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CCST > Skull, Cranial Nerves & Foramina > Flashcards

Skull, Cranial Nerves & Foramina Flashcards

1
Q

Where do cranial nerves have their nucleus?

A

Brain and brain stem

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2
Q

How do cranial nerves pass into the cranium?

A

Via foramina which are potential sites for compression and restriction

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3
Q

What are the foramina in the ANTERIOR cranium/fossa

A 
Cribiform plate (roof of ethmoid) - fibres from Olfactory Nerve CN I pass up through nasal cavity 
Optic Canal - located between body and lesser wing of sphenoid - carries optic nerve and ophthalmic artery
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4
Q

What are the fissures in the back of the orbit and describe location?

A

Superior Orbital Fissure - Between Sphenoid lesser and greater wing
Inferior Orbital Fissure - Between Greater Wing of sphenoid and Maxilla

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5
Q

What structures pass through the Superior Orbital Fissure?

A

Oculo-motor Nerve - eye movement
Trochlea Nerve - eye movement
Abducen Nerve - eye movement
Opthalmic Vein - venous drainage from orbit to cavernous sinus
Trigeminal Nerve - Opthalmic Branch - sensations from orbit and forehead

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6
Q

What structures pass through the Inferior Orbital Fissure?

A

Trigeminal Nerve - Maxillary branch

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7
Q

What foramina are in the Greater wing of the Sphenoid?

A

Foramen Ovale; Rotundum; Spinosum (ROS)

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8
Q

What other nerve passes through the Sphenoid?

A

Trigeminal Nerve

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9
Q

What foramina are in the Temporal Bone?

A

Internal Auditory Maetus = Facial Nerve and Vestibulocochlear
Stylomastoid Foramen = Facial Nerve

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10
Q

Where is the Internal Auditory Maetus located?

A

Within the medial wall of the petrous portion of the temporal bone

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11
Q

What nerves pass through the Internal Auditory Maetus?

A

Vestibular-Cochlear CN VIII
Facial Nerve CN VII

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12
Q

Where is the stylo-mastoid foramen>

A

Located between the styloid process and the mastoid process of the temporal bone

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13
Q

What nerve passes through the stylo-mastoid foramen?

A

Motor branch of Facial Nerve CN VII EXITS here

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14
Q

What nerves and structures pass through the Jugular Foramen?

A

Glosso-Pharangeal (IX)
Vagus (X)
Spinal Accessory (XI)
Internal Jugular Veins
Sigmoid and Petrosal Sinuses

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15
Q

Where is the Jugular Foramen located?

A

Between the occiput and mastoid portion of temporal bone on each side, antero and lateral to the Foramen Magnum.

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16
Q

What foramina are located between 2 bones and explain?

A

Jugular Foramen - Between the occiput and mastoid portion of temporal bone on each side
Foramen Lacerum - Between sphenoid body and petrous portion of temporal

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17
Q

What foramina are within the Occiput and where?

A

Foramen Magnum - large hole and base of skull
Hypoglossal Canal - condylar portion of occipital bone

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18
Q

What structures pass through the Foramen Magnum?

A

Spinal Cord
Spinal Roots - C4-C1 of Spinal Accessory Nerve
Vertebral Arteries

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19
Q

What passes through the Hypoglossal Canal?

A

Hypoglossal Nerve CN XII (brainstem to tongue)

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20
Q

Why is the Occiput prone to distortion at birth?

A

In 4 separate portions - surrounding the Foramen Magnum so severe birth trauma or head injuries before can affect how the bones fuse and impinge on the spinal cord and medulla.

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21
Q

Why are the vertebral arteries prone to compression?

A

They follow a vulnerable S shaped pathway. Through vertebral foramina is cervical vertebrae which turns medially around a tortuous S bend between the atlas (C1) and occiput.

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22
Q

What do vertebral arteries do?

A

The TWO vertebral arteries provide major ARTERIAL blood supply to brain (together with 2 CAROTID arteries)

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23
Q

Where do the vertebral arteries pass through?

A

Foramen Magnum

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24
Q

What foramina are between the temporal and occipital bone?

A

Jugular Foramen

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25
Q

What is the function of smaller foramina in the cranium?

A

They carry EMSSARY veins - enable drainage from veins on OUTSIDE of cranium into VENOUS sinuses INSIDE cranium

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26
Q

Name 1 Smaller Foramina and explain function

A

Foramen Caecum - carries emissary vein from nose to superior sagittal sinus, located at junction of frontal bone and ethmoid - so it is a passageway for infection from nasal cavity to meninges.

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27
Q

What are the face foramina and where are they found?

A

Supraorbital Notch - superior orbital rim on frontal bone
Infraorbital Notch - inferior orbital rim on maxilla bone
Mental Foramen - mandible
Mandibular Foramen - mandible

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28
Q

What 4 foramina do you associate with the Trigeminal Nerve?

A

Supraorbital Notch - carries frontal nerve - terminal branch of Opthalmic division of Trigeminal nerve EXITS here.

Infraorbital Notch - located in maxilla - Maxillary division of Trigeminal Nerve EXITS surface here.

Mandibular Foramen - located medial surface of ramus in mandible - point at which Mandibular Nerve ENTERS the JAW.

Mental Foramen -located each side of symphysis menti Mandibular division of Trigeminal - EXITS the JAW.

29
Q

Where is the mental foramen located?

A

In mandible on each side of symphysis menti.

30
Q

What passes through the Carotid Canal?

A

Carotid Nerve (sympathetic supply) from T1 and carotid artery

31
Q

Why is the Foramen Lacerum not a true foramina?

A

It is blocked by cartilage

32
Q

What structure would you associate with the Foramen Lacerum?

A

Carotid Artery

33
Q

What is the External Auditory Maetus?

A

Entry to external and outer ear canal

34
Q

What is the Eustachian Tube?

A

Tube between the MIDDLE ear to NASOPHARNYX

35
Q

Name the foramina/fissures leading to and from the eye?

A

Optic canal
Supra-orbital fissure
Infra-orbital fissure

36
Q

What nerves supply the extrinsic muscles of the eye and squints?

A

Oculomotor
Trochlear
Abducens

37
Q

What nerve supplies eye facial muscles?

A

Facial Nerve

38
Q

What is the x 2 arterial supply to the eye and what does it go through?

A

1) Ophthalmic artery and travels through optic canal with optic nerve. Branches of ophthalmic artery penetrate optic nerve to supply retina (Central Artery to Retina).
2) Vertebral arteries via C7 to C1 = Sbend between C1 atlas and occiput = foramen magnum = basilar artery = circle of Willis (around optic chiasma & hypothalamus) = arterial supply to occipital lobe of brain - location of visual cortex.

39
Q

What is the function of the OculoMOTOR nerve?

A

Motor nerve to EXTRINISIC muscles of the eye - eye movement.

40
Q

What passes through the Foramina Rotundum?

A

Trigeminal Nerve - Maxillary Branch

41
Q

What passes through the Foramina Ovale?

A

Trigeminal Nerve - Mandibular Branch

42
Q

What passes through the Foramina Spinosum?

A

Recurrent Meningeal Branch of the Trigeminal Nerve AND Middle Meningeal Artery

43
Q

Is the Vagus Nerve Sensory, Motor or Both?

A

Both

44
Q

What does the parasympathetic fibres of the Vagus nerve supply?

A

The thoracic and abdominal viscera - respiratory and digestive tract; lungs; heart; stomach, 1st part of colon (right side).

45
Q

What sensory information does the Vagus Nerve send to the CNS?

A

From viscera - most of Gastro-intestinal tract
Sensations from larynx; pharynx; palate
Taste and touch from epiglottis region of tongue (posterior 1/3).

46
Q

What do the motor fibres of the Vagus nerve supply?

A

Muscles of pharynx and larynx.

47
Q

Describe the pathway of the vagus nerve?

A

Medulla - JF - (with glossopharyngeal/spinal accessory/ internal jugular vein) - to provide sensory and motor branches to meninges, epiglottis, pharynx, larynx, palate and throat structures. - down neck in carotid sheath (with carotid artery and internal jugular vein) to branch off to organs of thorax and abdomen (lungs and heart) - through oesophageal opening in diaphragm to PARASYMPATHETIC SUPPLY to organs and receiving sensations from organs down to and including 1st half of colon (not adrenals).

48
Q

Where are the vagus sensory ganglia?

A

In and Below JF.

49
Q

Which Foramina and Nerve passing through are in the Anterior Cranial Fossa?

A

Cribriforma foramina in cribriform plate - ETHMOID
Olfactory Nerve

50
Q

Which Foramina and Nerves are in the Middle Cranial Fossa?

A

Optic canal - SPHENOID
Optic Nerve & Ophthalmic Artery

Superior Orbital Fissure - SPHENOID
Oculomotor Nerve
Trochlear Nerve
Abducent Nerve
Trigeminal - Ophthalmic Branch
Ophthalmic Vein

Foramen Rotundum - SPHENOID
Trigeminal - Maxillary Branch

Foramen Ovale - SPHENOID
Trigeminal - Mandibular Branch

Foramen Spinosum - SPHENOID
Trigeminal - Recurrent Meningeal Branch

Internal Acoustic Maetus - TEMPORAL - PETROUS
Facial Nerve
Vestibular-Cochlear Nerve

51
Q

Which Foramina and Nerves are in the Posterior Cranial Fossa?

A

Jugular Foramen - OCCIPITAL BONE (posterior aspect) & TEMPORAL BONE (anterior aspect)
Glossopharyngeal Nerve
Vagus Nerve
Spinal Accessory Nerve
Internal Jugular Vein
Inferior Petrosal and Sigmoid Sinuses

Hypoglossal Canal - OCCIPTAL BONE
Hypoglossal canal

Foramen Magnum - OCCIPITAL BONE
Vertebral Arteries
Spinal Cord and Medulla
Spinal Accessory Nerve - Spinal Branch

52
Q

Which cranial nerves emerge from: Forebrain

A

Olfactory and Optic

53
Q

Which cranial nerves emerge from Midbrain

A

Oculomotor; Trochlear

54
Q

Which cranial nerves emerge from the Pons?

A

Trigeminal; Abducent; Facial; Vestibulo-cochlear

55
Q

Which cranial nerves emerge from the Medulla?

A

Glossopharyngeal; Vagus; Spinal Accessory; Hypoglossal

56
Q

How does numbering of the Cranial Nerves differ from that of spinal nerves?

A

Identified by Roman Numerals I - XII

57
Q

Are cranial nerves part of the CNS or PNS?

A

PNS

58
Q

Which cranial nerve is involved in Meniere’s?

A

Vestibulocochlear

59
Q

If patient had one side of face drooping what condition would you expect and which cranial nerve might be involved?

A

Bells Palsy
Facial Nerve - paralysis of facial muscles

60
Q

Which cranial nerve is primarily involved in the secretion of saliva?

A

Glossopharangeal - parotid

61
Q

Which CN is involved with secretion of saliva but less so?

A

Facial - submandibular and sublingual

62
Q

Describe pathway and type of nerve supply in pupil dilation?

A

Hypothalamus sends signal to sympathetic chain - paravertebral chain which passes from T1 of chain to lower, middle, superior cervical sympathetic ganglion where is synapses before travelling with the carotid nerve, through the carotid sheath to enter the cranium. Sympathetic fibres pass straight through the ciliary ganglion to continue as short cilary nerves to supply the iris muscle for dilation.

63
Q

Why might a blow to the back of the head contribute to visual disturbances?

A

Visual images are processed by the visual cortex in the occipital lobe of the brain. Optic nerve pathway terminates in the visual cortex of the occipital lobe of the brain so a blow to the back of the head might affect the pathway and cause visual disturbances.

64
Q

Describe pathway and type of nerve involved in pupil constriction?

A

Parasympathetic nerve fibres travelling with oculomotor nerve (pre-ganglionic) where they synapse at the cilary ganglion and carry on as post ganglionic fibres to the muscles of the iris and ciliary muscles. -

65
Q

Which cranial nerves might be involved in asthma?

A

Vagus nerve

66
Q

Where is the Foramen Lacerum located and what structures pass through it?

A

The carotid canal is the name given to a passageway present in the temporal bone via which the carotid artery occurring internally in the neck passes into middle cranial fossa. The canal commences at the outer opening of the carotid foramen or the carotid canal on the temporal bone’s inferior surface and climbs vertically at first, then curves into a bend, finally moving forward horizontally and medially. The internal opening of the canal is called the foramen lacerum.

67
Q

Where is the internal auditory meatus located and which cranial nerves pass through it?

A

Medial wall of petrous portion of temporal bone. Facial nerve and vestibulocochlear.

68
Q

Explain the role of the carotid artery

A

Branches of the 2 internal carotid arteries and the basilar artery (the vertebral arteries become the basilar artery) combine at the bottom of the brain to create a ring of tiny blood vessels which is referred to as the circle of Willis. The carotid arteries consist of 2 sensory areas in the neck, the carotid body and the carotid sinus. The carotid body performs the function of regulating breathing and managing the blood oxygen content, while the carotid sinus maintains the blood pressure.

69
Q

Where is the circle of Willis?

A

The Circle of Willis is located inside the head (around eye level) that provides oxygenated blood supply to the brain.

The circle of Willis is formed by two group of arteries - the internal carotid arteries and two vertebral arteries.

These arteries provide the anterior and posterior circulation of the brain respectively.

The circle of Willis is a ring of interconnecting arteries located at the base of the brain around the optic chiasma, the pituitary stalk and the hypothalamus.

The Circle of Willis ensures that the (oxygenated) blood flow to the brain continues unimpeded, in case any of the principal suppliers are obstructed by injury, physical pressure or disease.

The internal carotid arteries originate from the common carotid arteries (left and right common carotid arteries), at the bifurcation of these arteries (common carotids) at the level of the 4th cervical vertebra. The internal carotid artery then courses upwards within the carotid sheath, and enters the skull through the carotid canal of the temporal bone.

Once in the cranial cavity, it runs anteriorly through the cavernous sinus, giving off a branch – the ophthalmic artery, then curls back to lie in the front half of the roof of the cavernous sinus. The artery then turns vertically upwards to the anterior perforated substance where it divides into the middle cerebral branch (middle cerebral artery) and the anterior cerebral branch (anterior cerebral artery)

CCST (21 decks)

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