The Cave- CNVII palsy, median nerve course

The seventh nerve lies in the pons near 6

Leaves with 8 through the C P angle
Into the facial canal
To become the geniculate ganglion

There’re branches to the stapedius and lacrimal glands
Chorda tympani joins it there
Then seven leaves via
Stylomastoid foramen through the parotids

The zebra bit my cat
There’s bilateral
Cortical representation
Of the upper face, hence these muscles are
Preserved in UMN lesion

In Bell’s phenomenon,
The patient tries to shut
The eye on the affected side
The eyeball moves upwards
and the eyelid
closes incompletely/

From brainstem there’re vascular, tumour and MS
CP Angle lesions like acoustic neuroma
Then petrous temporal bone like Bell’s palsy, Ramsay Hunt, OM, fracture

In the parotid there’s tumour, surgery
Let’s not forget sarcoidosis too
Ramsay’s hunt when there’s Herpes zoster infection in the GG

Bell’s palsy is idiopathic
Give eye drops and eye patch and PT
Tarsorraphy for chronic non-resolving cases

Oral prednisolone and acyclovir,
Check for facial synkinesis
7 regenerates anomalously
So you cry when you masticate

The median nerve forms from medial and lateral cord
In the axilla to the cubital fossa
In the forearm between 2 heads of pronator teres giving off AIN (pure motor)

In the wrist between FCR and FDS
Giving off palmar cutaneous branch
Then into carpal tunnel below flexor retinaculum

The ulnar nerve forms from medial cord in axilla
In the elbow behind medial epicondyle groove
In the forearm between 2 heads of FCU first giving off dorsal cutaneous

In the wrist between FCU and FDS
Giving off palmar cutaneous branch
Then into the hand above flexor retinaculum

The radial nerve forms from posterior cord in axilla
In spiral groove then in cubital fossa
Where it divides into superficial branch and deep branch aka PIN


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