PT 1011: Cranial Nerves

CRANIAL NERVES CRANIAL NERVES AND EXIT

• Peripheral nerves: nerves that either have Cranial Nerve Exit in the Skull
functions of giving motor or getting I Olfactory Cribriform plate
sensations or autonomic II Optic Optic Canal
o Motor: instructions come from brain; III Oculomotor Superior orbital fissure
efferent travel IV Trochlear Superior orbital fissure
o Sensory: sensory fibers are ascending, V Trigeminal
touch something that is hot, nerve feels it V-1 Ophthalmic Superior orbital fissure
and send impulse and brain says its hot V-2 Maxillary Foramen rotundum
V-3 Mandibular Foramen ovale
o Autonomic: cannot be control; smooth
VI Abducent Superior orbital fissure
muscles
VII Facial Internal acoustic meatus
• 12 Pairs Facial canal
• Numbered Anterior to Posterior Stylomastoid foramen
• Attach to Ventral surface of brain VIII Auditory / Internal acoustic meatus
• Exit brain through foramina in skull verstibulocochlear
• I + II attach to Forebrain (cerebrum + IX Glossopharyngeal Jugular foramen
diencephalon) X Vagus Jugular foramen
o Particularly at the cerebral cortex XI Accessory Jugular foramen
• III-XII attach to Brainstem (midbrain, XII Hypoglossal Hypoglossal canal
pons, medulla)
o III to IV from midbrain MOTOR VS. SENSORY NERVES
o V to VII from pons
o IX to XII from medulla SENSORY = AFFERENT
• Only X goes beyond the head-neck; all of
• Send nervous impulse from sensory
the others innervate the skull
receptors to brain to bring in information;
Oh Oh To Touch And Feel A Girl’s Vagina Ah ascending
Heaven! • e.g. pressure, temperature, pain
• Special senses such as vision, hearing,
I – Olfactory: most ventral, from cerebral cortex
smell
II – Optic: from cerebrum
Visceral Sensory
III - Oculomotor
• stretch, pain, temp., chemical changes,
IV - Trochlear irritation in viscera
• sensory innervation of viscera
V - Trigeminal (1-3)
• Special: taste
VI - Abducens
Somatic Sensory
VII - Facial
• touch, pain, pressure, vibration, temp. in
VIII - Auditory/Vestibulocochlear skin, body wall, limbs
• sensory innervation of outer part body
IX - Glossopharyngeal
• Special: hearing, equilibrium, vision, smell
X – Vagus: longest; goes to thoracic and stomach
MOTOR = EFFERENT
area
• Send nervous impulses from brain to body
XI - Accessory
to accomplish an action; descending
XII - Hypoglossal
PT 1011: Cranial Nerves

• e.g. movement of a muscle (especially OH! CRANIAL NERVE II (CN II)

those located in the head and neck region),
OPTIC NERVE
activation of a gland
• Comes from back of eyeball and leaves
Visceral Motor
orbital canal through optic canal
• motor innervation muscle of the viscera +
Function Vision
glands
Lesion Blindness
• innervation smooth + cardiac muscle,
To Test Use if Snellen’s chart
glands
Branchial Motor
• PERIPHERAL VISION: you can see what is
• motor innervation of pharyngeal arch m. in front of you, but if there's a car passing
• facial expression, pharyngeal constrictors, on the side, you cannot see it
suprahyoid, sternocleidomastoid, trapezius OH! CRANIAL NERVE III (CN III)
Somatic Motor OCULOMOTOR
• motor innervation of skeletal muscle • Motor that supplies
• innervation of skeletal muscles (except 1. levator palpebrae superioris: elevates the
pharyngeal arch m.) eyelids
2. Superior, middle, and inferior rectus and
SENSORY = S inferior oblique (extraocular muscle of
MOTOR = M eye movement): moves the eyeball, the
BOTH = B other 2 are not controlled by oculomotor
Some CN I 3. Constrictor pupillae of iris and cilliary
Say CN II muscle (cilliary constriction): for dilation
Marry CN III and constriction of pupils of the iris
Money CN IV • Pillar, opens the eyelids
But CN V
My CN VI Action Look at nose
Brother CN VII Lesion Ptosis - inability to open your eyelid
Says CN VIII Diplopia - double vision; if you ask
Big CN IX the patient to follow your finger,
Boobs CN X one will follow, one will stay
Matters CN XI paralyzed; one of the extraocular
Most CN XII muscle is not moving

OH! CRANIAL NERVE I (CN I)

• Superior, inferior, medial recti and inferior
OLFACTORY oblique
• from olfactory receptor nerve cell in the • Supplies muscles
olfactory mucous membrane at the upper of
nasal cavity (above superior nasal concha)
Function Smell
Lesion Anosmia – lost of sense of smell
To Test Close eyes and introduce a familiar
smell and let him identify what
smell is that
PT 1011: Cranial Nerves

• Since it covers the eye, it passes through

superior orbital fissure
• Sense of pain, pressure, temperature

• Medial rectus – middle

AND CRANIAL NERVE VI (CN VI)
• Lateral rectus - to the sides
• Superior oblique - when it contracts the ABDUCENT
eyeballs will look downward medially
• Inferior oblique - when it contracts, the • Lateral rectus (LR6)
eyeballs will look upward medially • Innervates lateral rectus
• Longest intracranial nerve
TO CRANIAL NERVE IV (CN IV)
FEEL CRANIAL VII (CN VII)
TROCHLEAR
FACIAL NERVE
• Superior oblique (SO4)
• One that innervates the superior oblique • Motor: muscles of facial expression,
• Most slender cranial nerve stapedius muscle of middle ear, stylohyoid,
posterior digastric
TOUCH CRANIAL NERVE V (CN V) o A hook, it closes the eye
• Sensory: taste from anterior 2/3 of tongue,
TRIGEMINAL
floor of mouth and palate
• Largest cranial nerve o Sweet, sour, salty = TASTE ONLY
• Motor and sensory function o If you bit your tongue and felt the
• 3 divisions: pain = its the trigeminal nerve
• Parasympathetic: salivary glands
Ophthalmic Sensory exits (submandibular and sublingual), lacrimal
(V-1) superior
and glands of nose and palate
oblique
Maxillary Sensory foramen o Secretes to the salivary glands
(V-2) ovale • Enters the internal acoustic meatus, passes
Mandibular motor foramen Supplies through the facial canal, and exit to the
(V-3) rotundum the stylomastoid foramen
muscles of
• Lesion: Bell’s Palsy
mastication
o Ipsilateral weakness of the face
o Eyes cannot close bc one muscle that it
• Only Motor branch is the mandibular innervates is the one that closes the
division supplying muscles of mastication eyes
PT 1011: Cranial Nerves

o Cerebral palsy - problem of the brain, • Motor

not necessarily a cranial nerve's fault
• Autonomic function HEAVEN! CRANIAL NERVE XII (CN XII)
HYPOGLOSSAL CANAL
A CRANIAL NERVE VIII (CN VIII)
AUDITORY (VESTIBULOCOCHLEAR) • Muscle of tongue
• Have right and left
• Vestibular – position and movement of • If right is paralyzed, the tongue will point
head, balance toward the lesion, so toward the right
• Cochlear – hearing • Motor function
• Controls balance
• Both are sensory properties
GIRL’S CRANIAL NERVE IX (CN IX)
GLOSSOPHARYNGEAL

• Motor: stylopharyngeus muscle (swallowing)

• parasympathetic: parotid gland
• sensory: sensation and taste of posterior
1/3 of tongue, pharynx, carotid sinus, and
carotid body
o Bitter taste
• Autonomic function: the third salivary gland,
PAROTID GLAND (largest salivary gland)
• Uvula is displaced/pointing to the stronger
other side
VAGINA CRANIAL NERVE X (CN X)
VAGUS NERVE

• Constrictor muscle of pharynx

• Intrinsic muscle of larynx
• Muscle of trachea, bronchi, heart,
alimentary tract
• Sensory: taste from epiglottis, vallecula
o Beyond tongue
• Goes extracranial; wandering nerve
• Innervates pharyngeal muscle - for gag
reflex
AH! CRANIAL NERVE XI (CN XII)
ACCESSORY

• Spinal accessory nerve

• Cranial root: muscle of soft palate, pharynx
and larynx
• Spinal root: sternocleidomastoid (muscle
that turns head) and trapezius
o Moving trapezius muscles - Shrugs
shoulder