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MD4001 > Cranial Nerves: Sensorimotor > Flashcards

Cranial Nerves: Sensorimotor Flashcards

1
Q

What are the 7 modalities served by the cranial nerves?

A

Motor:
• Somatic efferent
• Special visceral efferent
• General visceral efferent

Sensory:
• Somatic afferent
• Special visceral afferent (smell, taste)
• General visceral afferent
• Special somatic afferent ( sight, hearing, balance)

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2
Q

What are each of the cranial nerves?

A 
I - Olfactory 
II - Optic 
III - Occulomotor 
IV- Trochlear 
V- Trigeminal 
VI- Abducent
VII - Facial 
VIII- Vestibulocochlear 
IX- glossopharyngeal 
X- Vagus 
XI - Accessory 
XII - Hypoglossal
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3
Q

Where is the olfactory region?

A

The upper third of the nasal cavity

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4
Q

Describe the route of the olfactory nerve

A
  • Olfactory nerves pass through the cribriform plate (where they are anchored by the dura) and synapse at the olfactory bulb
  • Axons in the olfactory bulb form the olfactory canal
  • Project to the olfactory cortex then to the limbic system, hypothalamus and reticular formation (for visceral and behavioural response to odours)
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5
Q

What type of cells can differentiate into olfactory neurones?

A
  • Basal cells can differentiate into (bipolar) olfactory neurones
  • Can regenerate in humans
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6
Q

What is anosmia and what causes it?

A
  • Olfactory neuropathy cursed by upper respiratory tract infection
  • Trauma, causing the brain and olfactory bulb to move may tear the olfactory nerves
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7
Q

What may happen as a result of a fracture of the cribriform plate?

A
  • CSF rhinnorhea

* Blood stained CSF leaking from the nose

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8
Q

What are the modalities of the divisions of the trigeminal nerve?

A
  • V1 and V2 are afferent only

* V3 is afferent and efferent

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9
Q

What are the roots and nuclei of the trigeminal nerve?

A

Sensory root:
• Mesencephalic nucleus
• Principle (pontine) nucleus
• Spinal nucleus

Motor Root:
• Motor nucleus

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10
Q

Where do the roots of the trigeminal nerve emerge?

A

From the mid pons and run to the trigeminal ganglion

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11
Q

What are the divisions of the trigeminal nerve that emerge from the trigeminal ganglion?

A
  • Ophthalmic (V1)
  • Maxillary (V2)
  • Mandibular (V3)
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12
Q

Describe the course of the ophthalmic nerve

A
  • Runs in the lateral wall of the cavernous sinus
  • Passes through the superior orbital fissure
  • Into the orbit
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13
Q

Describe the route of the Maxillary nerve

A
  • Runs in the lateral wall of the cavernous sinus
  • Passes through foramen rotundum
  • Enters the pterygopalatine fossa
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14
Q

Describe the course of the mandibular nerve

A
  • Passes through foramen ovale

* Infratemporal fossa

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15
Q

Ophthalmic nerve

A

• Sensory only branch
• Picks up sympathetic fibres from the carotid plexus
• Gives off the meningeal branch near the trigeminal ganglion that supplies the dura
• 3 main branches:
- lacrimal
- frontal
- nasociliary

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16
Q

What are the 3 main branches of the ophthalmic nerve?

A
  • Lacrimal
  • Frontal
  • Nasociliary
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17
Q

Function of the lacrimal nerve

A
  • Supplies general sensation to the lacrimal gland, conjunctiva and upper eyelid in the vicinity of the lacrimal gland
  • Carries parasympathetic fibres from the facial nerve (CN VII) to the lacrimal gland
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18
Q

Function of the frontal nerve

A

• Supplies the upper eyelid and conjunctiva, frontal sinus and the scalp as far back as the vertex (afferent)

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19
Q

What are the divisions of the frontal nerve?

A
  • Supra-orbital

* Supra- trochlear nerve

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20
Q

Function of the nasociliary nerve

A
  • Supplies the skin of the medial, upper eyelid and root of the nose
  • Sensation to the cornea of the eye (corneal reflex afferent)
  • Tip of the nose
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21
Q

What are the divisions of the nasociliary nerve?

A
  • Gives off long ciliary nerves and anterior and posterior ethmoidal nerves
  • Continues as the infratrochlear nerve
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22
Q

Branches of the maxillary nerve

A
  • Zygomatic and infra-orbital branches into the orbit via the inferior orbital fissure
  • Palatine and superior alveolar branches to the palate and upper teeth
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23
Q

Describe the route of the infra-orbital nerve

A
  • Enters the orbit via the inferior orbital fissure
  • Exits the orbit via the infra-orbital canal
  • Into the infra-orbital foramen
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24
Q

What is the sensory supply of the maxillary nerve?

A
  • Lateral forehead
  • Zygomatic region
  • Lower lid
  • Side of the nose
  • Cheek (anteriorly)
  • Upper lip
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25
What are the branches of the mandibular nerve?
* Auriculotemporal * Buccal * Lingual * Inferior Alveolar
26
What is the sensory supply of the maxillary nerve?
* Skin of the auricle and temple * Posterior cheek * Lower lip and chin * General sensation to the anterior 2/3 of the tongue and the floor of the mouth * Lower gums and teeth
27
What is the motor supply of the mandibular nerve?
``` • Muscles of mastication - lateral pterygoid - medial pterygoid - masseter - temporalis • Tensor tympani • Tensor veli palatini • Mylohyoid • Anterior belly of digastric ```
28
What reflex tests the mandibular nerve?
Jaw jerk | • Tap chin with tendon hammer
29
What are the modalities of the oculomotor nerve?
* Somatic motor | * visceral motor
30
Where is the nucleus for the oculomotor nerve?
In the midbrain
31
Describe the course of the oculomotor nerve
* Passes between the posterior cerebral and superior cerebral arteries, before lying close to the posterior communicating artery * Runs anteriorly on the lateral Wall of the cavernous sinus * Passes through the superior orbital fissure and enters the orbit * In the orbit it divides into superior and inferior divisions (rami) through the tendinous ring of zinn
32
What may happen as a result of an aneurysm of the posterior communicating artery?
May compress the oculomotor nerve
33
Superior branch of the oculomotor nerve
• Oculomotor fibres and sympathetics from the superior cervical ganglion
34
Where is the nucleus of the trochlear nerve?
In the midbrain
35
Describe the course of the trochlear nerve
* Nerves exit the brainstem from its posterior surface * Runs anteriorly around the cerebral peduncle and enters the cavernous sinus * Passes through the superior orbital fissure * Supplies the superior oblique muscles
36
What does injury of the trochlear nerve result in?
* Patient not able to look medially and inferiorly | * Patient experiences diplopia (Blurred and double vision) while walking down stairs or reading a book
37
What are the modalities of the abducent nerve?
• Motor only
38
Where is the nucleus of the abducent nerve?
In the pons
39
Describe the course of the abducent nerve
* Exits the brainstem medially between the pons and medulla * Enters the cavernous sinus (through not it wall) * Enters the orbit through the superior orbital fissure * Supplies the lateral rectus
40
What would injury of the abducent nerve result in?
* Diplopia when looking right | * eye won't fully abduct
41
Where is the nucleus of the facial nerve?
In the pons
42
What are the nuclei of the facial nerve?
* Motor nucleus | * Nucleus solitarius
43
Motor nucleus of the facial nerve
* Superior and inferior divisons * Superior innervates the upper facial muscles * Inferior innervates lower muscles * Superior divison is connected to ipsilateral and contralateral motor cortices * Inferior division is connected to the contralateral cortex only
44
Where does the Motor root of the facial nerve emerge?
In the angle between the lower pons and the cerebellum - the cerebellopontine angle
45
Describe the course of the facial nerve
* Emerges from cerebelloponitne angle * Enters the temporal bone at the internal acoustic meatus with CNVIII and the labyrinthine artery * Enters the facial canal within the temporal bone * Cell bodies for taste fibres in geniculate ganglion * Chordates tympani * Exits the temporal bone through stylomastoid foramen * Sends branches to supply occipitals and auricular muscles * Enters the parotid gland and divides to form a plexus within it
46
Birth and facial nerve complication
* At birth, the mastoid process is not properly developed | * Facial nerve is at risk of compression during delivery with forceps leading to the paralysis of the facial muscles
47
What are the branches of the facial nerve?
* Temporal * Zygomatic * Buccal * Marginal mandibular * Cervical
48
What does the temporal nerve supply?
* Frontal belly of occipitofrontalis | * orbicularis oculi
49
What does the zygomatic nerve supply?
• Part of the orbiculares oculi
50
What does the buccal nerve supply?
* Buccinator | * Lip muscles
51
What does the marginal mandibular supply?
• Muscles of the lower lip and chin
52
What does the cervical nerve supply?
Platysma
53
Facial nerve injury at the cerebellopontine angle
* Balance and hearing problems * Ipsilateral facial muscle paralysis * Hyperacusis (pain on loud sounds) * Taste disturbances * Reduced lacrimal secretion
54
Facial nerve injury distal to the stylomastoid foramen
* Ipsilateral facial muscle paralysis | * Dry eye, drooling
55
Facial nerve injury within the petrous temporal bone
* Depending on exact location: * Reduced lacrimal secretion * Hyperacusis * Taste disturbance * Ipsilateral facial paralysis
56
Corneal reflex
* eyes close in response to touch * Efferent branch is facial nerve * Efferent branch is nasociliary of trigeminal
57
Where is the nuclei of the glossopharyngeal nerve?
In the medulla
58
What is the motor nucleus of the glossopharyngeal nerve?
Nucleus ambiguus
59
What is the sensory nucleus of the glossopharyngeal nerve?
Nucleus solitarius
60
Branches of the glossopharyngeal nerve
• Tympanic branch to the middle ear, tympanic membrane and mastoid air cells
61
Glossopharyngeal sensory
* General sensation from the middle ear, oropharynx, palatine tonsil, inferior aspect of soft palate, posterior 1/3 of the tongue * General visceral sensation from the carotid sinus and carotid body * Special visceral sensation (taste) from posterior 1/3 of the tongue
62
Motor supply glossopharyngeal
• Stylopharyngeal
63
Where are the nuclei of the vagus?
medulla
64
Motor nucleus of the vagus
• Nucleus Ambiguus
65
Sensory nucleus of the vagus
• Nucleus solitarius (taste and general visceral)
66
Describe the course of the vagus
• Leaves the brainstem and passes through the jugular foramen with CNIX and XI
67
General somatic sensation vagus
* Deep Auricle | * Parts of the external acoustic meatus
68
General visceral sensation vagus
* Laryngopharynx | * Larynx
69
Motor supply vagus
• Striated muscle of larynx and pharynx
70
Gag reflex
* Touch the posterior wall of the pharynx or the root of the tongue and the pharyngeal muscles supplied by the vagus will contract * Afferent = glossopharyngeal * Efferent = vagus
71
What is the modality of the accessory nerve
Motor only
72
Roots of the accessory Neve
* Spinal roots from C1 to C5 * Cranial root from nucleus ambiguus * Spinal roots enter the cranial cavity through the foramen magnum and join with the cranial root * both roots exit the skull via the jugular foramen as accessory nerve
73
Course of the accessory nerve
* Exits the skull via jugular foramen | * Crosses the posterior triangle in the investing layer of fascia, surrounded by lymph nodes
74
What does the accessory nerve innervate
* Trapezius | * Sternocleidomastoid
75
Modalities of the hypoglossal nerve
Motor only
76
Where is the hypoglsosal nucleus?
Medulla
77
Describe the course of the hypoglossal
* Exits brainstem anterior to the olive * Emerges from the hypoglossal (anterior condylar canal) * Descends in the neck, passing lateral to both the internal and external carotid arteries (associated with a loop of Cx nerves that supply a strap of muscles of the neck) * Enters the oral cavity under the tongue, between the mylohyoid and hypoglossus
78
What does the hypoglossal nerve supply?
All muscles of the tongue except palatoglossus
79
What does injury of the hypoglossal nerve cause?
* Ipsilateral tongue weakness | * Tongue deviates to the side of weakness
80
Innervation, posterior 1/3 of the tongue
* Taste by glossopharyngeal * General sensation by glossopharyngeal * Motor by hypoglossal except palatoglossus (vagus)
81
Innervation, anterior 2/3 of the tongue
* Taste by chordates tympani or nervous intermedium (facial) * General sensation by the lingual nerve of V3 * Motor by hypoglossal except palatoglossus (vagus)
82
Sensory innervation of the oropharynx, palatine tonsil, inferior aspect of soft palate, posterior 1/3 of tongue
Glossopharyngeal
83
Sensory innervation of laryngopharynx, vallecula and epiglottis
Vagus
84
Sensory innervation of the nasopharynx
Maxillary

MD4001 (28 decks)

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