Midterm 2

Question 1

In which lamina in spinal cord is Clark’s column located?

Answer 1

6th (very medial)

Question 2

which nuclei are found in the dorsomedial column of the brainstem?

Answer 2

• Occulomotor
• Trochlear
• Abducens
• Hypoglossal
  (- Accessory spinal root)

Question 3

which nuclei are found in the Ventrolateral column of the brainstem?

Answer 3

• Facial
• Motor trigeminal
• Ambiguous

Question 4

Which are the nuclei of the Ocuulomotor nerve and what functions do they have?

Answer 4

1) Occulomotor nucleus : Somatomotor
(located in upper midbrain at level of sup. colliculus)

2) Accessory acculomotor (Westphal- Edinger nucleus) :: GVM (parasympathetic)
(Located at same level, dorsally)

Question 5

where does the occulomotor exit the brain, skull and dura?

Answer 5

Brain: Laterally in Interpeduncular fossa (medial sulcus of crus cerebri)

Dura: lateral wall of cavernus sinus (between anterior and posterior pertroclinoidal folds)

Skull: Sup. Orb. Fissure

Question 6

In which cistern does the ocuulomotor pass?

Answer 6

• Interpeduncular cistern

Question 7

Into which branches does the occulomotor nerve divide and where is the bifurcation?

Answer 7

Division occurs in sup. orbital fissure (Runs in medial section of SOF, and lateral to optic n)

Divides into:

1) Superior rami
2) Inf branch of Occulomotor

Question 8

What does the Superior Rami of occulom otor nerve innervate?

Answer 8

Its the smaller n. pases above Opt. n, gives SM to:

• Superior rectus muscle
• Levator palpebrae superioris muscle

Question 9

What does the inferior branch of Occulomotor nerve innervate?

Answer 9

Passes below opt. n.

supplies:
- Medial and inf. rectus muscles (branch to)
- Inf. oblique m. (branch to)

Question 10

Which branch of occulomotor gives off fibers to ciliary ganglion?

Answer 10

branch to Inferior oblique muscle.

Its the longest branch and it passes between inf and lateral rectus muscles. gives off short ciliary to lower part of ciliary ganglion .
gives fibers from accessory occulomotor nucleus GVM, parasympathetic fibers.

Question 11

Where does the fibers coming from accessory ocuulomotor nerve go?

Answer 11

occulomotor nerve —> inf branch of 3—–> branch to inferior oblique —> short ciliary root —-> synapse in ciliary gangl. —> (Postsynaptic fibers) short ciliary nerve —> gives parasympht. innervation to sphincter pupillae m. and ciliary body.

Question 12

What function is the trochlear nucleus and where is it located?

Answer 12

SM

Found in midbrain at level on inf. colliculus, ventral to cerebral aqueduct .

Question 13

which cistern does the trochlear nerve pass through?

Answer 13

Quadrigeminal cistern (ambient cistern)

Question 14

Where does the trochlear nerve exit the brain, dura and skull ?

Answer 14

Brain: Dorsally below inf. colliculus on each side of frenulum of sup. medullary velum
( fibers cross in sup medullary velum)
Dura: lateral wall of Cavernus sinus within anterior pertroclinoidal fold.
Skull: SOF

Question 15

Where in the SOF does the Trochlear nerve travel?

What does it innervate?

Answer 15

enters SOF in lateral segment together with ophtalmic vein and reaches laterally to innervate superior oblique muscle.

Question 16

which is the only (true) cranial nerve which innervates a muscle contralaterally?

Answer 16

4

Question 17

What movements of the eye does superior oblique cause?

Answer 17

Abduction, depression and medial rotation

Question 18

Which are the nuclei of trigeminal nerve and what functions do they have?

Answer 18

1) mesencephalic nucleus: Proprioceptive (GSS)
2) Pontine (principle) sensory nucleus: Epicritic (GSS)
3) Spinal trigeminal nucleus: Protopathic GSS
4) motor root nucleus of trigeminal

Question 19

Which nucleus in the brainstem has psudounipolar neurons

Answer 19

Mesencephalic nucleus of trigeminal

Question 20

which neurons of trigeminal nerve synapse in the trigeminal ganglion?

Answer 20

Those which originate from spinal or principle nuclei ( not from mesencephalic and not motor obv.)

Question 21

Which nerves terminate in spinal trigeminal nucleus?

Answer 21

Protopathic fibers of CN’s 5, 7, 9 and 10.

Question 22

which CN gives the recurrent tentorial branch of the tentorium cerebellum?

Answer 22

CN V1 (opthalmic), before it divides into 3 main.

Question 23

which branches come from V1?

Answer 23

• Recurrent tentorial
• Lacrimal (Innervates skin of lateral corner of eye)
• Frontal (Gives supratrochlear and supraorbital)
• Nasociliary (Gives 5 branches and innervates a shit load)

Question 24

Which fibers from which nerve travels with the Lacrimal nerve of Opthalmic (V1)?

Answer 24

Zygomatic nerve guestfibers which goes to innervate lacrimal gland (from zygomatic branch of V2 originally from )

Question 25

Which branches does the Frontal nerve divide into and what do the innervate?

Answer 25

1) Supratrochlear nerve: Medial part of upper eyelid, central part of skin of forehead and root of nose (Skin?)
2) Supra orbital nerve: conjunctiva upper eyelid and skin of forehead.

Question 26

Which sections of the SOF does the divisions of V1 travel in?

Answer 26

1) lacrimal: in lateral section
2) Frontal : in lateral section
3) Nasociliary: in medial section

Question 27

Which branches does the Nasociliary nerve give off?

Answer 27

1) communicating brach: (sensory fibers from eyeball) synapses in trigeminal ggl.

2) Long ciliary branches:
- gives postsynaptic sympathetic fibers to dilator pupillae and sensory for ciliary body iris and cornea.
3) posterior ethmoidar nerve:
4) Anterior ethmoidal:
5) Infratrochlear nerve: (skin of eyelids and root of nose)

Question 28

what does the anterior ethmoidal nerve innervate?

Answer 28

Ant. meningeal branch : anterior part of dura
Internal nasal branches: anterosuperior nasal mucosa
terminal externas nasal branch: skin of dorsum and tip of nose.

Question 29

which nerve gives off recurrent meningeal nerve?

Answer 29

V2 ( supplies middle part of dura)

Question 30

which branch of CN5 gives ganglionic branches to pterygopalatine ggl?

Answer 30

Maxillary (V2)

Question 31

which branch does the maxillary branch give off before entering the orbit?
what is the nerve (V2) called when in the orbit?

Answer 31

• Zygomatic nerve ( nd the gglic branches)

- Infraorbital nerve

Question 32

Which are the 3 main branches of Maxillary nerve?

Answer 32

1) Pterygopalatine nerves (ganglionic branches (They dont synapse in pterygopalatine ggl.) )
2) Zygomatic nerve
3) Infraorbital n

Question 33

Which are the branches Pterygopalatine nerves of V2?

Answer 33

• Nasal branches
• Greater palatine nerves
• Lesser palatine nerves
• pharyngeal nerves

Question 34

which are the branches of the nasal branches of pterygopalatine nerves of V2?

Answer 34

-posterior, superior lateral: which supplies the upper part of lateral wall of the nasal cavity (inc. superior and middle conchae and meatuses +post ethmoidal sinus)

• Nasopalatine nerve (Scarpa’s nerve) supplies the mucous membrane of hard palate and then anastomoses with greater palatine nerve at the incisive foramen
• posterior superior medial nasal branch: to post sup. nasal septum.

-Pharyngeal nerves: supply mucus glands of nasopharynx.

Question 35

which nerve carries the postganglionic parasympathetic and sensory fibers of V2

Answer 35

• Greater palatine nerve, second branch of pterygopalatine nerve of V2; passes through greater palatine canal and supplies mucosa and glands of hardpalate and the ANTERIOR part of the SOFT palate.
  - ->gives off post. inf nasal nerves which supplies post nasal cavity This branch may arise independently from pterygopalatine ggl.

-Lesserpalatine nerves: trough lesser palatine foramina , supply mucosa and glands of SOFT palate AND UVULA

Question 36

which is the second branch of maxillary nerve?

Answer 36

Zygomatic nerve: branches into 2:
1) Zygomaticotemporal: supplies skin of facelateral to orbit (temporal region)

2)Zygomaticofascial nerve: supplies skin of cheekbone.

Question 37

what is the path of the infraorbital nerve , the 3 branch of V2?

Answer 37

into orbit via infraorbital fissure—> infraorbital canal —-> Canine fossa —–> supplies skin between lower eyelid and upper lip (from lateral eye corner to lateral lip corner) —-> then gives off Superior alveolar branches to supply maxillaty teeth. (gives off Ant.- Middle and post.- superior alveolar branches which form a plexus.