Neuiobiology

Cranial Nerves
1. Understand the function and anatomy of the cranial nerves and branches
2. Understand the clinical importance of the cranial parasympathetic system and otalgia
3. Understand the signs and symptoms of cranial nerve dysfunction
4. Appreciate the complexity of the cranial nerve distribution and pathway distribution and
gain experience of dealing with written clinical cases involving the cranial nerves

l LhoughL Lhe lecLure was rubblsh Llny plcLures and couldn'L really undersLand Lhe dude So l am
golng Lo use a LexLbook (neuroanaLomy Lhrough cllnlcal cases) for mosL of lL Lhen lf anyLhlng ln Lhe
ob[ecLlves above or Lhe lecLure lLself ls mlsslng l wlll go back and add LhaL ln Pope Lhls ls Ck
Also used Lhe 'Cranlal nerve Culde' as well
8ralnsLem orlglns of cranlal nerves
What are the components of the bra|nstem?
Mldbraln pons and medulla
Where |s the bra|nstem?
ln Lhe posLerlor fossa of Lhe cranlal cavlLy
What |s the super|or ||m|t of the bra|nstem and what structures does |t meet there?
1he mosL superlor (rosLral/fronL) componenL ls aL Lhe mlJbtoloJleocepbollc jooctloo where lL
meeLs Lhe Lhalamus and hypoLhalamus aL Lhe level of Lhe LenLorlum cerebelll
ow |s the bra|nstem d|v|ded?
1he mldbraln [olns Lhe pons aL Lhe pootomeseocepbollc jooctloo
1he pons [olns Lhe medulla aL Lhe pootomeJolloty jooctloo
1he medulla meeLs Lhe splnal cord (end of bralnsLem) aL Lhe cetvlcomeJolloty jooctloo aL Lhe level of
Lhe foramen magnum and pyramldal decussaLlon
Wh|ch cran|a| nerves or|g|nte outs|de the bra|nstem?
l ll olfacLory and opLlc
Wh|ch cran|a| nerves or|g|nate |n the m|dbra|n?
lll oculomoLor
Wh|ch cran|a| nerves or|g|nate |n the pons?
lv v vl vll Lrochlea Lrlgemlnal abducens and faclal
Wh|ch cran|a| nerves or|g|nate |n the medu||a?
vlll lx x xl xll vesLlbulocochlear glossopharyngeal vagus splnal accessory hypoglossal
Descr|be br|ef|y the course of the o|factory nerve
1he olfacLory bulbs and olfacLory LracLs run along Lhe venLral surface of Lhe fronLal lobes ln Lhe
olfacLory sulcl
8r|ef|y descr|be or|g|n of the opt|c nerve
1he opLlc nerves from each reLlna meeL aL Lhe opLlca chlasm formlg Lhe opLlc LracLs whlch wrap
laLerally around Lhe
mldbraln Lo enLer Lhe
laLeral genlculaLe
nuclel of Lhe
Lhalamus









Wh|ch nerves ex|t the bra|nstem ventra||y?
lll Lo xll all exlL venLrally wlLh Lhe excepLlon of lv whlch exlLs dorsally
Descr|be the or|g|n of the ocu|omotor nerve
1hls emerges
venLrally from Lhe
lnerpeduncular
fossa of Lhe
mldbraln passes
beLween Lhe
posLerlor cerebral
arLery and
superlor cerebral
arLery




Descr|be the or|g|n of the troch|ear nerve
1he Lrochlear nuerve exlLs Lhe mldbraln dorsally Lhe flbres also cross over as Lhey emergy whlch ls
unlque Lo Lhls nerve
Where does the tr|gem|na| nerve ex|t?
1he venLrolaLeral pons
Where does the abducens nerve ex|t?
venLrally aL Lhe ponLomedullary [uncLlon
Where do the fac|a| vest|bu|ococh|ear g|ossopharnyngea| and vagus nerve ex|t?
1hey exlL venLrolaLerally from Lhe pnodomedullary [uncLlon down Lo Lhe rosLral medulla
What |s the cerebe||opont|ne ang|e?
1he reglon where Lhe Cn vll vlll and lx exlL Lhe bralnsLem
Where does the sp|na| accessory nerve ex|t?
LaLerally from mulLlple rooLleLs along Lhe upper cervlcal cord
Where does the hypog|ossa| nerve ex|t?
LxlLs Lhe medulla venLrally beLween pyramlds and lnferlor ollvary nuclel

u|| Ioram|na and Cran|a| Nerve Lx|t o|nts
cN Nome xit loromen
l lfoctoty ctlbtlfotm llote
ll ptlc ptlc coool
lll colomotot 5opetlot tbltol llssote
lv 1tocbleot oetve 5opetlot tbltol llssote
v 1tlqemlool Netve v1 v2 vJ v1 sopetlot otbltol flssote
v2 fotomeo totooJom
vJ fotomeo ovole
vl AbJoceos 5opetlot otbltol flssote*
vll loclol oetve AoJltoty coool /stylomostolJ
fotomeo
vlll vestlbolococbleot AoJltoty coool
lx Clossopbotyoqeol Ioqolot fotomeo
x voqos Ioqolot fotomeo
xl 5plool occessoty oetve otets skoll fotomeo moqoom
leoves skoll joqolot fotomeo
xll nypoqlossol nypqoqlossol fotomeo/coool
O 1be obJoceos oetve fltst exlts tbe uoto tbtooqb uotellos coool tbeo ttovels polte o Jlstooce
befote exltloq tbe skoll ot tbe sopetlot otbltol flssote
Jic nerves exit vio te superior orbito/ fissure?
colomotot ttocbleo obJoceos (eosy to temembet eye movemeots) ooJ optbolmlc btoocb of tbe
ttlqemlool oetve
Jot ore te exit points of te tree bronces of te triqemino/ nerve?
v1 sopetlot otbltol flssote
v2 fotomeo totooJom
vJ fotomeo ovole
Jic nerves exit vio te juqu/or foromen?
Clossopbotyoqeol voqos splool occessoty oetves
Jic nerves exit vio te sty/omostoid foromen?
loclol oetve ooJ vestlbolococbleot
Jic ones ore /eft ?
lfoctoty ctlbtlfotm plote
ptlc optlc coool
nypoqlossol bypoqlossol coool

ensory and Motor Crgan|sat|on of the Cran|a| Nerves
8r|ef|y descr|be the organ|sat|on of the cran|a| nerve nuc|e| dur|ng embro|og|ca| deve|opment
1he cranlal nerve nuclel lnlLlally lle ad[acenL Lo Lhe venLrlcular sysLem ln common wlLh Lhe splnal
cord Lhe sensory nuclel lle dorsally whllsL Lhe moLor nuclel lle venLrally
As Lhe nervous syLem grows however Lhese form colums Lhree moLor columns and Lhree sensory
columns
What are the 6 co|umns of cran|a| nerve nuc|e| |n the bra|nstem?
8ranchlal moLor column speclal vlsceral efferenL
arasympaLheLlc column general vlsceral efferenL
SomaLlc moLor column general somaLlc efferenL
Spelcal somaLlc sensory column spelcal somaLlc afferenL
Ceneral somaLlc sensory column general somaLlc afferenL
vlsceral sensory column speclal vlsceral afferenL and general vlsceral afferenL
Wh|ch nuc|e| are part of the branch|a| motor co|umn and wh|ch nerves rece|ve |nput from them?
Splnal accessory nucleus Cn xl
laclal nucleus Cn vll
1rlgemlnal moLor nucleus Cn v
Wh|ch nuc|e| are part of the parasympathet|c co|umn and wh|ch nerves rece|pve |nput from them?
uorsal moLor nucleus of Cn x Cn x
lnferlor sallvaLory nucleus Cn lx
Superlor sallvaLory nucleus Cn vll
LdlngerWesLphal nucleus Cn lll
Wh|ch nuc|e| are part of the somat|c motor co|umn and wh|ch nerves rece|ve |nput from them?
Pypoglossal nucleus Cn lx
Abducens nucleus Cn vl
1rochlear nucleus Cn lv
CculomoLor nucleus Cn lll
Wh|ch nuc|e| are part of the v|scera| sensory co|umn and wh|ch nerves rece|ve |nput from them?
nucleus sollLarlus caudal porLlon (general vlsceral afferenL le cardloresplraLory nuclel) Cn lx
x
nucleus sollLarlus rosLral porLlon (speclal vlsceral afferenL le gusLaLory nucleus) Cn vll lx x
Wh|ch nuc|e| are part of the genera| somat|c sensory co|umn and wh|ch nerves rece|ve |nput from
them?
O 1he Lrlgemlnal nuclel Cn v vll lx x
4 Splnal Lrlgemlnal nucleus
4 Chlef sensory nucleus of Cn v Cn v
4 Mesencephallc nucleus of Cn v


What |s the funct|on of the somat|c motor nuc|e|?
1o provlde lnnervaLlon Lo Lhe exLraocular and lnsLrlnslc Longue muscles vla Cn lll lv vl and lx 1he
nuclel have Lhe same name as Lhe nerve Lhey supply
What |s the funct|on of the v|scera| motor nuc|e|?
1hls ls dlvded lnLo Lwo dlfferenL columns Lhe branchlal moLor nuclel and Lhe parasympaLhelc
moLor nuclel
1he branhclal moLor nuclel lnclude Lhe Lrlgemlnal moLor nucleus (Cn v) faclal nucleus (Cn vll)
nucleus amblguus (Cn lx x) and splnal accessory nucleus ( Cn xll)
1he branchlal moLor nucleus supplles sLrlaLed muscles lnvolved wlLh masLlcaLlon faclal expesslon
mlddle ear pharynx larynx sLernomasLold and upper porLlon of Lhe Lrapezlus

1he parasympaLheLlc nucleul are Lhe Ldlnger WesLphal nucleus (Cnlll) Lhe superlor sallvaLory
nucleus ( Cn vll) and Lhe lnferlor sallvaLory nucleus ( Cn lx) and Lhe dorsal moLor nucleus of Lhe
vagus (Cn x)
1hese parasympaLheLlc nucleu provlde preganlglonlc parasympaLheLlc flbres lnnervaLlng glands
smooLh muscle and cardlac muscle ln Lhe head hearL lungs and dlsgesLlve LracL proxlmal Lhe splenlc
flexure
What |s the funct|on of the v|scera| sensory co|umn?
1hls conLalns a slngle nucleus nucleus sollLarlus whlch ls dlvlded lnLo Lwo parLs
1he rosLral porLlon or gusLaLory nucleus recelves LasLe lnpuLs from prlmarlly Cn vll buL also lx and
x
1he caudal porLlon or cardloresplraoLry nucleus recelves lnpuLs for regulaLlon of cardlac resplraLory
and Cl fucnLlon from Cn lx and x Also lnvolved ln sleep regulaLlon
What |s the funct|on of the genera| somatosensory nuc|e| (tr|gem|na| nuc|e|)
1hese medlaLe Louch paln LemperaLure poslLlon and vlbraLlon sense for Lhe face slnuses and
menlnges
1hese lnpuLs are mosLly from Lhe Lrlgemlnal nerve buL some are from Cn vll lx and x also
What |s the funct|on of the spec|a| somat|c sensory nuc|e|?
1hese are Lhe nuclel LhaL medlaLe hearlng (Cn vlll) and Lhe vesLlbular nuclel medlaLlng balance ( Cn
vlll)
What are the spec|a| senses?
ClfacLlon vlslon hearlng vesLlbular sense and LasLe
Where are taste v|s|on and o|fact|on med|ated then |f not |n the spec|a| somat|c sensory nuc|e|?
1asLe ls ln Lhe rosLral nucleus sollLarlus vlslon and olfacLlon lle ouLslde Lhe bralnsLem
ow to remember wh|ch nuc|eus does what?
MosL of Lhem pro[ecL Lo/from a slngle nerve Lhe excepLlon Lo LhaL rule ls remembered wlLh Lhe
mcemonlc SA1
S sollLarlus pro[ecLs Lo Cn vll lx x
Amblguus pro[ecLs Lo Cn lx x
1rlgemlnal pro[ecLs Lo v vll lx x
1he oculomoLor Lrochlear abducens hypoglossal faclal splnal accesory nuclel all pro[ecL Lo Lhe
nerves Lhey share a name wlLh
1he cochlear and vesLlbular nucleus pro[ecL vla Lhe vesLlbulocochlear nerve
1haL leaves a few more Lo remember
LdlngerWesLphal ls vla oculomoLor nerve
Superlor sallvaLory nucleus ls vla Cn vll
lnferlor sallvaLory nucleus ls vla Cn lx
uorsal moLor nucleus of vagus ls vla Cn x

Iunct|ons and Course of the Cran|a| Nerves
Wh|ch cran|a| nerves are pure|y motor?
Cn lll lv vl xl xll
Wh|ch cran|a| nerves are pure|y sensory?
Cn l ll vlll
Wh|ch cran|a| nerves are m|xed?
Cn v vll lx x




For euch nerve - know the courxe from brulnxtem nuclel to perlpherul termlnutlon,
lncluJlng lntrucrunlul courxe, xkull exlt polntx, brunchex unJ perlpherul xenxory or
puruxymputhetlc gungllu.
Descr|be the anatomy of the o|factory nerve
ClfacLory sLlmull are deLecLed by speclallsed chemorecepLors on blpolar sensory neurones ln
olfacLory eplLhellum of upper nasal cavlLles
Axons of Lhese neurones Lravel vla shorL olfoctoty oetves LhaL Lraverse Lhe ctlblfotm plote of Lhe
eLhmold bone 1hey Lhen synapse ln Lhe olfoctoty bolbs
lrom Lhe olfacLory bulbs lnformaLlon Lravels vla Lhe olfoctoty ttocts whlch run ln Lhe olfacLory
sulcus beLween Lhe gyrus recLus and orblLal fronLal gyrl Lo reach olfacLory processlng area
(1he olfacLory bulbs LracLs are acLually a parL of Lhe cenLral nervous sysLem buL are commonly
referred Lo as Cn 1)
Also of Lhe olfacLory nerve does noL enLer Lhe bralnsLem

Descr|be the anatomy of the opt|c nerve
1he opLlc nerve carrles vlsual lnformaLlon from Lhe reLlna Lo Lhe laLeral genlculaLe nucleus of Lhe
Lhalamus and Lo Lhe exLragenlculaLe paLhways ( lf you recall from lasL week Lhese are Lhe
suprachlasmaLlc nucleus of Lhe hypoLhalamus preLecLal nucleus superlor colllculus)
1he opLlc nerve ls also noL really a nervebuL an exLenslon of Lhe cenLral nervous sysLem buL nobody
really cares 8y convenLlon Lhe vlsual paLhway ln fronL of Lhe opLlc chlasm ls called Lhe nerve Lhe
paLhway behlnd lL ls
called Lhe opLlc LracL
1he opLlc nerves Lravel
from Lhe orblL Lo Lhe
lnLracranlal cavlLy vla
Lhe opLlc canal