression, Posterior Belly of Digastric, and the Stylohyoid and Stapedius muscles.

***Branches are Temporal, Zygomatic, Buccal, Mandibular, and Cervical

49
Q

What is the parasympathetic motor function (GVE) of the Facial N. (CN VII)?

A

Innervates (and thereby increases secretions of) the lacrimal gland of the eye and two salivary glands – Submandibular and Sublingual.

50
Q

What happens if there is damage to CN V (Trigeminal)?

A

Trigeminal Neuralgia, caused by inflammation of the sensory components of the Trigeminal N. and results in intense, pulsating pain lasting minutes to hours.

51
Q

What happens if there is damage to CN VII (Facial)?

A
  • Decreased tearing (Dry eye)
  • Decreased salvation (Dry mouth)
  • Loss of taste sensation to anterior 2/3 tongue
  • Bell Palsy (Paralyzed facial muscles, eyelid droop, and sagging at corner of mouth)
52
Q

What are the functions of CN VIII (Vestibulocochlear)?

A

Cochlear branch conducts impulses for hearing

Vestibular branch conducts impulses for equilibrium (balance)

53
Q

What happens if there is damage to CN VIII (Vestibulocochlear)?

A

Lesions in vestibular branch produce loss of balance, nausea, vomiting, and dizziness.

Lesions in cochlear branch result in deafness (loss of hearing).

54
Q

What is the sensory function (SVA, GVA, GSA) of CN IV (Glossopharyngeal)?

A

General sensation and taste to the posterior 1/3 of tongue

Chemoreceptor fibers to the carotid bodies (structures on the carotid arteries that detect and monitor O2 and CO2 levels in the blood)

55
Q

What is the branchial motor function (SVE) of CN IV (Glossopharyngeal)?

A

Innervates stylopharyngeus (pharynx muscle)

56
Q

What is the parasympathetic motor function (GVE) of CN IV (Glossopharyngeal)?

A

Innervates (thus increasing secretion of) parotid salivary gland

57
Q

If there is damage to CN IV (Glossopharyngeal), what happens?

A

Reduced salivary secretion (dry mouth)

Loss of taste sensations to posterior 1/3 of tongue

58
Q

What is the sensory function (GVA, GSA) of CN X (Vagus)?

A

Visceral sensory information from pharynx, larynx, heart, lungs, and most abdominal organs.

General sensory information from external auditory canal, eardrum, and pharynx.

59
Q

What is the branchial motor function (SVE) of CN X (Vagus)?

A

Innervates most pharynx and larynx muscles

60
Q

What is the parasympathetic motor function (GVE) of CN X (Vagus)?

A

Innervates visceral smooth muscle, cardiac muscle, and glands of heart, lungs, pharynx, larynx, trachea, and most abdominal organs.

61
Q

If CN X (Vagus) is damaged, what happens?

A

Paralysis leads to a variety of larynx problems, including hoarseness, monotone, or complete loss of voice.

Other lesions may cause difficulty in swallowing or impaired gastrointestinal system mobility.

62
Q

What is the branchial motor function (SVE) of CN XI (Spinal Accessory)?

A

Innervation to SCM and Trapezius

63
Q

What happens if CN XI (Spinal Accessory) is damaged?

A

Paralysis of Trapezius and SCM, resulting in difficulty elevating shoulder (trapezius function) or turning head to opposite sides (SCM function)

64
Q

What is the somatic motor function (GSE) of CN XII (Hypoglossal)?

A

Innervates intrinsic tongue muscles (i.e., muscle fibers of tongue itself) and extrinsic tongue muscles (i.e., hyoglossus, genioglossus, styloglossus)

65
Q

What happens if CN XII (Hypoglossal) is damaged?

A

Swallowing and speech difficulties due to impaired tongue movement.

If a single Hypoglossal N. (either left or right) is paralyzed, a protruded (stuck out) tongue deviates to the side of the damaged nerve.

66
Q

Put the following steps in order for parasympathetic innervation to the Parotid Gland via CN IX (Glossopharyngeal):

A. Lesser Petrosal N. arises as a branch of Tympanic Plexus.

B. Parasympathetic fibers synapse in otic ganglion.

C. Postsynaptic fibers pass to Parotid Gland via branches of Auriculotemporal N. (CN V3).

D. Tympanic N. arises from CN IX and emerges with it from the Jugular Foramen.

E. Lesser Petrosal N. penetrates roof of tympanic cavity (tegmen tympani) to enter middle cranial fossa.

F. Tympanic N. enters middle ear via the tympanic canaliculus in petrous part of temporal bone.

G. Lesser Petrosal N. leaves cranium through Foramen Ovale.

H. Tympanic N. forms tympanic plexus on promontory of middle ear.

A

1) D
2) F
3) H
4) A
5) E
6) G
7) B
8) C

67
Q

Put the following steps in order for parasympathetic innervation to the Lacrimal Gland via CN VII (Facial):

A. Nerve of Pterygoid Canal travels through the Pterygoid Canal and enters the Pterygopalatine Fossa.

B. Greater Petrosal N. arises from CN VII at the geniculate ganglion and emerges from the superior surface of petrous part of temporal bone to enter middle cranial fossa.

C. Parasympathetic fibers from nerve of Pterygoid Canal in Pterygopalatine Fossa synapse in Pterygopalatine ganglion.

D. Postsynaptic parasympathetic fibers from the Pterygopalatine ganglion innervate the Lacrimal Gland via the Zygomatic Branch of CN V2 and Lacrimal N. (branch of CN V3).

E. Greater Petrosal N. joins Deep Petrosal N. (sympathetic) at Foramen Lacerum to form N. of Pterygoid Canal.

A

1) B
2) E
3) A
4) C
5) D

68
Q

Put the following steps in order for parasympathetic innervation to the Submandibular and Sublingual Glands via CN VII (Facial):

A. The Chorda Tympani passes through petrotympanic fissure between the tympanic and petrous parts of the temporal bone to join the Lingual N. (CN V3) in the infratemporal fossa.

B. The Chorda Tympani crosses the tympanic cavity medial to the handle of Malleus.

C. Parasympathetic fibers of Chorda Tympani synapse in Submandibular Ganglion

D. The Chorda Tympani branch arises from CN VII just superior to Stylomastoid Foramen.

E. Postsynaptic fibers follow arteries to the Submandibular and Sublingual Glands.

A

1) D
2) B
3) A
4) C
5) E

69
Q

Explain the path of travel for the parasympathetic fibers of CN III (Oculomotor).

A

Start at Edinger Westphal nucleus in brainstem. Presynaptic parasympathetic fibers go on to synapse at the Ciliary Ganglion. Postsynaptic parasympathetic fibers then travel to the eye.

70
Q

Explain the path of travel for sympathetic fibers to reach the eye.

A

Presynaptic sympathetic fibers exit the lateral horns of Thoracic Vertebrae. Exit through Anterior Root and Anterior Ramus to the White Ramus Communicans where it reaches its paravertebral ganglion of the sympathetic trunk. Here, the presynaptic fiber then travels up the sympathetic trunk to the Superior Cervical Ganglion where it synapses with the postsynaptic sympathetic fibers. These fibers then travel on the Carotid Periarterial Plexus (artery) to reach the eye.

NE Exam 1 (19 decks)

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