Download The Cranial Nerves

The Cranial Nerves
山东大学医学院 解剖教研室
李振华
Names of cranial nerves
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Ⅰ Olfactory nerve
Ⅱ Optic nerve
Ⅲ Oculomotor nerve
Ⅳ Trochlear nerve
Ⅴ Trigeminal nerve
Ⅵ Abducent nerve
Ⅶ Facial nerve
Ⅷ Vestibulocochlear nerve
Ⅸ Glossopharyngeal nerve
Ⅹ Vagus nerve
Ⅺ Accessory nerve
Ⅻ Hypoglossal nerve
Functional components
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General somatic afferent fibers (GSA): transmit exteroceptive
and proprioceptive impulses from head and face to somatic
sensory nuclei
Special somatic afferent fibers (SSA): transmit sensory impulses
from special sense organs of vision, equilibrium and hearing to the
brain
General visceral afferent fibers (GVA): transmit interoceptive
impulses from the viscera to the visceral sensory nuclei
Special visceral afferent fibers (SVA): transmit sensory impulses
from special sense organs of smell and taste to the brain
General somatic efferent fibers (GSE): innervate skeletal
muscles of eye and tongue
Special visceral efferent fibers (SVE): transmit motor impulses
from the brain to skeletal muscles derived from brachial (gill)
arches of embryo. These include the muscles of mastication, facial
expression and swallowing
General visceral efferent fibers (GVE): transmit motor impulses
from the general visceral motor nuclei and relayed in
parasympathetic ganglions. The postganglionic fibers supply
cardiac muscles，smooth muscles and glands
Classification of cranial nerves
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Sensory cranial nerves: contain only afferent (sensory) fibers
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Motor cranial nerves: contain only efferent (motor) fibers
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ⅠOlfactory nerve
ⅡOptic nerve
Ⅷ Vestibulocochlear nerve
Ⅲ Oculomotor nerve
Ⅳ Trochlear nerve
ⅥAbducent nerve
Ⅺ Accessory nerv
Ⅻ Hypoglossal nerve
Mixed nerves: contain both sensory and motor fibers--
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ⅤTrigeminal nerve,
Ⅶ Facial nerve,
ⅨGlossopharyngeal nerve
ⅩVagus nerve
Sensory cranial nerves
N.
Location of cell
body and axon
categories
Cranial
exit
Terminal
nuclei
Main
action
Ⅰ
Olfactory cells
(SVA)
Cribrifom Olfactory
foramina bulb
Smell
Ⅱ
Ganglion cells
(SSA)
Optic
canal
Lateral
geniculate
body
Vision
Ⅷ
Vestibular
ganglion(SSA)
Internal
acoustic
meatus
Vestibular
nuclei
Equilibri
um
Cochlear
nuclei
Hearing
Cochlear
ganglion (SSA)
Olfactory nerve
Olfactory mucosa (SVA)→ Cribriform foramina → Olfactory
bulb
Optic nerve
Ganglion cell (SSA) → Optic canal → Lateral geniculate body
Vestibulocochlear nerve
Vestibular ganglion(SSA) ↘
Cochlear ganglion (SSA) ↗
↗ Vestibular nuclei
Internal acoustic meatus
↘ Cochlear nuclei
Motor cranial nerves
N.
Nucleus of origin and
axon categories
Cranial exit
Main action
Ⅲ
Nucleus of oculomotor
(GSE)
Superior orbital
fissure
Motot to superior, inferior
and medial recti; inferior
obliquus; levator
palpebrae superioris
Accessory nucleus of
oculomotor (GVE)
Parasympathetic to
sphincter pupillea and
ciliary muscl
Ⅳ
Nucleus of trochlear
nerve (GSE)
Superior orbital
fissure
Motor to superior obliquus
Ⅵ
Nucleus of abducent
nerve (GSE)
Superior orbital
fissure
Motor to lateral rectus
Ⅺ
Nucleus of accessory
nerve (SVE)
Jugular foramen
Motor to
sternocleidomastoid and
trapezius
Ⅻ
Nucleus of hypoglossal Hypoglossal canal
nerve( GSE)
Motot to muscles of
tongue
Oculomotor nerve
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Components
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Main action－supplies
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General somatic efferent fibers (GSE)
General visceral efferent fibers (GVE)
Superior, inferior and medial recti; inferior obliquus; levator palpebrae
superioris
Sphincter pupillea and ciliary muscle
Ciliary ganglion: lies between optic nerve and lateral rectus
Oculomotor nerve
Accessory nerve
Abducent nerve
Hypoglossal nerve
Hypoglossal nerve
Oculamotor paralysis
Abducent nerve injury
Mixed cranial nerves
Trigeminal nerve
Components of fibers
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SVE fibers: originate from motor nucleus of
trigeminal nerve, and supply masticatory
muscles
GSA fibers: transmit facial sensation to sensory
nuclei of trigeminal nerve, the GSA fibers have
their cell bodies in trigeminal ganglion, which lies
on the apex of petrous part of temporal bone
Branches
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Ophthalmic nerve
眼神经 (Ⅴ1, sensory)
leave the skull through
the superior orbital fissure,
to enter orbital cavity
Branches
 Frontal nerve额神经:
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Supratrochlear nerve
滑车上神经
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Supraorbital nerve
眶上神经
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Lacrimal nerve
泪腺神经
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Nasociliary nerve
鼻睫神经
Distribution:
 Sensation from
cerebral dura mater
 Visual organ
 Mucosa of nose
 Skin above the eye and
back of nose
Maxillary nerve
上颌神经(Ⅴ2, sensory)
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Leave skull through
foramen rotundum
Branches
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Infraorbital nerve
眶下神经
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Zygomatic nerve
颧神经
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Superior alveolar
nerve 上牙槽神经
Pterygopalatine nerve
翼腭神经
Distribution:
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Sensation from cerebral
dura mater
Maxillary teeth
Mucosa of nose and
mouth
Skin between eye and
mouth
Mandibular nerve (Ⅴ3, mixed)
下颌神经
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Leave the skull through the
foramen ovale to enter the
infratemporal fossa
Branches
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Auriculotemporal nerve
耳颞神经
Buccal nerve 颊神经
Lingual nerve 舌神经
Inferior alveolar nerve下牙槽神经
Nerve of masticatory muscles
咀嚼肌神经
Distribution:
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Sensation from cerebral
dura mater
Teeth and gum of lower jaw
Mucosa of floor of mouth
Anterior 2/3 of tongue
Skin of auricular and
temporal regions and below
the mouth
Motor to masticatory
muscles, mylohyoid, and
anterior belly of digastric
Facial nerve (Ⅶ)
Components of fibers
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SVE fibers originate from nucleus of facial nerve, and supply
facial muscles
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GVE fibers derived from superior salivatory nucleus and relayed
in pterygopalatine ganglion and submandibular ganglion. The
postganglionic fibers supply lacrimal, submandibular and
sublingual glands
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SVA fiber from taste buds of anterior two-thirds of tongue which
cell bodies are in the geniculate ganglion of the facial nerve and
end by synapsing with cells of nucleus of solitary tract
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GSA fibers from skin of external ear
Course: leaves skull
through internal acoustic
meatus, facial canal and
stylomastoid foramen, it
then enters parotid gland
where it divides into five
branches which supply
facial muscles
Branches within the facial canal
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Chorda tympani 鼓索: joins lingual branch of mandibular nerve
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To taste buds on anterior two-thirds of tongue
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Relayed in submandibular ganglion, the postganglionic fibers supply
submandibular and sublingual glands
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Greater petrosal nerve岩大神经: GVE fibers pass to pterygopalatine
ganglion 翼腭神经节 and there relayed through the zygomatic and
lacrimal nerves to lacrimal gland
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Stapedial nerve 镫骨肌神经: to stapedius
Branches outside of facial canal
 Temporal
 Zygomatic
 Buccal
 Marginal mandibular
 Cervical
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Pterygopalatine ganglion 翼腭神经节 : lies in
pterygopalatine fossa under maxillary nerve
Submandibular ganglion 下颌下神经节: lies between
lingual nerve and submandibular gland
Injury to the facial nerve
Glossopharyngeal nerve (Ⅸ)
Components of fibers
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SVE fibers: originate from nucleus ambiguus, and supply
stylopharygeus
GVE fibers: arise from inferior salivatory nucleus and ralyed
in otic ganglion, the postganglionic fibers supply parotid gland
SVA fibers: arise from the cells of inferior ganglion, the
central processes of these cells terminate in nucleus of
solitary tract, the peripheral processes supply the taste buds
on posterior third of tongue
GVA fibers: visceral sensation from mucosa of posterior third
of tongue, pharynx, auditory tube and tympanic cavity, carotid
sinus and glomus, and end by synapsing with cells of
nucleus of solitary tract
GSA fibers: sensation from skin of posterior surface of
auricle and
Course: leaves the skull via jugular foramen
Branches
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Lingual branches 舌支: to taste buds and mucosa of posterior third
of tongue
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Pharyngeal branches 咽支: take part in forming the pharyngeal
plexus
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Tympanic nerve 鼓室神经: GVE fibers via tympanic and lesser
petrosal nerves to otic ganglion, with postganglionic fibers via
auriculotemporal (Ⅴ3) to parotid gland
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Carotid sinus branch 颈动脉窦支: innervations to both carotid sinus
and glomus
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Others: tonsillar and stylophayngeal branches
Otic ganglion 耳神经节: situated just below foramen ovale
Vagus nerve (Ⅹ)
components of fibers
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GVE fibers: originate from dorsal nucleus of
vagus nerve, synapse in parasympathetic
ganglion, short postganglionic fibers innervate
cardiac muscles, smooth muscles and glands of
viscera
SVE fibers: originate from ambiguus, to muscles
of pharynx and larynx
GVA fibers: carry impulse from viscera in neck,
thoracic and abdominal cavity to nucleus of
solitary tract
GSA fiber: sensation from auricle, external
acoustic meatus and cerebral dura mater
Course
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Exits the skull from jugular foramen
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Descends in the neck in carotid sheath between
internal (or common) carotid artery and internal
jugular vein
Right vagus nerve
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Enter thoracic inlet on right side of trachea
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Travels downward posterior to right
brachiocephalic vein and superior vena cava
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Passes posterior to right lung root
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Forms posterior esophageal plexus
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Forms posterior vagal trunk at esophageal hiatus
where it leaves thorax and passes into abdominal
cavity, then divides into posterior gastric and celiac
branches
Left vagus nerve
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Enter thoracic inlet between left common
carotid and left subclavian arteries, posterior to
left brachiocephalic vein
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Crosses aortic arch where left recurrent
laryngeal nerve branches off
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Passes posterior to left lung root
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Forms anterior esophageal plexus
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Forms anterior vagal trunk at esophageal
hiatus where it leaves thorax and passes into
abdominal cavity , then divides into anterior
gastric and hepatic branches
Branches in neck
 Superior laryngeal nerve: passes down
side of pharynx and given rise to
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Internal branch, which pierces thyrohyoid
membrane to innervates mucous membrane of
larynx above fissure of glottis
External branch, which innervates cricothyroid
Cervical cardiac branches : descending to
terminate in cardiac plexus
Others: auricular, pharyngeal and
meningeal branches
Superior laryngeal nerve
Internal branch
External branch
Branches in thorax
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Recurrent laryngeal nerves
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Right one hooks around right subclavian
artery, left one hooks aortic arch
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Both ascend in tracheo-esophageal
groove
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Nerves enter larynx posterior to
cricothyroid joint, the nerve is now
called inferior laryngeal nerve
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Innervations: laryngeal mucosa below
fissure of glottis , all laryngeal laryngeal
muscles except cricothyroid
Bronchial and esophageal branches
Branches in abdomen
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Anterior and posterior gastric
branches
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Run close to lesser curvature
and innervate anterior and
posterior surfaces of stomach
As far as pyloric antrum to fan
out into branches in a way like
the digits of a crow’s foot to
supply pyloric part
Hepatic branches: join hepatic
plexus and then supply liver and
gallbladder
Celiac branches: send
branches to celiac plexus to be
distributed with sympathetic
fibers to liver, pancreas, spleen,
kidneys, intestine as far as left
colic flexure