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SP Anatomy exam 3 > Cranial Nerves V, VII > Flashcards

Cranial Nerves V, VII Flashcards

1
Q

CBO of Facial SVE

A

Pharyngeal Arch II

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2
Q

Function of Facial SVE

A

Muscles of facial expression

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3
Q

CBO of Facial GVE

A

Superior Salivatory Nucleus

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4
Q

Termination of Facial GVE

A

(Parasympathetic) Submandibular and Pterygopalatine ganglia

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5
Q

Facial GSA innervation

A

Skin of ear

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6
Q

CBO and Destination of Facial GSA

A

Geniculate ganglion -> Trigeminal spinal nucleus

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7
Q

Facial SVA innervation

A

Anterior 2/3 of tongue

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8
Q

CBO and Destination of Facial SVA

A

Geniculate ganglion -> Solitary nucleus

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9
Q

Facial GVA innervation

A

Palatine tonsil & posterior nasal cavity

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10
Q

Fibers of VII make up ____ roots

A

2

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11
Q

Facial nerve proper consists of ____ fibers

A

SVE

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12
Q

_______ __________ of VII contains GVE and sensory fibers

A

Nervus intermedius

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13
Q

Fibers of VII exit the skull through the ___________ ________

A

Stylomastoid foramen

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14
Q

Facial n. passes through the ________ ______ where a plexus is formed

A

Parotid Gland

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15
Q

Superior salivatory nucleus -> _______ ________ n. -> Pterygopalatine ganglion

A

Greater Petrosal n.

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16
Q

Superior salivatory nucleus -> ________ ________ n. -> Submandibular ganglion

A

Chorda Tympani n.

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17
Q

Action of Facial SVE

A

Muscles of facial expression - Closes eye; closes lips

Stapedius m. - modulates sound volume

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18
Q

Action of Facial GVE

A

Salivation and Lacrimation

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19
Q

Bell’s Palsy def and symptoms

A

Facial n. lesion

  • Irritation of cornea
  • Paresis of facial mm. above and below the eye
  • Hyperacusis - increased sensitivity to noise
  • Reduced lacrimation & salivation
  • Numbness or pain of the ear, tongue, or face
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20
Q

Facial n. Paralysis

A

Complete over half the face

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21
Q

Which Facial n. component passes through the facial canal?

A

Both Facial n. proper and and Nervus intermedius

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22
Q

After coursing through the facial canal the facial n. turns to form the ________ _____

A

external genu

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23
Q

What is found at the external genu?

A

The geniculate ganglion

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24
Q

Intermediate nerve fibers and some fibers of the facial n. exit before reaching the ________ ________

A

Stylomastoid Foramen

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25
Q

Which branches of Facial n. exit prior to the Stylomastoid foramen?

A

Stapedial n., Branch to pterygopalatine ganglion, Chorda tympani n.

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26
Q

Crocodile tears

A

Unilateral tearing seen in anticipation of, and during meals

  • History of Bell’s Palsy
  • Parasympathetic fibers to submandibular ganglion have been re-routed to pterygopalatine ganglion
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27
Q

Supranuclear lesion (above nucleus)

A
  • Paralysis (paresis of muscles of facial expression below level of the eye
  • Paralysis is located on the side opposite the lesion
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28
Q

Hyperalgesia

A

noxious stimulus that evokes pain sensation greater than normal

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29
Q

Allodynia

A

non-noxious stimulus that evokes pain sensation

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30
Q

Inflammatory pain

A
  • caused by tissue damage
  • produces hypersensitivity at site and in adjacent normal tissue
  • resolves when disease is controlled
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31
Q

Neuropathic pain

A
  • Caused by nervous system lesion independent of peripheral pathology
  • Pain persists long after initiating event has healed
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32
Q

Peripheral Sensitization

A
  • Stimulation of afferent ending (“activation”)

- Repeated stimulation produces “autosensitization” (hyperalgesia)

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33
Q

Sensitizing agents

A

Bradykinin, Norepinephrine, Prostaglandins, Serotonin

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34
Q

True or False: Peripheral sensitization is non-reversible

A

False: Quickly reversible

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35
Q

Central Sensitization

A

Intense and prolonged stimulation of nociceptive fibers

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36
Q

Central Sensitization can result in:

A

Modification of peripheral receptor due to:

  • Increased gene expression resulting in
    1. Enhanced receptor sensitivity
    2. Increased number of receptor sites
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37
Q

Central Sensitization - Wind-up location

A

Posterior horn/trigeminal spinal nucleus

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38
Q

Enhanced activity of C (pain) fibers results in:

A
  1. Increased sensitivity of glutamate receptors

2. Suppressed activity of inhibitory interneurons

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39
Q

Microglia morphological states

A

Surveillance State (resting)
- Ramified configuration with small (micro) central region and long narrow processes
Enhanced Response State (activated)
- Enlarged, amoeboid configuration

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40
Q

Microglia are physically active with ____ and _____ _________ elements

A

Pre and Post synaptic

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41
Q

Astrocytes in Active State

A

Normal

  • Astrocytes interact between neuron and nearby vascular supply
  • They recycle neurotransmitters including glutamate (glutamate - glutamine shuttle)
42
Q

Astrocytes in Reactive State

A

During a state of Pain hypersensitivity

  • Release factors that
    1. enhance synaptic activity
    2. promote microglia into “Enhanced Response State”
43
Q

In response to peripheral inflammatory situation astrocytes:

A

Promote microglia toward Enhanced Response State

44
Q

ATP is one of several _________ factors

A

Promotor

45
Q

Microglia release ___________ __________ which activate neurons within the spinal cord dorsal horn / trigeminal spinal nucleus

A

Inflammatory Cytokines

46
Q

If peripheral inflammatory situation resolves:

A

Microglia Enhanced Response State returns to its resting state

47
Q

Chronic Neuropathic Pain

A

Due to long-term change in central nervous system structure

48
Q

In Chronic Neuropathic Pain, Microglia:

A

remain in Enhanced Response State that continue to release inflammatory cytokines

49
Q

In Chronic Neuropathic Pain, Astrocytes:

A

continue to promote activation of microglia in part through positive feedback from microglia

50
Q

Three Divisions of Trigeminal Nerve (CN V) and their innervations

A 
Ophthalmic division (V1)
- Upper face
- Sensory only
Maxillary division (V2)
- Middle face
-Sensory only
Mandibular division (V3)
- Lower face
- Sensory and motor
51
Q

Borders between skin areas served by each division are

A

Sharp (unlike overlap of afferent spinal nerves)

52
Q

about 2/3 of fibers in CN V are

A

C Fibers

53
Q

CBO of Trigeminal SVE

A

trigeminal motor nucleus

54
Q

Course of Trigeminal SVE

A

mandibular division (V3)

55
Q

Termination and Action of Trigeminal SVE

A

Voluntary control of striated muscles (Arch I)

- terminate in muscles of mastication

56
Q

Trigeminal Motor Nuclei location

A

Dorsolateral Pontine Tegmentum

57
Q

Supratrigeminal nucleus is part of ____ and responsible for ______

A

the immediately adjacent reticular formation; responsible for rhythmic actions of the motor neurons

58
Q

CN V motor root

A

Fibers exit through the pons as the smaller motor root. Larger sensory root accompanies it

59
Q

Jaw closing muscles include

A

Temporalis and Masseter muscles

60
Q

Jaw opening muscles include

A

digastric and infrahyoid muscles

61
Q

Jaw opening strength is _______ to determine than jaw closing strength

A

Easier

62
Q

Trigeminal GSAp

A
  • Serves neuromuscular spindles of mastication muscles

- Pressure/tension receptors in periodontal ligaments

63
Q

CBO of Trigeminal GSAp

A

Unipolar cell bodies, Trigeminal mesencephalic nucleus

64
Q

Trigeminal GSAp project to:

A

Trigeminal motor nucleus, Suprageminal nucleus

65
Q

What nerve controls distance between mandible and maxilla?

A

Trigeminal GSAp

66
Q

The trigeminal mesencephalic nucleus is found:

A

in the rostral pons and mesencephalon adjacent to the ventricle

67
Q

The trigeminal mesencephalic nucleus consists of ________ cells of _______ _____ origin

A

Unipolar; Neural Crest

68
Q

The nerve CB of the trigeminal mesencephalic nucleus are

A

are scattered on either side of the trigeminal mesencephalic tract located medially

69
Q

Lower motor neuron lesion _______ jaw-jerk reflex

A

Attenuates

70
Q

Upper motor neuron lesion ________ jaw-jerk reflex

A

May accentuate

71
Q

Trigeminal GSAe

A

Skin of face, oronasal mucous membranes, teeth, dura mater

72
Q

Trigeminal Spinal Nucleus subnuclei

A

Rostral -> Caudal

Pars oralis, Pars interpolaris, Pars caudalis

73
Q

Trigeminal GSAe sensations

A

Pain, Crude touch, temperature

74
Q

In Tooth pulp, 70-80% of fibers are:

A

A-delta and C fibers

75
Q

In Tooth pulp, 10-30% of fibers are:

A

A-beta fibers

76
Q

Tooth pulp fibers project to:

A 
Trigeminal principal sensory nucleus (heaviest)
- shared with pars oralis
Trigeminal Spinal Nucleus
- Pars oralis (heaviest - shared)
- Pars interpolaris (modest)
- Pars caudalis (light)
Upper Cervical Spinal Cord
77
Q

The Pars Oralis receives input from

A

Intraoral and perioral structures

78
Q

The Interpolaris proper is responsible for

A

Activation of trigemino-autonomic reflexes

79
Q

The Caudalis-Interpolaris transition zone

A
  1. Not somatotopically organized
  2. Responds to pain stimuli from many areas served by the CN V
  3. May be involved in activation of pain suppression mechanisms
80
Q

The Pars Caudalis is located in

A

Medullary Posterior Horn (MPH)

81
Q

Somatotopic Organization of Pars Caudalis

A
  • Inverted representation of face

- Onion peel - rostral (oral) to caudal (peripheral face) organization

82
Q

Pars Caudalis contains primarily

A

Pain fibers

83
Q

The Substantia gelatinosa of the Pars Caudalis

A
  • Contains excitatory and inhibitory interneurons

- Receives raphe spinal tract fibers (serotonin)

84
Q

The Pars Caudalis receives afferents from Cranial nn.

A

VII, IX, X

all from Ear

85
Q

The Pars Caudalis is a target of

A
  1. A-delta and C fibers
  2. Fibers from superficial structures including oral cavity and TMJ
    - convergence may be basis of referred pain
86
Q

Estrogen Receptors are present in the:

A

Trigeminal spinal nucleus, Parabrachial nucleus, Periaqueductal gray, Hypothalamus

87
Q

High estrogen levels and stress increase activity in __________________ in response to pain

A

Trigeminal spinal nucleus caudalis laminae

88
Q

GABA normally _________ pain-induced activity in trigeminal spinal nucleus caudalis

A

dampens

89
Q

GABAergic activity is __________ by high estrogen levels

A

suppressed

90
Q

Trigeminocardiac Reflex stimulation

A
  1. Eye and Periocular structures (oculo-cardiac reflex)
  2. Nasal Mucosa
  3. Face (Diving Reflex)
  4. Needle insertion into trigeminal nerve
  5. Temporomandibular joint surgery
  6. Traction on trigeminal nerve during neurosurgery
91
Q

Trigeminocardiac Reflex results in:

A
  1. Bradycardia (increased vagal tone)
    - Solitary nucleus, nucleus ambiguus
  2. Apnea
  3. Arterial hypotension
  4. Gastric hypermobility (fullness, nausea, vomiting)
92
Q

Trigeminal Neuralgia

A 
Excruciating, lancing pain
- usually unilateral
Affects V3 70%, V1 < 5%
Other considerations:
- Trigger point
- Onset in middle age
- Often responds to drug therapy
- Microvascular decompression may be effective
93
Q

Trigeminal Principal Sensory (chief or pontine) Nucleus

A

Homologous with the posterior column nuclei

  • two point discrimination
  • vibratory sense
94
Q

Ascending Trigeminal Pathways termination

A

ventral posteriomedial nucleus of the thalamus (VPM)

95
Q

The Ventral Trigeminothalamic tract projects

A

contralaterally to VPM

96
Q

The Dorsal trigeminothalamic tract projects

A

bilaterally to VPM

97
Q

Both Ascending Trigeminal Pathways give off fibers to

A

nearby reticular formation

98
Q

Corneal reflex

A

Stimulates cornea via Trigeminal nerve

99
Q

Corneal reflex trigeminal nerve projects to

A

Trigeminal principal nucleus
Trigeminal spinal nucleus
- Relays bilaterally to facial nucleus

100
Q

In Corneal reflex, which nerve closes eye?

A

Facial n.

101
Q

Direct Corneal reflex

A

Stimulates cornea and ipsilateral eye closes

102
Q

Consensual Corneal reflex

A

Stimates cornea and contralateral eye closes

SP Anatomy exam 3 (1 decks)

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