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76 Cards in this Set

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Generally Speaking: trigeminal nerve - think sensory to ____________, motor to _____________.
sensory to anterior 2/3 of head
motor to muscles of mastication
CN V:
Muscles of mastication are categorized as __________?
Sensory from head is categorized as __________?
Motor -> SVE
Sensory -> GSA
Why do most headaches have CN V involvement?
CN V does sensory from the dural blood vessels
Are the muscles of mastication smooth or skeletal muscle? (They are categorized as SVE)
Skeletal
In which division of CN V:
is motor function found?
is sensory function found?
sensory -> V1, V2, V3
motor -> V3 only
What other axons tend to run with the branches of CN V?
sympathetics & parasympathetics from CN III, VII, IX
CN VII is associated with the _________ ganglia (2) that "hitchhike" with CN V
pterygopalatine (V2) and submandibular (V3, off lingual nerve)
CN IX has the _________ ganglia that hitchhikes with CN V.
Otic (V3)
CN III has the _________ ganglia that hitchhikes with CN V.
Ciliary (V1, off nasociliary nerve)
Where is the only spot where primary sensory somata are found in the CNS?
primary sensory neurons from the muscles of mastication (travel in the mesencephalic nucleus of V)
There are 4 CN V nuclei in the brain: ___ sensory and ____ motor
3 sensory
1 motor
The principal sensory (pontine) trigeminal nucleus senses _________________.
cutaneous sense from skin of face; tactile sensation from teeth
The spinal trigeminal nucleus is found in the ____________.
inferior medulla
The oral, interpolar and caudal subnuclei are subnuclei of which larger nucleus?
Spinal trigeminal nucleus
The interpolar subnucleus senses _____________.
sense from tooth pulp
What does the caudal subnuclei of the spinal trigeminal nucleus sense?
P/T and light touch from face skin, tooth pulp pain.
The mesencephalic nucleus of CN V processes ___________? (2 things)
1. sense for jaw jerk reflex
2. proprioception from face/extraocular muscles
The motor nucleus of CN V supplies motor to 7 muscles. List them.
1. masseter
2. temporalis
3. lateral/medial pterygoids
4. tensor tympani
5. tensor vali palatini
6. anterior digastric
7. mylohyoid
Summary: muscles of mastication + tensor tympani and tensor veli palatini
Where does V1 exit the skull?
superior orbital fissure
Where does V2 exit the skull?
foramen rotundum
Where does V3 exit the skull?
exits via foramen ovale
Which division(s) of CN V have a motor component? How about a sensory component?
motor -> only V3
sensory -> ALL; V1, V2, V3
What are the three main branches of the opthalmic nerve? (V1)
NFL:
nasociliary
frontal
lacrimal
The nasociliary nerve branches into ___________? (3 branches)
long and short ciliary nerves
ethmoidal
infratrochlear
The frontal nerve has two branches: what are they?
supratrochlear
supraorbital
Where does V2 run?
Runs in the floor of the orbit.
What is the path of V2 once it passes through the foramen rotundum?
pterygopalatine fossa -> inferior orbital fissure -> infraorbital canal -> infraorbital foramen -> from there branches into 4 nerves.
What nerves (2) innervate the side of cheek and forehead? (hint: branches of V2)
zygomaticofacial and zygomaticotemporal
1. T/F: the ganglionic branches of V2 synapse as they pass through the pterygopalatine ganglion.
2. Where are these fibers headed?
FALSE: the nerve fibers pass through the pterygopalatine ganglion (on their way to the palate) without synapsing
The superior alveolar nerves (branches of V2) pass through the maxillary sinus and form the ____________ which goes to the teeth and gums.
superior dental plexus
What does the infraorbital nerve supply?
sensory to the:
1. inferior palpebral
2. external and internal nasal
3. superior eyelid.
The mandibular branch (V3) has two divisions. What are they and what is characteristic of each?
Anterior division: mostly motor
Posterior division: mostly sensory
What is the function of the buccal nerve of V3? (remember there are 2 buccal nerves..)
sensory to cheek and buccal gingiva
The auriculotemporal nerve provides ____________ (S/M) to _____________. (4)
sensory to the:
1. temple
2. lateral scalp
3.TMJ
4. auricle
The lingual nerve transmits sensory information from __________? (3)
1. anterior 2/3 of tongue
2. floor of mouth
3. gums
1. Which CN transmits sensory taste from the anterior 2/3 of the tongue?
2. How about somatic sensation for the anterior 2/3 of the tongue?
1. CN VII (facial)
2. CN V3, lingual nerve
The ____________ nerve transmits sensory from the inferior dental plexus and motor to the mylohyoid and ant. belly of digastrics?
Inferior alveolar n. (Posterior division of V3)
What CN(s) does a corneal reflex test?
CN V (nasociliary branch - sensory) and VII (motor to orbicularis oculi of both eyes)
What CN(s) does a jaw jerk reflex test?
bilateral test of both sensory and motor of CN V.
What is trigeminal neuralgia?
(aka. Tic douloureux)
quick, sharp, severe pain of unknown etiology
What is trismus?
"lockjaw" essentially spasms of the muscles of mastication. Can be caused by tetanus, fracture, oral abcess
What is the mechanism of the tetanus bacteria causing trismus? (FYI CARD)
tetanus infects CN V: it kills inhibitory neurons, leaving unregulated excitatory output = trabismus
The parasympathetics traveling on CNs travel with or are mediated by CN____. What are the 2 exceptions?
via CN VII (hitchhiker nerve)exceptions: parotid gland (CN IX), pupil and lens of eye (CN III)
There are two divisions of CN VII. What are they and in general what do they transmit?
1. facial nerve proper -> transmits motor
2. Nervus intermedius -> sensory (general and special) and autonomic
When you hear "nucleus solitarius" think _________?
taste; CN VII
The special sensory nuclei of CN VII are found where in the brainstem?
rostral end of the nucleus solitarius in the medulla
When it comes to motor of the facial nerve: why is it an "odd wadd?"
the FOREHEAD portion of the facial nucleus has BILATERAL input from the motor cortex, whereas the LOWER FACE portion has CONTRALATERAL input.
What is the parasympathetic nuclei of CN VII called and where is it found?
superior salivatory nucleus
found scattered in pontine tegmentum
The geniculate ganglion is a sensory ganglion for CN ____?
CN VII (facial)
describe the pathway of taste transmitted by the facial nerve.
taste -> lingual n. -> chorda tympani and greater petrosal n. -> tractus solitarius -> nucleus solitarius
The chorda tympani and the greater petrosal n. conjugate in the brainstem to form the _______________.
Facial nerve
According to Dr. Carr:
When you hear "tectum" think __________?
When you hear "tegmentum" think _________?
tectum - colliculi
tegmentum - middle of pons
The pterygopalatine ganglia is a ________ (P/S) ganglia that "hangs off of" the ______________ nerve.
parasympathetic ganglia
maxillary nerve
Pterygopalatine ganglion is associated with CN VII(nervus intermedius branch)
The submandibular ganglia is a ______ (P/S) ganglia that is suspended by the ______ nerve.
Parasympathetic
lingual
Describe the path to the pterygopalatine ganglia starting at the superior salivatory nucleus.
sup. salivatory nucleus -> greater petrosal n. -> joins deep petrosal n. -> nerve of the pterygoid canal -> pterygopalatine ganglia.
Describe the path to the submandibular ganglia starting at the superior salivatory nucleus.
sup. salivatory nucleus -> chorda tympani -> joins lingual n. after foramen ovale -> submandibular ganglia
Where do the nerve roots of CN VII exit the brainstem?
both M&S roots exit at the caudal border of the lateral pons.
What is the pathway of both roots of the facial nerve from inside the skull to the outside?
internal auditory meatus -> facial canal (in the petrous temporal bone) -> facial geniculum -> exit facial canal at stylomastoid foramen.
Which nerve exits the skull via the petrotympanic fissure?
Chorda Tympani (branch of CN VII)
Which ganglion is responsible for the most parasympathetic action in the head? What does it innervate?
The pterygopalatine ganglion. Innervates the lacrimal, nasal and oral glands via branches of V2.
The nerve to the stapedius muscle is a branch of CN ___; ____ division. Function?
CN VII, peripheral division.
Functions to dampen loud sounds
THe submandibular ganglia supplies parasympathetic to _______1_____ .
2. What is it a branch of?
1. PS to the submandibular & sublingual glands
2. branch of the chorda tympani
Which nerve supplies the auricular and occipitofrontalis muscles?
the posterior auricular nerve
T/F: the facial nerve innervates the parotid gland.
FALSE! (You might think it does because it passes through the parotid - but it doesn't). CN IX innervates the parotid gland.
The facial nerve has two divisions, temporofacial and cervicofacial. Name the branches of these divisions.
1. Temporal
2. Zygomatic
3. Buccal
4. Marginal Mandibular
5. Cervial
1 and 2 -> temporofacial
3, 4 and 5 -> craniofacial
Which branch of CN VII supplies motor to the frontalis and orbicularis oculi muscles?
Temporal branch
The ___________ branch of CN VII provides motor to the zygomaticus and orbicularis oris muscles. What is the action of the orbicularis oris?
zygomatic branch
Action: Smile (pull lips superior)
The buccal branch of CN VII provides _______ (S/M) innervation to _____________.
motor
buccinator and orbicularis oris muscles
The branch of CN VII that provides motor to the inferior portion of orbicularis oris? (makes us frown when contracted)
Marginal Mandibular Branch
The cervical branch of CN VII provides motor to ____?
the platysma
A pontine lesion is known as a lesion of CN ___ & ___. THis occurs because they lie so close together in the pons.
CN VI and VII.
A patient has a lesion to CN VI and VII. How would she present?
strabismus (CN VI)
______?. Paralysis of which portrion of CN VII?
If there is a lesion near the internal auditory meatus (ie. acoustic neuroma) which CNs are likely to be damaged?
CN VII and VIII
A lesion of Cn VII between the motor cortex and the facial nucleus presents as?
paralysis of the lower contralateral face. (not the forehead). This is considered an UMN
A lesion of the facial nerve or nucleus presents as?
paralysis of whole ipsilateral 1/2 of face: also see ptosis and mouth drop.
What is Bells palsy and where would a lesion be in this case?
Bells palsy - paralysis of 1/2 of face. It is a lesion past the stylomastoid foramen (must have exited the skull and facial canal - ie. it must be a LMN lesion)