7 CRANIAL NERVE

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Dr JITHENDER SINGH
SEVEN CRANIAL NERVE FACIAL
NERVE
• FACIAL NERVE IS THE NERVE
OF SECOND BRANCHIAL
ARCH.
• FUNCTIONAL COMPONENTS :
.SVE
• GVE
• SVA
• GSA
• Course
• Clinical implications
FUNCTIONAL
COMPONENT
• Special visceral
efferent (SVE)
fibres arise from motor
nucleus and supplies
the muscles derived
from the mesoderm of
2nd pharyngeal
arch, viz. muscles of
facial expression, etc.
Nucleus of Facial Nerve
Nucleus of facial nerve is situated in the lower
part of the pons, in the ventrolateral part of its
tegmentum, more or less in line with the motor
nucleus of the trigeminal nerve.
Its position is anterolateral and caudal to
abducent nucleus, and medial to the nucleus of
spinal tract of trigeminal nerve.
The fibres arising from the nucleus pursue an
aberrant course.
First they course dorsomedially towards the
floor of fourth ventricle to loop behind the
motor nucleus of the abducent nerve.
The loop (internal genu of facial
nerve) elevates the floor of fourth
ventricle and forms the facial
colliculus, and then course
ventrolaterally passing between
the nucleus of their origin and
nucleus of spinal tract of
trigeminal nerve to emerge
through the pontomedullary
junction on the ventral aspect of
the brainstem lateral to the
emergence of the abducent nerve.
• Neurobiotaxis of motor nucleus of facial nerve: In the early
embryogenesis the motor nucleus of facial nerve is located
dorsolateral to the cranial end of abducent nucleus, underneath
the facial colliculus. Thereafter, it migrates caudally along the
dorsal surface of that nucleus and then ventromedial to the latter
until the facial nerve nucleus reaches its permanent position in
close proximity to the spinal nucleus of the trigeminal nerve (a
site of maximum sensory stimulus) which establishes quick reflex
responses. Such migration of motor nucleus towards the sensory
nucleus is known as the “neurobiotaxis”. Eventually the motor fibres
of the facial nerve undergo a looped course (internal genu of
facial nerve) around the dorsomedial aspect of the abducent nerve
nucleus.
• Note nerve cell bodies migrate towards the source maximum
stimuli. This phenomenon is called as neurobiotaxis.
General visceral efferent
(GVE) fibres are
preganglionic
parasympathetic fibres to
the pterygopalatine and
submandibular ganglia for
lacrimation and salivation
respectively. These fibres
arise from the lacrimatory
and the superior salivatory
nuclei respectively.
• The preganglionic fibres arising from lacrimatory nucleus
terminate in the pterygopalatine ganglion, from which
postganglionic fibres arise and supply the lacrimal gland through
zygomatic branch of trigeminal nerve.
• The preganglionic
fibres arising from
superior salivatory
nucleus relay in the
submandibular
ganglion, from which
postganglionic fibres
arise and supply the
submandibular and
sublingual salivary
glands.
• Special visceral afferent (SVA)
fibres are concerned with the
taste sensations. The cell bodies
of these fibres lie in the geniculate
ganglion. The peripheral
processes of ganglion cells carry
taste sensations from the taste
buds on the anterior two-third of
the tongue except vallate papillae.
The central processes of ganglion
cells carry these sensations to the
upper part of the nucleus of tractus
solitarius.
• General somatic afferent (GSA)
fibres have their cell bodies in
the geniculate ganglion. The
peripheral processes of these
cells innervate part of the skin
of the external ear, while the
central processes terminate in
the spinal nucleus of trigeminal
nerve.
 COURSE AND DISTRIBUTION:
• The facial nerve arises by two roots—
motor and sensory on the ventral aspect
of brainstem from the lower border of
the pons opposite the groove between
the olive and inferior cerebellar
peduncle. The main trunk, i.e. motor
root enters the external auditory meatus
accompanied by the small sensory root
(nervous intermedius of Wrisberg),
vestibulocochlear nerve and labyrinthine
vessels.
• At the lateral end of meatus two
roots unite to form the trunk of the
facial nerve where it first runs
above the bony labyrinth of
internal ear and then bends
posteriorly in the medial wall of
the middle ear, forming genu of
facial nerve. It runs posteriorly in
the middle ear medial wall below
the lateral semicircular canal.
• Finally the nerve turns 90° and
runs in the posterior wall of the
middle ear till it reaches the
stylomastoid foramen at the base,
through which it leaves the
cranial cavity. Finally, it runs
anterolaterally to enter the
parotid gland, where it divides
into five terminal branches.
BRANCHES
The facial nerve gives off following branches:
• Greater petrosal nerve, which is joined by deep
petrosal nerve to form nerve of pterygoid canal. It
provides secretomotor supply to lacrimal, nasal and
palatal glands.
• Nerve to stapedius.
• Chorda tympani nerve, which joins lingual nerve. It
carries taste fibres from anterior two-third of the tongue
and provides preganglion fibres to the submandibular
ganglion.
• Posterior auricular nerve to supply occipitalis and
posterior auricular muscles.
• Nerve to posterior belly of diagastric and stylohyoid
muscles.
• Terminal branches (temporal, zygomatic, buccal,
mandibular and cervical to the muscles of facial
expression.
Differences between UMN and
LMN types of facial palsy The part
of motor nucleus of facial nerve
supplying the muscles of the lower
part of the face receives the
corticonuclear fibres from the
opposite cerebral hemisphere while

the part of motor nucleus of facial

nerve which supplies the muscles
of the upper part of the face
(frontalis, orbicularis oculi)
receives corticonuclear fibres from
both cerebral hemispheres.
• As a result in supranuclear lesions
(i.e. lesions involving the UMNs)
of the facial nerve the upper half
of the face on both sides is spared
and the lower half of the face is
affected on the opposite side,
• on the other hand in nuclear and
infranuclear lesions, i.e. lower
motor neuron (LMN) lesions
whole of the face is affected on
the side of lesion.
Thank you