Neuro-anatomy for theOphthalmologist   Raed Behbehani, MD, ABO
Neuro-anatomy   Orbits   Cranial Cavity   Venous sinus   Cavernous sinus   Cranial Nerves
Anterior Cranial Fossa   Anteriorly: Frontal bone.   Posteriorly: Lesser wing of sphenoid.   Floor : Orbital plate, cri...
Middle Cranial Fossa   Floor: “Butterfly shape”.   Anteriorly: The lesser wings of the sph., ant. Clinoids.   Posterior...
Posterior Cranial Fossa   Roof: Tent.Cerebelli.   Anteriorly : Petrous part of Temp. bone, Dorsum sellae.
CSF Circulation
Venous Sinuses
Venous sinuses   Superior SS .   Inferior SS join the Great vein of Galen     Straight sinus.   SSS, straight S, and t...
CSF
Cavernous sinus   Intercavernous comunications.   Tributaries: Sup and Inf Ophthalmic veins,    sup cerebral vein.   Dr...
Cavernous sinus
Cranial Nerves
Oculomotor Nerve  Nuclei lie at level of sup colliculi. Dorsally into the third ventricle. Laterally: MLF. Through teg...
Oculomotor Nerve   Interpeduncular fossa.   Lateral to PCOM (between PCA above and Post Cerebellar art.    Below).   La...
Oculomotor nucleus   MR subnucleus : 3 different masses.   SR subnuclue : innervates contralateral SR.   Central caudal...
3rd Nerve
Trochlear Nerve   Two nuclei in mesencephalon ventral to inferior colliculi.   Close to caudal end of IIIrd nerve nuclei...
Trochlear nerve   Around the crus cerebri between PCA and Sup cerebell art    (lateral to 3rd nv.) beneath the free edg...
Abducens Nerve   Midpons beneath the facial colliculus.   Longest course.
Abducens Nerve   Emerges at pontomeduallry junnction.
Abducens Nerve  Pierces the dura early upward onThe clivus.Vertical  Horizontal direction.Runs beneath the petroclinoid(...
Trigeminal nerve   Gessarian ganglion : Temporal bone within middle cranial fossa    (Meckel’s cave).   V1 SOF , V2 FR...
Trigeminal nerve V1Sensory. V2 carries PS from The facial (superficial Petrosal nv.) for Lacrimation, V3 Motor and Sens...
Facial nerve   Supranuclear neurons : in the frontal lobe    (pre-central gyrus).   Corticobulbar fibers in the middle o...
Facial nerve
Facial nerve   Facial colliculus.   PS component : Superior salivatory nucleus    (Sub-ling., Sub-Mand., Lacrimal gland)...
Facial-Motor visceral   Nervus intermedius (tearing,salivation,taste).
Facial Nerve
Facial Nerve   Ventrolateral pons : Facial motor root and 8th    nerve exit togather.   CPA: Vth, VIIth and VIIIth lie c...
Facial Nerve
Facial nerve   In the canal, nerve to stapedius , and chorda    tympani.   Facial nerve exit through the Stylomastoid   ...
Facial nerve-Motor
Facial nerve
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Neuro-anatomy For the Ophthalmologist

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Raed Behbehani , MD FRCSC , Dipl.ABO

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Neuro-anatomy For the Ophthalmologist

  1. 1. Neuro-anatomy for theOphthalmologist Raed Behbehani, MD, ABO
  2. 2. Neuro-anatomy Orbits Cranial Cavity Venous sinus Cavernous sinus Cranial Nerves
  3. 3. Anterior Cranial Fossa Anteriorly: Frontal bone. Posteriorly: Lesser wing of sphenoid. Floor : Orbital plate, cribriform plate. Anterior clinoids tentorium.
  4. 4. Middle Cranial Fossa Floor: “Butterfly shape”. Anteriorly: The lesser wings of the sph., ant. Clinoids. Posteriorly : Petrous port. Of Temp. bone, dorsum sellae. Foramina : SOF, Rotundum, Ovale, Spinosum, Lacerum,
  5. 5. Posterior Cranial Fossa Roof: Tent.Cerebelli. Anteriorly : Petrous part of Temp. bone, Dorsum sellae.
  6. 6. CSF Circulation
  7. 7. Venous Sinuses
  8. 8. Venous sinuses Superior SS . Inferior SS join the Great vein of Galen  Straight sinus. SSS, straight S, and two transverse S. frequenly join (confluence of sinuses). Straight S Sigimoid S Int Jugular vein.
  9. 9. CSF
  10. 10. Cavernous sinus Intercavernous comunications. Tributaries: Sup and Inf Ophthalmic veins, sup cerebral vein. Drainage: Sup and Inf petrosal sinus  Internial Jugular vein ( direct ) or via transverse sinus  Int Jug vein.
  11. 11. Cavernous sinus
  12. 12. Cranial Nerves
  13. 13. Oculomotor Nerve Nuclei lie at level of sup colliculi. Dorsally into the third ventricle. Laterally: MLF. Through tegmentum andRed nucleus  medial toCrus cerebri.
  14. 14. Oculomotor Nerve Interpeduncular fossa. Lateral to PCOM (between PCA above and Post Cerebellar art. Below). Lateral wall of cavernous sinus SOF.
  15. 15. Oculomotor nucleus MR subnucleus : 3 different masses. SR subnuclue : innervates contralateral SR. Central caudal nucleus: innervates LPS bilaterrally. Visceral subnuclei: anterior median, Edinger-Westphal, nucleus of Perlia.
  16. 16. 3rd Nerve
  17. 17. Trochlear Nerve Two nuclei in mesencephalon ventral to inferior colliculi. Close to caudal end of IIIrd nerve nuclei. Only somatic nerve to emerge from the dorsal aspect of the CNS. Decussation (anterior medullary velum ). Nucleus: anterior to periacqueductal gray matter.
  18. 18. Trochlear nerve Around the crus cerebri between PCA and Sup cerebell art (lateral to 3rd nv.) beneath the free edge of the tentorium  Pierces the dura and enters the lateral wall of the cavernous sinus beneath the 3rd cranial nerve.
  19. 19. Abducens Nerve Midpons beneath the facial colliculus. Longest course.
  20. 20. Abducens Nerve Emerges at pontomeduallry junnction.
  21. 21. Abducens Nerve Pierces the dura early upward onThe clivus.Vertical  Horizontal direction.Runs beneath the petroclinoid(Guber’s) Ligament.Within the cavernous sinus (lateralto the ICA).
  22. 22. Trigeminal nerve Gessarian ganglion : Temporal bone within middle cranial fossa (Meckel’s cave). V1 SOF , V2 FR , V3 FO.
  23. 23. Trigeminal nerve V1Sensory. V2 carries PS from The facial (superficial Petrosal nv.) for Lacrimation, V3 Motor and Sensory.
  24. 24. Facial nerve Supranuclear neurons : in the frontal lobe (pre-central gyrus). Corticobulbar fibers in the middle of internal capsule. Fibers cross (below MB) cross to innervate contralateral facial nucleus , some to ipsilateral.
  25. 25. Facial nerve
  26. 26. Facial nerve Facial colliculus. PS component : Superior salivatory nucleus (Sub-ling., Sub-Mand., Lacrimal gland). Nervus intermedius “7 ½ nerve” : carries PS and sensory input. Nucleus Solitarius : Sensory nucleus for taste.
  27. 27. Facial-Motor visceral Nervus intermedius (tearing,salivation,taste).
  28. 28. Facial Nerve
  29. 29. Facial Nerve Ventrolateral pons : Facial motor root and 8th nerve exit togather. CPA: Vth, VIIth and VIIIth lie close togather. Facial motor root  internal auditory meatus Fallopian canal. At geniculate ganglion: first branch of VII is Greater superficial petrosal nv. sphenopalatine ganglion lacrimal gland.
  30. 30. Facial Nerve
  31. 31. Facial nerve In the canal, nerve to stapedius , and chorda tympani. Facial nerve exit through the Stylomastoid foramen Parotid gland.
  32. 32. Facial nerve-Motor
  33. 33. Facial nerve

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