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3rd Year - Neurology > Gross Anatomy 4 - Cranial Nerve Clinical Testing > Flashcards

Gross Anatomy 4 - Cranial Nerve Clinical Testing Flashcards

1
Q

What type of fibres does the olfactory nerve (CN I) contain?

A

Special sensory

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2
Q

What type of fibres does the optic nerve (CN II) contain?

A

Special sensory

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3
Q

What type of fibres does the oculomotor nerve (CN III) contain?

A

Motor (somatic motor and parasympathetic)

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4
Q

What type of fibres does the trochlear nerve (CN IV) contain?

A

Motor

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5
Q

What type of fibres does each of the trigeminal nerve branches (CN V) contain?

A

CN V1 and V2 = sensory only

V3 = sensory and motor

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6
Q

What type of fibres does the abducent (CN VI) nerve contain?

A

Motor

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7
Q

What type of fibres does the facial nerve (CN VII) contain?

A

Special sensory
Sensory
Motor (Somatic and parasympathetic)

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8
Q

What type of fibres does the vestibulocochlear nerves (CN VIII) contain?

A

Special sensory

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9
Q

What type of fibres does the glossopharyngeal nerve contain (CN IX)?

A

Special sensory, sensory, visceral afferent

Motor - somatic motor and parasympathetic

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10
Q

what type of fibres does the vagus nerve nerve (CN X) contain?

A

Sensory, visceral afferent

Motor - somatic motor and parasympathetic

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11
Q

What type of fibres does the spinal accessory nerve contain (CN XI)?

A

Motor

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12
Q

What type of fibres does the hypoglossal nerve (CN XII) contain?

A

Motor

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13
Q

What is the full name for CN V1?

A

Ophthalmic division of the trigeminal nerve

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14
Q

What is the full name for CN V2?

A

Maxillary division of the trigeminal nerve

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15
Q

What is the full name for CN V3?

A

Mandibular division of the trigeminal nerve

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16
Q

Where does the trigmeninal nerve (CN V) connect to the CNS?

A

At the pons (only CN to attach here)

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17
Q

What is the intracranial course of the trigeminal nerve?

A

Inferior to the edge of the tentorum cerebelli between the posterior and middle cranial fossa

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18
Q

Which bone are the foramina for the trigeminal nerve (CN V) located in?

A

Sphenoid bone

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19
Q

Which base of skull foramina does CN V1 pass through?

A

Superior orbital fissure

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20
Q

Which base of skull foramina does CN V2 pass through?

A

Foramen rotundum

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21
Q

Which base of skull foramina does CN V3 pass through?

A

Foramen ovale

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22
Q

What superficial sensory function does CN V1 have?

A

Provides sensory innervation to the forehead, upper eyelid, cornea, all the conjunctiva, skin of the root/ bridge/ top of the nose

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23
Q

What superficial function does CN V2 have?

A

Provides sensory information from the skin of the lower eyelid, skin over the maxilla,skin of the ala of the nose, skin/ mucosa of the upper lip

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24
Q

What superificial sensory function does CN V3 have?

A

Provides sensory information from the skin over the mandible and TMJ (apart from the angle of the mandible)

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25
Q

What nerve provides sensory information from the angle of the mandible and some of the external ear?
Spinal nerves?
What is this a branch of

A

Great auricle nerve (C2, 3)

Sensory branch of the cervical plexus

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26
Q

Where is the trigeminal sensory ganglion located?

A

In the middle cranial fossa

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27
Q

What deep sensory function does CN V1 have? (4)

A

Bones and soft tissue of the orbit (except orbital floor and lower eyelid)
Superior anterior nasal cavity
All paranasal sinuses (except the antrum)
Anterior and posterior cranial fossae

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28
Q

What deep sensory function does CN V2 have? (4)

A

Lower posterior nasal cavity
Maxilla and maxillary sinus
Floor of the nasal cavity/ palate
Maxillary teeth and associated soft tissues

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29
Q

What deep sensory function does CN V3 have? (6)

A 
Middle cranial fossa
Mandible
Anterior 2/3rds of the tongue
Floor of the mouth
Buccal mucosa
Mandibular teeth and associated soft tissues
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30
Q

What group of muscles does CN V3 innervate?

A

Muscles of mastication
Tensor veli palatini
Tensor tymapni

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31
Q

What are the 3 pairs of jaw closing muscles innervated by CN V3?

A

Masseter
Temporalis
Medial pterygoid

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32
Q

What is the name of the jaw opening muscle innervated by CN V3?

A

Lateral pterygoid

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33
Q

Attachments of masseter?

A

Angle of mandible

Zygomatic arch

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34
Q

Attachments of temporalis?

A

Coronoid process of mandible

Lateral aspect of the neurocranium

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35
Q

Attachments of medial pterygoid?

A

(Medial side of) angle of mandible

Pterygoid plates of sphenoid bone

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36
Q

Attachments of lateral pterygoid?

A

Condyle of mandible and articular disc of TMJ

Pteryoid plates of sphenoid bone

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37
Q

What are the key points for testing CN V1? (3)

A

Forehead
Upper eyelid
Tip of nose

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38
Q

What are the key points for testing CN V2? (4)

A

Mid-cheek
Lower eyelid
Upper lip
Nostril of nose

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39
Q

What are the key points for testing CN V3? (3)

A

Mid-cheek, lower lip and chin

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40
Q

How do you test the motor function of the trigmeninal nerve?

A

Palpate the strength of contraction of the master and temporals by asking the patient to clench their teeth
Ask the patient to open their jaw against resistance

41
Q

where does the facial nerve connect to the CNS?

A

Anterolaterally at pontomedullary junction

42
Q

What is the intracranial course of the facial nerve?

A

Directly into internal acoustic meatus in the posterior cranial fossa

43
Q

What bone does the facial nerve pass through?

A

Temporal bone

44
Q

What foramina does the facial nerve pass through in the base of the skull?

A

Internal acoustic meatus

Stylomastoid foramen

45
Q

What is the extra cranial course of the somatic motor axons of the facial nerve?

A

Most of the axons pass into the parotid gland then into 1 of the 5 branches that supply the muscles of facial expression

46
Q

What is the name of the canal that connects the internal acoustic meatus to the stylomastoid foramen?

A

Facial canal (facial nerve passes through this)

47
Q

What bone is the facial canal located in?

A

Petrous temporal bone

48
Q

What is the name of the muscle in the ear that is supplied by the facial nerve?

A

Stapedius

49
Q

What is the function of stapedius?

A

Reduces stapes movement to protect the internal ear from excessive noise

50
Q

What nerve is the chorda tympani a branch of?

A

Facial nerve

51
Q

What does the chorda tympani supply?

A

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

Parasympathetic supply to the submandibular and sublingual salivary glands

52
Q

What nerve does the chorda tympani join with?

A

CN V3

53
Q

Name of the muscle of facial expression at the forehead?

A

Frontalis

54
Q

Name of the muscle of facial expression around the eyes?

A

Obicularis oculi

55
Q

Name of the muscle of facial expression between orbicularis oculi and orbicularis oris?

A

Elevator of lips

56
Q

Name of the muscle of facial expression around the lips?

A

Orbicularis oris

57
Q

What actions can you ask a patient to do in order to test the motor function of CN VII?

A

Frown
Close eyes tightly
Smile
Puff out cheeks

58
Q

What is the anatomical name for the border of the lips?

A

Vermillion border

59
Q

What type of fibres does the glossopharyngeal nerve (CN IX) carry?

A 
Special sensory
Somatic sensory
Somatic motor
Visceral afferent
Parasympathetic
60
Q

Where does CN IX attach to the CNS?

A

Lateral aspect of the medulla oblongata

61
Q

Intracranial course of the glossopharyngeal nerve?

A

Directly towards jugular foramen in the posterior cranial fossa

62
Q

Where does the glossopharyngeal nerve pass through the base of the skull?

A

At the junction between the temporal been and occipital bone via the jugular foramen

63
Q

What does the glossopharyngeal nerve provide general sensory fibres to? (7)

A 
Posterior 1/3d of tongue
Mucosa of most of the nasopharynx
Mucosa of all of the oropharynx
Mucosa of some of the laryngopharynx
Palatine tonsil
Eustachian tube
Middle ear cavity
64
Q

The general sensory axons from which CN supplies the afferent limb to the gag reflex?

A

CN IX

65
Q

What does the glossopharyngeal nerve provide special sensory axons to?

A

The valet papillae of the posterior 1/3rd of the tongue

66
Q

What does the glossopharyngeal nerve provide visceral afferent fibres to?

A

Carotid sinus baroreceptors and the carotid body chemoreceptors

67
Q

What does the glossopharyngeal nerve provide somatic motor sensation to?

A

1 of the longitudinal muscles of the pharynx (stylopharyngeus)

68
Q

What does the glossopharyngeal nerve provide parasympathetic supply to?

A

The parotid salivary gland

69
Q

What type of fibres does the vagus nerve contain?

A

Sensory
Motor
Visceral afferent
Parasympathetic

70
Q

Where does the vagus nerve connect to the CNS?

A

Lateral aspect of the medulla oblongata, immediately inferior to CN IX

71
Q

Describe the intracranial course of the vagus nerve?

A

Directly towards jugular foramen in the posterior cranial fossa

72
Q

Where does the vagus nerve pass through the base of the skull?

A

Junction between the temporal been and occipital bone at the jugular foramen

73
Q

What does the vagus nerve pass down the neck in?

A

The carotid sheath

74
Q

Where does the right branch of the vagus nerve pass in the chest?

A

Lateral aspect of the trachea

75
Q

Where does the left branch of the vagus nerve pass in the chest?

A

Lateral aspect of arctic arch

76
Q

Where do the branches of the vagus nerve pass in relation to the lung root?

A

Posterior

77
Q

How to test the vagus nerve?

A

Ask the patient to say Ah (also test CNV3) - uvula should lift straight up in midline
Ask the patient to swallow small amount of water
Listen to speech
Ask patient to cough

78
Q

How does the spinal accessory nerve connect to the CNS?

A

Via cervical spinal nerve anterior rootlets to the spinal cord

79
Q

Describe the intracranial course of the spinal accessory nerve?

A

Ascends through the foramen magnum then travels towards jugular foramen in posterior cranial fossa

80
Q

Where does the spinal accessory nerve pass through the base of the skull?

A

At the junction between the temporal bone and occipital bone

81
Q

Extracranial course of the spinal accessory nerve?

A

Axons supply sternocleidomastoid on deep surface, then continue across the posterior triangle of the neck deep to the investing fascia and supply the trapezius

82
Q

How to test the spinal accessory nerves?

A

Ask patient to shrug shoulders

Ask them to turn head to look up towards the opposite side

83
Q

How does the hypoglossal nerve attach to the CNS?

A

Via many rootlets that attach lateral to the pyramids of the medulla oblongata

84
Q

Describe the intracranial course of the hypoglossal nerve?

A

Passes anteriorly towards the hypoglossal canal in the posterior cranial fossa

85
Q

How does the hypoglossal nerve exit the base of the skull?

A

Via the hypoglossal canal of the occipital bone

86
Q

How does the hypoglossal nerve descend in the neck?

A

Lateral to the carotid sheath

87
Q

What does the hypoglossal nerve do at the level of the hyoid bone?

A

Pass anteriorly towards the lateral aspect of the tongue

88
Q

How do you test the hypoglossal nerve?

A

Ask the patient to stick their tongue straight out

89
Q

How do you test the optic nerve? (3)

A

Light reflexes
Visual field testing
Snellen chart

90
Q

How do you test the oculomotor nerve?

A

Extra ocular eye movements

91
Q

How do you test the trochlear nerve?

A

Down and in eye movement

92
Q

How do you test the trigeminal nerve? (2)

A

Facial sensations

Power of muscles of mastication

93
Q

How do you abducent nerve?

A

Eye lateral movement

94
Q

How do you test the facial nerve?

A

Power of muscles of facial expression

95
Q

How do you test the vestibulocochlear nerve?

A

Rhinne’s and Weber’s hearing tests

96
Q

How do you test the vagus nerve? (2)

A

Elevation of the soft palate

Normal swallow and speech

97
Q

How do you test the spinal accessory nerve? (2)

A

Turning of head and shrugging of shoulders

98
Q

How do you test the hypoglossal nerve?

A

Protrusion of the tongue

3rd Year - Neurology (17 decks)

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