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Neuroanatomy Test 3 > Cranial Nerves III, IV, V, VI, VII > Flashcards

Cranial Nerves III, IV, V, VI, VII Flashcards

1
Q

Where are the neuron cell bodies of the trochlear nerve anatomically found?

A

At level of inferior colliculus in midbrain

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2
Q

Where do the axons that leave the nuclear of the trochlear nerve travel?

A

Axons leave nucleus. decussate and exit from dorsal surface of brainstem as IV nerve

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3
Q

What does right trochlear nerve innervate?

A

Innervates the right superior oblique muscle

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4
Q

What is the action of the superior oblique muscle?

A

Depresses eye, abduction and medial rotation

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5
Q

What do lesions of the trochlear nerve cause?

A

Patient has difficulty looking down and in as in walking down stairs

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6
Q

Where are the neuron cell bodies of the abducens nerve anatomically found?

A

Lower pons and in the floor of the IV ventriclelandmark called the facial colliculus

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7
Q

What and where is the facial colliculus found?

A

Mound or hill located in the floor of the IV ventricle

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8
Q

Where do the axons that leave the nuclear of the abducens nerve travel?

A

Axons exit along pontomedullary junction

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9
Q

What does abducens nerve innervate?

A

Ipsilateral lateral rectus muscle

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10
Q

What is the action of the lateral rectus muscle?

A

Principal abductor of the eye

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11
Q

What do unilateral lesions of the abducens nerve cause?

A

1) Paralysis of ipsilateral lateral rectus muscle (no abduction
2) medial strabismus
3) Diplopia

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12
Q

What is medial strabismus?

A

Eye is strongly adducted

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13
Q

What is another term for medial strabismus?

A

Esotropia

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14
Q

What is diplopia?

A

Double Vision

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15
Q

Where are the neuron cell bodies of the oculomotor nerve anatomically found?

A

In the oculomotor nuclear complex located in midbrain at level of superior colliculus and above

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16
Q

What autonomic nucleus is included in the oculomotor nuclear complex?

A

Edinger-Westphal nucleus

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17
Q

What type of autonomic neuron are found in the Edinger-Westphal nucleus?

A

Preganglionic parasympathetic neurons

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18
Q

What do the neurons of the oculomotor nuclear complex innervate?

A

Contralateral superior rectus, medial rectus, inferior rectus, inferior oblique, lateral palpebra superioris muscle

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19
Q

What actions are the neurons of the oculomotor nuclear complex responsible for?

A

Controls vertical movements, adduction of eye and elevation of the superior eyelid

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20
Q

What do the preganglionic parasympathetic neurons innervate?

A

Postganglionic neurons of the ciliar ganglion

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21
Q

What does the ciliary ganglion innervate?

A

Constrictor pupillae muscle

Ciliary muscle

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22
Q

What does the ciliary muscle do?

A

controls accommodation of the lens -> increases convexity of lens which focuses on a near object

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23
Q

What are the reflexes that are involved in the III nerve?

A

Pupillary light reflex

accomodation or accommodation-convergence reflex

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24
Q

What is the pupillary light reflex?

A

Results in constriction of both pupils in response to increased light intensity of the retina

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25
Q

What is the afferent limb of the pupillary light reflex?

A

Sensory limb of the optic tract where some fibers go through the superior brachium

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26
Q

What is the pretectal nucleus?

A

Fibers that are to the left and right of the Edinger-Westphal nucleus

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27
Q

What is the efferent limb of the pupillary light reflex formed by?

A

Right and left edinger-westphal nuclei

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28
Q

What does the efferent limb of the pupillary light reflex do?

A

Travel fro left and right ciliary ganglia to stimulate the left and right constrictor pupillae muscles

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29
Q

What is a direct pupillary light response?

A

Constriction of pupil in the eye that received the light

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30
Q

What is the consensual pupillary light response?

A

Constriction of pupil in non stimulated eye

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31
Q

What is the accommodation or accommodation-convergence reflex?

A

Reflex action that occurs when one shifts gaze from a distant target to a new target

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32
Q

What is convergence?

A

When both medial recti muscles contract and permit focusing of a new target

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33
Q

What is accomodation in lenses?

A

Contraction of both celiary muscles that increases lens convexity and focus on a near object

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34
Q

What is pupillary constriction?

A

Contraction of both constrictor pupillary muscles

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35
Q

List the neural pathway of the accomodation reflex

A

Retinal fibers to the occipital lobe -> cortico-tectal fibers to the superior colliculus -> occulomotor nucleus, Edinger-Westphal nucleus and pretectal nucleus

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36
Q

What does the oculomotor nucleus do?

A

Innervates both medial recti muscles and allows for convergence to occur

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37
Q

What does the Edinger-WEstphal nucleus do?

A

Innervates the ciliary muscles via the ciliary ganglia and allows accommodation to occur

38
Q

What is the pretectal nucleus and what does it do?

A

Left and Right Eding-Westphal nuclei that act on left and right ciliary ganglia to activate the constrictor pupili muscles which allows for constriction of both pupils

39
Q

What does a unilateral lesion of the III nerve cause?

A

1) Ipsilateral paralysis of all skeletal muscles innervated by III nerve
2) Loss of innervation to the ciliary ganglion

40
Q

What is ptosis?

A

A drooping of superior palpebrum

41
Q

What will a ipsilateral paralysis of all skeletal muscles innervated by III nerve present as?

A

1) inability to adduct or vertically move ipsilateral eye results in eye being strongly abducted known as lateral or external strabismus
2) Ptosis

42
Q

What will a loss of innervation to the ciliary ganglion present as?

A

1) dilation of ipsilateral pupil with no direct response in ipsilateral eye
2) loss of accommodation of lens in ipsilateral eye (will not focus on nearby object

43
Q

What is Weber’s syndrome?

A

Lesion of the basal part of cerebral peduncle of midbrain

44
Q

What is Weber’s syndrome caused by?

A

Usually loss of blood supply to ventral part of midbrain

45
Q

What do the lesions of the basal part of the cerebral peduncle of the midbrain (cause of Weber’s syndrome) interrupt?

A

III nerve and cerebral crus (descending motor control fibers

46
Q

What does WEber’s Syndrome result in?

A

1) ipsilateral III nerve lesion

2) Upper Motor Neuron syndrome

47
Q

What does upper motor neuron syndrome cause?

A

Contralateral body hemiplegia and spastic paralysis

48
Q

Where are the neuron cell bodies of the trigeminal nerve anatomically found?

A

From the trigeminal motor nucleus

49
Q

Where is the trigeminal motor nucleus located?

A

In the upper pons (medial to the pontine trigeminal nucleus)

50
Q

Where do the V nerve lower motor receive innervation from?

A

The Lower motor neurons of the V nerve receive bilateral corticobulbar innervation (therefore in unilateral upper motor neuron lesions do not cause paralysis of muscles innervated by the V nerve

51
Q

What do the fibers of the V nerve that exit the pons innervate?

A 
Muscles of mastication
anterior body of the digastric
mylohyoid 
Tensory Veli Palatini
Tensor tympani
52
Q

What does an interruption of the motor fibers of the V nerve result in?

A

Flaccid paralysis of the muscles innervated by the V nerve and eventual atrophy

53
Q

Which side will the mandible deviate to with an interruption of the motor fibers of the V nerve?

A

Leads to a deviation of the mandible towards the lesion or paralyzed side

54
Q

Why does the mandible deviate to the paralyzed side with an interruption of the motor fibers of the V nerve?

A

Due to unopposed action of left lateral pterygoid (contralateral deviator)

55
Q

Is the facial nerve a sensory, motor or mixed nerve?

A

Mixed nerve with both sensory and motor components

56
Q

What are the two types of sensory fibers of the facial nerve?

A

Somatosensory neurons and gustatory fibers

57
Q

What ganglion are the sensory fibers of the facial nerve found in?

A

Geniculate ganglion

58
Q

Where are the cell bodies of the somatosensory neurons of the facial nerve found?

A

Cell bodies in geniculate ganglion

59
Q

What cutaneous areas do the peripheral processes of the somatosensory neurons of the facial nerve innervate?

A

Helps to innervate the skin of the:

1) external ear
2) wall of external auditory canal
3) external surface of tympanic membrane

60
Q

Where do the central processes of the somatosensory neurons of the facial nerve terminate?

A

Central processes enter brainstem, join the spinal tract of trigeminal nerve and terminate in the spinal (V) trigeminal nucleus on second order neurons

61
Q

Where do the fibers of the somatosensory of the neurons facial nerve that travel through the spinal trigeminal nucleus ascend to?

A

The VPM nucleus of the thalamus through the trigeminothalamic tract

62
Q

What are the third order neurons of the somatosensory neurons of the facial nerve and where does it project to?

A

Third order neurons of VPM nucleus project axons through the posterior limb of internal capsule and terminate in primary somatosensory cortex

63
Q

What are gustatory fibers?

A

Taste fibers

64
Q

What are the primary neuron cell bodies of gustatory fibers of the facial nerve?

A

Geniculate ganglia

65
Q

What are the peripheral processes of gustatory fibers of the facial nerve distributed to the through?

A

1) Chorda tympani to the anterior 2/3 of the tongue

2) Greater petrosal nerve to the palate

66
Q

What do the central processes of gustatory fibers of the facial nerve terminate in?

A

Solitary nucleus (rostral part) in the medulla

67
Q

Where do fibers from the solitary nucleus of the gustatory fibers of the facial nerve travel and what do they terminate on?

A

Ascend the brainstem through the ipsilateral central temental tract to terminate on the ventral posterior medial nucleus of the thalamus

68
Q

Where do the axons of thalamic neurons that project from the VPM nucleus that contain gustatory fibers of the facial nerve project to?

A

1) near the tongue area of primary somatosensory cortex in postcentral gyrus in the roof of the lateral sulcus
2) insula

69
Q

What are the two types of motor fibers associated with the facial nerve?

A

Lower motor Neurons (somatomotor neurons)

Preganglionic parasympathetic neurons

70
Q

What are the cell bodies of the somatomotor neurons of the facial nerve located in?

A

Fascial motor nucleus in the lower pons and axons traverse through the facial colliculus

71
Q

What do fibers that branch from the somatomotor branch of the facial nerve supply?

A

Muscles of fascial expression
Stapedius
Posterior belly of the digastric
Stylohyoid muscle

72
Q

What are the afferents to the motor nucleus of the facial nerve?

A

1) Corticobulbar

73
Q

What do bilateral corticobulbar innervation to lower motor neurons of the facial nerve supply?

A

Muscles of facial expression of upper 1/2 of face

74
Q

What do contralateral innervation to lower motor neurons of the facial nerve supply?

A

Muscles of facial expression of lower 1/2 of face

75
Q

What do corticobulbar fibers of the facial nerve from the superior olivary nucleus do?

A

Reflex contraction of stapedius in response to a loud noise

76
Q

What do corticobulbar fibers of the facial nerve provide somatosensory input to?

A

Somatosensory input from sensory nuclei of trigeminal nerve for stimulation of corneal reflex (blink reflex)

77
Q

WHat is the afferent limb for the corneal reflex?

A

V1 of trigeminal nerve carries sensation from cornea

78
Q

What is the efferent limb for the corneal reflex?

A

Motor fibers of VII nerve going to obicularis occuli muscle

79
Q

What is the direct corneal reflex?

A

response or blink that occurs in stimulated eye

80
Q

What is the consensual corneal reflex?

A

Response or blink that occurs in nonstimulated eye

81
Q

If a left eye doesn’t blink when the left eye or right eye is stroked but the right eye responds what is occurring?

A

Damage to the innervation of the orbicularis occuli

82
Q

What happens if both eyes don’t respond to stroking of the eye?

A

It is is V nerve issue

83
Q

What 2 nuclear groups make up the parasympathetic neurons of the facial nerve?

A

Superior salivatory nucleus

Lacrimal nucles

84
Q

Where are the fibers of the salivatory nucleus distributed through?

A

Chorda Tympani

85
Q

Where do the fibers of the salivatory nucleus terminate?

A

Terminate in submandibular ganglion (postganglionic parasympathetic neurons)

86
Q

What do the postganglionic fibers of the salivatory nucleus provide secretomotor innervation to?

A

Submandibular galnds
sublingual glands
lingual glands
labial glands

87
Q

Where are the fibers of the lacrimal nucleus distributed through?

A

Greater petrosal nerve

88
Q

Where do fibers of the lacrimal nucleus terminate?

A

Terminate in pterygopalatine ganglion or sphenopalatine ganglion (postganglionic parasympathetic neurons)

89
Q

What do the postganglionic fibers of the lacrimal nucleus provide secretomotor innervation to?

A

Nasal glands
palatine glands
lacrimal glands

90
Q

What is a condition that is a common disturbance of the facial nerve?

A

Bell’s Palsy

91
Q

What are the causes of Bell’s Palsy?

A

1) Thought to be caused by increased pressure on VII nerve (from inflammation/edema) as it traverses the facial canal in the petrous temporal bone or as it traverses the parotid gland
2) Neurological deficits that result are dependent upon where the damage occurs along the lengthe of the nerve and the degree of the compression

92
Q

What are the full effects of a facial nerve lesion (bell’s palsy)?

A

1) Flaccid paralysis of all muscles supplied by the VII nerve (muscles of fascial expression both upper and lower 1/2 of face (ipsilateral), hyperacousis (loud sounds due to stapedius muscle paralysis) and loss of blink reflex of ipsilateral eye)
2) ipsilateral loss or decrease taste sensation from anterior 2/3 of tongue
3) Decrease in salivation and loss or decrease of ipsilateral side therefore constant blinking in opposite eye due to irritation

Neuroanatomy Test 3 (7 decks)

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