N41, 42 Flashcards
basal plate
ventral horn
basal plate gives rise to
General somatic efferents and general visceral efferents (GSE and GVE)
alar plate
dorsal horn
alar plate gives rise to
General somatic afferents and general visceral afferents (GSA and GVA)
CN with GSE
3, 4, 6, and 12
CN with Special visceral efferents (SVE)
5, 7, 9, 10, 11 (branchial arches)
CN with GVE (parasympathetic)
3, 7, 9, 10
Corticonuclear projections arise from
SMA, PMC, and MI
Bilateral except
CN 7 and 12
motor of GSE of CN 3 oculomotor
ipsilateral nuclei to ipsilateral nerve
GVE of CN 3 oculomotor
Edinger-Westphal nucleus –> ciliary ganglion –> sphincter pupillae and ciliary mm
Lesion to CN 3
IPSILATERAL ptosis, lateral strabismus, mydriasis, pupillary light reflex absent, inability to laterally gaze
GSE of CN 4 trochlear
innervate contralateral superior oblique m
Lesion to CN4
CONTRALATERAL affected eye is elevated, diplopia in vertical plane (difficulty with steps)
GSE of CN 6
innervates IPSILATERAL lateral rectus
Lesion to CN6
IPSILATERAL medial strabismus, inability to laterally gaze
SVE of trigeminal
Mandibular division, bilateral innervation
Corneal reflex
stimulus to cornea –> opthalmic div of CN V –> spinal trigeminal nucleus –> facial motor nucleus –> facial n to orbicularis oculi –> both eyes close
Lacrimal tear reflex
stimulus to cornea –> opthalmic div of CN V –> spinal trigeminal nucleus–> bilateral GVE superior salivatory nucleus –> facial n GVE –> pterygopalatine –> greater petrosal –> lacrimal gland
Upper facial m are innervated by
bilateral facial n
Lower facial m are innervated by
contralateral facial n
GVE of CN 7
ipsilateral pterygopalatine –> greater petrosal
Lesion to CN 7
LMN: complete ipsilateral facial paralysis
Motor Cortex: innervation to eye is provided by contralateral innervation, only innervation to contralateral mouth is affected.
Lesion to LMN CN7 peripheral to stylomastoid foramen
Bells Palsy: paralysis of facial mm
Lesion of CN 7 proximal to chorda tympani
facial m paralysis and loss of taste to anterior 2/3 tongue
Lesion of CN 7 proximal to stapedius n
facial m paralysis and loss of taste to anterior 2/3 tongue + hyperacusis
Lesion of CN 7 proximal to geniculate ganglion
facial m paralysis and loss of taste to anterior 2/3 tongue + hyperacusis + absence of lacrimation
UMN lesion to Facial n
weakness of m. of contralateral LOWER face only, no fasciculations, disuse atrophy
SVE of CN 9
ipsilateral glossopharyngeal n.
GVE to CN 9
inferior salvitory to ipsilateral glossopharyngeal n –> tympanic plexus –> lesser petrosal –>
Lesion to CN 9
loss of parotid salvation and gag reflex
SVE of CN 10
ipsilateral vagus to soft palate pharynx and larynx
GVE of CN 10
innervation to mucous membranes (heart rate)
unilateral lesion of CN 10
ipsilateral paralysis of soft palate, vocal cord palsy
bilateral lesion to CN 10
death; asphyxiation
SVE of spinal accessory
innervation to ipsilateral SCM and trapezius
Lesion to CN 11
ipsilateral shoulder sag, plegia when pointing chin away from lesion
GSE of CN 12
ipsilateral innervation to intrinsic and extrinsic mm of tongue; corticonuclear projections are contralateral
lesion to LMN CN 12
deviation of tongue toward lesion, atrophy, fasciculations
lesion to UMN CN 12
contralateral paresis and tongue deviated away from lesion
Brainstem lesion
ipsilateral LMN for CN and contralateral UMN signs for CST
Medial medullary syndrome
anterior spinal artery, hypoglossal hemiplegia, contralateral UMN loss for CST, contralateral loss of tactile sensation
Alternating Abducens hemiplegia
Basilar a, LMN for ipsilateral abducens, contralateral UMN for CST
“Weber’s Syndrome” Alternating Oculomotor hemiplegia
posterior cerebral a., LMN for ipsilateral CN 3 and contralateral UMN for CST
