Head 3 (nerves) Flashcards

1
Q

Which cranial nerves carry parasympathetic pre-ganglionic fibers with them

A

3, 7, 9 (to the head)
10 (to cervical, thoracic, and abdominal viscera)

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2
Q

which cranial nerves are sensory

A

1, 2, 8

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3
Q

Which cranial nerves are mixed

A

5, 7, 9, 10

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4
Q

Which cranial nerves are motor

A

3, 4, 6, 11, 12

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5
Q

List the cranial nerves

A

1 - olfactory
2 - optic
3 - oculomotor
4 - trochlear
5 - trigemal
6 - abducent
7 - facial
8 - vestibulocochlear
9 - Glossopharyngeal
10 - Vagus
11 - Accessory
12 - Hypoglossal

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6
Q

Which cranial nerves are involved in eating/eliminating

A

5, 7, 9, 10, 12

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7
Q

which is the largest cranial nerve

A

Trigeminal n

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8
Q

List the branches of the trigeminal nerve and if they are sensory, motor, or mixed and which foramen each exits

A

V1 = Opthalmic, sensory (to eye and adnexa), orbital fissure
V2 = Maxillary, sensory, round foramen
V3 = Mandibular, mixed, oval foramen

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9
Q

Origin of Trigeminal n

A

Motor nucleus: pons
Sensory larger root: trigeminal ganglion

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10
Q

Describe the shape and location of the trigeminal ganglion

A

aka semilunar ganlion
crescent shape
locates in cranial cavity, outside the brain

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11
Q

What is in the trigeminal ganglion

A

Is a sensory ganglion containing cell bodies of pseudounipolar sensory neurons, similar to the dorsal root ganglion of the spinal cord. Gives the V1, V2 & the sensory part of V3 (mandibular)

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12
Q

Maxillary nerve origin

A

Trigeminal ganglion

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13
Q

Maxillary nerve course

A

Runs on cavernous sinus (with ophthalmic and 3) and passes through round foramen (orbitorotundum in Ru.)

Then goes to alar canal (in canine and equine) and rostral alar f.

to Ptyerygopalatine fossa to maxillar foramen to infraorbital canal and infraorbital f.

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14
Q

Maxillary nerve branches

A

Zygomatic, Pterygopalatine, infraorbital (continuation of maxillary n)

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15
Q

What are the branches of the zygomatic n

A

Zygomaticotemporal
Zygomaticofacial

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16
Q

What are the branches of the pteryogopalatine and what do they supply

A

Lesser palatine - soft palate
Greater palatine - hard palate
Caudal nasal - nasal cavity and maxillary sinus

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17
Q

What does the infraorbital n do

A

Runs in infraorbital canal and supplies the upper dental arcade via the caudal, middle, and rostral superior alveolar branches and continues outside the canal

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18
Q

What does the infraorbital n divide into and when does it divide

A

Outside the canal → divides into:
External nasal
Internal nasal
superior labial

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19
Q

What runs in the infraorbital canal and name its two openings

A

Infraorbital VAN
Caudal opening = maxillary foramen
Rostral opening = infraorbital foramen

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20
Q

Mandibular n course

A

Passes through oval foramen (foramen lacerum in horse)
short course ventrally to enter mandibular foramen of mandible
passes through mandibular canal and emerges at mental foramina as mental n.

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21
Q

Which main group of muscles does the mandibular n supply?

A

muscles of mastication (except caudal belly of digastric)

also supplies mylohyoideus, tensor veli palatini, and tensor tympani

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22
Q

List the motor branches of the mandibular n and what muscle they innervate

A

masticator -> massester m and rostral belly of digastric
deep temporal -> temporalis m
deep pterygoid -> pterygoid mm
mylohyoid -> mylohyoid m
tensory veli palatini -> tensory veli palatini m
tensor tympani n -> tensor tympani n m

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23
Q

List the sensory branches of the mandibular and what area they supply

A

Auriculotemporal - skin near rostral part of ear and eye (note: Gives sensation to same field for which the dorsal buccal of 7 provides motor innervation)
buccal - inside cheek
lingual - general and special sense of tongue
inferior alveolar - all lower teeth
mental - skin of chin

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24
Q

Describe the auriculotemporal n branches

A

Branches to transverse facial n and communicating br with dorsal buccal of 7

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25
Q

Facial nerve course

A

Origin: medulla oblongata at lateral part of trapezoid body
through Stylomastoid foramen
Very superficial under skin on lateral side of face

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25
Q

Which nerve passed through middle ear and can be affected by otitis media

A

Facial n

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25
Q

What does facial nerve do

A

Muscles of facial expression
Taste, rostral 2/3 of tongue
secretions (saliva, lacrimal, nasal)
Note: it is the only parasym supply to lacrimal gland

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25
Q

Name the three main branches of the facial nerve

A

Auriculopalpebral
Dorsal buccal
Ventral buccal

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25
Q

What does auriculopalpebral n do

A

Motor to orbicular oculi - muscle that closes eyelid

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25
Q

What does supraorbital n do and what is it a branch of

A

Sensory to upper eyelid
Branch of CN 5 ophthalmic nerve

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25
Q

Glossopharyngeal n origin and foramen

A

Lateral aspect of medulla oblongata and goes through jugular foramen

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25
Q

Glossopharyngeal n function

A

motor to pharynx
sensory to pharynx and carotid sinus (baro and chemo receptors)
Special sense for tastes in caudal 1/3 of tongue
parasympathetic to zygomatic and parotid salivary glands

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25
Q

Vagus n origin and foramen

A

Lateral aspect of medulla oblongata and goes through jugular foramen
note: longest CN

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25
Q

What does vagus n do

A

parasymp. innervation to viscera of pharynx, nech, thorax, and abdomen

motor and general sensory to soft palate, pharynx, larynx, trahea, esophagus, thoracic viscera, and abdominal viscera

Few special sense (taste from epiglottis)

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26
Q

What are the important branches from the vagus and what do they do

A

Cr laryngeal n: motor to one laryngeal n, sensory to laryngeal mucosa

Ca. laryngeal n: continuation of the recurrent laryngeal n and motor to laryngeal mm

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26
Q

What does the man’s face represent?

A

Otic Ganglion
1) Sensory branches (buccal n, lingual n, inf. alveolar n)
2) tensor veli palatini n
3) Temporalis m
4) medial pterygoid m
5) masseter m
6) Lateral pterygoid m
7)Tensor tympani n

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27
Q

How is accessory n unique

A

only cranial n that does not take part in innervation of head structures

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27
Q

What can occur with a trigeminal nerve injury

A

Trigeminal Neuritis: Results in sensory deficit of the face and dropped jaw (paralysis of the muscles of mastication).

Note: Wear gloves on dealing with any acute neurologic
disease (like trigeminal neuritis) as rabies is a
differential diagnosis, especially in unvaccinated
animals.

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28
Q

Accessory n course

A

Passes through F. magnum to join medullary root and exit via jugular. foramen

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28
Q

What are differentials for temporalis and masseter muscle atrophy

A

Masticatory muscle myositis
Trigeminal neuropathy

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29
Q

What does accessory n do

A

Motor to omotransversarius, cleidocephalicus, trapezius, and sternocephalicus

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29
Q
A

1) Auriculotemporal n
2) Mylohyoid n
3) Inferior alveolar
4) Lingual n

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30
Q

Hypoglossal n function

A

motor to all muscles of tongue

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30
Q

Describe the path of the inferior alveolar n

A

Enters the mandibular canal → lower dental
arcade
It exits the mental foramina as the mental
nerves.

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31
Q

Hypoglossal n course

A

Origin: Ventral(not lateral!!) aspect of medulla oblongata (motor nucleus of hypoglossa)
exits hypoglossal canal and runs lateral to ext. carotid a. with linguofacial trunk (horse and ruminant) or lingual a (dog)

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31
Q

Facial nerve sensory innervation

A

inner pinna
special sensory for taste for rostral 2/3 of tongue

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32
Q

What nerve(s) runs here and name the foramen

A

Optic (CN 2), optic canal

32
Q

Facial nerve motor innervation

A

Motor nerve of the face → mm of facial expression & caudal digastricus m

33
Q

What nerve(s) runs here and name the foramen

A

Oculomotor (CN 3) and Trochlear (CN 4)
orbital fissure (orbitorotundum in Ru.)

33
Q

Facial nerve parasympathetic ganglion and innervation

A

Pterygopalatine ganglion the innervation to:
Lacrimal gland
nasal glands
palatine glands

Also innervates
Mandibular and sublingual salivary glands

34
Q

Name this nerve

A

Trochlear n (CN 4)

34
Q

What foramen does the facial nerve run though

A

Sensory, motor fibers run through stylomastoid foramen

parasymp, special sensory fibers run through petrotympanic fissure

35
Q

What are these nerves branches of? and what is their function?

A

Branches of Ophtalmic nerve (V1 of trigeminal- all sensory)
1) Supraorbital n
2) frontal n
3) Lacrimal n
4) Nasociliary n
4’) Infratrochlear

35
Q

What is the chorda tympani n

A

Arises from the facial n. within the middle ear. It carries special sensory fibers from rostral 2/3 of tongue
(fungiform papillae) & parasympathetic fibers → sublingual & mandibular salivary glands.
Runs with mandibular lingual br

36
Q

Name nerve and clin sig

A

Cornual br of infratrochlear n
Important in dehorning in small ru.

36
Q

Describe the route of the chorda tympani n

A

It leaves via petrotympanic fissure, and ride with the lingual n. (regular sensory) of mandibular n. → tongue.

37
Q
A

1) Infratrochlear n
2) frontal n

37
Q
A

1) Dorsal buccal br of 7
2) ventral buccal br of 7
3) Stylomastoid foramen
4) auriculopalpebral n
5) palpebral br

38
Q

What are these nerves branches of? and what is their function

A

Branches of Maxillary nerve (V2 of trigeminal- all sensory)
5) maxillary n
6) infraorbital n
7) zygomatic n
8) pterygopalatine n
9) lesser palatine n
10) greater palatine n
11) caudal nasal n

38
Q

Which nerve runs through the parotid sg

A

7 (but does not innervate it)

39
Q

What innervates these sensory regions

A

1) Ophthalmic n
2) maxillary n
3) mandibular n

39
Q

Which nerve supplies the parotid sg

A

CN 9

40
Q

What are these nerves branches of? and what is their function

A

Branches of Maxillary nerve (V2 of trigeminal- all sensory)
1) Zygomaticotemporal n
2) Zygomatic n
3) Maxillary n
4) Pterygopalatine n
5) Superior alveolar nn (not a maxillary br)
6) Inferior alveolar n

40
Q

which cn’s share common entry at internal acoustic meatus and clin sig

A

7,8
So, vestibular involvement if facial nerve is affected by infection.

41
Q
A

1) Infraorbital n
2) Zygomaticotemporal n
3) Zygomaticofacial n

41
Q

Which nerve supplies the occipitomandibularis m

A

Facial n

42
Q
A

1) Cornual br of infratrochlear n
2) cornual br of zygomaticotemporal n
3) Frontal n

42
Q

Which nerve is vulnerable in the ruminant while in lateral recumbency

A

only the dorsal buccal branch
ventral is protected by edges of mandible and masseter

43
Q

What nerve(s) runs here and name the foramen

A

Mandibular n of Trigeminal n (CN 5),
Oval foramen (foramen lacerum in horse)

43
Q
A

1) Palpebral branches
2) auriculopalpebral n
3) Dorsal buccal br of 7
4) ventral buccal br of 7

44
Q

What are these nerves branches of? and what is their function

A

Branches of Mandibular n (V3 of trigeminal - motor and sensory)
13) Masticator n (motor)
14) Deep temporal n (motor)
15) Buccal n (sensory)
16) Deep pterygoid n (motor)
17) Auriculotemproal (sensory)
18) Lingual (sensory)
19) Inferior alveolar (sensory)
19’) Mylohyoid n (motor)
19’’) Mental (sensory)

44
Q
A

1) Dorsal buccal br of 7
2) Ventral buccal br of 7

45
Q
A

1) Auriculotemporal n
2) Mylohyoid n
3) Inferior alveolar
4) Lingual n

45
Q
A

1) Dorsal buccal br of 7
2) Ventral buccal branch of VII

46
Q
A

1) Maxillary br (CN 5)
2) Ophthalmic br (CN 5)
3) Facial nerve (CN 7)
4) Mandibular br (CN 5)
5) C2 (Dorsal branch)

46
Q

in which situations can the facial nerve be affected

A

Trauma to the face
Parotid salivary gland tumors or infections
Chronic middle ear infections (otitis media)

47
Q
A

Auriculopalpebral br of Facial n (CN 7)

47
Q

What clin sign would be seen if facial n is injured

A

Unilateral paralysis the lip and nose are pulled to the healthy side due to muscle tone

48
Q
A

1) Dorsal buccal br of CN 7
2) Ventral buccal br of CN 7
3) Parotid duct
4) Parotid salivary gland

48
Q

Which clinical sign if lesion is in central part of facial nerve

A

If lesions in central parts → affect the whole facial field
* paralysis of ear, eyelids, nose and lip muscles
* Loss of secretions of the lacrimal gland
* Reduce salivary gland secretion.

49
Q
A

5) Dorsal buccal br of CN 7
6) Ventral buccal br of CN 7
10) Parotid duct
11) Parotid salivary gland

49
Q

Which clin signs would be see if lesion is peripheral in facial nerve

A

Peripheral lesions (in middle ear or outside the skull)
* → unilateral paralysis of muscles of facial expression
* (asymmetrical dropping of the muzzle and inability to close the
eye → keratoconjunctivitis sicca. * In humans → hyperacusis (due to stapedial n paralysis). * In the horse the subcutaneous part of the nerve is damaged by
pressure from a tight halter → paralysis of lips and cheeks.

50
Q

Which unique response in the horse requires the facial nerve and in which situation may that be harmed

A

Flehmen

The buccal branches of the facial nerve Cross the lateral aspect of the masseter m. and is susceptible to injury→ facial paralysis
(e.g. a horse lying on a harness buckle during surgery- buccal on buckle)

50
Q

Describe the facial trigeminal reflex arc

A

CN7 supplies the motor component to the sensory component of CN5.
Pricking the face with a pin checks this arc.
If either nerve is paralyzed, then a twitch of the muscles will not be elicited.

51
Q

Describe the parasymp innervation of the glossopharyngeal n

A

Parasympathetic To dorsally located SGs (parotid, buccal & zygomatic)

52
Q

Describe general sensory innervation of the glossopharyngeal

A

middle ear
carotid Sinus & body
cd 1/3 of tongue pharynx

53
Q

Describe special sensory innervation of the glossopharyngeal

A

Taste buds on caudal 1/3 of tongue

54
Q

Describe motor innervation of the glossopharyngeal

A

Motor to mm of pharynx + branch to stylopharyngeus m. (by itself)

55
Q

Name the ganglion for the postganglionic neurons (parasymp) in the glossopharyngeal n

A

Otic ganglion

56
Q

The postganglionic neurons (parasymp) in the glossopharyngeal n run closely with which other nerve

A

Mandibular br

57
Q

Which foramens does the glossopharyngeal nerve exit

A

Jugular f. & Tympano-occipital fissure

58
Q

Clin sig of gag reflex

A

CN9 & CN10 are most important for swallowing - Gag reflex (afferent IX / efferent X)
* Gag reflex deficits as dysphagia may occur due to CN IX or X (loss of afferent pathways
from the laryngeal additus and from loss of motor vagal pathways to the pharyngeal Mm.)

59
Q

List Ddx for lack of gag reflex

A

CN IX has no contributions to larynx.
So if larynx is normal, probably 9 is the problem
if larynx affected then 10 is affected

Note: The gag reflex involves complex interplay among the CN 5,9,10 &12

60
Q

Why do rabies patients have a fear of water

A

Due to paralysis of the pharynx (9,10)
(therefore, if paralyzed have rabies as a differential)

61
Q

Where does cn9 travel in the horse

A

on guttural pouch caudal to stylohyoid bone

62
Q

What is the nucleus ambiguus

A

shared motor nucleus for IX, X, and XI

63
Q

Where does the lingual nerve run and clin sig

A

crosses the lateral aspect of stylopharyngeus
m. to reach root of tongue.

During its course, it is related to the lateral
aspect of the palatine tonsillar pouch.
Therefore, during surgical removal of the
palatine tonsil, one should consider the
close proximity of this nerve.

64
Q

What does the lingual n supply

A

The lingual nerve not only supplies the tonsil,
but also the caudal 1/3 of the tongue with
GVA (temp and nociception) and SVA fibers (vallate and foliate papillae).

65
Q

Vagus nerve special sensory innervation

A

special sensory taste to root of larynx, & pharynx, of tongue & epiglottis

66
Q

Vagus nerve motor innervation

A

Straited mm of larynx and pharynx (except stylopharyngeus)

66
Q

Clin sig of vagus motor innervation

A

The only n. supplying
the larynx -if paralyzed → no
swallowing

67
Q

Vagus nerve general sensory innervation

A

Sensory from larynx, pharynx, viscera

68
Q

Vagus nerve parasymp innervation

A

to viscera

69
Q

Where does the vagus nerve exit

A

Jugular foramen and tympano-occipital fissure

70
Q

Name the ganglia for the vagus

A

Proximal and distal ganglia of vagus

71
Q

Where does vagus run in horses

A

Over guttural pouch

72
Q

What can cause vagus nerve problems

A

Nucleus Ambiguous (motor) lesions- middle part

73
Q

Descrive hypoglossal n origin, exit, androute

A

rom the ventral aspect of medulla oblongata
(hypoglossal nucleus) *
Exit via hypoglossal canal
lies lateral to the external carotid artery *

follows the caudal curvature of the styloglossus M.

74
Q

Which nerves does the hypoglossal run closely with

A

Runs between 9 & 11

75
Q

Hypoglossal nerve innervation

A

Only motor
ALL tongue Mm. + geniohyoideus & sternohyoideus (via ansa cervicalis)

76
Q

What is the ansa cercicalis and what does it supply

A

Connection between C1 and CN12 *
This loop supplies:
* Geniohyoideus * Sternohyoideus * Sternothyroideus

77
Q

What clinical signs are seen with hypoglossal n dysfunction (compare unilateral vs bilateral)

A

Lack of resistance to pull tongue out of the mouth
* Inability to retract it.
* Dysphagia, animal can’t prehend food or water

unilateral paralysis, the tongue is curved towards the paralyzed
side & atrophied on the paralyzed side.

bilateral (diffuse cerebral damage or diseases of the medulla
oblongata (ex. Neoplasm) may involve the motor nucleus of the
CNXII → tongue paralysis → atrophy of the denervated tongue
muscles) → complete paralysis of the tongue which hangs flaccidly
from the mouth

78
Q

Where does hypoglossal nerve run in the horse

A

Passes through the medial compartment of the
guttural pouch (GP), in a common fold with the CN 9.

79
Q

Guttural pouch disease can affect which cranial nerves and what clinical signs might occur

A

damage of the
cranial nerves 7, 9, 11 & 12. → can be loss of sensibility & taste up to paralysis of the tongue.

80
Q

Guttural pouch (name #6-12)

A

(6) CN IX
(7) internal carotid a. enveloped by fold of (GP) (8) CN XII emerging from hypoglossal canal
(9) CN XI
(10) cranial cervical ganglion
(11) CN X
(12) cervical sympathetic trunk;