Cranial Nerves Module 1
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Questions and Answers

What is the usual duration of trigeminal neuralgia attacks?

  • 2-3 hours
  • Less than 1 hour
  • Up to 24 hours
  • 1-2 hours (correct)

    • What is the cause of Bell's palsy?

  • Viral infection
  • Edema or trauma
  • Unknown (idiopathic) (correct)
  • Tumor pressure

    • What is facial synkinesis?

  • A type of vestibular nerve disorder
  • A voluntary muscle movement causing simultaneous involuntary contraction of other facial muscles or glands (correct)
  • A type of paralysis
  • A type of trigeminal neuralgia

    • What is the main function of the vestibular nerve?

    <p>Balance and coordination</p> Signup and view all the answers

    What is the term for a complete or partial loss of function, often accompanied by weakness and loss of sensation?

    <p>Paralysis</p> Signup and view all the answers

    What is the term for paralysis with sustained tone (spasm) in the affected muscles?

    <p>Spastic paralysis</p> Signup and view all the answers

    What is Bell's palsy?

    <p>A form of flaccid paralysis of CN VII</p> Signup and view all the answers

    What is the goal of facial retraining (Mime Therapy) for Bell's palsy patients?

    <p>To develop a conscious connection between facial muscles and emotional expression</p> Signup and view all the answers

    Which cranial nerve is responsible for the sensation of smell?

    <p>Olfactory nerve</p> Signup and view all the answers

    Which of the following cranial nerves is responsible for parasympathetic control of the heart?

    <p>Vagus nerve</p> Signup and view all the answers

    Which cranial nerve has 3 divisions: Ophthalmic, Maxillary, and Mandibular?

    <p>Trigeminal nerve</p> Signup and view all the answers

    Which cranial nerve is responsible for the movement of the tongue?

    <p>Hypoglossal nerve</p> Signup and view all the answers

    What is the typical characteristic of trigeminal neuralgia?

    <p>Sudden, shock-like facial pain</p> Signup and view all the answers

    Which cranial nerve is responsible for the sensation of taste in the posterior one-third of the tongue?

    <p>Glossopharyngeal nerve</p> Signup and view all the answers

    Which cranial nerve is responsible for the movement of the muscles of facial expression?

    <p>Facial nerve</p> Signup and view all the answers

    Which cranial nerve is responsible for the sensation of hearing and balance?

    <p>Auditory-Vestibular nerve</p> Signup and view all the answers

    What is the primary function of the cochlear nerve?

    <p>To enable hearing</p> Signup and view all the answers

    What is the role of the inner ear semicircular canals?

    <p>To detect various motions of the head and body</p> Signup and view all the answers

    What is the result of otoliths ending up in the semicircular canals?

    <p>Misperception that the environment is spinning (vertigo)</p> Signup and view all the answers

    What is the most common type of dizziness?

    <p>Vertigo</p> Signup and view all the answers

    What is the typical trigger for benign paroxysmal positional vertigo (BPPV)?

    <p>Quick changes in head position</p> Signup and view all the answers

    What is the primary goal of Epley maneuvers?

    <p>To remove ear crystals from the semicircular canals</p> Signup and view all the answers

    What is cervicogenic dizziness?

    <p>Dizziness related to neck issues including muscle tension</p> Signup and view all the answers

    What should be ruled out before diagnosing cervicogenic dizziness?

    <p>Many other possible causes of dizziness</p> Signup and view all the answers

    What is the main cause of the occlusion mentioned in the content?

    <p>Osteophytes on the neck vertebrae</p> Signup and view all the answers

    Which of the following organs is NOT supplied by the vagus nerve?

    <p>Adrenal glands</p> Signup and view all the answers

    What is the main function of the Accessory nerve?

    <p>Motor to sternocleidomastoid and trapezius</p> Signup and view all the answers

    What is the typical presentation of a patient with acquired torticollis?

    <p>Head twisted to the opposite side and chin pointed towards the affected shoulder</p> Signup and view all the answers

    What is the function of the epidural space?

    <p>Filled with adipose and connective tissue</p> Signup and view all the answers

    What is the characteristic of the arachnoid membrane?

    <p>Spiderweb consistency</p> Signup and view all the answers

    What is the function of the subarachnoid space?

    <p>Filled with CSF</p> Signup and view all the answers

    What is the characteristic of the pia mater?

    <p>Thin and fragile</p> Signup and view all the answers

    What is the primary function of the choroid plexus in the ventricular system?

    <p>To produce cerebrospinal fluid</p> Signup and view all the answers

    What is a characteristic of a ganglion?

    <p>A collection of neurons in the peripheral nervous system</p> Signup and view all the answers

    What is the term for a collection of neuronal cell bodies in the central nervous system?

    <p>Grey matter</p> Signup and view all the answers

    What is a common cause of meningitis?

    <p>All of the above</p> Signup and view all the answers

    What is the term for a collection of axons in the central nervous system?

    <p>White matter</p> Signup and view all the answers

    What is a symptom of meningitis?

    <p>Neck stiffness</p> Signup and view all the answers

    What is the primary function of HLA?

    <p>To distinguish between self and non-self antigens</p> Signup and view all the answers

    Which type of immunity is acquired through direct exposure to an antigen?

    <p>Active natural immunity</p> Signup and view all the answers

    What is the term for the ability to distinguish between self- and non-self antigens?

    <p>Immunologic tolerance</p> Signup and view all the answers

    What is the result of the failure of mechanisms that eliminate T- or B-cells that fail to differentiate between self and non-self antigens?

    <p>Autoimmune disorders</p> Signup and view all the answers

    Which type of immunity is passed from a mother to her fetus?

    <p>Passive natural immunity</p> Signup and view all the answers

    What is the purpose of injecting antibodies from one system to another?

    <p>To provide passive artificial immunity</p> Signup and view all the answers

    Why may the immune system attack the body's own tissues in autoimmune disorders?

    <p>Because the body tissue has similar characteristics to a microbe</p> Signup and view all the answers

    What is the term for the mounting of an immune response against the body's own tissues?

    <p>Autoimmunity</p> Signup and view all the answers

    What is the primary function of T-Helper cells in the immune system?

    <p>To activate and regulate the activities of other cell types</p> Signup and view all the answers

    Which type of T-cells is involved in down regulation of immune responses?

    <p>Regulatory T-cells</p> Signup and view all the answers

    What is necessary for T-cells to recognize and respond to an antigen?

    <p>MHC presentation</p> Signup and view all the answers

    What is the function of MHC genes in the immune system?

    <p>To determine tissue and blood compatibility</p> Signup and view all the answers

    Which type of T-cells is involved in killing tumour cells?

    <p>T-cytotoxic cells</p> Signup and view all the answers

    What is the term for the process of differentiating between self vs. non-self recognition and reaction?

    <p>Self-tolerance</p> Signup and view all the answers

    What is the role of T-cells in immune responses?

    <p>To communicate with other immune system cells</p> Signup and view all the answers

    What is the term for the substances released by T-cells to activate and regulate other immune system cells?

    <p>T-messenger compounds</p> Signup and view all the answers

    What is the primary mechanism of inflammation in glomerulonephritis?

    <p>Immune complex formation on the glomerular basement membrane</p> Signup and view all the answers

    What is the characteristic of the hypersensitivity response in Type IV?

    <p>Sub-acute or chronic inflammation with infiltration of lymphocytes and macrophages</p> Signup and view all the answers

    What is the common cause of polyarteritis nodosa?

    <p>Penicillin or hepatitis B virus</p> Signup and view all the answers

    What is the characteristic of contact dermatitis?

    <p>Delayed type of hypersensitive response</p> Signup and view all the answers

    What is the result of immune complex formation in glomerulonephritis?

    <p>Inflammation of the glomerulus</p> Signup and view all the answers

    What is the characteristic of graft rejection?

    <p>Sub-acute or chronic inflammation with infiltration of lymphocytes and macrophages</p> Signup and view all the answers

    What is the primary cause of symptoms in contact dermatitis?

    <p>Direct allergen activation of T-lymphocytes</p> Signup and view all the answers

    What is the common outcome of polyarteritis nodosa?

    <p>Fatal complication due to occlusion or rupture of blood vessels</p> Signup and view all the answers

    What is the role of auto-antibodies in autoimmune diseases?

    <p>To create an immune attack on self-molecules</p> Signup and view all the answers

    What is the term for the immune complex formed in rheumatoid arthritis?

    <p>Rheumatoid factor</p> Signup and view all the answers

    Which autoimmune disease is characterized by an immune attack on self-myelin in the CNS?

    <p>Multiple sclerosis</p> Signup and view all the answers

    What is the result of immune complexes gathering in target tissues in autoimmune diseases?

    <p>Inflammation and tissue destruction</p> Signup and view all the answers

    What is the neuroglial cell targeted by auto-antibodies in multiple sclerosis?

    <p>Oligodendrocyte</p> Signup and view all the answers

    What is the consequence of a hyper-reactivity to UV light in lupus?

    <p>Triggering of autoimmune disease</p> Signup and view all the answers

    What is the effect of auto-antibodies on acetylcholine receptors in Myasthenia Gravis?

    <p>Destruction of acetylcholine receptors</p> Signup and view all the answers

    Which autoimmune disease involves an immune attack on synovial membranes of joints?

    <p>Rheumatoid arthritis</p> Signup and view all the answers

    What is the characteristic of Anaphylaxis?

    <p>Systemic reaction that is life-threatening</p> Signup and view all the answers

    What occurs in the bronchi in Asthma?

    <p>Constriction of airways, edema, and increased secretion of thick mucus</p> Signup and view all the answers

    What is a characteristic of Urticaria (hives)?

    <p>Local wheals and erythema in the upper dermis</p> Signup and view all the answers

    What is a characteristic of Angioedema (Quincke’s edema, Angioneurotic edema)?

    <p>Generalized edema of skin, lips, face, tongue, pharynx, and/or mucosa</p> Signup and view all the answers

    What is true about Gastrointestinal food allergies?

    <p>Reaction begins shortly after food ingestion and symptoms are primarily seen in the GI tract, skin, and respiratory system</p> Signup and view all the answers

    What is the common site of involvement in Type I responses?

    <p>Both local (atopic) reactions and systemic reactions</p> Signup and view all the answers

    What is the characteristic of Allergic Rhinitis?

    <p>Edema and hypersecretion of mucosal lining of the nasopharyngeal cavities</p> Signup and view all the answers

    What is the severity of Type I responses?

    <p>Varying in severity, from mild to life-threatening</p> Signup and view all the answers

    Study Notes

    Cranial Nerves

    • There are 12 pairs of cranial nerves that arise from the brain stem and mostly innervate the head.
    • The 12 cranial nerves and their important functions are:
      • Olfactory nerve: sensation of smell
      • Optic nerve: sensation of vision
      • Oculomotor nerve: movements of the eye and eyelid, parasympathetic control of pupil size
      • Trochlear nerve: movements of the eye
      • Trigeminal nerve: sensation of touch to the face, movement of muscles of mastication (chewing)
      • Abducens nerve: movements of the eye
      • Facial nerve: movement of muscles of facial expression, sensation of taste in anterior two-thirds of the tongue
      • Auditory-Vestibular nerve: sensation of hearing and balance
      • Glossopharyngeal nerve: movement of muscles in the throat, parasympathetic control of the salivary glands, sensation of taste in posterior one-third of the tongue, detection of blood pressure changes in the aorta
      • Vagus nerve: parasympathetic control of the heart, lungs, and abdominal organs, sensation of pain associated with viscera, movement of muscles in the throat
      • Spinal Accessory nerve: movement of muscles in the throat and neck
      • Hypoglossal nerve: movement of the tongue

    Cranial Nerve V: Trigeminal

    • The trigeminal nerve supplies sensations to the face and other structures of the head.
    • It has 3 divisions: ophthalmic, maxillary, and mandibular.
    • The mandibular division is motor for the muscles of mastication, including the masseter and temporals.
    • Trigeminal neuralgia is a painful condition characterized by extreme, sporadic, sudden shock-like facial pain in the areas of the face where the branches of the nerve are distributed.

    Cranial Nerve VII: Facial

    • The facial nerve is efferent to the muscles of facial expression, lacrimal (tear) glands, and two salivary glands.
    • Bell's palsy is a form of flaccid paralysis of CN VII, characterized by sudden onset, usually unilateral, and may be due to edema, viral infections, trauma, or pressure from a tumor.
    • Facial synkinesis is a condition where voluntary muscle movement causes simultaneous involuntary contraction of other facial muscles or glands.

    Cranial Nerve VIII: The Vestibulocochlear Nerve

    • The vestibulocochlear nerve consists of two separate nerves: the vestibular nerve and the cochlear nerve.
    • The vestibular nerve is responsible for maintaining balance, while the cochlear nerve is responsible for hearing.
    • The inner ear semicircular canals are filled with fluid and contain calcium carbonate crystals (otoliths) embedded in a membrane outside the semicircular canals, which are involved in the detection of various motions of the head and body.

    Cranial Nerve X: Vagus

    • The vagus nerve supplies motor parasympathetic fibers to all organs (except the adrenal glands) from the neck down to the second segment of the transverse colon.
    • It also controls a few skeletal muscles, including the muscles of the larynx.
    • The vagus nerve is responsible for various tasks such as heart rate, gastrointestinal peristalsis, sweating, and muscle movements in the mouth, including speech.

    Cranial Nerve XI: Accessory

    • This nerve is motor to sternocleidomastoid (SCM) and trapezius.
    • Patients with acquired torticollis (wry neck) present with the head twisted to the affected side and the chin pointed toward the opposite shoulder.

    The Meninges

    • The meninges protect the CNS from the overlying bone and are composed of:
      • Epidural space: adipose and connective tissue filled space between the wall of the vertebral canal and the dura mater
      • Dura mater: outermost layer, a tough inelastic surrounding
      • Subdural space: interstitial fluid-filled space between the dura mater and arachnoid membrane
      • Arachnoid membrane: middle layer with a spiderweb consistency
      • Subarachnoid space: CSF-filled space between arachnoid membrane and pia mater
      • Pia mater: innermost layer that adheres closely to the surface of the brain

    Meningitis

    • Meningitis is an inflammation of the meninges, usually caused by viral and bacterial infections.
    • Symptoms include neck stiffness, vomiting, fatigue, and confusion.
    • Other causes of meningitis include CSF leaks that can cause fluid to leak into the ears, nose, and spinal canal.

    The Ventricular System

    • The ventricular system is a fluid-filled cavern and canal system inside the brain.
    • CSF is produced by special tissue called choroid plexus in the ventricles of the cerebral hemispheres.

    Immune System Functions

    • T-cells work through cell-to-cell contact or by secreting messenger compounds to communicate with immune system cells.
    • T-cells can:
    • Attract cells
    • Prevent cells from leaving the area
    • Amplify the effectiveness of cells
    • Increase or decrease cell reactions
    • Activate and regulate B-cells
    • Signal natural killer cells
    • Increase local blood flow to facilitate immune cell movement
    • Determine if humoral or cellular immunity is needed

    T-Cell Functions

    • T-cells are involved in:
    • Differentiating between self vs. non-self recognition and reaction
    • Activating most cells and IgE's in allergen responses
    • Rejecting foreign tissue grafts
    • Controlling intracellular (viral) infections
    • Killing tumor cells

    Types of T-Cells

    • T-Helper cells (CD-4 cells):
    • Up-regulate immune responses
    • Release T-messenger compounds to activate and regulate other cell types
    • Activate B and T cells correctly depending on the type of immune challenge
    • Regulatory T-cells (Tregs):
    • Down-regulate immune responses
    • Suppress/modify immune responses
    • Decrease immune cell production
    • Control the mechanism to ensure the response matches the situation and healthy self-cells are not killed
    • T-cytotoxic cells (CD-8 cells):
    • Destroy identified/presented antigens
    • Kill virus-infected cells by various means (lytic enzymes, cytotoxins, perforins, interferon)
    • Involved in attacking cellular problems that antibodies cannot influence

    Self vs. Non-Self Recognition

    • T-cells recognize and respond to an antigen by:
    • Presenting the antigen through another cell or an antibody
    • Coding the antigen with a Major Histocompatibility Complex (MHC)
    • MHC determines tissue and blood compatibility
    • In humans, MHC is often called Human Leukocyte Antigens (HLA)

    Acquiring Immunity

    • Immunity can be acquired through:
    • Active natural immunity: develops through direct exposure to an antigen
    • Active artificial immunity: develops through purposeful introduction to an antigen (e.g., vaccines)
    • Passive immunity: passed from a mother to fetus, protecting the infant during the first few months of life
    • Passive artificial immunity: injecting antibodies from one system to another to help fight a current infection

    Auto-Immunity

    • Auto-immunity occurs when the immune system:
    • Mounts a response against the body's own tissues
    • Fails to differentiate between self- and non-self antigens
    • Examples of auto-immune diseases include:
    • Rheumatoid arthritis
    • Ankylosing spondylitis
    • Multiple sclerosis
    • Diabetes
    • Lupus (SLE)

    Type I Hypersensitivity

    • Type I responses vary in severity:
    • Mild, but annoying (e.g., seasonal allergies)
    • Severely debilitating (e.g., asthma)
    • Life-threatening (e.g., anaphylaxis)
    • Type I responses can vary based on the site of involvement:
    • Local (atopic) reactions
    • Systemic reactions (anaphylaxis)

    Local/Atopic Reactions

    • Examples of local/atopic reactions include:
    • Allergic rhinitis
    • Asthma
    • Urticaria (hives)
    • Angioedema (Quincke's edema)
    • Gastrointestinal food allergies

    Type IV Hypersensitivity

    • Type IV hypersensitivity is mediated by:
    • Specifically sensitized T-lymphocytes
    • Manifests as sub-acute or chronic inflammation with infiltration of the tissue by lymphocytes and macrophages
    • Examples of Type IV hypersensitivity include:
    • Contact dermatitis
    • Graft rejection

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    Description

    This quiz covers the 12 pairs of cranial nerves, their functions, and their roles in the central and peripheral nervous systems.

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