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Neuroscience1 > Medulla & CN IX, X, XI, XII > Flashcards

Medulla & CN IX, X, XI, XII Flashcards

1
Q

Location of cell bodies of CN XII

A

Cell bodies of LMN are in the hypoglossal nucleus (near the midline & ventral to central canal of medulla)

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2
Q

Where CN XII nerve fibers emerge

A
  1. Axons pass inferolateral next to medial lemniscus and pyramids
  2. Exit medulla as rootlets in the ventrolateral (preolivary) sulcus
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3
Q

Corticobulbar fibers of CN XII

A

UMN of CN XII

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4
Q

Corticobulbar fibers origin (CN XII)

A

Tongue region of the pre central gyrus (primary motor cortex)

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5
Q

Corticobulbar fibers termination (CN XII)

A

Fibers descend w/ the corticospinal tract to the medulla, where most cross midline and synapse in the contralateral hypoglossal nucleus

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6
Q

Sensory component of CN XII

A

Solitary nucleus (taste) and sensory trigeminal nucleus (bolus of food) sends info indirectly to hypoglossal nucleus by reticular formation

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7
Q

Sensory component of CN XII function

A

Reflex pathway controlling tongue in swallowing, suckling and chewing

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8
Q

LMN lesion of hypoglossal nerve

A
  • paralysis and muscle wasting of intrinsic/extrinsic muscles on ipsilateral side
  • protrusion of tongue, deviates to side of lesion
  • dysarthria- difficulty eating and speaking
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9
Q

UMN lesion of CN XII prior to crossing

A
  • weakness of only extrinsic muscles (primarily genioglossus) on side contralateral to the lesion
  • protrusion of tongue, deviates to opposite side of lesion
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10
Q

Alternating hemiplegia

A

Combo of UMN and LMN signs, ipsilateral and contralateral presentation in different parts of the body

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11
Q

CN X11 function

A

Hypoglossal nerve

Motor nerve that supplies the intrinsic/extrinsic muscles of the tongue

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12
Q

Damaged structures from a stroke of a paramedical branch of the anterior spinal artery

A

Hypoglossal nerve fibers, adjacent pyramid, medial lemniscus and ventral trigeminothalamic tract

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13
Q

Origin for cranial component of accessory nerve CN XI

A

LMN in the nucleus ambiguus that innervate a few of the laryngeal muscles

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14
Q

Origin for spinal component of CN XI

A

Cell bodies located in the cervical levels of the spinal cord (dorsal to the ventral horn), innervate said SCM and traps

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15
Q

Termination of spinal component of CN XI

A

Leave the spinal cord and ascend into cranial cavity to re-exit skull as accessory nerve

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16
Q

Termination of cranial component of CN XI

A

Small # of fibers exit medulla w/ the vagus nerve

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17
Q

UMN of CN XI tract/termination

A

Corticobulbar fibers descend w/ corticospinal fibers, decussate at pyramidal decussation and terminate in the cervical region (C2-4)

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18
Q

Clinical test for CN XI

A

Patient is asked to turn head (SCM) or shrug shoulders (traps), cranial component indistinguishable from vagus nerve

19
Q

LMN origin for CN X- Vagus Nerve

A

Nucleus ambiguus, located in the reticular formation

20
Q

LMN for CN X- function

A

Innervates skeletal muscle of soft palate, larynx, pharynx, vocalis muscle

21
Q

Preganglionic parasympathetic cell body location (CN X)

A

Dorsal motor nucleus of X

22
Q

Preganglionic parasympathetic axon termination (CN X)

A

Exit medulla as rootlets of X and synapse on postganglionic neurons in visceral walls of glands, cardiac muscle and smooth muscle of the thorax and abdomen

23
Q

Sensory fibers CN X tract

A

Travel along solitary tract and end in solitary nucleus, sometimes the spinal trigeminal nucleus (pain for face)

24
Q

Sensory fibers CN X- function

A

Carry pain and pressure from pharynx, larynx, thorax and abdomen

25
Q

UMN of CN X

A

Corticobulbar fibers innervate the nucleus ambiguus bilaterally, so unilateral lesion would not be easily noticed

26
Q

Carotid sinus reflex afferent part

A

CN IX carries info from baroceptors in the carotid artery (near the bifurcation into internal and external carotid arteries) to the solitary nucleus, then to the dorsal motor nucleus of X

27
Q

Carotid sinus afferent part

A

CN X- reflex arc that innervate so the heart to slow HR

28
Q

Carotid body reflex- afferent limb

A

CN X- carries sensory info from chemoreceptors in lung bronchioles, synapse in medullary respiratory center (in reticular formation), to control breathing rhythm

29
Q

Carotid body reflex- efferent limb

A

CN X- Carries descending info to spinal cord levels controlling inspiration (intercostal and diaphragm)

30
Q

Cough, gag, vomiting reflexes

A

Sensory fibers from oral/nasal cavity (CN XI) or gut (CN X) is relayed to LMN in nucleus ambiguus and spinal cord, and Preganglionic parasympathetic in dorsal motor nucleus of X

31
Q

Unilateral lesion of LMN of CN X symptoms

A

difficulty swallowing, hoarseness (dysphonia), inability to raise the soft palate on ipsilateral side

32
Q

Lesions of preganglionic parasympathetic fibers of CN X symptoms

A

disruption of gut reflexes, hyperactivity can cause gastric acid secretion= ulcers

33
Q

Large bilateral lesions of the medullary reticular formation symptoms

A

disrupts normal breathing rhythms, reflex control of vascular resistance to blood flow and results in coma. Patients need life support

34
Q

LMN origin/function glossopharyngeal nerve CN IX

A

located in rostral end of nucleus ambiguus

innervates stylopharyngeus muscle

35
Q

Preganglionic parasympathetic origin CN IX

A

reticular formation

36
Q

Preganglionic parasympathetic tract CN IX

A

exit medulla to synapse on postganglionic neurons in otic ganglion

37
Q

Preganglionic parasympathetic function CN IX

A

innervates the parotid gland

38
Q

Sensory neurons- carotid sinus reflex- CN IX origin

A

afferent limb starts in the caudal part of the solitary nucleus

39
Q

Sensory neurons CN IX origin

A

sensory trigeminal nucleus, primarily spinal nucleus of V

40
Q

Sensory neurons CN IX function

A
  • somatic sensations (touch,pressure,pain) from pharynx and post 1/3 of tongue (gag reflex)
  • taste sensation from post 1/3 of tongue to anterior solitary nucelus
41
Q

UMN CN IX

A

descends with corticobulbar system, synapses bilaterally on LMN in nucleus ambiguus

42
Q

CN IX reflexes

A
  • carries afferent (sensory) limb for carotid sinus, gag, vomiting and swallowing
  • motor- swallowing, salivation, taste reflexes
43
Q

Unilateral lesions of CN IX symptoms

A

difficulty speaking, swallowing (less severe than CN X), visceral reflex impariments

44
Q

Diagnostic deficits CN X vs. CN IX

A

CN X- deviation of uvula

CN IX- loss of gag reflex to touching of pharynx

Neuroscience1 (7 decks)

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