• Nervus olfaktorius (N.

I)
The olfactory nerve (I), actually composed of many small separate
nerve fibers, passes through perforations in the cribriform plate
part of the ethmoid bone. These fibers terminate in the upper
part of the nasal cavity and function to convey impulses containing
information about odors to the brain.
Examination Method: the patient closes his eyes, is told to find the
smell that is felt (coffee, tea, etc.)

OLFACTORY
NERVES
• The optic nerve (II)
passes through the optic foramen in the sphenoid bones as it
travels to the eye. It conveys visual information to the brain
Check Method: With a snellen card, and check the field of view.

OPTIC NERVE
• Ocumolotorius nervus (N.III)
The oculomotorius nerve is the third nerve of the two
twelve cranial nerves. This nerve controls most eye movements,
pupil constriction, and maintaining opening of the eyelids (IV and
VI cranial nerves too helps control eye movements.)
The function of the oculomotorius nerve is to control the
eye. This nerve has two components, one of which controls visual
tracking and the other which controls the eye's reflexes to light
Many conditions and diseases can damage the oculomotorius
nerve and cause problems. For example, oculomotor nerve palsy
occurs when the nerves become paralyzed by multiple sclerosis,
brain cancer, diabetes, eye trauma or pressure on the brain.
Check Method: Eyeball round test, move conjunctiva,
pupillary reflex and eyelid inspection
Trochlearis Nervus (N.IV)
Trochlear nerve is a combined nerve, but mostly consists of
motor nerves and is the smallest nerve in the cranial nerves. Motor
neurons originate from the palate of the midbrain and carry
impulses to the superior oblique muscles of the eyeball.
Sensory fibers from the spindle (fibers) muscles convey
information sensory muscles from the oblique muscle superior to
the brain. Its function is to move some of the eyeball muscles
The slimmest trochleal nerve and the only brain nerve that
travels through the posterior surface of the brain stem, emerging
from the trochleal nerve mesencephalon runs forward through the
fossa cranii media on the lateral wall of the cavernous sinus and
into the orbital cavity through superior orbitalis fissure. This nerve
is superior to the eyimusculus obliqus of the eyeball.
Check Method same with nerve ocumolotorius: Eyeball
round test, move conjunctiva, pupillary reflex and eyelid inspection
• Nervus trigeminus (N.V)
is the motor and sensory brain nerves. The motor fibers
supply the muscular muscles, temporalis, pterigoide internus et
exten, tympanic tensor, omohioide and the anterior part of the
digastric muscle.
The motor core is in the pons. Its motor fibers join the
sensory fibers of the trigeminal nerve originating from the Gasseri
ganglion. Its sensory fibers carry pain impulses, temperature, touch
and feelings of proprioceptiveness. The area is the face and
mucosa of the tongue and oral cavity and tongue, and nasal
cavity. Proprioceptive impulses, mainly from muscles innervated by
the mandibular branch to the Gasseri ganglion
• The first branch of N.V. is a branch of ophthalmicus. He
delivered protopathic impulses from the eyeball and the orbit,
the skin of the forehead to the vertex. Secretomotor impulses
are delivered to the lacrimal gland. The fibers from the
forehead compose the frontal nerve. He entered through the
orbital room through the supraorbitale foramen. The fibers from
the eyeball and the nasal cavity combine to become a beam of
nerve known as the nasosiliary nerve. The nerve file leading to
the lacrimal gland is known as the lacrimal nerve. The three
nerve files, namely the frontali nerve, the nasosiliary nerve and
the lacrimal nerve approach each other in the superior orbital
fissure and behind the fissure merge into the N.V branch I.
(ophthalmic nerve). The branch penetrates the dura mater and
continues its journey inside the wall of the cavernous sinus. Next
to the posterior clinoid process it exits the wall and ends in the
Gasseri ganglion. Nearby there are facial arteries (4)
• The second branch is the maxillary branch which is only
composed of somatosensory fibers that deliver protopathic
impulses from the cheeks, lower eyelids, upper lip, nose and
part of the nasal cavity, maxillary teeth, nasofarings space,
maxillary sinus, soft palate and roof of the oral cavity . Sensory
fibers enter the os. maxillary through the infraorbital foramen.
This nerve file is called the infraorbial nerve. The nerves of the
mucosa of the nasal cavity and the upper jaw and upper teeth
also join in this nerve and after that are called the maxillary
nerve, branch II N.V. It enters the cranial cavity through the
rotundum foramen and then penetrates the dura mater to walk
in the wall of the cavernous sinus and ends in the Gasseri
ganglion. The V nerve maxillary branch also receives sensory
fibers originating from the media dura fossa crania and
pterigopalatinum fossa. (4)
• Function: motor nerves,
mengunya movement,
sensation of the face,
tongue and teeth, corneal
reflexes and blinking
reflexes
• Check Method : move the
jaws of all sides, the
patient closes his eyes,
touch with cotton on the
forehead or cheeks. touch
the surface of the cornea
with cotton.
Nervus abducens : N. VI
Anatomy:
• Is a motor and sensory nerve
• The nucleus originates from ponds which innervates the lateral
rectus muscle of the eye
• Exit via via the superior orbital fissure
physiology:
• Motor nerves, lateral eye deviation
• Examination: eyeball round test, move conjunctiva, pupillary
reflex and eyelid inspection

Function: motor nerve, lateral eye deviation

Check Method same with nerve ocumolotorius: Eyeball round test,
move conjunctiva, pupillary reflex and eyelid inspection
Nervus Fasialis : N. VII
Anatomy:
• Sensory and motor nerves
• The motor nucleus is located in the ventraolateral part of the lower
tegmentum pons
• Nerves the facial muscles
• At the end of the cranalis the facial nerve exits the cranium through
the stylomastoid foramen
physiology :
• Sensory: taste on the anterior 2/3 of the tongue
• Motoric: muscle facial expression, tear glands and salivary glands

Checkmethod: smile, whistle, raise eyebrows, close the eyelids with the
prisoner, stick out lida to distinguish sugar and salt
 Anatomy: Origin The
vestibulokolear nerve
originates from the lateral
part of the angle formed
between the cerebellum and
the pons. Passing nerve VII to
internal acoustic meatus in
the temporal bone. The
cochlear section is located
anteriorly while the
vestibular is posterior.
meaning:
• Vestibular: Balance
• Cochlear: Hearing
• Is a sensory nerve with
another name
statoacoustic nerve

function : Play a role in the

process of hearing and
maintaining body balance
Anatomy:
• The glossopharyngeal nerve
originates from the medulla along
with the X and XI cranial nerves

• Through the glossopharyngeal nerve

jugular foramen it forms two superior
and petrosal / inferior sensory
ganglion

• Parasympathetic axons from from

the inferior salivary nucleus to the otic
ganglion (in the parotid gland) then
enter the tympanic branch. So that it
can simultaneously channel sensory
fibers from the ears
• • The glossopharyngeal
nerve then descends to the
neck and innervates the
stylopharyngeal muscle and
carotid body.

• • Passes the internal and

external carotid arteries to
enter the pharynx. Inside the
pharynx the sensory fibers of
the pharyngeal plexus
innervate the mucosa of the
pharynx and the posterior
part of the tongue.
Sensory: Motoris:
The supply of sensory The glossopharyngeal nerve
innervation of the has motor function in the
oropharynx and the stylopharyngeal muscle
posterior part (back) of the
tongue Check method: distinguish
sweet and sour taste
Sensory function of the
carotid sinus, carotid body,
and sometimes the skin of the
meatus acusticus' externus
and tympanic membrane.
• Nervus Vagus ( N.X)
Anatomy :
• The Vagus nerve develops from the medulla
• Then this nerve leaves posterior cranial fossa through the jugular
foramen
• Then the vagus nerve descends through the posterior carotid
sheath behind the internal jugular vein and the internal carotid
artery.
• The cardiac and tracheal branches arise in the chest and upper
part of the neck. The tracheal branch plays a role in sensory
function while the cardiac part has an autonomic function which
slows the heart rate
• There is also a recurrent laryngeal nerve that starts in the
superior mediastinum.
 Function:
• sensory and motor nerves,
vomiting and swallowing
reflexes
• Helps in keeping the larynx
open while breathing
• Monitoring and regulating
heart rate
Check method: touch the
posterior pharynx, the patient
swallows saliva, is told to say
Ahh...
• Nerve XI (Asesorius nerve)

• Is a combined nerve, but mostly consists of motor fibers. Motor

neurons originate in two areas: the cranial part starts from the
medulla and innervates the voluntary muscles of the pharynx and
larynx, the spinal portion emerges from the cervical spinal cord and
innervates the trapezius and sternocleidomastoid muscles. Sensory
neurons carry information from the same muscle that is maintained by
motor nerves; for example the larynx, pharynx, trapezius and
sternocleidomastoid muscles. Its function is to control the movement of
the head.
• Function: motor nerve, to move the shoulder?
• Way of examination: tell the patient to move the shoulder and do
resistance while the patient is against the prisoner.
Includes a combined nerve, but mostly consists of motor nerves.
Motor neurons start from the medulla and supply the tongue
muscle. Sensory neurons carry information from muscle spindles on
the tongue. Its function is to control the movement of the tongue.
Functions: motor nerves, for tongue movements
How to check: the patient is told to stick out the tongue and move
from side to side.
• SENSORIC SYSTEM
The sensory nervous system plays a role in conveying stimuli
received by keotak receptors in this case the sensory cortex (girus
post centralis). Perceptions of both pain, touch, pressure and
temperature will be accepted by skin receptors and then
transmitted to the brain through the spinal cord.
• 1) Dorsal column Medial Lemniscus
Impulses that enter the spinal cord Walk through the myelinated
fibers that enter
through the medial division of the dorsal root of the spinal
nerve to column 9 dorsalis ipsilateral white mass, then will be
divided into branches ascending and descendent. The
descendent branch forms a branch-reflex sequence
its branch to the dorsal column of the gray period. The
ascending branch is fiber first sensory liaison. When entering,
these fibers are right next to the medial dorsal hornus.
2) Spinothalamic tract
• The first-level neuron cell body is in the dorsal root ganglia and
has fibers that are thinner than the medial lemnikus fibers. The
fibers enter the spinal cord in the lateral part of the dorsal root
and separate into ascending and descending branches. The
ascending branch will be upward (1-2 segments) in the postero
lateral column before sneezing with second-level neurons
located in the dorsal column. Furthermore, the axonini will cross
the midline (ventralis white mass) and continue upward inside
ventrolateral (white period) as the spinothalamic tract.
• There are several spinothalamic fibers which have collateral
branches to several specific nucleus regions such as the reticular
formation. The spinothlamic tract ends at the nucleus of the
ventroposterior lateral thalamus. This tract is a transmission of
heat, cold, pain, itching and is an alternative pathway for
feeling rough.
Sensory Needle Cutting Syndrome. This syndrome varies depending on the
location of damage throughout the course of the sensory pathway.
• Cortical or subcortical lesions in the motor sensory area of the arm or leg
cause paresthesias and numbness in the opposite side of the extremity.
• Lesions of the sensory pathway just below the thalamus cause the loss of all
sensory qualities in the half of the contralateral body.
• Other sensory pathways other than pain and temperature experience
damage with hypesthesia on the contralateral side of the face and body.
• If the damage is limited to the trigeminal and spinothalamic lateral lemnikus
at the center of the brain, no pain and temperature sensation is found on the
contralateral face and body, all other sensory qualities are not disturbed.
• The involvement of medial lemniscus and the anterior spinothalamic tract,
removes all sensory qualities in the contralateral part of the body except
pain and temperature sensations.
• Damage to the nucleus and spinal trigeminal tract and lateral spinothalamic
tract, causing loss of pain and temperature sensation on the ipsilateral face
and the contralateral body.
• Posterior funicular damage causes the disappearance of attitude
sensation, vibration, discrimination and other sensations associated
with ipsilateral ataxia.
• Posterior horny lesions, eliminating temperature sensations and
ipsilateral pain all other qualities remain intact (sensibility dissociation
disorder).
• Injury to several adjacent posterior roots, followed by radicular and
painful peresthesia, and also decrease or loss of all sensory qualities
in each body segment. If the injured root is supplied with nerves from
the arm or leg, hypotonia or atony, areflexia and ataxia are found.
• Posterior Funiculus Injury Syndrome
1. Loss of attitude and locomotor sensation with the eyes closed the
patient cannot know the position of his limbs
2. Astereognosis: with eyes closed, the patient cannot recognize and
describe the shape and material of the object being touched.
3. The loss of two-point discrimination
4. Loss of vibration sensation: the patient cannot feel the vibration of
the tuning fork that is attached to the bone
MOTOR SYSTEM
• The motor system is a system that regulates all movements in humans.
Movement is regulated by the center of movement found in the brain,
including the motor area in the cortex, basal ganglia, and cerebellum.
• LESI NEURON MOTOR UPPER
• Upper motor neurons are all neurons that channel motor impulses to the lower
moto rneuron and are divided into pyramidal and extrapyramidal structures.
Upper motorneuron runs from the cerebral cortex to the spinal cord so that
work from the upper motorneuron will affect the activity of the darne
motorneuron

• LESI TRACTUS CORTICOSPINAL (PYRAMIDAL TRACTUS)

1. Positive Babinsky Test. Remember that babinsky signs are normally present
for the first year of life, because the corticospinal tractus is not milieled until the
end of the first life year.
2. Superficial abdominal flexionia. This reflex depends on tractal integrity,
which causes tonic excitation on internal neurons.
3. Areflemias cremaster.
4. Loss of appearance of smoothly trained voluntary movements.
• LESI TRACTUS DESCENDEN OTHER TRACTUS CORTICOSPINAL (TRACTUS EK STRAPIRAMIDAL)
1. Severe paralysis with little or no muscle atrophy
2. Spastic or hypertonization of muscles. the lower limb is in extension and the upper limb is maintained in
a flexed state
3. Increased muscle reflexes and clonus can be found in the flexors of the fingers, femoral quadriceps
muscles and thigh muscles.
4. Reaction of a folding knife. Having a passive movement in a joint is held by the presence of muscle
spasticity.

• LESI LOWER MOTOR NEURON

1. Paralysis of supplied muscle flaxid.
2. Supplied muscle atrophy.
3. Loss of supplied reflexes.
4. Vascular musculature. This situation is muscle twitching which is only seen if there is slow damage from
the cell.
5. muscular contractures. This is a shortening of the muscles that experience paralysis, which is more
common in the antagonistic muscles, where the work is no longer resisted by muscles that experience
paralysis.
6. Degenerative reactions. In normal circumstances the muscles that are innervated provide a response to
the stimulus by giving a paradoxical or intermittent flow and the presence of galvanized or direct
currents. in this case if the LMN is cut the muscle no longer responds to the disconnected electrical stimulus
after the event, although it still gives a response to the direct current after the current is lost.
• Lesions in the central motoric pathway
• 1. CORTICAL LESION (tumor, hematoma, infarction, etc.) results in paresis of
the hand or contralateral arm. The voluntary movement must be trained, most
often involved. Monoparesis occurs, paresis occurs due to the maintenance of
the almost total extrapyramidal tract. There are 4 small lesions in the cortex
resulting in flacid paresis and focal epilepsy which is rather frequent
(epilepsy Jackson).
• 2. Capsula Interna lesions: contralateral spastic hemiplegia due to pyramidal
and extrapyramid fibers close to each other. The corticonuclear tract is
involved so that contralateral facial paralysis occurs and the hypoglossal
nerve may occur. Most cranial motor nuclei are bilaterally innervated by the
tract. Rapid damage causes contralateral paralysis, which is first flacid
because of its effect like shock on peripheral neurons, after hours or days
paralysis becomes spastic because extrapyramidal fibers are also
damaged.
• 3. Peduncle lesions: the result of this lesion is contralateral spastic hemiplegia,
which is associated with ipsilateral paralysis of the oculomotor nerve.
• 4. Lesion pons: results from these lesions of contralateral hemiplegi and
possibly ilateral. Not all extrapyramid fibers are damaged because the
fibers that run down to the face and the hypoglossal nuclei are located more
dorsally, the facial nerve and hypoglossus may not be affected otherwise
there may be ipsilateral paralysis of the abdusens and trigeminal nerves.
• 5. Pyramid lesions: produce contralateral flacid hemiparesis. There is
no hemiplegia because only the pyramidal fibers are damaged. The
extrapyramid canal is located more dorsally in the medulla and
remains intact.
• 6. Cervical lesions: involvement of the lateral pyramid tract
originating from diseases such as amyotropic or multiple lateral
sclerosis, resulting in ipsilateral spastic hemiplegia because the
pyramidal tract has crossed, paralysis is spastic because
extrapyramidal fibers mixed with pyramidal fibers are also
damaged.
• 7. Thoracic lesions: interruptions in the lateral pyramidal tract caused
by diseases such as amyotropic or multiple lateral sclerosis resulting in
ipsilateral spastic monoplegia from the limbs. Bilateral damage
causes paraplegia
• 8. Anterior root lesions: paralysis due to these lesions is ipsilateral
and flaccid, due to damage to lower or peripheral motor neurons
• Lesions involving the pyramidal tract decusatio produce a rare
syndrome, krusiata hemiplegia (hemiplegia alterans).