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Lecture 1: CNS Overview - Paulman Cranial Nerves o Mnemonics On old Olympus' towering top a Fin and German viewed some hops Some say marry money but my brother says big brains matter more o Cranial Nerve I – Olfactory Whiff, c diff, sensory sniff o Cranial Nerve II – Optic Sensory nerve for eye Central and peripheral sight o Cranial Nerve III – Oculomotor Pupil constricting Eyes moving Prevent eyelid dropping o Cranial Nerve IV – Trochlear Works superior oblique Hard to look down if weak o Cranial Nerve V – Trigeminal Mastication Sensory and motor face sensation o Cranial Nerve VI – Abducens Eye abduction Motor nerve for motion Prevent double vision o Cranial Nerve VII – Facial Facial expression Sensory and motor 2/3 taste sensation o Cranial Nerve VIII – Vestibulocochlear Body balanced Used for the ear, sound sensor Sensory Lecture 1: CNS Overview - Paulman o Cranial Nerve IX – Glossopharyngeal Sensory 1/3 back of tongue taste Helps us swallow o Cranial Nerve X – Vagus Lets us speak and stay Dysphagia Sensory and motor Longest nerve in body Parasympathetic innervation to a large part of body Heart, larynx, trachea, bronchi, lungs, liver, gallbladder, stomach, pancreas, kidney, SI, proximal LI, left colic flexure dividing sacral parasympathetic supply from cranial supply o Cranial Nerve XI – Spinal Accessory Shrug your shoulders Test head resistance o Cranial Nerve XII – Hypoglossal Tongue movement Lecture 1 – CNS Overview Central Nervous System (CNS) o Brain, spinal cord, meninges Neurons and glia Peripheral Nervous System (PNS) o Axons, dendrites, ganglia o Autonomic Nervous system (ANS) Part of the PNS 2 components o Parasympathetic “Always on” Vegetative Functions: Lecture 1: CNS Overview - Paulman Respiration, peristalsis, steady heart rate, glandular secretion Smooth muscle and organs only None in body wall Cranio (4 nerves)-sacral (S2-S4) outflow (visceral afferent/efferent) o CN III, VII, IX and X Somatic – 1 neuron Efferent: controls striated (skeletal) muscle (SE) Afferent: Info from body wall and outside world into CNS (SA) Neuron inside CNS, no peripheral Visceral – 2 neurons Efferent: controls smooth muscle, glandular secretion (VE) Afferent: info from organs/tissues into CNS (VA) Send info out to sympathetic trunk. In SCG it synapses in neuron. Effector neuron sends out. Found in CNS and PNS All in the brain are autonomics o Sympathetic “Always off” Fight or flight response Increase heart rate, respiration, blood pressure Decrease peristalsis, reproductive function, digestion Thoraco-lumbar outflow (visceral afferent/efferent) T1 L2 (where it synapses) Brain lobes o Parietal initiating action o Occipital farthest from eyes, visual cortex Lecture 1: CNS Overview - Paulman o Temporal lobe coordination of sensory input, decision where to send info in brain to final processing o Brain stem cerebellum (coordination and motor function) Where info comes into brain and it is organized Sending info into right places o Hemispheres Both are mixed with art and logical, some areas are localized Left temporal lobe speech Right temporal lobe music Brain connects from side to side by the Corpus callosum (connecting body) Mass intermedia and something else (commissure?) Spinal cord o Brain matter and cell bodies are on the inside opposite of the brain Skull o Cranium made of bone, arteries, veins and nerves o 3 parts 1 – Outer table – very dense, hard 2 – Diploe – spongy bone, soft, vascular 3 – Inner table – very dense, hard o Not well vascularized from the outside o Receives most blood from dural arteries o Fixed in placed with plates/screws post-op o Bones Neurocranium Bony shell surrounding brain and meninges Calvarium “Skullcap” o Made of frontal, parietal and occipital bone De novo from mesenchymal cells Viscerocranium Facial skeleton Lecture 1: CNS Overview - Paulman Cartilaginous precursors and ossifies Bones arise from pharyngeal arch precursors (Gills, later) o Borders of the fossae Btwn anterior and middle is posterior border of lesser wing of sphenoid bone and sphenoid limbus (Central) Btwn middle and posterior made of petrous ridges of temporal bones laterally and posterior clinoid processes of the occipital bone centrally Anterior Fossa Cribriform plate (CN I) Middle Fossa Optic canal—CN II and ophthalmic artery Superior orbital fissure—CN III, IV, V1, VI, ophthalmic veins Foramen rotundum—CN V2 Foramen ovale—CN V3 Foramen spinosum—middle meningeal artery Foramen lacerum—nothing of consequence Posterior Fossa Internal auditory (acoustic) meatus—CN VII, VIII, labyrinthine artery Jugular foramen—CN IX, X, XI and superior jugular bulb (and inferior petrosal sinus)—origin of internal jugular vein Hypoglossal canal—CN XII Foramen magnum—spinal cord, meninges, CSF, spinal arteries / veins, vertebral arteries, Scalp o Innervation Anterior CN V Posterior cervical nerves o SCAL Skin Connective tissue (dense) Lecture 1: CNS Overview - Paulman Aponeurosis epicranial aponeurosis, broad flat tendon LCT Pericranium inner layer o Inner layer pericranium, diff than other periostea, continuous through numerous opening of skulll with dura matter o Clinical implications Coronal cuts gape badly Sagittal ones don’t gape Loose areolar layer allows the scalp to move on the skull but also provides a pathway for things to move around Fractures Hard to break skull Worst case scenario “Coup-Countrecoup” o Hit in forehead and distribute waves of impact around skull, so once waves goes to back, force hits force, cancel each other out and get fracture in back Veins o Superficial, everything goes to the jugular veins o Emissary veins Connect skull veins to the dural sinuses inside cranial cavity Some penetrate from scalp to dural sinuses o Clinical implications Meningitis Lymphatic o Many lymph channel, but few nodes which first appear in the collar (of cranial system)