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Year 2 Term 1 Control > Cranial nerves extra > Flashcards

Cranial nerves extra Flashcards

1
Q

What is the course of the facial nerve and what branches does it give off at which point?

A

Travels through internal acoustic meatus - gives off greater petrosal nerve
Goes through facial canal, whilst travelling through gives off a branch to the stapedius muscle followed by the chorda tympani
Exits the facial canal through the stylomastoid foramen at which point it gives off a posterior auricular branch and divides into 5 motor branches, temporal, zygomatic, buccal, marginal mandibular and cervical

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2
Q

What does the greater petrosal nerve carry?

A

Parasympathetic fibres to the lacrimal gland via the pterygopalatine ganglion

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3
Q

What does the chorda tympani nerve from the facial nerve carry?

A

Fibres that carry taste sensation from the anterior 2/3 of the tongue
Unites with the lingual branch of V3 to supply parasympathetic fibres to the sublingual and submandibular salivary glands via the submandibular ganglion

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4
Q

What 5 motor branches does the facial nerve split into after passing out of the stylomastoid foramen?

A

1) Temporal
2) Zygomatic
3) Buccal
4) Marginal mandibular
5) Cervical

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5
Q

What 2 muscles are supplied by the temporal branch of the facial nerve?

A

1) Frontalis

2) Orbicularis Oculi

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6
Q

Which muscle is supplied by the zygomatic branch of the facial nerve?

A

Orbicularis Oculi

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7
Q

Which 2 muscles are supplied by the buccal branch of the facial nerve?

A

1) Buccinator

2) Zygomaticus

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8
Q

Which 2 muscles are supplied by the marginal mandibular branch of the facial nerve?

A

1) Orbicularis oris

2) Mentalis muscle

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9
Q

Which muscle is supplied by the cervical branch of the facial nerve?

A

Platysma

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10
Q

Inability to swallow foods and regurgitation of liquids is likely due to damage to which cranial nerve?

A

Vagus CN X

and/or glossopharyngeal CN IX

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11
Q

Hoarseness is often due to damage to which cranial nerve and why?

A

Vagus CN X
Unable to oppose vocal chords due to weakness/paralysis of intrinsic laryngeal muscles which are supplied by the recurrent laryngeal nerve of the vagus

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12
Q

Unilateral tongue atrophy is likely due to damage of which cranial nerve?

A

Damage of the hypoglossal nerve on one side

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13
Q

Unilateral trapezius atrophy is likely due to damage to which cranial nerve?

A

Accessory CN XI

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14
Q

If one pupil was smaller than the other but both pupils reacted to light, what is this likely due to damage to?

A

The sympathetic trunk

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15
Q

Why does the uvula deviate from the midline on phonation in unilateral vagus nerve damage?

A

Levator veli palantini is supplied by the vagus nerve (with some influence from CN IX) on phonation failure of this muscle on one side to lift the soft palate results in deviation of the uvula away from the damaged side

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16
Q

Which cranial nerves emerge from the cerebellopontine angle?

A

Facial CN VII

Vestibulocochlear CN VIII

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17
Q

Which cranial nerve emerges from the interpeduncular fossa?

A

Oculomotor CN III

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18
Q

Which cranial nerve emerges immediately lateral to the medullary pyramids?

A

Hypoglossal nerve CN XII

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19
Q

Which cranial nerves emerge from immediately lateral to the medullary olives?

A

Glossopharyngeal CN IX

Vagus CN X

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20
Q

Which cranial nerve emerges from the dorsal surface of the brain stem?

A

Trochlear CN IV

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21
Q

Which 2 cranial nerves are not true peripheral nerves, why?

A 
The olfactory (CN I) and optic (CN II) 
They are actually CNS structures the olfactory bulbs and tracts and the optic tracts
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22
Q

Where are the true peripheral olfactory nerves?

A

Found in the nasal mucosa

Pass through the ciribiform plate of the ethmoid bone to the olfactory bulb where they synapse

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23
Q

The olfactory nerve is most commonly damaged as a result of head injury, how may such damage occur?

A

Haemorrhage following head injury

Craniofacial trauma as part of a head injury could also lead to damage of the peripheral olfactory nerves

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24
Q

What is anosmia?

A

Loss of smell

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25
Q

The optic nerve is formed from what embryonically?

A

Formed from an outgrowth of the embryonic diencephalon

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26
Q

Sensory components of the trigeminal nerve supply what?

A

The skin, teeth, mucous membranes of the face plus the anterior scalp and dura

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27
Q

What do motor fibres of the trigeminal nerve supply?

A

Muscles of mastication
A number of muscles involved in swallowing
Tensor tympani which dampens the amplitude of vibration of the tympanic membrane

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28
Q

What is the innervation and function of the tensor tympani muscle?

A

Dampens the amplitude of the vibration of the tympanic membrane
Innervated by the trigeminal nerve

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29
Q

Where are the cell bodies of most of the trigeminal sensory fibres located?

A

Located in the trigeminal ganglion (or semilunar ganglion) located at the convergence of the ophthalmic, maxillary and mandibular nerves

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30
Q

Through which foramina do the 3 divisions of the trigeminal nerve exit the cranial cavity?

A

Ophthalmic - superior orbital fissure
Maxillary - foramen rotundum
Mandibular - foramen ovale

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31
Q

The mandibular division of trigeminal nerve gives off what 4 important branches?

A

1) Auriculotemporal nerve
2) Inferior alveolar nerve
3) Buccal nerve
4) Lingual nerve

32
Q

The maxillary division of the trigeminal nerve gives off what 2 important branches?

A

1) Infraorbital nerve

3) Superior alveolar nerve

33
Q

Which 2 nerves from the trigeminal nerve hang from the pterygopalatine ganglion?

A

Greater and lesser palatine nerves

34
Q

What do the greater and lesser palatine nerves supply?

A

Greater palatine -> mucosa, glands and gingiva of hard palate, roof of oral cavity
Lesser palatine -> soft palate

35
Q

Which 2 reflexes are tested when examining the trigeminal nerve and which other cranial nerves are involve in these?

A

Jaw jerk
Afferent and Efferent limb = trigeminal nerve

Corneal reflex
Afferent limb = ophthalmic
Efferent limb = facial nerve to orbicularis oculi

36
Q

What is neuralgia?

A

Intense burning or stabbing pain which occurs along a damaged nerve

37
Q

What is trigeminal neuralgia?

A

Episodes of sharp stabbing pain in the cheek, lips, gums or chin on one side of the face

38
Q

What kind of fibres does the facial nerve carry?

A

Sensory, motor and autonomic (parasympathetic)

39
Q

What kind of fibres does the trigeminal nerve carry?

A

Sensory, motor and carries autonomic (parasympathetic)

40
Q

What are the sensory functions of the facial nerve?

A

Taste from anterior 2/3 of tongue
Floor of mouth and palate
Cutaneous sensation from external ear

41
Q

Where are the cell bodies of the sensory fibres runnin in the facial nerve located?

A

In the geniculate ganglion within the facial canal of the petrous temporal bone

42
Q

What are the parasympathetic functions of the facial nerve?

A

Innervation of the sublingual and submandibular salivary glands via the submandibular ganglion
PS fibres also to lacrimal gland, nasal and oral mucous membranes via the pterygopalatine ganglion

43
Q

What is the function of the facial nerve fibres running in the greater petrosal nerve?

A

Forms the pterygopalatine ganglion

Provides PS fibres to the mucous glands of the oral cavity, nose and pharynx and the lacrimal gland

44
Q

Motor functions of the facial nerve are tested by asking the patients to do what?

A

Raise their eyebrows, screw up their eyes, purse their lips and show their teeth

45
Q

What is Bells palsy?

A

Paralysis or severe weakness of muscles on one side of the face due to damage to the facial nerve

46
Q

What is hyperacusis?

A

Over sensitivity to certain frequencies and volume ranges of sound

47
Q

Why may damage to the facial nerve lead to hyperacusis?

A

Because the facial nerve gives off a branch to the stapedius muscle found in the middle ear which prevents excessive movement of the stapes bone, helping to control the amplitude of sound waves from the external environment

48
Q

How can the vestibular part of the vestibulocochlear nerve be tested?

A

Weber test - place tuning fork in the center of the forehead and ask if its louder in either ear - it should be the same volume in each

49
Q

How can the cochlear part of the vestibulocochlear nerve be tested?

A

Rinne test - place tuning fork on mastoid process and the next to the ear and ask which is louder, it should be louder next to the ear

50
Q

What is an acoustic neuroma?

A

A tumour affecting the vestibulocochlear nerve

51
Q

Dysphagia is caused by damage to which cranial nerves?

A

Vagus and/or glossopharyngeal

52
Q

What is dysphagia?

A

Difficulty swallowing

53
Q

What is dysphonia?

A

Difficulty in voice production normally characterised by hoarseness usually

54
Q

What is dysarthria?

A

Imperfect articulation due to poor control of muscles

55
Q

Which nerves are involved in the gag reflex?

A

Afferent limb = Glossopharyngeal CN IX
Efferent limb = Vagus CN X
Patient gags when posterior pharynx is brushed

56
Q

Is the glossopharyngeal nerve mostly sensory or motor?

A

Mostly sensory

57
Q

What sensory information is carried in the glossopharyngeal nerve?

A

Posterior 1/3 of tongue and oropharynx
Chemoreceptors in the carotid body and baroceptors in the carotid body
Cutaneous sensation from the ear

58
Q

The glossopharyngeal nerve also has a parasympathetic component, what does this supply?

A

PS fibres to the parotid gland via the otic ganglion

59
Q

The vagus nerve provides PS innervation to what?

A

Thoracic and abdominal viscera

60
Q

Aswell as PS fibres, the vagus nerve carries motor fibres to what?

A

Striated muscle

61
Q

The vagus nerve is joined by what?

A

The cranial root of the accessory nerve

62
Q

The vagus nerve is joined by the cranial root of the accessory nerve, what do they supply together?

A

Together they supply the striated muscles of the palate, pharynx and larynx

63
Q

The functioning of the vagus and cranial accessory nerves can be tested by asking the patient to say aah and observing the movements of the soft palate, what normally happens?

A

The uvula should move anteriorly but should lie centrally and not deviate on movement

64
Q

Do the spinal and cranial roots of the accessory nerve have the same function?

A

No they have completely different functions

65
Q

What is the origin of the spinal part of the accessory nerve?

A

Rootlets from the upper segments of the cervical cord

66
Q

How does the spinal part of the accessory nerve enter the cranial cavity?

A

Through the foramen magnum

67
Q

What happens once the spinal part of the accessory nerve runs into the cranial cavity?

A

Once the spinal accessory nerve has entered the cranial cavity through the foramen magnum it briefly joins the cranial accessory nerve to travel through the jugular foramen, then seperates off and runs to supply the sternocleidomastoid and trapezius muscle

68
Q

How would you test the functioning of the spinal root of the accessory nerve?

A

As patient to turn head and shrug against resistance

69
Q

Does the spinal accessory nerve have a sensory component?

A

No

70
Q

Where is the spinal accessory nerve particularly at risk of damage?

A

Posterior cervical neck - the spinal accessory nerve has a superficial course here

71
Q

Does the hypoglossal nerve have any sensory function?

A

No, the hypoglossal nerve is purely motor function

72
Q

What does the hypoglossal nerve supply?

A

Purely motor to the intrinsic and extrinsic muscles of the tongue

73
Q

What 3 processes are normal tongue movements necessary for?

A

1) Articulation
2) Chewing
3) Initiation of swallowing

74
Q

How would you assess the functioning of the hypoglossal nerve?

A

Ask patient to protrude tongue and check it doesnt deviate to either side

75
Q

Other than deviation, what changes may you observe in the tongue in a patient with unilateral hypoglossal nerve damage?

A

Damage to the tongue from teeth due to poor coordination when chewing

76
Q

What happens to PS and S fibres in the 4 autonomic ganglia of the head?

A

Pre and post synaptic parasympathetic fibres synapse here, sympathetic fibres are present, but pass through without synapsing

Year 2 Term 1 Control (14 decks)

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