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Cranial nerves and special

senses

[email protected]

Word roots • vagus (L.): wandering

• trochlea (G.): pulley

• glossus (G.): tongue

• cochlea (L.): snail

• chiasm (L.): cross

• rectus (L.): straight

• ocul, -i, -o (L.): eye

• opt- (L.): eye (optic, opthalmic etc.)

Special senses

• 5 „„traditional‟‟ senses: Touch, smell, sight,

hearing and taste.

• “touch” is what we have already talked about,

and is a colloquial term for general sensation.

This is covered by peripheral nerves and

cranial nerves.

• The cranial nerves cover the special senses,

and equilibrium (not traditionally covered).

Cranial nerves • Cranial nerves (CN) are part of the

PNS.

• Nerves attach to the brainstem

(except for CNI and CNII - direct

connection to brain).

• Synapse within distinct nuclei

(collections of cell bodies) in brainstem

(equivalent to grey matter of the spinal

cord).

Mnemonics 12 cranial nerves

Oh

Oh

Oh

To

Touch

And

Feel

Very

Gooey

Veal

And

Ham

Olfactory

Optic

Oculomotor

Trochlear

Trigeminal

Abducens

Facial

Vestibulocochlear

Glossopharyngeal

Vagus

Accessory

Hypoglossal

Some

Say

Marry

Money

But

My

Brother

Says

Big

Boobs

Matter

More

I

II

III

IV

V

VI

VII

VIII

IX

X

XI

XII S - sensory

M - motor

B - both

Moore and Dally (2009). Clinically Oriented Anatomy

Cranial nerve nuclei

Collections of grey

matter within distinct

locations throughout

the brainstem.

These are equivalent

to the grey matter

collections (ventral

and dorsal horns) in

the spinal cord.

CN I : Olfactory Sensory only

Special sense: Smell

Passes through cribriform

plate of ethmoid bone

and synapses

immediately onto

olfactory bulb (second

order neurons)

No connection to thalamus

Internal view of the skull

CN II : Optic

Sensory only

Sight (special sensory)

Passes through optic

canal in sphenoid

bone

Neurons from retina

(back of eyeball)

Half of neurons cross

over at optic chiasm

(peripheral visual

fields)

Visual Pathway

Visual fields

Retinal fields

Optic nerve

Optic chiasm

Optic tract

Lateral geniculate

body (thalamus)

Optic radiation

Visual cortex

(occipital lobe)

First order neuron in eyeball

Second order neuron from

eyeball to thalamus

Third order neuron from

thalamus to occipital lobe

Eye Three layers of the

eyeball:

* fibrous coat

- cornea (transparent)

- sclera (white part)

* vascular coat (uvea)

- iris

- lens

- choroid (vessels)

* neural coat

- retina --> synapse to

neurons that form CN II

Ellis (2010) Clinical Anatomy

Vision

Vision

CN III:

Oculomotor

Motor (Autonomic and

Somatic)

Passes through

superior orbital fissure

of sphenoid bone

controls extrinsic eye

muscles (movements

of the eyeball)

controls size of pupil

and shape of lens

CN IV:

Trochlear

Motor (somatic)

Passes through

superior orbital fissure

Controls the Superior

oblique muscle

moves the eye down

and out

Small ligament holds the superior oblique

muscle in place. This acts like a pulley,

which is where this nerve gets it‟s name

from.

Superior view of left orbit

CN V:

Trigeminal Sensory and motor

(depending on

branches)

Three branches:

- Opthalmic (V1)

- Maxillary (V2)

- Mandibular (V3)

Only mandibular has

motor fibres (controls

muscles of

mastication)

Supraorbital notch

(part of V1)

Infraorbital foramen

(part of V2)

Mental foramen

(part of V3)

Exit foramina for CNV

(sensory branches)

CN V:

Trigeminal All three branches provide

sensory innervation to the

face

Each branch passes

through a different hole in

the skull:

- Opthalmic - superior

orbital fissure

- Maxillary - foramen

rotundum

- Mandibular - foramen

ovale

Sensory distribution of trigeminal nerve

Tongue

Moore and Dally (2009). Clinically Oriented Anatomy (modified)

Ellis (2010). Clinical Anatomy (modified)

CN VI:

Abducens

Motor (somatic)

Nerve passes through

superior orbital fissure

in the skull

controls the Lateral

rectus muscle

abducts the eyeball

Eye - many cranial nerves

involved! 3 muscles to control extrinsic eye

muscles

* CN III oculomotor - medial rectus,

superior recuts, inferior rectus,

inferior oblique

* CN IV trochlear - superior oblique

* CN VI abducens - lateral rectus

CNIII, the oculomotor nerve, has

parasympathetic fibres. This controls

the size of the pupil (how much light

enters the eye) and the shape of the

lens.

CN II, optic nerve carries the visual information

back to the visual cortex, where it is interpreted

and integrated with other information.

CN VII, facial nerve carries PSNS fibres to

teh lacrimal gland. This produces

lubricating film (tears) that keeps the eye

moist.

Moore and Dally (2009). Clinically Oriented Anatomy

CN VII:

Facial

Motor (somatic and

autonomic) and

special sensory

Passes through the

internal acoustic

meatus, through

temporal bone, exits

stylomastoid foramen

Special sensory to

tongue (taste)

Motor to muscles of

facial expression

Facial nerve

Special sensory:

Taste

Anterior 2/3 tongue

Moore and Dally (2009). Clinically Oriented Anatomy (modified)

The facial nerve also

supplies PSNS

innervation to the

lacrimal glands (tears)

and salivary glands.

CN VIII:

Vestibulocochle

ar

Sensory (special)

Hearing (cochlear

part)

Equilibrium

(vestilbular part)

Passes through

internal acoustic

meatus

Cochlea (L.) = snail

Marieb (2009). Human Anatomy and Physiology (modified).

Martini (2009). Human Anatomy and Physiology (modified).

Martini (2009). Human Anatomy and Physiology (modified).

CN IX:

Glossopharynge

al

Motor (somatic) and

sensory (special and

somatic)

Passes through the

jugular foramen

sensory for the tongue

(general sensation and

taste)

sensory for the pharynx

(throat)

Glossopharynge

al

nerve

The glossopharyneal nerve

provides general sensation

(touch, pain, temperature etc)

AND

special sensation to the

posterior 2/3 of the tongue

CN X: Vagus

Motor (somatic and

autonomic)

Passes through jugular

foramen

Voluntary motor control

of laryngeal muscles

(controls voice)

Autonomic (PSNS)

motor control of gut,

salivary glands, heart

rate (slows).

CN X: Vagus

CN XI:

Accessory Motor (somatic)

Ascends through

foramen magnum,

then passes through

jugular foramen

Trapezius

Sternocleidomastoid

Pons

Thalamus

Medulla

oblongata

CN XII:

Hypoglossal

Motor (somatic)

Passes through

hypoglossal canal (near

foramen magnum)

Distinct location - roots

between olives and

pyramids on medulla

oblongata

Voluntary motor control of

tongue muscles Anterior view of dissected

brain stem and thalamus

Tongue

Trigeminal nerve (CNV)

GENERAL SENSORY Facial nerve (CNVII)

TASTE

Glossopharyngeal

nerve (CNIX)

TASTE and GENERAL

SENSORY

MOTOR = HYPOGLOSSAL only! XII

Skull foraminae

Peripheral nerves (test

yourself)

Posterior compartment of the thigh

Radial nerve

Sensory innervation to the face

Motor innervation of facial muscles

Intrinsic foot muscles plantar surface

Spinal segments of brachial plexus

Peripheral nerves (test

yourself)

Posterior compartment of the thigh

Radial nerve

Sensory innervation to the face

Motor innervation of facial muscles

Intrinsic foot muscles plantar surface

Spinal segments of brachial plexus

Tibial n.

Posterior arm and forearm

muscles

C5-T1

Lateral and medial plantar nerves

(Tibial n.)

Trigeminal nerve CNV

Facial nerve CNVII

Test yourself

Test yourself Corpus callosum

Frontal lobe

Anterior cerebral

artery

Pons 4th ventricle

cerebellum

parieto-occipital

sulcus