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neuro lectures > cranial nerves VII- XII > Flashcards

cranial nerves VII- XII Flashcards

1
Q

what is CNVII

A

facial

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2
Q

which fibres in facial nerve

A

sensory motor and parasympathetic

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3
Q

where is nucleus of facial nerve

A

in the tegmentum of the pons

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4
Q

where is facial nerve

A

attached to brain stem at the pontomedullary junction

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5
Q

somatic motor function of facial nerve

A

muscle of facial expression

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6
Q

visceral motor function of facial nerve

A

lacrimal glands (tears), submandibular & sublingual salivary glands

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7
Q

function of facial nerve

A

role of upper and lower motor neurones in the control of facial muscles

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8
Q

what causes facial weakness

A

differentiation between upper and lower motor neurone

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9
Q

what are the 2 roots of the facial nerve

A

medial - motor fibres
lateral - sensory and parasympathetic fibres (the nervus intermedius )

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10
Q

course of facial nerve

A

complex course through the temporal bone

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11
Q

special sensation of facial nerve

A

taste buds of the anterior 2/3rds of the tongue

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12
Q

fibre types in facial nerve

A

special sensory - taste anterior 2/3 tongue

motor - muscles of facial expression

parasympathetic- lacrimal glad, submandibular and sublingual salivary glands

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13
Q

how many branches of facial nerve

A

within the parotid, the terminal part of the facial nerve divides into 5 branches

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14
Q

how to test special sensory facial nerve

A

ask about taste, test taste sensation , anterior 2/3 tongue

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15
Q

what is the course of facial nerve closely related to

A

the middle ear

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16
Q

how does the facial nerve exit the skull

A

via the internal acoustic meatus

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17
Q

how to test lacrimation

A

is the eye dry

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18
Q

what do corticobulbar fibres of the facial nerve provide

A

*Contralateral innervation of the lower face
* Bilateral innervation of the upper face

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19
Q

how to test motor function of facial nerve

A

observe the face at rest - weakness, asymmetry, sagging

look for flattening of the nasolabial folds and drooping of the lower
eyelids

test the muscles and 5 branches
ask patient to:
frown and raise eyebrows
screw up eyes tightly
puff out cheeks
smile

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20
Q

how to test sensory function of facial nerve

A

touch the lateral aspect of the tongue with a cocktail stick
(dipped in sugar, salt, or vinegar)
and ask the patient to identify the taste

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21
Q

what is facial weakness a sign of

A

that someone’s had a stroke

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22
Q

what does injury of the facial nerve lead to

A

facial weakness

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23
Q

what is bell’s palsy

A

an idiopathic condition - unknown cause

inflammation of the facial nerve

thought to be related to viral infection

will see dribbling out the side of mouth

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24
Q

what is the most common lesion of the facial nerve

A

bells palsy

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25
what problems are caused by injury to facial nerve (5)
- bell’s palsy - inflammation or tumour of parotid gland - tumours - middle ear infection - fractures of the temporal lobe
26
describe motor cortex
part of it is dedicated to the upper face part of it is dedicated to the lower face the cell bodies of UMNS reside in the motor cortex their axons travel to the facial motor nuclei in the pons
27
upper and lower motor neurones
the upper axons synapse with cell bodies of the lower neurones in the facial motor nuclei (pons) axons of the umns for the upper and lower face cross the midline and synapse with the contra lateral fasciae motor nucleus the facial motor nucleus also receives input from the ipsilateral motor cortex which controls the upper face
28
what is CNVIII
vestibulocochlear
29
is vestibulocochlear sensory or motor
sensory
30
function of vestibulocochlear nerve
conducts auditory and vestibular-related impulses from the organ of corti (sound), semicircular canals, the utricle & the saccule (vestibular)
31
how does vestibulocochlear nerve exit the skill
via the internal acoustic meatus
32
how to test vestibulocochlear cochlear component
- crude testing - covering each ear and whispering into the opposite one - rinne and webers tests - audiometry (specialist equipment)
33
how to test vestibulocochlear nerve vestibular component
- observe patients balance, gait - caloric testing
34
what is a sign of vestibular disfunction
Nystagmus ( rapid involuntary abnormal eye movements)
35
what are the 2 causes of deafness
1. sound not getting to ear- (conductive deafness) 2. problems with the nerves/organ of corti - (neurological deafness)
36
effects of damage to vestibulocochlear nerve
* Deafness * Dizziness * Nausea * Loss of balance * Nystagmus
37
causes of damage to vestibulocochlear nerve
* The vestibulocochlear nerve runs very close to the bone * Is also very affected by surrounding tumours - if a tumour arises in the internal acoustic meatus then this will press on the vestibulocochlear & facial nerve * Skull fracture * Toxic drug effects * Ear infections
38
what is acoustic neuroma
tumour of vestibulocochlear nerve benign compresses the nerve progresses to compress the facial nerve as they run together
39
what is CN IX
glossopharyngeal
40
which fibres in glossopharyngeal
sensory motor and parasympathetic but motor is very minor
41
how does glossopharyngeal exit the skull
via the jugular foramen along with the vagus & accessory
42
where is glossopharyngeal
attached to the medulla via several small rootlets
43
motor function of glossopharyngeal
* Elevates the pharynx (motor to stylopharyngeus - swallowing & gag reflex) * Secretion of PAROTID GLAND (salivary) - via parasympathetic innervation
44
sensory function of glossopharyngeal
* Sensation from the external ear * Posterior 1/3 rd of tongue - touch, pain & temperature * Pharynx - touch, pain & temperature * Eustachian tube - touch, pain & temperature * Carotid sinus & body - baro & chemoreception
45
what is CN X
vagus nerve
46
which fibres in vagus
sensory, motor and parasympathetic
47
where is vagus
attached to medulla via several small rootlets between the pyramid & inferior cerebellar peduncle
48
how does vagus nerve exit the skull
via the jugular foramen
49
functions of vagus nerve
* Taste - via posterior pharynx * Swallowing - muscles of the pharynx & larynx ( EXCEPT the stylopharyngeus (CN 9) * Cardiovascular & GI regulation * Sensation of hunger * Sensation of fullness * Sensation to external ear
50
impact of vagus nerve on heart rate and blood pressure
causes a decreased heart rate & blood pressure when stimulated
51
how to examine glossopharyngeal and vagus nerves (3)
1. Observe quality of patients voice 2. Ask patient to say “Ah” and observe the elevation of the palate 3. Absence of the gag reflex suggests a lesion in the glossopharyngeal or vagus nerves
52
what is hoarseness of voice a sign of
vocal cord paralysis - caused by compression or damage of the RECURRENT LARYNGEAL NERVE (vagus derivative) which supplies all the intrinsic muscles of the larynx (except the cricothyroid muscle)
53
what is nasal voice a sign of
paralysis of the palate
54
how to identify bilateral lesions of the vagus nerve
palate fails to rise
55
how to identify unilateral paralysis of the vagus nerve
both the palate and uvula deviate to the normal side AWAY from the lesion
56
what is CN XI
accessory
57
which fibres in accessory nerve
motor
58
what does accessory nerve supply
the sternocleidomastoid & trapezius muscles
59
where are cell bodies of accessory nerve
in the ventral horn of the upper 5 segments of the spinal cord
60
course of accessory nerve
sends fibres through the foramen magnum which then exits the skull via the jugular foramen with vagus & glossopharyngeal
61
what does accessory nerve run in close proximity to
the internal jugular vein (which also exits the jugular foramen)
62
what does injury to accessory nerve result in
paralysis of the sternocleidomastoid and trapezius muscles on the same side as the lesion
63
cranial part of accessory nerve
rootlets arise from the medulla leaves via the jugular foremen by joining the vagus
64
spinal part of accessory nerve
from ventral horn spinal cord C1-C5 travels up through the foremen magnum leaves again through the jugular foremen innervates sternocleidomastoid and trapezius
65
how to test sternocleidomastoid of accessory nerve
ask patient to turn head against resistance - paralysis is present is there is difficulty rotation head to the side opposite to the lesion
66
how to test trapezius
ask patient to shrug the shoulders against resistance - paralysis is present if there is an inability to shrug
67
what is CN XII
hypoglossoal
68
describe hypoglossal nerve
motor nerve > muscles of the tongue arises from the medulla, leaves through the hypoglossal canal
69
is hypoglossal sensory or motor
motor
70
what does hypoglossal nerve supply
the extrinsic & intrinsic muscles of the tongue
71
where are cell bodies of hypoglossal nerve
in the hypoglossal nucleus which lies between the dorsal motor nucleus of the vagus and the midline of the MEDULLA
72
how does hypoglossol nerve exit the skull
through the hypoglossal cana
73
function of hypoglossol nerve
tongue movements in speech, food manipulation and swallowing
74
how to test hypoglossol nerve
* Ask patient to protrude the tongue * Atrophy & fibrillations (rapid uncontrolled contraction of muscle) are the tell-tale signs of LOWER MOTOR LESION - which results in the tongue deviation TOWARDS the lesion
75
what does damage to hypoglossol nerve cause
paralysis of the IPSILATERAL half of the tongue - licks the lesion (tongue movement towards lesion)
76
what is the motor supply to the posterior 1/3 of tongue
hypoglossol, except palatoglossus pharyngeal branch of vagus
77
what supplies sensory and taste. to posterior 1/3 of tongue
glossopharyngeal
78
what is sensory supply to anterior 2/3 of tongue
lingual branch of V3 from trigeminal
79
what supplies taste to anterior 2/3 of tongue
chorda tympani branch of facial nerve carried by lingual branch

neuro lectures (15 decks)

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