C.N.

TYPE

SENSO
RY

CRANIAL
EXIT
POINT
Cribiform
plate

I
Olfactory
II
Optic

NUCLEUS
NAME
Anterior
Olfactory

Olfactory
Tract

Mucosa of nasal cavity

Smell

SENSO
RY

Optic
foramen

Lateral
Geniculate

Thalamus

Retina of the eye

Vision
Raises eyelid

Anosmia or dysosmia
(fracture of cribiform plate)
Anopsia: visual field deficits
Loss of light reflex w/ III
Only CN affected by MS
Ptosis

Eye movement
MR: adduction (most
important muscle)

Diplopia
Loss of parallel gaze
External strabismus (loss of
adduction)

IV
Trochlear

MOTO
R

MOTO
R

Edinger Westphal
(Preganglionic
PS)
Trochlear

Upper
Midbrain

Dorsal to cerebellar
peduncle, ventral
to cerebral
aqueduct
Arise from the
DORSAL part ,
CROSS, and go
below inferior
colliculus to the
ventral part.

Lower
Midbrain

Superior Oblique m:
SO

Superior
Orbital
Fissure

Superior
Orbital
Fissure

Mesencephalic

V
Trigeminal
V1: Ophtalmic
V2: Maxillary
V3:
Mandibular

Corticobulbar
innervation

MIXED
(actual
ly, the
only
one
mixed
is V3,
the
rest
are
sensor
y
only!)

V1:
Superior
Orbital
Fissure

Above entry point of

V
Propioceptive imput
Monosynaptic reflex
Jaw jerk reflex

V2:
Foramen
Rotundum

Motor

V3:
Foramen
ovale

PERIPHERAL
INNERVATION

Levator palpebrae
superioris
Extraocular muscles
Superior Rectus m: SR
Medial Rectus m: MR
Inferior Rectus m: IR
Iinferior Oblique m: IO
Sphincter Pupillae
Cilliary muscle

Oculomotor
III
Oculomotor

NUCLEUS
LOCATION

Upper
Midbrain

FUNCTION

Pupil constriction
Lens accomodation
Downward gaze &
abducts eye
Intortion

Midbrain

V1:
Skin of forehead
Scalp
Cornea

V2:
Palate
Nasal cavity
Point of entry of V
Medial to main
Maxillary face & teeth
sensory nucleus
V3: Sensory
Supply muscles of
Anterior 2/3 of tongue
MASTICATION
Middle Pons Mandibular face &
teeth
Main Sensory (or
V3 : Motor
Chief or
Muscles of
Principal)
Point of entry of V
mastication:
Lateral to motor
o
Temporalis
nucleus
o
Masseter
TACTILE AFFERENTS
o
Medial pterygoid
=> synapse 2
o
Lateral
neuron => croos Lower Pons
pterygoid
to Spinal
midline => VPM
Anterior belly of
thalamus =>
cord (C2)
digastric
somotosensory
Mylohyoid
cortex
Middle Pons

SIGN OF DAMAGE

Midriasis
Cyclopegia , loss of near
response
Weakness looking down
(reading)
Diplopia
Tilts head AWAY from lesion

V1:
General sensation
(touch, pain & T)

V1:
Loss of general sensation
Loss of blink reflex w/ VII

V2:
General sensation

V2:
Loss of general sensation
Trigeminal Neuralgia

V3:
General sensation

V3:
Loss of general sensation
Trigeminal Neuralgia

V3:
Mastication

V3:
Weakness in chewing
Jaw deviation TOWARDS weak
side

 Tensor tympani
Tensor palati

Spinal tract &

nuclei

Caudal continuation
of main sensory
nucleus
Elongate nuclei
Position analogous
to dorsal horns of
SC (meaning:
posteriorly
PAIN & T afferents
Remember!!!
=> descend in
spinal tract =>
Complete V lesion (at entry or exit point of V) in ROSTRAL PONS, results in COMPLETE
reach nucleus =>
ANESTHESIA OF IPSILATERAL FACE & JAW WEAKNESS (bc the Motor & Main Nuclei are fucked
croos midline =>
up)
VPM thalamus =>
Lesion in LATERAL LOWER PONS or LATERAL MEDULLA, results in COMPLETE ANESTHESIA and
somotosensory
LOSS OF T SENSATION OF IPSILTAREAL FACE ONLY, muscle function & tactile sensation would
cortex

be intact. (bc spinal nuclei it the only one fucked up)

Abducens
VI
Abducens

MOTO
R

Superior
Orbital
Fissure

Found near the

midline, in the
floor of the 4th v.
VI fibers encircled
by VII fibers
(genu)

Pons

Motor

VII
Facial
Corticobulbar
innervations
(partially
bilateral)

MIXED

Bilateral upper
face innervation
Contralateral
lower face
innervatoin

Ventrolateral to VI
nuclei
Entry:
Anterior Genu of
Internal
Facial Nerve:
Fibers curve
Acoustic
around the
meatus
posterior side of
VI nuclei, then
Exit:
pass
stylomastoi
ventrolaterally

d foramen

Solitary

Respond to visceral
sensation (taste,
respiratory, GI)

Superior
Salivatory

VIII
Vestibulococh
lear

SENSO
RY

Internal
Acoustic
Meatus

Pons

Lateral Rectus

Facial expression
muscles
Posterior belly of
digastric
Stylohyoid
Stapedius
---------------------->
Submandibular &
sublingual g.
Skin behind ear
Anterior 2/3 tongue
palate
Lacrimal gland

Abduction

Facial expression

Controls amplitude of
sound

Diplopia
Internal Strabismus: medial
eye deviation
Loss of parellal gaze
Pseudoptosis
Corner mouth drops, cant
close eye, cant wrinkle
forehead, no blink reflex
Hyperacusis

Salivation
(preganglionic PS)
Taste
Tears (preganglionic
PS)

Pain behind ear

Ageusia (loss of taste),
disgeusia
Dry, red eye. Loss of
lacrimation, complete VII lesion

Right Corticobulbar fibers ( UMN Lesion) Left lower face weakness= mouth
droops (pt CAN blink, wrinkle forehead, bc pt still have the left corticobulbar
fibers innervating the upper face)
Left LMN lesion(VII) Complete left face weakness = Bell Palsy
Sensorineural hearing loss
Profound & unilateral lesion is
Vestibular
Pons
Hearing
Posterior surface of
in cochlear nuclei or cochlear
Balance
Medulla
Inner ear laberynth
Pons
part of VIII
Angular acceleration
structures
Slight bilateral hearing loss &
(head turning)
Ponto Semicircular canal
Cochlear
decrease ability to localize
Linear acceleration
Dorsal & Ventral
medullary Cochlear apparatus
sound lesion above superior
(gravity)
junction
olivary nucleus
Loss of balance
Nystagmus
Stylopharyngeus
Elevation of pharynx

IX
Glossopharyn
geal

MIXED

Jugular
Foramen

Ambiguus

LMN muscles
Behind inferior
ollive

Medulla

Solitary

Oropharynx
Carotid sinus/body
Parotid gland
Posterior 1/3 tongue

Sensation
Chemoreceptor
Salivation
Taste

Muscles of palate and

pharynx; except
tensor palate (V) and
stylopharyngeous (IX)

Swallowing

Same as X

Inferior
Salivatory
Ambiguus

X
Vagus
MIXED

Jugular
Foramen

LMN skeletal
muscles
Behind inferior
ollive

Dorsal Motor
Vagal

Corticobulbar
innervation

Major
Parasympatheti
c nuclei
preganglionic
fibers to thorax
and GI (foregut
& midgut)
Lateral to XII
nucleus, in the
floor of 4th v.

Larynx muscles
(recurrent laryngeal)

Medulla

Respond to visceral
sensation (taste,
respiratory, GI)
Imput of carotid
sinus and body

MOTO
R

XII
Hypoglossal
Corticobulbar
inn.

MOTO
R

Jugular
Foramen

Spinal Accesory

Cervical
spinal cord

Hypoglossal

Medulla

Sensory
PS

Dysphagia
Palate droop (ipsilateral
paralysis of soft palate
Uvula pointing AWAY from
lesion
Nasal regurgitation
Nasal speech
Hoarseness
Fixed vocal cord
Loss of gag reflex w/ IX
Loss of cough reflex
Delayed gastric emptying
Delayed gastric emptying

Carotid sinus/body

Chemoreceptor

Sternocleidomastoid

Head rotation to
Weakness turning chin to
opposite side
opposite side
Elevates and rotates
Shoulder droop
scapula
Remember: Intramedullary lesions DONT affect this
CN!!!
Tongue pointing TOWARDS
Tongue movement
affected side on protrusion

Trapezius

Hypoglossa
l canal

Fonation
Sensory

Larynx and
Laryngopharynx
GI tract & GI smooth
muscle & glands
(foregut & midgut)

Solitary

XI
Accesory
Corticobulbar
inn.

Loss of Gag reflex with X

Styloglossus
Hypoglossus
Genioglossus
Intrinsic tongue
muscles (except
palatoglossus by X)