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Neuro 2nd Half > trigeminal and facial nerves > Flashcards

trigeminal and facial nerves Flashcards

1
Q
A
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2
Q

three branches of trigeminal nerve

A

v1 ophthalmic

v2 maxillary

v3 mandibular

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3
Q

trigeminal is what type of innervation

A

motor and sensory

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4
Q

where are the cell bodies of the pseudounipolar sensory neurons of CNV?

A

trigeminal ganglion in middle cranial fossa

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5
Q

what muscles does CN V innervate?

A

muscles of mastication

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6
Q

where are the CNV cell bodies of motor neurons?

A

trigeminal motor nucleus in the pons

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7
Q

where is the trigeminal ganglion located?

A

meckels cave – between te dura of the middle cranial fossa and the petrous temporal bone

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8
Q

what foramen does each trigeminal branch leave cranial cavity through?

A

v1 - superior orbital fissure

v2 - foramen rotumdum

v3 - foramen ovale

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9
Q

what region is v1/v2/v3 associated w?

A

v1 - orbit

v2 - pterygopalatine fossa

v3 - infratemporal fossa

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10
Q

v1

branches

A

ophthalmic - ALL sensory for upper face/nasal cavity/cornea

NFLnerves

nasociliary –> long ciliary nerves, anterior and posterior ethmoid nerves, and infratrochlear nerve

frontal –> supraorbital (lateral) and supratrochlear (medial)

lacrimal

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11
Q

lacrimal nerve is joined by? why?

A

postganglionic parasympathetics from v2 for tear production

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12
Q

what branches from v1 enter eyeball?

A

long ciliary off the nasociliary nerve

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13
Q

what supplies sensory to skin on upper nose?

A

infratrochlear nerve

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14
Q

v2

A

maxillary - ALL sensory for middle face/upper teeth/hard and soft palate, sinuses

branches:

2 ganglionic –> greater and lesser palatine, pharyngeal, nasopalatine

zygomatic –> zygomaticotemporal and sygomaticofacial

infraorbital

superior alveolar –> posterior superior, middle superior, and anterior superior alveolar branches

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15
Q

which v2 branches pass through pterygopalatine ganglion withoUT synapsing?

A

ganglionic branches

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16
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17
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18
Q

what v2 branch is in lateral orbit/branch that ascends? two divisions?

A

zygomatic nerve

zygomaticotemporal

and zygomaticofacial

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19
Q

cutaneous sensory to cheek, lateral nose, and upper lip?

A

infraorbital nerve off v2

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20
Q

v2 supply to maxillary sinus and teeth?

A

posterior, middle, and anterior superior alveolar nerves

posterior superior comes off becore v2 becomes infraorbital nerve

anterior and middle superior come off v2 after it becomes the infraorbital nerve

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21
Q

v2 terminal branch (becomes) is?

A

infraorbital nerve

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22
Q

why is sinusitis often interpreted as a tooth ache?

A

because maxillary sinus is innervated by superior alveolar nerves which also innervate the maxillary teeth

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23
Q

v3

A

both motor and sensory! to mandible/floor of mouth, anterior 2/3 tongue, lower face skin

motor fibers to MMATT (muscles of mastication, mylohyoid, anterior digastric, tensor velipalatini and tensor tympani)

24
Q

v3 innervates structures derived from which pharyngeal arch

A

1st

25
Q

anterior v3 vs posterior v3

A

anterior is mostly motor

posterior is mostly sensory

26
Q

v3 motor fibers innervate ?

A

MMATT

muscles of mastication

mylohyoid

anterior digastric

tensor veli palatini

tensor tympani

27
Q

what two nerves come off main trunk v3 first?

A

meningeal branch (sensory) and medial pterygoid nerve (motor)

28
Q

meningeal branch reenters the skull through

A

foramen spinosum

29
Q

anterior division of v3

A

masseteric, deep temporal x2, lateral pterygoid (all motor) –> pass above upper head of lateral pterygoid m.

buccal (sensory)–> passes between heads of lateral pterygoid m

30
Q

posterior div of v3

A

auriculotemporal, lingual, and inferior alveolar (all sensory)

inf. alveolar gives off nerve to mylohyoid (motor)

31
Q

only motor branch in posterior v3 div?

only sensory branch in anterior v3 div?

A

nerve to mylohyoid

buccal nerve

32
Q

loss of corneal reflex –> lesions where?

A

v1

33
Q

which way will jaw deviate with weakness of muscles of mastication?

A

toward the side of weakness

34
Q

trigeminal neuralgia

A

tic douloureux

CN V disorder with recurrent short (<15 min) episodes of pain, usually in v2/v3 areas

35
Q

facial nerve VII has 4 components

A

lower motor neurons

parasympathetic fibers

taste fibers

somatosensory fibers

36
Q

where do facial lower motor neurons originate, exit, and innervate?

A

facial motor nucleus of pons

cerebellopantine angle as motor root

muscles from 2nd pharyngeal arch FESS-P (muscles of facial expression, stapedius, stylohyoid, and posterior digastric)

37
Q

facial nerve innervates

A

muscles of facial expression

stapedius

stylohyoid

posterior digastric

FESS-P

(2nd pharyngeal arch muscles)

38
Q

where do facial nerve VII parasympathetic fibers originate and innervate?

A

superior salivary nucleus

submandibular, sublingual, and lacrimal glands

39
Q

what innervates submandibular, sublingual, and lacrimal glands?

A

parasympathetic fibers from VII

40
Q

VII taste fibers

A

innervate anterior 2/3 tongue

41
Q

where are cell bodies of VII taste fibers? descend in? terminate in?

A

geniculate ganglion

solitary tract –> solitary nucleus

42
Q

what part of VII descends in spinal V tract

A

somatosensory fibers

43
Q

course of facial nerve

A

motor root and intermediate nerve enter internal acoustic meatus –> geniculate ganglion

at geniculate ganglion splits –> greater petrosal nerve and abrupt bend posteriorly

1) greater petrosal –> pterygopalatine ganglion –> lacrimal gland
2) VII at geniculate ganglion –> tympanic cavity –> nerve to the stapedius and chorda tympani come off –> nerve then exits petrous temporal bone through stylomastoid foramen –> parotid gland (superficial to retromandibular veina and ECA) –> divides into temporofacial and cericofacial branches –> terminal branches (temporal, zygomatic, upper and lower buccal, marginal mandibular, and cervical)

44
Q

terminal branches of facial nerve are purely

A

motor

45
Q

what is the sensory ganglion of CN VII?

A

geniculate ganglion

46
Q

what nerve contains the preganglionic parasympatheric fibers for the lacrimal gland?

A

greater petrosal nerve

47
Q

what nerve has the preganglionic parasympathetic fibers for submandibular and sublingual glands and taste fibers for ant. 2/3?

A

chorda tympani

48
Q

lesion of facial nerve –>

A

paralysis/weakness of facial musculature

49
Q

weakness of facial muscles on the entire ipsilateral side

A

peripheral facial nerve palsy

distorted appearance at rest and during movement

50
Q

peripheral facial nerve palsy effects

A

dropped eyebrow and corner of mouth on affected side

smooth forehead on affected side

asymmetrical smile

food in cheek due to paralysis of buccinator

absent corneal reflex in ipsilateral eye, but corneal sensation is intact(V1)

51
Q

where is lesion if taste is impaired?

A

proximal to chorda tympani origin

52
Q

impaired salivary secretion

A

lesion is proximal to origin of chorda tympani

dmaged parasympathetic fibers for glands

53
Q

impaired lacrimation (dry eye)

A

damage to parasympathetic fibers for lacrimal gland

lesion proximal to origin of the greater petrosal nerve

54
Q

bells palsy

A

all divisions of facial nerve become impaired over hrs/days - usually unilateral

viral or inflammatory cause

recovers over 2-3 weeks, sometimes residual effects

55
Q

voluntary central facial palsy

A

lesion to the corticobulbar system

upper MN palsy

corneal reflex stays intact and coluntary m of upper face are preserved due to bilateral input

unilateral corticobulbar lesion produces only weakness of muscles of contralateral lower face

56
Q

unilateral lesion of the corticobulbar system produces

A

weakness of muscles of contralateral lower face

corneal reflex and movement of upper face intact!

57
Q
A

Neuro 2nd Half (8 decks)

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