H&N summary table (senior's notes)

Question 1

Contents of the superior orbital fissure?

Answer 1

CN3, 4, 6
Outside ring: lacrimal, frontal, CN4
Inside ring: nasociliary, CN3,6
Superior ophthalmic vein

Question 2

Contents of the inferior orbital fissure?

Answer 2

Zygomatic branch of V2,
Inferior ophthalmic vein > cavernous sinus
All to the pterygopalatine fossa

Question 3

Contents of foramen ovale?

Answer 3

CNV3 nerves, Lesser petrosal nerve > otic ganglion, accessory meningeal artery, emissary veins

Question 4

Contents of the foramen spinosum?

Answer 4

Middle meningeal artery, CNV3 branches

Question 5

Content of stylomastoid foramen?

Answer 5

The facial nerve (facial canal)

Question 6

Contents of foramen magnum?

Answer 6

Vertebral artery, medulla oblongata

Question 7

Contents of jugular foramen?

Answer 7

CN9,10,11, IJV (sigmoid sinus)

Question 8

Contents of supraorbital foramen?

Contents of infraorbital foramen?

Answer 8

Supraorbital nerve (V1) and artery
Infraorbital nerve (V2) and artery

Question 9

Content of mandibular foramen?

Answer 9

Inferior alveolar nerve (V3)

Question 10

Content of mental foramen?

Answer 10

Mental nerve (V3)

Question 11

Contents of sphenopalatine foramen?

Answer 11

Sphenopalatine artery,
Nasopalatine nerve *V2,
from pterygopalatine fossa > nasal cavity

Question 12

Contents of greater and lesser palatine foramen respectively?

Answer 12

Greater and lesser palatine nerves and artery

Question 13

Content of incisive foramen?

Answer 13

nasopalatine nerve (V2)

Question 14

In the orbit, what 3 structures in the superior orbital fissure are out of the common tendinous ring?

Answer 14

CN4

V1- lacrimal nerve and frontal nerve

Question 15

Give the arrangement of origin of the cranial nerves in the brainstem.

Answer 15

CN1, 2 not from brainstem
CN 3-4 midbrain
CN5-7 pons
CN8-12 medulla

Question 16

State the course of the olfactory nerve.

Answer 16

1. Receptors at the roof of the nasal cavity
2. olfactory nerves
3. from olfactory mucosa to olfactory bulbs
4. leave cranium through the cribriform plate > synapse in the olfactory bulb
5. axons run in olfactory tracts
6. medial and lateral striae > synapse in olfactory cortex

Question 17

State the course of the optic nerve.

Answer 17

1. axons in retinal ganglion cells
2. Convey visual signals to the brain
3. 2 optic nerves surrounded by meninges and subarachnoid membrane
4. meet at the midline to form optic chiasm
5. divide into optic tracts > medial and lateral branch

Question 18

CN3 in the superior orbital fissure is in between which 2 arteries when it is along the wall of cavernous sinus?

Answer 18

1. posterior cerebral artery

2. superior cerebrellar artery

Question 19

State the location of the branches of CN V1 relative to the extraocular muscles.

Answer 19

1. The frontal branch is on top of the levator palpebrae superioris
2. The lacrimal branch is medial to the lateral rectus
3. The nasociliary branch is near the medial wall of the orbit > anterior ethmoidal nerve to the nasal cavity

Question 20

State the course of the CNV2 maxillary nerve.

Answer 20

Pass through the foramen rotundum.

1. enter the pterygopalatine foramen
2. • posterior superior alveolar nerve
     
     • infraorbital nerve > anterior/ middle superior alveolar nerve

Question 21

State the course of the mandibular nerve. (2 branches)

Answer 21

1. ramify at infratemporal fossa
2. 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
3. Inferior alveolar nerve
   - enter mandibular foramen
   - exit at the mental foramen

Question 22

Which cranial nerve has the longest intracranial course?

Briefly describe.

Answer 22

CN6

from pontomedullary junction to orbit, pass through the cavernous sinus just below ICA

Question 23

State the routes of the main facial nerves. (sensory, motor)

Answer 23

1. Facial nerve proper: motor
   - nerve to stapedius
   - through stylomastoid foramen
   - branch out motor nerves to different muscles (TZBMC)
2. Nervous intermedius (NTS): sensory
3. 1 Greater petrosal nerve (parasympathetic)
   - foramen lacerum
   - pterygoid canal
   - pterygopalatine fossa
   - pterygopalatine ganglion
   - 1. inferior orbital fissure 2. palatine canal
4. 2. Chordae tympani
      - emerge from facial canal, lie on tympanic membrane
      - exit through petrotympanic fissure
      - join lingual nerve (V3)
      - to the tongue and submandibular region

Question 24

Where do motor fibers of the CN7 exit the skull?

Answer 24

stylomastoid foramen > enter parotid gland to form plexus > control facial expression

Question 25

State the routes of the 2 accessory nerves.

Answer 25

1. 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 2. Cranial accessory nerve - from nucleus ambiguus - together with CN9,10, supply pharynx and larynx muscles

Question 26

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?

Answer 26

Hypoglossal nerve

Question 27

Give the branch and sub-branches of CNV1.

Answer 27

1. Lacrimal 2. Frontal - supraorbital - supratrochlear 3. Nasociliary - infratrochlear - anterior ethmoidal nerve

Question 28

Give the foramina that CNV2 pass through and the name of the nervdes.

Answer 28

1. infraorbital foramen - infraorbital nerve (anterior, middle superior alveolar nerve) 2. sphenopalatine foramen - nasopalatine nerve To maxillary teeth: - posterior superior alveolar nerve via palatine canal - Greater and lesser palatine nerve

Question 29

Give the branches (anterior and posterior) of the CNV3.

Answer 29

Anterior - buccal nerve (sensory) - deep temporal nerve - lateral pterygoid nerve Posterior - inferior alveolar nerve > nerve to myohyoid - lingual nerve - auriculotemporal nerve

Question 30

List all the motor supply from CNV3.

Answer 30

1. Tensor veli palatine 2. Tensor tympani 3. anterior belly of the digastric muscle 4. mylohyoid muscle 5. masticatory muscles

Question 31

Give the nerves passing through the 1. geniculate ganglion 2. stylomastoid foramen

Answer 31

Geniculate ganglion 1. Greater petrosal nerve (parasympathetic) 2. Nerve to stapedius (motor) 3. Chorda tympani (taste and parasympathetic) Stylomastoid foramen - form plexus at the parotid - 5 motor branches: Temporal, Zygomatic, Buccal, Marginal, Cervical

Question 32

List all the motor supply from Facial nerve proper.

Answer 32

1. Posterior belly of digastric 2. stapedius 3. Platysma 4. Buccinator 5. Facial muscles 6. Stylohyoid

Question 33

List the 4 sensory supply from the glossopharyngeal nerve.

Answer 33

1. Visceral: carotid body, carotid sinus 2. Taste: posterior 1/3 of tongue 3. Somatic: - interior of tympanic membrane - auditory tube - oropharynx - mucosa of the middle ear - palatine tonsils 4. ANS (parasympathetic) - parotid gland (otic ganglion)

Question 34

List the sensory supply from the vagus nerve.

Answer 34

1. Visceral - taste (epiglottis) 2. Somatic - dura of the posterior cranial fossa - laryngopharynx

Question 35

List the motor supply from the vagus nerve.

Answer 35

1. soft palate muscle (except tensor palatini V3) 2. Pharyngeal muscles (except Stylopharyngeus CN9) 3. Larynx 4. Tongue: palatoglossus only

Question 36

List the motor supply of CN9.

Answer 36

Stylopharyngeus muscle.

Question 37

State the origin of the sympathetic innervation of cranial nerves.

Answer 37

superior cervical ganglion, via the internal carotid plexus

Question 38

List all 4 parasympathetic routes, including the ganglions.

Answer 38

1. CN3, join V1 nasociliary nerve, passes through the ciliary ganglion to supply the iris and ciliary muscles 2. 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 3. CN9, lesser petrosal nerve passes through the otic ganglion, supplying the parotid gland via auriculotemporal nerve 4. CN7, chorda tympani joins V3 lingual nerve, passes through the submandibular ganglion to supply the submandibular and sublingual glands