Gross Anatomy Cranial Nerve Review Cranial Nerves See Moore pgs.

s. 643-667 (Chapter 10 Review of Cranial Nerves) CN1 (Olfactory Nerve) Special Visceral Afferent Enter/exit cribriform plate Conveys information from olfactory epithelium CN2 (Optic Nerve) Special Somatic Afferent (Special Visceral Afferent according to Moore pg. 644) Enter/exit optic canal Conveys information from retina CN3 (Occulomotor Nerve) Part 1 - General Somatic Efferent Enter/exit superior orbital fissure within annulus tendinus Superior Division Innervates superior rectus muscle Innervates levator palpebrae superioris muscle Inferior Division Innervates inferior rectus muscle Innervates medial rectus muscle Innervates inferior oblique muscle Part 2 General Visceral Efferent Carries preganglionic parasympathetic fibers along inferior division to ciliary ganglion Fibers synapse in ciliary ganglion Short ciliary nerves carry postganglionic parasympathetic fibers from ciliary ganglion to innervate sphincter of pupil and ciliaris muscle Ciliary ganglion also carries 1) postganglionic sympathetic fibers along short ciliary nerves to blood vessels of eyeball, 2) Afferent fibers from nasociliary nerve (CN5 V1) CN4 (Trochlear Nerve) General Somatic Efferent Enter/exit superior orbital fissure Innervates superior oblique muscle CN5 (Trigeminal Nerve) V1 (Opthalmic Nerve) General Somatic Afferent Enter/exit superior orbital fissure Sensory nerve with 3 main branches Frontal Nerve (Branch 1) Enter/exit superior orbital fissure above annulus tendinus Supraorbital Nerve Exit supraorbital foramen Innervates frontal sinus, conjunctiva upper eyelid, skin of forehead Supratrochlear Nerve Exit on medial side of supraorbital nerve

Innervates skin in middle of forehead to hairline Nasociliary Nerve (Branch 2) Enter/exit superior orbital fissure within annulus tendinus Infratrochlear Nerve Exits of medial wall of orbit above upper eyelid Innervates skin and conjunctiva of upper eyelid Anterior Ethmoid Nerve Courses w/ anterior ethmoid artery (ophthalmic artery) through anterior ethmoid foramen Innervates anterior ethmoid sinuses and anterosuperior part of nasal mucosa on both septum and lateral wall of nasal cavity Terminal branch is External Nasal Nerve, innervates skin on dorsum and tip of nose Posterior Ethmoid Nerve Courses w/ posterior ethmoid artery (ophthalmic artery) through posterior ethmoid foramen Innervates posterior ethmoid sinuses and sphenoid sinuses Long Ciliary Nerves (2) Innervates (sensory to) iris, cornea, and ciliary body Carry postganglionic sympathetic fibers to the dilator of the pupil Sensory Root to Ciliary Ganglion Sensory fibers to eyeball from nasociliary nerve pass through ciliary ganglion and course w/ short ciliary nerves (CN 3) Lacrimal Nerve (Branch 3) Enter/exit superior orbital fissure above annulus tendinus Courses forward in lateral part of orbit to the lacrimal gland Carries postganglionic parasympathetic fibers (secretomotor) from pterygopalatine ganglion via zygomaticotemproal nerve (CN5 V2) from greater petrosal nerve (CN7) [CN5 V1 via CN5 V2 via CN7] Carries postganglionic sympathetic fibers (vasoconstrictive) from pterygopalatine ganglion via zygomaticotemproal nerve (CN5 V2) from deep petrosal nerve (Superior Cervical Ganglion) [CN5 V1 via CN5 V2 via Superior Cervical Ganglion] V2 (Maxillary Nerve) General Somatic Afferent Enter/exit foramen rotunde then runs anterolaterally through pterygopalatine fossa Within fossa gives rise to 3 branches: Zygomatic Nerve (Branch 1) Arises in floor of orbit through inferior orbital fissure Innervates skin over zygomatic arch and anterior temporal region Gives rise to 2 terminal braches: Zygomaticofacial Nerve Exit zygomaticofacial foramen Zygomaticotemporal Nerve Exit zygomaticotemporal foramen Carries postganglionic parasympathetic fibers (secretomotor) to lacrimal nerve (CN5 V1) from pterygopalatine ganglion via zygomaticotemproal nerve (CN5 V2) from greater petrosal nerve (CN7)

[CN5 V1 via CN5 V2 via CN7] Carries postganglionic sympathetic fibers (vasoconstrictive) to lacrimal nerve (CN5 V1) from pterygopalatine ganglion via zygomaticotemproal nerve (CN5 V2) from deep petrosal nerve (Superior Cervical Ganglion) [CN5 V1 via CN5 V2 via Superior Cervical Ganglion] Ganglionic Branches (V2) Supporting Pterygopalatine Ganglion (Branch 2 and 3) Convey general sensory fibers from maxillary nerve that pass through ganglion (Note: all the braches of the pterygopalatine ganglion are mixed nerves with General Somatic Afferent fibers from the maxillary nerve, and General Visceral Efferent fibers from the nerve of the pterygoid canal [see below]) Pterygopalatine ganglion gives off numerous braches: Greater Palatine Nerve Innervates gingivae, mucous membranes, glands of hard palate Lesser Palatine Nerve Innervates gingivae, mucous membranes, glands of soft palate Nasopalatine Nerve Courses through sphenopalatine foramen along posterior half nasal septum Innervates mucosa in this region then dives down through incisive canal Innervates mucous membranes and gland of anterior part of hard palate Nerve of the Pterygoid Canal General Visceral Efferent Carries preganglionic parasympathetic fibers from CN7 via greater petrosal nerve, these are secretomotor to mucosa and glands and synapse in ganglion Carries postganglionic sympathetic fibers from Superior Cervical Ganglion via deep petrosal nerve, these are vasoconstrictive to mucosa and glands, do not synapse Posterior Superior Lateral Nasal Nerve Innervates mucosa on superior half of lateral wall of nasal septum Posterior Inferior Lateral Nasal Nerve Innervates mucosa on inferior half of lateral wall of nasal septum Maxillary nerve then leaves pterygopalatine fossa through inferior orbital fissure Henceforth it is known as the Infraorbital nerve It then gives rise to 3 large sensory branches: Posterior Superior Alveolar Nerve Sensory innervation to maxillary molars Middle Superior Alveolar Nerve Sensory innervation to maxillary molars and premolars Anterior Superior Alveolar Nerve Sensory innervation to premolars, a branch dives through the incisive canal and emerges as the Incisive Nerve to supply the maxillary canines and incisors (Note: nasopalatine nerve also courses through incisive canal) Maxillary Nerve then continues along floor or orbit through infraorbital sulcus It dives down through the infraorbital canal and emerges through the infraorbital foramen and serves to innervate (sensory to) the skin of the cheek, lower lid, lateral side of nose and upper lip

V3 (Mandibular Nerve) Mixed nerve w/ General Somatic Afferent (sensory) and Special Visceral Efferent fibers (motor) Enter/exit foramen ovale and enters infratemporal fossa Divides into anterior and posterior trunks Anterior trunk gives rise to: Long Buccal Nerve Innervates skin and mucosa of the cheek, buccal gingival adjacent o 2nd and 3rd molars Branches to Four of the Muscles of Mastication Motor nerve to Masseter, Temporalis, Medial Pterygoid, Lateral Pterygoid muscles Branches to Additional Muscles (not sure if these branches from anterior trunk) Motor nerve to anterior belly of the digastric (accessory muscle of mastication), tensor veli palatini, tensor tympani (Note: muscles of mastication and innervation derived from 1st pharyngeal gill arch) Posterior trunk gives rise to: Auriculotemporal Nerve Passes between neck of mandible and external acoustic meatus Innervates skin anterior to ear and posterior temporal region Carries postganglionic parasympathetic fibers (secretomotor) from otic ganglion to the parotid salivary gland, these general visceral efferent fibers come to the otic ganglion via the lesser petrosal nerve (preganglionic parasympathethic) from CN 9 (see below) Marker: middle meningeal artery passes between branches that make up auriculotemporal nerve Inferior Alveolar Nerve Enters mandibular foramen Sensory innervation to mandibular teeth Mental Nerve Terminal branch of mandibular nerve Exits through mental foramen Innervates skin of chin, lower lip, mucosa of lower lip Nerve of the Mylohyoid Runs along the mylohyoid groove Motor nerve to Mylohyoid muscle (accessory muscle of mastication) Lingual Nerve Enters mouth between medial pterygoid and ramus of mandible inferior to 3rd molar Sensory innervation to anterior 2/3 of the tongue, floor of the mouth, lingual gingivae Carries Special Visceral Afferent fibers via Chorda Tympani: Chorda Tympani Special Visceral Afferent, General Visceral Efferent Branch of CN7, passes through middle ear over tympanic membrane Joins lingual nerve in infratemporal fossa Carries taste fibers to anterior 2/3 of the tongue Carries preganglionic parasympathetic fibers (secretomotor) to submandibular ganglion for the submandibular and sublingual salivary glands CN6 (Abducens Nerve)

General Somatic Efferent Enter/exit superior orbital fissure Innervates lateral rectus muscle CN7 (Facial Nerve) Motor and sensory nerve, see Moore pgs. 658-660 Consists of two roots Smaller root has taste (Special Visceral Afferent), parasympathetic (General Visceral Efferent) and sensory (General Somatic Afferent) fibers Larger root carries motor fibers to muscles from 2nd pharyngeal arch (Special Visceral Efferent) Nerve enters internal acoustic meatus Within facial canal it gives rise to: Greater Petrosal Nerve (General Visceral Efferent) Joins the deep petrosal nerve as it passes through cartilage of foramen lacerum (Note: These two nerves form the nerve of the pterygoid canal) Carries preganglionic parasympathetic fibers to pterygopalatine ganglion After synapse, postganglionic parasympathetic fibers innervate lacrimal gland (See Above), and mucous glands of nasal cavity, palate, upper pharynx Nerve to Stapedius (Special Visceral Efferent) Innervates stapedius muscle in middle ear Prevents excess movement of the stapes Chorda Tympani Nerve Passes through middle ear over tympanic membrane Joins lingual nerve in infratemporal fossa Carries taste fibers to anterior 2/3 of the tongue (Special Visceral Afferent) Carries preganglionic parasympathetic fibers (secretomotor) to submandibular ganglion for the submandibular and sublingual salivary glands (General Visceral Efferent) (Note: Sensory fibers (General Somatic Afferent) to concha of auricle of external ear arise here) Larger motor root (Special Visceral Efferent) exits stylomastoid foramen Gives off motor braches to occipitalis and auricular muscles (via Posterior Auricular Branch) Gives off motor branches to posterior belly of the digastric and stylohyoid muscles Pierces parotid gland Gives off five terminal motor branches to muscles of facial expression: Temporal Branch Zygomatic Branch Buccal Branch Mandibular Branch Cervical Branch CN 8 (Vestibulocochlear Nerve) Special Somatic Afferent (Special Visceral Afferent according to Moore pg. 644) Enter/exit internal acoustic meatus Conveys equilibrium, balance (Vestibular fibers) and hearing (Cochlear fibers) information from inner ear

CN9 (Glossopharyngeal Nerve) Motor (General Visceral Efferent and Special Visceral Efferent) and sensory (General Somatic Afferent and Special Visceral Afferent) nerve, see Moore pgs. 662-663 Enter/exit jugular foramen Gives off two small branches: Tympanic Nerve Courses through middle ear Forms tympanic plexus on promontory of middle ear Provides sensory innervation (General Somatic Afferent) to the internal surface of the tympanic membrane Reforms as the lesser petrosal nerve Carries preganglionic parasympathetic fibers (General Visceral Efferent) to the otic ganglion to supply the parotid gland via the auriculotemporal nerve (CN5V3) (See Above) Carotid Branch Special Visceral Afferent Provides baroreceptor innervation to the carotid sinus Follows and gives motor innervation (Special Visceral Efferent) to Stylopharyngeus muscle (derived from 3rd pharyngeal arch) Gives of Pharyngeal Branch to Pharyngeal Plexus of nerves (CN9 and CN10), this gives sensory innervation (General Somatic Afferent) to the oropharynx Passes b/w superior and middle constrictor muscles to reach oropharynx Gives of two branches: Tonsilar Branch General Somatic Afferent Provides sensory innervation to the palatine tonsil Lingual Branch Provides general sensory innervation (General Somatic Afferent) to posterior third of tongue Provides taste fibers (Special Visceral Afferent) to posterior third of tongue CN10 (Vagus Nerve) Motor and sensory nerve, see Moore pgs. 664-666 Enter/exit jugular foramen Joins with cranial root of CN11 Enters carotid sheath and continues to root of the neck Gives off multiple branches: Pharyngeal Branch Innervation to pharyngeal constrictor muscles (Special Visceral Efferent), except cricopharyngeus, and pharyngeal longitudinal muscles, except stylopharyngeus (Note: pharyngeal muscles derived form 4th through 6th pharyngeal arches) Provides general sensory innervation (General Somatic Afferent) to laryngopharynx (Note: motor innervation is really cranial root CN11 via CN10) Superior Laryngeal Nerve Divides into two terminal nerves: Internal Laryngeal Nerve Sensory (General Somatic Afferent) to root of tongue to vocal folds

Carries preganglionic parasympathetic (General Visceral Efferent) to mucous membrane in same area External Laryngeal Nerve Motor innervation (Special Visceral Efferent) to the cricothyroid muscle Recurrent Laryngeal Nerves Sensory (General Somatic Afferent) and parasympathetic (General Visceral Efferent) to laryngeal mucous membrane from vocal folds down Motor innervation (Special Visceral Efferent) to muscles of larynx and cricopharyngeus muscle Cardiac Branches Provides sensory (General Visceral Afferent) and preganglionic parasympathetic fibers to heart Passes through superior thoracic aperture into thorax Provides sensory (General Visceral Afferent) and preganglionic parasympathetic (General Visceral Efferent) innervation to organs of thorax Passes through esophageal hiatus as anterior and posterior vagal trunks Provides sensory (General Visceral Afferent) and preganglionic parasympathetic (General Visceral Efferent) innervation or organs of abdomen as far as left colic flexure CN11 (Accessory Nerve) Enter/exit jugular foramen Motor nerve with many branches, see Moore pgs. 666-667 CN12 (Hypoglossal Nerve) Enter/exit hypoglossal canal Motor nerve with many branches, see Moore pgs. 667-669