Exam 1 Flashcards
1
Q
How many nerve pairs for cranial nerves?
Spinal nerve?
A
12
31
2
Q
What are cranial nerves attached to?
Spinal nerves?
A
Directly to brain
Spinal cord by ventral and dorsal rootlets
3
Q
Preganglionic short, release ACTH
Postganglionig, long, norepheniphrine
A
Sympathetic Division
4
Q
Preganglionic long, ACTH
Postgang short, Acth
A
Parasympathetic
5
Q
Olfactory nerve has fibers in olfactory mucosa that traverse to ___ and synapse on the ____
A
Cribriform plate
Olfactory bulb
6
Q
CN 2 has fibers from the retina that converts on _____ and are carried in optic nerve, chiasma, and tract, to the _____
A
Optic disc,
lateral geniculate bodies
7
Q
Describe CN 3
How many somatic and visceral muscles does it supply?
A
Motor; somatic, and parasympathetic
5 somatic muscles and 2 visceral
8
Q
Describe CN 4 and which muscle does it supply?
Action?
A
Somatic motor
Supplies superior oblique
Depress and abduct cornea, intorsion
9
Q
Describe CN 5.
A
Mixed; somatic motor and sensory
Great sensory nerve of face
Largest
Motor supply to mastication muscles
10
Q
Describe CN 6
Supplies what muscle and action?
A
Somatic motor
Lateral rectus
abducts cornea
11
Q
Describe the CN 7
From where does it carry taste info?
What muscles does it supply?
Glands?
A
Mixed. motor, somatic and parasympathetic: sensory; somatic and special
Facial expression nerve
anterior 2/3 of tongue
Facial expression ones including stylohyoid and stapedius
lacrimal and salivary
12
Q
What is the A.O. of CN 8?
Describe CN 8
A
Cerebellopontine recess
Special sensory
Sensory info from cochlea and vestibule
13
Q
Describe CN 9
From where does it carry taste info?
Which muscles supply?
Which gland?
A
Mixed; motor; somatic and parasympathetic: sensory; somatic and special
posterior 1/3 of tongue
somatic muscles inc. stylopharyngeus
parasympathetic supply parotid gland
14
Q
Descibe CN 10
Unique how?
Somatic motor supply to where?
Parasymptathetic supply to where?
A
Mixed; motor; somatic and parasympathetic: sensory; somatic
longest of cranial nerves
Pharyngeal constrictors
Bronchi, heart, GI tract from esophagus to distal 1/3 transverse colon
15
Q
Describe CN 11
What does it supply?
A
Motor
Supplies somatic muscles of pharynx, larynx, palate, trap, SCM
16
Q
Describe CN 12
What does it supply?
A
Motor
Supplies intrinsic and extrinsic muscles of the tongue
17
Q
Where is the skull opening for CN 1?
A
Cribriform plate of the ethmoid bone
18
Q
Where is the skull opening of CN 2?
3 and 4 and 6
A
Optic canal
Superior orbital fissure
19
Q
Where do the three branches of CN 5 exit the skull?
A
V1 Superior orbital fissure
V2 Foramen rotundum
V3 Foramen Ovale
20
Q
Were is the skull opening for cranial nerve 7 and 8?
A
Internal acoustic meatus
21
Q
Where is the skull opening for cranial nerves 9, 10, and 11?
A
Jugular foramen
22
Q
Where is the skull opening for cranial nerve 12?
A
Hypoglossal canal
23
Q
What are the two types of neurons in the somatic motor pathway?
A
Upper motor neurons and Lower motor neurons
24
Q
Describe the pathway for Upper Motor Neurons
A
Descends through corona radiata, internal capsule, crus cerebra,
most cross in pyramids and descend in lateral cortospinal tract
synapse in anterior horn (rexed lamina VII) of gray matter
25
Describe pathway for lower motor neurons
Exit cord via ventral rootlets
carried in named nerves to supply skeletal somatic muscles
26
Describe the three types of neurons in the somatic sensory pathway
Primary (1st order) - bodies located in DRG. Info from receptor to CNS synapse in cord and travel to synapse again in MO
Secondary - Decussate and bring info to thalamus
Tertiary - relay info to cerebral cortex (post central gyrus) where info is integrated
27
CN 1 types of neurons and their locations
Olfactory neurons - Olefactory epithelium in upper nasal cavity
Mitral cells - cell bodies in olfactory bulb
28
Describe olfactory neurons
What supports them?
Their axons collect (10-20) to form fila olfactoria which brings info to bulbs.
Olefactory hair cells support by functioning as receptors.
Unmylenited but covered by Schwann cells
29
Describe Mitral cells
Relay information posterior via olfactory tract. They split at the anterior perforated substance into:
Media stria -
Lateral stria
30
Where are primary sensory neurons in CN 1 found?
What are they supported by?
What do the primary neuron axons form together?
Are they mylenated?
Where do they pass through and then enter to synapsing with what?
Olfactory epithelium upper nasal cavity
Hair cells
Fila Olfactoria
No, but covered in by Schwann cells
Cribriform plate, olfactory bulb to synapse on dendrites of mitral cells.
31
Where are CN 1 secondary neurons located?
Relay info posteror via what?
At anterior perforated substance the fibers split into what two things?
Mitral cell bodies found in olfactory bulb
Olfactory tract
Medial and Lateral Stria
32
Medial stria fibers cross the midline via what?
Traveling to where?
Anterior Commissure
The Opposite olfactory bulb
33
Lateral stria fibers carry info to which three places?
Primary olfactory cortex; perimygdaloid and prepiriform area, including uncut (BM 34)
All of this is medial aspect of temporal lobe
34
Lok at note after this point in blue...
end of first page of unit 2
35
What are three clinical considerations for CN 1 Problems and how to test/identify?
Loss of smell - Cover one nostril and test both side (rare)
Skull fractures way to loose smell
CSF leakage - fluid clear
36
What are the three major layers of the eyeball?
Fibrous tunic
Vascular tunic
Retina
37
What is the fibrous tunic made up of?
Sclera - white part
Cornea - primar refactory part of eye
38
What is the Vascular tunic made of?
Ciliary bond
Iris
Chorid - blue thin layer
39
Describe the first 5 layers of the retina. (ten total)
Pigmented layer adjacent to choroid - cementing layer
Photosensitive outer of rods and cones
External limiting membrane
Outer nuclear layer - has rod and cone cell bodies
Outer plexiform layer - R and C synapse w bipolar cells here
40
Describe the second 5 layers of retina
Inner nuclear layer - bipolar cell bodies
Inner plexiform layer - bipolar cells synapse w ganglions
Ganglion cell layer - G cell bodies
Nerve fiber layer- ganglion cell axons. NOT myelinated
Internal limiting membrane - glial boundary from vitreous body
41
When depolarized photoreceptors relay info to bipolar cells by synapsing in outer plexiform layer, Bipolar cell bodies are found where?
Bipolar cells relay info to ganglion cells, the synapse occurs which layer?
Inner nuclear
Inner plexiform
42
Are optic nerve axons myelinated?
What cells form the myelin
Yes
Schwann
43
The optic tract travels around cerebral peduncles and fibers synapse in one of three nuclei of termination. They are?
(Most)Lateral geniculate body to cerebral cortex at BM 17
Superior colliculus to the tectospinal tract - SCM and Trap influenced
Pretectal nucleus of midbrain - light reflexes
44
Describe signs and symptoms of Lesion of optic nerve
Chiasma
Tract
One eye vision loss
Periph vision loss
Half field vision lost
45
What are four visual reflexes? (they are afferent only)
Direct and consensual light reflex (pupil constricts)
Accommodation reflex
Corneal reflex
Convergence (cross eye look close)
46
What muscles does CN 3 supply?
Which two types of fibers does it carry?
All extra ocular except SO and LR
Somatic and Parasymp
47
CN 3 nuclei of origin are somatic, located where?
Periaqueductal gray matter, anterior to cebral aqueduct, at the level of superior colliculi
48
What part of cerebral cortex sends axons TO the oculomotor nuclei?
Where else dos the nuclei receive fibers from?
BRDM 8
Superior colliculus and medial longitudinal fasciculus
49
CN 3 axons go anteriorly through Red nucleus and exit CNS in the ___. At this point the nerve becomes____
Interpeduncular fossa
Myelinated
50
CN 3 Nerves then penetrate the dura mater and exit through superior orbital fissure where it then splits into superior and inferior rami.
What muscles do each rami supply?
Superior Rami
Superior rectus
Levator Palp sup
Inferior ramus
medial rectus
Inferior rectus
Inferior oblique
51
Axons from the accessory oculomotor nucleus follow CN 3 and synapse where?
What type of fibers?
Ciliar ganglion
Pregang parasymp
52
Where is the ciliary ganglion located?
Posterior to eyeball about 1cm anterior to superior orbital fissure
53
Where do post gang parasymp axons go?
Supply what two things?
Follow course of ciliary arteries, pierce sclera and travel around its internal surface.
Ciaris
Papillary constrictor
54
What type of nerve is CN 4 and what does it supply?
Somatic Motor, SO
55
Where is the trochlear nucleus located?
What does it give rise to? What do they do?
In periaqueductal gray, caudal to oculomotor nuclei
Lower motor neurons that cross and exit midbrain inferior to inferior colliculi
56
What part of the cerebral cortex sends axons TO trochlear nucleus ?
Where else does nucleus receive fibers from?
BRDM 8
Superior colliculus and medial longitudinal fasciculus
57
What does CN 6 supply and what type of fibers is it?
Lateral Rectus
Somatic motor
58
Where is the abducens nucleus located at?
Its axons project where and exit CNS where?
Caudal part of the pons, floor of rhomboid fossa
Anteriorward and exit at inferior border of pons
59
The abducens nerve receives info from same parts of CNS as what other nerve?
Trochlear
60
Describe the three clinical considerations for CN 6
Strabismus - eyeballs point opposite. Internal or external
Diplopia - double vision. Subjective.
Ptosis - eylid droops cuz levator palp sup weakness. Oculomotor lesion cause maybe
61
Describe Oculomotor paralysis and what can happen
Potential causes
External ophthalmoplegia
ex strabismus eye down/out
Diplopia and Ptosis
Internal ophthalmoplegia no constrict pupil and loss of light and accommodation reflex.
Uncal herniation, PCA aneurysms or diabetes
62
Describe Trochlear and Abducens paralysis
Trochlear - rare, internal strabismus so can't look down. hard go downstairs
Abducens - most common, internal strabismus
63
What is damaged for internuclear ophthalmoplegia?
MLF - Medial Longitudinal Fasiculus
64
CHART ON PAGE 15
KNOW BOTH!
65
Describe CN 5
What are its three nuclei of termination?
Largest CN, Mixed, Great sensory nerve of the face
Main sensory, Spinal, Trigeminal mesencephalic
66
What is CN 5 nucleus of origin?
Which ganglion is associated with CN 5?
What are Cn 5 three branches?
Trigeminal motor nucleus
Trigeminal (semilunar) ganglion
Ophthalmic, maxillary, mandibular
67
Descibe Cn 5 sensory pathway to main and spinal nuclei
Name the analogous cord pathways
Cell bodies in trigeminal ganglion
Periph processes come from face to ganglion
Central process enter CNS and go to main trigeminal nucleus (touch, vibrate, joint proprioception) or spinal nucleus (pain and temp)
Lateral Spinothalmic Tract
68
Describe CN 5 sensory pathway to mesencephalic nucleus
Dendrites from periph go THROUGH trigeminal gang, enter CNS, ascend to mesencephalic nucleus
**Only sensory neurons that have cell bodies IN CNS***
69
CN 5 motor pathway
Axons from motor nucleus leave CNS to trigeminal ganglion to be carried in mandibular branch to supply mastication muscles
**ONLY mandibular branch motor***
70
Motor nucleus RECEIVES info from what 5 things?
Cerebral cortex
Reticular formation
Red nucleus
Tectum
MLF
Mesencephalic nucleus
71
Apparent origin of Trigeminal nerve?
Travels anterior-ward over pertrous part of temporal bone and enters ___ where the trigeminal ganglion is.
Lateral aspect of PONS
Trigeminal (Meckels) cave
72
Where does ophthalmic division of CN 5 enter orbit?
Where does it carry sensation from?
Superior orbital fissure
Skin over nose, forehead, and scalp.
Mucous membranes in frontal and sphenoid sinuses, membrane covering nasal septum.
73
What are the four branches of the Opthalmic division of trigeminal?
Meningeal nerve/tentorial branch
Lacrimal nerve
Frontal nerve
Nasociliary nerve
74
Describe the meningeal nerve/tentorial branch. What does it supply?
Comes off ophthalmic division before leaves skull. Supplies dura mater lining middle cranial fossa
75
Describe lacrimal nerve
Smallest branch of ophthalmic division.
Travels over lateral rectus, through lacrimal gland it supplies.
Carries some parasympathetic fibers to gland coming from pterygopalatine ganglion and reach lacrimal nerve by way of zygomatic and zygomaticotemporal
76
Describe Frontal nerve
Largest branch of opthalmic division.
Divides into
Supratrochlear nerve
sensation from medial eye corner
Supraorbital nerve
From conjunctiva, upper eyelid and forehead, also mucus membrane of frontal sinus
77
Describe the nasociliary branch of ophthalmic division trigeminal
Gives rise to three branches before dividing into two terminal branches
Ciliary ganglion communicating branch
Long ciliary nerve
Posterior ethmoid nerve - sphenoidal and ethmodial sinuses
Anterior ethmoid nerve - skin over nose and mucous over anterior nasal septum
Infratrochlear nerve - medial corner of eye and lacrimal sac
78
Where does the maxillary division of trigeminal enter the pterygopalatine fossa through?
Where does it carry sensation from?
Foramen Rotundum
Skin between eyes and mouth, over cheeks and temples. Also carries info from mucosa lining the maxillary sinuses, nasal conchae, palate and gingiva
79
Four branches of Maxillary division of trigeminal
Middle meningeal nerve
```
Zygomatic nerve
communicating branch
Zygomaticotemporal
zygomaticofacial
Infraorbital
superior alveolar nerve
```
Look at Kahle page 127
80
What does the infraorbital nerve give rise to? (three nerves)
Post. Middle. and Anterior.
superior alveolar nerves
81
The mandibular division of trigeminal exits vault through what?
Foramen ovale. Both sensory and motor roots.
82
Mandibular division carries sensation from?
Motor to what 8 muscles?
Skin over mandible, posterior cheek and temple. Mucosa of lower oral cavity and cheeks
Masseter, Temporalis, Med and Lat pterygoids, Tenor veli palatini, tensor tympani, mylohyoid, anterior digastric
83
What two branches of mandibular division are given off in the infra temporal fossa?
What happens next?
Recurrent meningeal branch (nervous spinosum) - info from middle cranial fossa dura, anterior cranial fossa, calvarium
Medial pterygoid nerve - motor to medial pterygoid, tensor veli palatine, tensor tympani
Divides into main motor anterior and main sensory posterior division
84
The anterior division of mandibular division gives rise to?
Masseter, Deep Temporal, Lateral Pterygoid, and Buccal nerves
85
Posterior division of Mandibular division gives rise to?
Auriculotemporal, Lingual, and Inferior alveolar nerve which has two branches
Incisive branch and mental nerve
86
Look over CN 5 Now
Fuck
87
Which two autonomic ganglia communicate with the mandibular division?
Submandibular and Otic ganglia
88
Clinical consideration for CN 5
Trigeminal Neuralgia - "worst pain imiganible, usualy unilateral. Throbbing, hot, maybe constant"
89
Describe CN 7
Where is its primary nucleus of origin?
Which nucleus contributes preganglionic parasymp fibers to facial nerve?
Mixed cranial nerve, "nerve of facial expression" supplies motor to facial muscles.
Motor nucleus of facial nerve
Superior Salivtory
90
Where do sensory fibers of facial nerve terminate?
Cell bodies are found in what ganglion?
Solitary nucleus
Geniculate
91
Describe CN 7 sensory pathways
General sense from outer ear and lateral tympanic membrane to geniculate ganglion. Then axons go to solitary nucleus
Taste info geniculate ganglion and solitary nucleus, taste from anterior tongue is chorda tympani
92
Describe CN 7 Motor pathways
LMN axons in motor nucleus exit CNS go through geniculate gang, innervate facial expression muscles (???)
93
What is interesting about the motor nucleus of facial nerve?
Receives info from both cerebral sides, but the part of the nucleus supplying muscle in inferior face receives ONLY info from contralateral cortex. Also receives from reticular formation.
94
Parasympathic pathways for CN 7
Pre parasymp fibers from superior salivatory nuc. synapse in pterygopalatine or submandibular ganglions.
Postgang fibers supply lac, submandib, sublingual, and small glands in oral and nasal cavities
95
A.O. of CN 7
What are the two roots at the AO?
Sulcus between pons and MO - lateral aspect
named cerebellopontine angle/recess
Motor root (facial nerve proper) and Intermediate nerve (carry sensory and parasymp)
96
Motor and intermediate roots from CN 7 AO travel and to internal acoustic meatus and then form a single trunk to enter facial canal, bending and forming? What is located there?
External genu of the facial nerve.
Geniculate ganglion!
97
What is the other name for the greater petrosal nerve?
Superficial petrosal nerve.
Info page 23
98
Nerve to stapedius comes off facial nerve and is motor. Supplies Stapedius muscle in middle ear
Cool
99
Third branch off of facial nerve?
Chorda tympani which transverses the tympanic cavity and combines with lingual nerve branch of mandib div trigem.
100
So to recap this shit. what are the three major branches off of facial nerve?
Greater petrosal nerve
Nerve to stapedius
Chorda Tympani
101
Read the last bit of facial nerve
FUCK!
102
Clinical considerations of facial nerve?
Bells Palsy
Superficial parodiectomy
103
100 card just because
Still fuck!
