Cranial Nerves Quiz Flashcards
What is a CN?
Emerges from the brain/brainstem; relays information to the head and neck
CNs involved in swallowing
Trigeminal, facial, glossopharyngeal, vagus, spinal accessory, hypoglossal
Trigeminal branches
V1: opthalmic (sensory)
V2: maxillary (sensory)
V3: mandibular (sensory and motor)
Trigeminal - sensory
Controls all somatosensation from the face and anterior 2/3 of the tongue
Trigeminal - motor
Controls movements for the: mylohyoid and anterior belly of digastric; tensor veli palatini; 4 muscles of mastication
4 muscles of mastication
Masseter, temporalis, medial and lateral pterygoids
Trigeminal - role in swallowing
Oral containment; bolts preparation; facial sensation; oral cavity sensation; oral clearance; influences pharyngeal swallow; VP closure; hyolaryngeal movement
Facial nerve muscles
Temporal, zygomatic, buccal, mandibular, cervical
Facial - sensory
Taste for anterior 2/3 of tongue
Facial - motor
Controls all motor movement for:
- face: facial expression, oral acceptance, pocketing prevention
- stylohyoid and posterior belly of digastric
- submandibular and sublingual salivary glands
Facial - role in swallowing
Utensil use/clearance; oral containment; bolus prep; anterior tongue sensation; oral clearance; hyolaryngeal movement
Glossopharyngeal - sensory
- Touch, pain, temperature, and taste for posterior 1/3 of tongue
- somatosensation from the mucosa of the soft palate and upper pharyngeal mucosa
Glossopharyngeal - motor
Provides motor innervation to the stylopharyngeus and partook salivary gland (laryngeal elevator)
Glossopharyngeal - role in swallowing
Oropharyngeal sensation; posterior tongue sensation; pharyngeal swallow onset; bolus prep; laryngeal elevation/pharyngeal shortening
vagus nickname
The wanderer
A&P of the pharynx
Superior laryngeal nerve and recurrent laryngeal nerve
Superior laryngeal nerve
Internal —> sensory above cords
External —> motor to cricothyroid muscle
Recurrent laryngeal nerve
Sensory —> below glottis
Motor —> all other muscles of larynx
Vagus - sensory
Mucous membrane at the valleculae, epiglottis, aryepiglottic folds and most of the larynx; mucous membrane below the level of the folds; special sensory taste to the epiglottis; general senesory to the soft palate, posterior tongue, lower pharynx and the UES
Vagus - motor
The pharyngeal constrictors; all the muscles of the soft palate except the tensor veli palatini; salpingpharyngeus; all intrinsic laryngeal muscles; cricothyroid
Cough reflex arc
Irritation of cough receptors in airways; afferent signals sent to medulla; efferent impulses related to muscles to produce cough
Vagus - role in swallowing
Pharyngeal sensation; pharyngeal swallow onset; velopharyngeal closure; hyolaryngeal clearance; airway protection; esophageal clearance
Spinal accessory - muscles
Trapezius and sternocleidomastoic
Spinal accessory - motor
Reduced ability to turn head and reduced ability to shrug shoulders
Spinal accessory- impact on swallowing
May later dysphagia management
Hypoglossal - motor
All intrinsic and extrinsic muscles
Hypoglossal - role in swallowing
Oral containment; bolts prep; lingual transport; oral clearance; tongue base retraction; pharyngeal clearance
Cervical spine nerve - motor
Geniohyoid - the primary contributor for anterior movement of the hyoid bone
Thyrohyoid - Supra- and infra-hyoid muscles can be considered secondary muscles of mastication
Dysarthria
Test diadochokinetic rate
Apraxia
Ask patient to pretend to blow out match, cluck their tongue, or whistle
Aspiration pneumonia causes
Inability to self-feed; dependent for oral care; number of decayed teeth; tube feeding; more than one medical diagnosis; number of medications; smoking
3 pillars of pneumonia
- Compromised immune system
- The presence of aspiration
- Poor oral health
Clinical swallow evaluation (CSE)
- Case history/chart review
- Patient observation
- Oromotor/CN examination
- Swallow trials
CSE use
Determination of readiness; clinical assessment; instrumental assessment
