Brittany Zarse Elizabeth Yeager Nathan Webb Slide 2 Mixed Nerve
Motor: muscles of facial expression except mastication muscles-
temporalis and masseter stapedius muscle secretor glands in mouth
and nasal cavities Sensory: taste anterior 2/3 tongue, hard and
soft palates epidermis of the external ear Slide 3 Clinical Testing
Look for asymmetry in voluntary facial movements Check taste
sensation on anterior 2/3 tongue Note excessive secretion of
salivary glands Check acoustic stapedial reflexes Clinical
Conditions Pons- paralysis of ipsilateral facial muscles, loss of
taste from anterior 2/3 tongue, excessive secretion from salivary
glands Unilateral UMN- paralysis of contralateral lower face
Bilateral UMN- paralysis of upper & lower face LMN- paralysis
of ipsilateral upper & lower face Slide 4 Slide 5 Sensory Nerve
Branches into vestibular and auditory nerves Vestibular Equilibrium
Head and body movements Stable visual fixation point- dolls eye
reflex Distal fibers innervate hair cells of semicircular canals
Auditory Hearing Distal fibers innervate hair cells of Organ of
Corti Slide 6 Clinical Conditions Vestibular Impaired equilibrium
Vertigo Nystagmus Auditory Neural hearing loss Tinnitus Slide 7
Receives general sensory fibers from the posterior 1/3 rd of the
tongue, the tonsils, soft palate, the pharynx, and the middle ear
(through the tympanic nerve) and Eustachian tube. Special sensory
fibers mediating taste from the posterior 1/3rd of the tongue and
oral pharynx Supplies parasympathetic fibers to the parotid gland
Supplies motor fibers to stylopharyngeus muscle and the upper
pharyngeal muscles. Slide 8 Is the longest CN Mixed nerve although
mostly sensory (90%). CNs IX and X are important for phonation and
swallowing. Also innervates cardiac and smooth muscles of
esophagus, stomach and intestine Slide 9 Motor nerve Head movement
control Tilting of the head forward and rotating to opposite side=
sternocleidomastoid muscle contraction Tilting of head back and to
the side= trapezius muscle contraction Clinical Testing Trapezius-
ask to shrug shoulders while giving resistance Sternocleidomastoid=
ask to turn head while giving resistance Slide 10 Motor Nerve
Innervates all of the intrinsic and 3 of the 4 major extrinsic
muscles of the tongue The other extrinsic tongue muscles is
innervated by what? Slide 11 Clinical testing Check for paralysis
by asking to stick out their tongue (will point towards paralyzed
side during unilateral paralysis) strength of the tongue measured
by pushing a finger against their cheek and seeing how strongly
they can push back Also look for signs of fasciculation
(Involuntary contractions and twitching of muscle) and muscular
atrophy. Slide 12 Damages to the following cranial nerves result
in: CN VII, Facial: paralysis of ipsilateral facial muscles,
excessive secretion from salivary glands, loss of taste from
anterior 2/3 tongue CN VIII, Auditory: impaired equilibrium,
vertigo, nystagmus, and neural hearing loss CN IX, Glosspharyngeal:
Affects elevation of pharynx during swallowing, Loss of gag reflex,
Excessive saliva secretion CN X, Vagus: Breathy voice, hoarseness
and diplophonia; Difficulty in swallowing (also impairs
parasympathetic functions such as heart-rate, function of smooth
muscles of trachea and bronchus, reflexes such as vomiting,
coughing, sneezing, sucking, and yawning.) CN XI, Accessory: head
movement problems CN XII, Hypoglossal: tongue paralysis, atrophy,
or fasciculation; dysarthria or chewing difficulties Slide 13 A.
Only motor B. Only sensory C. Mixed but primarily motor D. Mixed
but primarily sensory Slide 14 1. The facial nerve is
_______________. A. only motor B. only sensory C. mixed but
primarily motor Motor-facial muscles, stapeduis & secretor
glands of mouth & nose Sensory- taste 2/3 tongue, epidermis of
outer ear D. mixed but primarily sensory Slide 15 A. Orbicularis
Oris B. Mentalis C. Masseter D. Depressor Anguli Oris E. Temporlais
Slide 16 2. Which of the following facial muscles are not
innervated by CN VII? A. Orbicularis Oris B. Mentalis C. Masseter
CN V- Trigeminal D. Depressor Anguli Oris E. Temporlais CN V-
Trigeminal Slide 17 A. impaired stapedial reflex B. excessive
secretion of salivary glands C. impairment of voluntary facial
movements D. impaired equilbirium Slide 18 3. Lesions of CN VII
could result in all but which of the following: A. impaired
stapedial reflex B. excessive secretion of salivary glands C.
impairment of voluntary facial movements D. impaired equilbirium CN
VIII- Vestibulocochlear Slide 19 A. contralateral lower half of the
face B. ipsilateral lower half of the face C. contralateral side of
the face D. lower half of the face Slide 20 4. A unilateral UMN
lesion to CN VII will affect the __________. A. contralateral lower
half of the face The upper face remains unaffected because of
bilateral innervation The ipsilateral half remain unaffected
because pathways come from unaffected side of cortex B. ipsilateral
lower half of the face C. contralateral side of the face D. lower
half of the face Slide 21 A. only ipsilateral paralysis of facial
muscles B. only excessive secretions from salivary glands C. only
loss of taste from anterior 2/3 of tongue D. all of the above Slide
22 5. Damage to the facial nerve at the level of the pons will
result in __________. A. only ipsilateral paralysis of facial
muscles B. only excessive secretions from salivary glands C. only
loss of taste from anterior 2/3 of tongue D. all of the above Slide
23 Slide 24 6. Is Bells Palsy an example of an UMN or a LMN lesion?
LMN ipsilateral paralysis of upper and lower facial muscles Slide
25 A. Vestibular B. Auditory C. Maxillary D. Mandibular Slide 26 7.
The __________ branch of CN VIII is responsible for maintaining the
dolls eye reflex. A. Vestibular Also equilibrium and head and body
movements B. Auditory hearing C. Maxillary CN V- Sensation from
face, head, parts of the ear, oral & nasal cavities D.
Mandibular CN V- general sensory from mouth Slide 27 A. hair cells
of the Organ of Corti B. epidermis of the external ear C. hair
cells of the semicircular canals D. stapedius muslce Slide 28 8.
Distal fibers of the vestibular nerve innervate what? A. hair cells
of the Organ of Corti Auditory branch of CN VIII-Vestibulocochlear
B. epidermis of the external ear CN VII- Facial C. hair cells of
the semicircular canals D. stapedius muslce CN VII- Facial Slide 29
A. vertigo B. neural hearing loss C. nystagmus D. tinnitus Slide 30
9. A lesion to the auditory nerve will result in what? A. vertigo
lesion to vestibular nerve B. neural hearing loss C. nystagmus
lesion to vestibular nerve D. tinnitus Slide 31 A) Tongue and
pharynx movement B) Hearing and Balance C) Sense of Smell D) Visual
information Slide 32 A) Tongue and pharynx movement B) Hearing and
Balance (CN 8 Vestibulocochlear) C) Sense of Smell (CN 1 Olfactory)
D) Visual information (CN 2 Optic) Slide 33 A. Midbrain B. Pons C.
Medulla D. Cerebrum Slide 34 C) Medulla Slide 35 A) Sensory
information to 1/3 of the posterior tongue B) General sensory
information from the tonsils. C) General sensory information from
the soft palate and pharynx. D) All of these Slide 36 D) ALL OF
THESE A) Sensory information to 1/3 of the posterior tongue B)
General sensory information from the tonsils. C) General sensory
information from the soft palate and pharynx. Slide 37 A) CN X B)
CN IX C) CN XI D) CN V Slide 38 B) Cranial nerve IX. Supplies
parasympathetic fibers to the parotid gland Which is the largest of
the salivary glands found in the subcutaneous tissue of the face
which empties its secretion within the buccal cavity. Slide 39 A)
Partial paresis (weakening) of the unilateral stylopharyngeal
muscle. B) Impaired cutaneous sensation from the posterior tongue.
C) Poor control of parotid gland D) All of these E) None of these
Slide 40 D) ALL OF THESE A) Partial paresis (weakening) of the
unilateral stylopharyngeal muscle. Affects elevation of pharynx
during swallowing B Impaired cutaneous sensation from the posterior
tongue. Loss of gag reflex C Poor control of parotid gland
Excessive saliva secretion Slide 41 A) X B) V C) VIII D) VII Slide
42 A) CN X supplies general sensory information from the external
ear and parts of the external surface of the tympanic membrane.
BONUS: What kind of information? Slide 43 SENSORY INFORMATION for
touch, temperature and pressure Slide 44 A) Breathy Voice B)
Hoarseness and diplophonia C) Difficulty in swallowing D) All of
these Slide 45 D) ALL OF THESE A) Breathy Voice and B) hoarseness
and diplophonia are caused by paralysis of the intrinsic muscles of
the larynx on the affected side. C) difficulty in swallowing is
cause by the inability to elevate the soft palate on the affected
side (due to paralysis of the levator palatini muscle) Slide 46 A)
V B) VII C) X D) XI Slide 47 C) CN X Slide 48 A) I B) IX C) X D)
XII Slide 49 C) X vagus nerve A) I, damage could result in
Anosmia/hyposmia Reduction/loss of the ability to smell Hyperosmia
Abnormally acute sensation of smell B) IX, damage could result in
loss of gag reflex, elevation of pharynx, and excessive saliva D)
XII, damage could result in paralysis of tongue Slide 50 Slide 51
Both! The accessory nerve is both motor and sensory! Slide 52 A. CN
X B. CN XII C. CN XI D. CN VII Slide 53 A. CN X B. CN XII C. CN XI
The spinal accessory- Its in charge of tilting the head forward,
backward, and to the side! D. CN VII Slide 54 Slide 55 FALSE! The
hypoglossal nerve innervates all INTRENSIC and 3 out of the 4
EXTRENSIC Slide 56 A. The paralyzed side B. Always the right C. The
un-paralyzed side D. Always the left Slide 57 A. The paralyzed side
B. Always the right C. The un-paralyzed side D. Always the left
Slide 58 A. Sternocleidomastoid B. Sternomastoid C. Trapezius D.
Trapazoid Slide 59 A. Sternocleidomastoid (tilting of head forward
and to opposite side) B. Sternomastoid C. Trapezius D. Trapazoid
(silly goose!) Slide 60 A. Involuntary contractions and twitching
of muscle B. The fluid-like movement of cilia C. Vomiting D.
Intense pain in the neck muscles due to damage to the CN XI. Slide
61 A. Involuntary contractions and twitching of muscle B. The
fluid-like movement of cilia C. Vomiting D. Intense pain in the
neck muscles due to damage to the CN XI. Slide 62 A. CN VII B. CN
IX C. CN X D. CN XII Slide 63 A. CN VII B. CN IX C. CN X D. CN XII-
The hypoglossal nerve Slide 64
