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Cranial nerves

Cranial nerves

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Cranial nerves

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  1. Cranial nerves Assoc. prof. Stefan Sivkov,MD, PhD

  2. Names I N. olfactorius II N. opticus III N. oculomotorius IV N. trochlearis V N. trigeminus VI N. abducens VII N. facialis VIII N.vestibulocochlearis IX N. glossopharyngeus X N. vagus XI N. accessorius XII N. hypoglossus

  3. Nuclei, components, course

  4. Cranial nerves • Somatic • Somatomotor • Somatosensory • General somatosensory • Specific somatosensory • Autonomic • Visceromotor • General visceromotor • Specific visceromotor • Viscerosensory • General viscerosensory • Specific viscerosensory

  5. Components • General somatosensory fibers (GSS): extero- and proprioseptive impulsesfrom head and face • Specific somatosensory fibers (SSS): specific impulses from eye and ear • General viscerosensory fibers (GVS): from visceral organs to viscerosensory nuclei. • Specific viscerosensory fibers(SVS): specific impulses for smell and taste • General somatomotor fibers (GSM): for skeletal muscles of eye and tongue • Specific visceromotor fibers (SVM): for skeletal muscles with branchiogenic origin. Mastication, expression, swallowing • General visceromotor fibers (GVM):from visceromotor nuclei; relay in parasympathetic ganglia. Heart muscle,smooth muscles, glands.

  6. Nuclei Columns • Medial.Somatomotor. In the central grey matter; derive from basal plate of neural tube; supply striated muscles with myotomic origin; (ІІІ, ІV, VІ, ХІІ). • Ventrolateral.Specific visceromotor.Migrate ventrolaterally forminginner genu; derive from basal plate; supply muscles withbranchiogenic origin; (V, VІІ).

  7. Visceromotor column. • Lateral to medial and dorsal to ventrolateral clmn; derive from basal platenext to sulcus limitans; origin to efferent preganglionic fibers; parasympathetic supply of smooth muscles; (ІІІ, VІІ, ІХ, Х). • Sensory column. • Lateral tosulcus limitans; derive fromalar plate; accept central processes of sensory ganlia cells; • General viscerosensory – close tosulcus limitans (VІІ, ІХ, Х). • General somatosensory- intermediate, general sensation from head/face (V) • Specific somatosensory - lateral, hearing and balance impulses (VІІІ)

  8. Organization of brain stem (afterHerrick)

  9. Appearance of brain surface

  10. Course within skull

  11. Exit of skull

  12. Motor, sensory, mixed

  13. Classification • Sensory: only afferent (sensory) fibers • N. Olfactorius • N. Opticus • N. Vestibulocochlearis • Motor: only efferent (motor) fibers • N. Oculomotorius • N. Trochlearis • N. Abducens • N. Accessorius • N. Hypoglossus • Mixed: sensory and motor fibers • N. Trigeminalis • N. Facialis • N. Glossopharyngeus • N. Vagus

  14. Сетивни нерви

  15. N. olfactorius Обонятелна лигавица (СВС)→ For. cribriformes → Bulbus olfactorius

  16. N. opticus Ganglion cell → Canalis opticus → Corpus geniculatum laterale

  17. N. vestibulocochlearis Ganglion Vestibulare (SSA) - Meatus internus acusticus - Nuclei Vestibulares Ganglion Cochlearе (SSA) - Canalis spiralis - NucleiCochleares

  18. Моторни нерви

  19. N. oculomotorius N. oculomotorius • Компоненти • Общо соматомоторни влакна • Общо висцеромоторни влакна • Ядра • nucl. oculomotorius • nucl. accessorius • Поява • sulcus cruris medialis • Ход • латерална стена наsinus cavernosus • Напускане на черепа • Fissura orbitalis superior • Инервация • Mm. recti superior, inferior, medialis; m. obliquus inferior; m. levator palpebrae superioris • M. sphincter pupillae & m. ciliaris • Ganglion ciliare : между n. opticus & m. rectus lateralis

  20. Ganglion ciliare Парасимпатикови влакна от nucleus accessorius n. oculomotorii достигат ganglion ciliare по n. oculomotorius (radix parasympathica) и се прекъсватв него. Сетивни влакна от n. nasociliaris (radix sensoria) и симпатикови влакна от plexus caroticus internus (radix sympathica) преминават през ганглия без да се прекъсват. Парасимпатикови влакна достигат (поnervi ciliares breves) доm. cliliaris (акомодация) и m. sphincter pupillae (свиване на зеницата).

  21. Damage ofn. oculomotorius • Diverging strabismus (squinting) • Double vision • Dilated pupil (mydriasis) • Impaired accomodation

  22. N. trochlearis [IV] Nucleus • Nucl. n. trochlearis (ОСМ) Appearance • Below colliculus inferior Course • Lateral wall of sinus cavernosus Exit • Fissura orbitalis superior Supply • Somatomotorа: • M. obliquus superior

  23. N. abducens N. abducens [VI] Nucleus Nucl. n. abducentis (ОСМ) AppearanceFissura pontomedullaris, Course Thru sinus cavernosus, lateral to а. carotis int. Exit Fissura orbitalis superior Supply Somatomotor: M. rectus lateralis

  24. Converging strabismus (squinting) • Double vision Damage of n. abducens

  25. N. accessorius N. accessorius Nucleus Nucl. ambiguus - caudal (SVM) Nucl. spinalis n. accessorii (GSM) Appearance Sulcus retroolivaris – radix cranialis Btw radices ventralis & dorsalis – radix spinalis Course Radix spinalis enters skull thru for. magnum, joinsradix cranialis Exit For. Jugulare - pars cranialis – r. externus inn. vagus - pars spinalis – r. externus Supply M. trapezius, m. sternocleidomastoideus

  26. N. hypoglossus [XII] Nucleus Nucl. n. hypoglossi(GSM) Appearance Sulcus anterolateralis btw oliva & pyramis Course Cisterna basalis Exit Canalis n. hypoglossi Supply Somatomotor: Mm. styloglossus, hyoglossus, genioglossus, own muscles of toungue

  27. N. hypoglossus N. hypoglossus

  28. Mixed nerves

  29. N. trigeminus [V] Components • SVM: from nucleus motorius n. trigemini, muscles of mastication. • GSS влакна: from head and faceto sensory nuclei ofn.trigeminus; neurons in ganglion trigeminale, lying on pars petrosa на os temporale.

  30. Branches • N. ophthalmicus(V1, sensory) exits thru fissura orbitalis superior, enters orbit • Branches • N. frontalis: • N. supratrochlearis • N. supraorbitalis • N. lacrimalis • N. nasociliaris

  31. Supply: Sensory: • Dura mater cerebri • Eye • Nasal mucosa • Skin epicranial&eye area, back of nose Sympathetic fibersform. dilator pupillae. From upper Th segments, thru superior cervical ganglion. Reach branches ofa. carotis interna

  32. N. maxillaris (V2, sensory) • Exit thru foramen rotundum • Branches • N. infraorbitalis • N. zygomaticus • N. alveolaris superior • N. pterygopalatinus

  33. Supply: • Dura mater cerebri • Teeth – upper jaw • Nasal& oral mucosa • Skin btwn eyes and mouth

  34. N. mandibularis (V3, mixed) • Exit thru foramen ovaleи enters fossa infratemporalis • Branches • N. auriculotemporalis • N. buccalis • N. lingual • N. alveolaris inferior • Nn. for masticatory muscles

  35. Supply: Sensory: • Dura mater cerebri • Teeth and gums of lower jaw • Mucosa and floor of mouth • Anterior 2/3 of tongue • Skin temporal area, ear, below mouth Motor: Muscles of mastication, m. mylohyoideus, venter anterior m. digastricus

  36. Facial Nerve VII • Somatic Motor - facial expressions • Autonomic Motor - salivary and lacrimal glands, mucous membranes of nasal and palatine mucosa • Special Sensory - taste on anterior 2/3’s of tongue • Damage produces sagging facial muscles and disturbed sense of taste (no sweet and salty)

  37. Branches of Facial Nerve Clinical test: Test anterior 2/3’s of tongue with substances such as sugar, salt, vinegar, and quinine; test response of tear glands to ammonia fumes; test motor functions by asking subject to close eyes, smile, whistle, frown, raise eyebrows, etc.

  38. N. facialis [VII] Components • SVM from nucleus n. facialisfor muscles of expression • GVM(n. intermedius)fromnucleus salivatorius superior,interrupt inganglion pterygopalatinum & ganglion submandibulare. Postganglionic fibersreachglandulae lacrimalis, submandibularis & sublingualis • SVS(n. intermedius)from taste buds in anterior 2/3 of tongue, neurons in ganglion geniculi of n. facialis reaching nucleus tractus solitarii • GSS skin external ear

  39. Course Thru meatus acusticus internus, canalis facialis и for. stylomastoideum, enters gl. рarotidea, formingplexus intraparotideus and giving offfive branches for muscles of expression

  40. Branches in canalisn.facialis • Chorda tympani: joins n. lingualis ofn. mandibularis • Tate in anterior 2/3 of tongue • Interrupt in ganglion submandibulare, postganglionic fibers reaching gl. submandibularis и gl. sublingualis

  41. N. petrosus major: GVM fibers to ganglion pterygopalatinum, postganglionic fibers thru n. zygomaticus & n. lacrimalis reachgl. lacrimalis • N. stapedius: for m. stapedius

  42. Branches ouside the skull • Rr. temporales • Rr. zygomatici • Rr. buccales • R. marginalis mandibulae • R. coli