CN I OLFACTORY

Special Sensory
Cribiform Plate of Ethmoid
Olfactory Bulb Olfactory Tract
To Nasal Mucosa
Anosmia Loss of sense of smell
Uncinate Fits olfactory hallucinations
CN II OPTIC
Special Sensory
Optic Canals
Retinal Ganglion Cell
Optic nerve
Optic Chiasm
Pituitary
Lateral Geniculate
Nuclei
(and midbrain)
Papilledema Moore, 1090
Optic Neuritis Moore, 1090
Visual Field Defects Moore, 1090
CN III OCULOMOTOR
Somatic Motor
Parasympathetic: dashed = preganglionic
solid = postganglionic
Sympathetic (not part of CN III here,
Coming from Internal Carotid Plexus)
Superior Rectus
Levator Palpebrae
Superioris
Medial Rectus
Inferior Rectus
Inferior Oblique
Oculomotor Nucleus
Accessory Oculomotor
(Edinger-Westphal)
Nucleus
Ciliary Muscle
Constrictor Pupillae
Dilator Pupillae
Ciliary
Ganglion
Long C
iliary N
.
Short
Ciliary
Nerves
Oculomotor Nerve Palsy
- Ptosis
- No Pupillary Reflex
- Dilation of the Pupil
- Eye Abducted
- No Lens Accomadation
Compression of CN III
Aneurism of Posterior Cerebral
or Superior Cerebellar Artery
N
asociliary N
. (V
1
)
Eyelid
Efferent fibers to
Olfactory Bulb
Superior division
Inferior division
Special Somatic Sensory (SSA)
Special Visceral Sensory (SVA)
Somatic/Visceral Motor (GSE/GVE)
CN IV TROCHLEAR
Motor
Superior Oblique
(Eye Down and Out)
Trochlear Nerve Injury (Rarely alone)
- Diplopia
CN VI Abducent
Lateral Rectus
LR
6
SO
4

Trochlear
Nucleus
Abducent
Nucleus
Abducent Nerve Injury
- Long intercranial course
- Stretched due to fluid pressure
- Paralysis
- Diplopia except opposite side of lesion
or
Aneurism of Willis
or
Septic Thrombosis of Cavernous Sinus
Motor
Somatic Motor (GSE)
Somatic Motor (GSE)
CN V TRIGEMINAL
V
1
Opthalmic
Trigeminal
Ganglion
Meningeal
Lacrimal Gland
Lateral upper eyelid
Conjunctiva
Lacrimal Nerve
Lateral Scalp
Forehead
Frontal Sinus
Internal Upper Eyelid
Medial Scalp
Forehead
Medial Upper Eyelid
Frontal Nerve
Supraorbital N.
Supratrochlear N.
Supraorbital
Foramen
Sup. Ext. Nasal Wall
Medial Eyelids
Conjunctiva
Lacrimal Sac
Ciliary
Ganglion
Eyeball
Short
Ciliary
Nerves
Iris, Cornea
L
o
n
g

C
i
l
i
a
r
y

N
e
r
v
e

Sphenoid Sinus
Post. Ethmoidal
Air Cells
N
a
s
o
c
i
l
i
a
r
y

N
e
r
v
e

P
o
s
t
.

E
t
h
m
o
i
d
a
l


N
e
r
v
e

Post. Ethmoidal
Foramen
Ethmoidal
Air Cells
Ant. Ethmoidal
Foramen
A
n
t
.

E
t
h
m
o
i
d
a
l

N
e
r
v
e

Ant. 1/3
Nasal
Septum
Lat.
Nasal
Wall
Tip
of
Nose
Nasal
Cavity
E
x
t
e
r
n
a
l

N
a
s
a
l

B
r
a
n
c
h

L
a
t
e
r
a
l

I
n
t
e
r
n
a
l

N
a
s
a
l

M
e
d
i
a
l

I
n
t
e
r
n
a
l

N
a
s
a
l

Infratrochlear/
External Nasal/
Internal Nasal
Sensory
(roof of orbit)
General Sensory (GSA)
CN V TRIGEMINAL
V
2
Maxillary
Trigeminal
Ganglion
Upper Lip
Medial Cheek
Side of Nose
Meningeal
Pterygo-
Palatine Fossa w/
Ganglion
Hard Palate
Soft Palate
Lesser
Palatine
Foramen
Roof of Pharynx
Sphenoid Sinus
P
h
a
r
y
n
g
e
a
l

B
r
a
n
c
h

Sensory to posterior
2/3 lateral nasal wall
Nasal Concha
Ethmoidal Air Cells
G
r
e
a
t
e
r

P
a
l
a
t
i
n
e

N
.

N
a
s
o
p
a
l
a
t
i
n
e

N
e
r
v
e

Sensory to posterior
2/3 nasal septum
Incisive Canal
Sphenopalatine
Foramen
Deep
Petrosal N.
(from Internal
Carotid Plexus)
Vidian N.
Of Pterygoid Canal
Upper Teeth
Maxillary Sinus
Post., Mid., & Ant.
Superior Alveolar N.
Inferior Orbital
Fissure
Infraorbital
Foramen
Infraorbital Nerve
Lacrimal
Gland
Temporal Fossa
(side of forehead)
Zygomatic Arch
(lateral cheek)
Lacrimal Nerve (v
1
)
Zygomatic N.
Zygomaticotemporal N.
Zygomaticofacial N.
Zygomaticotemporal
Foramen
Zygomaticofacial
Foramen
Sensory
Parasympathetic
dashed = preganglionic
solid = postganglionic
Sympathetic
Greater
Palatine
Foramen
Greater
Petrosal N.
(from CN VII)
General Sensory (GSA)
Infraorbital canal
CN V TRIGEMINAL
V
3
Mandibular
Sensory
Special Sensory
Parasympathetic: dashed = preganglionic
solid = postganglionic
Motor
Trigeminal
Ganglion
Otic
Ganglion
Foramen
Ovale
Meningeal
Foramen
Spinosum
Lesser Petrosal
Nerve (IX)
Parotid Gland
(Parasympathetics
from CN IX)
Middle
Meningeal
Artery
A
u
r
ic
u
lo
te
m
p
o
r
a
l N
.
Lower Teeth
Gums
Lower Lip
Chin
Mental N.
Mental Foramen
Inferior Alveolar Nerve
Mandibular
Foramen
Mylohyoid
Anterior Digastric
Anterior 2/3
Tongue
Lingual Nerve
Chorda
Tympani
VII
Submandibular
Ganglion
Submandibular Gland
Sublingual Gland
Buccal Nerve Skin over Buccinator
Cheek Mucosa
Gums
Muscles of Mastication
Medial Pterygoid
Lateral Pterygoid
Temporalis
Masseter
----------------------------------
Tensor Veli Palatini Muscle
Tensor Tympani Muscle
Auricle
Scalp
Lateral Face
Taste
Sensation
CN VII Facial
Geniculate
Ganglion
Motor
Nucleus
of Facial
Nerve
Superior
Salivatory
Nucleus
Solitary Tract Nucleus
Internal
Acoustic
Meatus
Deep
Petrosal
Nerve
I
n
t
e
r
n
a
l

C
a
r
o
t
i
d

P
l
e
x
u
s

Internal
Carotid
Artery
Greater Petrosal N.
Hiatus of
Greater
Petrosal Pterygoid Canal
Containing
Vidian Nerve
Pterygo-
Palatine
Ganglion
Lacrimal Gland
Via V
2

Stapedius
Stylohyoid
Posterior Digastric
Taste on Anterior
2/3 of Tongue
Submandibular
Ganglion
Submandibular &
Sublingual Glands
Stylomastoid
Foramen
Chorda Tympani Nerve
Parotid
Gland
Muscles
Of
Facial
Expression
(Including
Buccinator
&
Platysma)
Temporal
Zygomatic
Buccal
Mandibular
Cervical
Post. Auricular
Special Sensory
Parasympathetic: dashed = preganglionic
solid = postganglionic
Motor
Auricular Muscles
Occipitalis Muscle
Posterior
Auricular
Nerve
Occiptial Branch
(Lingual Nerve of V
3
)
Sympathetic
CN VIII Vestibulocochlear
Internal
Acoustic
Meatus
Cochlear
Ganglion
Vestibular
Ganglion
V
estibular N
erve
Cochlear Nerve
Cochlea
Vestibular
Apparatus
Special Sensory
Vestibular
Nuclei
Cochlear
Nuclei
Vestibulocochlear Nerve Injuries
- Tinnitus, vertigo, loss of Hearing
Deafness (conductive & sensorineural)
Acoustic Neuroma
Trauma & Vertigo
Mnire Syndrome endolymphatic hydrops, tinnitus, vertigo, nausea
Vestibular Disease TIA transient ischemic attack
Hearing
Balance
CN IX Glossopharyngeal
Sensory
Special Sensory
Parasympathetic
Motor
Inferior
Salivatory
Nucleus
Spinal Tract &
Spinal Nucleus of
Trigeminal Nerve
Solitary
Tract
Nucleus
Nucleus
Ambiguus
Otic
Ganglion
Parotid
Gland
Lesser Petrosal N. Tympanic Nerve
Jugular Foramen
Superior
Glossopharyngeal
Ganglion
Inferior
Glossopharyngeal
Ganglion
Tympanic Plexus
Stylopharyngeus
Taste & Sensation of
Posterior 1/3 of Tongue
Carotid Body
Carotid Sinus
Pharynx
Palatine Tonsil
Pharyngeal Branch
Tonsillar Branch
Lingual Branch
Carotid
Branch
Pharyngotympanic tube &
Pharyngeal Opening
Internal
Carotid
Artery
Lesions of CN IX (uncommon)
- Taste Absent posterior 1/3
- Gag Reflex missing on side of lesion
- Jugular Foramen Syndrome
Glossopharyngeal Neuralgia (uncommon)
- Pain Paroxysms burning or stabbing
CN X Vagus
1
2
3
1) Posterior Nucleus of Vagus
(Parasympathetic)
2) Solitary Tract Nucleus
(Visceral Afferents)
3) Nucleus Ambiguus
(Motor to Pharyngeal &
Laryngeal Muscles)
Jugular Foramen
Superior & Inferior
Ganglia of Vagus Nerve
All Pharyngeal Muscles
(except Stylopharyngeus IX)
All Palate Muscles
(except Tensor Veli Palatini V
3
)
Pharyngeal Branch
Cricothyroid Muscle
(tenses, adducts,
elongates vocal cords)
Superior Laryngeal N.
All Intrinsic Laryngeal Muscles
(except Cricothyroid Ext. branch)
Sensory & Parasympathetic to Larynx
below vocal cords;
Parasympathetic (Efferent & Afferent) to
Upper Esophagus & Trachea
Recurrent Laryngeal N.
To Thorax & Abdominal Viscera
Sensory Above
Vocal Cords
Parasympathetic
Internal Branch
Sensory
Parasympathetic
Motor
Lesions of Vagus Nerve
- Injury to pharyngeal branch
!Dysphagia (difficulty swallowing)
- Lesion of superior laryngeal nerve
!Anesthia in upper larynx & paralysis
of cricothyroid muscle
!Voice is weak & tires easily
- Injury to Recurrent Laryngeal
!Caused by aortic aneurysm or neck
operations
!Hoarseness, dysphonia (" voice quality)
!If both sides, aphonia (no voice) &
inspiratory stridor (crowing sound during
inspiratory phase)
A
u
r
i
c
u
l
a
r

B
r
a
n
c
h

External Acoustic
Meatus
CN XI Spinal Accesory
Motor
Nucleus
Ambiguus
C1
C2
C3
C4
Foramen
Magnum
Jugular
Foramen
Sternocleidomastoid
Trapezius
Sensory (Proprioceptive)
Injury During Special Procedures
Lesions
- Weakness and atrophy
- Impairment of opposite side rotary
movements (SCM) & shrugging
movements
- Scapular winging during shoulder
abduction
CN XII Hypoglossal
C1
C2
Hypoglossal
Canal
All Glossus Muscles
(except Palatoglossus - X)
Hypoglossal
nucleus
Motor
CN V TRIGEMINAL
V
1
Opthalmic
Trigeminal
Ganglion
Lacrimal Gland
Lateral upper eyelid
Conjunctiva
Lacrimal Nerve
Frontal Nerve
Supraorbital N.
Supratrochlear N.
Supraorbital
Foramen
Short
Ciliary
Nerves
L
o
n
g

C
i
l
i
a
r
y

N
e
r
v
e

Nasociliary Nerve
P
o
s
t
.

E
t
h
m
o
i
d
a
l


N
e
r
v
e

A
n
t
.

E
t
h
m
o
i
d
a
l

N
e
r
v
e

I
n
f
r
a
t
r
o
c
h
l
e
a
r

Sensory
(roof of orbit)
General Sensory (GSA)
I
n
t
e
r
n
a
l

N
a
s
a
l

E
x
t
e
r
n
a
l

N
a
s
a
l

CN V TRIGEMINAL
V
2
Maxillary
Trigeminal
Ganglion
Pterygo-
Palatine Fossa w/
Ganglion
G
r
e
a
t
e
r

P
a
l
a
t
i
n
e

N
.

N
a
s
o
p
a
l
a
t
i
n
e

N
e
r
v
e

Mid.,& Ant.
Superior Alveolar N.
Infraorbital
Foramen
Infraorbital Nerve
Zygomatic N.
Zygomaticotemporal N.
Zygomaticofacial N.
Sensory
General Sensory (GSA)
(Infraorbital canal)
Lateral cheek
Side of
forehead
Upper Lip
Cheek
Side of Nose
CN V TRIGEMINAL
V
3
Mandibular
Sensory
Special Sensory
Branchial Motor
Trigeminal
Ganglion
Foramen
Ovale
Meningeal
Foramen
Spinosum
A
u
r
ic
u
lo
te
m
p
o
r
a
l N
.
Lower Teeth
Gums
Chin
Lower Lip
Mental N.
Mental Foramen
Inferior Alveolar Nerve
Mandibular
Foramen
Mylohyoid
Anterior Digastric
Anterior 2/3
Tongue
Lingual Nerve
Buccal Nerve Mucosa of Mouth
and Gums
Muscles of Mastication
Nerve to:
Medial Pterygoid
Lateral Pterygoid
Temporalis
Masseter
----------------------------------
Tensor Palatini Muscle
Tensor Tympani Muscle
Sensation
External auditory
meatus
External tympanic
membrane
Nerve to
Mylohyoid
(infratemporal fossa)
Meningeal Branch
(mandibular canal)