Head & Neck Anatomy

Front 1

CN I?

Back 1

olfactory nerve

Front 2

cn I component?

Back 2

special sensory

Front 3

CN I function?

Back 3

olfaction (smell)

Front 4

Course of CN I?

Back 4

1) receptor cells line nasal cavity
2) nerve fibres pass cribriform plate of ethmoid bone to olfactory bulb

Front 5

Olfactory lies in the _ _ _?

on the _ _ of the frontal lobe

Back 5

anterior cranial fossa

inferior surface

Front 6

why should unexplained anosmia be investigated?

Back 6

1) tumour, abcess in frontal lobe of brain

2) tumour of meninges in ant cranial fossa

(both would compress olfactory bulb and/or tract)

Front 7

other examples of lesions to olfactory nerve?

Back 7

1) blunt trauma
2)meningitis
3) tumour of frontal lobe

Front 8

cn II?

Back 8

optic nerve

Front 9

CNI component?

Back 9

special sensory

Front 10

cn I exit foramina?

Back 10

cribfriform plate on ethmoid

Front 11

cn II component?

Back 11

special sensory

Front 12

cn II function?

Back 12

sight

Front 13

cn II course?

From the _?
....forms _ _
....through _ _ of _
....to the _ _
....forms the _ _
....passes to the _ _ _

Back 13

From the retina
....forms optic nerve
....through optic canal of sphenoid
....to the optic chiasma
....forms the optic tract
....passes to the lateral geniculate body

Front 14

cn II exit foramina?

Back 14

optic canal

Front 15

what is the optic chiasma? (or chiasm)

location?

Back 15

part of the brain where the optic nerve partially crosses...

...in the pituitary fossa = sella turcica (meaning turkish saddle)

Front 16

Damage _ the optic chiasm causes loss of vision in the visual field of the same side only.

Back 16

Damage before the optic chiasm causes loss of vision in the visual field of the same side only.

Front 17

Damage _ the chiasm causes loss of vision laterally in both visual fields (bitemporal hemianopia). It may occur in large pituitary adenomata.

Back 17

Damage in the chiasm causes loss of vision laterally in both visual fields (bitemporal hemianopia). It may occur in large pituitary adenomata.

Front 18

Damage _ the chiasm causes loss of vision on one side but affecting both visual fields: the visual field affected is located on the opposite side of the lesion.

Back 18

Damage after the chiasm causes loss of vision on one side but affecting both visual fields: the visual field affected is located on the opposite side of the lesion.

Front 19

By far, the three most common injuries to the optic nerve are from -, - - (especially in those younger than 50 years of age) and anterior - - - (usually in those older than 50).

Back 19

By far, the three most common injuries to the optic nerve are from glaucoma, optic neuritis (especially in those younger than 50 years of age) and anterior ischemic optic neuropathy (usually in those older than 50).

Front 20

what is bitemporal hemianopia?

what might cause it?

Back 20

Bitemporal hemianopsia (or Bitemporal hemianopia) is a type of partial blindness where vision is missing in the outer half of both the right and left visual field due to compression of the optic chiasm

...Since the adjacent structure is the pituitary gland, some common tumors causing compression are Pituitary adenomas, and Craniopharyngiomas. Also another relatively common neoplastic etiology is Meningiomas.

Front 21

What is Homonymous hemianopsia, or homonymous hemianopia?

...causes?

Back 21

a type of partial blindness resulting in a loss of vision in the same visual field of both eyes.

...usually injury to the brain from stroke or trauma..

...It may also be caused by tumour localised at the occipital lobe in the brain.

Front 22

cnIII?

Back 22

oculomotor n

Front 23

components of cnIII?

Back 23

general motor & parasympathetic motor

Front 24

function of cnIII?

Back 24

MOST BUT NOT ALL EYE MUSCLES

muscles: superior/inferior/medial rectus, levator palpebrae superioris,
inferior oblique

parasympathetic to ciliary ganglion for pupillary constriction

Front 25

presentation of cnIII palsy (paralysis)?

(3)

Back 25

-superior EYELID ptosis
-pupil fully DILATED
-pupil fully ABDUCTED + DEPRESSED (DOWN & OUT)

Front 26

Horner's vs cnIII lesion differential?

Back 26

ptosis!

Horner's syndrome ptosis occurs with a constricted pupil (due to a loss of sympathetics to the eye)

cn III lesion = ptosis occurs with a dilated pupil (due to a loss of innervation to the sphincter pupillae).

... also ptosis much more severe, occasionally occluding the whole eye. The ptosis of Horner syndrome can be quite mild or barely noticeable.

Front 27

cn III exit formina?

Back 27

(3, 4, V1, 6) = superior ORBITAL fissure

Front 28

1) What is Horner's syndrome?

2) Explain it's presentation

Back 28

1) Due to lesion or compression of one side of the cervical or thoracic sympathetic chain which generates symptoms on the ipsilateral (same side as lesion) side of the body


2) S A V E D

Small pupil (miosis)

Anhydrosis (reduced sweating)

Vasodilation

Enopthalmos (sunken eyes)

Drooping (variable ptosis)

Hint 28

S A V E D

Front 29

cn IV?

Back 29

Trochlear nerve

Front 30

cn IV components?

Back 30

efferent motor

Front 31

distribution/function of cn IV?

Back 31

motor nerve to superior oblique m

Front 32

exit foramina cn IV?

Back 32

superior orbital fissure

Front 33

cn VI?

Back 33

Abducens nerve

Front 34

cn VI components?

Back 34

efferent motor

Front 35

cn VI exit foramina?

Back 35

superior orbital fissure

Front 36

cn VI dist/function?

Back 36

n to lateral rectus m

Front 37

cn V?

Back 37

trigeminal nerve

Front 38

3 divisions of cn V?

Back 38

v1 = opthalmic
v2 = maxillary
v3 = mandibular

Front 39

distribution of cn V1?

Back 39

sensation from dura, skin of forehead, scalp, roof of nasal cavity and skin on tip of nose, ethmoid air cells

Front 40

dist of cn V2?

Back 40

sensation from dura, nasal mucosa, soft palate, skin of lower eyelid and beneath the eye, side of nose, cheek, lip, upper teeth, hard palate

Front 41

dist of cn V3?

Back 41

sensation from dura, anterior ear and scalp,
mucosa lining cheek and gums, skin of cheek,
lower teeth, skin of chin.
motor to temporalis, masseter, medial pterygoid, lateral pterygoid, anterior belly of digastric, mylohyoid, tensor palati, and tensor tympani.

Front 42

exit foramina for cn V1?

Back 42

superior orbital fissure

Front 43

exit foramina for cn V2?

Back 43

foramen rotundum

Front 44

exit foramina for cn V3?

Back 44

foramen ovale

Front 45

cnvII?

Back 45

facial nerve

Front 46

components of cnVII?

Back 46

special and general sensory (afferent) SMALL

general and parasympathetic (motor) LARGE

Hint 46

FACE, EARS, TASTE, TEARS

Front 47

exit foramina cnVII?

Back 47

internal acoustic meatus

Front 48

distribution of cnVII?

Back 48

FACE: motor to muscles of facial expression,

EARS: sensation skin from ext meatus, stapedius m, muscles of auricle,

TASTE: sensation of taste for anterior 2/3 tongue, , taste from palate.

TEARS:
lacrimal secretion, submandibular and sublingual glands secretion.

Hint 48

FACE< EARS < TASTE< TEARS

Front 49

course of cnVII?

Back 49

- leaves through posterior cranial fossa through internal acoustic meatus with CNVIII

- 2 components:
...small sensory = nervus intermedius

...LARGE motor

- travels with CNVIII briefly before leaving to enter the facial canal

- in this canal gives off the 3 main branches (n to stapedius/chorda tympani/greater petrosal n)

STAGE 2..

- exits through stylomastoid foramen

...over jaw

...pierces parotid gland( does NOT supply)

- ends in 5 terminal branches that supply motor to mms of facial expression

Hint 49

- leaves through _ cranial fossa through _ _ _ with CN_

- 2 components:
...small sensory = _ _

...LARGE motor

- travels with _ briefly before leaving to enter the _ _

- in this canal gives off the 3 main branches (n to _/_ _ /_ _ n)

STAGE 2..

- exits through _ foramen

...over _

...pierces _ gland( does NOT supply)

- ends in _ terminal branches that supply motor to mms of facial expression

Front 50

1) what is bell's palsy? 2) describe the clinical effects...

Back 50

1) is paralysis of cnVII resulting in an inability to control the muscles of the same side...
...several conditions can cause cnVII paralysis e.g. brain tumour, stroke. if NO CAUSE = BELL'S.

It is a mononeuropathy (one nerve) and most common cause of acute facial paralysis.

2) BELL'S Palsy:
Blink reflex abnormal
Earache
Lacrimation [deficient, excess]
Loss of taste
Sudden onset
Palsy of VII nerve muscles
· All symptoms are unilateral.

Hint 50

B E L L S P..

Front 51

1) Name the 5 terminal branches of CNVII (or the 5 major facial branches (in parotid gland))

Back 51

Temporal Zygomatic Buccal Marginal (mandibular) Cervical

Hint 51

To Zanzibar By Motor Car

Front 52

cn VIII?

Back 52

vestibulocochlear nerve

Front 53

components of CNVIII?

Back 53

special sensory (afferent)

Front 54

exit foramina of CNVIII?

Back 54

internal acoustic meatus

Front 55

CNVIII consists of 2 parts - what are they called and what is the function of each?

Back 55

cochlear n = sensation from cochlea for hearing

vestibular n = sensation from semicircular canals and vestibule for equilibrium

Front 56

effects of damage to CNVIII?

Back 56

# hearing loss
# vertigo
# false sense of motion
# loss of equilibrium (in dark places)
# nystagmus (involuntary eye mvt)
# motion sickness
# gaze-evoked tinnitus

Front 57

cn IX?

Back 57

glossopharyngeal

Front 58

cn IX components?

Back 58

general and special sensory (afferent)

general and parasympathetic motor (efferent)

Front 59

cn IX distribution?

Back 59

SS: taste posterior 1/3 of tongue, carotid body + sinus

GS: posterior 1/3 of tongue, oropharynx, pharyngeal mucosa

GM: stylopharyngeus

PS: parotid gland via the otic ganglion

Hint 59

SS GS GM PS

Front 60

cn IX exit foramen?

Back 60

jugular foramen

Front 61

course of cn IX?

Back 61

exits the jugular foramen with the vagus and accessory nerves but is in its own dural sheath

Front 62

cn X?

Back 62

vagus nerve

Front 63

components of cn X?

Back 63

special sensory
general sensory
motor
parasympathetic

Front 64

dist/function of cn X?

Back 64

sensory from: inferior pharynx, larynx, thoracic & abdominal organs

sense of taste: from root of the tongue and taste buds on epiglottis

motor: to soft palate, pharynx, intrinsic laryngeal muscles (phonation), palatoglossus.

parasympathetic: thoracic & abdominal viscera.

Hint 64

sensory from: inferior _, _, _ & _ organs

sense of taste: from root of the _ and taste buds on _

motor: to _ palate, _, intrinsic _ muscles (phonation), _.

parasympathetic: _ & _ viscera.

Front 65

exit foramina of cn X?

Back 65

jugular foramen

Front 66

course of cn X? (M&D pg 1150)

Back 66

...Through the jugular foramen

...continues inferiorly in the carotid sheath to the root of the neck (supplying branches to the palate, pharynx and larynx)

(cn X differs in the thorax on the two sides)

...cn X supplies branches to the heart, bronchi and lungs

...the vagi (plural of vagus) join the esophageal plexus surrounding the esophagus, which is formed by the branches of the vagi and sympathetic trunks

...this plexus follows the esophagus through the diaphragm into the abdomen, where the anterior and posterior vagal trunks break up into branches that innervate the esophagus, stomach and intestinal tract as far as the left colic flexure.

Hint 66

...Through the _ _

...continues inferiorly in the _ _ to the root of the neck (supplying branches to the _, _ and _)

(cn X differs in the thorax on the two sides)

...cn X supplies branches to the _, _ and _

...the _ (plural of vagus) join the _ plexus surrounding the _, which is formed by the branches of the _ and _ trunks

...this plexus follows the _ through the _ into the abdomen, where the anterior and posterior _ trunks break up into branches that innervate the _, _and _tract as far as the _ _ _.

Front 67

List the main branches of cn X?

(10)

Back 67

meningeal

auricular

pharyngeal

branches to the carotid body

laryngeal

cardiac

pulmonary

oesophageal

gastric

intestinal

Hint 67

Mavis And Philip Bring (branch) Loving Cos Philip Ordinarily Goes Insane

Front 68

cn XI?

Back 68

accessory nerve

Front 69

components of cn XI?

Back 69

motor (efferent)

Front 70

exit foramina of cn XI?

Back 70

jugular foramen

Front 71

dist/function of cn XI?

Back 71

motor to sternocleidomastoid and trapezius mms

Front 72

course of cn XI?

Back 72

spinal root

- c1 to c5
-ascends via the foramen magnum

cranial root

- 4-6 rootlets emerge from the medulla oblongata
- form a single nerve

------------------------------

-exits though jugular foramen

-cranial root then joins vagus n

-spinal passes over lateral mass of atlas to enter deep surface of SCM (it then crosses the posterior triangle of the neck)

Hint 72

spinal root

- c_ to c_
-ascends via the _ _

cranial root

- _-_ rootlets emerge from the _ _
- form a _ nerve

------------------------------

-exits though _ _

-cranial root then joins _ n

-spinal passes over lateral mass of _ to enter deep surface of _ (it then crosses the _ triangle of the neck)

Front 73

cn XII?

Back 73

hypoglossal nerve

Front 74

components of cn XII?

Back 74

general motor (efferent)

Front 75

exit foramina cn XII?

Back 75

hypoglossal canal

Front 76

dist/function of cn XII?

Back 76

motor to 3 of 4 extrinsic tongue muscles (genioglossus, hyoglossus, styloglossus)...

...motor to intrinsic tongue muscles

Front 77

course of cn XII?

Back 77

...from hypoglossal canal

...travels briefly with the internal carotid and external carotid...

...pass over hyoid...

...runs anteriorly; lateral to hyoglossus and deep to mylohyoid...

...ends in terminal branches

Hint 77

...from _ _

...travels briefly with the _ carotid and _ carotid...

...pass over _...

...runs _; _ to _ and deep to _...

...ends in _ branches

Front 78

1) describe the effect of a unilateral cnXII palsy?

2) how would you test for it?

Back 78

1) if there is a loss of function (unilateral paralysis) the tongue will point to the affected side

2) one could use a wooden tongue depressor (or a finger!) and ask the patient to push against the implement to test their strength (and thus nerve function)