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PNS > Exam 2 > Flashcards

Exam 2 Flashcards

1
Q

The vestibulocochelar nerve is purely a ____ nerve

Composed of how many nerves?

A

Sensory

  1. Vestibular and chochlear
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2
Q

The vestibular nerve terminates _____

Which consists of how many parts?

What are they?

A

Vestibular nuclear complex

4

Superior, Medial, Lateral Inferior

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3
Q

Vestibular nerve fibers arise from cell bodies located in ______

This has how many parts?

They are?

A

Vestibular Ganglion

2

Superior and Inferior

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4
Q

The cochlear nerve terminates in what two places?

Axons of which ganglion compose the cochlear nerve?

A

Anterior and Posterior cochlear nuclei

Axons from the spiral ganglion

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5
Q

Peripheral processes of the cochlear nerve extend from spiral ganglion to _____

Axons from these cell bodies carry in cochlear nerve and terminate in two cochlear nuclei located where?

Axons then cross other side of brainstem and synapse where?

From which axons form what?

A

Spiral organ (organ of corti)

Posterior, superior MO, lateral to vestibular nuclei

Trapezoid nuclei

Lateral lemniscus

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6
Q

Peripheral processes from vestibular ganglion extend to what three inner ear structures?

Central processes convey info to vestibuar nuclei located where?

Most fibers terminate where? Some will travel directly to cerebellum by way of what?

A

Saccule, Utricle, Semicircular canals

in the MO on floor of rhomboid fossa

Medial vestibular nucleus (schwalbe)

Some by way of inferior cerebellar peduncle

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7
Q

Vestibulocochlear nerve Apparent Origin

Travels in the posterior cranial fossa to the _______ which it enters with facial nerve

A

Cerebellopontine Angle

Internal Acoustic Meatus

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8
Q

The cochlear nerve carries how many fibers?

Traverses the IAM then leaves temporal bone and reaches the ____ ganglion of the cochlea

A

30-40 thousand

Spiral ganglion

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9
Q

Vestibular nerve carries how many fibers?

Approaches ear divides into sup and inf branches. Which branch is smaller?

What are they composed of?

What do they supply?

A

20,000

Inferior (8000 fibers)

Inferior - saccular nerve and posterior ampullary

Superior - lateral and anterior ampullary nerves

Inferior - saccule and posterior ampullary crest

Superior - lateral and anterior semicircular canals

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10
Q

What supplies the utricle?

What is Voits nerve?

A

Branch from lateral ampullary nerve and a branch off superior branch.

Branch off of superior branch that sends directly to saccule

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11
Q

Clinical of CN VIII

Acousitc Neuroma

Tinnitus

Cochlear implants

Vestibular disesase

A

Vestibular schuanoma - hear, balance vertigo

Ringing ear, sign of Menieres disease

Sensory neural hear loss

Equilibrium and vertigo prob, dizzy

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12
Q

What is the diff diagnosis for cervicogenic vertigo?

A

Swivel chair, hold head still and move in chair should cause vertigo

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13
Q

What type of fibers does the Glossopharyngeal nerve carry?

A

Motor, Sensory, Autonomic (para).

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14
Q

CN IX motor to ____

Sensory from ___

Taste info from ____

Parasympathetic leading to _____

A

Stylopharyngeus

Pharynx

Posterior tongue

Parotid gland

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15
Q

The motor fibers in CN IX arise from cell bodies located in the _____ part of the _______

Preganglionic para fibers arise from ________

Afferent fibers terminate in _______

Two periph ganglia ____ and ____ are associated with CN IX. Which is smaller

A

Superior part of Nucleus Ambiguus

Salivatory nucleus

Solitary nucleus

Superior and Inferior

Superior ganglion is smaller

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16
Q

What are the three sensory pathways for CN IX?

A

General, Taste, Visceral afferent

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17
Q

Info from nasopharynx, oropharynx, posterior tongue, uvula, and palatine tonsils and tympanic cavity is which sensory pathway of CN IX?

Cell bodies of these neurons are located where?

The fibers synapse in which nucleus?

A

General sensory

Inferior ganglion

Spinal nucleus of trigeminal nerve

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18
Q

Taste info from the posterior tongue is carried from neurons from the ____ganglion.

Axons from these cells synapse in the superior part of _____ nucleus

Some incoming fibers from this ganglion synapse in inferior part of the nucleus and they carry ______ info to the _____ and _____

A

Inferior ganglion

Solitary

Visceral afferent

Carotid sinus and body

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19
Q

CN IX motor pathway the _____ contributes LMN to three CN.

A

Nucleus ambiguus

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20
Q

Parasympathetic pathway CN IX

_____ nucleus gives rise to pre gang para axons.

Fibers synapse in ____ganglion from which _____ fibers arise to supply which three glands?

A

Inferior salvatory

Otic
Postganglionic

Parotid, buccal, inferior labial glands

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21
Q

AO of CN IX

Nerve exits via ___

___ ganglion located inside cranium and ____ ganglion is outside

A

Superior lateral M.O.

Jugular foramen

Superior

Inferior

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22
Q

The tympanic nerve arises from the _____ ganglion.

Carries which types of fibers?

Carried through _____ into the tympanic cavity.

Receives postganglionic sympathetic fibers from superior cervical ganglion to form ____

A

Inferior

Pregang para, and sensory

Tympanic Canaliculus

Tympanic Plexus

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23
Q

The tympanic plexus carries somatosensory info from what three things?

A

Tympanic cavity

Pharyngotympanic tube

Mastoid air cells

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24
Q

Pregang parasymp fibers pass through tympanic plexus and reform as ______ nerve which travels through _____ canal to the otic ganglion

A

Lesser petrosal nerve

Lesser Petrosal canal

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25
Q

Postganglionic parasympathetic fibers from otic ganglion are carried in which branch of trigimenial and to what three glands?

A

Mandibular

Parotid, Buccal and inferior labial

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26
Q

The ___ branch of CN IX ascend from below and enters the nerve at inferior ganglion. Carries afferent info from _____ in carotid body and _____ in carotid sinus

Similar info may be carried in what nerve

A

Carotid branch

Chemoreceptors

Baroreceptors

Vagus

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27
Q

____ branches of CN IX convey sensory info from mucosa of pharynx.

____ branch of CN IX leave glossopharyngeal nerve to supply which muscle?

A

Pharyngeal

Muscular

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28
Q

Which two CN IX branches reach the oral cavity?

Which one conveys sensory info from palatine tonsils and oral mucosa?

Which carries general sensory and taste info from tongue posterior

A

Tonsillar

Lingual

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29
Q

Describe the Vagus nerve

A

Mixed
Carries Parasymp sensory
Carry some taste from epiglottal region

Longest

Most important parasymp nerve

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30
Q

Apparent origin of CN X

Motor fibers cell bodies located in ____ which receives info from both cerebral hemispheres

A

Lateral MO

Nucleus Ambiguus

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31
Q

Pregang para fibers of CN X arise from ____

It receives info indirectly from ____ and ____

Incoming somatic sensory infor terminates in _____ nucleus of CN V

Taste and viscerosensory info terminates in nucleus of _____ _____

A

Posterior (dorsal) nucleus of vagus

Hypothalmus and carotid sinus

Spinal

Solitary tract

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32
Q

Two peripheral ganglia associated with vagus nerve??

What is important about them?

AKA names for them?

A

Superior and Inferior

NOT same ones for glossopharyngeal nerve.

Superior = Jugular
Inferior = Nodose
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33
Q

What are the three Sensory pathways of CN X?

A

Somatic sensory
Taste
Visceral sensory

34
Q

CN X info from dura, auricle, EAC, lateral tympanic membrane, mucosa of pharynx, to spinal nucleus of trigeminal

Info from epiglottis carried in superior part of nucleus of solitary tract by neurons in inferior gang

Info carried from larynx and laryngopharynx, visera in thoracic/abdominal cavities, pressure receptors in aortic arch and chemoreceptors in para-aoritc body

A

Somatic sensory

Taste

Visceral

35
Q

_____ info carried to inferior part of nucleus for solitary tract by neurons in inferior ganglion. (vagus nerve)

A

Visceral sensory

36
Q

AO of vagus nerve

Exit skull via ____

A meningeal branch supplies dura of _______ fossa

A

Lateral MO

Jugular foramen

Posterior cranial fossa

37
Q

Jugular foramen is compartmentalized by a ______

The glosspharyngeal nerve travels ____ to this

The vagus nerve and accessory nerve travel ____ to this

A

Fibrous septum

Posterior

Anterior

38
Q

Which ganglion of CN X is larger and more cylindrically shaped? (superior or inferior)

Where are they located?

A

Inferior - inferior to jugular foramen

Superior is smaller and located in the jugular foramen

39
Q

The auricular branch of Vagus is given off at the ____ ganglion.

Couses through the ____ and ______ to reach the EAM

Carries sensory info from meatus and small portion of ____

A

Superior

Mastoid canaliculus and tympanomastoid fissure

auricle

40
Q

What are the three branches of vagus given off in the neck?

A

Pharyngeal

Branches to carotid

Superior laryngeal
Internal laryngeal
External laryngeal

Recurrent Laryngeal

Superior and inferior cervical cardiac branches

41
Q

Pharyngeal branch and branches to the carotid of vagus are given off of the ____ ganglion

Superior laryngeal branch given off where???

Recurrent laryngeal comes off??

Superior and inferior cervial cardiac branches given off where?

A

Inferior

Inferior to inferior ganglion

Left side - vagus b4 passes in front of aortic arch
Right side - passes posterior under subclavian artery

Superior - leave vagus and travel with great vessels to cardiac plexus

Inferior - same except come off recurrent laryngeal

42
Q

Vagus nerve enters thorax, passes posterior to root of _______ lung and contribute to _____ plexus

Then ___ vagus passes posteriorly over esophagus and ____ vagus goes anterior. Both contribute to ____ plexus

A

Ipsilateral

Pulmonary

Right
Left
Esophageal

43
Q

Which of the Pulmonary plexuses is larger?

Both carry ____ info

____ receives sympathetic fibers from cervical sympathetic ganglia

_____ receive sympathetic fibers from thoracic ganglia

A

Posterior

Sympathetic

Anterior

Posterior

44
Q

The ____ vagus nerve enters abdominal cavity through esophageal opening and becomes _____

Sends branches to _____ stomach and terminates in a large celiac branch that sends branches to which organs?

Vagal supply to the organs through which three plexuses

A

Right
Posterior vagal trunk

Posterior
Duodenum, liver, kidneys, SI, proximal 2/3 colon

Celiac, superior mesenteric, renal

45
Q

The ____ vagus becomes the anterior vagal trunk .

Sends branches to where?

A

Left

Stomach, liver, pancreas, superior duodenum

46
Q

Three clinical considerations of Vagus nerve?

A

Bilateral Transection
Fatal

Lesion in vault or close to skull
Widespread problem

Damage to recurrent laryngeal
Speech hoarseness or volume problems

47
Q

CN XI is an exclusively ____ nerve

Its two roots contribute LMN that supply which muscles?

A

Motor

SCM, Trap, Soft palate, pharynx, and larynx muslces

48
Q

Cell bodies of CN XI located in ____ and contribute axons to the ____ root of the nerve

Spinal nucleus of accessory nerve is found where?

Expends from level of foramen magnum inferiorly to what cord level?

A

Nucleus ambiguous
Cranial root

Anterior horn of gray matter

C5 or C6

49
Q

AO of cranial root of CN 11

Combines briefly with spinal root before exit skull through ____

Fibers then separate and join ____ nerve at ____ ganglion

A

Lateral MO

Jugular foramen

Vagus
Inferior

50
Q

Once cranial root fibers are carried in vagus nerve they distribute to ____ plexus along with external and recurrent laryngeal nerves

Contribute motor supply to laryngeal muscles other than _____

A

Pharyngeal

Cricothyroid

51
Q

AO of spinal root of CN 11

Combine w anterior and posterior rootlets to form a trunk that will ascend between _____ and ____

Enter skull through ____

A

Lateral Cervical cord

denticulate ligaments and posterior rootlets

Foramen magnum

52
Q

Spinal root passes laterally to combine with cranial root and passes through _____

Then goes deep to ______ muscle sending fibers

Then traverses ___ triangle and goes deep to trap

A

Jugular foramen

SCM

Posterior

53
Q

Where else might Trapezius receive motor supply besides CN 11?

A

Cervical plexus supplies lower 2/thirds of muscle

54
Q

What happens if there is interruption of the spinal portion of CN 11?

Two other clinical things?

A

Loss of motor supply to SCM and trap. Right side loss no turn head left

Trap and Brachial plexus damage

Spasmodic torticollis

55
Q

Hypoglossal nerve is exclusively ____

Supplies intrinsic and extrinsic muscles of tongue except ______

Formed by axons with cell bodies in which nucleus?

Located where?

A

Motor,

Palatoglossus

Nucleus of hypoglossal nerve

Floor or rhomboid fossa

56
Q

AO of hypoglossal nerve

Forms two bundles which exit skull via

Descends forming a loop to reach base of ____

Fibers distribute into terminal branches supplying the ____

A

Between pyramid and olive of MO

Hypoglossal canal

Tongue

Tongue

57
Q

Some fibers from ___ and ____ cervical nerves travel with but are not incorporated with hypoglossal nerve.

These fibers separate from hypoglossal nerve to form ______

Some fibers continue with hypoglossal and ultimately supply ____ and ____

Lingual branches are given off to supply three things

A

first and second

Superior root of ansa cervicallis

Geniohyoid, thyrohyoid

Hypoglossus, genioglossus, styloglossus

58
Q

Main clinical consideration for hypoglossal nerve?

Lesion side deviate where?

Larynx could deviate where?

A

Hemiatrophy of tongue

Lesion left tongue deviates LEFT

To good side during swallow

59
Q

How many Spinal nerve pairs are there?

A

31

8
12
5
5
1
60
Q

Roots off the spinal cord separate into number of rootlets that attach to the cord at the _____-

A

Posterolateral Sulcus

61
Q

What two places are spinal ganglia typically located?

3 Exceptions?

A

Inside or just medial to the IVF

C1 and C2 - vertebral arches

Sacral gang - within Vert Canal

Coccygel - inside dura matter

62
Q

Before combining to form mixed spinal nerve a ____ branch is given off.

It is present at ___ spinal levels

Re enter vert canal through IVF and devices into ____, ____, and ____ branches

Provides somatosensory and sympathetic supply to dura, vessels, periosteum, ligaments in which portions of canal

A

Meningeal (sinuvertebral)

ALL

Ascending, descending, transverse

Anterior and Lateral

63
Q

What two things do the mixed spinal nerves divide into?

A

Posterior and Anterior Rami

64
Q

Splits into lateral and medial branches (except C1)

Smaller rams (except C1, S4 S5)

Motor innervation to deep back

Sensory to skin along spine

A

Posterior Dorsal Ramus

65
Q

Motor innervation to anterior and lateral trunk muscles

Motor inneration to skeletal musles in extremiteis

Contribute to great plexuses

Sensory innfervation to skin of extremities and anterior lateral trunk

A

Anterior Ventral Ramus

66
Q

Where are sympathetic chain communicans located?

What carries mylenated axons from cell bodies found in lateral horn cells at cord level T1-L2?

What carries unmylenated post gang sump fibers from cell bodies located in sympathetic chain to spinal nerve, located in each spinal nerve!

A

At or just medial to bifurcation of mixed spinal nerve

White rams communicants

Gray ramus communicans

67
Q

What is the cervical plexus formed by?

Nerve roots form a series of _____ _____

Communicate with which cranial nerves?

A

Anterior (primary) rami of C1-C4

Communicating loops

10 - 12

68
Q

Fibers from inferior vagal ganglion communicate with loop formed by which roots of cervical plexus>?

Fibers from which nerve carry proprioceptive info and communicate with C2,C3 and C4 loop?

SCM to ____

Trap to ___ and ____

A

C1 and C2

Spinal accessory

C2

C3 and C4

69
Q

The _____ nerve communicates with C1 fibers that later separate to become superior root of ansa cervicalis. C1 supply thyrohyoid and geniohyoid remain with the nerve.

A

Hypoglossal nerve

70
Q

What three gray rami communicans go with superior cervical ganglion?

A

Vasomotor, Sudomotor, Pilomotor

71
Q

Superficial branches of the cervical plexus are all _____

Lesser occipital nerve carries fibers from C2 to supply skin on superior 1/3 of the ____ and skin behind it.

May be implicated in cases of ______ _____

A

Sensory

Auricle

Cervicogenic Headache

72
Q

Great auricular nerve carries fibers from ___ and ___

Enter parotid gland and divide into ___ and ___ branches

____ branch combines with facial nerve to supply skin over parotid

____ branch supplies skin over mastoid process

A

C2 and C3

Anterior and Posterior

Anterior

Posterior

73
Q

Transverse cutaneous nerve of neck carries fibers from C_ & C_

Divides into ___ and ____ branches

Both of them supply what muscle?

A

2 and 3

Ascending and descending

Platysma

74
Q

The trunks of cervical plexus from C_ and C_ combine to form trunk giving rise to medial, intermediate, and lateral _______ nerves

____ supplies skin inferior to sternal clavicle to inferior rib2

____supplies skin over deltoid and pec major to inferior rib 2

___supplies skin over superior and lateral shoulder

A

C3 and C4

Supraclaviclular

Medial

Intermediate

Lateral

75
Q

Deep branches of cervical plexus are divided into ____ and ____

____ ____ passes through posterior triangle

____ ____ passes through anterior triangle

A

Medial and Lateral series

Lateral Series

Medial Series

76
Q

What are the two branches off of the lateral series of deep branch of cervical plexus?

A

Spinal accessory nerve

Muscular branches 
  SCM (C234)
  Trap (C2, maybe 3)
  Levator scap (C34)
  Middle scalene (C34)
77
Q

What are the 4 major branches off of the medial series of cervical plexus branch?

A

Communicating branches

Muscular

Branches from C2 and C2

Phrenic nerve

78
Q

Look at last part of notes!!!

A

Shit

79
Q

Look at diagrams!

A

Shit

80
Q

What are two clinical considerations of Cervical plexus?

A

Subluxation

Spinal cord injuries.

PNS (5 decks)

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