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MD4001 Anatomy > Cranial nerves: Sensory and Motor > Flashcards

Cranial nerves: Sensory and Motor Flashcards

1
Q

What bone is the cribiform plate located in?

A

Ethmoid

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2
Q

What is the olfactory region?

A

Upper third of the nasal cavity (superior nasal concha, roof of nasal cavity and nasal septum)

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3
Q

What is the olfactory bulb anchored by?

A

Dura mater

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4
Q

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

A

Olfactory tract

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5
Q

Where do olfactory axons project to?

A

Olfactory cortex first and then to the limbic system, hypothalamus and reticular formation

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6
Q

What is the only sense which reaches the cortex first then goes to the thalamus?

A

OLfactory - smell

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7
Q

What cells can differentiate to bipolar (olfactory) neurons?

A

Basal cells

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8
Q

What is anosmia?

A

Loss of smell

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9
Q

What can ansomia be caused by?

A
  • Olfactory neuropathy caused by upper respiratory tract infection
  • Trauma, causing the brain and olfactory bulb to move may tear the olfactory nerves
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10
Q

What can fractures of the cribiform plate (on ethmoid) cause?

A

CSF rhinorrhoea (blood stained CSF leaking from the nose)

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11
Q

What do the cilia on bipolar neurons act like?

A

Receptors - activated by other molecules which must be dissolved in mucus (mucus glands therefore help olfaction)

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12
Q

What is the average lifespan of bipolar neurons?

A

40 - 60 days (basal cells turn into bipolar) (only neurons in adult humans that can be regenerated)

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13
Q

What is the largest cranial nerve?

A

Trigeminal nerve (CN V) (mixed nerve)

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14
Q

What divisions of the trigeminal are afferent only?

A

V1 and V2

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15
Q

What division of the trigeminal nerve is both afferent and efferent?

A

V3

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16
Q

What are the 4 nuclei (and 2 roots)?

A
  • Sensory roots: to mesencephalic nucleus, principal (pontine) nucleus, spinal nucleus
  • Motor root: from motor nucleus
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17
Q

Nerves crrying what senses terminate on what nucleus?

A

Mesencephalic

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18
Q

What fibres terminate on the principal or pontine nucleus?

A

Touch and pressure

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19
Q

What fibres terminate on the spinal nucleus?

A

Pain and temperature

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20
Q

Where do the sensory and motor roots of CNV emerge

A

Mid-pons and run towards the trigeminal ganglion

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21
Q

What do the 3 divisions of the trigeminal nerve emerge from?

A

Trigeminal ganglion

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22
Q

What type of fibres does the opthalmic nerve carry?

A
  • Sensory

- Sympathetic fibres from the carotid plexus are carried along with it

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23
Q

What branch does the opthalmic nerve give off near the trigeminal ganglion that supplies the dura?

A

Meningeal branch

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24
Q

What are the 3 main branches of the opthalmic nerve?

A
  • Lacrimal
  • Frontal
  • Nasociliary
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25
Q

What does the lacrimal nerve supply?

A

General sensation to the lacrimal gland, conjunctiva and upper eyelid in vicinity of Lacrimal gland

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26
Q

What does the opthalmic nerve also carry?

A

Parasympathetic fibres of fascial nerve to the lacrimal glans

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27
Q

What does the frontal nerve supply?

A

Largest branch of opthalmic

- Supplies upper eyelid and conjunctiva, frontal sinus and the scalp as far back as vertex

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28
Q

What does the frontal nerve divide into?

A

Supra-orbital and supra-trochlear nerves

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29
Q

What are the branches of the nasociliary nerve?

A
  • Long ciliary nerves
  • Ant and post ethmoidal
  • Infratrochlear nerve
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30
Q

What does the nasociliary nerve supply sensation to?

A
  • Cornea of the eye -> Afferent limb of cornea reflex

- Tip of the nose (shingles can spread from here to cornea)

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31
Q

What kind of fibres are carried by the maxillary nerve (V2)?

A

Sensory

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32
Q

The maxillary nerve sends zygomatic and infra-orbital branches via what fissure?

A

Inferior orbital fissure

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33
Q

What does the infra-orbital nerve exit the orbit via?

A

Infra-orbital canal -> infra-orbital foramen

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34
Q

What branches of the maxillary nerve go to the palate and upper teeth?

A

Palatine and superior alveolar branches

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35
Q

What does the maxillary nerve supply sensation to?

A
  • Lateral forehead
  • zygomatic region
  • Lower lid
  • Side of nose
  • Cheek (anteriorly)
  • Upper lip
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36
Q

What fibres are contained in the mandibular nerve?

A

Sensory and motor

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37
Q

What are the branches given off by the mandibular nerve?

A
  • AUriculotemporal
  • Buccal
  • Lingual
  • Inferior alveolar branches
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38
Q

What does the mandibular nerve supply sensory information to?

A
  • Skin of auricle and temple
  • Cheek, posteriorly
  • LOwer lip and chin
  • General sensation to the anterior 2/3 of the tongue, and the floor of the mouth
  • The lower gums and teeth
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39
Q

What is the skin over the angle of the mandible supplied by?

A

Cervical plexus

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40
Q

What does the mandibular nerve supply motor information to?

A

Muscles of mastication:

  • Lateral pterygoid
  • Medial pterygoid
  • Masseter
  • Temporalis
  • Tensor tympani
  • Tensor veli palatini
  • Mylohyoid
  • Anterior belly of digastric
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41
Q

What nerve is tested in the jaw jerk reflex?

A

Trigeminal

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42
Q

What kind of fibres are carried in the oculomotor nerve?

A

Somatomotor and visceromotor (parasympathetic)

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43
Q

Where is the oculomotor nucleus found?

A

Midbrain

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44
Q

What does the oculomotor nerve pass between?

A
  • Posterior cerebral and superior cerebellar arteries before lying close to posterior communicating arteries
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45
Q

What does the oculomotor nerve run anteriorly on?

A

Lateral wall of the cavernous sinus

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46
Q

What does the oculomotor nerve pass through to get to the orbit?

A

Superior orbital fissure

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47
Q

What does the oculomotor nerve divide into?

A

Superior and inferior divisions (rami)

48
Q

What is the name of the tendinous ring which the superior and inferior divisions of the oculomotor nerve pass through?

A

Tendinous ring of Zinn

49
Q

What does the superior branch of the oculomotor nerve supply motor nerves to?

A
  • Levator palpebrae superioris
  • Superior rectus
    Also contains branches from superior cervical ganglion
50
Q

What does the inferior branch of the oculomotor nerve supply?

A
  • Medial rectus muscle
  • Inferior rectus muscle
  • Inferior oblique
  • Ciliary ganglion
51
Q

What kind of muscle is the levator palperbrae superioris?

A

Mixed - smoot and striated fibres

- Innervated by both sympathetics and oculomotor

52
Q

What fibres are carried by the trochlear nerve?

A

Motor only

53
Q

Where is the trochlear nerve nucleus?

A

Midbrain

54
Q

Where does the trochlear nerve exit the brainstem from?

A

Posterior surface (only nerve that does this)

55
Q

Describe the pathway taken by the trochlear nerve?

A
  • Exits branistem from posterior surface
  • Runs anteriorly around cerebral peduncle and enters cavernous sinus
  • Runs anteriorly on lateral wall of cavernous sinus
  • Enters through superior orbital fissure
  • Enters orbit
  • Moves slightly medially
  • Supplies superior oblique
56
Q

What muscle does the trochlear nerve supply?

A

Superior oblique

57
Q

What does injury to the trochlear nerve result in?

A
  • Patient not being able to look medially and inferiorly

- Patient experiences diplopia (blurred/double vision) while walking downstairs or reading a book

58
Q

Why is the trochlear nerve long and thin?

A

Only supplies one muscle (superior oblique)

59
Q

What fibres are carried by the abducens nerve?

A

Motor

60
Q

Where is the abducens nerve nucleus?

A

Pons

61
Q

Where does the abducens nerve exit the brainstem?

A
  • Medially, anteriorly- between pons and medulla

- Bulbo-pontine groove

62
Q

What are the 3 nerves which are involved in eye movement?

A
  • Oculomotor
  • Trochlear
  • Abducens
63
Q

Describe the pathway of the abducens nerve?

A
  • Enters cavernous sinus (within)
  • Enter superior orbital fissure
  • In orbit supplies lateral rectus muscle
64
Q

What will injury to the abducens nerve result in?

A

Right abducens nerve will result in:

- Diplopia when looking right - the right eye would not abduct fully

65
Q

What kind of fibres are carried by the facial nerve?

A

Mixed - motor, sensory and parasympathetic fibres (one nucleus for each)

66
Q

Where are the nuclei for the facial nerve found?

A

Pons

67
Q

What are the divisions of the motor nucleus (nucleus solitarius) of the facial nerve?

A

Superior and inferior divisions which innervate the upper and lower facial muscles, respictively (upper third vs lower 2/3s)

68
Q

What is the superior division of the facial motor nucleus connected to?

A

Ipsilateral and contralteral motor cortices

69
Q

What is the inferior dividon of the facial motor nucleus connected to?

A

Contralateral cortex only

70
Q

Where does the motor root of the facial nerve emerge?

A

Angle between the lower pons and the cerebellum - cerebellopontine angle

71
Q

Where does the facial nerve enter the temporal bone and what accomponies it?

A

internal acoustic meatus, with VIII and labyrinthe artery

72
Q

How can an accoustic neuroma affect the facial nerve?

A
  • Benign tumour in VIII
  • Both VIII and VII pass through small acoustic meatus
  • Compresses facial nerve
73
Q

What is the labyrinthe artery a branch of?

A

Basillar or anterior inferior cerebellar

74
Q

What is at the bottom of the internal acoustic meatus?

A

Opening of the facial canal -facial nerve enters here

75
Q

What is the first bend of the facial canal called and what is contained in it?

A

Genu - Geniculate ganglion - sensory ganglion of facial nerve

76
Q

How mant bends are in the facial canal?

A

2
- Genu
-

77
Q

What nerves come off of the facial nerve in the facial canal?

A
  • Nerve to stapedius - dampens movement of stapius

- Chorda tympani

78
Q

Where does the facial nerve exit the temporal bone?

A

Stylomastoid foramen

79
Q

Delivery by forceps can cause an injury to what cranial nerve?

A

Facial

80
Q

The facial nerve sends branches to supply what muscles?

A

Occipitalis and auricular muscles

81
Q

Describe the facial nerve plexus?

A
  • Enters parotid gland and divides to form a plexus within (superficial to the external carotid artery and retromandibular vein)
82
Q

How many nerves branch off of the facial nerve to supply the muscles of facial expression, posterior belly of diagastric and stylohyoid?

A

5

83
Q

What are the 5 branches of the facial nerve?

A
  • Temporal - supplies frontalis and orbicularis oculi
  • Zygomatic - Orbicularis oculi (small part), upper lip muscles
  • Buccal - cheek lip muscles
  • Marginal mandibular - lower lip muscles,
  • Cervical - goes to platisma

Two Zebras Befriended My Cat

84
Q

Marginal mandibular branch located where?

A
  • Inferior to mandible
  • Overlies submandibular gland
  • Around lymph nodes - AT RISK DURING SURGERY, saliva can dribble as mouth cannot close fully
85
Q

What can facial nerve injury at cerebellopontine angle cause?

A
  • Balance and hearing problems
  • Ipsilateral facial muscle paralysis
  • Hyperacusis (pain on loud sounds)
  • Taste disturbances
  • Reduced lacrimal secretion
86
Q

What can facial nerve injury within the petrous temporal bone, depending on exact location cause?

A
  • Redued lacrimal secretion
  • Hyperacusis (pain on loud sounds)
  • Taste disturbances
  • Ipsilateral facial muscle paralysis
87
Q

What can facial nerve injury distal to the stylomastoid foramen cause?

A
  • Ipsilateral facial msucle paralysis

- Dry eye, drooling

88
Q

What is central facial palsy?

A
  • Upper motor neuron lesion

- Can raise eyebrows, cannot blow cheeks

89
Q

What is peripheral facial palsy?

A
  • Lower motor neuron lesion

- Cannot raise eyebrows or blow cheeks

90
Q

What is the cornea reflex?

A
  • When you touch the cornea you close your eyes
  • Afferent limb is trigeminal nerve (nasociliary branch)
  • Efferent limb is facial nerve
91
Q

Where is the nuclei of the glossopharyngeal nerve?

A

Medulla

92
Q

What kind of fibres are located in CN IX?

A

Mixed - motor + sensory

93
Q

What is the motor nucleus of the glossopharyngeal nerve?

A

Nucleus ambiguus (shared with 10, 11)

94
Q

What os the sensory nucleus of the glossopharyngeal nerve?

A

Nucleus solitarius (shared with 7, 10)

95
Q

Where does the tympanic branch of the Glossopharyngeal nerve go to?

A
  • Middle ear
  • Tympanic membrane
  • mastoid air cells
96
Q

What does the glossopharyngeal nerve receive sensation from?

A
  • General sensation from middle ear, oropharynx, palatine tonsil, inferior aspect of soft palate, posterior 1/3 tongue
  • General visceral sensation from carotid sinus and carotid body
  • Special visceral sensation (taste) from posterior 1/3 tongue
97
Q

What does CN IX provide motor supply to?

A

Stylopharyngeal muscle

98
Q

Where are the vagus nuclei located?

A

Medulla

99
Q

What is the motor nucleus of the vagus called?

A

Nucleus ambiguus

100
Q

What is the sensory nucleus of the vagus called?

A

Nucleus solitarius

101
Q

What does the vagus pass through after leaving the brainstem?

A

Jugular foramen (with IX and XI)

102
Q

Where does the vagus receive general somatic sensation from?

A
  • Deep auricle

- Parts of the external acoustic meatus

103
Q

Where does the vagus receive general visceral sensation from?

A

Laryngopharynx and larynx

104
Q

Where does the vagus supply motor fibres to?

A

Striated muscles of the pharynx and larynx

105
Q

Describe the gag reflex?

A

when root of tongue or posterior wall of oropharynx is touched - gag is stimulated

  • Afferent limb - glossopharyngeal nerve
  • Efferent limb is vagus
  • Both nuclei are in medulla
  • Defect in CN IX or X will affect swallowing and/or gag reflex
106
Q

What kind of fibres are located within the accessory nerve?

A

Motor

107
Q

What are the 2 roots of the accessory nerve?

A
  • Spinal root: from C1-5

- Cranial root: from nuc ambiguus

108
Q

What does the accessory nerve enter the cranial cavity via?

A

Foramen magnum - joins with cranial root

109
Q

What do both the spinal and cranial root exit the skull via?

A

Jugular formane as accessory nerve

110
Q

Where does the accessory nerve cross?

A

The post. triangle in the investing layer of fascia, surrounded by lymph nodes

111
Q

What does the spinal accessory supply?

A

Trapezius and sternoccleidomastoid

112
Q

What is the nucleus of the hypoglossal nerve?

A

Hypoglossal nucleus in medulla

113
Q

Where does the hypoglossal nerve exit the brainstem?

A

Anterior to olive

114
Q

Where does the the hypoglossal nerve emerge from?

A

Hypoglossal (anterior condylar) canal

115
Q

How does the hypoglossal nerve descend the neck?

A

Passes lateral to both the internal and external carotid arteries snd associated with a loop of Cx nerves that supply the strap muscles of the neck

116
Q

Where does the hypoglossal nerve enter the oral cavity?

A

Under the tongue between mylohyoid and hypoglossus to supply all the tongue muscles except palatoglossus

117
Q

If hypoglossal nerve is injured what is the result?

A

Ipsilateral tongue weakness, therefore the tongue deviates to the side of the lesion

MD4001 Anatomy (7 decks)

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