CRANIAL NERVES

Lanka Ranaweera Dept. of Anatomy

Objectives
Describe the anatomy of V nerve Describe the sensory distribution of face Name the muscles of mastication Describe the features of lesions of V nerve Describe the anatomy of VI nerve Describe the anatomy & functions of VII nerve Describe the features of lesions of VII nerve

NERVOUS SYSTEM
Structurally
central N.S. spinal cord brain spinal nerves (31) cranial nerves (12) peripheral N.S.

Functionally
somatic N.S.

autonomic N.S.
symp. para.

Cranial nerves
I II III IV V VI VII VIII IX X XI XII Olfactory nerve Optic nerve Occulomotor nerve Trochlear nerve Trigeminal nerve Abducent nerve Facial nerve Vestibulocochler nerve Glossopharyngeal nerve Vagus nerve Accessary nerve Hypoglossal nerve

Trigeminal Nerve (V)

Largest cranial nerve 3 divisions : opthalmic / maxillary / mandibular Functional components : Sensory & motor Function : sensory - grater part of the head
_

motor - several mm (C mastication mm)

Opening in skull : superior orbital fissure (opthalmic) foramen rotundum ( maxillary) foramen ovale (mandibular )

Trigeminal ganglion

Trigeminal Nerve

thalamus

Mescencephalic nucleus
midbrain Trigeminal lemniscus pons
Trigeminal ganglion

Medulla oblongata

Main sensory nucleus Spinal nucleus

Motor nucleus
Spinal cord

Trigeminal nerve nuclei in the brain stem

Cerebral cortex
Motor nucleus of V nerve Mescencephalic nucleus
Main sensory nucleus of V nerve

Trigeminal nerve

pons

Trigeminal ganglion

Trigeminal nerve nuclei & its

central connections

Olfactory bulb

Olfactory tract

II & optic tract Infundibulum & mamilary body Midbrain

III IV

V VI VII VIII IX X
XI

XII

Base of the brain

Pathway of the Trigeminal nerve

Trigeminal nerve

leaves anterior of pons

(small motor root & larger sensory root)

forward out of posterior cranial fossa middle cranial fossa rest on petrous part of temporal bone

Sensory root forms trigeminal ganglion

Ophthalmic nerve

maxillary nerve

mandibular nerve

(sensory)

(sensory)

(sensory + motor)

superior orbital

foramen rotundum

foramen ovale

fissure

Ophthalmic division (V1)

frontal nerve lacrimal nerve nasociliary nerve

Supratrochlear supraorbital scalp up to vertex upper eyelid frontal air sinus upper eye lid lacrimal gland conjunctiva ciliary ganglion eyeball cornea conjunctiva dorsum of nose

Supratrochlear nerve Supraorbital nerve

Infratrochlear nerve
Ant. ethmoidal nerve Pos. ethmoidal nerve frontal nerve nasociliary nerve opticl nerve Opthalmic nerve

Zygomatic nerve
Lacrimal nerve Short ciliary nerve Ciliary ganglion Long ciliary nerve

Opthalmic division of trigeminal nerve

Maxillary division (V2)

Foramen rotundum
Pteregopalatine fossa Infra orbital fissure

Zygomatic nerve

Infraorbital nerve

Pteregopalatine ganglion branches

mucous mem. of palate nasopharynx uvula, tonsils Nasal septum

Skin of temple lower eye lid upper lip skin of cheek

teeth-upper jaw maxillary sinus

Zygomatic nerve Maxillary division Pterigopalatine ganglion

Lacrimal nerve

Ant. sup. alveolar nerve

Post. sup. alveolar nerve Infraorbital nerve

Maxillary division of trigeminal nerve

Mandibular division (V3)

foramen ovale Infratemporal fossa

Nervus spinosus

Nerve to Medial-pterygoid

T e n s o r p a l a t i

T e n s o r

Otic ganglion

Anterior trunk
Buccal nerve
(sensory) Skin of cheek Mucose mem.-of cheek masseter temporalis Lateral pterygoid

posterior trunk
(sensory)

t y m p a n i

motor branch

auricular-temporal n.

lingual nerve

inferior alveolar n.
???

skin of temple floor of mouth skin of auricle ant.2/3 of tongue*

sublingual gland** _ submandibular gland** * associated c chorda tympani from VII nerve ** via submandibular ganglion

Inferior alveolar nerve

Mandibular canal

mental nerve

nerve to mylohyoid Teeth of lower jaw mylohyoid mm

+

skin of chin
+

anterior belly of digastric

lower lip

Nerve to temporalis Foramen ovale Auriculotemporal nerve

Nerve to masseter
Parotid branch Nerve to pterygoid Buccal nerve

Nerve to mylohyoid

Mental nerve Lingual nerve Inferior alveolar nerve

Mandibular division of trigeminal nerve

Sensory distribution of face & scalp by trigeminal nerve

Features of lesions trigeminal nerve

Wasting of muscles of mastication

Loss of sensory modalities

Abducent Nerve (VI)

Functional component : motor Function : turns eyeball laterally

One motor nucleus pons

Opening in skull : superior orbital fissure

Abducent Nerve

Cerebral cortex

Medial longitudinal fasciculus Nucleus of VI nerve Tectobulbar fibers from sup. colliculus

Abducent nerve
pons

Abducent nerve nucleus & its central connections

Olfactory bulb

Olfactory tract

II & optic tract Infundibulum & mamilary body Midbrain

III IV

VI
VII VIII IX X XII XI

Base of the brain

Pathway of the abducent nerve

Abducent nerve through cavernous sinus anteriorly through pons groove between lower border of pons & medulla oblongata

Lateral relation : 3/4/5/ cranial nerves Medial relation : internal carotid artery

Superior orbital fissure

orbit

lateral rectus muscle

pituitary Internal carotid artery Sphenoid sinus

III IV V1 V2 VI

Cavernous sinus in coronal section

Mid brain

Abducent nerve

pons

Lateral rectus Medulla oblongata

Distribution of the abducent nerve

Facial Nerve(VII)
Functional component: motor sensory secretomotor/parasympathetic 3 nuclei in pons : main motor nucleus parasympathetic nucleus sensory nucleus Opening in skull : Internal acoustic meatus facial canal stylomastoid foramen

Facial Nerve

Thalamus & hypothalamic nuclei

Cerebral cortex
Dcending autonomic pathway Sensory nucleus Parasympathetic nuclei Main motor nucleus

Nucleus of VI nerve

pons

Facial nerve

Facial nerve nucleus & its central connections

Main motor nucleus

Nucleus part

muscle of upper
part of face afferents corticonuclear fibers from both cerebral hemispheres

muscle of lower
part of face afferents corticonuclear fibers from opposite cerebral hemispheres

Parasympathetic nuclei

Superior salivatary nucleus afferents

fibers from hypothalamus + fibers from nucleus of tractus solitarius (taste)

lacrimal nucleus afferents

fibers from hypothalamus (emotional responses) + fibers from sensory nuclei of trigeminal nerve

Sensory nucleus
Lies close to motor nucleus Upper part of the nucleus of tractus solitarius Taste fibers geniculate ganglion sensory nucleus
Cross midian plane

internal capsule

thalamus and hypothalamic nuclei

Corona radiata

taste area of the cortex

(lower part of postcentral gyrus)

Pathway of the facial nerve

motor root pass posteriorly
central processes of the unipolar cells of geniculate ganglion

sensory root(nervus intermedius)

+ around abducent nucleus pass anteriorly emerge from anterior surface of brain between the pons & medulla oblongata
efferent preganglionic parasympathetic fibers from parasympathetic nuclei

Olfactory bulb

Olfactory tract

II & optic tract Infundibulum & mamilary body Midbrain

III IV

V VI

VII
VIII IX X XII XI

Base of the brain

Laterally posterior cranial fossa (C VIII nerve) internal acoustic meatus (petrous part of temporal bone)

facial canal
medial wall of tympanic cavity nerve expands & form
sensory geniculate ganglion

grater petrosal nerve lacrimal gland turns backwards over promontory of middle ear

downwards & medial to the middle ear

chorda tympani

nerve to stapedius

Join c

lingual nerve submandibular & sublingual glands

ant. 2/3 of tongue stylomastoid foramen Stylohyoid mm Parotid gland

Post. belly of digastric mm

Parotid gland

temporal

zygomatic

buccal

mandibular

cervical

branch

branch

branch

branch

branch

Facial nerve

Geniculate
ganglion

Grater petrosal nerve

Nerve to pterygoid canal

V2 V
3

Zygomatic nerve

Pterygopaltine Nerve to stapedius Deep petrosal nerve Chorda tumpani Sublingual gland Subman. gland Temporal branch ganglion

Lingual nerve

zygomatic branch
Post. auricular branch cervical branch Buccall branch Mandibular branch

Distribution of facial nerve

Facial expression defects associated with lesions of UMN (1) & LMN (2)

Upper motor neuron lesion

Lower motor neuron lesion

Cranial Nerve Summary

# V Name Trigeminal Foramina V1: Sup Orb Fissure V2: Foramen Rotundum V3: Foramen Ovale Superior Orbital Fissure Internal Auditory Canal Function Sensory: Face

VI Abducens VI Facial I

Cranial Nerve Summary

# Name Foramina Function

V1: Sup Orbital Fissure V2: Foramen Trigeminal Rotundum V3: Foramen Ovale
Abducens Superior Orbital Fissure

Sensory: Face Motor : Mastication, Tensor Tympani, Tensor Palati mylohyoid Motor: Lateral Rectus

VI

VII Facial

Internal Auditory Canal

Sensory: Taste (Anterior 2/3 Tongue) Motor : Muscles Of Facial Expression Salivary Glands, Lacrimal Glands