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Neuro (NSB) > Cranial Nerves (GSE/LMN) > Flashcards

Cranial Nerves (GSE/LMN) Flashcards

1
Q

describe the major divisions of the brain rostral to caudal

A

prosencephalon, midbrain, pons, medulla oblongata

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2
Q

define prosencephalon and diencephalon and the common names these terms refer to

A

prosencephalon/forebrain: cerebrum (telencephalon), thalamus (diencephalon)

diencephalon: between brain; contains epithalamus, hypothalamus, and thalamus

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3
Q

know what structures contribute CLINICALLY to the brainstem (3)

A

midbrain, pons, medulla

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4
Q

in terms of GSE/LMN function, list the 5 groups of cranial nerves

A
  1. 3, 4, 6
  2. 5
  3. 7
  4. 9, 10, 11
  5. 12
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5
Q

list where in the brain the cranial nerves enter and exit

A

CN2: prosencephalon
CN3 and 4: midbrain
CN5: pons
CN 6-12: medulla oblongata

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6
Q

describe the basic course the cranial nerves take as they course through the cranial cavity along the ventral aspect of the brain and how this can help you localize

A

3, 4, 5 ophthalmic, 6: via orbital fissure

5, 7, 8: pons/medulla junction

7, 8 and horner: tympanic cavity, middle ear

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7
Q

describe how postural reactions, evaluation of other cranial nerves, and mentation allow you to determine if a lesion is in one of the major divisions of the brain (CNS) or in the PNS (cranial nerve)

A

mentation: abnormal = central lesion

postural reactions: abnormal = central lesion

other cranial nerve neighbors: affected = central

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8
Q

what do lesions at or caudal to the midbrain result in?

A

gait abnormalities like GP proprioceptive ataxia/UMN paresis, vestibular ataxia, or cerebellar ataxia, as well as ipsilateral deficits in cranial nerves and ipsilateral postural reaction deficits (CN 3-12, behaves like spinal cord because ipsilateral because no crossover yet/after crossover)

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9
Q

what divisions of the brain contain the GSE/LMN for CN 3, 4, and 6?

A

pons: 3 and 4
medulla: 6

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10
Q

list the extraocular muscles innervated by CN 3 4 and 6

A

rectus muscle, oblique muscles, retractor bulbi muscle

LR 6, SO4, rest by 3

6: lateral rectus
4: dorsal oblique
3: medial, dorsal, ventral rectus, ventral oblique

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11
Q

what muscle of the superior eyelid is innervated by CN 3?

A

levator palpebrae suprioris (elevates upper eyelide)

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12
Q

what are the 2 types of functions of CN3?

A

GSE/LMN and parasympathetic

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13
Q

what is the foramen where CN 3, 4, and 6 exit the cranial cavity?

A

emerge from ventral brainstem, course ventrally along cranial cavity, and exit at the orbital fissure

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14
Q

which way will the eye move with stimulation of CN3?

A

medial, dorsa, ventral, extorsion

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15
Q

which way will the eye move with stimulation of CN 4?

A

intorsion

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16
Q

which way will the eye move with stimulation of CN 6?

A

lateral

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17
Q

what position will the eye have with a lesion affecting CN 3, CN 4, OR CN 6?

A

3: will move ventral and lateral
4: will extorsion
5: will move medial

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18
Q

describe the eye position relative to the orbit if CN3, CN4 AND CN6 are affected/abnormal

A

eye will look “normal” because everyone dropped their rope; so instead try to get the patient to follow an object with just eyes or move head side to side and should see nistagmus via CN 8 telling 3 4 and 6 to move eyes

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19
Q

what major division of the brain contains the GSE/LMN nuclei for the trigeminal nerve?

A

pons

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20
Q

what major division of the brain does the trigeminal nerve exit/enter?

A

ophthalmic exits at orbital fissure
maxillary exits at round foramen of alar canal
mandibular exits at oval foramen

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21
Q

name the 3 major branches of the trigeminal nerve; which has sensory funciton? which has motor function?

A

ophthalmic: sensory
maxillary: sensory
mandibular: sensory AND motor

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22
Q

what foramina do the branches do the trigeminal nerve use to exit the cranial cavity?

A

ophthalmic: orbital fissue
maxillary: round foramen of alar canal
mandibular: oval foramen

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23
Q

list the muscles of mastication (4)

A
  1. temporalis
  2. masseter
  3. pterygoid muscles: support eye in rostral postion
  4. rostral belly digastricus
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24
Q

describe the location of the temporalis and masseter muscles

A

temporalis: top of head
masseter: big cheek boy

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25
Q

what muscles of mastication open and which close the mouth?

A

digastricus is only opener of mouth, so temporalis, masseter, and pterygoids all close

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26
Q

name the cranial nerves that innervate the digastricus; name the cranial nerve that innervates the rostral belly and the caudal belly

A

rostral belly: mandibular of trigeminal
caudal belly: facial

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27
Q

describe the findings of a unilateral lesion affecting the mandibular branch of the trigeminal nerve

A

ipsilateral atrophy but no loss of function of muscles of mastication because the other side can still chew

28
Q

describe the findings of a bilateral lesion affecting the mandibular branches of the trigeminal nerve

A

inability to close the mouth (dropped jaw)

29
Q

broadly describe where each of the main branches of the trigeminal nerve provides cutaneous (sensory) innervation to the skin of the head/fave

A

ophthalmic: eye, medial canthus, nasal mucosa

maxillary: lateral canthus/lip over maxilla, skin on lateral rostral side of face

mandibular: skin over mandible, tongue, skin on lateral caudal side of face

30
Q

specifically, describe where you would test/stimulate the skin that would assess the autonomous zone for each of the main branches of the trigeminal nerve

A

ophthalmic: medial canthus
maxillary: lateral canthus
mandibuular: skin over mandible or tongue

31
Q

name the cranial nerve reflex that is the main means of assessing the ophthalmic and maxillary branches of the trigeminal nerve; describe how this is performed and the reaction (motor/efferent) that is observed

A

palpebral reflex; touch medial and lateral canthi and look for blinking or pulling back

32
Q

name the main branch of the trigeminal nerve assessed when the mucosa of the nasal septum is stimulated; is this a response or a reflex? what does that imply?

A

ophthalmic! this is a response, which implies involvement of the contralateral prosencephalon

33
Q

what major division of the brain contains the GSE/LMN nuclei of the facial nerve?

A

exits from rostral medulla with CN 8

34
Q

what major division of the brain does the facial nerve exit and enter?

A

exit via internal acoustic meatus, through the facial canal, out through the stylomastoid foramen

35
Q

what other cranial nerve does the facial nerve (CN7) course alongside as it exits the cranial cavity?

A

CN8 vestibulocochlear

36
Q

what canal does the facial nerve use to exit the skull and in what bone? what foramen? what is it exposed to along the course of its canal and how does this affect the nerve?

A

facial canal in petrosal bone then out through the stylomastoid foramen; along the course of the canal, the facial nerve is exposed to the tympanic cavity (middle ear), making it vulnerable to injury/disease with middle ear issues

37
Q

name 2 other nervous system structures involving the tympanic cavity and inner ear

A
  1. vestibulocochlear nerve (CN8)
  2. sympathetic nerves involved with horner syndrome
38
Q

what does observing deficits involving the facial nerve, vestibulocochlear nerve, and horner syndrome localize to?

A

disease/lesion of middle/inner ear

39
Q

within the canal in the petrosal bone, what 2 branches does the facial nerve give off? function?

A
  1. major petrosal nerve: provides preganglionic parasympathetics
  2. stapedius nerve: innervates the stapedius muscle that protects the ear from loud noises
40
Q

what is the name of the group of muscles that the facial nerve innervates? broadly describe their function

A

the muscles of facial expression; facial expressions

41
Q

once outside of the skull, name the 2 major branches of the facial nerve

A
  1. buccal branches: involves movement of lips and nose
  2. auricular palpebral branch: involves eyelid and ear movements
42
Q

describe the findings of a lesion of the facial nerve

A
  1. drooping snoot
  2. drooling bc lips can’t keep saliva in mouth
  3. ears not moving
  4. lips drooping
  5. not blinking
43
Q

name the cranial reflex and cranial nerve response that are the main means of testing the function of the facial nerve

A

pelpebral and menace: if both abnormal = lesion in 7

auricular reflex; poke in the ears and see if they feel/move it

44
Q

what does the facial nerve provide to the head?

A

preganglionic parasympathetic innervation to the glands of the head

lacrimal gland: provides tears

45
Q

what are 2 other glandular tissues innervated by the facial nerve? give function and consequence of loss of function

A
  1. salivary glands: produce saliva; loss of function results in xerostomia (dry mouth)
  2. lateral nasal glands: moisture to the nasal cavity and nasal planum; loss of function results in build up of nasal crust
46
Q

what cranial nerves provide preganglionic parasympathetic innervation to the head?

A

3, 7, 9, 10

47
Q

from the ganglion, what cranial nerve branches do postganglionic parasympathetic axons course with? what does this mean?

A

course with branches of CN 5 (hop on the trigeminal bus because it goes everywhere), meaning that in addition to dysfunction of one of the CN nerves that has preganglionic parasympathetic function, diseases affecting CN V can also result in loss of parasympathetic functions

48
Q

what neurotransmitter is released from postganglionic parasympathetic axons?

A

acetylcholine

49
Q

what cranial nerve provides for the preganglionic parasympathetic neurons to 2 salivary glands, lateral nasal glands, and lacrimal glands? what branch carries these preganglionic axons?

A

facial nerve; major petrosal branch

50
Q

broadly define KCS

A

stands for keratoconjunctivitis sicca; is essentially dry eye due to decreased tear production

51
Q

what method is use in clinical practice to measure tear duct production

A

Schirmer tear test

52
Q

what are the 3 ways of decreasing tear production?

A
  1. glandular: immune-mediated destruction of the lacrimal gland
  2. neurological: cranial nerve 5
  3. neurological: cranial nerve 7
53
Q

describe why one would see KCS with lesions involving the facial nerve (neurogenic) and trigeminal nerve (neurotropic)

A

CN 5 tells CN 7 to make tears; so need both working for proper tear production

54
Q

state the anticipated measurement of tear production with a lesion affecting the parasympathetic fibers of CN 7

A

decreased

55
Q

state the anticipated measurement of tear production with a lesion affecting CV 5 (sensory function, not postganglionic axons)

A

decreased

56
Q

name the major division of the brain that contains the GSE/LMN nuclei of CN 9 10 and 11 and the nucleus that gives rise to them

A

a large nucleus that spans the caudal medulla; exit via jugular foramen to tympano-occipital fissure

57
Q

describe the relationship of CN 9 10 and 11 to the guttural pouch in the horse

A
58
Q

name the branch of CN 10 that provides innervation that OPENS the rima glottidis of the larynx; name the muscle that accomplishes this

A

vagus nerve has a branch called recurrent laryngeal nerve that provides GSE function to cricoarytenoideus dorsalis, which opens the rima glottidis

59
Q

name the time/phase of respiration when the rima glottidis is actively opened

A

opened to open the larynx during inspiration; deficits in the recurrent larygneal branch of the vagus nerve will result in laryngeal paralysis

60
Q

name the cranial nerve reflex that is used to assess CN 9 and 10

A

gag reflex

61
Q

describe the clinical consequence anticipated with dysfunction of CN 9 and 10

A

dysphagia

62
Q

how else might you assess the function of CN 9 and 10 other than a reflex test?

A

??

63
Q

name the muscle of the shoulder that is innervated by the spinal branch of CN 11

A

trapezius

64
Q

name the major division of the brain that contains the GSE/LMN nuclei for CN 12

A

in the caudal medulla

65
Q

describe the function of CN 12

A

provides GSA to extrinsic and intrinsic muscle of the tongue

66
Q

describe the clinical finding in the tongue with unilateral deficits in CN 12 (2 key features)

A

atrophy and ??

67
Q

describe how you would figure out if there was bilateral CN 12 dysfunction

A

??

Neuro (NSB) (19 decks)

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