Cranial nerves Nervi craniales

Cranial nerves 12 pairs Emerging from the brain stem (except CN I and CN II), where they have their nuclei (somatomotor, somatosensitive, sensoric, parasympathic) Outside brain - ganglias (sensitive, parasympathetic) Sympathetic fibres join along the course, from plexuses following the blood vessels

Cranial nerves CN I – n. olfactorius - sensoric CN II – n. opticus - sensoric CN III – n. oculomotorius - motor + PS CN IV – n. trochlearis - motor CN V – n. trigeminus – sensitive + motor CN VI – n. abducens - motor CN VII – n. facialis – motor + PS CN VIII – n. vestibulocochlearis - sensoric CN IX – n. glossopharyngeus – PS + sens + motor + senz CN X – n. vagus – PS + motor + sensitive + sensoric CN XI – n. accessorius - motor CN XII – n. hypoglossus – motor

Cranial nerves origin in the brain stem

General scheme for CN studying number, Latin and English term developmental type of CN nuclei + their location transmitted modalities where CN submerge into skull course of CN + topography branches overview of supplied area clinical examination, reflexes palsy / iritation

I – n. olfactorius Olfactory nerve Rather bundle of nerve fibres, than a nerve Pure sensoric nerve Bipolar neurons Ability to regenerate N. terminalis, n. vomeronasalis - rudiments

Olfactory tract Fila olfactoria, bulbus – interconnection, tractus, trigonum, stria olfactoria (med. + lat.), brain areas Disorders: anosmia, parosmia, kakosmia

II – n. opticus Optic nerve Diencephalon pouch Consist of axons of the 3rd nerves of the optic tract Covers: vagina externa + interna (from meninges) A.+ V. centralis retinae Pars intraocularis Pars orbitalis Pars canalis optici Pars intracranialis

Optic tract N. opticus –> chiasma opticum –> tractus opticus Disorders: amaurosis, hemianopsia, scotom

Nerves for the eye movement

External muscles of the eye-ball 4 recti (superior, inferior, lateralis, medialis) 2 oliqui (superior + inferior) m. levator palpebrae superioris smooth muscles: m. orbitalis, mm. tarsales

Nerves for the eye movement CN III, IV and VI for 7 muscles CN IV and VI pure somatomotor functions CN III – somatomotor + PS functions

III - n. oculomotorius Oculomotor nerve nc. oculomotorius (somatomotor) nc. Edinger-Westphal (PS) Ramus superior + inferior (r. communicans ad ggl. ciliare) Palsy: diplopia, divergent strabismus, ptosis, mydriasis Innervates: m. rectus superior m. rectus medialis m. rectus inferior m. obliquus inferior m. levator palpebrae sup.

ggl. ciliare Ciliary ganglion

m. sphincter pupilae m. dilatator pupilae m. ciliaris

IV - n. trochlearis Trochlear nerve, pure somatomotor Innervates m. obliquus superior Nucleus trochlearis Only one which emerges from the brain stem dorsally sinus cavernosus, fissura orbitalis superior, ATC Zinni Palsy: diplopia when looking down and laterally (downstairs)

IV - n. abducens Abducens nerve, pure motor (nc. abducens) Innervates m. rectus lateralis Dorello´s canal, sinus cavernosus, fissura orbitalis superior, ATC Zinni Palsy: diplopia, convergent strabism

Nerves for eye-movement

Orbita

Sinus cavernosus

Anulus tendineus communis Zinni

Anulus tendineus communis (Zinni)

V – n. trigeminus Trigeminal nerve – 3 branches 3 sensitive nuclei: nc. mesencephalicus nc. pontinus nc. spinalis (in medulla oblongata) 1 motor nucleus: nc. motorius Vegetative part joins along the course Emerging from the pons Sensitive ganglion trigeminale (Gasseri) PS ganglions (ciliare, pterygopalatinum, oticum, submandibulare)

V1 – n. opthalmicus Senzitive nerv 3 main branches: n. frontalis n. lacrimalis (sensitive + PS) n. nasociliaris Connections with nerves for eye-movement (sensitive fibres) Parasympatic fibres for n. lacrimalis from connection from n. zygomaticus (V2)

V1 – n. opthalmicus

V2 – n. maxillaris Sensitive nerve Parasympathetic fibres for ggl. pterygopalatinum from n. facialis passes foramen rotundum, branches out in fossa pterygopalatina n. infraorbitalis n. zygomaticus nn. pterygopalatini

V3 – n. mandibularis Sensitive and motor nerve Parasympatic fibres for ggl. oticum from n. IX, for ggl. submandibulare from VII passes foramen ovale, branches out in fossa infratemporalis

V3 – n. mandibularis muscle branches (n. massetericus, nn. temporales profundi, nn. pterygoidei) n. bucalis n. auriculotemporalis n. lingualis n. alveolaris inferior

V3 – n. mandibularis

Ganglia of trigeminus ggl ciliare ggl pterygopalatinum PS fibres for glands interconnects in the ganglias Sympatic fibres for smooth muscles pass through Sensitive fibres pass through ggl pterygopalatinum ggl submandibulare ggl oticum

ggl. ciliare Ciliary ganglion

m. sphincter pupilae m. dilatator pupilae m. ciliaris

ggl. pterygopalatinum PS for lacrimal gland, glands of nose, mouth from n. petrosus major (n. VII)

ggl. oticum PS from nucleus of CN. IX to parotid gland

ggl. submandibulare Near of n. lingualis and submandibular gland PS from n. lingualis (by chorda tympani, n. VII) S from plexus of a. facialis rr. glandulares for submandibular and sublingual glands (PS)