1. The Cranial Nerves SHANDONG UNIVERSITY Liu Zhiyu

2. Names of cranial nerves
Ⅰ Olfactory nerve
Ⅱ Optic nerve
Ⅲ Oculomotor nerve
Ⅳ Trochlear nerve
Ⅴ Trigeminal nerve
Ⅵ Abducent nerve
Ⅶ Facial nerve
Ⅷ Vestibulocochlear
nerve
Ⅸ Glossopharyngeal
Ⅹ Vagus nerve
Ⅺ Accessory nerve
Ⅻ Hypoglossal nerve

3. Fiber components of cranial n.
General somatic afferent(sensory) fibers 一: transmit exteroceptive and proprioceptive impulses from head and face to somatic sensory nuclei of the brain stem;
Special somatic afferent (sensory) fibers transmit sensory impulses from special sense organs of vision, equilibrium and hearing to the brain ;

4. Fiber components of cranial n.
General visceral afferent (sensory) fibers transmit interoceptive impulses from the viscera to the visceral sensory nuclei-nucleus of solitery tract;
Special visceral afferent (sensory) fibers transmit sensory impulses from special sense organs of smell and taste to the brain;

5. Fiber components of cranial n.
General somatic afferent (motor) fibers : arises from the General somatic motor nuclei and innervate skeletal muscles of eye and tongue.
Special visceral afferent (motor) fibers : arises from the Special visceral motor nuclei in the brain and to skeletal muscles derived from gill arches () of embryo：such as the m. of mastication, facial expression and swallowing.

6. Fiber components of cranial n.
General visceral afferent (motor) fibers : arise from the general visceral motor nuclei and relayed in parasympathetic ganglions,e postganglionic fibers supply cardiac muscles，smooth muscles and glands.

7. Classification of cranial nerves
Sensory cranial nerves : contain only sensory fibers
Ⅰ. Olfactory nerve
Ⅱ. Optic nerve
Ⅷ. Vestibulocochlear nerve

8. Classification of cranial nerves
Motor cranial nerves : contain only motor fibers
Ⅲ. Oculomotor nerve
Ⅳ. Trochlear nerve
Ⅵ. Abducent nerve
Ⅺ. Accessory nerve
Ⅻ. Hypoglossal nerve

9. Classification of cranial nerves
Mixed nerves : contain both sensory and motor fibers
Ⅴ. Trigeminal nerve
Ⅶ. Facial nerve
Ⅸ. Glossopharyngeal nerve
Ⅹ. Vagus nerve

10. Sensory cranial nerves
I．Olfactory nerve
II. Optic nerve
VIII.Vestibulocochlear nerve

11. Olfactory nerve Olfactory cell → Olfactory nerve → Cribriform foramina
→ Olfactory bulb
Olfactory nerve
Function: conduct the smell

12. Optic nerve Ganglion cell of retina → Optic nerve → Optic canal →
optic chiasma→optic tract → lateral geniculate body.

13. Vestibulocochlear nerve
Vestibular nuclei
Cochlear nuclei
Cochlear ganglion
Vestibulocochlear nerve
Internal acoustic meatus
Vestibular ganglion

14. Sensory cranial nerves
Location of cell body
Cranial
exit
Terminal
nuclei
Main
action Ⅰ
Olfactory cells
Cribrifom
foramina
Olfactory bulb
Smell Ⅱ
Ganglion cells of retina
Optic canal
Lateral geniculate body
Vision Ⅷ
Vestibular ganglion of internal ear
Internal acoustic meatus
Vestibular nuclei
Equilibrium
Cochlear ganglionof internal ear
Cochlear nuclei
Hearing

15. Motor cranial nerves III.Oculomotor nerve trochlear nerve
VI. Abducent nerve
XI. accessory nerve
XII. hypoglossal nerve

16. Oculomotor nerve Components
Nucleus of oculomotor n.
Accessory nucleus of oculomotor n.
Oculomotor nerve
Components
General somatic motor（efferent） fiber arises from nucleus occulomotor
General visceral motor （efferent） fiber arises from accessory nucleus of Ⅲ
supplies : Superior, inferior and medial recti; inferior
obliquus; levator palpebrae superioris
Sphincter pupillae and ciliary muscle
Nucleus of oculomotor n.
Accessory nucleus of oculomotor n.

17. Oculomotor nerve Course: Leave the brain at the interpeduncular fossa;
Pass through the lateral wall of cavernous sinus
Via superior orbital fissure enter the orbita
Oculomotor nerve

18. The injury of the oculomotor n. may lead to:
Droping of the upper eyelid;
lateral strabismus ;
Dilation of the pupil;
The pupillary reflexes disappear
Oculamotor paralysis

19. Trochlear n. arises from the nucleus of trochlear nerve,
and pass through the superior orbital fissure to supply the superior obliquus
trochlear nerve

20. abducent n.
arises from the nucleus of abducent nerve, and pass through the superior orbital fissure to supply the lateral rectus
Abducent nerve

21. Accessory nerve Cranial root ：arises from nucleus ambiguus;
Spinal root arises from the accessory nucleus
pass through jugular foramen,and supplies 2 muscles
Accessory nerve
sternocleidomastoid
trapezius

22. Hypoglossal nerve Hypoglossal canal Nucleus of hypoglossal nerve

23. Function of Cranial Nerve 12
supplies the intrinsic and extrinsic muscles of the Tongue
genioglossus
extend the tongue with Contraction
So what happens if the CN12 has been damaged ?

24. Motor cranial nerves N. Nucleus of origin Cranial exit supply Ⅲ
Nucleus of oculomotor
Superior orbital
fissure
superior, inferior and medial recti; inferior obliquus; levator palpebrae superioris
Accessory nucleus of oculomotor (Parasympathetic )
sphincter pupillea and ciliary muscl Ⅳ
Nucleus of trochlear nerve
superior obliquus Ⅵ
Nucleus of abducent nerve
lateral rectus Ⅺ
Nucleus of accessory nerve
Jugular foramen
sternocleidomastoid and trapezius Ⅻ
Nucleus of hypoglossal nerve
Hypoglossal canal
muscles of tongue

25. Mixed cranial nerves V. Trigeminal nerve VII.Facial nerve
IX. Glossopharyngeal nerve
X. Vagus nerve

26. Trigeminal nerve Components of fibers
General somatic afferent fibers: transmit facial sensation to sensory nuclei of trigeminal nerve, the fibers have their cell bodies in trigeminal ganglion,
Special viceral efferent fibers: originate from motor nucleus of trigeminal nerve, and supply masticatory muscles

28. Branches Ophthalmic nerve (Ⅴ1, sensory) Branches Frontal nerve :
leave the skull through the superior
orbital fissure, to enter orbital cavity
Branches
Frontal nerve :
Supratrochlear nerve
Supraorbital nerve
Lacrimal nerve :→lacrimal gland
Nasociliary nerve ; → eyeball

29. Distribution:
Visual organ
Part of mucosa of nose
Skin above the palpebral fisure and back of nose
cerebral dura mater

30. Maxillary nerve (Ⅴ2, sensory)
Leave skull through foramen rotundum
Branches
Infraorbital nerve
Zygomatic nerve
Superior alveolar nerve
Pterygopalatine nerve

31. Distribution: Maxillary teeth Mucosa of nose and mouth
Skin between the palpebral fissure and oral fissure.
cerebral dura mater

32. Mandibular nerve (Ⅴ3, mixed)
Leave the skull through the foramen ovale 卵圆孔 to enter the infratemporal fossa
Branches
Auriculotemporal nerve
Buccal nerve
Lingual nerve
Inferior alveolar nerve Nerve of masticatory muscles

33. Distribution: cerebral dura mater; Mandibular teeth and gum;
Mucosa of floor of mouth
Anterior 2/3 of tongue;
Skin of auricular and temporal regions and below the oral fissure;
masticatory muscles, mylohyoid, and anterior belly of digastric m.

34. Facial nerve (Ⅶ) Components of fibers
Special visceral efferent fiber: fibers originate from nucleus of facial nerve, and supply facial muscles.
General visceral efferent fiber: fibers arise from superior salivatory nucleus and relayed in pterygopalatine ganglion and submandibular ganglion. The postganglionic fibers supply lacrimal, submandibular and sublingual glands.

35. Facial nerve (Ⅶ) Components of fibers.
Special visceral afferent fiber: fiber from taste buds of anterior 2/3 of tongue which cell bodies are in the geniculate ganglion of the facial nerve and end the nucleus of solitary tract.
General somatic afferent fiber: fibers distribute the skin of external ear.

36. 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.

37. 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 ganglionthe postganglionic fibers supply submandibular and sublingual glands
Branches within the facial canal

38. Greater petrosal nerve : fibers pass to pterygopalatine ganglion and the postganglionic fibers through the zygomatic and lacrimal nerves to lacrimal gland
Stapedial nerve to stapedius

39. Branches outside of facial canal
Temporal branch
Zygomatic branch
Buccal branch
Marginal mandibular branch
Cervical branch

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

41. 1. Is this paralysis belong to supranuclear paralysis and infranuclear paralysis？
2. How to distinguish the supranuclear paralysis and infranuclear paralysis
Injury to the facial nerve

42. Glossopharyngeal nerve (Ⅸ)
Components of fibers
Special visceral efferent fiber: originate from nucleus ambiguus, and supply stylopharygeus.
general visceral efferent fiber: arise from inferior salivatory nucleus and ralyed in otic ganglion, the postganglionic fibers supply parotid gland.
Special visceral afferent fiber: transmit the taste of posterior third of tongue to the nucleus of solitary tract.

43. Glossopharyngeal nerve (Ⅸ)
Components of fibers
general visceral afferent fiber: transmit the visceral sensation from mucosa of posterior third of tongue, pharynx, auditory tube and tympanic cavity, carotid sinus and glomus, to the nucleus of solitary tract.
general somatic afferent fiber: conduct the sensation from skin of posterior surface of auricle.

44. 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 : → tympanic cavity and auditory tube, and its general visceral motor fibers via lesser petrosal nerves to end the otic ganglion, the postganglionic fibers via auriculotemporal n.(Ⅴ3) to parotid gland

45. Branches Carotid sinus branch : →carotid sinus and glomus
Others: tonsillar and stylophayngeal branches
Otic ganglion : situated just below foramen ovale

46. Pharyngeal branches
Lingual branches
Carotid sinus branch

47. Vagus nerve (Ⅹ) components of fibers
general visceral efferent fiber: originate from dorsal nucleus of vagus nerve, synapse in parasympathetic ganglion, short postganglionic fibers innervate cardiac muscles, smooth muscles and glands of viscera
Special visceral efferent fiber: originate from the nucleus ambiguus, to muscles of pharynx and larynx

48. Vagus nerve (Ⅹ) components of fibers
general visceral afferent fiber: carry impulse from viscera in neck, thoracic and abdominal cavity to nucleus of solitary tract
general somatic afferent fiber: conduct the sensation from auricle, external acoustic meatus and cerebral dura mater to the spinal nucleus of trigeminal n.

49. Course Right vagus nerve Exits the skull from jugular foramen
Descends in the neck in carotid sheath between internal (or common) carotid artery and internal jugular vein
Right vagus nerve
Enter thoracic cavity on right side of trachea and infront of right subclavian a. and passes posterior to right lung root
Forms posterior esophageal plexus
and posterior vagal trunk
Passes though the esophageal hiatus into abdominal cavity, then divides into posterior gastric 胃后支and celiac branches 腹腔支

50. Left vagus nerve
Enter thoracic cavity between left common carotid and left subclavian arteries, Descends infront of the aortic arch
Passes posterior to the root of left lung Forms anterior esophageal plexus and anterior vagal trunk
Passes though the esophageal hiatus into abdominal cavity, and divides into anterior gastric and hepatic branches.

51. Branches in neck Superior laryngeal nerve Internal branch
which pierces thyrohyoid membrane to innervates mucous membrane of larynx above fissure of glottis
External branch, which innervates cricothyroid
Internal branch
External branch
Cervical cardiac branches descending to terminate in cardiac plexus

52. 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 muscles except cricothyroid
Bronchial and esophageal branches

53. Anterior and posterior gastric branches
Branches in abdomen
Anterior and posterior gastric branches
Run close to lesser curvature and innervate anterior and posterior surfaces of stomach
Hepatic branches :
supply liver and gallbladder
Celiac branches:
send branches to celiac plexus whose fibers distribute with sympathetic fibers to liver, pancreas, spleen, kidneys, intestine as far as left colic flexure

54. Nucleus of oculomotor n.
Accessory nucleus of oculomotor n.

55. Auriculotemporal nerve
Inferior alveolar nerve

56. The nerve distribution of tongue 舌的神经分布
Hypoglossal n. → the musels of tongue;
Mandibular n. → anterior 2/3 mucosa of tongue;
Facial n. → anterior 2/3 teste buds of tongue;
Glossopharygeal n. →the mucosa and teste buds of the root of tongue

57. ? The nerve distribution of the eyeball
III →sup. Inferior and medial rectus,inferior obliquus
IV→ superior obliquus VI→lateral rectus
Optic n. → visual sense;
Ophthalmic n. →general sense of eyeball;
sympathetic n. →dilator pupillae;
parasympathetic n. →sphincter pupillae and ciliary m.