C.N.

TYPE CRANIAL EXIT NUCLEUS NUCLEUS PERIPHERAL INNERVATION FUNCTION SIGN OF DAMAGE
POINT NAME LOCATION
I SENSORY Cribiform plate Anterior Olfactory Olfactory Tract Mucosa of nasal cavity Smell Anosmia or dysosmia (fracture of
Olfactory cribiform plate)
II  Anopsia: visual field deficits
Optic SENSORY Optic foramen Lateral Geniculate Thalamus Retina of the eye Vision  Loss of light reflex w/ III
 Only CN affected by MS
Levator palpebrae superioris Raises eyelid Ptosis
Extraocular muscles  Diplopia
Oculomotor Upper Midbrain  Superior Rectus m: SR Eye movement  Loss of parallel gaze
III MOTOR Superior  Medial Rectus m: MR MR: adduction (most  External strabismus (loss of adduction)
Oculomotor Orbital Fissure  Inferior Rectus m: IR important muscle)
 Iinferior Oblique m: IO
Edinger Westphal Upper Midbrain Sphincter Pupillae Pupil constriction Midriasis
(Preganglionic PS) Cilliary muscle Lens accomodation Cyclopegia , loss of near response
Trochlear  Downward gaze & abducts  Weakness looking down (reading)
IV MOTOR Superior  Dorsal to cerebellar Lower Midbrain Superior Oblique m: SO eye  Diplopia
Trochlear Orbital Fissure peduncle, ventral to
cerebral aqueduct  Intortion  Tilts head AWAY from lesion
 Arise from the DORSAL
part , CROSS, and go
below inferior colliculus
to the ventral part.
 Mesencephalic  Midbrain V1: V1: V1:
V1: Superior  Above entry point of V  Skin of forehead General sensation (touch, pain &  Loss of general sensation
Orbital Fissure  Propioceptive imput  Scalp T°)  Loss of blink reflex w/ VII
 Monosynaptic reflex 
 Cornea
Jaw jerk reflex
V2: V2: V2:
V2: Foramen  Middle Pons  Palate General sensation  Loss of general sensation
 Motor
Rotundum  Point of entry of V  Nasal cavity  Trigeminal Neuralgia
 Medial to main sensory  Maxillary face & teeth
nucleus V3: Sensory V3: V3:
 Supply muscles of  Anterior 2/3 of tongue General sensation  Loss of general sensation
V MIXED MASTICATION
 Middle Pons  Mandibular face & teeth  Trigeminal Neuralgia
Trigeminal (actually,
the only  Main Sensory (or V3 : Motor
V1: Ophtalmic one Chief or Principal)  Muscles of mastication:
V2: Maxillary mixed is  Point of entry of V o Temporalis
 Lateral to motor nucleus
V3: Mandibular V3, the V3: Foramen o Masseter V3: V3:
 TACTILE AFFERENTS =>
rest are ovale synapse 2° neuron => o Medial pterygoid Mastication  Weakness in chewing
sensory croos midline => VPM o Lateral pterygoid  Jaw deviation TOWARDS weak side
Corticobulbar only!) thalamus =>  Anterior belly of digastric
innervation somotosensory cortex  Lower Pons to  Mylohyoid
Spinal cord  Tensor tympani
 Spinal tract & nuclei (C2)  Tensor palati
 Caudal continuation of
main sensory nucleus
 Elongate nuclei
 Position analogous to Remember!!!
dorsal horns of SC  Complete V lesion (at entry or exit point of V) in ROSTRAL PONS, results in COMPLETE ANESTHESIA OF IPSILATERAL FACE & JAW
(meaning: posteriorly WEAKNESS (bc the Motor & Main Nuclei are fucked up)
 PAIN & T° afferents =>  Lesion in LATERAL LOWER PONS or LATERAL MEDULLA, results in COMPLETE ANESTHESIA and LOSS OF T° SENSATION OF
descend in spinal tract IPSILTAREAL FACE ONLY, muscle function & tactile sensation would be intact. (bc spinal nuclei it the only one fucked up)
=> reach nucleus =>
croos midline => VPM
thalamus =>
somotosensory cortex
 Abducens  Diplopia
 Found near the midline,  Internal Strabismus: medial eye
VI MOTOR Superior in the floor of the 4th v. Pons Lateral Rectus Abduction deviation
 VI fibers encircled by VII
Abducens Orbital Fissure  Loss of parellal gaze
fibers (genu)
 Pseudoptosis
 Motor  Facial expression muscles Facial expression  Corner mouth drops, can´t close eye,
VII  Ventrolateral to VI  Posterior belly of digastric can´t wrinkle forehead, no blink reflex
Facial Entry: Internal nuclei  Stylohyoid  Hyperacusis
 Anterior Genu of Facial
Acoustic
Nerve: Fibers curve
 Stapedius ----------------------> Controls amplitude of sound
Corticobulbar meatus Pons Submandibular & sublingual g. Salivation (preganglionic PS)
around the posterior
innervations MIXED side of VI nuclei, then Skin behind ear Pain behind ear
(partially bilateral) Exit: pass ventrolaterally Anterior 2/3 tongue palate Taste Ageusia (loss of taste), disgeusia
 Bilateral upper face stylomastoid  Solitary
innervation Lacrimal gland Tears (preganglionic PS) Dry, red eye. Loss of lacrimation, complete
foramen  Respond to visceral VII lesion
 Contralateral lower
sensation (taste,
face innervatoin
♥respiratory, GI)  Right Corticobulbar fibers ( UMN Lesion)  Left lower face weakness= mouth droops (pt CAN blink, wrinkle
 Superior Salivatory 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
 Vestibular  Pons   Hearing  Profound & unilateral  lesion is in
VIII Internal  Posterior surface of Medulla Inner ear laberynth structures  Balance cochlear nuclei or cochlear part of VIII
Pons  Semicircular canal  Slight bilateral hearing loss & decrease
Vestibulocochlear SENSORY Acoustic  Angular acceleration (head
ability to localize sound  lesion above
Meatus  Ponto-  Cochlear apparatus turning)
 Cochlear superior olivary nucleus
 Dorsal & Ventral
medullary  Linear acceleration (gravity)  Loss of balance
junction
 Nystagmus
 Ambiguus Stylopharyngeus Elevation of pharynx
IX Jugular  LMN  muscles Oropharynx Sensation
Glossopharyngeal MIXED Foramen  Behind inferior ollive Medulla Loss of Gag reflex with X
Carotid sinus/body Chemoreceptor
 Solitary
Parotid gland Salivation
 Same as X
Posterior 1/3 tongue Taste
 Inferior Salivatory
 Ambiguus  Dysphagia
 LMN  skeletal Muscles of palate and Swallowing  Palate droop (ipsilateral paralysis of
muscles pharynx; except tensor palate soft palate Uvula pointing AWAY
 Behind inferior ollive (V) and stylopharyngeous (IX) from lesion
 Dorsal Motor Vagal
 Nasal regurgitation
 Major
X
Parasympathetic Larynx muscles  Nasal speech
Vagus Jugular nuclei preganglionic (recurrent laryngeal) Fonation  Hoarseness
MIXED Foramen fibers to thorax and GI Medulla  Fixed vocal cord
Corticobulbar (foregut & midgut) Sensory  Loss of gag reflex w/ IX
innervation  Lateral to XII nucleus,
Larynx and Laryngopharynx  Loss of cough reflex
in the floor of 4th v.
 Solitary  Delayed gastric emptying
 Respond to visceral GI tract & GI smooth muscle & Sensory  Delayed gastric emptying
sensation (taste, glands (foregut & midgut) PS
♥respiratory, GI)
 Imput of carotid sinus Carotid sinus/body Chemoreceptor
and body
XI Jugular Cervical spinal Sternocleidomastoid Head rotation to opposite side Weakness turning chin to opposite side
Accesory MOTOR Foramen Spinal Accesory cord Trapezius Elevates and rotates scapula Shoulder droop
Corticobulbar inn. Remember: Intramedullary lesions DON’T affect this CN!!!
XII Hypoglossal  Styloglossus Tongue pointing TOWARDS affected side
Hypoglossal MOTOR canal Hypoglossal Medulla  Hypoglossus Tongue movement on protrusion
Corticobulbar inn.  Genioglossus
 Intrinsic tongue muscles
(except palatoglossus by X)