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Second Year Osteopathy > Nerves > Flashcards

Nerves Flashcards

1
Q

What is the anterior half of the scalp and face supplied by?

A

Branches of trigeminal nerve (CN V)

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2
Q

What does the trigeminal nerve divide into?

A
  • Ophthalmic (CN V1) - sensory
  • Maxillary (CN V2) - sensory
  • Mandibular (CN V3) - sensory and motor
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3
Q

Ophthalmic Nerve (CN V1)

A
  • superior division of trigeminal nerve
  • smallest division
  • enters orbit through SOF
  • innervates skin over frontal bone, upper eyelids, dorsum and tip of nose
  • provides sensory innervation to aspects of eye & orbital structures, mucous membranes of upper nasal cavities & frontal sinuses
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4
Q

Maxillary Nerve (CN V2)

A
  • intermediate division of trigeminal nerve
  • leaves cranium through foramen rotundum
  • innervates skin over maxillary bones, upper lip, lateral aspect of nose, inferior eyelid and anterior part of temporal fossa
  • provides sensory innervation to mucous membranes of nasal cavities, upper teeth and gingivae (gums)
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5
Q

Mandibular Nerve (CN V3)

A
  • inferior & largest division of trigeminal nerve
  • exits cranium through foramen ovale
  • contains motor fibres
  • gives cutaneous innervation to auricle, external acoustic meatus, tympanic membrane, temporal region, cheek, skin overlying mandible (except angle) and lower lip
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6
Q

What is nerve the posterior scalp supplied by?

A

branches of the cervical nerves

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7
Q

Lesser Occipital nerve

A
  • C2, C3
  • innervates skin on lateral aspect of scalp, posterior and superior auricle and posterolateral neck
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8
Q

Greater occipital nerve

A
  • C2
  • innervates skin over the posteromedial surface of scalp, from vertex to base of occipital bone
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9
Q

How many Cranial Nerves are there?
And some facts about their naming.

A
  • 12 pairs
  • named by roman numerals
  • named according to their attachment to brain in an anterior to posterior direction
  • named CN because they emerge through foramina or fissures in the cranium/skull
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10
Q

Where do the Cranial Nerves arise from?

A
  • mainly off the brain stem
  • brain stem = connecting link b/w remainder of brain and spinal cord
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11
Q

What are the 5 main functional components of Cranial Nerves?

A

Motor
- Somatic motor (efferent)
- Visceral motor (efferent) (parasympathetic)
Sensory
- General sensory (afferent) (touch, pain, temperature)
- Visceral sensory (afferent)
- Special sensory

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12
Q

Where do the Cranial nerves innervate?

A

structures in the head and neck and visceral organs of the trunk

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13
Q

Mnemonic for the Cranial Nerves

A

On old Olympus towering top, a fat vicious goat vandalised a hat

Observing Old Orange Tigers there are few very grey varieties around hilltops

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14
Q

Which functional component is the CN I - Olfactory Nerve?

A

Special Sensory nerves
- approx. 20 olfactory nerves on each side

  • special sense of smell
  • Olfactory stimuli (arouse emotions, induce visceral responses through the ANS)
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15
Q

CN I - Olfactory Nerve (Origin/End)

A

Origin:
- cell bodies and dendrites are within the olfactory mucosa of the nasal cavity

End:
- olfactory bulb, continue on to the olfactory area in cerebral cortex
- composed to both neurons and chemoreceptors
- respond to volatile chemicals

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16
Q

Where do the Olfactory nerve fibres pass through?

A

through foramina of the cribriform plate of ethmoid bone

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17
Q

Which functional component is the CN II - Optic Nerve?

A
  • special sensory nerve
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18
Q

Pathway of the CN II Optic Nerve

A
  • from retinal cells in the back of the eye

begins:
- where axons of these cells pierce the sclera
- conducts impulss from the photoreceptors in the retina
passes:
- posteriorly/medially in the orbit or eye socket
exits:
- through optic canal

  • largest CN
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19
Q

Which functional component is the CN III Oculomotor Nerve?

A
  • motor to 4 of the 6 extraocular mm (superior, inferior, medial rectus mm, inferior oblique mm)
  • motor to the upper eyelid mm (levator palpebrae superioris)
  • proprioceptive fibres to the above mm
  • parasympathetic to the sphincter of the pupil (causes constriction of the pupil) & ciliary mm of the lens (produces accommodation of the lens, near vision)
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20
Q

Pathway of the CN III Oculomotor nerve

A
  • Originates from the midbrain
  • Includes both somatic motor nerves and parasympathetic nerves (visceral efferent/motor)
  • Emerges from the midbrain and leaves the cranial cavity and enters the orbit through the SOF
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21
Q

Which functional component is the CN IV Trochlear Nerve?

A
  • somatic motor nerve to one of the extraocular mm (superior oblique) and proprioception
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22
Q

Pathway of the CN IV Trochlear Nerve

A
  • Originates from the midbrain, EMERGES from the dorsal surface and winds around the brainstem
  • The only CN to emerge dorsally from the brainstem
  • The smallest CN but has the longest intracranial course!
  • Pierces the dura and leaves the cranium through the SOF of the orbit
23
Q

Which functional component has the CN V Trigeminal Nerve?

A

three components:
- Ophthalmic V(1) nerve (sensory, SOF)
- Maxillary V(2) nerve (sensory, foramen rotundum)
- Mandibular V(3) nerve (sensory and motor, blend together as they traverse the foramen ovale)

24
Q

Pathway of the CN V Trigeminal Nerve

A

originates from the Pons, one small root, one large root

  • second largest CN
25
Q

Functions of the CN V Trigeminal nerve

A

Motor
- Mandibular (mm of mastication
(masseter, temporalis, medial and lateral pterygoids), mylohyoid mm, anterior belly of digastric
mm, tensor veli palatini mm, tensor tympani mm)

Sensory
- principal general sensory nerve for the head.
- face, teeth, mouth, nasal cavity, dura

26
Q

Which functional component has the CN VI Abducent Nerve?

A

somatic motor nerve to an extraocular mm and proprioception

  • abducts the eye
27
Q

Pathway of the CN VI Abducent Nerve

A

origin:
- pons, emerges from brain stem b/w pons and medulla
exits:
- cranium through SOF into orbit

28
Q

Which functional component has the CN VII Facial Nerve?

A
  • special sensory fibres (taste)
  • somatic sensory fibres
  • Somatic Motor fibres
  • visceral motor (parasympathetic fibres)
29
Q

Pathway of the CN VII Facial Nerve

A
  • Emerges from the junction of the pons and the medulla
  • Course - passes through the internal acoustic meatus, facial canal within the temporal bone and exits through the stylomastoid foramen (the longest intraosseous CN)
  • Enters the parotid gland and where it gives rise to the terminal branches which supply the muscles of facial expression.
30
Q

How many roots has the CN VII Facial Nerve?

A

2 roots
- larger motor root (muscles of facial expression)
- smaller intermediate root (carries taste, somatic sensory fibres, parasympathetics)

31
Q

Functions of the CN VII Facial Nerve

A
  • taste to the anterior 2/3rds of the tongue and soft palate
  • sensory to external ear
  • motor to mm of facial expression, throat, middle ear, proprioception to the above mm
  • parasympathetic to the submandibular and sublingual salivary glands, lacrimal gland, glands of the nasal cavity and palate
32
Q

Which are the terminal branches of the Facial Nerve (CN VII)

A
  • posterior auricular
  • temporal
  • zygomatic
  • buccal
  • mandibular
  • cervical
33
Q

Which functional component has the CN VIII Vestibulocochlear Nerve?

A

Special Sensory
- vestibular nerve (equilibrium, state of balance)
- cochlear nerve (hearing)

34
Q

Pathway of the CN VIII Vestibulocochlear Nerve

A
  • Emerges from the junction between the pons and the medulla
  • Enters the internal acoustic meatus, here it separates into the Vestibular and Cochlear Nerves (it is accompanied by the motor and intermediate nerve of the Facial Nerve

only CN that doesn’t exit the skull

35
Q

Which functional compartment has the CN IX Glossopharyngeal nerve?

A
  • Special Sensory (taste)
  • Somatic Sensory
  • Visceral Sensory
  • Somatic Motor
  • Visceral Motor (parasympathetic fibres)
36
Q

Functions of the CN XI Glossopharyngeal Nerve

A

Sensory
- posterior 1/3 of the tongue for taste
- mucosa of the pharynx, palatine tonsils
- posterior 1/3 of tongue, auditory tube, middle ear, carotid body and sinus

Motor
- Stylopharyngeus mm

Proprioception
- Stylopharyngeus mm

Parasympathetic
- to parotid gland and glands in posterior 1/3 of tongue

37
Q

Pathway of the CN XI Glossopharyngeal Nerve

A
  • emerges from medulla
  • exits cranium through jugular foramen
38
Q

Which functional compartment has the CN X Vagus Nerve?

A

Sensory
- inferior pharynx (somatic)
- larynx (somatic)
- thoracic and abdominal organs (visceral)

39
Q

Pathway of CN X Vagus nerve

A
  • longest CN with most extensive course
    Origin:
  • arises by a series of rootlets from the medulla
    Exits:
  • leaves skull through jugular foramen (along with CN IX & XI
40
Q

Functions of the CN X Vagus nerve

A

Special Sensory (taste)
- root of tongue, tastebuds on the epiglottis
Somatic Motor
- soft palate (pharynx, intrinsic laryngeal mm, palatoglossus (elevates posterior part of tongue, draws soft palate onto tongue)
Proprioception fibres to above mm
Parasympathetic
- fibres to thoracic and abdominal viscera

41
Q

Which functional compartment has the CN XI Accessory nerve?

A

Somatic motor nerve

  • has cranial and spinal root
42
Q

Pathway of the CN XI Accessory Nerve

A

Origin:
- cranial root - medulla (part of CN X, travels with CN XI)
- spinal root - upper 5-6 cervical segments
Pass:
- spinal roots of CN XI pass through foramen magnum and join with cranial roots
Exit:
- together through jugular foramen

43
Q

Functions of the CN XI Accessory Nerve

A

Motor:
- soft palate (mm, movable posterior 1/3rd of the palate suspended from the posterior border of the hard palate), pharynx

  • SCM, trapezius (spinal)
44
Q

Which functional compartment has the CN XII Hypoglossal nerve?

A
  • Motor Nerve (most of mm of tongue, both intrinsic & extrinsic)
  • Proprioceptive fibres from the mm
45
Q

Pathway of the CN XII Hypoglossal nerve

A

Origin:
- medulla
Exit:
- cranium through hypoglossal canal

46
Q

Cervical Plexus - formed by

A

ventral rami of the C1 to C4 spinal nerves
(minor contribution from C5)

47
Q

Cervical Plexus - facts

A
  • form loops attaching to one another
  • overlie middle scalene muscle, deep to SCM
  • each ramus, except first, divides into ascending & descending branches that unite with adjacent spinal nerves to form loops
  • branches arise off loops (deep - motor, superficial - cutaneous)
48
Q

Cervical plexus - Cutaneous branches

A

all exit around the posterior border of the SCM Into the posterior triangle of the neck

49
Q

Which nerves arising from loop between C2 and C3

A

Lesser occipital nerve (C2/3) - posterior lateral neck and scalp

Great auricular nerve (C2/3) - travels to parotid gland, then divides and suplies skin over angle of mandible, mastoid process, and posterior part of auricle

Transverse cervical nerve (C2/3) - supplies skin over anterior triangle of neck

50
Q

Which nerves arising from loop between C3 and C4

A

Supraclavicular nerve (C3/4) - supplies some skin over the anterolateral neck and shoulder

51
Q

Muscular branches of the Cx Plexus

A
  • given off segmentally to the prevertebral muscles
  • branch from C1 joins with Hypoglossal nerve CN XII - suplied some of the hyoid muscles
  • branches from C2/3 to SCM, branches from C3/4 to trapezius (mainly sensory)
52
Q

What is the Ansa Cervicalis (C1, 2, 3)?

A

Handle
- formed by two roops to a loop (superior root, inferior root
- loops meet at inferior part of internal jugular vein, often embedded in the wall of the carotid sheath
- innervates the infrahyoid muscles

53
Q

What is the Phrenic Nerve?

A
  • formed mainly from C4, but also C3 and C5
  • Pathway runs over anterior scalene muscle, under prevertebral fascia, into thoracic cavity
  • motor supply to diaphragm

Second Year Osteopathy (9 decks)

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