Facial nerve From Wikipedia, the free encyclopedia Nerve: Facial nerve

Cranial nerve VII The nerves of the scalp, face, and side of neck. Latin Gray's MeSH nervus facialis subject #202 901 Facial+Nerve

The facial nerve is the seventh (VII) of twelve paired cranial nerves. It emerges from the brainstem between the pons and

the medulla, and controls the muscles of facial expression, and functions in the conveyance of taste sensations from the anterior two-thirds of the tongue and oral cavity. It also supplies preganglionic parasympathetic fibers to several head and neck ganglia. [edit]Course The motor part of the facial nerve arises from the facial nerve nucleus in the pons while the sensory part of the facial nerve arises from the nervus intermedius. The motor part and sensory part of the facial nerve enters the petrous temporal bone into the internal auditory meatus (intimately close to the inner ear) then runs a tortuous course (including two tight turns) through the facial canal, emerges from the stylomastoid foramen and passes through the parotid gland, where it divides into five major branches. Though it passes through the parotid gland, it does not innervate the gland (This is the responsibility of cranial nerve IX, the glossopharyngeal nerve). The facial nerve forms the geniculate ganglion prior to entering the facial canal. [edit]Branches Greater petrosal nerve - provides parasympathetic innervation to lacrimal gland, sphenoid sinus, frontal sinus,maxillary sinus, ethmoid sinus, nasal cavity, as well as special sensory taste fibers to the palate via the Vidian nerve. Nerve to stapedius provides motor innervation for stapedius muscle in middle ear Chorda tympani - provides parasympathetic innervation to submandibular gland and sublingual gland and special sensory taste fibers for the anterior 2/3 of the tongue. [edit]Outside skull (distal to stylomastoid foramen)

Posterior auricular nerve - controls movements of some of the scalp muscles around the ear Branch to Posterior belly of Digastric and Stylohyoid muscle Five major facial branches (in parotid gland) - from top to bottom: Temporal (frontal) branch of the facial nerve Zygomatic branch of the facial nerve Buccal branch of the facial nerve Marginal mandibular branch of the facial nerve Cervical branch of the facial nerve Traditional mnemonic devices for the five major branches of the facial nerve include "To Zanzibar By Motor Car", "Tell Ziggy Bob Marley Called", "Two Zebras Broke My Car", and "The Zoo Bought Monkey Clothes."

[edit]Embryology The facial nerve is developmentally derived from the hyoid arch (second pharyngeal branchial arch) [edit]Function [edit]Efferent Its main function is motor control of most of the muscles of facial expression. It also innervates the posterior belly of the digastric muscle, the stylohyoid muscle, and the stapedius muscle of the middle ear. All of these muscles are striated muscles of branchiomeric origin developing from the 2nd pharyngeal arch. The facial also supplies parasympathetic fibers to the submandibular gland and sublingual glands via chorda tympani. Parasympathetic innervation serves to increase the flow of saliva from these glands. It also supplies parasympathetic innervation to the nasal mucosa and the lacrimal gland via the pterygopalatine ganglion.

The facial nerve also functions as the efferent limb of the corneal reflex and the blink reflex. [edit]Afferent In addition, it receives taste sensations and general sensation from the anterior two-thirds of the tongue and sends them to the gustatory portion of the solitary nucleus. The facial nerve also supplies a small amount of afferent innervation to the oropharynx below the palatine tonsil. There is also a small amount of cutaneous sensation carried by the nervus intermedius from the skin in and around the auricle (earlobe). [edit]Location of Cell Bodies The cell bodies for the facial nerve are grouped in anatomical areas called nuclei or ganglia. The cell bodies for the afferent nerves are found in the geniculate ganglion for both taste and general afferent sensation. The cell bodies for muscular efferent nerves are found in the facial motor nucleus whereas the cell bodies for the parasympathetic efferent nerves are found in the superior salivatory nucleus. [edit]Pathology People may suffer from acute facial nerve paralysis, which is usually manifested by facial paralysis. Bell's palsy is one type of idiopathic acute facial nerve paralysis, which is more accurately described as a multiple cranial nerve ganglionitis that involves the facial nerve, and most likely results from viral infection and also sometimes as a result ofLyme disease. Iatrogenic Bell's Palsy may also be as a result of an incorrectly placed dental localanesthetic (Inferior alveolar nerve block). Although giving the appearance of a hemi-plegic stroke, effects dissipate with the drug. [edit]Testing the facial nerve Voluntary facial movements, such as wrinkling the brow, showing teeth, frowning, closing the eyes tightly (inability to do so is

called lagophthalmos)[1] , pursing the lips and puffing out the cheeks, all test the facial nerve. There should be no noticeable asymmetry. In an UMN lesion, called central seven, only the lower part of the face on the contralateral side will be affected, due to the bilateral control to the upper facial muscles (frontalis and orbicularis oculi). Lower motor neuron lesions can result in a CNVII palsy (Bell's palsy is the term used to describe the idiopathic form of facial nerve palsy), manifested as both upper and lower facial weakness on the same side of the lesion. Taste can be tested on the anterior 2/3 of the tongue. This can be tested with a swab dipped in a flavoured solution, or with electronic stimulation (similar to putting your tongue on a battery). Corneal reflex. The afferent arc is mediated by the General Sensory afferents of the Trigeminal Nerve. The efferent arc occurs via the Facial Nerve. The reflex involves consensual blinking of both eyes in response to stimulation of one eye. This is due to the Facial Nerve's innervation of the muscles of facial expression, namely Orbicularis Oculi, responsible for blinking. Thus, the corneal reflex effectively tests the proper functioning of both Cranial Nerves V and VII.

Nervus intermedius Nerve: Nervus intermedius

Plan of the facial and intermediate nerves and their communication with other nerves. (N. intermedius labeled at upper left.) Gray's subject #202 901

The nervus intermedius, or intermediate nerve, is the part of the facial nerve (cranial nerve VII) located between the motor component of the facial nerve and the vestibulocochlear nerve (cranial nerve VIII). It contains the sensory and parasympathetic fibers of the facial nerve. Upon reaching the facial canal, it joins with the motor root of the facial nerve at the geniculate ganglion.

[edit]Parasympathetic fibers The superior salivatory nucleus contains the cell bodies of parasympathetic axons within the nervus intermedius. These fibers reach the geniculate ganglion but do not synapse. Some of these preganglionic parasympathetic fibers persist within the greater petrosal nerve as they exit the geniculate ganglion and subsequently synapse with neurons in the pterygopalatine ganglion. These postganglionic neurons send axons that provide parasympathetic innervation to thelacrimal gland. The remaining preganglionic fibers continue as the mixed facial nerve proper as it extends through the facial canal. Before the nerve exits the skull via the stylomastoid foramen and after the nerve to the stapedius muscle has branched off, the facial nerve gives off the chorda tympani nerve. This nerve exits the skull through the Petrotympanic fissure and merges with the lingual nerve, after which it synapses with neurons in the submandibular ganglion. These postganglionic neurons provide parasympathetic innervation to the submandibular and sublingual glands. [edit]Sensory fibers The sensory component of the nervus intermedius carries input about sensation from the skin of the external auditory meatus, from the mucous membranes of thenasopharynx and nose, and taste from the anterior two-thirds of the tongue, floor of the mouth, and the palate. The sensory information from the mucous membranes of the nasopharynx and palate is carried along the greater petrosal nerve, while the chorda tympani nerve (and lingual nerve) carries taste input from the anterior two-thirds of the tongue, floor of mouth, and palate. The geniculate ganglion contains the cell bodies of the sensory component of the nervus intermedius.

Geniculate neuralgia is a pain syndrome associated with the nervus intermedius.