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4050 final reviewFace PowerPointWhich cranial supply sensory and motor functions of the face? Sensory from face: Trigeminal nerve V Motor from face: Facial nerve(VII)Sensory from face: Trigeminal nerve (V)• Cutaneous sensations from face (pain&touch): trigeminal Vo Proprioception from face: Facial (VII)• Touch from cornea of eye and nasal mucosa: Trigeminal (V) off ophthalmic branch• Teeth and gums: trigeminal (V)• Skin of external ear and EAC: Vagus (X) with some (V)Branching of V· Trigeminal (V) has 3 brancheso Ophthalmic: sensoryo Maxillary: sensoryo Mandibular: sensory and motor for masticationTesting sensory of V in face:· With eyes closed, stroke above eyebrows to test ophthalmic branch. Stroke upper lip to test maxillary branch. Stroke between lower lip and chin to test mandibular branch.· Touching pinna or EAC test vagus nerve (X)Motor innervation to muscles of facial expression: facial nerve (VII)· Bilateral UMN innervation to the upper face· Unilateral UMN innervation is contralateral to the lower face· LMNs innervate the whole face on the same side as the cranial nerveBranching of VII· VII facial brancheso SVE to muscles of facial expression including muscles to close the eyeo GVE to lacrimal glands, nasal mucosa, and some salivary glands· Facial nerve (VII) also mediates visceral innervation to lacrimal glands, nasal mucosa, and sali-vary glands· Facial nerve (VII) also innervates stapedius muscleo VII: dampens vibrations of the ossicles associated with loud noises (stapedius muscle)o V: dampens vibrations of the ossicles associated with noise of chewing (tensor tympani)Pathology of motor of face (VII)· UMN lesion (cerebral stroke)o Complete involvement below eye, some involvement around eye, little difficulty with forehead (only applies for voluntary movement, not emotionally initiated movement)· LMN lesion: Moebius syndrome, bilateral congenital atrophy of VII. Bell’s palsy, unilateral com-pression,o Paralysis of the entire side of face ipsilateral to compression site.Testing motor of VII in face:· Look for asymmetry of face at rest· Wrinkle forehead and look up· Close eyes as tightly as possible· Smile, pucker lips, pout lipsWhole side of face affected = ________lesion on ipsilateral side, associated with _________dysarthria Lower face affected, with some weakness of upper face = ___________ lesion on the contralat-eral side associated with ________ dysarthria. corticospinal tract UMNTONGUE4050 final reviewWhich cranial nerves supply sensory and motor functions of the tongue? Tongue has 2 types of sensa-tion (taste and touch) and is also able to move. Each of these functions is filled by different cranial nerves· Sensory: trigeminal (V), mandibular branch Glossopharyngeal (IX)· Motor: Hypoglossal (XII)General Sensory: touch on tongue· General sensory (touch): anterior 2/3 of tongue, (V) trigeminal nerve· General and special sensory (touch and taste): posterior 1/3 of tongue, (IX) glossopharyngeal nerveSpecial sensory: taste on tongue· Special sensory (taste): anterior 2/3 of tongue, (VII) facial nerve· General and special sensory (touch and taste): posterior 1/3 of tongue, (IX) glossopharyngeal nerveClinical testing of sensory functions of tongue:· Swab dipped in flavored solutiono Tests taste (function of special sensory branch of VII)o Tests touch (function of mandibular branch, general sensory of V)Motor functions of tongue: All tongue movement - (XII) hypoglossal nerve· Motor input to muscles that change the tongue’s shapeo Shorten, narrow, elongate, flatten, and make concave· Move the tongue through spaceo Protrude, draw tongue up and back. Retract and depressTesting tongue movement:· Protrude tongue (deviation to side of injured cranial nerve)· Lateralize tongue to corners of mouth or to internal cheek (inability to lateralize on side of in-jured cranial nerve)· Elevate tongue while you hold chin down· Look for involuntary movements and wasting away of the tongueClinical pathology of tongue in different dysarthrias:· Flaccid dysarthria: look for atrophy, changes in functional ability and involuntary movement· Spastic dysarthria: articulation in imprecise and distorted because muscles are too tight· Ataxic dysarthria: articulation is sometimes precise, sometimes not, due to discoordination· Hyperkinetic dysarthria: tongue may move involuntarilyLower jawWhich cranial nerves supply muscles used for movement of mandible? · Sensory: Trigeminal (V) proprioception from jaw· Motor: trigeminal (V) mandibular branch, movement of jawJaw movement: Trigeminal (V) mandibular branch, motor input to muscles that close and open jaw and more the jaw laterallyPathology of motor V· LMN lesion of mandibular branch: flaccid paresis or paralysis of the ipsilateral muscles of masti-cation. Slight deviation of jaw to the same side as the damaged LMN· Unilateral UMN disease is unlikely to affect function, because of bilateral innervationTesting motor of trigeminal nerve (LMN damages)· Palpate area of masseter as patient bites down as hard as possible, then relaxes· Look for atrophy of the temporal muscle4050 final review· Jaw closing while you hold chin down and forehead in place. Client bites down hard against re-sistance· Jaw opening with resistance under chin· Patient moves jaw side to sideSoft palateWhich cranial nerves supply muscles used for movements of soft palate? Soft palate has sensation and isable to move. · Sensory: Glossopharyngeal nerve (IX)· Motor: Trigeminal (V) and Vagus nerve (X)Sensory innervation of soft palate· Glossopharyngeal (IX) mediates sensation from soft palate, posterior 1/3 of tongue, tonsils, and pharynx. Also mediates sensation from the middle earMotor innervation of soft palate· Vagus (X) provides provides primary innervation of soft palate· Trigeminal (V) partially responsible for flattening and tensing of soft palate, and opens Eu-stachian tube. Testing soft palate movement· Motor (V&X): soft palate should raise symmetrically when producing /a/, raise so no nasality is heard on oral soundsClinical presentation of dysarthria of soft palate:· Flaccid dysarthria: consistently hypernasal, because soft palate cannot lift at all· Spastic dysarthria: consistently hypernasal, muscles cannot reach posterior pharynx· Ataxic dysarthria: inconsistent hypernasality; cannot coordinate timing of palate liftingPharynxWhich cranial nerves supply muscles for sensation and movements of pharynx?·


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UNT SPHS 4050 - Face PowerPoint

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