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Neuro Exam 3 > Review Cranial Nerves > Flashcards

Review Cranial Nerves Flashcards

1
Q

CN I

A

olfactory

-SVA - smell

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2
Q

olfactory bulb

A

where CN I synapses

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3
Q

anosmia

A

complete loss of smell

CN I lesion

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4
Q

CN I lesions

A

trauma - frontal lobe

sliding on cribriform plate shears the nerves

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5
Q

CN II

A

optic nerve

-SSA - vision

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6
Q

CN II problems

A

alterations in vision

change in intracranial pressure

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7
Q

testing CN II

A

fundoscope

visual field exam

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8
Q

pupillary light reflex

A

in by 2 out by 3

can also test CN II

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9
Q

papilledema

A

increased ICP

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10
Q

CN III

A

oculomotor
GSE - 5 of 7 extraocular eye muscles
GVE-P - to intraocular eye muscles (ciliary muscle and sphincter pupillae)

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11
Q

course of CN III

A

oculomotor and edinger westphal nuclei
-travel through superior orbital fissure

-superior division - superior rectus and levator palpebrae superioris

inferior division - medial rectus, inferior rectus, inferior oblique, and motor to ciliary ganglion

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12
Q

testing CN III

A

extraocular eye movements

make the “H”

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13
Q

accomodation reflex

A

in by 2, out by 3

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14
Q

CN III lesion pathology

A
  • uncal hernations
  • cavernous sinus pathology
  • aneurysm of posterior cerebral or superior cerebellar aa
  • compression against temporal bone - increased ICP
  • diabetic neuropathy
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15
Q

arteries near CN III

A

posterior cerebral a

superior cerebellar a

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16
Q

increased ICP

A

all cranial nerves can be affected

mostly CN II first

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17
Q

CN III lesion symptoms

A

paralysis extraocular - down and out
ptosis - cannot elevate eyelid
-paralysis sphincter - no pupil light reflex
-paralysis ciliary - no accomodation

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18
Q

cross section of CN III***

A

GSE - located centrally
GVE-P - fibers located peripherally

therefore, GVE-P affected first***

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19
Q

compression injuries of CN III***

A

damage to GVE-P

-loss of pupil constriction presents first

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20
Q

diabetic neuropathy in CN III***

A

sparing of GVE-P but GSE loses blood supply

pupillary sparing***

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21
Q

CN IV

A

trochlear nerve

GSE - superior oblique

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22
Q

course of trochlear nerve

A

only one to exit dorsal surface
-superior orbital fissure

innervates superior oblique

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23
Q

test CN IV

A

adduct eye and look down
-lesion cannot do this

extraocular movements

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24
Q

lesion to CN IV

A

neutral position - neutral position slightly elevated and adducte

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25
Q

CN V

A

trigeminal nerve
SVE - arch 1 derivatives
GSA

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26
Q

arch 1 derivatives

A

muscles of mastication
CN V innervation

temporalis
masseter
M/L pterygoid
anterior belly digastric
mylohyoid
tensor tympani
tensor veli palatini
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27
Q

GSA of trigeminal

A 
face
teeth 
oral cavity
external ear
paranasal sinuses
nasal cavity
eye and conjunctiva
dura
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28
Q

course of trigeminal nerve

A

sensory and motor nucleus
-trigeminal ganglion

gives off:
V1 - superior orbital fissure
V2 - foramen rotundum to PPF
V3 - foramen ovale to infratemporal fossa

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29
Q

V3

A

only one carrying the motor portion**

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30
Q

branches of trigeminal

A

route to distribute the autonomics

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31
Q

ophthalmic nerve

A

V1

  • sensory to eye
  • suspends ciliary ganglion
  • supplies upper dermatome of face
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32
Q

maxillary nerve

A

V2

  • sensory root to PPG
  • maxillary teeth
  • nasal cavities and paranasal sinuses
  • middle dermatome of face
  • upper lip, nostril, temple
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33
Q

mandibular nerve

A

V3

  • suspends otic ganglion and submandibular
  • lower dermatome of face
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34
Q

testing CN V

A

test sensation to the face
-in each dermatome

can also test corneal reflex

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35
Q

corneal reflex

A

in by V1 (nasociliary branch)

out by VII

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36
Q

jaw jerk reflex

A

lightly tap mandible
-response - mm. mastication contract

afferent - V3
efferent - V3

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37
Q

symptoms of CN V lesion

A

hyperacusis - loss of SVE to tensor tympani
deviation of jaw to side of lesion***
loss of sensory to face
loss of corneal reflex

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38
Q

jaw towards or away from CN V lesion

A

towards lesion

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39
Q

CN VI

A

abducens

GSE - lateral rectus

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40
Q

course of CN VI

A

abducent nucleus

  • superior orbital fissure
  • innervates lateral rectus
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41
Q

within cavernous sinus**

A

internal carotid a

abducens nerve

42
Q

walls of cavernous sinus**

A

maxillary nerve
opthalmic nerve
trochlear nerve
oculomotor nerve

43
Q

cavernous sinus infection**

A

first deficits is abducens - due to it being inside sinus

cannot abduct eye

44
Q

CN VII

A 
facial nerve
*SVE - arch 2
*GVE-P
*SVA
GVA - not clinically important
GSA -
45
Q

arch 2 muscles

A

SVE of CN VII

mm facial expression
posterior belly digastric
stylogyoid
stapedius

46
Q

GVE-P of CN VII

A

greater petrosal:
mucous of deep head
lacrimal gland

chorda tympani:
SM/SL

47
Q

SVA of CN VII

A

taste to anterior 2/3

48
Q

course of CN VII

A

motor nucleus - SVE
salivatory nucleus - GVE-P
solitary nucleus - SVA (all taste)

49
Q

solitary nucleus

A

all taste

50
Q

geniculate ganglion

A

cell bodies for taste

-anterior 2/3 tongue

51
Q

course of facial nerve

A

exits internal acoustic meatus
-courses roof middle ear

geniculate ganglion - near middle ear

-exits stylomastoid foramen

52
Q

greater petrosal nerve

A

first branch of facial nerve

-right at bend in middle ear - leaves hiatus for greater petrosal nerve (GVE-P)

53
Q

chorda tympani

A

second branch of facial nerve

  • branches in middle ear
  • to oral cavity

SVA and GVE-P

54
Q

nerve to stapedius

A

third branch of facial nerve

-SVE to stapedius

55
Q

at stylomastoid foramen

A

all SVE of facial nerve

to mm of facial expression

after exits foramen: Ten zebras bit my camel.

56
Q

testing CN VII

A

test muscles of facial expression
-use both upper and lower

also corneal reflex

taste anterior 2/3

57
Q

belly palsy

A 
lose all muscles of facial expression
hyperacusis
loss taste anterior 2/3 tongue
dry, red eye
dry nasal passages
zerostomia
58
Q

pathway of facial nerve**

A

know it

59
Q

CN VIII

A

vestibulocochlear nerve
SSA - hearing
SSA - balance

60
Q

course of CN VIII

A

exits internal acoustic meatus - with facial nerve

  • cochlear portion to cochlear duct (sound)
  • vestibular portion to vestibule (proprioception)
61
Q

lesion of CN VIII

A

acoustic neuroma

-vertigo, hearing loss, tinnitus

62
Q

acoustic neuroma

A

schwann cell tumor

  • usually benign - slow growing
  • lesion of CN VIII

can also affect CN VII** - all components

63
Q

tinnitus

A

ringing in ear

64
Q

CN IX

A

glossopharyngeal nerve

  • SVE - arch 3
  • GVE-P
  • SVA
  • GVA
  • GSA - not clinically important
65
Q

arch 3 muscles

A

stylopharyngeus

nerve - glossopharyngeus

66
Q

GVE-P of glossopharyngeal

A

lesser petrosal to parotid gland

67
Q

SVA of glossopharyngeal

A

taste to posterior 1/3 of tongue

68
Q

GVA of glossopharyngeal **

A 
most of pharynx
auditory tube
posterior 1/3 tongue
middle ear
carotid body
carotid sinus
69
Q

course of CN IX

A

solitary nucleus, nucleus ambiguus, inferior salivatory nucleus

superior and inferior ganglia

motor limb to otic ganglion

exits at jugular foramen

  • associated with carotid sheath
  • course of sylopharyngeus into pharynx
70
Q

tympanic branch of CN IX

A

GVE-P and GVA

71
Q

GVA branch of tympanic

A

pain to inner ear**

-ear infection

72
Q

carotid branch

A

of CN IX

GVA - carotid body and sinus

73
Q

stylopharyngeus n

A

of CN IX

SVE

74
Q

pharyngeal, tonsillar, lingual branches

A

GVA

SVA to tongue

75
Q

gag reflex

A

in by 9 out by 10

afferent CN IX
efferent CN X

76
Q

lesion of CN IX

A

xerostomia - lose parotid pathay

loss taste posterior 1/3 tongue

lose gag reflex

77
Q

CN X

A 
vagus nerve
SVE - arch 4 and 6
GVE-P
SVA - not clinically important
GVA
GSA
78
Q

SVE of CN X

A

to arch 4 and 6

muscles of palate (except tensor veli palatini)
muscles of pharynx (except stylopharyngeus)
larynx muscles
esophagus skeletal m.

79
Q

GVE-P of CN X

A

everything from neck down

**not tested

80
Q

GVA of CN X

A

general sensation to lower respiratory, thoracic viscera

81
Q

GSA of CN X

A

external ear

-tympanic membrane and acoustic meatus (external)

82
Q

nuclei of CN X

A

dorsal nucleus of vagus
solitary nucleus
nucleus ambiguus

has superior and inferior ganglion

83
Q

nucleus ambiguus

A

glossopharyngeal and vagus

84
Q

meningeal nerve

A

branch of vagus

GSA to meninges

85
Q

auricular nerve

A

branch of vagus

to mastoid formamen

GSA to external ear

86
Q

pharyngeal branches***

A

SVE and GVE-P
branches of vagus
-to pharyngeal plexus

to constrictor mm of pharynx and palate

PS to pharynx as well

87
Q

superior laryngeal n***

A

of vagus

SVE
GVE-P
GVA
SVA

internal and external branch**
-know these**

88
Q

recurrent laryngeal n***

A

of vagus

SVE, GVE-P, GVA

to everything except cricothyroid in larynx

89
Q

lesions of vagus

A

usually lose single component

90
Q

testing SVE of vagus

A

examine oral cavity

-pillars, arches - make sure contracting

91
Q

uvula

A

deviates OPPOSITE lesion in vagus lesion

92
Q

lesion of superior laryngeal n

A

lose cough reflex

93
Q

CN XI

A

spinal accessory nerve
GSE - to sternocleidomastoid and trapezius

is actually cervical spinal nerve

94
Q

test SCM

A

rotate head against resistance

95
Q

test trap

A

raise shoulders

96
Q

lesion of CN XI

A

drooping of shoulder

-usually SCM okay, but lose trapezius

97
Q

CN XII

A

hypoglossal nerve

GSE to tongue

all intrinsic and extrinsic muscles of tongue
-except palatoglossus

98
Q

course of CN XII

A

hypoglossal canal

to tongue

99
Q

test CN XII

A

protrude tongue

-look for atrophy

100
Q

tongue

A

points TOWARD side of lesion

Neuro Exam 3 (15 decks)

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