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PNS > EXAM I > Flashcards

EXAM I Flashcards

1
Q

How many pairs of spinal nerves are there?

A

31

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2
Q

Two main subdivisions of the nervous system

A

Somatic and visceral (autonomic)

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3
Q

Where do the cell bodies of somatic sensory neurons lie?

A

In the PNS in the dorsal root ganglion

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4
Q

Which neuron’s axon is longer in the sympathetic division, preganglionic or postganglionic?

A

Postganglionic

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5
Q

Which neuron is longer in the PSNS, pregang. Or postgang?

A

Preganglionic

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6
Q

What neurotransmitter is released from SNS postganglionic neuron

A

Norepinephrine

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7
Q

What splanchnic nerves are parasympathetic?

A

Pelvic

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8
Q

Where are visceral afferent cell bodies located?

A

DRG or cranial nerve ganglion

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9
Q

What CNs are special sensory?

A

I, II, VII, VIII, IX, X

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10
Q

What CNs are motor?

A

III, IV, V, VI, VII, IX, X, XI, XII

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11
Q

What is the largest CN?

A

Trigeminal

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12
Q

Smallest CN?

A

Trochlear

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13
Q

What CNs exit the superior orbital fissure?

A

III, IV, V1, VI

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14
Q

What CNs exit the internal acoustic meatus?

A

VII and VIII

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15
Q

What CNs exit the jugular foramen?

A

IX, X, XI

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16
Q

Two types of upper motor neurons and where they can be found?

A

Pyramidal: in the cortex
Extrapyramidal: found in the brainstem

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17
Q

Where do pyramidal fibers synapse?

A

Rexed lamina 7 and 9

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18
Q

Where do extrapyramidal UMNs synapse?

A

Rexed lamina 7, brainstem and CN nuclei

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19
Q

Where are cell bodies of LMNs located?

A

Rexed lamina IX and CN nuclei of origin

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20
Q

How many neurons in the somatic sensory pathway?

A

3

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21
Q

Where are first order neurons in the somatic sensory pathway located?

A

DRG and synapse in the spinal cord

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22
Q

Where do second order sensory neurons terminate?

A

Thalamus, after decussating

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23
Q

Where do third order sensory neurons relay information to?

A

From thalamus to cerebral cortex (post central gyrus mostly)

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24
Q

Where are olfactory neurons found?

A

In the superior nasal cavity in the superior nasal concha only

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25
Q

What are the receptors of olfactory neurons called?

A

Olfactory hairs

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26
Q

Are olfactory neurons axons myelinated?

A

No, but are covered by schwann cells

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27
Q

What is the path of olfactory neurons?

A

They enter through the cribiform plate, go through the olfactory bulb and synapse on mitral cells

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28
Q

What are found at the synapses between olfactory neurons and mitral cells?

A

Synaptic glomeruli

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29
Q

Where do fibers from the medial olfactory stria go?

A

Cross the midline via the anterior commissure and travel to the opposite olfactory bulb

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30
Q

Where do lateral olfactory stria fibers go?

A

Carry info to the primary olfactory cortex (periamygdaloid and prepiriform area, including the uncus) broadman area 34

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31
Q

How many neurons in the olfactory pathway?

A

2

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32
Q

Is smell segregated into right and left?

A

No

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33
Q

Why is the sensory olfactory pathway only a 2 neuron pathway?

A

Mitral axons do not go through the thalamus, go straight to the cortex

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34
Q

What sign is associated with CSF leakage?

A

Halo sign (CSF)

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35
Q

What nerve is poorly developed in humans and was important for tracking prey?

A

Vomeronasal nerve

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36
Q

Three tunics of the eye and what they consist of….

A 
Fibrous tunic (outer): sclera and cornea
Vascular tunic (middle): ciliary body, iris and choroid
Retina (inner): 10 layers (know diagram page 174)
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37
Q

Three types of cones

A

Red, green and blue

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38
Q

What is required for cones to function and where are they most concentrated?

A

Require light, and concentrated on the center of the retina (fovea)

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39
Q

What layer are bipolar cells found in?

A

The inner nuclear layer

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40
Q

What layer is the synapse between bipolar and ganglion cells?

A

Inner plexiform layer

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41
Q

Where do ganglion cells lead?

A

Information is conveyed in the nerve fiber layer toward the optic disc, axons are carried in the optic nerve after leaving the eye

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42
Q

Are optic nerve axons myelinated?

A

Yes, not myelinated in the retina until they leave the eye

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43
Q

What cells form the myelin on CN II?

A

Intrafascicular oligodendrocytes

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44
Q

What fibers from the eye from CN II will decussate?

A

Fibers from the medial side of each retina

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45
Q

Where does the CN II fibers terminate?

A

One of three nuclei: lateral geniculate body (MC) and relayed to cortex in the occipital lobe (Bdmn 17), superior colliculus and relayed to tectospinal tract, or pretectal nucleus of the midbrain

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46
Q

What muscles are innervated through tectospinal tract?

A

SCM and trapezius

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47
Q

How many neurons in the vision pathway?

A

4

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48
Q

Lesion of the optic nerve would cause:

A

Smaller field of vision, loss of depth perception

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49
Q

Loss of the optic chiasma would cause?

A

Tunnel vision

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50
Q

Loss of an optic tract would cause?

A

Loss of right or left visual field

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51
Q

How to test direct and consensual light reflex

A

Flashlight

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52
Q

How does the eye change for an accommodation reflex?

A

Changing the shape of the lens

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53
Q

How to test corneal reflex

A

Touch the cornea and the eye will shut

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54
Q

What is the convergence reflex?

A

The eyes move together

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55
Q

What extraoccular muscles does CN III supply?

A

All except superior oblique and lateral rectus

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56
Q

Where do oculomotor nuclei originate?

A

Periaqueductal grey, anterior to cerebral aqueduct

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57
Q

What part of the cortex sends axons to the oculomotor nuclei?

A

BDMN 8

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58
Q

Where else does the CN III nuclei receive fibers from?

A

Superior colliculus and medial longitudinal fasciculus

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59
Q

Where does CN III exit the CNS?

A

Interpeduncular fossa

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60
Q

Where does CN III go after it penetrates the dura?

A

Travels along the cavernous sinus and exits the skull through the superior orbital fissure. Then splits into superior and inferior rami in the eye socket.

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61
Q

Muscles supplied by the superior ramus of CN III

A

Superior rectus

Levator palpebrae superioris

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62
Q

Muscles supplied by inferior ramus

A

Medial rectus: medial branch
Inferior rectus: central branch
Inferior oblique: lateral branch

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63
Q

What is contained in the accessory oculomotor nucleus? Where do these fibers go?

A

Preganglionic Parasympathetic neurons. These fibers follow the oculomotor nerve and synapse in the ciliary ganglion

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64
Q

Where is the ciliary ganglion located?

A

Posterior to the eyeball 1 cm anterior the SOF

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65
Q

Where do postgang parasymp fibers go after they leave the ciliary ganglion? What do they supply?

A

Follow ciliary arteries and pierce the sclera (know schematic page 179)
Supply:
Ciliaris
Sphinter pupillae

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66
Q

Are fibers exiting the oculomotor nuclei UMN or LMN?

A

LMN because axons extend into the PNS

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67
Q

Muscle supplied by trochlear nerve

A

Superior oblique muscle

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68
Q

Where is the trochlear nucleus located?

A

Periaqueductal gray caudal to oculomotor nuclei

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69
Q

What part of cerebral cortex sends axons to the trochlear nucleus?

A

BDMN 8

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70
Q

Where else does does the trochlear nucleus receive axons from?

A

Superior colliculi and medial longitudinal fasciculus

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71
Q

What is the course of CN IV when is exits the CNS?

A

Curves around the brainstem and continues in the lateral wall of the cavernous sinus. Enters the orbit throught the SOF and supplies superior oblique.

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72
Q

How to test trochlear nerve destruction

A

Have patient look down. NOT down and out because other muscles will be involved

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73
Q

What muscle does the abducens nerve supply?

A

Lateral rectus

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74
Q

Where is the abducens nucleus located?

A

Caudal part of the pons, at floor of the rhomboid fossa.

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75
Q

How do axons from the abducens nucleus exit the CNS?

A

Axons project anteriorward and exit CNS at the border of the pons

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76
Q

What type of fibers do the trochlear and abducens nerves use to communicate with the cavernous plexus?

A

Sympathetic

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77
Q

Where does the abducens nerve travel after it penetrates the dura?

A

Travels along the cavernous sinus and exits skull through the SOF, innervates lateral rectus

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78
Q

What is strabismus?

A

Eyes are not pointing at the same thing (think Steve Buscemi’s character from Mr. Deeds)

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79
Q

Internal strabismus vs external strabismus?

A

Internal: eyes cross (converge)
External: eyes diverge

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80
Q

Diplopia definition

A

Double vision from an alignment problem or processing error. Difficult to demonstrate objectively

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81
Q

Ptosis definition

A

One eyelid drops due to weakness of levator palpebrae superioris. Oculomotor nerve lesions may be the cause

82
Q

Two types of Oculomotor paralysis

A

External ophthalmoplegia

Internal ophthalmoplegia

83
Q

What does external ophthalmoplegia involve?

A

External strabismus; affected eye deviates down & out
Diplopia
Ptosis

84
Q

Internal ophthalmoplegia involves…

A

Inability to constrict pupil as well as loss of light and accommodation reflexes

85
Q

Characteristics of trochlear paralysis

A

Rare

Internal strabismus, inability to look down causing difficulty descending stairs

86
Q

Etiologies of ophthalmoplegia

A

Uncal herniation, PCA aneurysms, or diabetes

87
Q

Abducens paralysis characteristics

A

Most common

Internal strabismus and diplopia

88
Q

Internuclear ophthalmoplegia involves what structures? Will present how?

A

Involves damage to the MLF

Will cause nystagmus when abducting the eye

89
Q

Does trigeminal carry more motor fibers or more sensory fibers?

A

Sensory

90
Q

Three trigeminal nuclei or TERMINATION

A

Main sensory nucleus
Spinal nucleus
Trigeminal mesencephalic nucleus

91
Q

Trigmenial nucleus of ORIGIN

A

Trigeminal motor nucleus

92
Q

Peripheral ganglion associated with the trigeminal nerve

A

Trigeminal (semilunar) ganglion—> peripheral sensory neurons

93
Q

Sensory pathway to the main trigemnial spinal nuclei

A

1) Cell bodies are located in the trigeminal ganglion
2) Peripheral processes go from face to the ganglion
3) Central processes go from trigeminal ganglion, enter CNS to go to main trigeminal nucleus or spinal nucleus

94
Q

What types of sensations go to the main Trigeminal nucleus? Spinal nucleus?

A

Main trigeminal: Touch, vibration and joint proprioception

Spinal: pain and temperature

95
Q

Pathway to the mesencephalic nucleus

A

1) Dendrites from periphery pass THROUGH the trigeminal gang, enter CNS and ascend to mesencephalic nucleus
2) these are the only primary sensory neurons that have cell bodies in the CNS

96
Q

What types of sensation are carried to the (trigeminal) mesencephalic nucleus?

A

Proprioceptive info from the TMJ

97
Q

Where do axons from the motor nucleus go when they leave the CNS?

A

Travel through the trigeminal ganglion and are carried in the mandibular division

98
Q

What muscles do axons from the motor nucleus supply?

A

Muscles of mastication

99
Q

What parts of the brain does the motor nucleus receive info from?

A

Cerebral cortex, reticular formation, red nucleus, tectum, MLF and the mesencephalic nucleus

100
Q

Apparent origin of the trigeminal nerve

A

Lateral aspect of pons

101
Q

What is significant about the trigeminal (Meckel’s) cave?

A

Trigeminal ganglion is found here, it is pouch of dura in the petrous part of the temporal bone

102
Q

Three branches that arise from the trigeminal ganglion

A

Ophthalmic
Maxillary
Mandibular

103
Q

Function of V1

A

Sensory only
Sensory from skin over the nose, forehead and scalp
Sensation from mucous membranes in the frontal and sphenoid sinus and membranes covering the nasal septum

104
Q

When does the meningeal nerve arise and what does it supply?

A

Arises before ophthalmic leaves the SOF and supplies dura in the middle cranial fossa

105
Q

Course of the lacrimal nerve

A

Travels along the superior part of lateral rectus muscle, passes through the lacrimal gland and goes to skin of the upper eyelid

106
Q

What does the lacrimal nerve supply

A

Lacrimal gland

Parasympathetic fibers to lacrimal gland as well (from V2)

107
Q

How do parasympathetic fibers get to the lacrimal nerve?

A

They originate in pterygopalatine ganglion (CN VII) and reach the nerve by way of zygomatic and zygomaticotemporal nerves (CN V2)

108
Q

What is the largest of the four branches of ophthalmic?

A

Frontal nerve

109
Q

Two branches of frontal nerve and their functions

A

Supratrochlear: sensation from the medial corner of the eye
Supraorbital: sensation from conjunctiva, upper eyelid and forehead, and mucous membrane lining the frontal sinus

110
Q

What are the four branches of of ophthalmic?

A

Meningeal
Lacrimal
Frontal
Nasociliary

111
Q

What are the three branches of and two terminal branches of nasociliary?

A 
A communicating branch to ciliary ganglion
Long ciliary nerve
Posterior ethmoid nerve
Anterior ethmoid nerve
Infratrochlear nerve
112
Q

Function of long ciliary n.

A

Supplies the eyeball

113
Q

Function of posterior ethmoid n.

A

Sensory info from sphenoidal and ethmoidal sinuses

114
Q

Fxn anterior ethmoid n.

A

Supplies skin over the nose by way of external nasal nerve, mucous membrane on anterior part of nasal septum by internal nasal nerve

115
Q

Fxn infratrochlear nerve

A

Supplies medial corner of eye and lacrimal sac

116
Q

When the Maxillary division goes through the foramen rotundum, where does it enter?

A

Pterygopalatine fossa

117
Q

What is the sensory function of the maxillary division as a whole?

A

Sensation from skin between eyes and mouth, over cheeks and temples. Also, info from mucosa in maxillary sinuses, conchae, palate and gingiva

118
Q

What are the four branches of V2

A

Middle meningeal n.
Zygomatic nerve
Ganglionic branches
Infraorbital nerve

119
Q

When is middle meningeal nerve given off? What does it supply?

A

Before the division exits the round foramen

Supplies meninges of middle cranial fossa

120
Q

How does zygomatic nerve enter the orbit?

A

Inferior orbital fissure

121
Q

Three branches of zygomatic nerve

A

Communicating branch
Zygomaticotemporal
Zygomaticofacial

122
Q

What is the fxn of communicating branch of the zygomatic nerve?

A

Carries postgang. Parasymp. Fibers from pterygopalatine ganglion to the lacrimal gland

123
Q

What does zygomaticotemporal supply?

A

Skin over the temple

124
Q

What does zygomaticofacial supply?

A

Skin over the cheek

125
Q

What do the ganglionic branches of maxillary supply?

A

Sensory info from the upper pharynx, nasal cavity, and palate through the pterygopalatine ganglion to the maxillary division

126
Q

What branches does the infraorbital nerve give rise to

A

Posterior, middle and anterior superior alveolar nerves

127
Q

How does infraorbital nerve enter the orbit?

A

It goes through the inferior orbital fissure and infraorbital canal

128
Q

Infraorbital nerve supplies…

A

Skin of lower eyelid, skin over the upper jaw and the maxillary sinus

129
Q

What do posterior middle and anterior superior alveolar nerves supply?

A

Sensory info from the teeth

130
Q

Which of the three branches of trigeminal distribute postgang parasymp fibers from the pterygopalatine ganglion?

A

Maxillary

131
Q

How do pregang parasymp fibers reach the pterygopalatine ganglion?

A

From the facial nerve by way of the greater petrosal nerve

132
Q

Are there sympathetic fibers in the pterygopalatine ganglion?

A

Yes, they run THROUGH it by way of fibers from the superior cervical ganglion

133
Q

Do sensory fibers pass through the pterygopalatine ganglion?

A

Yes

134
Q

Does the mandibular division exit the foramen ovale as one root?

A

No, it exits as a large sensory root and a small motor root which combine in the infratemporal fossa

135
Q

Mandibular carries sensation from where?

A

Skin over the mandible, posterior cheek, and posterior temple, also from mucosa of lower oral cavity and cheeks

136
Q

What does the motor aspect of V3 innervate?

A

8 muscles, including muscles of mastication (masseter, temporalis, medial pterygoid, lateral pterygoid)

137
Q

What two branches are given off V3 in the infratemporal fossa?

A

Recurrent meningeal branch (nervus spinosum) and medial pterygoid nerve

138
Q

What does recurrent meningeal supply?

A

Sensory info from dura of middle cranial fossa, anterior cranial fossa and calvarium

139
Q

What does medial pterygoid nerve supply?

A

Motor supply for medial pterygoid muscle. Some fibers pass through otic ganglion to innervate tensor veli palatine and tensor tympani

140
Q

For V3, the anterior division is predominantly _________ and the posterior division is primarily ____________

(Motor or sensory)

A

Motor, sensory

141
Q

Four branches from the anterior division of V3

A

Masseter
Deep temporal
Lateral pterygoid
Buccal

142
Q

Three branches from the posterior division

A

Auriculotemporal
Lingual nerve
Inferior alveolar nerve

143
Q

What does the masseter nerve innervate?

A

Motor innervation from the masseter, sensory info from the TMJ

144
Q

Deep temporal nerve supplies…

A

Temporalis muscle

145
Q

Lateral pterygoid nerve supplies…

A

Lateral pterygoid muscle

146
Q

Buccal nerve supplies…

A

Sensation from the cheek (skin and mucosa) and the buccal gingivae of the molars

147
Q

What does the auriculotemporal nerve pass through?

A

Through the parotid gland, posterior to the TMJ and into the infratemporal fossa

148
Q

What does the auriculotemporal nerve innervate?

A

Carries sensory info from skin of temple and ear, also carries postgang parasymp fibers from the otic ganglion to parotid gland.

149
Q

Lingual nerve supplies…

A

Sensory info from mucosa of oral cavity.

150
Q

What branch of CN VII does the lingual nerve combine with in the infratemporal fossa?

A

chorda tympani

151
Q

Inferior alveolar nerve supplies…

A

Sensory info from the lower teeth and chin

152
Q

Three branches of inferior alveolar nerve

A

Incisive branch
Mental nerve
Motor fibers

153
Q

Incisive branch of inferior alveolar supplies…

A

Incisors, canines, 1st premolars and the adjacent gingivae

154
Q

Mental nerve supplies…

A

Labial gingivae sensation adjacent to the incisors and the skin of lower lip and chin

155
Q

Motor fibers from inferior alveolar nerve innervate…

A

Mylohyoid and the anterior belly of digastric

156
Q

What two autonomic ganglia communicate with the mandibular division?

A

Submandibular ganglion and the otic ganglion

157
Q

The submandibular ganglion receives preganglionic fibers from where?

A

CN VII by way of the lingual nerve, after it combines with chorda tympani

158
Q

How does the otic ganglion send postganglionic fibers?

A

By way of auriculotemporal nerve, to the parotid gland

159
Q

The higher up the lesion on the MO, will it affect a greater or lesser area of the face?

A

Greater

160
Q

Will the lingual nerve ever convey taste info?

A

Yes, to the chorda tympani

161
Q

CN VII (facial nerve) is also known as

A

The nerve of facial expression (supplies motor innervation to many facial muscles)

162
Q

What is the primary nucleus of origin of CN VII?

A

The motor nucleus of the facial nerve

163
Q

What nucleus contributes pregang parasymp fibers to the facial nerve?

A

Superior salivary nucleus

164
Q

Where do sensory fibers from the facial nerve terminate where?

A

Upper part of the solitary nucleus

165
Q

Where are the cell bodies of the sensory neurons of CN VII found?

A

Geniculate ganglion

166
Q

What sensation is carried to the geniculate ganglion?

A

General sensation from the external ear and lateral tympanic membrane

167
Q

What part of the tongue for taste is innervated by the facial nerve?

A

Anterior 2/3 of the tongue

168
Q

Where are the cell bodies of “taste” neurons found? Where do they terminate?

A

The cell bodies are found in the geniculate ganglion and the axons terminate in the solitary nucleus

169
Q

Are there any motor fibers in the geniculate ganglion?

A

Yes, LMN from the motor nucleus of CN VII travel THROUGH the geniculate ganglion before innervating the muscles of facial expression

170
Q

Which cerebral hemisphere does each motor nucleus of CN VII receive information from?

A

Both cerebral hemispheres

171
Q

The part of the motor nucleus of CN VII innervating the lower part of the face will receive fibers from what hemisphere?

A

ONLY from the contralateral cortex

172
Q

What other structure, besides the cortex does the motor nucleus of CN VII receive info from?

A

Reticular formation

173
Q

Where do pregang parasymp fibers from the superior salivary nucleus synapse?

A

In the pterygopalatine ganglion or the submandibular ganglion

174
Q

What do postgang fibers of CN VII innervate?

A

Lacrimal gland, submandibular and sublingual glands as well as other small glands

175
Q

Apparent origin of the facial nerve?

A

Lateral pontomedullary sulcus

176
Q

Two roots of facial nerve present at the apparent origin

A 
Motor root (facial nerve proper)
Intermediate nerve (carries sensory and parasymp fibers)
177
Q

Where do the roots of facial nerve combine?

A

Internal acoustic meatus

178
Q

Where is the geniculate ganglion located?

A

Where the facial nerve bends posteriorly after entering the face

179
Q

Course of the greater petrosal nerve

A

Comes off the geniculate ganglion, travels anterior through the hiatus of the greater petrosal nerve, re-enters the temporal bone through foramen lacerum, travels in the pterygoid canal and joins the pterygopalatine ganglion

180
Q

The greater petrosal nerve is also called

A

Superficial petrosal nerve

181
Q

Where is the nerve to the stapedius given off?

A

In the internal acoustic meatus (facial canal)

182
Q

What does nerve to the stapedius supply?

A

Stapedius muscle of the middle ear

183
Q

Where does chorda tympani arise?

A

In the facial canal

184
Q

Fxn of chorda tympani

A

Carries preganglionic parasympathetic fibers and taste fibers from anter 2/3 of tongue

185
Q

What three nerves arise off of facial nerve in the facial canal?

A

Greater petrosal, nerve to the stapedius and chorda tympani

186
Q

Course of chorda tympani

A

Arises off facial in the facial canal, traverses the tympanic cavity and leaves the temporal bone through the pterygotympanic fissure where it combines with the lingual nerve

187
Q

What three branches of facial nerve are located between the stylomastoid foramen and the parotid gland?

A

Digastric branch
Stylohyoid branch
Posterior auricular nerve

188
Q

What is innervated by the digastric branch of CN VII?

A

Posterior belly of the digastric muscle

189
Q

What is innervated by the stylohyoid branch of facial nerve?

A

Stylohyoid muscle

190
Q

What two branches does the posterior auricular nerve divide into?

A

Occipital branch and auricular branch after traveling posteriorly to the ear

191
Q

What is formed when the facial nerve enters the parotid gland?

A

The parotid plexus

192
Q

What two trunks arise at the parotid plexus?

A

Temporofacial and cervicofacial

193
Q

What 5 main branches arise from the temporofacial and cervicofacial trunks of CN VII?

A 
Temporal branches
Zygomatic branches
Buccal branches
Marginal mandibular branch
Cervical branch
194
Q

What do the temporal branches of CN VII alone supply?

A

Intrinsic auricular muscles as well as superior and anterior auricular muscles

195
Q

In conjunction with zygomaticofacial nerve (V2) and auriculotemporal nerve (V3), what muscles are supplied by the temporal branches of CN VII?

A

Orbicularis oculi, currugator supercilii and frontal belly of the occipitofrontalis

196
Q

What is supplied by zygomatic branches of CN VII?

A

Orbicularis oculi

197
Q

What is supplied by buccal branches of CN VII?

A

The buccinator, orbicularis oris and levator anguli oris

198
Q

What is supplied by the marginal mandibular branch of CN VII?

A

Risorius, and chin and lower lip muscles

199
Q

What is supplied by the cervical branch of CN VII?

A

The platysma

200
Q

What is facial nerve paralysis called?

A

Bell’s palsy

201
Q

Why would a superficial parotidectomy be necessary? What nerves would be implicated?

A

If the parotid gland is cancerous

All nerves arising from the parotid plexus may be implicated

PNS (1 decks)

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