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Cranial Nerves
Course, function, branches, clinical
| Term | Definition |
|---|---|
| Which are only sensory nerves? | CN I, CN II, CN VIII |
| Which are only motor nerves? | CN III, CN IV, CN VI, CN XI, CN XII |
| Which are mixed nerves? | CN V, CN VII, CN IX, CN X |
| What is the CN I course? | 20 olfactory nerve from nasal cavity roof mucosa cell bodies -> through ethmoid cribriform plate -> olfactory bulb -> olfactory tract -> primary olfactory cortex (piriform/entorhinal cortex, amygdala) in uncus of temporal lobe |
| What is the CN II course? | Retinal GC axons form optic nerve -> optic canal -> optic chiasm -> optic tract -> lateral geniculate nucleus/midbrain superior colliculus -> LGN forms optic radiation -> primary visual cortex of occipital lobe |
| What is CN II surrounded by? | All 3 layers of meninges -> increased intracranial Pa can lead to optic nerve welling -> papilloedema -> blurry optic disc |
| Lesion of optic nerve causes? | Total ipsilateral eye visual loss |
| Lesion of optic chiasm causes? | Bitemporal hemianopia -> lose temporal fields as temporal fibres decussate in chiasm |
| Lesion of lateral optic chiasm causes? | Ipsilateral nasal hemianopia -> lose ipsilateral nasa field |
| Lesion of optic tract causes? | Contralateral homonymous hemianopia -> lose ipsilateral nasal field and contralateral temporal field -> left lesion -> lose right fields in both eyes |
| Complete lesion of optic radiation causes? | Contralateral homonymous hemianopia w/ macular sparing (double vascular supply btwn ICA/ECA from posterior cerebral artery/middle cerebral artery stroke or bilateral maculae projection) |
| Partial lesion of optic radiation causes? | Inferior optic radiation affected -> bilateral contralateral superior quadrantanopia, superior optic radiation affected -> bilateral contralateral inferior quadrantanopia, both have macular sparing |
| What is the nature/nuclei of CN I? | Special sensory afferent, no nucleus |
| What is the nature/nuclei of CN II? | Special sensory afferent, no nucleus |
| What is the nature/nuclei of CN III? | General somatic efferent -> nucleus of CN III, general visceral efferent (parasympathetic -> accessory Edinger-Westphal nucleus) |
| What is the CN III course? | Anterior midbrain/pons -> anteriorly in subarachnoid space -> anteriorly through cavernous sinus (superolateral to ICA) -> divides into superior/inferior branches -> SOF -> w/in tendinous ring -> orbit |
| What do CN III divisions innervate? | Superior -> LPS, superior rectus, inferior -> medial rectus, inferior rectus, inferior oblique, preganglionic branch to ciliary ganglion |
| What is the nature/nuclei of CN IV? | General somatic efferent -> nucleus of trochlear nerve |
| What is the CN IV course? | Dorsal midbrain below inferior colliculus -> decussate -> anterior around contralateral brainstem -> anteriorly throuch cavernous sinus (inferior to CN III) -> SOF -> outside tendinous ring -> orbit |
| What is the nature/nuclei of CN V? | Special visceral efferent -> motor nucleus of CN V, general somatic afferent -> principal sensory, mesencephalic nucleus, spinal nucleus |
| What is the CN V course? | Lateral pons (superior pontine sulcus) -> travel inferolaterally to trigeminal ganglion in Meckel's cave in posteromedial MCF (lateral to superior petrosal sinus) -> 3 branches split off -> Va through SOF, Vb through rotundum, Vc through ovale |
| What are the branches of CN Va? | Ophthalmic branches off w/in SOF -> nasociliary (through tendinous ring -> cornea, conjunctiva, nasal cavity mucosa), frontal (supraorbital/trochlear -> forehead skin), lacrimal (lateral forehead sensation/parasympathetic lacrimal gland - Vb zygomatic) |
| What are the branches of CN Vb? | Maxillary branches off after foramen rotundum -> zygomatic (IOF -> parasymp post-ganglionic), infraorbital (IOF -> cheek sensation), sphenopalatine (parasymp pre-ganglionic), palatine (greater - hard palate, lesser - soft palate) |
| What are the branches of CN Vc? | Med pterygoid -> tensor tympani, tensor veli palatini, med/lat pterygoid, buccal -> masseter, lingual -> ant 1/3 tongue sensation, inf alveolar -> mental, mylohyoid -> mylohyoid, ant digastric, auriculotemporal (temporal scalp/postganglionic to parotid) |
| What is the nature/nuclei of CN VI? | General somatic efferent -> nucleus of CN VI |
| What is the CN VI course? | Caudal pons (beneath floor of 4th ventricle) -> pontomedullary junction -> superior margin of petrous temporal bone -> runs against clivus -> cavernous sinus -> SOF -> w/in tendinous ring |
| What is the nature/nuclei of CN VII? | Special visceral efferent -> motor nucleus of CN VII, special visceral afferent -> NST, general visceral efferent -> superior salivatory nucleus, general somatic afferent -> prinicipal sensory, |
| What is the CN VII course? | Pontomedullary junction -> cerebellopontine angle -> IAM -> facial canal of petrous temporal bone -> geniculate ganglion -> some branches off -> stylomastoid foramen (parotid) and foramen lacerum (greater petrosal) |
| What are the branches of CN VII? | Greater petrosal -> (parasymp preganglinoic -> pterygopalatine ganglion, nerve to stapedius, chorda tympani (parasymp preganglionic -> submandibular ganglion), posterior auricular, occipitalis, post digastric, stylohyoid, parotid plexus |
| What are the branches of CN VII parotid plexus? | Temporal -> frontalis, zygomatic -> orbicularis oculi, buccal -> orbicularis oris, mandibular -> depressor anguli oris, cervical -> platysma |
| What is the CN VIII course? | Vestibular/cochelar roots emerge from pontomedullary junction -> merging of roots in petrous temporal bone (PCF) -> lateral to CN VI/VII -> IAM -> splits into roots -> spiral/vestibular ganglion |
| What is the nature/nuclei of CN VIII? | Special somatic afferent -> cochlear and vestibular nuclei |
| What is the nature/nuclei of CN IX? | Special visceral efferent -> nucleus ambiguus, general visceral efferent -> inferior salivatory nucleus, somatic visceral afferent -> NST, general visceral afferent -> nucleus ambiguus/NST, general somatic afferent -> spinal nucleus |
| What is the CN IX course? | Several rootlets (posterior olive) a -> jgular foramen -> superior/inferior IX ganglia -> anteroinferiorly towards tongue (superior and // arch of CN XII) -> btwn stylopharyngeus/glossus -> post 1/3 tongue mucosa -> branches |
| What are the branches of CN IX? | Tympanic (sensation andlesser petrosal (parasymp preganglinoic -> otic ganglion)), carotid sinus (chemo/mechanoreceptors), pharyngeal, stylopharyngeus, tonsilar (palatine sensation), lingual branch (post 2/3 tongue sensation/taste) |
| What is the nature/nuclei of CN X? | General visceral efferent -> dorsal motor nucleus, special visceral efferent (nucleus ambiguus), general visceral afferent -> NST, general somatic afferent -> spinal nucleus of CN V |
| What is the CN X course? | Rootlets from medulla oblongata (posterior olive) -> jugular foramen -> carotid sheath -> right posterior to oesophagus/primary right bronchus, left posterior to oesphagus/primary left bronchus but anterior to aortic arch |
| What are the branches of CN X? | Auricular (external tympanic membrane sensation), pharyngeal (w/ CN IX plexus, tongue palatoglossus), superior laryngeal (sensation above vocal cords and cricothyroid), recurrent laryngeal (sensation below vocal cords and other laryngeal muscles) |
| What is the nature/nuclei of CN XI? | Somatic visceral efferent -> nucleus ambiguus (cranial), general visceral efferent -> spinal accessory nucleus (C1-5) |
| What is the CN XI cranial course? | Medulla oblongata (posterior olive) -> cerebellomedullary cistern -> jugular foramen -> posterior triangle of neck |
| What is the CN XI spinal course? | Rootlets fuse -> travels superiorly posterior to dentate ligaments (pia mater -> dura mater) -> foramen magnum |
| What is the nature/nuclei of CN XII? | General somatic efferent -> nucleus of CN XII |
| What is the CN XII course? | Medulla oblongata (anterior olive) -> hypoglossal canal -> emerge inferior to digastric tendon -> inferiorly through retrostyloid space (medial to ICA then lateral) -> horizontal -> vertical posterior to submandibular gland -> sublingual area (branches) |
| What are the branches of CN XII? | Superior root of ansa cervicalis -> sternohyoid/thyroid/omohyoid, terminal lingual branches -> tongue intrinsic/extrinsic (genioglossus, hyoglossus, styloglossus), geniohyoid |
Created by:
vykleung
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