The Cranial Nerves

Cranial Nerves

 Indicated by
 Roman numerals I-XII from
anterior to posterior
 Names
 May have one or more of
three functions
 Sensory (special or general)
 Somatic motor (control of
skeletal muscles)
 Parasympathetic (regulation
of glands, smooth muscles,
cardiac muscle)

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 Names of Cranial Nerves
 Ⅰ Olfactory nerve
 Ⅱ Optic nerve
 Ⅲ Oculomotor nerve
 Ⅳ Trochlear nerve
 Ⅴ Trigeminal nerve
 Ⅵ Abducent nerve
 Ⅶ Facial nerve
 Ⅷ Vestibulocochlear nerve

 Ⅸ Glossopharyngeal nerve
 Ⅹ Vagus nerve
 Ⅺ Accessory nerve
 Ⅻ Hypoglossal nerve
 Functional Components
 General somatic afferent fibers (GSA): transmit
exteroceptive and proprioceptive impulses from head
and face to somatic sensory nuclei
 Special somatic afferent fibers (SSA): transmit
sensory impulses from special sense organs of
vision, equilibrium and hearing to the brain
 General visceral afferent fibers (GVA): transmit
interoceptive impulses from the viscera to the visceral
sensory nuclei
 Special visceral afferent fibers (SVA): transmit
sensory impulses from special sense organs of smell
and taste to the brain
 Functional Components
 General somatic efferent fibers (GSE): innervate
skeletal muscles of eye and tongue
 Special visceral efferent fibers (SVE): transmit motor
impulses from the brain to skeletal muscles derived from
brachial (gill) arches of embryo. These include the
muscles of mastication, facial expression and swallowing
 General visceral efferent fibers (GVE): transmit motor
impulses from the general visceral motor nuclei and
relayed in parasympathetic ganglions. The
postganglionic fibers supply cardiac muscles ， smooth
muscles and glands
 Classification of Cranial Nerves
 Sensory cranial nerves: are composed entirely of afferent
(sensory) nerve fibers bringing sensations the brain
 Ⅰ Olfactory nerve
 Ⅱ Optic nerve
 Ⅷ Vestibulocochlear nerve
 Motor cranial nerves: are composed entirely of efferent (motor)
fibers
 Ⅲ Oculomotor nerve
 Ⅳ Trochlear nerve
 Ⅵ Abducent nerve
 Ⅺ Accessory nerve
 Ⅻ Hypoglossal nerve
 Mixed cranial nerves: possess both sensory and motor fibers---
 Ⅴ Trigeminal nerve,
 Ⅶ Facial nerve,
 Ⅸ Glossopharyngeal nerve
 Ⅹ Vagus nerve
Olfactory Nerve
 Olfactory Nerve
Olfactory cells (SVA)→ Cribriform foramina → Olfactory bulb
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 Optic Nerve
Ganglion cells (SSA) → Optic canal → Lateral geniculate body
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 Vestibulocochlear Nerve
Vestibular ganglion(SSA) ↘ ↗ Vestibular nuclei
Internal acoustic meatus
Cochlear ganglion (SSA) ↗ ↘ Cochlear nuclei
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 Sensory Cranial Nerves
N. Location of cell Cranial Terminal Main action
body and axon exit nuclei
categories
Ⅰ Olfactory cells Cribrifom Olfactory bulb Smell
(SVA) foramina
Ⅱ Ganglion cells Optic Lateral Vision
(SSA) canal geniculate
body
Ⅷ Vestibular Internal Vestibular Equilibrium
ganglion(SSA) acoustic nuclei
meatus
Cochlear ganglion Cochlear nuclei Hearing
(SSA)
Motor Cranial Nerves
Ⅲ Superior orbital fissure

Hypoglossal canal
Ⅻ
Ⅹ
Jugular foramen

Ⅺ
 Oculomotor Nerve
 Components
 General somatic efferent fibers (GSE)

 General visceral efferent fibers (GVE)

 Main action － supplies

 Superior, inferior and medial recti; inferior obliquus; levator palpebrae
superioris
 Sphincter pupillea and ciliary muscle

 Ciliary ganglion: lies between optic nerve and lateral rectus

Oculomotor nerve
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Abducent Nerve

Abducent nerve
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 Trochlear n.

Oculomotor n.

Abducent n.
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 Accessory Nerve
 Cranial roots
 Originate from nucleus ambiguus
 Join the spinal roots to exit the
jugular foramen
 Join the vagus nerve and distribute
to the muscles of pharynx and
larynx
 Spinal roots
 Originate from nucleus of
accessory nerve
 Ascend through the foramen
magnum and exit the cranium
through the jugular foramen
 Innervate the sternocleidomastoid
and trapezius muscles
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 Hypoglossal Nerve
Nucleus of hypoglossal
→ Hypoglossal canal → Muscles of tongue
nerve( GSE)

Hypoglossal nerve
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 Motor Cranial Nerves
N. Nucleus of origin and Cranial exit Main action
axon categories
Ⅲ Nucleus of oculomotor Superior Motot to superior, inferior and
nerve (GSE) orbital fissure medial recti; inferior obliquus;
levator palpebrae superioris
Accessory nucleus of Parasympathetic to sphincter
oculomotor nerve (GVE) pupillea and ciliary muscles

Ⅳ Nucleus of trochlear Superior Motor to superior obliquus

nerve (GSE) orbital fissure
Ⅵ Nucleus of abducent Superior Motor to lateral rectus
nerve (GSE) orbital fissure
Ⅺ Nucleus ambiguus Jugular Motor to sternocleidomastoid
(cranial root, SVE) foramen and trapezius
Nucleus of accessory
nerve (spinal root, SVE)
Ⅻ Nucleus of hypoglossal Hypoglossal Motot to muscles of tongue
nerve( GSE) canal
Motor Cranial Nerves
 Oculamotor paralysis

Abducent nerve injury

Mixed Cranial Nerves
 Trigeminal Nerve (Ⅴ)

Components of fibers
 SVE fibers: originate from
motor nucleus of trigeminal
nerve, and supply masticatory
muscles
 GSA fibers: transmit facial
sensation to sensory nuclei of
trigeminal nerve, the GSA
fibers have their cell bodies in
trigeminal ganglion, which lies
on the apex of petrous part of
temporal bone
 Trigeminal Nerve (Ⅴ)
Ophthalmic nerve (Ⅴ1, sensory)
 Leave the skull through the superior orbital
fissure, to enter orbital cavity
 Branches
 Frontal nerve
 Supratrochlear nerve
 Supraorbital nerve
 Lacrimal nerve
 Nasociliary nerve
 Trigeminal Nerve (Ⅴ)
Ophthalmic nerve
 Branches
 Frontal nerve
 Lacrimal nerve

 Nasociliary nerve

 Distribution
 Sensation from cerebral dura mater

 Visual organ

 Mucosa of nose

 Skin above the eye and back of nose

 Trigeminal Nerve (Ⅴ)
Maxillary nerve (Ⅴ2, sensory)
 Leave skull through foramen rotundum
 Branches
 Infraorbital nerve

 Superior alveolar nerve

 Zygomatic nerve

 Pterygopalatine nerve
 Trigeminal Nerve (Ⅴ)
Maxillary nerve
 Branches
 Infraorbital nerve

 Superior alveolar nerve

 Zygomatic nerve

 Pterygopalatine nerve

 Distribution
 Sensation from cerebral dura mater

 Maxillary teeth and gum

 Mucosa of nose, mouth and maxillary

sinus
 Skin between eye and mouth
 Trigeminal Nerve (Ⅴ)
Mandibular nerve (Ⅴ3, mixed)
 Leave the skull through the foramen ovale
to enter the infratemporal fossa
 Branches
 Auriculotemporal nerve

 Buccal nerve

 Lingual nerve

 Inferior alveolar nerve

 Nerve of masticatory muscles

 Trigeminal Nerve (Ⅴ)
Mandibular nerve
 Distribution
 Sensation from cerebral dura mater

 Teeth and gum of lower jaw

 Mucosa of anterior 2/3 of tongue and

floor of mouth
 Skin of auricular and temporal

regions and below the mouth

 Motor to masticatory muscles,

mylohyoid, and anterior belly of

digastric
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 Facial Nerve (Ⅶ)
Components of fibers
 SVE fibers originate from nucleus of facial nerve, and supply facial
muscles
 GVE fibers derived from superior salivatory nucleus and relayed in
pterygopalatine ganglion and submandibular ganglion. The
postganglionic fibers supply lacrimal, submandibular and sublingual
glands
 SVA fibers from taste buds of anterior two-thirds of tongue which
cell bodies are in the geniculate ganglion and end by synapsing with
cells of nucleus of solitary tract
 GSA fibers from skin of external ear
 Facial Nerve (Ⅶ)

Course:
 Exits the brain stem through
the bulbopontine sulcus
 Leaves the skull through
internal acoustic meatus, facial
canal and stylomastoid
foramen, it then enters parotid
gland where it divides into five
branches which supply facial
muscles
 Facial Nerve (Ⅶ)

Branches within the facial canal

 Chorda tympani : joins lingual
branch of mandibular nerve
 SVA fiber to taste buds on anterior
two-thirds of tongue
 GVE fibers relayed in
submandibular ganglion, the
postganglionic fibers supply
submandibular and sublingual
glands
 Facial Nerve (Ⅶ)
 Greater petrosal nerve : GVE fibers pass to pterygopalatine ganglion
and there relayed through the zygomatic and lacrimal nerves to lacrimal
gland
 Stapedial nerve: to stapedius

Pterygopalatine ganglion
 Facial Nerve (Ⅶ)

 Pterygopalatine ganglion
: lies in pterygopalatine
fossa under maxillary nerve
 Submandibular ganglion
: lies between lingual
nerve and submandibular gland
 Facial Nerve (Ⅶ)

Branches outside of facial canal

 Temporal
 Zygomatic
 Buccal
 Marginal mandibular
 Cervical
Facial nerve (Ⅶ)
Injury to the facial nerve
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 Glossopharyngeal Nerve (Ⅸ)
Components of fibers
 SVE fibers: originate from nucleus ambiguus, and supply
stylopharygeus which elevates the pharynx during swallowing and
talking
 GVE fibers: arise from inferior salivatory nucleus and relayed in otic
ganglion, the postganglionic fibers supply parotid gland
 GVA fibers: visceral sensation from mucosa of posterior third of
tongue, pharynx, auditory tube and tympanic cavity, carotid sinus and
glomus, and end by synapsing with caudal part of nucleus of solitary
tract
 SVA fibers: arise from the cells of inferior ganglion, the central
processes of these cells terminate in rostral part of nucleus of solitary
tract, the peripheral processes supply the taste buds on posterior third
of tongue
 GSA fibers: The cell bodies are located in the superior ganglion. The
central process carry impulse from skin of posterior surface of auricle to
spinal nucleus of trigeminal n.
 Glossopharyngeal Nerve (Ⅸ)
 Course:
 Exits the brain stem through the retroolivary sulcus
 leaves the skull via jugular foramen
 Branches
 Lingual branches : to taste buds and mucosa of posterior third of tongue
 Pharyngeal branches : take part in forming the pharyngeal
plexus ， distribute to the walls of pharynx
 Tympanic nerve : GVE fibers via tympanic and lesser petrosal nerves to otic
ganglion, with postganglionic fibers via auriculotemporal (Ⅴ3) to parotid
gland
 Carotid sinus branch : innervations to both carotid sinus and carotid
glomus
 Others: tonsillar and stylophayngeal branches
 Otic ganglion : situated just below foramen ovale
Glossopharyngeal Nerve (Ⅸ)
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 Vagus Nerve (Ⅹ)
Components of fibers
 GVE fibers: originate from dorsal nucleus of vagus nerve, synapse in
parasympathetic ganglion, short postganglionic fibers innervate cardiac
muscles, smooth muscles and glands of viscera
 SVE fibers: originate from ambiguus, to muscles of pharynx and
larynx
 GVA fibers: The cell bodies are located in the inferior vagal ganglion.
The central process carry impulse from viscera in neck, thoracic and
abdominal cavity to nucleus of solitary tract
 GSA fibers: The cell bodies are located in the superior vagal ganglion.
The central process carry impulse from auricle, external acoustic
meatus and cerebral dura mater to spinal nucleus of trigeminal n.
 Vagus Nerve (Ⅹ)

Course
 Exits the brain stem through the
retroolivary sulcus
 Leaves the skull from the
jugular foramen
 Descends in the neck in carotid
sheath behind the internal (or
common) carotid artery and
internal jugular vein
 Left Vagus Nerve
Course
 Enter thoracic inlet between left common
carotid and left subclavian arteries
 Crosses the left side of the aortic arch where
left recurrent laryngeal nerve branches off
 Passes posterior to left lung root contributing
to the pulmonary plexus
 Descends on the anterior surface of the
esophagus and forms anterior esophageal
plexus
 Forms anterior vagal trunk at esophageal
hiatus where it leaves thorax and passes into
abdominal cavity , then divides into anterior
gastric and hepatic branches
 Right Vagus Nerve
Course
 Travels downward anterior to the right
subclavian artery and enter thoracic inlet on
right side of trachea
 Passes posterior to right lung root
contributing to the pulmonary plexus
 Then passes on to the posterior surface of
esophagus and forms posterior esophageal
plexus
 Forms posterior vagal trunk at esophageal
hiatus where it leaves thorax and passes into
abdominal cavity, then divides into posterior
gastric and celiac branches
 Vagus Nerve (Ⅹ)
Branches in neck
 Superior laryngeal nerve : passes
down side of pharynx and given rise
to
 Internal branch, which pierces

thyrohyoid membrane to
innervates mucous membrane of
larynx above fissure of glottis
 External branch, which

innervates cricothyroid
 Cervical cardiac branches :
descending to terminate in cardiac
plexus
 Others: auricular, pharyngeal and
meningeal branches
Vagus Nerve (Ⅹ)

Superior laryngeal nerve

Internal branch
External branch
 Vagus Nerve (Ⅹ)
Branches in thorax
 Recurrent laryngeal nerves
 Right one hooks around right subclavian
artery, left one hooks aortic arch
 Both ascend in tracheo-esophageal groove
 Nerves enter larynx posterior to cricothyroid
joint, the nerve is now called inferior
laryngeal nerve
 Innervations: laryngeal mucosa below fissure
of glottis, all laryngeal muscles except
cricothyroid
 Bronchial and esophageal branches
Innervation of the
larynx
 Vagus Nerve (Ⅹ)
Branches in abdomen
 Anterior and posterior gastric branches
 Run close to lesser curvature and innervate
anterior and posterior surfaces of stomach
 As far as pyloric antrum to fan out into
branches in a way like the digits of a crow’s
foot to supply pyloric part
 Hepatic branches : join hepatic plexus and
then supply liver and gallbladder
 Celiac branches : send branches to celiac
plexus to be distributed with sympathetic fibers to
liver, gallbladder, pancreas, spleen, kidneys,
intestine as far as left colic flexure
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Cranial Nerve Reflexes
 X (Vagus): reflexes having to do with heart rate, blood
pressure, and respiration
 Reflexes involving both cranial nerves and brainstem:
 Turning the eyes toward sudden noise, touch on skin,

flash of light
 Eyes tracking a moving object.

 Reflex using VIII, V, and VII to contract muscles

associated with middle ear that protect ear ossicles

 Chewing reactions to textures of food, movement of

tongue pushing food under tooth-row and out of

harm's way

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