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Neuroanatomy Cranial
Cranial Nerves
| Question | Answer |
|---|---|
| CN 1 | Olfactory Nerve |
| CN 1 Function | Smell |
| CN 2 | Optic Nerve |
| CN 2 Function | Vision |
| CN 3 | Oculomotor Nerve |
| CN 3 Function | Eye Movement, Pupil Constriction |
| CN 4 | Trochlear Nerve |
| CN 4 Function | Eye Movement |
| CN 5 | Trigeminal Nerve |
| CN 5 Function | Somatosensory Information (touch, pain) from the face and head; muscles for chewing |
| CN 6 | Abducens Nerve |
| CN 6 Function | Eye Movement |
| CN 7 | Facial Nerve |
| CN 7 Function | Taste (anterior 2/3 of tongue); somatosensory information (touch, pain) from ear; controls muscles used for facial expression. |
| CN 8 | Vestibulocochlear Nerve |
| CN 8 Function | Hearing; balance |
| CN 9 | Glossopharyngeal Nerve |
| CN 9 Function | Taste (posterior 1/3 of tongue); somatosensory information (touch, pain) from tongue, tonsil, phaarynx; controls some muscles used for swallowing. |
| CN 10 | Vagus |
| CN 10 Function | Sensory, motor, and autonomic functions of viscera (glands, digestion, heart rate, breathing) |
| CN 11 | Spinal Assessory Nerve |
| CN 11 Function | Controls muscles used in head movement |
| CN 12 | Hypoglossal Nerve |
| CN 12 Function | Controls muscles of the tongue |
| Spinothalamic Tract carries | FROM BODY: awareness of pain and temperature |
| SPINOTHALAMIC TRACT: | The spinothalamic tract is a sensory pathway originating in the spinal cord. It transmits information to the thalamus about pain, temperature, itch and crude touch. |
| Posterior Column Medial Lemniscus Pathway | The posterior column-medial lemniscus pathway is the sensory pathway responsible for transmitting fine touch, vibration and conscious proprioceptive information from the body to the cerebral cortex |
| PCML | Posterior Column Medial Lemniscus Pathway |
| Posterior Column / Medial Lemniscus carries | FROM BODY: touch, pressure, tactile proprioception. |
| Spinal Trigeminal / Ventral Trigeminal | pain and temperature information FROM HEAD |
| Dorsal Trigeminal | Tactile and proprioceptive information FROM HEAD |
| Solitary Tract | A structure in the brainstem that along with the Solitary Nucleus carries and receives visceral sensation and taste from the body. |
| Lateral Lemniscus | carries auditory input up the sides of the brainstem to the cerebrum |
| Reticular Formation | The Lateral Lemniscus carries the auditory input and the Reticular Formation alerts the Cerebrum that the input is coming. |
| Medial Longitudinal Fasciculus | A group of axons on each side of the brainstem that carries information about the direction that the eyes should move, also carries info about head movement and innervates some muscles of the back. |
| Droopy eyelids | CN III Oculomotor |
| Facial Weakness | CN IV Facial |
| Inability to elevate the shoulder | CN XI Spinal Assessory |
| Weakness of tongue | CN XII Hypoglossal Nerve |
| Loss of taste on the anterior tongue | CN VII Facial |
| Trigeminal neuralgia | Tic Douloureux |
| Trigeminal neuralgia / tig douloureux | CN V Trigeminal |
| Deviation of the uvula in production of /a/ | CN X Vagus |
| Loss of corneal blink reflex | CN VII Facial |
| Lateral strabismus | eye deviates laterally |
| Medial strabismus | eye deviates medially |
| Lateral strabismus nerve | CN III Oculomotor |
| Medial strabismus | CN VI Abducens |
| Dysphagia | difficulty in swallowing |
| Dysphagia nerve | CN X and CN XII if affected bilaterally |
| Loss of sensation to the face | CN V Trigeminal |
| Vocal fold paralysis and hoarseness | CN X Vagus |
| Difficulty chewing | CN V Trigeminal CN VII Facial and CN XII hypoglossal |
| Pain in the pharynx and external auditory meatus | CN IX glossopharyngeal |
| Double vision (diplopia) | CN III, CN IV and CN VI |
| Deafness | CN VIII vestibulocochlear |
| Visual field cut | CN II |
| Loss of taste in the posterior tongue | CN IV glossopharyngeal |
| Which muscles are innervated by the Trigeminal Motor Nucleus | Mastication, tensor tympani and other small muscles |
| Brief attack of excruciating pain in the distribution of the trigeminal nerve? | tic douloureux or trigeminal neuralgia |
| Subserves taste? | CN VII anterior 2/3 of the tongue and palate |
| Which muscles are innervated by the branchial motor fibers of CN VII? | facial expression and the stapedius (the smallest striated muscle in the tympanic cavity in the middle ear) |
| Which muscle is innervated by the branchial motor fibers of CN IX? | Stylopharyngeus muscle |
| What is the function of the stylopharyngeal muscle? | elevation of the pharynx during speech and swallowing |
| Lesions to CN IX can have what effect? | loss of gag reflex, loss of taste on posterior 1/3 of tongue |
| Name the attack of severe pain in the distribution of CN IX | gloospharyngeal neuralgia |
| What are the three speech functions of the branchial motor fibers of CN X? | Velum movement, pitch change, vocal fold movement |
| Lesions involving CN X can have what effect? | deviation of soft palate to the intact side, hoarseness, breathiness, dysphasia |
| What is the function of the cranial portion of CN XI? | innervates muscles of the larynx and the velum along with CN X |
| Heard | CN VIII Vestibulocochlear |
| Tingly face | CN V Trigeminal |
| Gagging | CN IX Glossopharyngeal |
| Bitter taste | CN VII Facial and CN IX Glossopharyngeal |
| Focusing of the eyes | CN III Oculomotor |
| Moving the eyes | CN IV Trochlear |
| Gazing up (raising eyes) | CN III Oculomotor |
| Saw something | CN II Optic |
| Chewing | CN V Trigeminal |
| Swallowing | CN X |
| Blinking | CN VII Facial |
| Sticking out your tongue | CN XII Hypoglossal |
| Making a face at someone | CN VII Facial |
| Pitch change in voice | CN X Vagus |
| Shrugging ones shoulders | CN XI Spinal Assessory |
| Muscles innervated by Trigeminal Motor Nucleus | Muscles of mastication, tensor tympani and other small muscles |
| CN VII subserves taste from which part of the head? | anterior 2/3 of the tongue and palate |
| What would be the lesion effect of the Right Hemisphere Lesion involving CN VII on the patient's face? | Left lower contralateral facial weakness |
| Lesion of right optic nerve = | Defect: blindness of right eye (right circle is totally darkened) |
| Lesion of optic chiasma in midline | Defect: bitemporal hemianopsia (outer sides of both circles are darkened) |
| Lesion of right edge of optic chiasma | Defect: nasal hemianopsia in right eye (nose side of right circle is darkened) |
| Lesion of right optic tract | Defect: left homonymous hemianopsia (left sides of both circles are darkened) |
| Lesion: cortical level damage | Defect: left homonymous hemianopsia with macular sparing (left side of both circles are darkened with inner points spared.) |
| Fields of vision: Where are the temporal fields? | Out toward the temples on both sides. |
| Fields of vision: Where are the Nasal fields? | Toward the nose on both sides. |
| How many quadrants are in fields of vision? | Left right and top and bottom |
| At level of retina you are looking at what? | You are looking at both visual fields (visual worlds) |
| The right nasal retina is where? | Close to nose on right side toward back of eye. |
| The right temporal retina is where? | Close to temple on right side toward back of eye. |
| Where is the optic nerve? | The optic nerve is just behind the eyeballs on each side. |
| Where is the optic tract? | The optic tract is on both sides but after the optic chiasm. |
| Where is the optic chiasm? | After the optic nerves but before the optic tracts. It is where the nasal optic nerves cross over to the other side. |
| LGN is what? | Lateral Geniculate Body. Those lima bean looking things on both sides that are right after the optic tracts. |
| What does the right temporal retina look at? | The right temporal retina looks at the left nasal side of view. |
| What does the right nasal retina look at? | The right temporal view. |
| Lateral Geniculate Body? | Right after the optic tracts LGN |
| Each eyeball looks at what? | Both visual worlds / fields. |
| At level of optic chiasm what do you see? | Only the opposite side. |
| Temporal retina looks at what? | At opposite side of where retina is. |
| The image has to end up | Backwards |
| To get backwards, nasal fibers which look at same side have to cross over at the level of the | Fibers cross over at the level of the Optic Chiasm |
| Past Optic Chiasm you only see the opposite side of what | You see the opposite side of the visual field past the optic chiasm |
| At optic chiasm, temporal fibers do this | Temporal fibers stay on the same side at the level of the optic chiasm. |
| At the level of the optic chiasm, which fibers cross over? | The nasal fibers cross over at the level of the optic chiasm. |
| The loopy things past the LGN bodies are called what? | Optic radiation, except for the higher one which is called Meyer's Loop. |
| If the fibers are cut past the LGNs and past the Optic Radiations, close to the occipital poles and on the right side, what is the defect? | Left homonymous hemianopia with macular sparing. |
| If the lesion was in the right optic nerve before the optic chiasm, what would the defect be? | Blindness in right eye. |
| If the lesion was in the optic chiasm where the nasal fibers cross, NOTE THE TEMPORAL FIBERS DO NOT CROSS OVER, what would the defect be? | Bitemporal hemianopia (outside half of both circles is darkened because nasal fibers look at opposite side at the level of optic chiasm. |
| If the lesion was after the optic chiasm but before the LGN on the right sides, what would the defect be? | After the optic chiasm, only looking at opposite visual field, so the defect would be the left sides of the visual fields are dark and would be called left homonymous hemianopsia |
| If the lesion is in the right side of Meyer's Loop, what is the defect? | It would be in the last quarter vision field, known as Left Homonymous Superior Quadrantanopia |
| If the lesion is in the Optic Radiation in the right side, what is the defect? | It is called Left Homonymous Inferior Quadrantanopia and it is a vision field loss in the 3rd quarter. |
| If the lesion is right before the occipital poles and after the optic radiations and on the right side, what is the defect? | It is called Left Homonymous Hemianopia with macular sparing. |
| Lesion = right optic nerve | Defect = blindness of right eye |
| Lesion = optic chiasma in midline | Defect = bitemporal hemianopsia |
| Lesion = right edge of optic chiasma | Defect = nasal hemianopia, right eye |
| Lesion = right optic tract | Defect = left homonymous hemianopsia |
| Lesion = cortical level damage | Defect = left homonymous hemianopia with macular sparing. |
| The spinal cord extends from the | foramen magnum |
| The spinal cord is continuous with | the medulla |
| The spinal cord has how many segments? | 31 |
| The segments of the spinal cord are | 31 segments 8 cervical, 12 thoracic, 5 lumbar, 5 sacral and 1 coccygeal |
| Which is shorter the spinal cord or the vertebral canal? | The spinal cord is shorter than the vertebral canal |
| The spinal cord extends down to which part of vertebral column? | L-1 through L-2 |
| Filament that courses through L1-S2 | Cauda Equina (in the lumbar cistern) |
| The spinal cord has 2 enlargements | Cervical enlargement and Lumbar enlargement |
| The cervical enlargement contains motor neurons for which part of the body? | The cervical enlargement contains motor neurons that supply the upper extremities. |
| The lumbar enlargement extends from which part of the vertebral column? | L2 - S3 |
| The lumbar enlargement contains motor neurons that supply which part of the body? | The lumbar enlargement contains motor neurons that supply the lower extremities. |
| Dorsal rootlets carry which kind of information from the body to the spinal cord? | Dorsal rootlets carry sensory information from the body to the spinal cord. |
| Ventral rootlets carry which kind of information from the spinal cord to the muscles? | Ventral rootlets carry motor information from the spinal cord to the muscles. |
| Dorsal and ventral roots join to form what? | Spinal nerves. |
| Dorsal comes into the spinal cord and ventral comes out. Which kind of information do each carry? | Doral comes into the spinal cord carrying sensory information and ventral comes out carrying motor information. |
| The spinal cord has meningeal layers. What are they called? | Dura Mater, Arachnoid, and Pia Mater. |
| The spinal cord Dura Mater is what? | A single layered meningeal layer in the spinal cord. |
| What is the Arachnoid meningeal layer in the spinal cord closely attached to? | The Dura Mater in the spinal cord. |
| Does the Arachnoid meningeal layer in the spinal cord have a subarachnoid space? | Yes. |
| Spinal dural sheath and arachnoid end at which vertebral segment? | The dural sheath and the arachnoid end at S2. |
| At what vertebral segment does the spinal cord end? | The spinal cord ends at L1 - L2. |
| Where is the Lumbar Cistern and what is it filled with? | The lumbar cistern is located between L1 and L2 and S2 and is filled with CSF. |
| What is the Pia Mater like in the spinal cord? | The pia mater in the spinal cord is THICK and gives rise to the DENTATE LIGAMENT. |
| What does the Dentate Ligament that arises from the Pia Mater DO? | The dentate ligament anchors the spinal cord to the arachnoid and to the dura. |
| What are three functions of the spinal cord? | Sensory Processing, Controlling Motor Outflow, and Reflexes |
| How is the spinal cord grey and white matter organized? | Opposite of that in the brain; in the spinal cord, the white matter is OUTSIDE, and the grey matter is within. |
| Grey matter in the spinal cord is divided into what? | Horns |
| White matter in the spinal cord is divided into what? | Funiculi |
| What is the posterolateral sulcus? | The posterolateral sulcus is where the dorsal rootlets enter the spinal cord. |
| What is the anterolateral sulcus? | The anterolateral sulcus is where the ventral rootlets EXIT the spinal cord. |
| What is located at the tip of the grey matter in the spinal cord, posteriorly? | The substantia gelatinosa. It is in the posterior tip of the grey matter and it carries pain and temperature information. |
| The anterior horn of the grey matter in the spinal cord contains what? | The anterior horn contains large motor neurons that supply skeletal muscles and also lower motor neurons that allow for muscle contraction. |
| What can happen as a result of the destruction or interruption of lower motor neurons? | Complete paralysis of involved muscles. |
| What is Clarke's nucleus? | Clarke's nucleus is located in the grey matter; it is a relay station for info going to the cerebellum. It sends info from the legs to the brain. |
| Where is Clarke's nucleus located? | Clarke's Nucleus is located between T1 and L2. |
| Posterior Column Medial Lemniscus System | FROM BODY: touch, pressure, tactile proprioception. |
| PCML Fasciculus Gracilis | sends sensory information from lower body/limbs |
| PCML Fasciculus Cuneatus | sends sensory information from the upper body/limbs |
| Kinesthia and loss of proprioception could come from what? | Damage to PCML |
| Spinothalmic Tract | carries information from the body to the thalamus regarding localization of painful stimuli |
| Substantia gelatinosa | located in posterior horn of grey matter of spinal cord |
| spinothalamic tract carries | pain and temperature info, itch sensation, pressure sensation from bladder and bowel, sexual sensation |
| Contralateral analgesia can occur from damage to | spinothalmic tract |
| Spinocerebellar tract | gets EXTRA information and that using that information, the cerebellum tells us how to move. |
| Major functions of the brainstem, | Conduit function, cranial nerve function, integrative fuction |
| Which cranial nerves emerge from brainstem? | CN II through XII project to or emerge from brainstem. |
| Pyramids | major motor pathway on ventral surface of medulla |
| Olive | also called inferior olives or inferior olivary nucleus |
| Olive | An oval swelling, a relay nuclei for proprioception going into the cerebellum |
| Sulcus Limitans organization | Motor medial, separate motor and sensory, on dorsal surface of medulla |
| Facial Colliculus | On Pons, where CN VI is located, |
| Tegmentum | On dorsal portion of pons, contains CN 5, 6, 7, & 8 |
| Midbrain structures: | cerebral aqueduct in center, tectum on dorsal surface |
| Superior Colliculi | Visual pathway |
| Inferior colliculi | auditory pathway |
| Tegmentum on cerebral peduncles | contains nuclei of CN III oculomotor and CN IV trochlear |
| Red Nucleus | a paired nucleus that receives info from contralateral cerebellum |
| substantia nigra | synthesizes dopamine a neural transmitter |
| Parkinson's Disease | no dopamine production from substantia nigra |
| substantia nigra | strong connection with putamen and caudate nucleus |
| Reticular formation | control of movement, modulates pain signals, arousal and consciousness |
| CN VII Facial travels | in solitary tract to solitary nucleus |
| Facial nerves are in PNS or CNS? | PNS because nerves are in PNS |
| Lower contralateral facial weakness | unilateral upper motor neuron lesion |
| weakness in ipsilateral half of face | unilateral lower motor neuron lesion |
| entire face weakness | bilateral lesion |
| Branchial motor nerves arise from | nucleus ambiguous |
| sytlopharangeous muscle | innervated by glossopharyngeal nerve CN IX |
| CNX | velum movement, pitch change, vocal fold movement |
| CN X arises from | Nucleus ambiguous |
| CNX can affect | phonation of /a/, swallowing, respiratory, cardiovascular and swallowing problems |
| bilateral damage to CN X | respiratory, cardiovascular and swallowing problems can be fatal, laryngeal paralysis |
| unilateral damage to CN X | deviation of soft palate to intact side, hoarseness, breathiness |
| damage to CN XI | difficulty moving head away from side of lesion, weakness in shoulder elevation on affected side, hoarse voice quality |
| branchiomeric nerves | muscles of larynx, pharynx, jaw, face, midle ear muscles, sternocleidomastoid, trapezius |
| sensory nuclei | lateral to sulcus limitans |
| visceral nuclei | nearer the sulcus limitans |
| Branchiomeric nerves #s | CN V, VII, IX, X and XI |
| CN III | Oculomotor |
| Levator palpebrae superioris | elevates and retracts upper eyelid |
| superior rectus | controls upward eye gaze |
| medial rectus | controls medial eye movement |
| inferior rectus | controls downward eye gaze |
| inferior oblique | controls upward and medial eye gaze |
| pupillary sphincter | in oculomotor nerve CN III controls pupil size |
| cilliary muscles | control shape of lense CN III |
| Pupillary light reflex | CN III constriction of pupil to light |
| lateral strabismus | eye deviates laterally |
| diplopia | double vision |
| ptosis | drooping of the eyelid |
| which CN abducts the eye | CN VI ABDUCENS |
| Damage to CN VI can cause what | medial strabismus (eye deviates medially) |
| Hypoglossal Nerve CN XII is what? | 100% motor! only moves the tongue. |
| Bilateral lesion to CN XII | difficulties in speaking and eating |
| weakness of one side of the tongue | ipsilateral damage to CN XII |