Primer 2, Cranial nerves Flashcards
What brain structure is responsible for extraocular movements during REM sleep?
Paramedian Pontine Reticular Formation (PPRF)
Name 7 teratogens (A-F)
ACE inhibitors Alkylating agents Aminoglycosides Carbamazepine Diethylstilbestrol (DES) Excessive vitamin A Folate antagonists
Which areas of the hypothalamus regulate the autonomic nervous system?
Anterior hypothalamus.
Posterior hypothalamus = SNS
CNI 1 Site of exit from the skull 2 Function 3 Lesions 4 How to test function
Olfactory 1 Cribriform plate 2 Smell 3 Cribriform plate fracture/Kallmann syndrome 4 Smell something
CNII 1 Site of exit from the skull 2 Function 3 Lesions 4 How to test function
Optic nerve 1 Optic canal 2 Sight 3 4 Snellen Eye chart/peripheral vision
CNIII 1 Site of exit from the skull 2 Function 3 Lesions 4 How to test function
Oculomotor nerve
1 Superior orbital fissure
2 PNS to ciliary and sphincter muscles. Innervates medial/superior/inferior recti and inferior oblique
3 Transtentorial/Uncal herniation, diabetes, weber syndrome
4 H in space (follow my finger), pupillary light reflex, convergence
CNIV 1 Site of exit from the skull 2 Function 3 Lesions 4 How to test function
Trochlear nerve 1 Superior orbital fissure 2 Superior oblique muscle 3 Head trauma 4 Moving the finger
CNV, first branch 1 Site of exit from the skull 2 Function 3 Lesions 4 How to test function
Trigeminal, opthalmic 1 Superior orbital fissure 2 Sensation from medial nose and forehead 3 Trigeminal neuralgia 4 Facial sensation
CNV, second branch 1 Site of exit from the skull 2 Function 3 Lesions 4 How to test function
Trigeminal, maxillary 1 Foramen rotundum 2 Sensory from lateral nose, upper lip, superior buccal area 3 4 Facial sensation
CNV, third branch 1 Site of exit from the skull 2 Function 3 Lesions 4 How to test function
Trigeminal, mandibular
1 Foramen ovale
2 Sensory and motor to masseter, motor to Lateral pterygoid/Temporalis/Medial pterygoid. Sensory from lower lip, lateral face, lower border of mandible
3
4 Facial sensation, Open the jaw (lesion will cause jaw to deviate towards lesion due to unopposed force)
Which muscle opens the jaw?
Lateral pterygoid muscle
Which muscles closes the jaw?
Masseter, Temporalis, Medial pterygoid muscles
CNVI 1 Site of exit from the skull 2 Function 3 Lesions 4 How to test function
Abducens 1 Superior orbital fissure 2 Lateral rectus muscle 3 Medial inferior pontine syndrome. Symptoms: Contralateral hemiparesis, contralateral tactile and vibration sensation. 4 H in space
CNVII 1 Site of exit from the skull 2 Function 3 Lesions 4 How to test function
Facial nerve
1 Internal acoustic meatus
2 PNS to lacrimal, submandibular, sublingual glands
Muscles of facial expression, stapedius, stylohyoid, posterior belly of the digastric muscle
Taste from anterior 2/3 of the tongue
3 Bell’s palsy
4 Wrinkle forehead, show teeth, puff out cheeks, close eyes tightly, Say mememe (lip function)
Number and name of branches of facial nerve?
Five. "To Zanzibar By Motor Car" Temporal Zygomatic Buccal Marginal mandibular Cervial
What does the facial nerve pass through?
Parotid gland
CNVIII 1 Site of exit from the skull 2 Function 3 Lesions 4 How to test function
Vestibulocochlear 1 Internal acoustic meatus 2 Equilibrium and hearing 3 Acoustic schwanoma, Vertigo, Nystagmus, Nausea, Vomiting 4 Hearing and nystagmus
CNIX 1 Site of exit from the skull 2 Function 3 Lesions 4 How to test function
Glossopharyngeal 1 Jugular foramen 2 PNS to parotid gland, Stylopharyngeus, Sensory from pharynx, middle ear, auditory tube, carotid body and sinus, external ear, posterior 1/3 of tongue (including taste) 3 PICA infarct 4 Gag reflex
CNX 1 Site of exit from the skull 2 Function 3 Lesions 4 How to test function
Vagus
1 Jugular foramen
2 PNS body viscera, laryngeal and pharyngeal muscles
Sensory from trachea, oesophagus, viscera, external ear and epiglottis
3 Thyroidectomy, PICA infarct
4 Elevating palate (say AAA or k k k)
Uvula deviates away from lesion. Weak side will collapse
CNXI 1 Site of exit from the skull 2 Function 3 Lesions 4 How to test function
Spinal accessory 1 Jugular foramen 2 Sternocleidomastoid, trapezius muscles 3 PICA infarct 4 Turning head, shrugging shoulders
CNXII 1 Site of exit from the skull 2 Function 3 Lesions 4 How to test function
Hypoglossal
1 Hypoglossal canal
2 Intrinsic tongue muscles
3 Anterior spinal artery infarct
4 Tongue protrusion, say lalala(deviates toward lesion ("lick your wounds"))Corneal reflex testes what?
V1, nasociliary branch (sensory) and temporal branch of facial nerve (motor, orbicularis oculi)
Lacrimation reflex, afferent, efferent?
Afferent= V1, Efferent= Facial nerve
Jaw jerk reflex?
V3 (afferent= muscle spindel from masseter. Efferent= masseter). No reflex = normal
Pupillary reflex?
Afferent = Optic Efferent= Oculomotor
Gag reflex?
Afferent = IX Efferent = X
Cranial nerve nuclei in the midbrain?
III
IV
Cranial nerve nuclei in the pons?
V
VI
VII
VIII
Cranial nerve nuclei in the medulla?
IX
X
XII
Cranial nerve nuclei in the spinal cord?
XI
Name and number the cranial nerves
I-Olfactory II-Optic III-Oculomotor IV-Trochlear V-Trigeminal VI-Abducens VII-Facial VIII-Vestibulocochlear IX-Glossopharyngeal X-Vagus XI-Accessory XII-Hypoglossal
Function of pineal gland?
Melatonin secretion
Circadian rhythms
Function of superior colliculi?
Conjugate vertical gaze
Function of Inferior colliculi?
Auditory. Information is sent to primary auditory cortex.
Perinaud syndrome?
Paralysis of conjugate vertical gaze due to lesion in superior colliculi?
Superior rectus muscle
Innervation
Function
Lesion results in
III
Look upward
Deviation downwards
Medial rectus muscle
Innervation
Function
Lesion results in
III
ADduction of eye
ABduction of eye
Lateral rectus muscle
Innervation
Function
Lesion results in
VI
ABduction of eye
ADduction of eye
Inferior rectus muscle
Innervation
Function
Lesion results in
III
Look downward
Deviation upward
Superior oblique muscle
Innervation
Function
Lesion results in
IV
Down and lateral gaze
Medial and superior gaze
Inferior oblique muscle
Innervation
Function
Lesion results in
III
Upward and lateral gaze also extorts eye.
Deviation medially
Which nerves go through the cavernous sinus?
Oculomotor Trochlear Abducent Opthalmic division Maxillary division
Where does the danger triangle drain to?
Cavernous sinouses
Non-nerve structures in the cavernous sinuses?
Internal carotid artery
Pituitary gland
Optic chiasm
Sphenoidal sinuses
Reticular activating system contains?
Reticular formation Mesencephalic nucleus Thalamic intralaminar nucleus Dorsal hypothalamus Tegmentum
Name the vagal nuclei
Nucleus Solitarius
Nucleus ambiguus
Dorsal motor nucleus
Nucleus Solitarius
Visceral sensory information
Taste
Baroreceptors
Gut distention
Nucleus Ambiguus
Motor innervation of
Pharynx
Larynx
Upper esophagus
Dorsal Motor Nucleus
Sends autonomic (parasympathetic) fibers to
Heart
Lungs
Upper GI tract
Horner’s syndrome
Sympathectomy of face:
Ptosis (drooping of eyelid, sup. tarsal muscle)
Anhidrosis (absence of sweating) and rubor of affected side of face
Miosis (pupil constriction)
Associated with lesion of spinal cord above T1 (e.g. Pancoast tumpr, Brown-Séquard syndrome (cord hemisection). late-stage syringomyelia))
Name 6 teratogens (L-W)
Lithium Phenytoin Tetracyclines Thalidomide Valproate Warfarin
