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Cranial nerves Extension of CNS I: Olfactory N II: Optic N Related to eye movements III: Oculomotor N IV: Trochlear N VI: Abducens N Related to face V: Trigeminal N VII: Facial N VIII: Vestibulocochlear N IX: Glossopharyngeal N X: Vagus N XI: Accessory N XII: Hypoglossal N Cranial 1 Olfactory N Cranial 2 Optic N Optic chiasm Pituitary gland Cranial 3 CN: III, IV, VI for Extraocular muscles (EOM) Superior rectus Inferior rectus Medial rectus Lateral rectus Superior oblique Inferior oblique Right eye Cranial 4 Oculomotor N Components Somatic motor Extraocular muscles (EOM): SR, IR, MR, IO Levator palpebre superioris muscle Visceral motor (parasympathetic) Sphincter pupillae muscle Ciliary muscle Course: from midbrain, finally through superior orbital fissure Cranial 5 CN III palsy Functions Movements of eye Elevation of upper eyelid Constriction of pupil (parsympathetic) Palsy EOM weakness Diplopia Strabismus Drooping of eyelid (ptosis) Pupil dilatation (miosis) Cranial 6 CN III palsy Cranial 7 Trigeminal N General sensory nerves for head / face Ophthalmic nerve (V1): pure sensory, smallest Maxillary nerve (V2): pure sensory Mandibular nerve (V3): mixed motor/sensory, largest Motor nerves for muscles of mastication Cranial 8 Cranial 9 Ophthalmic N (V1) thru’ cavernous sinus, superior orbital fissure Frontal n Lacrimal n Nasocilary n Cranial 10 Cranial 11 Maxillary N (V2) thru’ foramen rotundum, cavenous sinus with meningeal branch Zygomatic n Infraorbital n Superior alveolar n Cranial 12 Foramen rotundum Cranial 13 Mandibular N (V3) thru’ foramen ovale Motor fibers to m. of mastication Sensory fibers Meningeal branches Auriculotemporal N Buccal N Lingual N Inferior alveolar N Cranial 14 Foramen ovale Cranial 15 Cranial 16 III IV VI V1 V2 Pit. ICA Air sinus Cranial 17 Venous sinus Facial N: motor branches Facial canal N. to stapedius Stylomastoid foramen Facial motor branches (within parotid glands): Temporal, Zygomatic, Buccal, Mandibular, Cervical to Stylohyoid; post. belly of digastic Cranial 18 “Sensory root” of Facial N Taste fibers Chorda tympani N. from anterior 2/3 of tongue Greater petrosal N. from soft palate Pre-ganglionic parasympathetic fibers to Submandibular ganglion Submandibular; Sublingual Pterygopalatine ganglion Lacrimal galnds Glands of nasal/palatine mucosa Cranial 19 Facial canal Greater petrosal: soft palate Chorda tympani: to Tongue (2/3) Cranial 20 Cranial 21 Facial palsy of peripheral lesion Cranial 22 Boy shot in face is robbed of his smile Jordan, 13, said yesterday: “My face is still very sore. My mates have been round to cheer me up but when I try to laugh I can’t - it is very painful.” http://iservice.libertytimes.com.tw/liveNews/news.php?no=639359&type=%E5%9C%8B%E9%9A%9B http://www.thesun.co.uk/sol/homepage/news/4311689/Boy-shot-in-face-is-robbed-of-his-smile-TeenagerJordan-Winstanley-was-hit-with-an-air-gun-pellet-shot-by-a-mystery-sniper-hiding-in-bushes.html Cranial 23 Glossopharyngeal N from medulla, leave skull thru’ jugular foramen Motor to stylopharyhgeal m. Sensory Taste: post. 1/3 of tongue General: pharynx, post. 1/3 of tongue Parasympathetic: parotid gland Cranial 24 CN 9 (+10) palsy Cranial 25 Vagus N: course from Medulla; pass thru’ Jugular foramen Neck: carotid sheath with jugular v. and carotid a. recurrent laryngeal n for vocal cord Parasympathetic innervation Thoracic viscera abdomen viscera Cranial 26 Vagus Aorta Recurrent laryngeal N Cranial 27 Vagus N Cranial 28 Accessory N: Components Spinal roots of CN XI from motor neurons of cervical cord (C1-C6) unite to form a trunk thru’ foramen magnum innervate sternocleidomatoid / trapezius m. Cranial roots of CN XI together with vagus N. to innervate skeletal muscles of pharynx / palate Cranial 29 Accessory N: Course Spinal roots Cranial 30 Accessory N: Course SCM CN XI Cranial 31 Hypoglossal N from medulla, via Hypoglossal canal Motor branches to tongue All intrinsic tongue m. Extrinsic tongue m. Styloglossus, Hyoglossus, Genioglossus (exception: palatoglossus by CN 9/10) Cranial 32 Hypoglossal N Styloid proc. Hypoglossal canal Mental spine Hyoid Cranial 33 Palsy of Hypoglossal nerve, right Cranial 34 Cranial N: Review Pathway of cranial nerves Course, Termination Functions of cranial nerves Motor Sensory: general, special Autonomic Loss of functions related to location of lesion Cranial 35
