Olfactory Nerve

Optic Nerve

Occulomotor Nerve 1- Deep cerebral origin 2- Cerebral course 3- Cerebral exit 4- Cranial course 5- Cranial exit 6- Distribution and 7- Injury

Occulomotor Nerve Interpeduncular Fossa

Occulomotor nerve

Somatic Motor Nucleus Parasympathetic Nucleus (Edinger-Westphal) Pretectal Nucleus (Pupillary Light Reflex) Interstitial Cell of Cajal (Vertical Gaze) Cavernous Sinus

Occulomotor Nerve Lesion

1- Ptosis 2- Un-opposed Action of Lateral Rectus 3- Intact Lateral Rectus 4- Affected Medial Rectus 5- Affected Superior Rectus6- Affected Inferior Rectus

Trochlear Nerve 1- Deep cerebral origin 2- Cerebral course 3- Cerebral exit 4- Cranial course 5- Cranial exit 6- Distribution and 7- Injury

Trochlear Nerves

Trochlear nerve

Trochlear Nerve Superior oblique Muscle Cavernous Sinus

Trochlear Nerve Injury

Predict the functional deficit resulting from damage to each nerve. There is a very cool web site that allows you to simulate the eye motions expected from lesions to different cranial nerves and different eye muscles. Check it out at This patient has a damaged right trochlear nerve (IV). The right superior oblique muscle is paralyzed. Note that movements to the right are not affected, but movements down and, especially, down and to the left result in asymmetrical eye movements. The right eye is not able to move down and in.

2- Abducent Nerve 1- Deep cerebral origin 2- Cerebral course 3- Cerebral exit 4- Cranial course 5- Cranial exit 6- Distribution and 7- Injury

Abducent Nerves

Abducent nerve

Abducent and Para-Abducent Nuclei Abducent Nerve Lateral Rectus Muscle Cavernous Sinus

Abducent Nerve Injury

Adducted by intact medial rectus Failure of abduction due to affected lateral rectus

Trigeminal Nerve

Mandibular Division ophthalmic maxillary

(Ophthalmic Division of Trigeminal Nerve)

Ophthalmic nerve

Trigeminal Ganglion Ophthalmic Nerve Mandibular Nerve Maxillary Nerve 1- Lacrimal Branch of Ophthalmic Nerve 2- Frontal Branch of Ophthalmic Nerve 3- Nasociliary Branch of Ophthalmic Nerve

Branches of Ophthalmic Division Trigeminal Nerve

1- The Lacrimal Nerve Course, Relations and Distribution

Trigeminal Ganglion Lacrimal Nerve Lateral Rectus Muscle Communicating Branch from Zygomatic Branch of Maxillary Nerve Glandular Branches Palpebral Terminal Branch

2- The Frontal Nerve Course, Relations and Distribution

2- Frontal Branch of Ophthalmic Nerve a large supraorbital branches smaller supratrochlear branch

3- The Nasociliary Nerve Course, Relations and Distribution

3- Nasociliary Branch of Ophthalmic Nerve

Nasociliary Nerve Anterior Ethmoidal Nerve Infratrochlear Nerve

The Maxillary Nerve Origin, Course and Termination

Maxillary Nerve Foramen Rotundum Pterygo-palatine Fossa Pterygo-maxillary Fissure Inferior Orbital Fissure Infra-orbital Groove Infra-orbital Canal Infra-orbital Foramen

The Mandibular Nerve

Origin and Exit from the Skull

Trigeminal Nerve Mandibular Division

Roots, Course, Relations and Termination

Anterior DivisionPosterior Division

Facial Nerve

Definition and General Description

Facial Nerve

Deep Origin (Nuclei) and Course in The Brain

Motor Nucleus of Facial Nerve Facial Colliculus Superior Salivatory Nucleus Solitarius Spinal Nucleus of The Trigeminal Nerve

Facial Nerve Motor Nucleus of Facial Nerve Superior Salivatory Nucleus Solitarius Spinal Nucleus of The Trigeminal Nerve

Cerebral Course

Motor Nucleus of Facial Nerve Facial Colliculus Superior Salivatory Nucleus Solitarius Spinal Nucleus of The Trigeminal Nerve

Nucleus Solitarius Motor Nucleus of Facial Nerve Superior Salivatory Nucleus Submandibular Ganglion Pterygopalatine Ganglion Proprioception

Cerebral Exit (Exit off The Brain)

Facial Nerve Motor Root Sensory Root (Nervous Intermedius)

Cranial Exit (Exit off The Skull)

Stylomastoid Foramen Facial Nerve

Course and Relations

1- Inside The Skull

Middle Ear Cavity Internal Auditory Meatus Genu Stylomastoid Foramen

Semicircular Canals Cochlea Genu of Facial Nerve Facial Nerve Middle Ear Cavity

Facial Nerve Chorda Tympani Facial Canaliculus Facial Nerve

2- Ouside The Skull

Branches of Facial Nerve

Greater Superficial Petrosal Tympanic Nerve Nerve to Stapedius Corda Tympani Posterior Auricular Nerve Descending Motor Branch Terminal Branches

Facial Palsy

Glossopharyngeal nerve

Definition and General Description

Vagus Nerve Facial Nerve Glossopharyngeal Nerve

Deep Origin (Nuclei) and Course in The Brain

Facial Nerve Vagus Glossopharyngeal Nerve 1- Nucleus Ambiguous Stylopharyngeus 2- Inferior Salivatory Nucleus 3- Nucleus Solitarius 4- Spinal Nucleus of Trigeminal Nerve soft palate tonsil Auricle Parotid Gland V3 otic ganglion lesser petrosal Nerve Tympanic Plexus Tongue auditory tube

10 th 12 th Glossopharyngeal Nerve 11 th 1- Nucleus Ambiguous 2- Inferior Salivatory Nucleus 3- Nucleus Solitarius 4- Spinal Nucleus of Trigeminal Nerve olive

Cerebral Exit (Exit off The Brain)

Glossopharyngeal Nerve Olive Preolivary Fissure Pyramid 10 th 12 th 11 th

Branches of The Glossopharyngeal Nerve

Vagus Facial Nerve Glossopharyngeal Nerve 1- Tympanic Nerve (nerve of Jacopson) tympanic plexus lesser petrosal nerve Parotid Gland otic ganglion 2- Carotid Nerve 3- Nerve to Stylopharyngeus 4- Pharyngeal Branches 5- Tonsillar Branches 6- Lingual Branches

Vagus Nerve

1- Parasympathetic Fibres (Heart, Bronchial Tree and Abdomen) 2- Visceral Motor Fibres 3- Visceral Sensory Fibres (Mucous Membrane of Viscera 4- Special Sense Fibers (Taste) 5- Somatic Sensory Fibres (Dura, Auricle and Tympanic Membrane

Deep Origin (Nuclei) and Course in The Brain

Dorsal Motor Nucleus of Vagus (Parasympathetic) Nuleus and Tractus Solitarius (Taste and Visceral Sensations) Nucleus Ambiguous (Motor) Spinal Nucleus and Tract of Trigeminal Nerve (General Sensation from Face) Vagus Nerve

Dorsal Nucleus of Vagus Spinal Nucleus and Tract of Trigeminal Nerve Olive Vagus Nerve Emerging Between Olive and Inferior Cerebellar Peduncles Nucleus Solitarius Nucleus Ambiguous

Cerebral Exit (Exit off The Brain)

Vagus Nerve Olive Accessory Nerve Pyramid Glossopharyngeal Nerve

Branches

Vagus Nerve 1- Meningeal Branch 2- Auricular Branch 3- Pharyngeal Branch 4- Superior Laryngeal Branch Pharyngeal Plexus 5- Carotid Branch 6- Cardiac Branches 7- Recurrent Laryngeal Nerve External Laryngeal Cricothyroid Muscle Internal Laryngeal Thyrohyoid Membrane

First Part of Subclavian Artery Vagus Nerve Right Recurrent Laryngeal Nerve

Injury of Vagus Nerves

Unilateral Paralysis Accumulation of Saliva and Food Paralyzed SideDuring Phonation Removal of Arytenoid Cartilage

Accessory nerve

Accessory Nerve Cranial Part vagus C1 C2 C3 C4 C5 Nucleus Ambiguous Spinal Part

Deep Origin (Nuclei) and Course in The Brain

Accessory Nerve Cranial Part vagus C1 C2 C3 C4 C5 Nucleus Ambiguous

10 th 12 th 9 th Accessory Nerve Nucleus Ambiguous olive

Cerebral Exit (Exit off The Brain)

Accessory Nerve Olive Preolivary Fissure Pyramid 10 th 12 th 11 th 9 th

Branches of The Accessory Nerve

A- From The Cranial Part

Cranial Accessory Nerve Joins The Vagus Nerve At The Level of its Inferior Ganglion And Distributed Through Vagus (Recurrent Laryngeal Branch) Nucleus Ambiguous

B- From The Spinal Part

Spinal accesory nerve To Trapezius Muscle To Sternomastoid

Hypoglossal Nerve

Definition and General Description

It is the motor nerve of all muscles of the tongue EXCEPT The Palatoglossus Muscle Which is supplied by Vagus Nerve Geniohyoid Thyro- hyoid Hypoglossal Nucleus Sternohyoid Omohyoid Sternothyroid Hypoglossal Nerve

Deep Origin (Nuclei) and Course in The Brain

Hypoglossal Nucleus Hypoglossal Nerve Hypoglossal Trigone

Hypoglossal Nerve Nucleus Hypoglossal Nerve Fibers Passing Anteriorly Through Medulla Oblongata Olive Pyramid Hypoglossal Nerve Emerging Between Olive and Pyramid

Cerebral Exit (Exit off The Brain)

Rootlets of the Hypoglossal Nerve Olive Preolivary Fissure Pyramid

Cranial Course and Exit (Exit off The Skull)

The Hypoglossal Nerve Leaves The Skull Through The Anterior Condylar Canal (Hypoglossal Canal)

Hypoglossal Nerve Injury

Normal Healthy Tongue

Atrophy and Wrinkling of The Affected Side

The Tongue Points to The Affected Side Tongue Healthy Genioglissus Mandible Paralysed Genioglissus

The Cervical Sympathetic Trunk

General Discription and Formation

Cervical Part of Sympathetic Chain Superior Cervical Ganglion (At The Level of C2 and C3 Vertebrae) Middle Cervical Ganglion (At The Level of C6 Vertebra) Inferior Cervical Ganglion (Lies Between Transverse Process of C7 and First Rib) Fused with The First Thoracic Ganglion (Stellate Ganglion)

Upper 5 thoracic nerves White and Gray communicants Thoracic part of sympathetic chain Cervical part of sympathetic chain Superior cervical ganglion Middle cervical ganglion Inferior cervical ganglion

Injury of Cervical Sympathetic Chain

Horner’s Syndrome Ptosis Miosis Anhydrosis Flushing (Redness)

Scar on The Left Side of The Neck