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Human Systems and Anatomy > Cranial Nerves - Prof Rea > Flashcards

Cranial Nerves - Prof Rea Flashcards

1
Q

what are the 12 cranial nerves

A

olfactory
optic
oculomotor
trochlear
trigeminal
abducens
facial
vestibulocochlear
glossopharyngeal
vagus
spinal accessory
hypoglossal

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2
Q

what is the first cranial nerve

A

olfactory

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3
Q

what is the second cranial nerve

A

optic

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4
Q

what is the third cranial nerve

A

oculomotor

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5
Q

what is the fourth cranial nerve

A

trochlear

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6
Q

what is the fifth cranial nerve

A

trigeminal

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7
Q

what is the sixth cranial nerve

A

abducens

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8
Q

what is the seventh cranial nerve

A

facial

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9
Q

what is the eighth cranial nerve

A

vestibulocochlear

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10
Q

what is the ninth cranial nerve

A

glossopharyngeal

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11
Q

what is the tenth cranial nerve

A

vagus

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12
Q

what is the eleventh cranial nerve

A

spinal accessory

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13
Q

what is the twelfth cranial nerve

A

muscles of the tongue

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14
Q

what are the three main functional components of the cranial nerves

A

motor innervation to voluntary muscles
motor innervation to involuntary muscles
sensory

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15
Q

describe the motor innervation to voluntary muscles by cranial nerves

A

can either be somatic motor or branchial motor

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16
Q

which of the voluntary muscle innervations come from the pharyngeal arches

A

branchial motor

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17
Q

what are the involuntary muscles provided by the cranial nerves

A

sphincter papillae and lacrimal glands

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18
Q

describe the sensory component of cranial nerve innervation

A

sensation from the viscera, general sensation and special senses

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19
Q

what does the sphincter pupillae do

A

constrict the pupil

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20
Q

what do the lacrimal glands do

A

tear production

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21
Q

what are the pharyngeal arches remnants of

A

gills because we evolved from fish

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22
Q

why do pupils constrict in bright light

A

to protect the back of the retina

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23
Q

what is general sensation

A

touch pressure temperature and pain

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24
Q

what are special senses

A

taste
smell
sight
hearing
balance

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25
Q

which nerve fibres are capable of regeneration

A

olfactory

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26
Q

what are olfactory ensheathing cells used for

A

used in spinal cord injury patients to enable them to regain some function

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27
Q

what is anosmia

A

no smell

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28
Q

what can be injected into the patients with spinal cord injuries

A

olfactory ensheathing cells

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29
Q

describe the function of the olfactory nerve

A

special sensory for smell from the nasal mucosa of each nasal cavity, nasal septum and superior conchae.
has olfactory epithelium

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30
Q

describe the function of the optic nerve

A

special sensory for vision.
the nerve cell bodies are found in the retina and exit the orbital canal via the optic chiasm.
vision comes from the retina

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31
Q

what is multiple scelorosis

A

a demyelinated disease which can lead to disrupted vision

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32
Q

what is the optic chiasm

A

the crossing point of fibres of the left and right optic nerves.
some fibres stay on the same side, others cross over, and this happens at the chiasm.

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33
Q

what is myelin

A

fatty sheath that surrounds the axons of the nerve fibres.

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34
Q

how can MS affect vision

A

results in loss of myelin and this can result in weakness of the limbs and reduction of sight
in severe cases there can be complete loss of vision as the axon of the optic nerve is surrounded by myelin

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35
Q

which cranial nerve is a direct extension of the brain

A

the optic nerve

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36
Q

what are the extra ocular muscles

A

muscles that surround the eye and are responsible for movement of the eyeball itself

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37
Q

describe the sphincter pupillae

A

smooth muscle that constricts the eye as part of the pupillary light reflex

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38
Q

what does the ciliary muscle control

A

accommodation ie looing at far or near objects and focusing on things. it alters the shape of the lens, but not the pupillary size.

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39
Q

which muscles control pupil size

A

sphincter pupillae and dilatory pupillae

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40
Q

what is the ciliary ganglion

A

this is where the presynaptic and post synaptic fibres synapse.

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41
Q

where are the parasympathetic fibres of the eye distributed to

A

the sphincter pupillae and ciliary muscle

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42
Q

what can cause compression of the oculomotor nerve

A

aneurysm
diabetes
inflammation
trauma

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43
Q

what does the inferior oblique muscle do

A

move the eye upward and outward

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44
Q

what does the levator palpebrae do

A

hold the eyelids open

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45
Q

what does the medial rectus do

A

move the eye toward the nose

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46
Q

what does the ciliary muscle allow the eye to do

A

look both into the distance and close up

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47
Q

what are the muscles provided by the oculomotor nerve

A

superior rectus
medial rectus
inferior oblique
levator palpebrae superiosis

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48
Q

what delivers the parasympathetic innervation to the sphincter pupillae and ciliary muscle

A

the ciliary ganglion

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49
Q

what does raised intracranial pressure lead to

A

compression oculomotor nerve

50
Q

describe the trochlear nerve

A

cell bodies of this nerve are located in the midbrain
deliver motor innervation to the superior oblique
it is rarely paralysed on its own

51
Q

what is diplopia

A

double vision

52
Q

what is the main role of the superior oblique muscle

A

medial rotation, as well as abducting the eyeball and repressing it. can be found to move the eye down and outward

53
Q

what are the clinical presentations of diplopia

A

patient complaining of dizziness and lightness on their feet

54
Q

describe the opthalmic division of the trigeminal nerve

A

general sensation from:
- cornea
- scalp
- eyelids
- nose
- mucosa of nasal cavity
- paranasal sinuses

55
Q

describe the maxillary division of the trigeminal nerve

A

general sensation from:
- maxilla
- upper lip
- maxillary teeth
- maxillary sinuses

56
Q

what nerve supplies the maxillary teeth

A

the superior alveolar nerve, from the maxillary branch of the trigeminal nerve

57
Q

what are the maxillary sinuses

A

air filled cavities within the maxillary bones of the skull that help to lighten the skull and provide vocal resonance

58
Q

describe the mandibular division of the trigeminal nerve

A

general sensation from:
- side of the mandible
- mandibular teeth
- mucosa of the mouth
- anterior two thirds of the tongue

59
Q

what nerve supplies the mandibular teeth

A

inferior alveolar nerve, from the mandibular division of the trigeminal nerve

60
Q

what does the masseter do

A

elevate the mandible

61
Q

describe the attachments of the masseter muscle

A

extend from the zygomatic arch to the angle and ramus of the mandible

62
Q

describe the attachments of the temporalis muscle

A

parietal bone and the sphenoid bone to the coronoid process of the mandible

63
Q

what does the temporalis muscle do

A

elevate and retract the mandible

64
Q

describe the attachments of the lateral pterygoid

A

sphenoid bone and the lateral pterygoid plate to the condyle of the mandible

65
Q

what does the lateral pterygoid do

A

protrudes the mandible and is involved in side to side movement of the mandible

66
Q

what does the medial pterygoid do

A

elevation of the mandible, aid closure of the jaw, assist in lateral pterygoid muscle in side to side movement of the jaw

67
Q

describe the attachments of the medial pterygoid

A

lateral pterygoid plate, palatine bone, and maxillary tuberosity to the medial angle of the mandible

68
Q

label this

A
69
Q

label this

A
70
Q

where in the brain does the abducens arise

A

the pons

71
Q

describe where the trochlear nerve arises from

A

midbrain

72
Q

what does the abducens nerve do

A

innervate somatic motor to the lateral rectus

73
Q

what does the lateral rectus do

A

abduct the eyeball - look laterally

74
Q

describe the clinical problem associated with abducens nerve

A

can be stretched in raised intracranial pressure due to a bleed or trauma, leading to the patient not being able to move their eye laterally on the affected side, and it typically is medially rotated

75
Q

what is LR6 SO4

A

mnemonic to aid recall of motor innervation in the eyes.
lateral rectus supplied by CN6, abducens
superior oblique supplied by CN4, trochlear

76
Q

describe the branchial motor function of the facial nerve

A

motor innervation to the muscles of facial expression, scalp, stapedius

77
Q

describe the special sensory innervation of the facial nerve

A

taste to anterior two thirds of the tongue and palate

78
Q

describe the visceral motor innervation of the facial nerve

A

parasympathetic innervation to the submandibular and sublingual glands
salivary glands, lacrimal glands and glands of the nose and palate

79
Q

how many facial expression

A

43

80
Q

what do the muscles of facial expression come from

A

the second pharyngeal arch

81
Q

how does the facial nerve enter the face to innervate it

A

through the stylomastoid foramen

82
Q

what happens if the stapedius muscle doesnt work

A

sounds appear louder

83
Q

describe the function of the vestibulocochlear nerve

A

vestibular sensation from the semicircular ducts
hearing from the spinal organ

84
Q

describe internal acoustic neuromas

A

slow growing benign tumours which slowly develop over the years
can cause loss of hearing and altered balance, and ringing in the ears
larger ones can cause headaches, double vision, numbness and weakness on one side of the face

85
Q

what does the spiral organ provide

A

hearing

86
Q

what do semi circular canals provide

A

vestibular sensation

87
Q

list the functions of the glossopharyngeal nerve

A

somatic motor
visceral motor
visceral sensory
special sensory
somatic sensory

88
Q

describe somatic motor function of the glossopharyngeal nerve

A

motor to stylopharyngueus

89
Q

describe the visceral motor of the glossopharyngeal nerve

A

parasympathetic innervation to the parotid gland

90
Q

describe the visceral sensory function of the glossopharyngeal nerve

A

parotid gland
pharynx
middle ear

91
Q

describe the special sensory function of the glossopharyngeal nerve

A

posterior one third of the tongue

92
Q

describe the somatic sensory innervation of the glossopharyngeal

A

external ear

93
Q

what does the stylopharyngeus do

A

this is the only muscle of the pharynx that is innervated by the glossopharyngeal nerve, and it raises the larynx and pharynx and dilates the pharynx to enable flood to pass down, thereby inhibiting swallowing

94
Q

describe the somatic motor innervation of the vagus nerve

A

muscles of the pharynx
intrinsic muscles of larynx
muscles of palate
muscle in upper two third of the oesophagus

95
Q

describe the vagus nerves visceral motor function

A

parasympathetic innervation to the trachea, bronchi, gastrointestinal tract, and the heart

96
Q

describe the vagus nerve

A

the wandering nerve

97
Q

describe the visceral sensory function of the vagus

A

tongue, larynx, respiratory tract, heart, upper gi tract to the left colic flexure

98
Q

describe the special sensory function of the vagus nerve

A

epiglottis and the palate

99
Q

describe the general sensory function of the vagus nerve

A

auricle
external auditory meatus

100
Q

describe the clinical test for the cranial nerves IX and X

A

ask the patient to say ahh and watch the uvula at the back of the mouth. if there is palsy of either nerve, the uvula will be pulled to the unaffected side

101
Q

describe the function of the spinal accessory nerve

A

somatic innervation to the sternocleidomastoid and trapezius muscle

102
Q

describe the attachments of the sternocleidomastoid muscle

A

mastoid process behind the ear, to the clavicle and the sternum

103
Q

how to test for the spinal accessory muscle

A

test the trapezius and sternocleidomastoid contraction with and without resistance on the patient

104
Q

describe the function of the hypoglossal nerve

A

somatic motor innervation to the intrinsic and extrinsic muscles of the tongue except for the palatoglossus

105
Q

what supplies the palatoglossus

A

the vagus nerve

106
Q

how to test the hypoglossal nerve

A

ask the patient to stick out their tongue and it should be symmetrical when coming out. if there is palsy, the tongue would stick out to the affected side due to unopposed action of the normal side of the tongue

107
Q

how to test the first cranial nerve

A

ask the patient to smell toothpaste or coffee, and ask if they notice any changes in smell

108
Q

describe the test for vision

A

pupil dilation using a torch, ask the patient to read a document provided they have glasses if they need them

109
Q

describe the test for oculomotion

A

follow your finger in a H shaped pattern

110
Q

describe the different nuclei for the vagus nerve and their functions

A

dorsal motor nucleus
- parasympathetic fibres to GIT and lungs
nucleus ambiguus
- motor innervation to the soft palate, larynx and pharynx
- preganglionic nerve fibres to the heart
solitary nucleus
- receives afferents from visceral organs
- taste information
spinal trigeminal nucleus
- afferents that converge here relay sensory information regarding pain, temperature and deep touch of the outer ear, cranial fossa and the mucosa of the larynx

vagus nerve exits the skull via the jugular foramen

111
Q

summarise the olfactory nerve via information from kenhub

A
  • has no nucleus
  • sensory innervation to the nasal mucosa
  • fila olfactoria are the branches
  • pass through the cribiform plate of the ethmoid bone
  • cell bodies are found in the olfactory area covering the superior nasal cavity
  • special afferent nerve
112
Q

summarise the optic nerve via the information from kenhub

A
  • innervates retina of the eye to bring visual information to the brain
  • neural fibres originate from photoreceptors of the retina and converge at the optic disc, to form the optic nerve
  • optic nerve leaves the orbit via the optic canal
  • on the floor of the middle cranial fossa, the nasal parts of each nerve cross to the opposite side to form the optic chiasm and continue as two optic pathways
  • cell bodies are found in the retina
113
Q

describe the oculomotor nerve from the information in kenhub

A

somatic and visceral efferent motor nerve
- two nuclei - nucleus of the oculomotor nerve (somatic) and the accessory nuclei of the oculomotor nerve (parasympathetic)
- chief motor nerve supplying the eye
- originates from the midbrain
- exits skull through superior orbital fissure
- miosis, lens accommodation
- parasympathetic innervation goes to the sphincter pupillae for miosis

114
Q

describe the trochlear nerve according to kenhub information

A

general somatic motor
- originates from the midbrain
- enters orbit through the superior orbital fissure
- superior oblique muscle

115
Q

describe the trigeminal nerve according to kenhub information

A

mixed nerve
fibres originate from the brain stem and form the trigeminal ganglion near the apex of the petrous part of the temporal bone

opthalmic division leaves the skull via the superior orbital fissure
maxillary division leaves the skull via the foramen rotundum
mandibular division leaves the skull via the foramen ovale

has four nuclei

motor innervation
- muscles of mastication
- mylohyoid
- anterior belly of digastric
- tensor tympani muscles

sensory
- scalp
- face
- orbit
- anterior two thirds of the tongue

116
Q

describe the abducens nerve according to information from kenhub

A

general somatic efferent nerve

lateral rectus muscle

originates from the brainstem and exits the skull via the superior orbital fissure

one nucleus

117
Q

describe the facial nerve according to information from kenhub

A

multimodal nerve originating from the brainstem as two separate divisions

the large primary root carries motor fibres

smaller intermediate root carries sensory and parasympathetic fibres

divisions leave the skull via the internal acoustic meatus and travel through the facial canal where they join to form the facial nerve proper and leave the cranium through the stylomastoid foramen

four nuclei

receives taste from the anterior two thirds of the tongue

118
Q

describe the vestibulocochlear nerve according to information from kenhub

A

special somatic afferent nerve

vestibular nerve
- balance and motion
cochlear nerve
- hearing

both parts unite to form the vestibulocochlear nerve at the fundus of the internal acoustic meatus, and then enter the cranium through the internal acoustic meatus

119
Q

describe the glossopharyngeal nerve according to the information from kenhub

A

originates from the brainstem and exits the skull through the jugular foramen

enables swallowing, salivation, taste sensation

four nuclei
- nucleus ambiguus
- inferior salivatory nucleus
- nuclei of the solitary tract
- spinal nucleus of the trigeminal nerve

motor innervation
- stylopharyngeus
- pharyngeal constrictors
- parotid gland

sensory innervation
- posterior one third of the tongue for both taste and general sensation
- middle ear
- pharynx
- epiglottis
- carotid body and sinus

120
Q

describe the accessory nerve according to the information from kenhub

A

exits the skull via the jugular foramen

two nuclei
- ambiguus
- C1-C5

motor innervation
- laryngeal muscles
- sternocleidomastoid
- trapezius

121
Q

describe the hypoglossal nerve according to information from kenhub

A

leaves the skull via the hypoglossal foramen
- enables tongue movements

one nucleus

motor
- intrinsic tongue muscles
- extrinsic tongue muscles except for the palatoglossus

Human Systems and Anatomy (57 decks)

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