Podcast
Questions and Answers
Which cranial nerves exit the skull through the jugular foramen?
Which cranial nerves exit the skull through the jugular foramen?
- CN VII, VIII, and IX
- CN IX, X, and XII
- CN X, XI, and XII
- CN IX, X, and XI (correct)
- CN VIII, IX, and X
The glossopharyngeal nerve (CN IX) provides sensory innervation to which part of the tongue?
The glossopharyngeal nerve (CN IX) provides sensory innervation to which part of the tongue?
- Tip of the tongue
- Lateral margins
- Anterior two-thirds
- Posterior one-third (correct)
- Entire tongue
Which of the following muscles is innervated by the glossopharyngeal nerve (CN IX)?
Which of the following muscles is innervated by the glossopharyngeal nerve (CN IX)?
- Genioglossus
- Hyoglossus
- Styloglossus
- Palatoglossus
- Stylopharyngeus (correct)
In addition to motor and sensory functions, the glossopharyngeal nerve (CN IX) has a role in:
In addition to motor and sensory functions, the glossopharyngeal nerve (CN IX) has a role in:
A lesion of the glossopharyngeal nerve (CN IX) may result in:
A lesion of the glossopharyngeal nerve (CN IX) may result in:
The cell bodies of the parasympathetic fibers of the glossopharyngeal nerve are located in which nucleus?
The cell bodies of the parasympathetic fibers of the glossopharyngeal nerve are located in which nucleus?
Referred pain from the tonsils due to tonsillitis is carried by which nerve?
Referred pain from the tonsils due to tonsillitis is carried by which nerve?
Which of the following is NOT a function of the vagus nerve (CN X)?
Which of the following is NOT a function of the vagus nerve (CN X)?
What clinical sign could indicate damage to the vagus nerve (CN X)?
What clinical sign could indicate damage to the vagus nerve (CN X)?
The gag reflex involves the contraction of pharyngeal muscles. Which nerve provides the efferent (motor) component for this reflex?
The gag reflex involves the contraction of pharyngeal muscles. Which nerve provides the efferent (motor) component for this reflex?
Which of the following accurately describes fibers associated with the cranial root of the accessory nerve?
Which of the following accurately describes fibers associated with the cranial root of the accessory nerve?
A patient exhibits weakness in shrugging their right shoulder and difficulty turning their head to the left. Where is the most likely location of the lesion?
A patient exhibits weakness in shrugging their right shoulder and difficulty turning their head to the left. Where is the most likely location of the lesion?
The accessory nerve (CN XI) is unique because it:
The accessory nerve (CN XI) is unique because it:
Which of the following muscles is innervated by the hypoglossal nerve (CN XII)?
Which of the following muscles is innervated by the hypoglossal nerve (CN XII)?
A patient protrudes their tongue, and it deviates to the right. This indicates a lesion of which nerve?
A patient protrudes their tongue, and it deviates to the right. This indicates a lesion of which nerve?
The hypoglossal nerve (CN XII) exits the cranial cavity through which opening?
The hypoglossal nerve (CN XII) exits the cranial cavity through which opening?
Which nucleus provides motor innervation to the intrinsic muscles of the larynx?
Which nucleus provides motor innervation to the intrinsic muscles of the larynx?
The carotid body, which detects changes in blood oxygen and carbon dioxide levels, sends sensory information to the brain via which nerve?
The carotid body, which detects changes in blood oxygen and carbon dioxide levels, sends sensory information to the brain via which nerve?
A patient presents with loss of taste sensation on the posterior one-third of the tongue and difficulty swallowing. Which cranial nerve is most likely affected?
A patient presents with loss of taste sensation on the posterior one-third of the tongue and difficulty swallowing. Which cranial nerve is most likely affected?
Which of the following cranial nerves provides somatic sensation to the skin on the back of the ear?
Which of the following cranial nerves provides somatic sensation to the skin on the back of the ear?
Which of the following would NOT be affected by damage to the hypoglossal nerve?
Which of the following would NOT be affected by damage to the hypoglossal nerve?
After a stroke, a patient has difficulty swallowing, a weak cough, and their uvula deviates to the left upon saying "Ahhh." Which cranial nerve is most likely affected?
After a stroke, a patient has difficulty swallowing, a weak cough, and their uvula deviates to the left upon saying "Ahhh." Which cranial nerve is most likely affected?
The efferent limb of the gag reflex is mediated by fibers within the:
The efferent limb of the gag reflex is mediated by fibers within the:
A patient has undergone a carotid endarterectomy. Post-operatively, they exhibit tongue deviation to the left upon protrusion. Which nerve was most likely damaged during the procedure?
A patient has undergone a carotid endarterectomy. Post-operatively, they exhibit tongue deviation to the left upon protrusion. Which nerve was most likely damaged during the procedure?
Which of the following cranial nerves carries general sensory information from the middle ear cavity?
Which of the following cranial nerves carries general sensory information from the middle ear cavity?
Which of the following cranial nerves contributes to the regulation of blood pressure through innervation of the carotid sinus?
Which of the following cranial nerves contributes to the regulation of blood pressure through innervation of the carotid sinus?
A patient is unable to shrug their right shoulder or turn their head to the left against resistance. This indicates a lesion of:
A patient is unable to shrug their right shoulder or turn their head to the left against resistance. This indicates a lesion of:
A patient has difficulty speaking and their tongue deviates to the left upon protrusion. This suggests damage to:
A patient has difficulty speaking and their tongue deviates to the left upon protrusion. This suggests damage to:
The gag reflex is mediated by which two cranial nerves?
The gag reflex is mediated by which two cranial nerves?
Which of the following best describes the course of the spinal accessory nerve?
Which of the following best describes the course of the spinal accessory nerve?
If the hypoglossal nerve is damaged, what would you expect to observe?
If the hypoglossal nerve is damaged, what would you expect to observe?
A patient cannot feel the gag reflex when the left side of their posterior tongue and pharynx is touched. However, when the right side is touched, a gag reflex occurs. What does this information tell you?
A patient cannot feel the gag reflex when the left side of their posterior tongue and pharynx is touched. However, when the right side is touched, a gag reflex occurs. What does this information tell you?
A patient has an isolated lesion affecting the nucleus ambiguus. Which of the following deficits would you MOST likely observe?
A patient has an isolated lesion affecting the nucleus ambiguus. Which of the following deficits would you MOST likely observe?
What is the effect on tongue movement of an UMN lesion affecting the hypoglossal nerve?
What is the effect on tongue movement of an UMN lesion affecting the hypoglossal nerve?
Following a traumatic injury, a patient is noted to have a weak gag reflex and difficulty swallowing. Further examination reveals loss of taste sensation on the posterior 1/3 of the tongue on the right side, but normal sensation on the left. What is the MOST likely location of the lesion causing these deficits?
Following a traumatic injury, a patient is noted to have a weak gag reflex and difficulty swallowing. Further examination reveals loss of taste sensation on the posterior 1/3 of the tongue on the right side, but normal sensation on the left. What is the MOST likely location of the lesion causing these deficits?
During a complex neurosurgical procedure near the cerebellopontine angle, a surgeon inadvertently damages a nerve as it exits the brainstem. Post-operatively, the patient exhibits a loss of gag reflex, hoarseness, and difficulty swallowing. Which of the following is the MOST likely nerve injured?
During a complex neurosurgical procedure near the cerebellopontine angle, a surgeon inadvertently damages a nerve as it exits the brainstem. Post-operatively, the patient exhibits a loss of gag reflex, hoarseness, and difficulty swallowing. Which of the following is the MOST likely nerve injured?
A patient comes to the emergency department with signs and symptoms suggestive of a stroke. Upon examination, the physician notes the following: loss of pain and temperature sensation on the right side of the face, loss of gag reflex, hoarseness, and the uvula deviates to the left. What is the MOST likely location of the stroke?
A patient comes to the emergency department with signs and symptoms suggestive of a stroke. Upon examination, the physician notes the following: loss of pain and temperature sensation on the right side of the face, loss of gag reflex, hoarseness, and the uvula deviates to the left. What is the MOST likely location of the stroke?
A patient presents with difficulty in protruding their tongue, and upon examination, fasciculations are observed on the left side of the tongue. MRI reveals an ischemic infarct in the medulla. Which of the folllowing is MOST likely the arterial supply affected?
A patient presents with difficulty in protruding their tongue, and upon examination, fasciculations are observed on the left side of the tongue. MRI reveals an ischemic infarct in the medulla. Which of the folllowing is MOST likely the arterial supply affected?
Flashcards
Vagus Nerve (X)
Vagus Nerve (X)
Exits the medulla and exits via the jugular foramen.
CN IX Taste Function
CN IX Taste Function
Taste from the posterior 1/3 of the tongue.
CN IX Motor Function
CN IX Motor Function
A nerve that innervates the stylopharyngeus muscle
Vagus Nerve Function
Vagus Nerve Function
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Motor Function of Vagus Nerve
Motor Function of Vagus Nerve
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CN XI Function
CN XI Function
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CN IX Nucleus Associations
CN IX Nucleus Associations
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CN XII (Hypoglossal) Function
CN XII (Hypoglossal) Function
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Nerves for Gag Reflex
Nerves for Gag Reflex
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CN XII (Hypoglossal) Lesion
CN XII (Hypoglossal) Lesion
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Cranial Accessory Nerve
Cranial Accessory Nerve
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Hypoglossal Nerve Rootlets
Hypoglossal Nerve Rootlets
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Performing a Gag Reflex Test
Performing a Gag Reflex Test
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Study Notes
Here are some study notes based on the provided text, formatted in bullet points, with 5 options to choose from:
- Option 1*
Cranial Nerves IX, X, and XI Overview
- CN IX, X, and XI exit the skull through the jugular foramen.
- CN IX is both sensory (S) and motor (M).
- IX is the glossopharyngeal nerve, X is the vagus nerve, ,and XI is the accessory nerve
Glossopharyngeal Nerve (IX)
- Target areas include the tongue and pharynx.
- It provides sensation from the posterior 1/3 of the tongue.
- Other target areas include the external ear, the tympanic membrane
- Taste sensation from the posterior 1/3 of tongue is a key function.
- Innervates the stylopharyngeus muscle (the only motor branch).
- Involved in swallowing, taste, and respiratory reflexes.
- Stimulates the parotid gland.
- Provides general sensation from the posterior 1/3 of the tongue, pharynx, the external ear, and the tympanic membrane.
- Provides visceral sensation from the carotid body and gag sensation from oropharynx,.
- Damage leads to loss of taste and gag reflex
Vagus Nerve (X)
- Longest course travels from head to abdomen.
- Exits the medulla via the jugular foramen.
- Innervates the smooth muscle and glands of the pharynx and larynx as well as thoracic and abdominal viscera
- It plays a role in somatic sensory and visceral sensory functions.
- Stretch receptors and chemoreceptors are also functions
- Wide supply to the pharynx and larynx.
- Is clinically tested by checking speech for hoarseness and assessing the gag reflex.
Accessory Nerve (XI)
- Functions in somatic motor functions to sternocleidomastoid and trapezius muscles.
- The nerve enters the cranial cavity, ascends, and enters the jugular foramen.
- Converges to form the spinal accessory nerve.
- Tested by shrugging shoulders and flexing neck while applying resistance
Cranial Accessory Nerve
- Much smaller (than the spinal component).
- Leaves from the nucleus ambiguus.
- Briefly contacts spinal accessory nerve
- Joins the vagus nerve and distributes with it so the pharyngeal and laryngeal muscles
Hypoglossal Nerve (XII)
- Functions in somatic motor function, to the extrinsic and intrinsic muscles. Excludes palatoglossus.
- Crosses the posterior cranial fossa between subarachnoid spaces and exits via the hypoglossal canal in the occipital bone.
- Fibers go to both sides and muscles of tongue are both sides ( exception is contralateral function with genioglossus
- Option 2*
Cranial Nerves IX, X, and XI - Overview
- These nerves exit the skull through the jugular foramen.
- CN IX is glossopharyngeal and is both sensory and motor.
Glossopharyngeal Nerve (IX)
- A mixed nerve (sensory and motor) targeting the tongue and pharynx.
- Sensory functions include taste from the posterior 1/3 of the tongue.
- Branches include: lingual sensation, tonsilar branch, and pharyngeal branch.
- Only motor branch targets anterolateral stylopharyngeus muscle.
- Involves swallowing, taste, and resp reflexes.
- Provides carotid body sensation and gag reflex.
- Lesions affect taste, tongue sensation, and gag reflex.
Vagus Nerve (X)
- Has the longest course, from the head to the abdomen and exists from medulla
- The nerve can be assessed for hoarseness and gag reflex
Accessory Nerve (XI)
- Controls sternocleidomastoid and trapezius.
- It enters into the jugular foramen.
Hypoglossal Nerve (XII)
- Somatic motor functions of extrinsic and intrinsic functions
- Exits via hypoglossal canal, and fibres go to both sides of tongue muscles
- Lesions cause tongue deviation
- Option 3*
CN IX, X, XI - Jugular Foramen Nerves
- These cranial nerves pass through the jugular foramen.
Glossopharyngeal Nerve (CN IX)
- Functions include saliva production, swallowing, gag reflex and has both sensory and motor components
- Carries taste sensation from the posterior 1/3 of the tongue.
- Has pharyngeal, tonsillar, and lingual distribution.
- Damage may cause pain in the ear during swelling of tonsils.
- Damage has the potential to cause the lack of a gag reflex or loss of taste.
Vagus Nerve (CN X)
- Longest cranial nerve.
- Supplies the larynx.
Accessory Nerve (XI)
- Controls muscles in the neck and shoulder.
- Is tested with head and shoulder movement against resistance
Cranial and Spinal Components
- Enters and exits through the jugular foramen.
- Distributes with vagus nerve.
Hypoglossal Nerve (CN XII)
- Controls Tongue muscles
- Injury causes the tongue to deviate to the weak side
- Option 4*
General Notes
- Cranial nerves 9, 10, and 11 all pass through the Jugular Foramen.
Glossopharyngeal Nerve (IX)
- Affects the tongue and pharynx
- A problem with this nerve results in loss of taste. Is tested when testing patients gag reflex
Vagus Nerve (X)
- Related to muscles of the soft palate and throat.
- Responsible for smooth muscle in the pharynx and the larynx.
Accessory Nerve (XI)
- Controls shoulder and neck muscles, trapezius, and sternocleidomastoid.
- Enters cranial space, then into jugular foramen.
Testing: Sternomastoid and Trapezius
- Shrug patient shoulders
- Neck flexing
Hypoglossal Nerve (XII)
- Contralateral control muscles to side of muscles
- Option 5*
CN IX, X, XI, XII: Key Cranial Nerves
- Overview of cranial nerves. Includes glossopharyngeal, vagus, accessory and hypoglossal
Glossopharyngeal Nerve (CN IX)
- Sensory + Motor Nerve
- Taste from back third of tongue, throat function. GAG REFLEX- pharynx, gag etc.
- Middle ear referred pain
- Lesions causes gag reflex is affected and not normal and taste is affected.
Vagus Nerve (CN X)
- Multiple areas innervated in the body!
- Tested clinically: Speak, Say "AH"- look at uvula to see if its midline, GAG reflex.
Spinal Accessory Nerve (CN XI)
- Motor nerve Function: Trapezius, SCM.
- Controls motor
- Testing: Ask patient to shrug shoulders against downwards pressure + Lateral Neck Flexion against pressure (SCM test).
Hypoglossal Nerve (CN XII)
- Motor function
- Have tongue sticking straight out- if injury will deviate towards injury side
- Have them push tongue onto cheek.
- Damage causes- dysarthria
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