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MVST IB Head and Neck Anatomy: Ntroduction To The Ranial Erves
MVST IB Head and Neck Anatomy: Ntroduction To The Ranial Erves
13 October 2015
Dr Cecilia Brassett
SOMATOMOTOR
This cell column lies close to the midline, comprising the nuclei of four cranial nerves. The
former two lie at the level of the superior and inferior colliculus in the midbrain, while the latter
two are located in the pons and medulla. Their fibres supply striated muscles, as follows:
III (oculomotor)
IV (trochlear)
VI (abducent)
XII (hypoglossal)
levator palpebrae superioris of the upper eyelid and four extraocular muscles
superior oblique muscle of the eye
lateral rectus muscle of the eye
intrinsic and extrinsic muscles of the tongue, except palatoglossus
VISCEROMOTOR
This cell column comprises preganglionic parasympathetic neurones that give fibres to CN III, VII
(facial), IX (glossopharyngeal) and X (vagus). The nuclei and structures they supply are as follows:
III (Edinger-Westphal nucleus, midbrain)
VII (superior salivatory nucleus, pons)
IX (inferior salivatory nucleus, pons)
X (dorsal nucleus of the vagus, medulla)
BRANCHIOMOTOR
This cell column of nuclei lies more laterally and deeply, innervating striated muscle of branchial
arch origin. These involve CN V (trigeminal), VII, IX, X and the cranial part of XI (accessory):
V (trigeminal motor nucleus, mid-pons)
VII (facial motor nucleus, lower pons)
IX, X and cranial XI (nucleus ambiguus)
The following diagram shows the brain stem viewed from the dorsal aspect. The afferent
(sensory) cranial nerve nuclei are shown on the left and the efferent (motor) nuclei on the right.
VISCEROSENSORY
The nucleus tractus solitarius lies most medially in the medulla, receiving sensory fibres from:
VII
IX
SPECIAL SENSORY
Fibres conveying the special senses of hearing and equilibrium run in CN VIII (vestibulocochlear)
and end in the cochlear and vestibular nuclei in the medulla on the floor of the fourth ventricle.
SOMATOSENSORY
All fibres conveying general sensation from structures in the head enter the brain through CN V
at the level of the pons to end in the trigeminal sensory nucleus. This is the largest cranial nerve
nucleus and has three components: the mesencephalic nucleus for proprioception, the pontine
(chief) nucleus for discriminative sensation and light touch, and the spinal trigeminal nucleus for
deep touch, pain and temperature.
Note that while all somatosensory fibres terminate in CN V nuclei, general sensation is conveyed
initially by other cranial nerves depending on the area being supplied:
VII
IX
X
For individual cranial nerves, it is important to understand that they may comprise different
types of fibres, e.g. CN VII contains visceromotor (parasympathetic to glands), branchiomotor
(to facial muscles), viscerosensory (taste fibres) and somatosensory fibres.
CN VII and VIII run together to pass into the internal acoustic meatus. The fibres of CN VIII are
distributed to the organs of the inner ear, while CN VII passes through the middle ear to emerge
via the stylomastoid foramen to be distributed to the facial muscles.
CN IX, X and XI pass through the anterior part of the jugular foramen, which is occupied by the
sigmoid sinus posteriorly. CN XII exit through its hypoglossal canal in the occipital bone.