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41 Cards in this Set
- Front
- Back
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In the occulomotor nerve (CN 3), the nuclei is located ______________ of the rostral ____________. It receives bilateral innervation from the ________________________. It exits the brain ___________ in the ____________________________. It innervates all ________________ for eye movement and elevates eyebrow.
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in the middle; midbrain
frontal eye field ventrally; interpeduncular fossa extraocular muscles |
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In the trochlear nerve (CN 6), nuclei is located in the ______________ of the caudal ________________. It is unique because it exits _________ below the __________________________ and _____________ in the midbrain before exiting. It innervates the _____________________ muscle that rotates the eye medially & downward.
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middle; midbrain
dorsally; inferior colliculus decussates superior oblique muscle |
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This is the largest of the cranial nerves. The nuclei is distributed continuously throughout the ________________, but the nerve root exits from the ______________________. It has a small _______ division and a large ________ division. The motor division supplies the muscles of ________________, the ______________, and ______________.
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trigeminal (CN 5)
brainstem ventrolateral pons small motor; large sensory muscles of mastication, tensor palatine & tensor tympani |
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In CN 5, the sensory vision encompasses the same modalities as the ______________________ & ________________ system. What (5) things does it discriminate? What does it innervate?
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dorsal column; anterolateral
touch, vibration, proprioception, pain, thermoception the face, anterior scalp, portion of meninges, oral tract, nasal mucosa, teeth, and anterior 2/3 of tongue |
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What are the branches of CN 5?
Where do the proprioceptive and motor divisions travel? What does V2 innervate? V3? |
V1 opthalmic division
V2 maxillary division V3 mandibular division within V3 V3- upper lips, upper teeth, palate V2- lower lips, anterior 2/3 of tongue |
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SUBDIVISIONS OF TRIGEMINAL NUCLEUS
Where is the principle nucleus of CN 5? What does it receive? Where is the mesencephalic nucleus (2 areas)? It receives proprioceptive info from the __________________ muscles (V3). Where is the motor nucleus? |
in the pons
discriminative touch, vibration, skin motion, hair motion, tongue proprioception from 3 divisions in the rostral pons & caudal midbrain masticatory muscles in the upper pons |
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SUBDIVISIONS OF TRIGEMINAL NUCLEUS
The spinal nucleus extends from _____________ to ___________. What does it receive from the 3 divisions? The spinal trigeminal tract runs alongside the spinal nucleus and carries sensory info ________ from the entry point of CN 5 down to the ____________ second order neurons. |
lower pons to spinal cord
pain, crude tough, temperature sensation caudally; medullary |
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What are the 3 divisions of the spinal nucleus of CN 5?
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pars oralis, pars interpolaris, pars caudalis
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Which cranial nerves also carry somatosensory information (mixed nerves)? (pharyngeal, laryngeal, & ear)
This info either terminates in the ___________ nuclei or gives off collateral to this. |
CN 7, CN 9, CN 10
trigeminal |
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Abducens nerve (CN 6) nuclei is located ____________ in the ________________.
It exits ______________ at the _____________________________. It innervates _____________________ muscle that controls eye abduction. |
medially; caudal pons
ventrally; pontomedullary innervates lateral rectus muscle |
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The facial nerve (CN 7) is a mixed nerve with a _________ nucleus in the ______________. It is classified as a _______________________ nerve. It exits the _____________________ laterally. The fibers leave the __________ nucleus and loop around the __________ nucleus. They travel with the _____________________ nerve for part of their course.
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motor; caudal pons
branchial motor pontomedullary junction facial; abducens vestibulocochlear |
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The facial nerve (CN 7) provides motor innervation to all of the muscles of __________________. The nerve divides into ____ branches.
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facial expression
5 |
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There is a separate division of the facial nerve called _____________________.
It carries ____________ sensation from the _______________ of the tongue. This terminates in the rostral _____________ (also called the ____________________ nucleus). Taste then projects to the ______ and then to the taste center in the ____________. |
chorda tympani
taste; anterior 2/3 solitary nucleus ; gustatory vPm; insula |
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In the facial nerve, the output from the superior salivatory nucleus travels with the _________. It innervates the ________________ & _____________ salivary glands, nasal & __________ glands, and ___________ glands.
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facial
submandibular and sublingual salivary, palatine, lacrimal |
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The gossopharyngeal nerve (CN 9) exits the _______ and the _______________________ and innervates the ________________________ (which is active during sawllow and part of the gag reflex). Visceral motor fibers originate in the ________________________ and innervate the _______ gland. Somatic info is carried from the external ________, _____________, and _________________ of the tongue. Taste from the posterior 1/3 of the tongue terminates in the ___________ nucleus.
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medulla/ post-olivary sulcus
stylopharyngeus inferior salivatory nuclues; parotid gland gustatory |
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The vagus nerve (CN 10) exits the __________________ to the hypoglossal as rootlets. The branchial motor fibers supply the muscles of the ______________ & ______________, and the somatic sensation innevates the pharynx, larynx, ____________, and small portion of the external _____________.
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post-olivary sulcus
pharynx & larynx meninges, ear canal |
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The vagus nerve carries taste from the ________________ and posterior pharynx to the _________________________. It also carries general visceral sensation from the _____________ & ____________ receptors of the aortic arch, _________________ system, and ______________ tract.
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epiglottis; gustatory nucleus
chemoreceptors, baroreceptors; cardiorespiratory system, digestive tract |
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The nucleus of the accessory nerve is in the ______________________, but fibers move ___________ and exit ____________. The branchial motor fibers innervate the _____________ and upper fibers of the __________. The left __________________________ turns the head to the right, and lesions cause weakness turning away from a lower motor lesion.
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spinal cord
rostrally; brainstem sternomastoid; trapezius sternocleidomastoid |
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The hypglossal nerve exits the _____________ _____________ as rootlets between the _____________ and _______________. It provides __________ motor innervation to all the muscles of the ______________ (intrinsic & extrinsic).
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ventral medulla; pyramid & inferior olive
somatic; tongue |
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________________________ is recurrent episodes of severe facial pain, often provoked by ________ stimuli (chewing/touching a trigger point).
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trigeminal neuralgia; innocuous
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___________________ is pain conveyed by trigeminal afferents.
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TMJ syndrome
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Loss of facial sensation is caused by 1) ______________________ (ipsilateral) and 2) __________________________ (bilateral).
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lesions in the brainstem
herpes zoster |
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Brainstem lesions characteristically compromise _______ facial sensation and ______ body sensation.
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ipsilateral
contralateral |
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__________________________ is also called Wallenburg's syndrome. it is usually caused by _______________________.
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Lateral medullary syndrome
vertebral artery thrombosis |
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What are the symptoms of Wallenburg syndrome? (4)
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1) ipsilateral ataxia & vertigo
2) decreased pain & body temp sensation of the ipsi face & contra body 3) hoarseness & dysphagia w/ ipsi vocal fold paralysis 4) decreased pharyngeal sensation (loss of taste) w/ ipsi loss of gag reflex |
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In Wallenburg syndrome, ipsi ataxia & virtigo cause...
It is caused by... |
unsteady gait, nystagmus, nausea, & vomiting
the interruption of the inferior cerebral peduncle & vestibular nuclei |
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In Wallenburg... decreased pain & temp sensation is caused by the interuption of...
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the ipsi spinal trigeminal sructures & contra spinothalamic tract
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In Wallenburg, hoarseness & dysphagia w/ VF paralysis is caused by...
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interruption of nucleus ambiguus
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In Wallenburg, decreased pharyngeal sensation w/ loss of gag reflex is caused by interruption of...
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solitary tract & solitary tract nucleus
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In some cases of Wallenburg syndrome, the facial nerve may be interrupted leading to...
What is an interesting symptom? |
ipsilateral facial weakness
in some cases, pt may report the world turning upside down or sideways |
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Medial pontine syndrome... infarcts of the ________________________ perforating branches. It extends from the __________ surface toward the ____ ventricle. Infarcts tend to end sharply @ the _________. They are usually __________ infarcts so TIA is a cause. They result from ________________, which produces ____________, or small vessel thrombosis. It may be a warning sign for _______________________.
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paramedian pontine
ventral; 4th midline lacunar hypertension, microemboli basilar thrombosis |
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2 types of lesions:
1) upper motor lesion... you will see... 2) lower motor lesion ... you will see... |
1) drooping in the lower part of the face
2) drooping in the whole face (both upper & lower drooping) |
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If there is a hypoglossal pathology, an upper motor neuron lesion will cause ______________________ tongue weakness (will deviate towards the weak side). Lower motor neuron lesion will cause _______________ tongue weakness (tongue will deviate to the weak side).
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contralateral tongue
ipsilateral |
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To test CN 3 (occulomotor), 4 (trochlear), 6 (abducens), what do you do?
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Have the pt follow your finger up, down, left, right, inward (toward the pt), outward.
Note whether there is smooth transition & full range of eye movement. Use a pen light into each eye to test pupils |
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TRIGEMINAL
To test CN 5 motor, |
Palpate massteter as the patient bites down. It should feel firm & bulky.
Note the strength of jaw closure. Open the jaw against resistance, and lateralize the jaw. |
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TRIGEMINAL
To test CN 5 sensory... |
While the pt's eyes are closed, stroke 3 parts of the face (L & R)
-opthalmic -maxillary -mandibular Test sensory to 2 sides of the tongue (anterior 2/3) |
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FACIAL
To test CN 7 motor... To test CN 7 sensory... |
Look at facial expression (forehead, eyes, mouth) (ostly affects volitional movement)
Pt may report that ordinary sounds are uncomfortably loud (because it innervates stapedius muscle). Taste from anterior 2/3 of the tongue (both sides) - salty, bitter, sweet. |
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How do we test CN 9 glossopharyngeal?
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Tested w/ CN 10 (gag reflex)
Sensory and taste from posterior 1/3 of tongue |
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How do we test CN 10 vagus?
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Palate- @ rest and when saying "ah"; note symmetry
Larynx- prolonged phonation of /a/; 7-8 seconds is acceptable Pitch Vocal cough Stress test vocal mechanism |
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How do we test CN 11 spinal accessory?
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-Size and symmetry of sternocleidomastoid
-Turn head to one side, hold it there while pushing it back to the middle -Thrust head forward while resisting movement -Shrug shoulders |
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How do we test CN 12?
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-Tongue surface @ rest
-Tongue protrusion -Tongue lateralization -Check strength & range of mvmt -Tongue elevation -Articulation |
