H&N summary table (senior's notes) Flashcards
Contents of the superior orbital fissure?
CN3, 4, 6
Outside ring: lacrimal, frontal, CN4
Inside ring: nasociliary, CN3,6
Superior ophthalmic vein
Contents of the inferior orbital fissure?
Zygomatic branch of V2,
Inferior ophthalmic vein > cavernous sinus
All to the pterygopalatine fossa
Contents of foramen ovale?
CNV3 nerves, Lesser petrosal nerve > otic ganglion, accessory meningeal artery, emissary veins
Contents of the foramen spinosum?
Middle meningeal artery, CNV3 branches
Content of stylomastoid foramen?
The facial nerve (facial canal)
Contents of foramen magnum?
Vertebral artery, medulla oblongata
Contents of jugular foramen?
CN9,10,11, IJV (sigmoid sinus)
Contents of supraorbital foramen?
Contents of infraorbital foramen?
Supraorbital nerve (V1) and artery Infraorbital nerve (V2) and artery
Content of mandibular foramen?
Inferior alveolar nerve (V3)
Content of mental foramen?
Mental nerve (V3)
Contents of sphenopalatine foramen?
Sphenopalatine artery,
Nasopalatine nerve *V2,
from pterygopalatine fossa > nasal cavity
Contents of greater and lesser palatine foramen respectively?
Greater and lesser palatine nerves and artery
Content of incisive foramen?
nasopalatine nerve (V2)
In the orbit, what 3 structures in the superior orbital fissure are out of the common tendinous ring?
CN4
V1- lacrimal nerve and frontal nerve
Give the arrangement of origin of the cranial nerves in the brainstem.
CN1, 2 not from brainstem
CN 3-4 midbrain
CN5-7 pons
CN8-12 medulla
State the course of the olfactory nerve.
- Receptors at the roof of the nasal cavity
- olfactory nerves
- from olfactory mucosa to olfactory bulbs
- leave cranium through the cribriform plate > synapse in the olfactory bulb
- axons run in olfactory tracts
- medial and lateral striae > synapse in olfactory cortex
State the course of the optic nerve.
- axons in retinal ganglion cells
- Convey visual signals to the brain
- 2 optic nerves surrounded by meninges and subarachnoid membrane
- meet at the midline to form optic chiasm
- divide into optic tracts > medial and lateral branch
CN3 in the superior orbital fissure is in between which 2 arteries when it is along the wall of cavernous sinus?
- posterior cerebral artery
2. superior cerebrellar artery
State the location of the branches of CN V1 relative to the extraocular muscles.
- The frontal branch is on top of the levator palpebrae superioris
- The lacrimal branch is medial to the lateral rectus
- The nasociliary branch is near the medial wall of the orbit > anterior ethmoidal nerve to the nasal cavity
State the course of the CNV2 maxillary nerve.
Pass through the foramen rotundum.
- enter the pterygopalatine foramen
- posterior superior alveolar nerve
- infraorbital nerve > anterior/ middle superior alveolar nerve
- posterior superior alveolar nerve
State the course of the mandibular nerve. (2 branches)
- ramify at infratemporal fossa
- auriculotemporal branch:
- 2 root encircle the middle meningeal artery
- run between TM joint and auricle
- under the parotid gland
- ascend with superficial temporal artery/vein
- carry V3 sensory, CN9 parasympathetic for parotid - Inferior alveolar nerve
- enter mandibular foramen
- exit at the mental foramen
Which cranial nerve has the longest intracranial course?
Briefly describe.
CN6
from pontomedullary junction to orbit, pass through the cavernous sinus just below ICA
State the routes of the main facial nerves. (sensory, motor)
- Facial nerve proper: motor
- nerve to stapedius
- through stylomastoid foramen
- branch out motor nerves to different muscles (TZBMC) - Nervous intermedius (NTS): sensory
- 1 Greater petrosal nerve (parasympathetic)
- foramen lacerum
- pterygoid canal
- pterygopalatine fossa
- pterygopalatine ganglion
- 1. inferior orbital fissure 2. palatine canal - Chordae tympani
- emerge from facial canal, lie on tympanic membrane
- exit through petrotympanic fissure
- join lingual nerve (V3)
- to the tongue and submandibular region
- Chordae tympani
Where do motor fibers of the CN7 exit the skull?
stylomastoid foramen > enter parotid gland to form plexus > control facial expression
State the routes of the 2 accessory nerves.
- Spinal accessory nerve
- for SCM and trapezius
- arise from the cervical spinal cord (C1-C5)
- enter cranial cavity from foramen magnum > posterior cranial fossa
- exit through the jugular foramen - Cranial accessory nerve
- from nucleus ambiguus
- together with CN9,10, supply pharynx and larynx muscles
Which cranial nerve is lateral to carotid, facial and lingual artery, and is deep to the posterior belly of the digastric muscle at the submandibular triangle?
Hypoglossal nerve
Give the branch and sub-branches of CNV1.
- Lacrimal
- Frontal
- supraorbital
- supratrochlear - Nasociliary
- infratrochlear
- anterior ethmoidal nerve
Give the foramina that CNV2 pass through and the name of the nervdes.
- infraorbital foramen
- infraorbital nerve (anterior, middle superior alveolar nerve) - sphenopalatine foramen
- nasopalatine nerve
To maxillary teeth:
- posterior superior alveolar nerve via palatine canal
- Greater and lesser palatine nerve
Give the branches (anterior and posterior) of the CNV3.
Anterior
- buccal nerve (sensory)
- deep temporal nerve
- lateral pterygoid nerve
Posterior
- inferior alveolar nerve > nerve to myohyoid
- lingual nerve
- auriculotemporal nerve
List all the motor supply from CNV3.
- Tensor veli palatine
- Tensor tympani
- anterior belly of the digastric muscle
- mylohyoid muscle
- masticatory muscles
Give the nerves passing through the
- geniculate ganglion
- stylomastoid foramen
Geniculate ganglion
- Greater petrosal nerve (parasympathetic)
- Nerve to stapedius (motor)
- Chorda tympani (taste and parasympathetic)
Stylomastoid foramen
- form plexus at the parotid
- 5 motor branches: Temporal, Zygomatic, Buccal, Marginal, Cervical
List all the motor supply from Facial nerve proper.
- Posterior belly of digastric
- stapedius
- Platysma
- Buccinator
- Facial muscles
- Stylohyoid
List the 4 sensory supply from the glossopharyngeal nerve.
- Visceral: carotid body, carotid sinus
- Taste: posterior 1/3 of tongue
- Somatic:
- interior of tympanic membrane
- auditory tube
- oropharynx
- mucosa of the middle ear
- palatine tonsils - ANS (parasympathetic)
- parotid gland (otic ganglion)
List the sensory supply from the vagus nerve.
- Visceral
- taste (epiglottis) - Somatic
- dura of the posterior cranial fossa
- laryngopharynx
List the motor supply from the vagus nerve.
- soft palate muscle (except tensor palatini V3)
- Pharyngeal muscles (except Stylopharyngeus CN9)
- Larynx
- Tongue: palatoglossus only
List the motor supply of CN9.
Stylopharyngeus muscle.
State the origin of the sympathetic innervation of cranial nerves.
superior cervical ganglion, via the internal carotid plexus
List all 4 parasympathetic routes, including the ganglions.
- CN3, join V1 nasociliary nerve, passes through the ciliary ganglion to supply the iris and ciliary muscles
- CN7, Greater petrosal nerve join deep petrosal nerve + nerve to the pterygoid canal, synapse pterygopalatine ganglion > join V2 (zygomaticotemporal nerve), supplying the lacrimal gland, nasal cavity secretory gland and the palatine gland
- CN9, lesser petrosal nerve passes through the otic ganglion, supplying the parotid gland via auriculotemporal nerve
- CN7, chorda tympani joins V3 lingual nerve, passes through the submandibular ganglion to supply the submandibular and sublingual glands
