Lecture 9: Trigeminal Nerve (V) and Facial Nerve (VII) Flashcards

1
Q

What number is the trigeminal nerve?

A

V

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2
Q

What is CN V?

A

Trigeminal Nerve

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3
Q

What is the function of the trigeminal nerve?

A

Sensory information to the face and motor to the jaw

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4
Q

What is CN VII?

A

Facial Nerve

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5
Q

What CN is the facial nerve?

A

CN VII

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6
Q

What is the function of the Trigeminal Nerve V?

A

Sensory innervation to the face and motor innervation to the jaw

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7
Q

What is the function of the facial nerve?

A

Motor innervation to the face

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8
Q

What are the three divisions of the Trigeminal Nerve V?

A

V1 - Ophthalmic
V2 - Maxillary
V3 - Mandibular

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9
Q

Where does the V1- Ophthalmic exit the skull?

A

The Superior Orbital Fissure

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10
Q

Where does V2 - Maxillary exit the skull?

A

The Foramen Rotundum

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11
Q

Where does V3 - Mandibular exit the skull?

A

The Foramen ovale

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12
Q

Where on the brain stem does the trigeminal nerve exit?

A

The pons

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13
Q

What nerve provides all sensation of the face?

A

The trigeminal nerve

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14
Q

What does V1 - Ophthalmic branch do?

A

Supplies sensation to the forehead

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15
Q

What does V3 - Mandibular branch do?

A

Supplies sensation and motor to the mandible

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16
Q

What does V2 - Maxillary branch innervate?

A

The cheek and upper teeth area

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17
Q

What are the two main functions of the Trigeminal Nerve (V)?

A

*Sensation and proprioception and pain/temperature information from the head
*Motor - Controls the muscles of mastication

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18
Q

What kind of nerve is V1 - Opthalamic?

A

Pure sensory

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19
Q

What kind of nerve is V2 - Maxillary?

A

Pure sensory

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20
Q

What kind of nerve is V3 - Mandibular?

A

Motor and Senory

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21
Q

What is the function of V1?

A

Sensation to the eye and forehead

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22
Q

What is the function of V2?

A

Sensory to the cheek and upper teeth

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23
Q

What is the function of V3?

A

Sensation to the mandible and lower teeth
Motor to the muscles of mastication

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24
Q

What is the trigeminal ganglion?

A

A collection of cell bodies in the PNS that house cell bodies of the trigeminal sensory afferents

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25
Q

What areas does v1 provide sensation for?

A

*Skin to forehead and scalp
*Upper eyelid, tip of the nose
*Cornea and nasal cavity
*Paranasal air sinuses (frontal)
*Regulates corneal reflex

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26
Q

Through what branch does V1 supply sensation to the forehead and scalp?

A

The Supraorbital nerve

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27
Q

What is the Supraorbital nerve do?

A

The branch of V1 that supplies sensation to the ophthalmic division

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28
Q

What nerve regulates the corneal reflex?

A

V1

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29
Q

What nerves travel through the superior orbital fissure?

A

CN III
CN IV
CN VI
CN V1

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30
Q

What areas does the V2 supply?

A

*Maxillary air sinus
*General sensation to nasal cavity
*Lower eyelid, skin of cheek, upper lip
*Maxillary (upper) teeth and gums

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31
Q

What kind of nerve is V2?

A

Pure sensory

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32
Q

What nerve causes a toothache?

A

V2

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33
Q

What is the main branch of V2?

A

The infraorbital nerve

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34
Q

What kind of nerve is V3?

A

Sensory and Motor

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35
Q

What is the main branch of CN V?

A

V3

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36
Q

What are the sensory functions of V3?

A

*Sensation to lower lip, skin of mandible, chin
*Sensation to mandibular teeth and gums (inferior alveolar nerve)
*Sensation to Ant 2/3 of the tongue

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37
Q

What are the two main branches of the sensory portion of V3?

A

Inferior alveolar nerve
Lingual nerve

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38
Q

What does the inferior alveolar nerve do?

A

Supplies sensation to the mandibular teeth and gums

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39
Q

What does the lingual nerve do?

A

Supply sensation to the anterior 2/3 of the tongue

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40
Q

What does the lingual nerve hitchhike on?

A

The chorda tympani which carries taste to the anterior 2/3 of the the tongue from CN VII

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41
Q

What is the general nerve pathway from V1, V2 and V3?

A
  1. Sensory information from the V1, V2 or V3 is sensed
  2. It then goes to the trigeminal ganglion (does not synapse
  3. Synapses at a nucleus of the brainstem (which nucleus depends on the sensation)
  4. It then synapse at the VPM (ventral posteromedial nucleus) of the thalamus
  5. Then to the Contralateral primary sensory cortex
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42
Q

What are the trigeminal nucleus?

A

Three large nuclei in the brainstem where V1, V2 and V3 synapse

43
Q

What are the three Trigeminal Nucleus?

A

*Spinal Nucleus
*Chief/Main Nucleus
*Mesencephalic Nucleus

44
Q

What does the Spinal Nucleus sense?

A

Pain and temperature from V1, V2 and V3

45
Q

What does the Chief/Main Nucleus sense?

A

Touch from V1, V2 and V3

46
Q

What does the Mesencephalic nucleus sense?

A

Proprioceptive tone from the chewing muscles from V3

47
Q

What nucleus senses pain and temperature from V1, V2 and V3?

A

The Spinal Nucleus

48
Q

What nucleus senses touch from V1, V2 and V3?

A

The Chief/Main Nucleus

49
Q

What nucleus sense proprioceptive tone from V3?

A

The Mesencephalic nucleus

50
Q

What occurs at the Trigeminal Nucleus?

A

The trigeminal nerves synapse for the first time there

51
Q

What is the pain pathway for below the head and neck?

A

The spinothalamic anterolateral pathway

52
Q

What is the pathway of pain from V1, V2, and V3?

A
  1. Pain is sensed in V1,V2 or V3
  2. It synapses of the spinal trigeminal nucleus in the medulla and switches sides
  3. It then travels up the trigeminothalamic tract to the VPM nucleus of the thalamus, where it synapses
  4. It then travels to the contralateral primary sensory cortex
53
Q

Where does the head pathway switch sides?

A

It switches when it synapses at the spinal trigeminal nucleus

54
Q

Which trigeminal nucleus does the pain pathway of the head synapse?

A

The spinal trigeminal nucleus

55
Q

Where does the pain pathway of the head synapse?

A

*Spinal trigeminal nucleus of the medulla
*VPM nucleus of the thalamus

56
Q

What is the order of neurons in the pain pathway of the head?

A
  1. From V to spinal trigeminal nucleus
  2. From spinal trigeminal nucleus to VPM
  3. From VPM to contralateral primary sensory cortex
57
Q

What nucleus does the light touch, pressure pathway of the head synapse one?

A

The chief nucleus

58
Q

What is the light touch, pressure pathway of the head?

A
  1. Light touch or pressure is sensed in V1, V2 and V3
  2. It synapses at the chief nucleus in the pons and switches sides
  3. It travels up the trigeminothalamic tracts to the VPM in the thalamus
  4. The travels to the contralateral primary sensory cortex
59
Q

Where does the light touch pain pathway of the head synapse?

A

At the Chief nucleus in the pons and the VPM of the thalamus

60
Q

What is the order of neurons in the light touch pain pathway of the head?

A
  1. From sense to chief nucleus in the pons
  2. From chief nucleus in pons to VPM
  3. From VPM to contralateral primary sensory cortex
61
Q

Where does the light touch pain pathway of the head switch sides?

A

At the level of the pons when it synapses on the chief nucleus

62
Q

What is the light touch pressure pathway of the head and neck analogous to?

A

The dorsal column medial lemniscal pathway

63
Q

What are the differences between the dorsal column medial lemniscal pathway and the light touch pain pathway in the head?

A

The dorsal column medial lemniscal pathway doesn’t cross over until it synapses at the medulla at the gracile or cuneate nucleus and synapse at the VPL nucleus of the thalamus

64
Q

What does the Mesencephalic nucleus do?

A

Carries proprioceptive information from muscles of mastication to the brainstem to relay information on the force of a bite

65
Q

What are the steps in the proprioception pathway (V3) of the head?

A
  1. Proprioception from the chewing muscles is sensed
  2. This then synapses at the mesencephalic nucleus and crosses sides
  3. It then travels up the trigeminothalamic tract to the VPM nucleus of the thalamus
  4. Then to the contralateral primary sensory cortex
66
Q

Where does the V3 Proprioception pathway of the head cross over?

A

The Mesencephalic nucleus

67
Q

Where does the V3 Proprioception pathway of the head synapse over?

A

The Mesencephalic nucleus and the mesencephalic nucleus

68
Q

What is the Motor Trigeminal nucleus?

A

Another nucleus of the brainstem that sends it neurons through the mandibular nerve to the muscles of mastication

69
Q

What are the Motor functions of the mandibular nerve?

A

It innervates the muscles of mastication: Masseter and Temporalis

70
Q

What are the muscles of mastication?

A

The Masseter and the Temporalis

71
Q

What do the masseter and temporalis muscle do?

A

Shuts the mandible

72
Q

What nerve allows the jaw to shut?

A

V3

73
Q

What nucleus in the thalamus do all the head pathways synapse at?

A

The VPM nucleus in the thalamus

74
Q

Where do all the head pathways cross over?

A

At the brainstem when they synapse at the trigeminal nuclei

75
Q

What are the characteristics of the innervation of UMN to the V3?

A

The innervation is bilateral meaning the the upper motor neuron innervates both sides because we don’t just chew one side

76
Q

What occurs in the Corticobulbar tract of V3?

A

The UMN in the primary motor cortex will act on the LMN in the trigeminal motor nucleus to allow the muscles of mastication to chew (bilaterally, so it innervates both sides)

77
Q

What are the four parasympathetic neurons?

A

*Oculomotor (III)
*Facial (VII)
*Glossopharyngeal (IX)
*Vagus (X)

78
Q

What are the motor nerves in the head that receive bilateral innervation?

A

*Oculomotor (III)
*Abducens (VI)
*Trochlear (IV)
*Trigeminal (Mandibular V3)
*Facial (with exceptions)
*Hypoglossal (XII)

79
Q

What type of nerve is the Facial Nerve?

A

Mixed nerve - Motor, Sensory, Parasympathetic

80
Q

What is the Motor function of the Facial Nerve?

A

*Muscles of facial expression
*Stapedius

81
Q

What is the sensory function of the Facial Nerve?

A

*Taste to the anterior 2/3 of the tongue (via chorda tympani)
*Some sensory to skin around the ear (tragus)

82
Q

What is the Parasympathetic function of the Facial Nerve?

A

*Lacrimal gland (eye)
*Sublingual and submandibular salivary glands (below the tongue)

83
Q

Where does the lingual nerve originate?

A

It is a branch of V3 mandibular nerve

84
Q

Which nerve does the Facial Nerve (VII) sit close to?

A

The vestibulocochlear nerve

85
Q

Where does the facial nerve exit the brainstem?

A

Between the pons and the medulla

86
Q

Where does the Facial nerve exit the cranial vault?

A

Internal Acoustic Meatus

87
Q

What innervates the stapedius muscle?

A

The facial nerve

88
Q

What nerve supplies taste ti the anterior 2/3 of the tongue?

A

The facial nerve via the chorda tympani

89
Q

What is the chorda tympani?

A

The part of the facial nerve that supplies taste to the anterior 2/3 of the tongue and joins the lingual nerve. The sublingual and submandibular glands innervated by the facial nerve also hitchhike onto the chorda tympani to join the lingual nerve

90
Q

What are the five branches of the CN VII?

A

*Temporal
*Zygomatic
*Buccal
*Marginal mandibular
*Cervical

91
Q

What is the stylomastoid foramen?

A

The part of the face that the facial nerve exits

92
Q

What part of the face does the facial nerve exit?

A

The stylomastoid foramen

93
Q

What nerve is responsible for the urge to blink during the corneal refelc?

A

Touch from V1 and motor from CN VII

94
Q

What is interesting about the motor innervation of the face?

A

The top ⅓ of the face is bilaterally innervated meaning the nerves from both sides innervate both sides. So if there is a stroke on one side the other side is weak but can still move. The bottom ⅔ of the face is not bilaterally innervated meaning the one nerve innervates each side. So if there is a stroke in one nerve the side of the face that it innervates can’t move. The contralateral side can’t move.

95
Q

What does a LMN lesion in the motor pathway of the face cause?

A

Ipsilateral paralysis of entire 1/2 of face

96
Q

What does an UMN lesion in the motor pathway of the face cause?

A

Contralateral paralysis of lower 2/3 of the face

97
Q

Lingual nerve vs Chorda Tympani?

A

The lingual nerve is a branch of V3 that innervates sensation to the anterior 2/3 of the tongue. The Chorda tympani is a branch of the facial nerve that innervates taste to the anterior 2/3 of the tongue and it hitchhikes onto the lingual nerve

98
Q

What synapses at the nucleus if the solitary tract?

A

Taste axons

99
Q

Through which ganglion does the facial nerve innervate the submandibular and sublingual salivary glands?

A

The submandibular ganglion (V3)

100
Q

What will the chorda tympani of CN VII contain?

A

*Parasympathetic innervation of the salivary glands
*Taste to anterior 2/3 of the tongue

101
Q

What allows for the eyeballs to stay moist?

A

The lacrimal innervation from CN VII and blinking

102
Q

What is the superior salivatory nucleus?

A

Where the preganglionic parasympathetics from the facial nerve come out join with the chorda tympani and goes to the salivary glands

103
Q

What is the nucleus of the solitary tract?

A

Where the taste axons of the facial nerve synapse