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USAHS Neuroanatomy Test 3 > Cranial Nerves in Neuroscience > Flashcards

Cranial Nerves in Neuroscience Flashcards

1
Q

Cranial Nerves

A 
CNI: Olfactory
CNII: Optic
CNIII: Oculomotor
CNIV: Trochlear
CNV: Trigeminal
CNVI: Abducens
CNVII: Facial
CNVIII: Vestibulocochlear
CNIX: Glossopharyngeal
CNX: Vagus
CNXI: Accessory
CNXII: Hypoglossal
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2
Q

All cranial nerves are dorsal in the brainstem except…

A

Trochlear: Wraps around from ventral side
Olfactory: Not on brainstem

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3
Q

Superior Orbital Fissure (CN exit points)

A

CN 3, 4, 5 (V1: opthalmic), 6

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4
Q

Foramen Rotundum (CN exit points)

A

CN5 (V2: Maxillary)

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5
Q

Foramen Ovale (CN exit points)

A

CN5 (V3: Mandibular)

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6
Q

Internal Auditory Canal (CN exit points)

A

CN8

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7
Q

Sylomastoid Foramen (CN exit points)

A

CN7

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8
Q

Hypoglossal Canal (CN exit points)

A

CN12

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9
Q

Internal Jugular Foramen (CN exit points)

A

CN9, 10, 11

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10
Q

Foramen Magnum (CN exit points)

A

None

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11
Q

Olfactory Nerve (CNI)

A
  • Chemoreceptors detect odor, located in nasal epithelium
  • Chemoreceptors synapse in olfactory bulb, info travels via olfactory tract
  • Chemoreceptors> Bulb> Tract
  • Chemoreceptors (Mitral & tufted cells)
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12
Q

Olfactory Nerve (CNI) Deficits

A
  • Anosmia: Olfactory Sensory Loss
  • Unilateral Deficits: Patient rarely aware; other nostril compensates
  • Bilateral Deficits: Accompanied with decreased taste
  • Causes: Head trauma, Viral infections, PD, Az, Intracranial lesions
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13
Q

Optic Nerve (CNII)

A
  • Synapses on LGN of thalamus
  • Before Optic Chiasm: Optic Nerve
  • After Optic Chiasm: Optic Tract
  • Recall all vision deficits from unit 8
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14
Q
A

(monocular visual loss)

-Total blindness of right eye due to complete lesion of right optic nerve

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15
Q
A

Bilateral hemianopia due damage of the optic chiasm (loss of temporal vf)

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16
Q
A

Right nasal hemianopia due to lesion involving right perichiasmal area

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17
Q
A
  • Left Contralateral homonymous hemianopia due to damage of…
  • LGN
  • Occipital Lobe
  • Optic Tract
  • Optic Radiations
  • MCA Stem Infarct
  • PCA Infarct
  • Primary Visual Cortex
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18
Q
A

Left contralateral inferior quadrantanopia due to involvement of superior right optic radiations (or upper bank)

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19
Q
A

Left contralateral superior quadrantanopia due to involvement of lower right optic radiations (meyers loop or lower bank)

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20
Q

Optic Nerve (CNII) Visual Field Deficits (image)

A
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21
Q

Oculomotor (CNIII), Trochlear (CNIV), Abducens (CNVI)

A
  • Always grouped together

- ALL control extraocular eye muscles

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22
Q

Trochlear Nerve (CNIV)

A

Rotates top of eye medially and moves downward

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23
Q

Abducens Nerve (CNVI)

A

Abducts eye laterally in horizontal direction

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24
Q

Oculomotor Nerve (CNIII)

A

ALL OTHER EYE MOVEMENTS

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25
Q

Trigeminal Nerve (CNV)

A 
-3 Divisions
Opthalmic (V1): Superior Orbital Fissure
Maxillary (V2): Rotundum
Mandibular (V3): Ovale
-All do sensory to face, small motor portion to V3 for mastification
-Cells here located in Meckels cave
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26
Q

Trigeminal Nerve (CNV) Deficit

A

Trigeminal Neuralgia: Tix Douloureux

  • Brief severe pain lasting seconds to minutes
  • Episodes caused from chewing, shaving, anything to the face (sensory to face)
  • Cause unknown, usually occurs in MS patients (due to demyelination, can be treated with medication)
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27
Q

Facial Nerve (CNVII)

A
  • Controls muscles of facial expression (blinking, frowning, smiling, facial droop)
  • Also tear production (lacrimal duct and gland), salivation, taste 2/3 tongue
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28
Q

Facial Nerve (CNVII)

A

Facial Weakness: UMN & LMN

  • UMN Lesion: Upper face spared, signal bilaterally ascends causing contralateral presentation
  • LMN Lesion: (after pons) Upper and lower face affected (bells palsy), presents ipsilaterally
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29
Q

Facts about Bell’s Palsy (CNII)

A
  • Quick recovery in about 80% of patients within 3 weeks
  • Divisions of the nerve are impaired then recover
  • Unknown cause
  • Will not show on MRI
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30
Q

Vestibulocochlear Nerve (CNVIII)

A

Dual purposes: Hearing and vestibular sense from inner ear

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31
Q

Outer: Parts of the Ear

A

Pinna> External Auditory Canal> Tympanic Membrane (ear drumb)

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32
Q

Middle: Parts of the Ear

A

3 Ossicles: Malleus, Incus, Stapes (vibrate sound)> Tensor Tympani & Stapedius Muscle (attached to ossicles to regulate vibrations & protect ear from really loud noises)> Oval & Round Window (air is converted into waves)

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33
Q

Inner: Parts of the Ear

A

Bony Labyrinth & Membranous Labyrinth > Central Duct

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34
Q

Organ of Corti (Parts of the Ear)

A

Receptor for Hearing (within cochlea which is in membranous labyrinth)

35
Q

Within the Cochlea (CNIII)

A

2 Main Ducts

  1. Scala Vestubuli
  2. Scala Tympani
    - Central Duct/Scala Media
36
Q

Scala Vestubuli (ducts within cochlea)

A

Sound vibrations enter here from oval window and transmits sound waves

37
Q

Scala Tympani (ducts within cochlea)

A

Found at apex, spirals around and ends at round window

38
Q

Central Duct/Scala Media (ducts within cochlea)

A

Surrounded by scala vestibule above and scala tympani below

39
Q
A

Bony Labyrinth: Yellow

Membranous Labyrinth: Purple (contains cochlea, semi-circular canals, and vestibulae)

40
Q

High vs. Low Frequencies (CNVIII)

A
  • High Frequencies activate hair cells at oval window (ex. high pitched voices)
  • Low Frequencies activate hair cells near apex of cochlea (ex. deeper voices)
41
Q

Depolarization (CNVIII)

A

Stereocilia bends to kinocilia

42
Q

Hyperpolarization (CNVIII)

A

Stereocilia bends away kinocilia

43
Q

Within the inner ear, we have our organ of corti which is the sensory receptor for…

A

Hearing

44
Q

We have hair cells within the organ of corti that are going to move…

A

Inward as sound travels through the ear (depolarization) and move back to neutral (hyperpolarization) as sound is transferred

45
Q

Synapses for Auditory (CNVIII)

A

Medial geniculate nucleus of the thalamus

46
Q

Primary Auditory Cortex (CNVIII)

A

Heschel’s Gyrus

47
Q

Secondary Auditory Cortex (CNVIII)

A

Wenicke’s

48
Q

Auditory information ascends… (CNVIII)

A

Bilaterally with decussations at multiple levels. No unilateral hearing deficits

49
Q

Damage to Wernicke’s Area (CNVIII)

A
  • Does not affect hearing

- Affects interpretations of hearing (wernicke’s aphasia)

50
Q

Damage to one side of CN 8

A
  • Only has little effect on our hearing because of the collaterals/cross-over connections
  • Similar to ALS tract in the spinal cord
  • Volume may be “turned down” but it isn’t muted
51
Q

Unilateral Hearing Loss

A

Structural

52
Q

3 Vestibular Components of CN 8

A
  • Peripheral sensory apparatus
  • Central processor
  • Mechanism for motor output
53
Q

Peripheral Sensory Apparatus (3 Vestibular Components of CN 8)

A

“Balance Center”

-Visual, vestibular, proprioceptive

54
Q

Central Processor (3 Vestibular Components of CN 8)

A

Vestibular nuclei in the cerebellum

55
Q

Mechanism for Motor Output (3 Vestibular Components of CN 8)

A

Direct connection

  • Vestibulospinal tract
  • Tectospinal tract and eye muscles
56
Q

Semicircular Canals (CNVIII)

A

Are receptors for vestibular information

57
Q

3 Semicircular Canals (CNVIII)

A
  • Right and left lateral
  • Left. anterior and right posterior
  • Left posterior and right anterior
58
Q

Semicircular Canals detect…

A

Angular acceleration and rotational movements of head in space

  • Detected by the Crista ampullaris (sensory receptor)
  • Work together with our vision
59
Q

Ampula (CNVIII)

A
  • At the base of our SCCs
  • The little bulge
  • These contain the christa ampullaris
60
Q

Crista Ampularis (CNVIII)

A
  • Primary sensory structure responding to vestibular info
  • The “base” of the troll hair
  • Hair cells on top of crista ampularis that project into the cupula
61
Q

Cupula (CNVIII)

A

Shifts the opposite way from where we turn our heads

*Keeps the balance

62
Q

Otoliths

A

-Utricle: response to gravity in horizontal plane
Example: riding in a car
-Saccule: response to gravity in vertical plane
Example: riding in an elevator
*sensory receptor for otoliths- MACULA
-Within otoliths, there are otoconia. These are crystals.
-When these crystals travel outside of the otoliths, someone can have BPPV.
-More receptors for vestibular info
-Still within the membranous labyrinth
-Different than the crista ampullaris

63
Q

Lesion to Vermis (cerebellum: CNVIII)

A

-Gait ataxia, trunk instability, balance

64
Q

Lesion to flocculus (cerebellum: CNVIII)

A

-Issues with gain of VOR

VOR= Ratio of eye movement to head movement

65
Q

VOR and VSR (cerebellum: CNVIII)

A

VOR: Purpose is to keep vision stable while the head is moving (vestibular ocular reflex)
VSR: Purpose is to keep head and body stabilized (vestibular spinal reflex)

66
Q

Vestibular input (cerebellum: CNVIII)

A
  • Going to the vermis and flocculus

- Monitors vestibular performance and keeps it in check (error detector, movement corrector)

67
Q

Vestibulocochlear Nerve (CNVIII) Deficits

A

-Gold standard to determine hearing loss: Audiometry test= Audiogram
-Vestibular Neuritis
-Vestibular Labrinthitis
-Meninere’s Disease
(see also BPPV and Acoustic neuroma in notes)

68
Q

Vestibular Neuritis (CNVIII Deficits)

A

Inflammation of vestibular ganglia or nerve, does not cause hearing loss. Intense vertigo for days and loss of postural control for weeks to months

69
Q

Vestibular Labyrinthitis (CNVIII Deficits)

A

Same presentation as vestibular neuritis but HEARING LOSS.

70
Q

Meninere’s Disease (CNVIII Deficits)

A

Excess fluid and pressure, lifetime disease, recurrent episodes of vertigo and fluctuating hearing loss and tinnitus- ringing in ear

71
Q

Clinical tests to determine what type of hearing loss (Vestibulocochlear Nerve (CNVIII)

A
  • Rinne Test

- Weber Test

72
Q

Rinne Test (Clinical tests to determine hearing loss type, CNVIII)

A
  • Used to determine conduction hearing loss by comparing bone to air conduction- strike tuning fork then place on mastoid process. Damage in middle ear. (conductive hearing loss)
  • Tuning fork outside ear= soft
  • Tuning fork on mastoid= louder
  • With deficit= hear fork on bone
  • W/o deficit= hear fork in air
73
Q

Weber Test (Clinical tests to determine hearing loss type, CNVIII)

A
  • Used to determine sensorineural hearing loss by placing tuning fork in center of skull
  • Place tuning fork on skull, sound is quieter on affected side.
  • Damage in cochlea (inner ear), due to prolonged exposure to sounds.
  • With deficit= hear fork in air
  • W/o deficit= hear fork on skull
74
Q

Rinne Test (image)

A

“Rinne under the pinne”

75
Q

Weber Test (image)

A

“weber its right or left”

76
Q

Glossopharyngeal Nerve (CNIX)

A

Sensation for posterior tongue and pharynx- also salivation and carotid body reflexes

77
Q

Vagus Nerve (CNX)

A
  • Largest innervation to organs

- Parasympathetic innervation to organs (heart, lungs, digestive tract)

78
Q

Spinal Accessory Nerve (CNXI)

A
  • Sternocleidomastoid: Turns head opposite direction
  • Upper trapezius: Elevates shoulder
  • LMN Deficits: Ipsilateral weakness in shoulder shrug, Not able to turn head away from side of lesion
79
Q

Hypoglossal Nerve (CNXII)

A
  • Tongue movement
  • Contralateral weakness of tongue- UMN lesion
  • Ipsilateral weakness of tongue- LMN lesion= (hypoglossal nucleus or below)
  • Dysarthria: abnormal articulation of speech
  • Dysphagia: impaired swallowing
  • Red flags for PT/OT: aspiration pneumonia
80
Q

Horner’s Syndrome (CNXII)

A

Disruption of sympathetic nerves

  • Ptosis: Drooping of eyelid
  • Small pupils
  • Miosis: Increased sweating
  • Anhydrosis: Can’t sweat on face
  • Enophthalmos: Eye falls into cavity
81
Q

Vagus Nerve Impairment (CNXII)

A
  • Dyspnea: Difficulty breathing
  • Dysphonia: Difficulty speaking
  • Dysphagia: Difficultly swallowing
  • Dysarthria: Abnormal production of speech
  • Tachycardia (inc HR)
82
Q

Dysarthria

A

-Abnormal production of speech

CN V, VII, IX, X, XII

83
Q

Dysphagia

A

-Difficulty swallowing

CN XII, IX, X, or XII

USAHS Neuroanatomy Test 3 (6 decks)

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