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Semester 4 - Head and Neck > Session 4 - Cranial nerves > Flashcards

Session 4 - Cranial nerves Flashcards

1
Q

What are the two mnemoics for cranial nerves?

A

Oh Oh Oh To Touch And Feel Very Girly Vaginas So Heavenly

Some Say Marry Money
But My Brother Says Big Boobs Matter Most

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2
Q

Name the 12 cranial nerves

A 
Olfactory - Sensory
Optic - Sensory
Oculomotor - Motor
Trochlear - Motor
Trigeminal - Both
Abducent - Motor
Facial - Both
Vestibulocochlear - Sensory
Glossopharyngeal - Both 
Vagus - Both 
Spinal accessory - Motor
Hypoglossal - motor
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3
Q

Name and outline the sensory function of the CN I?

A

Olfactory nerve

Smell

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4
Q

What pathology can be involved with the olfactory nerve?

A

Fracture of the cribiform plate associated with leakage of CSF from nose (rhinorrhea) and anosmia

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5
Q

Name and outline the sensory function of the cranial nerve II

A

Optic nerve

Sight

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6
Q

Outline the pathology of the optic nerve

A

Can be damaged due to
- Direct trauma to eye, orbit or optical canal
- Pressure on optic pathway
Causes a loss of pupillary constriction and visual field defects

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7
Q

Name and outline the motor function of CN III

A 
Oculomotor
Innervates
- Extraocular muscle
- Ciliary muscles
- Sphincter pupillae
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8
Q

Outline pathology of the oculomotor nerve

A

Fracture of cavernous sinus or anurysm

Causes - Dilated pupils, ptosis, eyes turned down and out, loss of pupillary reflex on affected side

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9
Q

Name and outline motor innervation of CN IV

A

Trochlear

Innervates the superior oblique of the eye

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10
Q

Name a pathology of the trochlear nerve

A

Stretching of the nerve during its course around the brainstem OR orbit fractures
Causes inability to look down when eye adducted

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11
Q

Name CN V and its three branches

A

Trigeminal nerve
Opthalmic
Maxillary
Mandibular

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12
Q

What does the opthalmic branch do?

A

Sensory for skin and cornea

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13
Q

How can the opthalmic branch be tested?

A

Corneal reflex (poking sclera)

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14
Q

What does the maxillary branch innervate?

A

Skin, mucous membrane of nose, palate and upper dental arcade

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15
Q

What does the mandibular branch do?

A

Sensory - Skin, lower teeeth, cheek and anterior 2/3rd of toung
Motor - Innervates muscles of mastication

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16
Q

What do lesions of trigeminal nerve lead to?

A

Paralysis of muscles and sharp, intense facial pain

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17
Q

What is CN VI? What is its motor function?

A

Abducens

Motor - Innervates the lateral rectus muscle

18
Q

What occurs in pathology of abducens?

A

Fractures involving cavernous sinus or orbit

Eye fails to move laterally, diplopia on lateral gaze

19
Q

What is cranial nerve VII and what are its sensory and motor functions?

A 
Facial nerve
Sensory
Taste - Anterior 2/3 tongue 
Supplies part of external acoustic meatus and auricle
Motor
Muscles of facial expression 
Submandibular and sublingual glands
Nasal mucosa, paranasal sinuses and lacrimal gland
20
Q

Name three ways in which facial nerve can be injured

A

Laceration in parotid region
Fracture of temporal bone
Intracranial haematoma

21
Q

What symptoms are there in laceration of in parotid region facial nerve damage?

A

 Paralysis of facial muscles, eye remains open, angle of mouth droops, forehead does not wrinkle
(Bell’s palsy)

22
Q

What occurs in fracture of temporal bone injury to facial nerve?

A

Bell’s palsy

Involvement of cochlear nerve and chroda tympani - Dry cornea, loss of taste in anterior 2/3rds of tounge

23
Q

What are the symptoms of facial nerve damage due to intracranial haematoma?

A

 Forehead wrinkles because of bilateral innervation of frontalis muscle
 Paralysis of contralateral facial muscles

24
Q

What is bell’s palsy?

A

Form of facial paralysis resulting from dysfunction of facial nerve. Most common mononeurpathy. Inflammatory condition leads to swelling of facial nerve, especially in narrow bone canal beneath ear.
Eye on affected side cannot be closed, which leads to dry cornea and there may be a loss of taste in anterior 2/3 tongue.

25
Q

What three pathologies must be excluded before a diagnosis of bell’s palsy can be made?

A

Stroke
Lyme disease
Herpes zoster virus

26
Q

How is Bell’s palsy treated?

A

Corticosteroids

27
Q

What is CN VIII and what are its main functions?

A

Vestibulocochlear nerve
Vestibulo branch - controls balance
Cochlear branch - Hearing

28
Q

What are some possible pathologies of the vestibulocochlear nerve and their symptoms?

A

o Skull fractures, ear infections, tumour of the nerve (acoustic neuroma) may all cause nerve lesions
 Progressive, unilateral hearing loss, tinnitus, vertigo
 Acoustic neuroma frequently impairs Facial Nerve (CN VII) too

29
Q

What is CN IX and what are its sensory and motor functions?

A 
Glossopharyngeal nerve
Sensory 
- Taste to posterior 1/3rd of tongue 
General sensory widely distributed to the pharynx, oropharyngeal isthmus, dorsum of palate, auditory tube
- CAROTID BODY AND SINUS

Motor

  • Innervates stylopharngeus
  • PAROTID
30
Q

How can the glossopharngeal nerve be damaged?

A

Loss of taste to posterior 1/3rd tongue

31
Q

What is CN X and what are its sensory and motor function?

A

Vagus nerve
Sensory
 General Sensory lower pharynx and larynx, external auditory meatus and back of auricle
 Special Sensory (taste) to epiglottis

Motor
 Innervates all muscles of the pharynx, except Stylopharyngeus
 Innervates muscles of airways, larynx, heart and GI tract
 Innervates all of the palate muscles, except tensor veli palatine

32
Q

How can pathology of vagus nerve cause hoarseness of voice?

A

 Hoarseness of voice due to paralysis of vocal fold
o Left recurrent laryngeal nerve is lower than the right
o Bronchial or oesophageal carcinoma
o Enlarged mediastinal lymph nodes
o Stretched over an aneurysm of the aortic arch

33
Q

How can mitral stenosis cause hoarseness of voice?

A

o Mitral stenosis  Enlarged LA  Pushed up left pulmonary artery, compressing the left recurrent laryngeal nerve against the aortic arch

34
Q

How can a thyroidectomy cause damage to superior laryngeal nerve?

A

 External branch lies close to superior thyroid artery and may be damaged when ligating the blood vessel

35
Q

What is CN XI? What are its motor functions?

A

Accessory nerve
Innervates pharync, larynx and soft palate
Trapezius and SCM

36
Q

What can cause lesions of accesory nerve?

A

Surgery or lacerations to the neck can cause parlysis of SCM and superior trapezius and shoulder drop

37
Q

What is CN XII and what are its motor functions?

A

Innervates extrinsic and intrinsic muscles of the tounge, except for palatoglossus

38
Q

How can hypoglossal nerve be damaged?

A

Neck lacerations and basal skull fractures

Protruded tongue will deviate towards affected side due to arrangement of muscles

39
Q

What are the muscles of facial expression?

A

Three groups

Orbital Group

  • Obicularis Oculi
  • Corrugator supercilli

Nasal group

Oral Group

  • Orbicularis Oris
  • Buccinator
  • risorius, zygomaticus major, zygomaticus minor, levator labii superioris, levator labii superioris alaeque nasi and levator anguli oris
40
Q

Danger of facila nerve damage in terms of orbital group

A

The eye cannot shut - this can cause the cornea to dry out. This is known as exposure keratitis.
The lower eyelid droops, called ectropion. Lacrimal fluid pools in the lower eyelid, and cannot be spread across the surface of the eye. This can result in a failure to remove debris, and ulceration of the corneal surface.`

Semester 4 - Head and Neck (27 decks)

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