Neurology (02/04) Cranial Nerves IX, X, XI, & XII Flashcards
A patient reports a loss of pain sensation on the left side of the face after a stroke. what is the most likely location for this lesion?
left spinal trigeminal tract/nucleus
some patient with loss of pain sensation on the left side of the face. what brainstem level is most likely involved?
left lateral, dorsal medulla
spinal trigeminal tract is lateral in the brainstem
what is the axon type for CN XII?
somatic motor
what is the origin for XII?
hypoglossal nucleus
what is the peripheral termination for XII?
tongue mm
what is the main m of the tongue that XII innervates?
genioglossus (in charge of tongue protrusion)
where does XII exit the brainstem?
adjacent to pyramid
what three things result from hypoglossal nerve (LMN) lesion?
- deviation TOWARD lesion
- fasciculations [LMN]
- atrophy [LMN]
CN XII also has corticobulbar fibers from the motor cortex associated with it. where do these fibers decussate?
adjacent to hypoglossal nucleus
what three things result form corticobulbar (UMN of XII) lesion?
- deviation towards OPPOSITE side (bc it decussates)
- no fasciculations [UMN]
- minimal atrophy [UMN]
what type of axon type is CN XI?
branchial motor
where is the CNS origin for CN XI?
accessory nucleus in cervical spinal cord
where is the peripheral termination of CN XI?
sternocleidomastoid m and trapezius
where is the accessory nucleus located?
cervical spinal cord
what three things occur due to accessory nerve lesion on the trapezius m?
- scapula and clavicle hang due to weak trapezius
- weak shoulder shrug as levator scapulae must work alone
- muscle atrophy leads to scalloped appearance of neck contour
what is the CNS origin of the somatic sensory division of CN IX?
spinal trigeminal nucleus/
superior ganglion of IX
what is the peripheral termination of the somatic sensory division of CN IX?
skin of outer ear
what is the CNS origin of the visceral sensory division of CN IX?
nucleus of solitary tract/
inferior ganglion of IX
what is the peripheral termination of the visceral sensory division of CN IX?
-taste buds and mucosa on posterior 1/3 of the tongue and corotid body & sinus, and pharynx and middle ear
what is the CNS origin of the visceral motor division of CN IX?
inferior salivatory nucleus/
otic ganglion
what is the peripheral termination of the visceral motor division of CN IX?
parotid gland
CN IX (glossopharyngeal) has afferents that are responsible for the measurement and detection of changes in blood pressure of the ____ ____ and ____ ____
- carotid body
- carotid sinus
the CN IX efferent fibers that innervate stylopharyngeus m and other pharyngeal and laryngeal mm synapse in ____ ____
nucleus ambiguous
regarding glossopharyngeal neuralgia, sudden burst of pain start in the _____ _____ or wall of _____, then radiate to the ____
- posterior tongue
- pharynx
- ear
regarding glossopharyngeal neuralgia, the trigger zone is on the _____/_____ and attacks are precipitated by ____ or ______
- tongue/pharynx
- swallowing
- talking
what is the CNS origin for the brachial motor axon division of CN IX?
-nucleus ambiguus
what is the peripheral origin of the brachial division of CN IX?
pharynx (stylopharyngeus)
what is the CNS origin of the somatic sensory division of CN X?
spinal trigeminal nucleus/
superior ganglion of X
(same as IX)
what is the peripheral origin of the somatic sensory division of CN X?
skin of outer ear (same as IX)
what is the CNS origin of the visceral sensory division of CN X?
nucleus of the solitary tract/
inferior ganglion of X
(same as IX)
what is the peripheral origin of the visceral sensory division of CN X?
taste buds: epiglottis &esophagus
thoracic and abdominal viscera, mucosa of larynx and pharynx
what is the CNS origin of the visceral motor division of CN X?
dorsal motor nucleus/
nucleus ambiguus
what is the peripheral termination for the visceral motor division of CN X?
thoracic and abdominal viscera
what is the CN origin of the brachial division of CN X?
nucleus ambiguus
what is the peripheral termination of the brachial division of CN X?
larynx and pharynx
what is the CNS nucleus that has fibers from both CN’s 9 and 10?
nucleus ambiguus
where is the lowest point of parasympathetic innervation from the cranial nerves?
left colic flexure (anything below it is supplied by sacral)
the LATERAL efferent of CN X coming out of nucleus ambiguous deal with mm of ____ and _____
- speech
- swallowing
the MEDIAL efferents of CN X coming out of nucleus ambiguous deal with the ____ and ____
- heart
- lungs
regarding CN X, the ____ _____ nucleus of the vagus deals with all viscera up to transverse colon (parasympathetic)
dorsal motor
what nerve is the AFFERENT component of the gag reflex?
CN IX
what nerve is the EFFERENT component of the gag reflex/
CN X
concerning the gag reflex, you touch on side of the ______ to elicit a ______ response
- pharynx
- bilateral
what are the two possibilities for the AFFERENT component of the tongue thrust reflex?
V or IX
what is the EFFERENT component of the tongue thrust reflex?
XII
clinical consideration dealing with the response to a trigger, the vagus decreases heart rate and blood pressure, decreasing cerebral blood row, resulting in fainting and confusion
vasovagal syncope
clinical consideration when stimulating the vagal nerve to modulate mood or seizure activity
vagal nerve stimulator
what four nerves are at risk for jugular foramen syndrome?
- IX
- X
- XI
- XII
concerning jugular foramen syndrome, pain in the ear is due to what two cranial nerves?
- IX
- X
concerning jugular foramen syndrome, headaches and meningeal irritation are due to what cranial nerve?
X
concerning jugular foramen syndrome, hoarseness is due to what cranial nerve?
X
concerning jugular foramen syndrome, dysphagia is due to what cranial nerve?
X
concerning jugular foramen syndrome, loss of a gag reflex is due to what two cranial nerves?
- IX
- X
concerning jugular foramen syndrome, the uvula deflects to side that is ______ to lesion due to the unopposed levator palati
contralateral
