Functional Anatomy Of Cns V And Vii

Front 1

Generally Speaking: trigeminal nerve - think sensory to ____________, motor to _____________.

Back 1

sensory to anterior 2/3 of head
motor to muscles of mastication

Front 2

CN V:
Muscles of mastication are categorized as __________?
Sensory from head is categorized as __________?

Back 2

Motor -> SVE
Sensory -> GSA

Front 3

Why do most headaches have CN V involvement?

Back 3

CN V does sensory from the dural blood vessels

Front 4

Are the muscles of mastication smooth or skeletal muscle? (They are categorized as SVE)

Back 4

Skeletal

Front 5

In which division of CN V:
is motor function found?
is sensory function found?

Back 5

sensory -> V1, V2, V3
motor -> V3 only

Front 6

What other axons tend to run with the branches of CN V?

Back 6

sympathetics & parasympathetics from CN III, VII, IX

Front 7

CN VII is associated with the _________ ganglia (2) that "hitchhike" with CN V

Back 7

pterygopalatine (V2) and submandibular (V3, off lingual nerve)

Front 8

CN IX has the _________ ganglia that hitchhikes with CN V.

Back 8

Otic (V3)

Front 9

CN III has the _________ ganglia that hitchhikes with CN V.

Back 9

Ciliary (V1, off nasociliary nerve)

Front 10

Where is the only spot where primary sensory somata are found in the CNS?

Back 10

primary sensory neurons from the muscles of mastication (travel in the mesencephalic nucleus of V)

Front 11

There are 4 CN V nuclei in the brain: ___ sensory and ____ motor

Back 11

3 sensory
1 motor

Front 12

The principal sensory (pontine) trigeminal nucleus senses _________________.

Back 12

cutaneous sense from skin of face; tactile sensation from teeth

Front 13

The spinal trigeminal nucleus is found in the ____________.

Back 13

inferior medulla

Front 14

The oral, interpolar and caudal subnuclei are subnuclei of which larger nucleus?

Back 14

Spinal trigeminal nucleus

Front 15

The interpolar subnucleus senses _____________.

Back 15

sense from tooth pulp

Front 16

What does the caudal subnuclei of the spinal trigeminal nucleus sense?

Back 16

P/T and light touch from face skin, tooth pulp pain.

Front 17

The mesencephalic nucleus of CN V processes ___________? (2 things)

Back 17

1. sense for jaw jerk reflex
2. proprioception from face/extraocular muscles

Front 18

The motor nucleus of CN V supplies motor to 7 muscles. List them.

Back 18

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

Front 19

Where does V1 exit the skull?

Back 19

superior orbital fissure

Front 20

Where does V2 exit the skull?

Back 20

foramen rotundum

Front 21

Where does V3 exit the skull?

Back 21

exits via foramen ovale

Front 22

Which division(s) of CN V have a motor component? How about a sensory component?

Back 22

motor -> only V3
sensory -> ALL; V1, V2, V3

Front 23

What are the three main branches of the opthalmic nerve? (V1)

Back 23

NFL:
nasociliary
frontal
lacrimal

Front 24

The nasociliary nerve branches into ___________? (3 branches)

Back 24

long and short ciliary nerves
ethmoidal
infratrochlear

Front 25

The frontal nerve has two branches: what are they?

Back 25

supratrochlear
supraorbital

Front 26

Where does V2 run?

Back 26

Runs in the floor of the orbit.

Front 27

What is the path of V2 once it passes through the foramen rotundum?

Back 27

pterygopalatine fossa -> inferior orbital fissure -> infraorbital canal -> infraorbital foramen -> from there branches into 4 nerves.

Front 28

What nerves (2) innervate the side of cheek and forehead? (hint: branches of V2)

Back 28

zygomaticofacial and zygomaticotemporal

Front 29

1. T/F: the ganglionic branches of V2 synapse as they pass through the pterygopalatine ganglion.
2. Where are these fibers headed?

Back 29

FALSE: the nerve fibers pass through the pterygopalatine ganglion (on their way to the palate) without synapsing

Front 30

The superior alveolar nerves (branches of V2) pass through the maxillary sinus and form the ____________ which goes to the teeth and gums.

Back 30

superior dental plexus

Front 31

What does the infraorbital nerve supply?

Back 31

sensory to the:
1. inferior palpebral
2. external and internal nasal
3. superior eyelid.

Front 32

The mandibular branch (V3) has two divisions. What are they and what is characteristic of each?

Back 32

Anterior division: mostly motor
Posterior division: mostly sensory

Front 33

What is the function of the buccal nerve of V3? (remember there are 2 buccal nerves..)

Back 33

sensory to cheek and buccal gingiva

Front 34

The auriculotemporal nerve provides ____________ (S/M) to _____________. (4)

Back 34

sensory to the:
1. temple
2. lateral scalp
3.TMJ
4. auricle

Front 35

The lingual nerve transmits sensory information from __________? (3)

Back 35

1. anterior 2/3 of tongue
2. floor of mouth
3. gums

Front 36

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?

Back 36

1. CN VII (facial)
2. CN V3, lingual nerve

Front 37

The ____________ nerve transmits sensory from the inferior dental plexus and motor to the mylohyoid and ant. belly of digastrics?

Back 37

Inferior alveolar n. (Posterior division of V3)

Front 38

What CN(s) does a corneal reflex test?

Back 38

CN V (nasociliary branch - sensory) and VII (motor to orbicularis oculi of both eyes)

Front 39

What CN(s) does a jaw jerk reflex test?

Back 39

bilateral test of both sensory and motor of CN V.

Front 40

What is trigeminal neuralgia?

Back 40

(aka. Tic douloureux)
quick, sharp, severe pain of unknown etiology

Front 41

What is trismus?

Back 41

"lockjaw" essentially spasms of the muscles of mastication. Can be caused by tetanus, fracture, oral abcess

Front 42

What is the mechanism of the tetanus bacteria causing trismus? (FYI CARD)

Back 42

tetanus infects CN V: it kills inhibitory neurons, leaving unregulated excitatory output = trabismus

Front 43

The parasympathetics traveling on CNs travel with or are mediated by CN____. What are the 2 exceptions?

Back 43

via CN VII (hitchhiker nerve)exceptions: parotid gland (CN IX), pupil and lens of eye (CN III)

Front 44

There are two divisions of CN VII. What are they and in general what do they transmit?

Back 44

1. facial nerve proper -> transmits motor
2. Nervus intermedius -> sensory (general and special) and autonomic

Front 45

When you hear "nucleus solitarius" think _________?

Back 45

taste; CN VII

Front 46

The special sensory nuclei of CN VII are found where in the brainstem?

Back 46

rostral end of the nucleus solitarius in the medulla

Front 47

When it comes to motor of the facial nerve: why is it an "odd wadd?"

Back 47

the FOREHEAD portion of the facial nucleus has BILATERAL input from the motor cortex, whereas the LOWER FACE portion has CONTRALATERAL input.

Front 48

What is the parasympathetic nuclei of CN VII called and where is it found?

Back 48

superior salivatory nucleus
found scattered in pontine tegmentum

Front 49

The geniculate ganglion is a sensory ganglion for CN ____?

Back 49

CN VII (facial)

Front 50

describe the pathway of taste transmitted by the facial nerve.

Back 50

taste -> lingual n. -> chorda tympani and greater petrosal n. -> tractus solitarius -> nucleus solitarius

Front 51

The chorda tympani and the greater petrosal n. conjugate in the brainstem to form the _______________.

Back 51

Facial nerve

Front 52

According to Dr. Carr:
When you hear "tectum" think __________?
When you hear "tegmentum" think _________?

Back 52

tectum - colliculi
tegmentum - middle of pons

Front 53

The pterygopalatine ganglia is a ________ (P/S) ganglia that "hangs off of" the ______________ nerve.

Back 53

parasympathetic ganglia
maxillary nerve
Pterygopalatine ganglion is associated with CN VII(nervus intermedius branch)

Front 54

The submandibular ganglia is a ______ (P/S) ganglia that is suspended by the ______ nerve.

Back 54

Parasympathetic
lingual

Front 55

Describe the path to the pterygopalatine ganglia starting at the superior salivatory nucleus.

Back 55

sup. salivatory nucleus -> greater petrosal n. -> joins deep petrosal n. -> nerve of the pterygoid canal -> pterygopalatine ganglia.

Front 56

Describe the path to the submandibular ganglia starting at the superior salivatory nucleus.

Back 56

sup. salivatory nucleus -> chorda tympani -> joins lingual n. after foramen ovale -> submandibular ganglia

Front 57

Where do the nerve roots of CN VII exit the brainstem?

Back 57

both M&S roots exit at the caudal border of the lateral pons.

Front 58

What is the pathway of both roots of the facial nerve from inside the skull to the outside?

Back 58

internal auditory meatus -> facial canal (in the petrous temporal bone) -> facial geniculum -> exit facial canal at stylomastoid foramen.

Front 59

Which nerve exits the skull via the petrotympanic fissure?

Back 59

Chorda Tympani (branch of CN VII)

Front 60

Which ganglion is responsible for the most parasympathetic action in the head? What does it innervate?

Back 60

The pterygopalatine ganglion. Innervates the lacrimal, nasal and oral glands via branches of V2.

Front 61

The nerve to the stapedius muscle is a branch of CN ___; ____ division. Function?

Back 61

CN VII, peripheral division.
Functions to dampen loud sounds

Front 62

THe submandibular ganglia supplies parasympathetic to _______1_____ .
2. What is it a branch of?

Back 62

1. PS to the submandibular & sublingual glands
2. branch of the chorda tympani

Front 63

Which nerve supplies the auricular and occipitofrontalis muscles?

Back 63

the posterior auricular nerve

Front 64

T/F: the facial nerve innervates the parotid gland.

Back 64

FALSE! (You might think it does because it passes through the parotid - but it doesn't). CN IX innervates the parotid gland.

Front 65

The facial nerve has two divisions, temporofacial and cervicofacial. Name the branches of these divisions.

Back 65

1. Temporal
2. Zygomatic
3. Buccal
4. Marginal Mandibular
5. Cervial
1 and 2 -> temporofacial
3, 4 and 5 -> craniofacial

Front 66

Which branch of CN VII supplies motor to the frontalis and orbicularis oculi muscles?

Back 66

Temporal branch

Front 67

The ___________ branch of CN VII provides motor to the zygomaticus and orbicularis oris muscles. What is the action of the orbicularis oris?

Back 67

zygomatic branch
Action: Smile (pull lips superior)

Front 68

The buccal branch of CN VII provides _______ (S/M) innervation to _____________.

Back 68

motor
buccinator and orbicularis oris muscles

Front 69

The branch of CN VII that provides motor to the inferior portion of orbicularis oris? (makes us frown when contracted)

Back 69

Marginal Mandibular Branch

Front 70

The cervical branch of CN VII provides motor to ____?

Back 70

the platysma

Front 71

A pontine lesion is known as a lesion of CN ___ & ___. THis occurs because they lie so close together in the pons.

Back 71

CN VI and VII.

Front 72

A patient has a lesion to CN VI and VII. How would she present?

Back 72

strabismus (CN VI)
______?. Paralysis of which portrion of CN VII?

Front 73

If there is a lesion near the internal auditory meatus (ie. acoustic neuroma) which CNs are likely to be damaged?

Back 73

CN VII and VIII

Front 74

A lesion of Cn VII between the motor cortex and the facial nucleus presents as?

Back 74

paralysis of the lower contralateral face. (not the forehead). This is considered an UMN

Front 75

A lesion of the facial nerve or nucleus presents as?

Back 75

paralysis of whole ipsilateral 1/2 of face: also see ptosis and mouth drop.

Front 76

What is Bells palsy and where would a lesion be in this case?

Back 76

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)