The Cranial Nerves

PG 1ST Yr. (Dept. of Radiology & Imaging)

Names of cranial nerves

           

Olfactory nerve Optic nerve Oculomotor nerve Trochlear nerve Trigeminal nerve Abducent nerve Facial nerve Vestibulocochlear nerve Glossopharyngeal nerve Vagus nerve Accessory nerve Hypoglossal nerve

Functional components
 

   

General somatic afferent fibers (GSA): transmit exteroceptive and proprioceptive impulses from head and face to somatic sensory nuclei Special somatic afferent fibers (SSA): transmit sensory impulses from special sense organs of vision, equilibrium and hearing to the brain General visceral afferent fibers (GVA): transmit interoceptive impulses from the viscera to the visceral sensory nuclei Special visceral afferent fibers (SVA): transmit sensory impulses from special sense organs of smell and taste to the brain General somatic efferent fibers (GSE): innervate skeletal muscles of eye and tongue Special visceral efferent fibers (SVE): transmit motor impulses from the brain to skeletal muscles derived from brachial (gill) arches of embryo. These include the muscles of mastication, facial expression and swallowing General visceral efferent fibers (GVE): transmit motor impulses from the general visceral motor nuclei and relayed in parasympathetic ganglions. The postganglionic fibers supply cardiac muscles smooth muscles and glands

Classification of cranial nerves



Sensory cranial nerves: contain only afferent (sensory) fibers

Olfactory nerve Optic nerve Vestibulocochlear nerve

Motor cranial nerves: contain only efferent (motor) fibers

Oculomotor nerve Trochlear nerve Abducent nerve Accessory nerv Hypoglossal nerve

Mixed nerves: contain both sensory and motor fibers--Trigeminal nerve, Facial nerve, Glossopharyngeal nerve Vagus nerve

Sensory cranial nerves

N. Location of cell body and axon categories Olfactory cells (SVA) Ganglion cells (SSA) Vestibular ganglion(SSA) Cochlear ganglion (SSA) Cranial exit Terminal nuclei Main action

Cribrifom Olfactory foramina bulb Optic canal Internal acoustic meatus Lateral geniculate body Vestibular nuclei Cochlear nuclei

Smell Vision

Equilibrium Hearing

Cranial Nerve I: Olfactory

 

Arises from the olfactory epithelium Passes through the cribriform plate of the ethmoid bone Fibers run through the olfactory bulb and terminate in the primary olfactory cortex Functions solely by carrying afferent impulses for the sense of smell

Olfactory nerve
Olfactory mucosa (SVA) bulb Cribriform foramina Olfactory

Cranial Nerve II: Optic

 

Arises from the retina of the eye Optic nerves pass through the optic canals and converge at the optic chiasm They continue to the thalamus where they synapse From there, the optic radiation fibers run to the visual cortex Functions solely by carrying afferent impulses for vision

Optic nerve
Ganglion cell (SSA) Optic canal Lateral geniculate body

Vestibulocochlear nerve
Vestibular ganglion(SSA) Internal acoustic meatus Cochlear ganglion (SSA) Cochlear nuclei Vestibular nuclei

Origins -- arises from the cochlear and vestibular portions of the inner ear Sensory functions -- senses of equilibrium and hearing Motor functions -- none

Motor cranial nerves

N. Nucleus of origin and axon categories Nucleus of oculomotor (GSE) Cranial exit Superior orbital fissure Main action Motor to superior, inferior and medial recti; inferior obliquus; levator palpebrae superioris Parasympathetic to sphincter pupillea and ciliary muscl Superior orbital fissure Superior orbital fissure Jugular foramen Motor to superior obliquus Motor to lateral rectus Motor to sternocleidomastoid and trapezius Motor to muscles of tongue

Accessory nucleus of oculomotor (GVE) Nucleus of trochlear nerve (GSE) Nucleus of abducent nerve (GSE) Nucleus of accessory nerve (SVE)

Nucleus of hypoglossal Hypoglossal canal nerve( GSE)

Oculomotor Nerves CNIII



Components
General somatic efferent fibers (GSE) General visceral efferent fibers (GVE)

Main action supplies

Superior, inferior and medial recti; inferior obliquus; levator palpebrae superioris Sphincter pupillea and ciliary muscle

Ciliary ganglion: lies between optic nerve and lateral rectus

Oculomotor nerve

Hypoglossal nerve

Hypoglossal nerve

Mixed cranial nerves

Trigeminal nerve
Components of fibers


SVE fibers: originate from motor nucleus of trigeminal nerve, and supply masticatory muscles GSA fibers: transmit facial sensation to sensory nuclei of trigeminal nerve, the GSA fibers have their cell bodies in trigeminal ganglion, which lies on the apex of petrous part of temporal bone

Branches


Ophthalmic nerve
( 1, sensory) leave the skull through the superior orbital fissure, to enter orbital cavity Branches Frontal nerve:
 

Supratrochlear nerve Supraorbital nerve

Distribution:  Sensation from cerebral dura mater  Visual organ  Mucosa of nose  Skin above the eye and back of nose

Lacrimal nerve Nasociliary nerve

Maxillary nerve


( 2, sensory) Leave skull through foramen rotundum Branches

Infraorbital nerve Zygomatic nerve Superior alveolar nerve Pterygopalatine nerve

Distribution:


 

Sensation from cerebral dura mater Maxillary teeth Mucosa of nose and mouth Skin between eye and mouth

Mandibular nerve (


3,

Distribution:


mixed) Leave the skull through the foramen ovale to enter the infratemporal fossa Branches
Auriculotemporal nerve Buccal nerve Lingual nerve Inferior alveolar nerve Nerve of masticatory muscles

  

Sensation from cerebral dura mater Teeth and gum of lower jaw Mucosa of floor of mouth Anterior 2/3 of tongue Skin of auricular and temporal regions and below the mouth Motor to masticatory muscles, mylohyoid, and anterior belly of digastric

Facial nerve ( )
Components of fibers


SVE fibers originate from nucleus of facial nerve, and supply facial muscles GVE fibers derived from superior salivatory nucleus and relayed in pterygopalatine ganglion and submandibular ganglion. The postganglionic fibers supply lacrimal, submandibular and sublingual glands SVA fiber from taste buds of anterior two-thirds of tongue which cell bodies are in the geniculate ganglion of the facial nerve and end by synapsing with cells of nucleus of solitary tract GSA fibers from skin of external ear

Course: leaves skull through internal acoustic meatus, facial canal and stylomastoid foramen, it then enters parotid gland where it divides into five branches which supply facial muscles

Branches within the facial canal



Chorda tympani : joins lingual branch of mandibular nerve

To taste buds on anterior two-thirds of tongue Relayed in submandibular ganglion, the postganglionic fibers supply submandibular and sublingual glands

Greater petrosal nerve: GVE fibers pass to pterygopalatine ganglion and there relayed through the zygomatic and lacrimal nerves to lacrimal gland Stapedial nerve : to stapedius

Branches outside of facial canal  Temporal  Zygomatic  Buccal  Marginal mandibular  Cervical

Pterygopalatine ganglion : lies in pterygopalatine fossa under maxillary nerve Submandibular ganglion : lies between lingual nerve and submandibular gland

Glossopharyngeal nerve ( )
Components of fibers
 

SVE fibers: originate from nucleus ambiguus, and supply stylopharygeus GVE fibers: arise from inferior salivatory nucleus and ralyed in otic ganglion, the postganglionic fibers supply parotid gland SVA fibers: arise from the cells of inferior ganglion, the central processes of these cells terminate in nucleus of solitary tract, the peripheral processes supply the taste buds on posterior third of tongue GVA fibers: visceral sensation from mucosa of posterior third of tongue, pharynx, auditory tube and tympanic cavity, carotid sinus and glomus, and end by synapsing with cells of nucleus of solitary tract GSA fibers: sensation from skin of posterior surface of auricle and

Course: leaves the skull via jugular foramen Branches



Lingual branches : to taste buds and mucosa of posterior third of tongue Pharyngeal branches : take part in forming the pharyngeal plexus Tympanic nerve : GVE fibers via tympanic and lesser petrosal nerves to otic ganglion, with postganglionic fibers via auriculotemporal ( 3) to parotid gland
Carotid sinus branch : innervations to both carotid sinus and glomus Others: tonsillar and stylophayngeal branches

 

 

Otic ganglion : situated just below foramen ovale

Vagus nerve ( )
components of fibers


GVE fibers: originate from dorsal nucleus of vagus nerve, synapse in parasympathetic ganglion, short postganglionic fibers innervate cardiac muscles, smooth muscles and glands of viscera SVE fibers: originate from ambiguus, to muscles of pharynx and larynx GVA fibers: carry impulse from viscera in neck, thoracic and abdominal cavity to nucleus of solitary tract GSA fiber: sensation from auricle, external acoustic meatus and cerebral dura mater

Course
 

Exits the skull from jugular foramen Descends in the neck in carotid sheath between internal (or common) carotid artery and internal jugular vein Enter thoracic inlet on right side of trachea Travels downward posterior to right brachiocephalic vein and superior vena cava Passes posterior to right lung root Forms posterior esophageal plexus Forms posterior vagal trunk at esophageal hiatus where it leaves thorax and passes into abdominal cavity, then divides into posterior gastric and celiac branches

Right vagus nerve

 

  

Left vagus nerve



Enter thoracic inlet between left common carotid and left subclavian arteries, posterior to left brachiocephalic vein Crosses aortic arch where left recurrent laryngeal nerve branches off Passes posterior to left lung root Forms anterior esophageal plexus Forms anterior vagal trunk at esophageal hiatus where it leaves thorax and passes into abdominal cavity , then divides into anterior gastric and hepatic branches

  

Branches in neck  Superior laryngeal nerve: passes down side of pharynx and given rise to
Internal branch, which pierces thyrohyoid membrane to innervates mucous membrane of larynx above fissure of glottis External branch, which innervates cricothyroid


Cervical cardiac branches : descending to terminate in cardiac plexus Others: auricular, pharyngeal and meningeal branches

Superior laryngeal nerve

Internal branch

External branch

Branches in thorax


Recurrent laryngeal nerves

Right one hooks around right subclavian artery, left one hooks aortic arch Both ascend in tracheo-esophageal groove Nerves enter larynx posterior to cricothyroid joint, the nerve is now called inferior laryngeal nerve Innervations: laryngeal mucosa below fissure of glottis , all laryngeal laryngeal muscles except cricothyroid

Bronchial and esophageal branches

Branches in abdomen


Anterior and posterior gastric branches

Run close to lesser curvature and innervate anterior and posterior surfaces of stomach As far as pyloric antrum to fan out into branches in a way like the digits of a crows foot to supply pyloric part

Hepatic branches: join hepatic plexus and then supply liver and gallbladder Celiac branches: send branches to celiac plexus to be distributed with sympathetic fibers to liver, pancreas, spleen, kidneys, intestine as far as left colic flexure