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194 Cards in this Set
- Front
- Back
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List the Cranial Nerves
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Olfactory, Optic, Oculomotor, Trochlear, Trigeminal, Abducens, Facial, Vestibulocochlear, Glossopharyngeal, Vagus, Accessory, Hypoglossal
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3 major divisions of the trigeminal nerve
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Opthalmic, Maxillary, Mandibular
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What cranial nerves pass the Hypoglossal foramen?
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hypoglossal (XII)
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What cranial nerves pass the jugular foramen?
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Glossopharyngeal, Vagus, Accessory (9, 10, 11)
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What cranial nerves pass the Internal Auditory Meatus?
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Facial and Vestibulocochlear (7, 8)
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What cranial nerves pass the Foramen ovale?
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V3 (Mandibular trigeminal)
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What cranial nerves pass the foramen rotundum?
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V2 (maxillary trigeminal)
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What cranial nerves pass the supraorbital fissure?
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V1 (opthalmic trigeminal), Oculomotor, Trochlear, Abducens
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What cranial nerves pass the Optic canal?
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optic nerve (II)
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What cranial nerves pass the cribiform plate?
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olfactory (1)
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What is anosmia?
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loss of smell
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The cribiform plate is part of what bone?
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Ethmoid bone
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What myelinates the optic nerve?
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oligodendroglia
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What types of tumors compress the optic nerve/chiasm?
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pituitary tumors
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What types of nerve fibers are found in the optic nerves? (GSE, GVE, GSA, GVA etc.)
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special somatic afferents
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What types of nerve fibers are found in the olfactory nerves? (GSE, GVE, GSA, GVA etc.)
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special visceral afferents
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What types of nerve fibers are found in the occulomotor nerve?
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GSE, GVE (sympathetic, parasympathetic)
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What 4 extrinsic eye muscles are innervated by the occulomotor efferent somatic fibers?
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superior, medial, inferior rectus and inferior oblique
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What skeletal muscle (not extrinsic eye) does the occulomotor GSA innervate?
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levator palpebrae superioris (upper eyelid)
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What 2 intrinsic eye muscles are innervated from the ciliary ganglion (occulomotor parasympathetics)?
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constrictor pupillae and ciliary muscle
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What does the ciliary muscle do?
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thickens the lens
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What 2 intrinsic eye muscles are innervated from the internal carotid plexus (occulomotor sympathetics)?
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dilator pupillae and muller muscle (superior tarsal)
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The Muller's muscle is smooth muscle part of what skeletal muscle?
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levator palpebrae superioris
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The occulomotor nerve passes between which 2 arteries?
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superior cerebellar and posterior cerebral arteries
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Where does the occulomotor nerve exit the skull?
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supraorbital fissure
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What deficits do we see in a patient with 3rd nerve palsy?
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inability to open eyelid. affected eye is looking down and out, fixed dilated pupil. complete ptosis
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What type of nerve fibers are found in the trochlear nerve? (GSE, GVE etc.)
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somatic efferents
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What is the only cranial nerve derived from the brainstem?
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Trochlear
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What muscle does the trochlear nerve innervate?
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superior oblique
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How does the trochlear nerve enter the orbit?
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superior orbital fissure
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What do we see in patients with trochlear nerve deficits?
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double vision, tilted head AWAY from affected side to compensate
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Which branch of the trigeminal nerve has motor nerves?
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V3 (Mandibular)
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What part of the brain does the Trigeminal nerve arise?
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pons
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4 muscles innervated by mandibular trigeminal
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chewing muscles: tensor tympani, tensor velli palatine, digastric belly, mylohyoid
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What is the parasympathetic glanglion of V1
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ciliary ganglion
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What does the V2 cranial nerve pass through to get into the skull?
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foramen rotundum
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What parasympathetic ganglion is associated with the V2 cranial nerve?
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pterygopalatine ganglion
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What parasympathetic ganglion is associated with the V3 cranial nerve?
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otic ganglion
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What does the V3 pass to innervate the sensory lower face?
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mental foramen
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What do we see in patients with trigeminal neuralgia?
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major sensitivity to gentle touches/breezes
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What trigeminal branches are mostly involved with trigeminal neuralgia?
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V2, V3
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How is trigeminal neuralgia treated?
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antiepileptic drugs, lesion semilunar ganglion, craniotomy all reduce sensitivity
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What does the Abducens nerve innervate?
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lateral rectus muscle
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What do we see in patients with abducens nerve damage?
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lateral gaze deficit: both eyes can look straight, but damaged eye cannot move
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What is cranial nerve 6
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abducens
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What is cranial nerve 3
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occulomotor
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What is cranial nerve 4
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trochlear
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What is cranial nerve 2
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optic
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What is cranial nerve 1
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olfactory
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What is cranial nerve 5
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trigeminal
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What is cranial nerve 7
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facial
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3 primary vesicles of brain development
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forebrain, midbrain, hindbrain
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What is the forebrain called?
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prosencephalon
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What is midbrain called?
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Mesencephalon
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What is hindbrain called?
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Rhombencephalon
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What are the 2 secondary vesicles of the prosencephalon
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Telencephalon and Diencephalon
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What are the 2 secondary vesicles of the rhombencephalon?
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Metencephalon and Myelencephalon
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Telencephalon gives rise to what part of the brain?
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Cerebrum, basal ganglia, lateral ventricles (remnant)
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Diencephalon gives rise to what part of the brain?
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Thalamus, Hypothalamus, Pineal, 3rd ventricle (remnant)
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Mesencephalon gives rise to what part of the brain?
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Midbrain, Aquaduct of Sylvius (remnant)
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Metencephalon gives rise to what part of the brain?
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Pons, Cerebellum, 4th ventricle (remnant)
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Myelencephalon gives rise to what part of the brain?
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Medulla
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The lateral ventricles are a remnant of what developmental brain vesicle?
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telencephalon
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The 3rd ventricle is a remnant of what developmental brain vesicle?
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Diencephalon
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The duct of Sylvius is a remnant of what developmental brain vesicle?
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Mesencephalon
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The 4th ventricle is a remnant of what developmental brain vesicle?
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Metencephalon
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The precentral gyrus controls what body function?
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primary motor
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The postcentral gyrus controls what body function?
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sensory
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The superior gyrus of temporal lobe controls what body function?
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audition (hearing)
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Where is Brodmann's area 4 located in the brain?
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pre-frontal gyrus/primary motor cortex
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Where is the cerebral peduncle located (what part of the brain)?
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midbrain
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Motor function is controlled by what major tract?
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corticospinal tract
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Axons from the primary "upper" motor neurons leave the pyramid through what space?
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interpeduncular
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What are the 2 corticospinal tracts?
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lateral and anterior (medial)
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Where do lateral corticospinal tract neurons synapse in the spinal cord?
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ventral horns
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What do lateral corticospinal tract motor neurons innervate?
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limb motor neurons ("lower" motor neurons)
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What do anterior corticospinal tract motor neurons innervate?
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trunk muscles
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Which corticospinal tract crosses in the pyramids?
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lateral tract (anterior remains uncrossed the whole way down)
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What are Brodmans areas 3, 1, 2?
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primary sensory cortex/postcentral gyrus
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What are the 2 major sensory tracts (columns) in the spinal cord?
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Dorsal (lemniscal) and Anterolateral (spinothalamic)
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What do the dorsal sensory columns sense?
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discriminative touch, proprioception and vibration
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What do the anterolateral columns sense?
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temperature, pain, crude touch
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Where do dorsal column fibers cross?
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pyramids
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Where do anterolateral fibers cross?
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at spinal level they exit
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Injury to corticospinal tract above pyramids leads to ...
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contralateral motor loss
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Injury to corticospinal tract below pyramids leads to ...
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ipsilateral motor loss
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Injury to dorsal tract in spinal cord leads to ....
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contralteral sensory loss below lesion (disc touch, proprioception, vibration) ??? Shouldn't this be ipsilateral?
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Injury to anterolateral tract in spinal cord leads to ....
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ipsilateral crude touch, pain and temperature sensory loss below the lesion
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3 parts of the brain stem
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Mesecephalon, Metecephalon, Medulla Oblongata
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What are the 2 major parts of the medulla oblongata?
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Inferior olive and Pyramids
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Where are the superior and inferrior colliculi found?
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brain stem (mesecephalon)
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What do the superior colliculi control?
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visual input
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What do the inferior colliculi control?
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auditory input
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What nerve is found just anterior to the inferior olive of the medulla oblongata?
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hypoglossal
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Nervus intermedius is found between what 2 cranial nerves?
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facial and vestibulocochlear
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What is the 1st branch off the subclavian artery?
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Vertebral artery
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What transverse foramen (which vertebrae) does the vertebral artery pass through?
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C1-C6, NOT C7
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Where does the vertebral artery enter the skull?
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foramen magnum
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The internal carotid artery enters the skull through which foramen?
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carotid canal
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The vertebral artery become what artery once it enters the skull?
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Basilar
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Where is the basilar artery in relation to the pons?
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lays on the anterior aspect of the pons
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Occlusions of the basilar artery may affect what part of the brain?
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brainstem (double vision, nausea)
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What is the name of the anastomoses between the internal carotid and vertebral artery?
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Circle of Willis
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3 branches of the vertebral artery
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anterior and posterior spinal arteries, posterior inferior cerebellar artery
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What artery passes through the cavernous sinus?
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internal carotid
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1st branch of internal carotid artery
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opthalmic artery
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3 terminal branches of the internal carotid
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posterior communicating artery, middle and anterior cerebellar artery
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The Circle of Willis is found around what cranial nerve?
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Optic Chiasm (CN2)
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2 layers of dura mater
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periosteal and meningeal layer
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Superior sagittal sinus is found between what two layers?
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periosteal and meningeal dura layers
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What are dural partitions? What is an example of one?
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inwards projections of dura mater; falx cerebri
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The crista galli is part of what bone?
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ethmoid bone
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What passes through the opening of the tentorium cerebelli?
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midbrain and basilar artery
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What is a transtentorial herniation?
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medial temporal lobe and uncus herniate through tentorial notch
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What 3 clinical signs do we note in an uncal herniation?
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blown (dilated) pupil, hemiplegia, coma
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Why do we see a blown pupil in uncal herniation?
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compression of occulomotor nerve (parasympathetic preganglionic nerves) = no longer close pupils in response to light
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Why do we see hemiplegia in an uncal herniation?
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compression of the cerebral peduncles (corticospinal tract follows it)
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Why do we see coma in an uncal herniation?
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distortion of the reticular activating system involved in alertness and awakeness
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Compression of the diaphragma sellae can affect what structure?
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infundibulum of pituitary stalk
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The anterior cranial fossa has blood supplied by what artery?
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anterior meningeal artery
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The middle cranial fossa is supplied blood by what arteries?
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middle meningeal and accessory meningeal
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The middle meningeal artery enters the skull through ...
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foramen spinosum
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What artery passes foramen spinosum?
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middle meningeal
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The accessory meningeal artery enters the skull through what foramen?
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Ovale (with V3)
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An epidural bleed caused by a hit to the pterion likely damages what artery?
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middle meningeal artery
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In an epidural bleed, where does blood collect?
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Between periosteum/calvaria and periosteal dural layer
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What shape do we see blood collect in an epidural bleed?
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lens shaped
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Stretching of the dura mater causes what symptoms in patients?
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headaches
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What causes stretching of the dura mater?
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dilation/constriction of blood vessels
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Fun Fact: The dura is not attached to the arachnoid mater
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There is a potential space called subdural space.
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Blood vessels travel through what meningeal layer?
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subarachnoid space.
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What causes subdural bleeds in older patients?
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atrophy of the brain puts strain on the veins going to dural sinuses. blood fills space between arachnoid and meningeal dura mater
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What shape does a subdural bleed appear in an X-ray?
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cresent shape
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Subarachnoid bleeds are caused by what?
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severe trauma to cerebral arteries in subarachnoid space
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What are the 4 typical herniation sites of the brain?
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subfalcine, central, uncal, tonsilar
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Dural venous sinuses drain into what?
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internal jugular
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What bones bound the cavernous sinus
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sphenoid and sella turcica
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What artery and nerve pass through the cavernous sinus?
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internal carotid and abducens
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What nerves lie in the wall of the cavernous sinus
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CN 3, 4, V1, V2
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Where is CSF reabsorbed into the venous system in the brain?
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arachnoid villi in the superior sagittal sinus
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How does CSF get from the 4th ventricle to the arachnoid villi?
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medial foramen of Magendie and lateral Foramen of Lushka
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Cause of Hydrocephalus
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blockage of Aqueduct of Sylvius; tumor or congenital
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The occulomotor nerve runs between which two arteries?
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superior cerebellar and posterior cerebral artery
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Facial nerves uses what branch to control anterior 2/3 tongue taste?
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chorda tympani
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5 Facial nerve sensory branches to face
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Temporal, Zygomatic, Buccal, Marginal Mandibular, Cervical
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What cranial nerve is embedded in the parotid gland
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Facial (CN7)
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What is the attenuation reflex?
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40-80 mseconds after loud sound, tensor tympani and stapedius contract to mask sound and protect
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Loss of blink reflex is seen in what common facial nerve disorder?
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Bell's Palsy
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What are the 2 sensory components of the vestibulocochlear nerve?
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vestibular and cochlear
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Typical location of acoustic neurome
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cerebellopotine angle
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Acoustic neuroma symptoms
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tinnitus, vertigo, maybe facial paralysis (close proximity to CN7, may impinge)
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The glossopharyngeal nerve arises in what relationship to the inferior olive?
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just posterior
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What nerve sends taste from the posterior 1/3 of the tongue?
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glossopharyngeal
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Damage to a vagus nerve causes deviation of the uvula to which side?
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Contralateral side of damage
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What are the 2 components of CN 11
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Cranial and spinal roots
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Where does CN11 enter, then exit the skull.
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Enters: foramen magnum. Exits: Jugular Foramen
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Where does the hypoglossal nerve come off the brainstem?
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anterior to the inferior olive
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Damage to the hypoglossal nerve causes deviation of the tongue to which side?
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ipsilateral side of damage
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5 Layers of SCALP
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Skin, connective tissue (dense), aponeurosis, loose CT, pericranium/periosteum
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why is scalp moveable?
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loose connective tissue
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What layers of the scalp are connected?
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SCA
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SCALP innervation: anterior to ear and vertex
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trigeminal branches (V1, V2, V3)
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SCALP innervation: posterior to ear and vertex
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C2, C3 rami (cervical plexus)
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Emissary veins of the scalp are found in what layer?
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LCT
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Blood in the scalp collects in what layer?
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Dense CT
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Arteries of the scalp are found in what layer?
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DCT
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Emissary veins can carry infection in what scalp layer?
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LCT
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Face muscles are derived from which brachial arch
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2nd
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Orbicularis oculi function
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shut eye
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Buccinator function
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pulls cheeks towards teeth
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Orbicularis Oris function
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close lips
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3 parts of orbicularis oculi
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palpebral, orbital, lacrimal
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palpebral orbicularis oculi function
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close eyes lightly
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orbital portion of orbicularis oculi function
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close eyes tightly
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Buccinator muscle innervation
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buccal branch of CN 7
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Cheek mucosa and skin innervation
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buccal branch of CN V3 (mandibular)
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Fun Fact: The Buccinator is innervated by the buccal branch of CN7 (motor). The mucosa and skin of the cheek is innervated by buccal branch of CN V3 (sensory)
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Classic board question right here
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Platysma muscle functions
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depress mandible, tense skin over neck
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Platysma innervation
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motor: Facial nerve. sensory: C2, C3 rami
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Fun Fact: The facial nerve passes through the parotid gland, but gives no innervation to it
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yyyea whatevaaa
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The parotid duct must pierce what muscle to enter the mouth?
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buccinator
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Where does the facial nerve exit the skull?
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stylomastoid foramen
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Parotid Gland: sensory innervation
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C2/C3, auricotemporal (V3)
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Parotid Gland: vasomotor
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sympathetic carotid plexus
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Parotid Gland: secretion innervation
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parasympathetic glossopharyngeal (CN9)
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3 branches of opthalmic (V1)
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frontal, nasociliary, lacrimal
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3 branches of maxillary (V2)
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infraorbital, zygomaticofacila, zygomaticaltemporal
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3 branches of mandibular (V3)
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auriculotemporal, buccal, mental
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Major artery to the face
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facial artery off of external carotid
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Why is the nose area of the face considered a danger area?
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facial vein has no valves and infection can go to the cavernous sinus
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Major lymph nodes of the head
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submental, submandibular, parotid, mastoid, occipital
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Where do we see contralateral lymph drainage in the face?
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lower lip (seen in smokers/lip cancer)
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4 components of facial nerve
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Somatic motor, visceral motor (parasympathetics), special sensory (taste), general sensory (EAM skin)
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Effect of a central CN7 lesion
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contralateral paralysis (except forehead)
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