DEVELOPMENT NERVOUS SYSTEM (NS)

The nervous system is derived from the ectoderm, which is the outermost layer of
the embryonic disc.
Structurally, the nervous system is divided into two parts:

 Central nervous system – consists of the brain and the spinal cord.
 Peripheral nervous system – consists of cranial and spinal nerves, ganglia,
plexuses, and sensory receptors.

DEVELOPMENT OF THE CENTRAL NERVOUS SYSTEM (CNS)

-begins at the third week
-as a slipper-shaped plate of thickened ectoderm, the neural plate, in the middorsal
region in front of the primitive node. Its lateral edges soon elevate to form the
neural folds.
- later the neural folds approach each other in the midline, and fused and give rise
to neural tube.

Figure 1 A–C. Transverse sections through successively older embryos showing formation of the neural
groove, neural tube, and neural crest. Cells of the neural crest, migrate from the edges of the neural
folds and develop into spinal and cranial sensory ganglia (A–C). D. Scanning electron micrograph of a
mouse embryo showing the neural tube (NT) and neural crest cells (arrows) migrating from the dorsal
region (compare with B and C).

Fusion of the neural tube begins in the cervical region and proceeds in cephalic and
caudal directions.
Once fusion is initiated, the open ends of the neural tube form the cranial and
caudal neuropores that communicate with the overlying amniotic cavity.
Closure of the cranial neuropore proceeds cranially from the initial closure site in
the cervical region and from a site in the forebrain that forms later.
This later site proceeds cranially, to close the rostralmost region of the neural tube,
and caudally to meet advancing closure from the cervical site.
Cclosure of the cranial neuropore occurs at the 25th (i.e. the 18- to 20-somite
stage); closure of the caudal neuropore occurs approximately 2 days later (i.e. on
the 27th day.
The cephalic end of the neural tube shows three dilations -the primary brain
vesicles:
(i) the prosencephalon, or forebrain;
(ii) the mesencephalon, or midbrain; and
(iii) the rhombencephalon, or hindbrain.
With progress in development the neural tube simultaneously two flexures:
(1) The cervical flexure at the junction of the hindbrain and the spinal cord and
(2) The cephalic flexure in the midbrain region .
-at 5 weeks the prosencephalon consists of two parts:
(a) the telencephalon, formed by a midportion and two lateral outpocketings, the
primitive cerebral hemispheres, and
(b) the diencephalon,
The diencephalon is characterized by outgrowth of the optic vesicles (Fig. 19.5).
Note: a deep furrow, the rhombencephalic isthmus, separates the mesencephalon
from the rhombencephalon (hindbrain).
The rhombencephalon also consists of two parts:
(a) The metencephalon, which later forms the pons and cerebellum, and
(b) The myelencephalon.
The boundary between these two portions is marked by the pontine flexure
(Fig.4 above).
Later Development
Brain and Cerebellum
In the fifth week of development, swellings appear at the cranial end of the
neural tube. Three primitive vesicles appear first, and subsequently these
develop into five secondary vesicles.

These vesicles will give rise to all the structures of the brain and cerebellum,
as well as the ventricular system shown in the table below:

Secondary Neural
Primary Vesicles Cavity Derivatives
Vesicles Derivatives
Cerebral
Telencephalon hemispheres and Lateral ventricle
globus pallidus
Prosencephalon
Thalamus,
Diencephalon hypothalamus, Third Ventricle
and epithalamus
Mesencephalon Mesencephalon Midbrain Cerebral aqueduct
Pons and Upper part of
Metencephalon
cerebellum 4 ventricle
th

Rhombencephalon Lower part of

Myelencephalon Medulla 4 ventricle/central
th

canal
Meanwhile, neuroderm cells begin to differentiate into neurones and glial
cells. Neurones migrate throughout the brain, and once they have reached
their final destination they develop axons and dendrites, forming synapses.

Note:
1. The lumen of the spinal cord, the central canal, is continuous with that of the
brain vesicles.
2. The cavity of the rhombencephalon (hindbrain) is the fourth ventricle,
3. The cavity of the diencephalon is the third ventricle, and
4 The cavities of the cerebral hemispheres are the lateral ventricles.
5. The lumen of the mesencephalon (midbrain) connects the third and fourth
ventricles. This lumen becomes very narrow and is then known as the aqueduct of
Sylvius.
6. The lateral ventricles communicate with the third ventricle through the
interventricular foramina of Monr
SPINAL CORD
NEUROEPITHELIAL, MANTLE, AND MARGINAL LAYERS
-wall of a newly closed neural tube consists of neuroepithelial cells that is
pseudostratified nature and connected by junctional complexes.
During the neural groove stage and immediately after closure of the tube,
The cell divide rapidly, producing more and more neuroepithelial cells (
neuroepithelial layer or neuroepithelium).
Once the neural tube closes, neuroepithelial cells begin to give rise to another cell
called primitive nerve cells, or neuroblasts.
Neuroblasts are characterized by a large round nucleus with pale nucleoplasm
and a dark-staining nucleolus. (Fig. 19.7). Neuroblasts form the mantle layer, a
zone around the neuroepithelial layer (Fig. 19.8). The mantle layer later forms the
gray matter of the spinal cord.
The outermost layer of the spinal cord, called the marginal layer, contains nerve
fibers emerging from neuroblasts in the mantle layer.
Because of myelination of nerve fibers, this layer takes on a white appearance and
is called the white matter of the spinal cord (Fig. 19.8).

BASAL, ALAR, ROOF, AND FLOOR PLATES

-continuous addition of neuroblasts to the mantle layer, each side of the neural tube
leads to a ventral and a dorsal thickening.
- ventral thickenings is called the basal plates- contain ventral motor horn cells,
form the motor areas of the spinal cord.
-dorsal thickenings is called the alar plates- form the sensory areas (see Fig.below).
-a longitudinal groove, the sulcus limitans, marks the boundary between the two
(the basal plates and the alar plates).
Note: The dorsal and ventral midline portions of the neural tube, known as the roof
and floor plates, respectively, do not contain neuroblasts; they function mainly as
pathways for nerve fibers crossing from one side to the other.

In addition to the ventral motor horn and the dorsal sensory horn, a group of
neurons accumulates between the two areas and forms a small intermediate horn.
Intermediate horn, containing neurons of the sympathetic portion of the
autonomic nervous system, is seen only at thoracic (T1–T12) and upper lumbar
levels (L2 or L3) of the spinal cord.
HISTOLOGICAL DIFFERENTIATION
Nerve Cells, Neuroblasts, or primitive nerve cells, arise exclusively by division of
the neuroepithelial cells. Initially they have a central process extending to the
lumen (transient dendrite), but when they migrate intprocess disappears, and
neuroblasts are temporarily round and apolar.

With further differentiation, two new cytoplasmic processes appear on opposite

sides of the cell body, forming a bipolar neuroblast.
(Fig. B).
The process at one end of the cell elongates rapidly to form the primitive axon,
and the process at the other end shows a number of cytoplasmic
arborizations/differentiations, the primitive dendrites (Fig.C ). The cell is then
known as a multipolar neuroblast and with further development it becomes the
adult nerve cell or neuron.
Once neuroblasts form, they lose their ability to divide. Axons of neurons in the
basal plate break through the marginal zone and become visible on the ventral
aspect of the cord. Known collectively as the ventral motor root of the spinal
nerve, they conduct motor impulses from the spinal cord to the muscles (Fig. 2A).
While axons of neurons in the dorsal sensory horn (alar plate) behave differently
from those in the ventral horn. They penetrate into the marginal layer of the cord,
where they ascend to either higher or lower levels to form association neurons Fig.
2 B.

Glial Cells/ gliablasts

-are primitive supporting cells
- gliablasts are formed by neuroepithelial cells after production of neuroblasts
ceases.
-they migrate from the neuroepithelial layer to the mantle and marginal layers.
In the mantle layer, they differentiate into:
Protoplasmic astrocytes and Fibrillar astrocytes (Fig. 19.11).
Another type of supporting cell possibly derived from gliablasts is the
oligodendroglial cell- is seen mainly in the marginal layer, forms myelin sheaths
around the ascending and descending axons in the marginal layer.
-a third type of supporting cell, the microglial cell, appears in the CNS in the
second half of development.
Microglial cell are highly phagocytic cells derived from mesenchyme (Fig. 19.11).
Note: When neuroepithelial cells cease to produce neuroblasts and gliablasts, they
differentiate into ependymal cells lining the central canal of the spinal cord.
ANATOMY OF THE FACE

The most anterior region of the head is the face

- a unique aspect of each individual

- contribute to the display of emotions (muscles of facial expression), feeding (mouth), seeing (eye),
smelling (nose), and communicating (mouth and ear).

- distinguishing feature/qualities for personal identification (from person to person mostly iris
recorgination)

The face is divided into upper face, middle face, and lower face. The entire face is covered by skin
superficially, while the deep anatomy contains muscles (muscles of facial expression & muscles of
mastication), fat pads, nerves, vessels, and bones

Upper Face

- starts from the hairline superiorly and ends just under the lower eyelid. Its lateral borders terminate
around the temporal region. The upper face region contains the forehead, eyes, and temporal region.
Middle Face

-starts superior at the lower eyelid and spans inferior terminating just above the upper lip. The ears
enclose the lateral borders of the central face. The central face region contains the nose, cheeks, and
ears.

Lower Face

-bings superiorly at the upper lip and ends inferiorly at the lower border of the chin. –its lateral border is
made up of the angle of the mandible. The lower face region contains the lips, chin, and jaws.

FACIAL MUSCLES

- are a group of striated skeletal muscles supplied by the facial nerve (cranial nerve VII).

- control facial expression.

-also called mimetic muscles; because they are only found in mammals, although they derive from
neural crest cells found in all vertebrates. They are the only muscles that attach to the dermis.

Location:

- just under the skin (subcutaneous)

- control facial expression.

-generally originate from the surface of the skull bone (rarely the fascia)

-insertion- on the skin of the face.

Function: When they contract, the skin moves.

-also cause wrinkles at right angles to the muscles’ action line

- are supplied by the facial nerve (cranial nerve VII), with each nerve serving one side of the face

In contrast, the nearby masticatory muscles (muscles of mastication) are supplied by the mandibular
nerve, a branch of the trigeminal nerve (cranial nerve V).

Development

- are derived from the second branchial/pharyngeal arch.

-like the branchial arches, originally derive from neural crest cells.

- begin to form around the eighth week of embryonic development.

BLOOD

-derived from the external carotid artery and the branches of the external carotid artery.

Note: As the common carotid artery ascends cranially, it branches into;

the internal and external carotid arteries.

The external carotid artery

-branches into superior thyroid, lingual, facial, ascending pharyngeal, occipital, posterior auricular,
maxillary, and superficial temporal arteries.

The facial, superficial temporal, and maxillary arteries are the main vessels that will provide perfusion to
the face.

The superficial temporal artery travels toward the temporal and forehead region. The superficial
temporal artery perfuses the structures mainly in the temporal and forehead territories.

The facial artery is responsible for supplying the majority of the face. The facial artery travels toward the
nose and lips, while the maxillary artery provides some perfusion to the cheek region. The maxillary
artery travels toward the deep structures and perfusing the deeper facial structures. As for the venous
drainage, the face drains the majority of the venous blood via the facial vein. The facial vein eventually
drains the blood back into the internal jugular vein.

LYMPHATIC DRAINAGE

The lymphatic drainage of the face is dependent on the location on the face.

The nasal region contains facial lymph nodes, while the region closer to the ears and angle of the
mandible contain preauricular lymph nodes.

The lymph in the face tends to drain to submental, submandibular, and cervical lymph nodes depending
on which is closer. The right side of the face will eventually drain into the right lymphatic duct while the
left side will drain into the thoracic duct. The right lymphatic duct and the thoracic duct then drain back
into the central circulation.

INNERVATION

The face has two main nerve innervations.

The nerves that innervate the face are cranial nerves. The facial nerve is responsible for the innervation
of the muscles that participate in facial expression. The facial nerve penetrates through the parotid
gland and then branches into five nerves: temporal, zygomatic, buccal, marginal mandibular, and
posterior cervical nerve. The temporal branch of the facial nerve travels toward the temporal and
forehead region. The zygomatic branch of the facial nerve travels along the zygoma and cheek region.
The buccal branch of the facial nerve travels toward the buccal region. The marginal mandibular branch
of the facial nerve travels toward the mandible. Lastly, the posterior cervical branch of the facial nerve
travels toward the cervical region. These nerve branches provide motor innervation to the facial muscles
that are near their corresponding paths/territories.
SENSORY INNERVATION OF THE FACE: the trigeminal nerve proves the sensory innervation to the face.
The trigeminal nerve branches into three nerve branches. are the ophthalmic, maxillary, and mandibular
nerves.

The ophthalmic nerve travels toward the forehead and provides sensory to the forehead and eye region.

The maxillary nerve travels toward the maxilla bone and provides sensory innervation to the cheek and
nose.

The mandibular nerve travels with the mandible and provides sensory innervation to the jaw and lips.

The trigeminal nerve also innervates the masseter muscle that contributes to the fullness of the cheeks.

The eyes also receive additional innervation from the optic, oculomotor, trochlear, trigeminal, abducens,
and facial nerves.

The nose also receives special sensory innervation from the olfactory nerve. Lastly, the ears funnel in
sound and convert it into audible sound via the vestibulocochlear nerve.

facial muscles

Definition and function A group of muscles originating mainly from the bones of the skull and inserting
onto the skin of the face, which produce facial expressions

Muscles Occipitofrontalis, orbicularis oculi, corrugator supercilii, procerus, nasalis, orbicularis

oris, levator labii superioris, levator labii superioris alaeque nasi, zygomaticus minor, buccinator,
zygomaticus major, levator anguli oris, risorius, depressor anguli oris, depressor labii inferioris, mentalis,
platysma

Innervation Facial nerve (CN VII)

Blood supply Facial artery

List of muscles

The facial muscles include

• Occipitofrontalis muscle

• Temporoparietalis muscle (Temporalis muscle)

• Procerus muscle

• Nasalis muscle
• Depressor septi nasi muscle

• Orbicularis oculi muscle

• Corrugator supercilii muscle

• Depressor supercilii muscle

• Auricular muscles (anterior, superior and posterior)

• Orbicularis oris muscle

• Depressor anguli oris muscle

• Risorius

• Zygomaticus major muscle

• Zygomaticus minor muscle

• Levator labii superioris

• Levator labii superioris alaeque nasi muscle

• Depressor labii inferioris muscle

• Levator anguli oris

• Buccinator muscle

• Mentalis

NOTE: 1. The platysma is supplied by the facial nerve. Although it is mostly in the neck and can be
grouped with the neck muscles by location, it can be considered a muscle of facial expression due to its
common nerve supply.

2. The stylohyoid muscle, stapedius and posterior belly of the digastric muscle are also supplied by the
facial nerve, but are not considered muscles of facial expression

3. Most of these muscles receive innervation from the facial nerve and participate in facial expression
except for the masseter muscle. The innervation of the masseter muscle is via the trigeminal nerve, and
this muscle participates in mastication.

GROUPINGS

1. Muscles of the mouth, or buccolabial group (are 11 number)

- a broad group of muscles that form a functional compound that controls the shape and movements of
the mouth and lips.

-majority of the mouth muscles are connected by a fibromuscular hub (called the modiolus) onto which
their fibers insert.

- the modiolus it is located at the angles of the mouth and it is primarily formed by the buccinator,
orbicularis oris, risorius, depressor anguli oris and zygomaticus major muscles.
• Elevating and everting the upper lip: levator labii superioris, levator labii superioris alaeque nasi,
risorius, levator anguli oris, zygomaticus major and zygomaticus minor muscles.

• Depressing and everting the lower lip: depressor labii inferioris, depressor anguli oris and
mentalis muscles.

• Closing the lips: orbicularis oris muscle.

• Compressing the cheek: buccinator muscle.

2. Muscles of the nose

-this group includes the nasalis and procerus muscles.

-are primarily involved in creating facial expressions, but they also contribute to respiration.

3. Muscles of the eyelid

Orbicularis oculi muscle

Corrugator supercilii muscle (Corrugator glabellae muscle, Muscle of Koyter)

4. Muscles of the cranium and neck

Occipitofrontalis muscle (Musculus frontalis & galea aponeurotica)

Platysma muscle

5. Muscles of the external ear

The auricular muscles are thin, fan-shaped muscles that connect the auricle to the scalp, and move the
auricle to a certain extent. These muscles include:

• The auricularis anterior, that arises from the lateral border of the epicranial aponeurosis and
attaches to the spine of the helix of the auricle.

• The auricularis posterior, that arises from the mastoid process of the temporal bone and inserts
into the ponticulus on the eminentia conchae.

• The auricularis superior that arises from the epicranial aponeurosis and converges into a thin,
flat tendon to insert onto the upper part of the auricle.

All auricular muscles are innervated by the branches of the facial nerve; the auricularis anterior and
superior are supplied by temporal branches, while the auricularis posterior is supplied by the posterior
auricular branch. The blood supply for the auricular muscles is mostly derived from the posterior
auricular artery.

Since the auricular muscles are quite rudimentary, their function is mainly insignificant in humans. Most
of the movements of the ear produced by these muscles are observed during smiling and yawning,
involving pulling the auricle anteriorly, posteriorly or superiorly.
Clinical significance/Applied Anatomy

Damage to the facial nerve results in facial paralysis of the muscles of facial expression on the involved
side. Paralysis is the loss of voluntary muscle action; the facial nerve has become damaged permanently
or temporarily. This damage can occur with the following: stroke, Bell palsy, or parotid salivary gland
cancer (malignant neoplasm) because the facial nerve travels through the gland.

Damaged to parotid gland can also be due to surgery or temporarily by trauma. These situations of
paralysis not only inhibit facial expression but also seriously impair the patient’s ability to speak, either
permanently or temporarily.