Cranial Nerves - Lecture 8\ Flashcards
how many cranial nerves arise emerge from the brain
12 pairs
what do the cranial nerves pass through
skull foramina
fissures
canals
what do cranial nerves distribute
their innervation to different structures in the head and neck
which nerves is the “wanderer”
vagus nerve
continuous into the trunk and supplies the thoracic region and abdominal organs
how are cranial nerves numbered
in the order they arise in the brain
rostrally to caudally
cranial nerves can be
sensory
motor
mixed
CN1
olfactory nerve
where does CN1 arise from
olfactory epithelium
where does CN1 run through
cribriform plate of the ethmoid bone
through the olfactory bulb
where does CN1 terminate
primary olfactory cortex
CN1 fxn
carrying afferent impulses for the sense of smell
what is CN1
special visceral afferent
parts of CN1
olfactory bulb
olfactory tract
temporal cortex
with age CN1
olfactory ability decreases with age
anosmia: impaired
CN2
optic nerve
where does CN2 arise from
retina of the eye
what does CN2 pass through
optic canals and converge at the optic chiasm
continue to the thalamus where they synapse
then run to visual cortex
CN2 fxn
carrying afferent impulses for vision
what is CN2
special somatic afferent
how does vision run
retina –> optic nerve –> optic chiasm –> lateral geniculate body –> optic radiations –> visual cortex in occipital lobe
clinically injury to CN2 results in
visual field loss
CN3
oculomotor N
how do fibers of CN3 run
fibers extend from the ventral midbrain
pass through the superior orbital fissure
go to the extrinsic eye muscles
CN3 fxn
raising the eyelid
directing the eyeball
constricting the iris
controlling lens shape
CN3 ptosis
eyelid droop
CN3 ophthalmoplegia
problems in adjusting to light
deviation of eye movements
diplopia
what is diplopia
double vision
CN4
trochlear N
where do fibers of CN4 emerge from
dorsal midbrain
where do CN4 fibers enter
orbits via the superior orbital fissures
what does CN4 innervate
superior oblique muscle
CN4 is a
motor nerve
directs the eyeball
what is CN4
general somatic efferent
what is CN4 the only to do
exit brainstem dorsally
exits contralaterally
Fxn of CN4
anterior oblique muscle for eye movement
clinically CN4
difficulty looing downward and outward when trochlear is injured
eye drifts upward relative to the normal eye
CN5
trigeminal N
3 divisions of CN5
opthalamic (V1)
maxillary (V2)
mandibular (V3)
what does Cn5 convey
sensory impulses from various areas of the face
V1 and V2
supplies motor fibers for mastication (V3)
what is CN5
general somatic afferent
special visceral efferent
what is CN5 principle for
principle sensory nerve for head, face, orbit and oral cavity
what does CN5 mediate
sensations of pain, temperature, proprioception and fine discriminative touch
3 sensory branches of CN5
opthalamic
maxillary
mandibular
CN5 is motor for
mastication muscles for chewing and speaking
reflex for jaw jerk reflex (mandibular)
muscles for chewing and speaking
internal and external pterygoid
temporalis
masseter
mylohyoid
anterior belly of digastric
tensor veli palatini
tensor tympani
CN5 tic doulourex or trigeminal neuralgia
most excruciating pain known
caused by inflammation of nerve
severe cases of tic doulourex or trigeminal neuralgia
nerve is cut
relieves agony but results in loss of sensation on that side of the face
CN6
abducens N
where do CN6 fibers leave
inferior pons
where do CN6 fibers enter
orbit
via the superior orbital fissure
what does CN6 innervate
lateral rectus muscle
abducts the eye
motor nerve
what is CN6
general somatic efferent
CN6 injured
medial rectus muscle is unopposed –> eye shifts medially
CN6 is susceptible to
disruption
CN6 –> medial strabismus
turns in medially
double vision
CN7
facial nerve
what is CN7
general visceral efferent
special visceral afferent
special visceral efferent
PS innervation CN7
lacrimal gland and palatal saliva
what does CN 7 innervate
mucous membrane secretions in mouth and pharynx
CN7 –> special visceral afferent
gustatory sensations from anterior 2/3 of tongue
CN 7 -> special visceral efferent
primary motor nerve for facial muscles
lacrimal secretion –> tears
Bell’s Palsy –> Cn7
paralysis of facial muscles on affected side and loss of taste sensation
what causes bells palsy
herpes simplex I virus
what happens to someone with bell’s palsy
lower eyelid droops
corner of mouth sags
tears drip continuously
eye cannot be complete closed (dry eye may occur)
bells palsy may
disappear spontaneously without treatment
CN8
vestibulocochlear
CN8 fibers arise from
hearing and equilibrium apparatus of the inner ear
what do CN8 fibers pass through
internal acoustic meatus
where do CN8 fibers enter
brainstem at the pons-medulla border
2 divisions of CN8
cochlear (hearing)
vestibular (balance)
fxn CN8
sensory
equilibrium and hearing
what is CN8
special somatic afferent
vestibular nerve –> CN8
gives feedback about position of head in space and balance
acoustic N –> CN8
hearing
CN8 clinically
tests for equilibrium, vertigo, or dizziness, nystagmus and hearing loss
CN9
glossopharyngeal N
CN9 fibers emerge from
medulla
how do CN9 fibers leave the skull
jugular foramen
run to throat
CN9 is
mixed nerve with motor and sensory fxns
CN9 –> motor
innervates part of the tongue and pharynx
provides motor fibers to the parotid salivary gland
CN9 –> sensory
fibers conduct taste and general sensory impulses from the tongue and pharynx
what is CN9
general visceral afferent
general visceral efferent
special visceral afferent
special visceral efferent
CN9 general visceral afferent
mediates general visceral sensation from soft palate, palatal arch, posterior 1/3 of tongue and carotid sinus
CN9 general visceral efferent
secretion from parotid gland
salivary gland
CN9 special visceral afferent
taste sensation from posterior 1/3 of tongue
CN9 special visceral efferent
contributes to swallowing through stylopharyngeus and upper pharyngeal constrictor fibers
CN9 clinically
may be evident in dysphagia or loss of taste to posterior 1/3 of tongue
loss of gag reflex
excessive oral secretions
dry mouth
what does CN9 need to have strong clinical signs
bilateral damage
CN 10
vagus N
where do CN10 fibers emerge
medulla via jugular foramen
CN10 is a
mixed nerve
most fibers of Cn10 are
PS fibers to the heart, lungs and visceral organs
CN10 sensory fxn
taste
what does paralysis of CN10 lead to
hoarseness
total destruction of CN10
incompatible with life
general visceral afferent –> CN10
sensation from pharynx, larynx, thorax, abdomen
regulates nausea, oxygen intake, lung inflation
general visceral efferent –> CN10
innervates glands, cardiac muscles, trachea, bronchi, esophagus, stomach and intestine
special visceral afferent –> Cn10
mediates taste sensation from posterior pharynx and epiglottis
special visceral efferent –> CN10
controls muscles of larynx, pharynx, soft palate for phonation, swallowing and resonance
bilateral lesion to brainstem –> Cn10
fatal d/t respiratory involvement
unilateral lesion to brainstem –> CN10
ipsilateral paresis or paralysis of soft palate, pharynx and larynx
pharyngeal branch –> CN10
pharynx and soft palate involvement
uvula pulled to unaffected side
bilateral soft palate droops
recurrent laryngeal branch –> CN10
unilateral –> paralysis of vocal folds
bilateral –> inspiratory stridor and aphonia
damage to CN10
autonomic reflexes reduced
anesthesia of pharynx and larynx
loss of taste
damage to superior laryngeal branch –> CN10
loss of ability to change pitch
CN11
accessory N
how is CN11 formed
by cranial root emerging from the medulla
&
spinal root arising from the superior region of the SC
CN11 –> spinal root
passes upward into the cranium via the foramen magnum
how does CN11 leave the cranium
via jugular foramen
CN11 is primarily a
motor N
CN11 –>motor N
supplies fibers to the larynx, pharynx and soft palate
innervates the traps and SCM –> move the head and neck
CN12
hypoglossal N
CN12 fibers arise from
medulla
CN12 exit
the skull via the hypoglossal canal
what does Cn12 innervate
both extrinsic and intrinsic muscles of the tongue
contribute to swallowing and speech
damage to CN12
difficulties in speech and swallowing
inability to protrude tongue
what is CN12
general somatic efferent
CN12 –> general somatic efferent
controls tongue movement
controls extrinsic and intrinsic muscles of tongue expect palatoglossal (X)
eating, sucking and chewing reflexes
LMN unilateral lesion –> CN12
cause wrinkling and flaccidity of tone with atrophy over time
unilateral UMN lesion –> Cn12
do not have much affect as tongue is bilaterally innervated
CN12 damage
dysarthria and dysphagia
how can you check CN12 damage
ask pt to complete oral motor movements
CN combos
more than one N involved with some structures
ex: eyes muscle control
sensory fibers to tongue –> CN combos
anterior 2/3 special and general sensation –> facial and trigeminal
posterior 1/3 special and general sensation –> glossopharyngeal