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DIT Primer > Primer 2 - Cranial Nerves > Flashcards

Primer 2 - Cranial Nerves Flashcards

1
Q

What is Kallmann syndrome and why is it related to CN I?

A

Genetic syndrome where the hypothalamus doesn’t make GnRH which results in hypogonadism and strangely enough, lack of smell.

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2
Q

What is the CN II and what is its exit site?

A

Optic nerve, exits optic canal.

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3
Q

What is CNIII and its exit site?

A

Occulomotor, exit site is Superior orbital fissure.

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4
Q

What is the function of the CNIII?

A

Parasympathetic to the ciliary and sphicter muscles of the eye; innervates the medial rectus, superior rectus, inferior rectus, and inferior oblique.

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5
Q

What are lesions that can affect the CNIII?

A

Uncal (transtentorial) herniation, Weber syndrome, DM.

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6
Q

What is Weber syndrome?

A

A form of stroke characterized by the presence of occulomotor nerve palsy and contralateral hemiparesis.

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7
Q

How do you test the CNIII?

A

Patient follow the finger, pupillary light reflex, and conversion.

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8
Q

What is the CNIV and where is it’s exit?

A

Trochlear nerve, exits superior orbital fissure.

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9
Q

What does the CNIV do?

A

Innervates the superior oblique muscle.

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10
Q

How can the CN IV be damaged and how can we test it?

A

Head trauma; patient follow the finger.

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11
Q

What is the CNV and where do each of it’s 3 branches exit?

A

Trigeminal. First branch is opthalmic, exits the superior orbital fissure. Second branch is maxillary, exits the foramen rotundum. Third is mandibular, exits the foramen ovale.

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12
Q

What is the function of the mandibular branch?

A 
Innervates muscles of mastication:
1. Masseter muscle.
2. Temporalis muscle.
3. Medial pterygoid muscle.
4. Lateral pterygoid.
Provides sensation of the lower lip, lateral face, lower border of the mandible.
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13
Q

Which muscles close the jaw?

A
  1. Masseter muscle.
  2. Temporalis muscle.
  3. Medial pterygoid muscle.
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14
Q

Which muscle open the jaw?

A

Lateral pterygoid muscle.

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15
Q

How do we test the mandibular branch? What happens to the jaw if there is a lesion of the mandibular branch and why?

A

Facial sensation and opening the jaw. Jaw will deviate towards the lesion due to unopposed force.

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16
Q

What does the opthalmic branch do? What is a common pathology associated with it?

A

Provides sensory from the medial nose and forehead. One of the most common pathologies is the trigeminal neuralgia.

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17
Q

How do we check the opthalmic branch?

A

Facial sensation.

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18
Q

What does the maxillary branch do?

A

Sensory to later nose, upper lip.

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19
Q

How do we test the maxillary branch?

A

Facial sensation.

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20
Q

What is CNVI and where does it exit?

A

Abducens, it exits the superior orbital fissure.

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21
Q

What does CNVI do? And what is a common lesion for it?

A

Innervates the lateral rectus muscle. Common lesion is medial inferior pontine syndrome (contralateral hemiparesis, contralateral loss of tactile and vibration).

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22
Q

How do we test the CNVI?

A

Patient follow finger.

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23
Q

What is the CNVII and where does it exit?

A

Facial and exits the interal acoustic meatus.

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24
Q

What are the 5 branches of CNVII and a mnemonic?

A
  1. Temporal.
  2. Zygomatic
  3. Buccal
  4. Marginal mandibular
  5. Cervical.

[Tim Zulu Bit My Chin].

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25
Q

What is the function of CNVII?

A
  1. Parsympathetic to lacrimal, submandibular, and sublingual glands.
  2. Muscles of facial expression, stapedius, stylohyoid, posterior belly of the digastric muscle.
  3. Taste from anterior 2/3 of the tongue.
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26
Q

What is a common lesion for CNVII? and how do we distinguish it from stroke?

A

Bell’s palsy is a common lesion (causes inability to control muscles of the face of the side affected.) Bells palsy patient can’t wrinkle the forehead (stroke pts generally can).

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27
Q

How can we test CNVII?

A

Wrinkle forehead, show teeth, puff out cheeks, close eyes tightly, and say mememe (lip function).

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28
Q

What structure do the 5 branches of CNVII run through?

A

Parotid gland but doesn’t innervate it.

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29
Q

What is CNVIII and where does it exit?

A

Vestibulocochlear nerve; exits through internal acoustic meatus.

30
Q

What does CNVIII and what is a common lesion?

A

Equilibrium and hearing, common lesion is acoustic schwannoma (causes vertigo, nyastagmus, nausea).

31
Q

How do we test CNVIII?

A

Hearing and nyastagmus.

32
Q

What is CNIX and where does it exit?

A

Glosopharyngeal, exits through jugular foramen.

33
Q

What does CNIX do?

A
  1. Parasympathetic to parotid gland, stylopharyngeus muscle.
  2. Sensory from the pharynx, middle ear, auditory tube, carotid body and sinus, external ear, posterior 1/3 of tongue (including taste)
34
Q

What is a common lesion to CNIX and how do we test it?

A

PICA (Posterior Inferior Cerebellar artery) Infarct.

It is tested by gag reflex.

35
Q

What is CNX and where does it exit?

A

Vagus, exits thru jugular foramen.

36
Q

What does CNX do?

A

Parasympathetic to body viscera, laryngeal and pharyngeal muscles, external ear, epiglotis.

37
Q

What are some common lesions of CNX?

A

Thyroidectomy, PICA infarct.

38
Q

How do we test CNX? What is a clinical sign that tell us which side is affected?

A

Gag reflex and elevating the palate with the sound “ahhh” or “kakaka”. Uvula deviates away from the side of the lesion (weak side is going to collapse, deviating from the side of the lesion).

39
Q

What is CNXI and where does it exit?

A

Spinal Accesory, exits through the jugular foramen.

40
Q

What does CNXI do? And how do we test it?

A

Innervates the sternocleidomastoid and trapezius muscle. Tested by patient elevating the shoulder and turning the head to the sides.

41
Q

What is a common lesion to the CNXI?

A

PICA lesion.

42
Q

What is CNXII and where does it exit? What is a common lesion?

A

Hypoglossal, exits the hypoglossal canal. Common lesion is interior spinal artery infarct.

43
Q

How do we test CNXII and what is the presentation to guide us to the side of the lesion?

A

Tested by protruding the tongue, tongue diviates TOWARDS the lesion (lick your wounds).

44
Q

What am i testing when I touch the cornea with a cotton swab?

A

I am testing two CN; the opthlamic branch of the trigeminal nerve, which senses the touch and the temporal branch of the facial nerve provides the motor function of the eye closing.

45
Q

What other test can I do to test both the opthalmic branch of the trigeminal nerve and temporal branch of the facial nerve?

A

Lacrimal reflex.

46
Q

What is the Jaw/Jerk reflex and what CN does it test?

A

Tap on the chin and normally there is no reaction. If there is, then there is a probable upper motor neuron problem. This test the mandibular branch of the Trigeminal (CNV) nerve.

47
Q

What is pupillary reflex and what CN does it test?

A

Shine the light on the eye. Test both CN II and IIII; CNII senses the light and the CNIII will cause the pupillary constriction.

48
Q

What CN are tested in gag reflex?

A

CN IX and X.

49
Q

What cranial nerve nuclei does the Midbrain contain?

A

CNIII and CNIV.

50
Q

What cranial nerve nuclei does the pons contain?

A

CNV, VI, VII, VIII.

51
Q

What cranial nerve nuclei does the Medulla contain?

A

CNIX, CNX, CNXII

52
Q

What cranial nerve nuclei does the Spine contain?

A

CNXI

53
Q

What is the inferior colliculi located and what does it do?

A

Located in the dorsal side of the brainstem (below the superior colliculi and below the trochlear nerve), auditory information and the information to the primary auditory cortex.

54
Q

Where is the superior colliculi located and what does it do?

A

In the dorsal side of brainstem lateral and bellow the pineal body and above the inferior colliculi, it contains the conjugate vertical gaze center.

55
Q

What innervates the superior rectus muscle, what does it do normally and what happens when it is damaged?

A

CNIII. Causes the eye to look up, if damaged then deviation downwards.

56
Q

What innervates the medial rectus muscle, what does it do normally and what happens when it is damaged?

A

CNIII, causes adduction of the eye, when damaged causes abduction of the eye.

57
Q

What innervates the lateral rectus muscle, what does it do normally and what happens when it is damaged?

A

CNVI, causes abduction of the eye, damage causes adduction of the eye.

58
Q

What innervates the inferior rectus muscle, what does it do normally and what happens when it is damaged?

A

CNIII, causes eye to look downward, damaged causes deviation upward.

59
Q

What are the eye muscles that are controlled by the CNIII?

A
  1. Levator palpebrae superioris muscle.
  2. Superior rectus muscle.
  3. Inferior rectus muscle.
  4. Inferior oblique muscle.
  5. Medial rectus muscle.
60
Q

Which nerve innervates the superior oblique muscle? What does it do and what happens when damaged?

A

CNIV, causes eye to look downward and laterally and twist inwards the eye. Damage causes deviation medially and superiorly.

61
Q

What innervates the inferior oblique muscle, what does it do normally and what happens when it is damaged?

A

Innervated by CNIII, causes the eye to extorts the eye, and causes eye to look upward and laterally. Damage causes deviation medially.

62
Q

What is the 1st Cranial Nerve and its exit site?

A

Olfactory; Cribiform plate.

63
Q

What are the nerves that run through the cavernous sinus?

A
  1. Oculomotor
  2. Trochlear
  3. Abducent
  4. Trigeminal nerve: the ophthalmic and maxillary (V1 and V2).
64
Q

What is the danger triangle of the face?

A

Area that covers the nose to the upper lip that drains to the cavernous sinus (patient with acne that infects a vein and travels to the cavernous sinus.

65
Q

What are the structures other than nerves that run through the cavernous sinus?

A
  1. Internal carotid artery
  2. Optic chiasm
  3. Pituitary gland
  4. Sphenoidal sinuses.
66
Q

What are the structures involved in the Reticular Activating System?

A
  1. Reticular formation.
  2. Mesencephalic nucleus.
  3. Thalamic intralaminar nucleus
  4. Dorsal hypothalamus
  5. Tegmentum
67
Q

What does the Nucleus solitarius do?

A

Sensory information for the Vagus nerve.

  • Taste
  • Baraoreceptors
  • Gut distention
68
Q

What does the Nucles Ambiguus do?

A

Relays motor innervation for the Vagus nerve:

  • Pharynx
  • Larynx
  • Upper esophagus
69
Q

What does the Dorsal Motor Nucleus do?

A

Serves as autonomic information for vagus nerve in:

  • Heart
  • Lungs
  • Upper GI tract
70
Q

What is Horner Syndrome?

A

Problem with sympathetic innervation to the face by spinal cord lesion above T1.

  • Ptosiss: Dropping of the eyelid.
  • Anhidrosis: Absence of sweating.
  • Miosis: Pupil constriction.
71
Q

What are 3 pathologies that can cause Horner Syndrome?

A
  1. Pancoast tumor.
  2. Brown-Sequard syndrome.
  3. Late-stage syringomyelia.

DIT Primer (30 decks)

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