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Head and Neck > Session 5 - cranial nerves > Flashcards

Session 5 - cranial nerves Flashcards

1
Q

where do cranial nerves arise from

A

brainstem

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2
Q

what does the brain stem regulate

A

cardio-respiratory functions

maintains consiousness

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3
Q

what does the brain stem continue as when it passes though the foramen magnum

A

spinal cord

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4
Q

what is nuclei

A

collection of cell bodies of nerve fibres that make up the whole cranial nerve

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5
Q

which cranial nerves arise from the forebrain

A

olfactory

optic

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6
Q

which cranial nerves arise from the midbrain

A

occulomotor

trochlear

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7
Q

which cranial nerves arise from the pons

A

trigeminal
abducens
facial
vestibulocochlear

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8
Q

which cranial nerves arise from the medulla

A

glossopharyngeal
vagus
accesory
hypoglossal

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9
Q

what axons does cranial nerve I olfactory carry
and what is its function
what is its route

A

special sensory
smell
olfactory region of nasal cavity- cribriform foramina- olfactory bulb- olfactory tracts- forebrain

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10
Q

how can the olfactory nerve be tested

A

test one nostril at a time

use smelling salts

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11
Q

what is anosmia

what is the most common cause of anosmia

A

loss of sense of smell

common cold

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12
Q

what axons does cranial nerve II optic carry
and what is its function
what is its route

A

special sensory
vision
takes signals from the retina, passes through the optic canal. the optic fibres from the left and cross over at the chiasma. from the optic chiasma they go along the optic tracts to the primary visual cortex in the occipital lobe
originate from the forebrain

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13
Q

how can the optic nerve be tested

A 
visual test (snellen chart and visual fields)
testing pupils responses and reflexes using pen torches
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14
Q

why does the optic nerve swell when there is raised intracranial pressure
and what clinical sign does this present as

A

the optic nerve carries extensions of meninges

presents as papillodema

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15
Q

why might you get bitemporal hemianopia

A

pituitary tumors compress the optic chiasm

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16
Q

what axons does cranial nerve III occulomotor carry
and what is its function
what is its route

A

motor
and carries some autonomic parasympathetic fibres
motor function - innervates most of the extra occular muscles and levator palpibrae superioris (muscle thag keeps eyelid open)
autonomic- sphincter pupillae, whcih constrcits to make the pupil smaller
and ciliary muscle, which changes the shape of the lens
orginates in the mid brain and travels in the cavernous sinus and through the superior orbital fissure to the orbit

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17
Q

why might the occulomotor nerve get compressed

A

increased intracranial pressure can cause the uncus of the temporal bone to slip over the edge of the tentorium cerebelli, as the occulomotor nerve runs just at the edge of the tentorium cerebelli this squashes the occulomotor nerve

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18
Q

of the occulomotor nerve undergoes compression which function is first to go and why

how would a patient present

A

the parasympathetic functions
the parasympathetic fibres sit around the periphery of the occulomotor nerve
so the innervation to the pupil is lost and this is shown as blown or fixed dilated pupil

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19
Q

how can you test the occulomotor nerve

A

inspection of eyelids and pupils and eye movements

test the pupillary light reflexes

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20
Q

how does the pupil look in severe ptosis

A

down and out position

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21
Q

what axons does cranial nerve IV trochlear carry
and what is its function
what is its route

A

motor
supplies the extra orbital muscles superior oblique
midbrain, then through the cavernous sinus and out the superior orbital fissure into the orbit (runs along with the occulomotor nerve)

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22
Q

which cranial nerve is the only nerve to emerge through the dorsal aspect of the brainstem

A

trochlear nerve IV

has the longest intracranial course

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23
Q

how do you test the trochlear nerve

A

eye movements (also tests III,VI)

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24
Q

How might patient correct damage to the trochlear nerve

A

they get diplopia which worse on downward gaze

corrected by tilting their hear

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25
what axons does cranial nerve V trigeminal carry and what is its function what is its route
sensory and motor main sensory nerve supplying the face innervates the muscles of mastication originate from the pons there are three divisions, opthalmic, maxillary and mandibular opthalmic goes through superior orbital fissure and into the orbit to provide sensation to cornea and conjunctiva in the eye maxillary travels through foramen rotundum mandibular travels through foramen ovalis
26
how do you test the trigeminal nerve
check the dermatomal areas relation to CV Va, Vb and Vc test the muscles of mastication test corneal reflex
27
which nerve has the afferent limb of the corneal reflex
CN V trigeminal
28
what is trigeminal neuralgia
it is a sudden attack of severe sharp shooting facial pain that can last from a few seconds to two minutes it usually affects one side of the face usually cause by compression of the trigeminal nerve
29
what is shingles also knows as and which nerve does it affect
Orofacial acute herpes zoster (shingles) is an acute viral disease affecting the trigeminal nerve (CN V). It is the result of reactivation of the varicella zoster virus (VZV) that remained dormant in the trigeminal nerve root ganglion following exposure or clinical manifestation of chickenpox. Reactivation could be due to immunosuppression, or it could be age-related
30
what is the infraorbital nerve a branch of | and where does it provide sensation to
CNVb maxillary division | provides sensation to the skin on the cheek and below the eyelid
31
what is a blowout fracture which nerve does it injure
it is fracture of the orbit the contents of the orbit are forced back causing an increase in pressure in the orbit cavity the floor of the orbit gives way causing damage to the infraorbital nerve causes decreased sensation to the area under the eye
32
what are two branches of the CN Vc madibular division
inferior alveolar which runs through the base of the mandible and then becomes the mental nerve as it comes through the mental foramen- provides sensation to lip and chin lingual nerve- goes to tongue and general sensory innervation to the anterior 2/3 of the tongue
33
which nerve will be damaged in a fracture to the mandible | and how does this present
the inferior alveolar nerve | presents with numbness over lip, chin and along lower gum and teeth
34
which nerve is numbed in tooth extraction
the inferior alveolar nerve | but it also affects the lingual nerve as they are so close to each other
35
what axons does cranial nerve VI abducens carry and what is its function what is its route
motor innervates lateral rectus muscle of the eye originates from the pons, along cavernous sinus, through superior orbital fissure and out of the orbit
36
how do we test cranial nerve VI abducens
eye movements | patients present with diplopia
37
what axons does cranial nerve VII facial carry and what is its function what is its route
motor, special sensory and autonomic (parasympathetic) motor- muscles of facial expression special sensory- taste to anterior 2/3 of the tongue parasympathetics- lacrimal and salivary glands originates from pons and travels through internal auditory meatus and along the petrous part of the temporal bone and exits through the base of the skull giving off five branches extracranially and 2 branches intracranially
38
which branch of the facial nerve VII provides tastes to the anterior 2/3 of the tongue
chorda tympani nerve
39
which branch of the facial nerve VII provides parasympathetics to lacrimal and salivary glands
greater petrosal nerve
40
why might an acousitc neuroma affect the facial nerve
acoustic neuromas are usually found on the vestibulocochlear VIII nerve it runs through the internal auditory meatus with the facial nerve so an acoustic neruoma can compress the facial nerve
41
which nerves senses eye closure (sensory) | and which nerves causes the closure of the eyelid (motor)
trigeminal nerve | facial nerve
42
how do you test the facial nerve VII
test muscles of facial expression test the corneal reflex (efferent limb) test taste on the anterior 2/3 of the tongue
43
what axons does cranial nerve VIII vestibulocochlear carry and what is its function what is its route
special sensory hearing and balance originates from the pons and goes through the internal auditory meatus. In the distal aspect of the IAM, the vestibulocochlear nerve splits, forming the vestibular nerve and the cochlear nerve.
44
what does the vestibular part of the vestibulocochlear nerve do?
The vestibular nerve innervates the vestibular system of the inner ear, which is responsible for detecting balance
45
what does the cochlear part of the vestibulocochlear nerve do?
The cochlear nerve travels to cochlea of the inner ear, forming the spiral ganglia which serve the sense of hearing.
46
where is the primary auditory cortex located
in the temporal lobe
47
how do you test the vestibulocochlear nerve
test hearing and enquire about balance | rinnes and webers tests (tuning fork)
48
what is presbyacusis
it is a progressive, usually bilateral, sensorineural hearing loss that occurs in older people as they age
49
what is nystagamus which nerve is damaged
a condition of involuntary eye movement may result in reduced or limited vision vestibulocochlear CNVIII
50
damage to which nerve can cause vertigo
viestibulocochlear
51
what is an acoustic neuroma and which nerves does it affect symptoms
it is a benign tumours of the shwann cells surrounding the vestibulocochlear nerve, and thus compressing it can also effect the facial and trigeminal nerve sensorineural unilateral hearing loss tinnitus vertigo numbness, pain or weakness down one half of face
52
what axons does cranial nerve IX glossopharyngeal nerve carry and what is its function what is its route
general sensory, special sensory, autonomic and motor general sensation of soft palete, tonsils and phraynx special sensory to middle ear and tympanic membrane (hearing) and sensory from carotid body and sinus (senses increases in pressure) taste and genera sensation to posterior 1/3 on tongue autonomic innervation to parotid gland motor innervation to stylopharyngeus which helps you swallow from medulla it runs through the jugular foramen and descends down the neck
53
how do you test the glossopharyngeal IX nerve
gag reflex | usually tested along with crainal nerve X vagus
54
what axons does cranial nerve X vagus carry and what is its function what is its route
general sensory, motor, and parasympathetic autonomic fibres sensory to lower pharynx and larynx muscles of soft palette, pharynx(swallow) and larynx(vocal cords) parasympathetic to thoracic and abdominal viscera arises from the medulla, goes through the jugular foramen to enter the neck in the carotid sheath
55
which vessels do the left and right recurrent laryngeal (branches of vagus) nerves go under and what do they innervate
left- left recurrent laryngeal nerve turns under arch of aorta right- right recurrent laryngeal nerve turns under right subclavian they innervate the vocal cords
56
how do you test the vagus nerve X
noting speech- look out for hoarseness of voice swallow and cough ahhh to observe any deviations of the uvula- as muscles above uvular contract to maintain it in the midline gag reflex (efferent limb)
57
what axons does cranial nerve XI (spinal) accessory carry and what is its function what is its route
motor spinal root innervates sternocleidomastoid and trapezius comes off the spinal cord runs through the foramen magnum and then through jugular foramen to supply muscles in the neck
58
how do we test the spinal accessory nerve
shrug shoulders against resistance | turn head against resistance (both sides)
59
which nerve runs down through the neck in the posterior triangle
spinal accessory
60
what axons does cranial nerve XII hypoglossal carry and what is its function what is its route
motor innervates muscles of the tongue from medulla it goes through the hypoglossal cabal and heads towards the tongue it runs medial to angle of mandible and crosses internal and external carotid arteries in neck
61
how do you test the hypoglossal nerve XII
inspection for weakness and atrophy of tongue muscles on the ipsilateral side movement of tongue
62
describe how a carotid sinus message works
``` CN IX (glossopharyngeal) detects afferent signals from carotid sinus relaying any increased pressure to brainstem (medulla) eff efferent response in this reflex is increased autonomic output via vagus to AV node in heart to slow heart rate ```

Head and Neck (11 decks)

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