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MD4001 - Anatomy > Cranial Nerves - Sensorimotor Function > Flashcards

Cranial Nerves - Sensorimotor Function Flashcards

1
Q

How many cranial nerves are there and where do they arise from?

A

12 pairs of cranial nerves arise from the cerebrum or brain stem

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2
Q

How is the nuclei of the cranial nerves laid out?

A

Their nuclei are essentially laid out from medial to lateral in the brainstem and sequentially, longitudinally in the midbrain, pons and medulla

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3
Q

What are the motor modalities of the cranial nerves?

A

somatic efferent, special visceral efferent to muscles derived from brachial arch, general visceral efferent (parasympathetic)

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4
Q

What are the sensory modalities of the cranial nerves?

A

somatic efferent, special visceral afferent (smell and taste), general visceral afferent, special somatic afferent (sight, hearing and balance)

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5
Q

What do the cranial nerves pass through?

A

foramina on cranial bones

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6
Q

What is the function of the cranial nerves? And what nerve is the exception to this?

A

With the exception of vagus, all cranial nerves innervate structures of the head and neck

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7
Q
A
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8
Q

What area is referred to as the olfactory region?

A

The upper third of the nasal cavity (superior nasal concha, roof od the nasal cavity and nasal septum)

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9
Q

Where do the olfactory nerves pass through? And what is it anchored by?

A

Olfactory nerves pass through the cribriform plate, where they are anchored by dura mater and synapse at the olfactory bulb

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10
Q

What do axons of the neurons in the olfactory bulb form?

A

olfactory tract

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11
Q

Where does the olfactory tract project to?

A

Projects to the olfactory cortex FIRST and then to the limbic system, hypothalamus and reticular formation for visceral and behavioural responses to odours

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12
Q

What is Anosmia? And what is likely to cause this clinical condition?

A
  • Olfactory neuropathy caused by upper respiratory tract infections (loss of sense of smell)
  • Trauma, causing the brain and olfactory bulb to move may tear the olfactory nerves
  • Fractures of the cribriform plate may cause CSF rhinorrhoea (blood stained CSF leaking from the nose)
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13
Q

What is unqiue about the basal cells of the olfactory region?

A
  • Basal cells can differentiate to bipolar (olfactory neurons)
    • Regeneration in adult humans
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14
Q

What is unique about the special sense olfaction?

A

Only sense that travels to the cortical field prior to thalamus

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15
Q

What is the largest cranial nerve and what are its main divisions?

A
  • The largest cranial nerve = Trigeminal Nerve
  • Has three divisions: V1, V2 and V3
    • V1 and V2 are afferent only
    • V3 is both afferent and efferent
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16
Q

What is the function of the trigeminal nerve?

A

Supplies general, conscious sensation to much of the face, head and associated orbital, nasal and oral cavities

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17
Q

How many nuclei does the trigeminal nerve have?

A
  • Has 4 nuclei (and 2 roots)
    • Sensory roots: to mesencephalic nucleus, principle (pontine) nucleus, spinal nucleus
    • Motor root: from motor nucleus
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18
Q

Where do the sensory and motor roots of the trigeminal nerve emerge?

A

the mid-pons and run towards the trigeminal ganglion

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19
Q

What emerges from the trigeminal ganglion?

A
  • Three divisions of the trigeminal nerve
    • V1 = opthalmic division
    • V2 = maxillary division
    • V3 = mandibular division
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20
Q

What is the course of CN V1

A

lateral wall of the cavernous sinus –> superior orbital fissure –> orbit

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21
Q

What is the course of CN V2

A

Lateral wall of cavernous sinus –> foramen rotundum –>

pterygopalatine fossa

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22
Q

What is the course of CN V3

A

foramen ovale –> infratemporal fossa

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23
Q

Describe the opthalmic nerve

A
  • Sensory division only
  • Picks up sympathetic fibres from the carotid plexus
  • Gives off meningeal branch near trigeminal ganglion that supplies dura
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24
Q

What are the three branches of the opthalmic nerve?

A

o Lacrimal
o Frontal
o Nasocillary

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25
Q

What is the function of the lacrimal branch of the opthalmic nerve?

A
  • Supplies general sensation to the lacrimal gland, conjunctive and upper eyelid in the vicinity of Lacrimal gland
  • Also carries parasympathetic fibres of facial nerve (VII) to the lacrimal gland
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26
Q

What is the largest branch of the opthalmic nerve and what does it divide into?

A

Frontal Nerve

  • Divides into supra-orbital and supra-trochlear nerves
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27
Q

What is the function of the frontal nerve?

A
  • Supplies the upper eyelid and conjunctiva, frontal sinus and scalp as far back as vertex
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28
Q

What branches does the nasocillary nerve give off?

A

Gives off long ciliary nerve(s), anterior and posterior ethmoidal nerves, before continuing as infratrochlear nerve

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29
Q

What does the nasocillary nerve supply?

A
  • Supplies the skin of medial, upper eyelid and root of nose
  • Sensation to the cornea of the eye afferent limb of cornea reflex
  • The tip of the nose
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30
Q

Describe the maxillary division of the trigeminal nerve

A

Sensory only division

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31
Q

What are the major branches of the maxillary division of the trigeminal nerve?

A
  • Sends zygomatic and infra-orbital branches into the orbit via the inferior orbital fissure
    • Infra-orbital nerve exits the orbit via infra-orbital canal infra-orbital foramen
  • Sends palatine and superior alveolar branches to the palate and upper teeth
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32
Q

What does the maxillary nerve (CN V2) supply?

A
  • Lateral forehead
  • Zygomatic region
  • Lower lid
  • Side of nose
  • Cheek (anteriorly)
  • Upper lip
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33
Q

What type of fibres does the mandibular branch of the trigeminal nerve contain?

A

Contains both sensory and motor fibres

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34
Q

What branches does the mandibular nerve give off?

A

Gives off auriculotemporal, buccal, lingual and inferior alveolar branches

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35
Q

What does the mandibular nerve provide sensation to?

A

o Skin of auricle and temple
o Cheek, posteriorly
o Lower lip and chin
o General sensation to the anterior 2/3 of the tongue, and the floor of the mouth

o The lower gums and teeth

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36
Q

What does the mandibular nerve provide motor function to?

A

o Muscles of mastication: lateral pterygoid, medial pyerygoid, masseter and temporalis

o Tensor tymapni
o Tensor veli palatini
o Mylohyoid

o The anterior belly of digastric

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37
Q

What is Jaw Jerk and what is its function?

A

Tests the mandibular division of the trigeminal nerve (CN V3) and nuclei

38
Q

Where is the oculomotor nerve nucleus located?

A

midbrain

39
Q

What is the course of the oculmotor nerve?

A
  • Passes between the posterior cerebral and superior cerebellar arteries, before lying close to the posterior communicating artery
  • Runs anteriorly on the lateral wall of the cavernous sinus
  • Passes through superior orbital fissure and enters the orbit
40
Q

What does the oculomotor nerve divide into?

A

Divides into superior and inferior divisions (rami)

  • Through common tendinous ring of Zinn
41
Q

What type of nerve is the oculomotor nerve?

A

Motor and parasympathetic

42
Q

What does the superior branch of the oculomotor nerve supply?

A
  • Levator palpabrae superiosis
  • Superior rectus
43
Q

What does the inferior branch of the oculomotor nerve supply?

A
  • Inferior rectus
  • Inferior oblique
  • Medial rectus
  • ciliary ganglion
44
Q

What type of nerve is the trochlear nerve?

A

Motor only

45
Q

Where is the nucleus of the trochlear nerve?

A

the midbrain

46
Q

What is the course of the trochlear nerve?

A
  • Runs anteriorly around cerebral peduncle
  • Enters cavernous sinus
  • Passes through superior orbital fissure
47
Q

What does the trochlear nerve supply?

A
  • Supplies superior oblique
48
Q

What occurs in injury of the trochlear nerve?

A
  • Injury to the trochlear nerve results in the patient not being able to look medially and inferiorly
  • Patient experiences diplopia while walking downstairs or reading a book
49
Q

What type of nerve is the abducent nerve?

A

Motor only

50
Q

Where is the nucleus of the abducent nerve located?

A

the pons

51
Q

What is the course of the abducent nerve?

A
  • Nerve exits brainstem medially, between pons and medulla
  • Enters cavernous sinus
  • Enters orbit through superior orbital fissure
52
Q

What muscle does the abducent nerve supply?

A

Lateral rectus

53
Q

What would occur due to injury to the right abducent nerve?

A

diplopia when looking right – the right eye would not abduct

fully

54
Q

What type of nerve is the facial nerve?

A

Mixed nerve

55
Q

Where is the nucleus of the facial nerve?

A

in Pons

56
Q

What is the motor nucleus of the facial nerve and what divisions does it have?

A
  • Motor nucleus – Nucleus solitarius (sensory)
  • Motor nucleus has superior and inferior divisions which innervate the upper and lower facial musclesrespectively
57
Q

What is the superior division of the motor root of the facial nerve connected to?

A
  • The superior division is connected to the ipsilateral and contralateral motor cortices
58
Q

What is the inferior division of the motor root of the facial nerve connected to?

A
  • The inferior division is connected to contralateral cortex only
59
Q

What is the course of the motor root of the facial nerve?

A
  • The motor root emerges in the angle between the lower pons and the cerebellum – the cerebellopontine angle
  • Enters the temporal bone at the internal acoustic meatus, with VIII and the labyrinthine artery
60
Q

Where does the facial nerve eneter the facial canal?

A

within the temporal bone

61
Q

Where are the cell bodies for taste fibres located?

A

geniculate ganglion (sensory ganglion of the facial nerve)

62
Q

Where does the facial nerve exit the facial canal?

A

Exits through the temporal bone through stylomastoid foramen

63
Q

What branches does the facial nerve give off/recieve?

A
  • Sends a branch to stapedius
  • Receives (gives off) chorda tympani
  • Sends branches to supply occipitalis and the auricular muscles
64
Q

What occurs when the facial nerve enters the parotid gland?

A
  • Enters the parotid gland and divides to form a plexus within (superficial to the external carotid artery

and retromandibular vein)

  • 5 nerves branch off and supply the muscles of facial expression, posterior belly of digastric and stylohyoid
65
Q

What are the 5 branches of the facial nerve beyond the parotid gland?

A
  • Temporal
  • Zygomatic
  • Buccal
  • Mandibular
  • Cervical
66
Q

What occurs when there is a facial nerve injury ay the cerebellopontine angle?

A
  • Balance and hearing problems
  • Ipsilateral facial muscle paralysis
  • Hyperacusis (pain on loud sounds)
  • Taste disturbances
  • Reduced lacrimal secretion
67
Q

What occurs when the is a facial nerve injury within the petrous temporal bone?

A 
o Reduced lacrimal secretion
o Hyperacusis (pain on loud sounds)

o Taste disturbances
o Ipsilateral facial muscle paralysis

68
Q

What occurs when there is a facial nerve injurt distal to the stylomastoid foramen?

A

o Ipsilateral facial muscle paralysis

o Dry eye, drooling

69
Q

Describe cental facial palsy

A
70
Q

Describe peripheral facial palsy

A
71
Q

What type of nerve is the glossophayrngeal nerve and where are its nuclei located?

A

Mixed nerve; nuclei in medulla

72
Q

What are the motor and sensory nucleus of the glossopharyngeal nerve?

A

Motor nucleus is nucleus ambiguus, sensory nucleus is nucleus solitarius

73
Q

What branch of the glossopharyngeal nerve goes to the middle ear?

A

Tympanic branch to middle ear, tympanic membrane and mastoid air cell

74
Q

What sensory input does the glossopharyngeal nerve recieve?

A

o General sensation from middle ear, oropharynx, palatine tonsil, inferior aspect of soft palate, posterior 1/3 tongue

o General visceral sensation from carotid sinus and carotid body

o Special visceral sensation (taste) from posterior 1/3 tongue

75
Q

What is the motor supply of the glossophayrngeal nerve?

A
  • Motor supply to stylopharyngeal muscle
76
Q

What type of nerve is the vagus nerve and where are its nuclei located?

A
  • Mixed nerve; nuclei in medulla
77
Q

What is the course of the vagus nerve?

A
  • Leaves brainstem, passes through jugular foramen with IX and XI
78
Q

What are the different nuclei of the vagus nerve?

A
  • Motor nucleus is nucleus ambiguus, sensory nucleus is nucleus solitarius (taste and general visceral)
79
Q

What is the general somatic sensation of the vagus nerve?

A

General somatic sensation from deep auricle and parts of the external acoustic meatus

80
Q

What is the general visceral sensation of the vagus nerve?

A
  • General visceral sensation from the laryngopharynx and larynx
81
Q

What is the motor supply of the vagus nerve?

A

straited muscles of the pharynx and larynx

82
Q

What type of nerve is the accessory nerve and where are its roots located?

A

Motor only

  • Spinal root: from C1-C5
  • Cranial root: from nucleus ambiguous
83
Q

What is the course of the accessory nerve?

A
  • Spinal root enters cranial cavity through foramen magnum
    • Joins with cranial root
  • Both roots exit skull via jugular foramen as accessory nerve
  • Crosses the posterior triangle in the investing layer of fascia, surrounded by lymph nodes
84
Q

What does the accessory nerve supply?

A
  • Spinal accessory supplies trapezius and sternocleidomastoid
85
Q

What type of nerve is the hypoglossal nerve and where is its nucleus located?

A
  • Motor only
  • Hypoglossal nucleus in medulla
86
Q

Describe the course of the hypoglossal nerve

A

Exits the brainstem anterior to olive

  • Emerges from hypoglossal (anterior condylar) canal
  • Descends the neck, passing lateral to both the internal and external carotid arteries and associated with

a loop of Cx nerves that supply the strap muscles of the neck

  • Enters oral cavity under the tongue between the hyoglossus
87
Q

What is the function of the hypoglossal nerve?

A

supply all the tongue muscles except palatoglossus

88
Q

What occurs if the hypoglossal muscle is injured?

A

 If injured, ipsilateral tongue weakness, therefore tongue deviates to the side of the lesion

89
Q

Describe the innervation of the anterior 1/3 of the tongue

A
  • Taste by glossopharyngeal nerve
  • General sensation by glossopharyngeal
90
Q

Describe the innervation of the posterior 2/3 of the tongue

A
  • Taste by chorda tympani of Nervus Intermedius (facial)
  • General sensation by lingual nerve of V2

MD4001 - Anatomy (6 decks)

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