questions 8

Cranial Nerves

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Topic updated on 05/14/17 7:15pm

Overview

Cranial nerves illustration

Illustration by Ava Yap

 
Introduction
  • All cranial nerves (except I and II) arise from the brain stem
    • between dorsal and ventral portions
      • midbrain (III, IV)
      • pons (V, VI, VII, VIII)
      • medulla (IX, X, XI, XII)
Cranial Nerve Name Type Function Cranial Exit Notes
I Olfactory Sensory
  • Olfaction
Cribiform plate
  • Only CN without thalamic relay to cortex 
II Optic Sensory
  • Vision
Optic canal  
III Oculomotor Motor
  • Eye movement
    • SR, IR, MR, IO
  • Pupillary constriction
  • Accommodation
  • Eyelid opening
    • levator palpebrae
Superior orbital fissure
  • Center contains output to ocular muscles which is affected primarily 1st by vascular disease
  • Periphery contains parasympathetic output which is affected 1st by compression
IV Trochlear Motor
  • Eye movement
    • SO
Superior orbital fissure  
V Trigeminal Motor, sensory
  • Mastication (V3)
  • Facial sensation
    • opthalmic (V1), maxillary (V2), mandibular (V3) divisions

V1 - superior orbital fissure

V2 - foramen rotundum

V3 - foramen ovale 

 
VI Abducens Motor
  • Eye movement
    • LR
Superior orbital fissure  
VII Facial Motor, sensory
  • Facial movement
  • Taste from anterior 2/3 of tongue
  • Lacrimation
  • Salivation
    • submandibular, sublingual glands
  • Eyelid closing
    • orbicularis oculi
  • Stapedius 
    • dampens excessive sound 
Internal auditory meatus
  • Visceral sensation recieved by nucleus solitarius
VIII Vestibulocochlear Sensory
  • Hearing
  • Balance
Internal auditory meatus  
IX Glossopharyngeal Motor, sensory
  • Taste from posterior 1/3 of tongue
  • Swallowing
  • Salivation 
    • parotid gland
  • Monitoring carotid body and sinus chemo- and baroreceptors
  • Stylopharngeus
    • elevates pharynx, larynx
Jugular foramen
  • Motor output orginates in nucleus ambiguus
  • Visceral sensation recieved by nucleus solitarius
X Vagus Motor, sensory
  • Taste from epiglotic region
  • Swallowing
  • Palate elevation
  • Midline uvula
  • Talking
  • Coughing
  • Thoracoabdominal viscera
  • Monitoring aortic arch chemo- and baroreceptors
  • Stimulation of auricular branch can cause vasovagal syncope
Jugular foramen
  • Motor output orginates in nucleus ambiguus
  • Visceral sensation recieved by nucleus solitarius
  • Parasympathetic fibers to heart, lungs, and upper GI orginates from dorsal motor nucleus
  • Gives recurrent laryngeal nerve which innervates all laryngeal muscles except cricothyroid
XI Accessory Motor
  • Head turning and shoulder shrugging
    • SCM, trapezius
Jugular foramen
  • Motor output orginates in nucleus ambiguus
XII  Hypoglossal Motor
  • Tongue movement
Hypoglossal canal  

 

 


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Qbank (4 Questions)

TAG
(M1.NE.26) Where does the only cranial nerve without a thalamic relay nucleus enter the skull? Topic Review Topic

1. Foramen rotundum
2. Jugular foramen
3. Internal auditory meatus
4. Superior orbital fissure
5. Cribriform plate

PREFERRED RESPONSE ▶
TAG
(M1.NE.40) A 45-year-old man is brought to the emergency department after being found down in the middle of the street. Bystanders reported to the police that they had seen the man as he exited a local bar, where he was subsequently assaulted. He sustained severe facial trauma, including multiple lacerations and facial bone fractures. The man is taken to the operating room by the ENT team, who attempted to reconstruct his facial bones with multiple plates and screws. Several days later, he complains of the inability to open his mouth wide or to completely chew his food, both of which he seemed able to do prior to the surgery. Where does the affected nerve exit the skull? Topic Review Topic

1. Foramen ovale
2. Foramen rotundum
3. Superior orbital fissue
4. Jugular foramen
5. Inferior orbital fissue

PREFERRED RESPONSE ▶
TAG
(M1.NE.41) A 45-year-old man is brought to the emergency department after being found down in the middle of the street. Bystanders reported to the police that they had seen the man as he exited a local bar, and he was subsequently assaulted. He sustained severe facial trauma, including multiple lacerations and facial bone fractures. The man is taken to the operating room by the ENT team, who attempt to reconstruct his facial bones with multiple plates and screws. Several days later, he complains of the inability to open his mouth wide or to completely chew his food, both of which he seemed able to do prior to surgery. Which of the following is a characteristic of the injured nerve branch? Topic Review Topic

1. Sensory component only
2. Voluntary motor component only
3. Voluntary motor and sensory components
4. Parasympathetic component only
5. Sympathetic component only

PREFERRED RESPONSE ▶
TAG
(M1.NE.4756) A 4-year-old male is accompanied by his mother to a head and neck surgeon for a follow-up visit after the patient underwent a branchial cyst operation. The child’s immediate post-operative period was uneventful. However, the mother reports that the child has had trouble speaking since the operation. His words appear more slurred than before. The child’s pain has been well controlled with acetaminophen. The child was born at 34 weeks’ gestation and stayed one day in the neonatal intensive care unit for prematurity prior to being discharged without any abnormal findings. On examination, the incision is clean, dry, non-erythematous, and shows signs of healing. The child is asked to stick out his tongue and findings are shown in Figure A. Which of the following muscles is most likely affected in this patient? Topic Review Topic
FIGURES: A          

1. Mylohyoid
2. Palatoglossus
3. Styloglossus
4. Stylohyoid
5. Stylopharyngeus

PREFERRED RESPONSE ▶
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