lecture 19: CN XI and XII Flashcards

1
Q

which of the following nuclei is not shared by Cn IX and X

inferior salivatory nucleus
sensory trigeminal nucleis
nucleus ambiguous
nucleus solitaries

A

inferior salivatory nucleus

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2
Q

a patient presents with a uvular deviation to the left when saying ahh and an absent gag reflex unilaterally, which of these structures is damaged

left vagus n
right vagus n
left glosso n
right glosso n

A

right vagus n

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3
Q

what is CN XI

A

accessory n

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4
Q

is the accessory n motor, sensory or mixed

A

motor

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5
Q

what is the main function of the accessory n

A

voluntary motor innervation of sternocleidomastoid and trapezius

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6
Q

what does the sternocleidomastoid muscles do

A

contralateral rotation and ipsilateral flexion of the neck

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7
Q

true or false: the SCM does ipsilateral rotation and ipsilateral flexion of the neck

A

false, contralateral rotation

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8
Q

what does the trapezius muscle m do

A

scapular movement, upper limb support and posterior stability

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9
Q

how does the accessory n enter the skull

A

via foramen magnum

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10
Q

why does the accessory n need to enter the skull thru foramen magnum

A

because it starts in cervical region of the spine

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11
Q

how does the accessory n exit the skul

A

via jugular foramen

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12
Q

the accessory n exits skull via via jugular foramen with what other two nerves

A

glosso and vagus

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13
Q

where is the accessory nuclei located

A

in the lateral portion of the anterior grey horn (spinal root from c1-c5/6

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14
Q

true or false: the accessory nuclei is located in the lateral portion of anterior grey horn

A

true

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15
Q

spinal root for accessory nuclei is what cervical levels

A

c1-c5./c6

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16
Q

true or false, accessory nuclei get corticonuclear input

A

true

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17
Q

is the accessory nuclei somatic or branchial motor

A

branchial motor

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18
Q

is there a cranial component to the accessory nuclei

A

yes it is associated with nucleus ambigguus
(cranial root believed to join the vagus nerve en route to muscles of palate, larynx and pharynx

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19
Q

explain the UMN control of the XI n

A

1) UMN in primary motor cortex (neck area)
2) corona radiata
3) internal capsule (gene)
4) cerebral peduncle
5) basal pons
6) pyramids (decussation)
=ipsialteral for SCM
=contralateral for trap

7) synapse with LMN in accessory motor nucleis

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20
Q

explain what happens at the pyramids for cortciconuclear control of the CN XI

A

UMN stays ipsialtearl for the SCM
UMN goes contralateral for trapezius

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21
Q

where do UMN synapse with LMN for the CN XI

A

in accessory nuclei

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22
Q

is hypoglossal n purely motor, sensory or mixed

A

motor

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23
Q

what is the general function of the hypoglossal n

A

voluntary motor innervation of intrinsic tongue muscles (change the shape of the tongue)

voluntary motor innervation of all extrinsic tongue muscles (except palatoglossus CN X)
=movement of the tongue

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24
Q

what do the intrinsic muscles of the tongue do to the tongue

A

change the shape of the tongue

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25
Q

what do the extrinsic muscles of the tongue do

A

movement of the tongue (retraction. elevation)

26
Q

what are some examples of external tongue muscles

A

genioglossus
hyoglossus
styloglossus
(palatoglossues)

27
Q

what is the only extrinsic tongue muscle not innevated by the hypoglossal

A

palatoglossus (CN X)

28
Q

which n innervates palatoglossus

A

CN X

29
Q

how does the hypoglossal n exit the skull

A

via the hypoglossal canal (at the edge of the foramen magnum)

30
Q

the hypoglossal nucleus is what type of nucleus

A

somatic motor

31
Q

true or false; the hypoglossal nucleus carries motor innervation to all muscles of the tongue

A

false, all muscles except palatoglossus

32
Q

where does the hypoglossal nerve emerge from in the brainstem

A

emerges from the medulla ventral to the olives
(between pyramids and olives)

33
Q

true or false, the hypoglossal n emerges from the medulla dorsal to the olives with CN IX and X

A

false, ventral

34
Q

what is the level of the brainstem where we would find hypoglossal nucelus

A

rostral medulla

35
Q

what is the characteretisc symptom for a trapezius problem

A

shoulder droop

36
Q

what is the characteretisc symptom for a SCM problem

A

weak SCM (Difficulty turning to opposite side)

37
Q

will the symptoms for a trapezius issue always be contralateral to the lesion

A

no contralat for UMN
ipsilat for LMN

38
Q

will the symptoms for a SCM issue always be contralateral to the lesion

A

false, always IPSI

39
Q

an UMN of spinal accessory will cause what deficits

A

deficits to the contralateral trapezius
deficits to the ipsilat SCM (difficulty turning to opposite side)

40
Q

person lesions the UMN of the spinal accessory at the right cerebral peduncle, what is the symptoms

A

deficits to the left trapezius (left shoulder drop)
deficits to the right SCM (difficulty turning to left side)

41
Q

an LMN of spinal accessory will cause what deficits

A

deficits to the ipsilateral trapezius
deficits to the ipsilat SCM (difficulty turning to opposite side)

42
Q

person lesions the LMN of the left spinal accessory nucleus, what are the symptoms

A

deficits to the left trapezius (left shoulder drop)
deficits to the Left SCM (difficulty turning to right side)

43
Q

a person has an issue with their right trapezius and right SCM at the same time, is the lesion UMN or LMN

A

LMN

44
Q

true or false: the hypoglossal and spinal accessory nucleus are both. branchial motoro

A

false
accessory=branchial
hypoglossal=somatic

45
Q

explain pathway for UMN (corticinucleuar) for hypoglossal n

A

1) UMN in primary motor cortex (tongue region)
2) corona radiate
3) IC (genu)
4) cerebral peduncle
5) basal pons
6) synapse with LMN in the hypoglossal nucleus
-contraltaeral for the genioglossus only
-bilateral for all other tongue muscles

46
Q

explain the synapse with LMN in the hypoglossal corticunuclear pathway (ie> explain the decussation)

A

-contraltaeral for the genioglossus only
-bilateral for all other tongue muscles

47
Q

what is the function of the genioglossues muscle

A

tongue protrude

48
Q

true or false and why: the majority of the tongue muscles will be unaffected by an UMN lesion

A

true because they receive bilateral innervation

49
Q

explain the deficits seen in an UMN nerve palsy for hypoglossal n

A

UMN lesion results in tongue deviation to the contralateral side (paralyzing contralateral genioglossus)

50
Q

an UMN lesion results in tongue deviation to the BLANK side (paralyzing Blank genioglossus)

A

contrlatearl for both

51
Q

an UMN lesion results in tongue deviation to the contralateral side (paralyzing BLANK genioglossus)

A

CONTRLATERAL

52
Q

If i lesion my right UMN in hypoglossal n pathway, what will be the deficits

A

tongue will deviate towards contralateral side/left side (paralyze my left genioglossues)

53
Q

If i lesion my right LMN in hypoglossal n pathway, what will be the deficits

A

tongue will deviate towards ipsilateral side/right side (paralyze my right genioglossues)

rightside of tongue will looks fucked up (fasciualtions)

54
Q

explain the deficits seen in a LMN nerve palsy for hypoglossal n

A

LMN lesion results in tongue deviation to the ipsilateral side (paralyzing ipsialteral genioglossus)

tongue will not be symmetrical (ie facsiculatinons, weird appearance on one side since all muscles affected)

55
Q

a LMN lesion results in tongue deviation to the BLANK side (paralyzing Blank genioglossus)

A

ipsualtearl for both

56
Q

a LMN lesion results in tongue deviation to the ipsialteal side (paralyzing BLANK genioglossus)

A

ipsialteral

57
Q

add slides on medial medullary syndrome

A
58
Q

what is the associated foramen of the accessory n

A

enter skull thru foramen magnum
exit through jug foramen

59
Q

true or false, the spinal accessory innervates the SCM and the lat dorsi

A

false, the SCM and trap

60
Q
A