Zgross - Cranial Nerves Vii-Xii - Mt2

Front 1

Generally where are CNVII's parasympathetic, sensory and motor innervations to?

Back 1

Parasympathetic (green)
To the lacrimal and nasal glands (GVE)
To the mandibular and sublingual salivary glands (GVE)

Sensory (red)
For taste to the rostral 2/3 of the tongue (SVA)
To part of the external ear (GSA)
To the soft palate (GVA)

Motor (blue) - To muscles from the 2nd pharyngeal arch (GSE-SVE)

Front 2

What nerve does facial nerve give rise to? What does that nerve then join and form?

Back 2

The facial n. gives rise to the major petrosal n. that then joins postganglionic sympathetic fibers from the cranial cervical ganglion and forms the pterygopalatine ganglion.

Front 3

Where does facial nerve pick up parasympathetic fibers?

Back 3

Preganglionic parasympathetic fibers from the nerve of the pterygoid canal synapse at the pterygopalatine ganglion. As postganglionic fibers, then, these course with the zygomaticotemporal n. to the lacrimal gland and with the pterygopalatine n. to the glands of the nasal cavity.

Front 4

What is the dysfunction of the parasympathetic fibers of facial n.?

Back 4

Dryness of the eye and a slight decrease in salivation.

Front 5

Where does the GVA modality come in with facial n.?

Back 5

CNVII carries sensory fibers to the soft palate.

Front 6

What nerve contains taste fibers from the fungiform papillae on the rostral 2/3 of the tongue? What modality is this innervation?

Back 6

Chorda tympani n. (from facial n.)

SVA

Front 7

What are the dysfunctions of the GSE modality of facial nerve?

How do you test it?

Back 7

Dysfunction: Facial nerve damage at the level of the stylomastoid foramen results in flaccid paralysis of the muscles of facial expression – drooping of the ear, widening of the palpebral fissure, drooling of saliva out the corner of the mouth

Tests:
Palpebral reflex, corneal reflex, and menace response evaluate the auriculopalpebral n.
Ear twitch
Traction on one of the tactile sinus hairs of the upper muzzle results in twitching – evaluates the dorsal buccal br.
Traction on one of the sinus hairs of the lower muzzle results in twitching – evaluates the ventral buccal br.

Front 8

How do you differentiate between ophthalmic n. and maxillary n. in the palpebral reflex?

Back 8

Ophthalmic n. innervates more medially than maxillary n. (which is more lateral).

Front 9

Which branches of facial n. go to the caudal auricular and stylohoid mm.?

Back 9

Muscular branches.

Front 10

What is the facial n. branch that innervates the ear? What is the modality?

Back 10

Sensory branches (that's the name, not just a description).

It's GSA

Front 11

What two nerves is vestibulocochlear n. composed of?

Where does it originate?

Where does it leave the petrous temporal bone? Coursing with what nerve?

Back 11

Composed of vestibular n. and cochlear n.
Originates in the membranous labyrinth of the inner ear in the petrous temporal bone
Leaves the petrous temporal bone via the internal acoustic meatus along with the facial n.

Front 12

What are the dysfunctions and tests for vestibular nerve?

Back 12

Dysfunction:
Disequilibrium, circling, head tilt, nystagmus (involuntary rapid movement of the eyeball). The circling and head tilt are toward the ipsilateral (same) side of the lesion.
Tests:
Observe gait – should also be performed with animal blindfolded. Righting reflexes

Front 13

What are the receptors transmitting afferent impulses to the brain that relate to the position of the head relative to the pull of gravity and to angular acceleration?

What is the modality?

Back 13

Cristae (angular motion) and maculae (linear motion).

Modality is SP - special proprioception

Front 14

How does the cochlear n. transmit hearing? What is the modality?

Back 14

Transmits impulses perceived as hearing through receptors in the spiral organ within the cochlea. These transmit to the spiral ganglion. The impulses travel along the cochlear portion of CNVIII to the CNS.

Front 15

What is the dysfunction and tests for CNVIII?

Back 15

Dysfunction: deafness
Tests:
Clap hands or whistle
Genetic deafness in
white cats with blue
eyes and in Dalmatian
dogs

Front 16

Where do CN IX, X, and XI exit the cranial cavity? What structures do they exit with?

Back 16

The jugular foramen and tympano-occiptial fissure along with the internal carotid a. and sympathetic fibers.

Front 17

Generally where is CN IX sensory, motor and parasympathetic to?

Back 17

Sensory (red)
To the caudal portion of the tongue, pharyngeal sinus and carotid sinus (GVA)
Taste from the caudal 1/3 of the tongue (SVA)

Motor (blue)
To stylopharyngeus and, with CN X, other pharyngeal mm. (GSE-SVE)

Parasympathetic (green)
To the parotid and zygomatic salivary glands (GVE)

Front 18

What are the GVA innervations of glossopharyngeal? Via what branches?

Back 18

Sensory from baroreceptors in the wall of the carotid sinus and chemoreceptors in the carotid body (carotid sinus n.)
Sensory from the pharyngeal mucosa via the pharyngeal br.
Sensory (touch, pain, thermal) from the caudal 1/3 of the tongue via the lingual br.

Front 19

What is the carotid sinus reflex?

Back 19

Increased digital pressure on the carotid sinus area that should cause a slowing of the heart rate.

Front 20

What is the SVA innervation of glossopharyngeal? Via what branch?

Back 20

Sensory for the sense of taste from the caudal 1/3 of the tongue (via lingual br.)

Front 21

Where do parasympathetic fibers synapse with CN IX? Which nerve do they course with and where are they going?
What is their dysfunction?

Back 21

They come in at the otic ganglion and course with auriculotemporal n. (CN V) to the parotid and zygomatic salivary glands.

Dysfunction:
Partial dryness of the mouth

Front 22

Generally what are the sensory, motor, and parasympathetic innervations of vagus nerve?

Back 22

Sensory (red)
To the pharynx, larynx, trachea, ear, esophagus, and thoracic and abdominal viscera

Motor (blue)
To muscles of the pharynx, larynx, and esophagus (from the 4th pharyngeal arch)

Parasympathetic (green)
To cervical, thoracic, and abdominal viscera

Front 23

The GVA (Sensory) modality of vagus n. serves four areas, what are they? What branches of vagus innervate the areas?

Back 23

Pharynx and cranial 1/3 of the esophagus via the pharyngeal br.
Laryngeal mucosa via the cranial laryngeal n.
Middle 1/3 of the esophagus and trachea via the recurrent laryngeal n.
Distal 1/3 of the esophagus and the abdominal digestive tract via the dorsal and ventral vagal trunks

Front 24

Where are the nerve cell bodies of the GVA and SVA modalities of CN X located?

What kind of ganglion is this? SHE"LL ASK US THIS!!!

Back 24

Cell bodies located in the distal ganglion of the vagus (nodose ganglion).

This is a sensory ganglion (like a dorsal root ganglion, in that it only has sensory fibers). SHE"LL ASK US THIS!!!

Front 25

The GSE (motor) modality of vagus n. serves four areas, what are they? What branches of vagus innervate the areas?

Back 25

Pharyngeal musculature and cranial 1/3 of the esophagus via the pharyngeal br.
Cricothyroideus m. via the cranial laryngeal n.
Middle 1/3 of the esophagus and to the rest of the laryngeal musculature via the recurrent laryngeal n.
Caudal 1/3 of the esophagus via dorsal and ventral vagal trunks

Front 26

What are the dysfunctions of the GSE and GVA modalities of vagus nerve?

How do you test them?

Back 26

Dysfunction of GSE (SVE) and GVA:
Dysphagia and dysphonia
Loss of cough reflex and vomiting reflex

Tests (similar to CN IX):
Swallowing reflex, gag reflex, and cough reflex (and sneeze reflex)

Front 27

Where are the cell bodies located for the GSA modality of Vagus n.?

Back 27

The jugular ganglion (the proximal ganglion of the vagus).

Front 28

What are the SVA and GSA innervations of CN X?

Back 28

Sensory (SVA) for taste from the base of the tongue and the pharynx

Sensory (GSA) to the horizontal ear canal, external acoustic meatus and tympanic membrane via the tympanic br.

Front 29

What is the dysfunction of the GVE modality of vagus nerve?

Back 29

Tachycardia and decreased peristalsis

Front 30

Where specifically is the parasympathetic area of vagus nerve?

Back 30

Parasympathetic (GVE) to smooth muscle, cardiac muscle and glands in the:
Cervical region via the recurrent laryngeal n.
Thoracic region via the recurrent laryngeal n. and vagal trunks
Abdominal region via the vagal trunks

Front 31

What are the two portions of accessory nerve?

Which one does recurrent laryngeal n. arise from?

Back 31

Bulbar and spinal

Recurrent laryngeal arises from the bulbar portion

Front 32

Which portion of the accessory nerve courses through the foramen magnum?

How can you tell the dysfunctions of this portion?

Back 32

The spinal portions.

Dysfunction: atrophy of the cranial shoulder muscles and difficulty in drawing the limb forward

Front 33

What are the dysfunctions of the bulbar portion of accessory nerve?

Back 33

Dysfunction: associated with vagus n. damage

Front 34

What are the dysfunctions and test for CN XII function?

Back 34

Dysfunction:
Acute – tongue is drawn to the contralateral (opposite) side of lesion (surface of the tongue is smooth)
Chronic – tongue is drawn to ipsilateral (same) side of lesion (surface of the tongue is wrinkled)

Test:
Tension on the tongue should result in reflex retraction

Front 35

Where does CNVIII leave the cranium?

Back 35

It doesn't, it courses within the skull.

Front 36

Can you decipher and understand this picture?

Back 36

Great, because when you made this card, you couldn't.

This is of parasympathetic innervation to the head (though I'm not sure that's all that's shown).

Front 37

What nerves provide the cutaneous innervation to the ear?

Back 37

Trigeminal nerve
Auriculotemporal n. of mandibular n.

Facial
Auricular nn.

Second cervical nerve
Greater occipital n. (dorsal branch of C2)
Great auricular n. (ventral br. of ventral br. of C2)

(there is a pic of trigeminal innervation on slide 34 of this lecture, and of 2nd cervical n. on page 35)

Front 38

What are the cutaneous autonomous zones of the head?

Back 38

See the pic

Front 39

What is the primary nerve to block in the head?

Back 39

CN V

Front 40

What is the effect of blocking the ophthalmic n.? Where do you block it?

What procedure would benefit from the block of this nerve?

Back 40

Anesthetize nerve near the orbital fissure

Desensitizes the eye and orbit

Used in enucleations.

C in the picture

Front 41

What is the effect of blocking the maxillary n.? Where do you block it?

In what common procedure would this nerve be blocked?

Back 41

Anesthetize nerve as it courses perpendicular to the palatine bone between the maxillary foramen and orbital fissure

Desensitizes the maxilla, upper teeth, nose and upper lip

This nerve would be blocked for maxillary teeth extractions

B in picture

Front 42

What is the effect of blocking the infraorbital n.? Where do you block it?

What common procedure would blocking this nerve not reliably assist in?

Back 42

Anesthetize nerve as it emerges through the infraorbital foramen

Desensitizes the upper lip and nose, the roof of nasal cavity, surrounding skin up to infraorbital foramen

Blocking this nerve would not be sufficient for a teeth cleaning.

A in the picture

Front 43

What is the effect of blocking the inferior alveolar n.? Where do you block it?

What procedure is this block used in?

Back 43

Anesthetize nerve as it enters the mandibular canal at the mandibular foramen

Desensitizes the mandible including all lower teeth, skin and mucosa of the chin and lower lip

Used in mandibular teeth extractions.

E in the picture (medial to the mandible)

Front 44

What is the effect of blocking the mental nn.? Where do you block it?

What common procedure would blocking this nerve not reliably assist with?

Back 44

Anesthetize nerves near mental foramina

Desensitizes the lower lip

Blocking this nerve would not be sufficient for a teeth cleaning.

D in the picture

Front 45

Where do the vagal and sympathetic fibers fork off to of the vagosympathetic trunk?

Back 45

Vagus goes to the distal ganglion of CNX.

Sympathetic trunk goes to the cranial cervical ganglion.

Front 46

Damage to which nerve would lead to a decrease in salivation?

Back 46

CN VII and CN IX

Front 47

What are the motor functions of CN XI?
What is the classification of CN XI?
What is the dysfunction of CN XI?

Back 47

Motor to the COST muscles.

GSE (SVE)

Atrophy of neck mm, unable to draw shoulder cranially.