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Cranial Nerves
Sanjaya Adikari
Department of Anatomy
12 pairs of cranial nerves
III to XII attached to
brain stem
Their cell bodies form
nuclei in the brain stem
First cell body of sensory
nerves lie out side CNS
(form ganglia)
Summary of cranial nerves
Aspects to study
1. Position of nucleus
2. Emerging point from brain stem
3. Intracranial course
4. Point of exit from the cranial cavity
5. Extracranial course
6. Distribution
Few terms: Somatic, branchial and visceral
Branchial (Pharyngeal) Arches
• Core of mesodermal
tissue covered by
ectoderm and
endoderm
• Each of the arch will
have its own
bone/cartilage, muscles,
nerve and artery
endoderm
ectoderm
Branchial
Premaxilla, maxilla, zygomatic
bone, part of temporal bone and
mandible
Mandibular branch of
trigeminal nerve (V)
Facial nerve (VII)
Glossopharyngeal nerve
(IX)
Superior laryngeal branch
of vagus nerve (X)
Recurrent laryngeal branch
of vagus nerve (X)
Visceral
• In relation to internal organs
– Heart
– Lung
– Intestines
………………
……………..
Few hints
Nerve A
Nerve B
Posterior horn
Lateral horn
Anterior horn
Motor
Sensory
Motor
Sensory
Posterior
Spinal cord (thoracic or lumbar)
Somatic sensory
Visceral sensory
Visceral motor
Somatic motor
SM
VM
VS
BM
SS
Brain stem
SpS
GSS
Types of sensations
Visceral sensory
Somatic sensory
General Visceral sensory
pain, temperature, touch, viration
position sense
Special Visceral sensory
taste
General Somatic sensory
pain, temperature, touch, vibration
position sense
Special Somatic sensory
hearing
SM
VS
GSS
SS
III
IV
VI
XII
BM
V
VII
IX
X
XI
VM
III
VII
IX
X
VII
IX
X
V
VII
IX
X
VIII
Functional components of cranial nerves
Somatic Motor
Muscles of the orbit
(III, IV, VI)
Muscles of tongue
(XII)
III
IV
VI
XII
Branchial Motor
Muscles of mastication (V)
Facial muscles (VII)
Pharyngeal and laryngeal
muscles (Nucleus ambiguus
via IX, X, XI nerves)
Visceral Motor
Edinger Westphal nucleus
(accessory oculomotor)
Salivary nuclei (NI part of VII, IX)
Dorsal motor nucleus of vagus
(for cardiac muscles, smooth
muscles of alimentary tract)
Sensory
Consists of single nuclei for visceral
and somatic sensory
Visceral sensory with taste
Nucleus of tractus solitarious which
receives taste fibres from the tongue
through VII, IX
and sensory from heart, lungs and
other viscera through X
General somatic sensory
Sensory nucleus of trigeminal
nerve extending from the
midbrain to the cervical spinal
cord
Special somatic sensory
Hearing via VIII
(vestibulocochlear nerve)
SM VM
VS
BM
GSS
SS
V
VII
IX
X
XI
III
IV
VI
XII
III
VII
IX
X
VII
IX
X
V
VII
IX
X
VIII
Intracranial course and exit
Sanjaya Adikari
Department of Anatomy
Superior orbital fissure
(III, IV, V1, VI)
Foramen rotundum
(V2)
Foramen ovale
(V3)
Foramen spinosum
Foramen lacerum
Internal acoustic meatus
(VII, VIII)
Jugular foramen
(IX, X, XI)
Hypoglossal canal
(XII)
Optic canal
(II)
Olfactory Nerve (I)
Olfactory bulb
Olfactory tract
Anterior perforated
substance
Uncus
Bypass thalamus and goes directly into
the taste area
Nerve filaments
Cribriform plate of
ethmoid bone
Optic Nerve (II)
T
N
T
Optic Nerve (II)
Optic nerve
Optic chiasma
Optic tract
Superior colliculus
(body reflexes)
Pretectal nucleus
(pupillary reflexes)
Lateral geniculate body
of thalamus
Internal
capsule
Optic
radiation
Oculomotor Nerve (III)
Somatic motor nucleus
Visceral motor nucleus
(Edinger westphal nucleus)
Nerve emerges from ventral
aspect of midbrain
travel’s in the lateral wall of the
cavernous sinus
Oculomotor Nerve… cont.
Levator palpabrae
superioris
Dilator pupillae
Superior rectus
Medial rectus, inferior
rectus, inferior oblique
Ciliary muscle
Sphincter pupillae
Ciliary ganglion
Superior division
Inferior division
Sympathetic from
Internal carotid plexus
Parasympathetic from
EW nucleus
Trochlear Nerve (IV)
Somatic motor nucleus
Emerges from the dorsal aspect of
midbrain
Travels in the lateral wall of the
cavernous sinus
Supplies the superior oblique muscle
Abducens Nerve (VI)
Somatic motor nucleus
Nucleus lies in lower pons near
midline
Emerge between pons and pyramid
of medulla
Travels through the cavernous sinus
Supply the lateral rectus muscle
Oculomotor N (III)
Ventral
midbrain
Lateral wall
Cavernous S
Divide
Sup. & Inf.
divisions
Sup/infrao
rbital
fissure
Trochlear N (IV)
Dorsal
midbrain
Lateral wall
Cavernous S
Superior
orbital
fissure
Abducent N (VI)
Between
Pons & pyramid
of medulla
within
Cavernous S
Superior
orbital
fissure
Cavernous sinus
1- Oculomotor N
2- Trochlear N
3- Abducent N
4- Ophthalmic branch of TN
5- Maxillary branch of TN
6- Sympathetic plexus of N
7- Internal carotid A
8- Pituitary gland
LR6(SO4)3
Trigeminal nerve (V)
Branchial motor nucleus
Somatic sensory nucleus
Emerge from the ventral aspect of pons
Sensory and motor roots emerge
separately
Trigeminal nerve… cont.
Cell bodies of 1st order
SA fibres
Trigeminal ganglion
Somatic
sensory
nucleus
Branchial
motor
nucleus
Foramen ovale
Ophthalmic
division
Maxillary
division
Lat. Wall of
cavernous
sinous
Mandibular
division
Mandibular
nerve
(mixed)
Facial Nerve (VII)
Branchial motor nucleus
Visceral motor nucleus
(Superior salivary nucleus)
Taste sensory nucleus
(Tractus solitarius)
Main facial nerve and the
nervous intermedius parts
emerge from the
cerebellopontine angle
Geniculate ganglion
(taste 1st order cell bodies)
Nucleus of
Tractus
solitarious
Chorda tympani
nerve
Taste from
anterior tongue
Nervous
intermedius
Facial Nerve…cont.
Branchial motor
nucleus
Nerve to
stapedius
Stylomastoid
foramen
Pure branchial motor facial nerve
Supply muscles of facial
expression
Ear drum
VE to submandibular gland
and glands on the mouth floor
Greater petrosal
nerve
Sup. salivary
nucleus
Internal acoustic
meatus
Vestibulocochlear Nerve (VIII)
Cochlear nerve
Vestibular nerve
Hair cells of spiral
organ
Hair cells of utricle,
saccule and semilunar
canals
Spiral ganglion of cochlea
Vestibular ganglion
Internal acoustic
meatus
Cerebellopontine
angle
Cochlear
nuclei
in pons
Vestibular
nuclei
in medulla
Glossopharyngeal Nerve (IX)
Branchial motor nucleus (Nucleus ambiguus)
supplies stylopharyngeus muscle
Parasympathetic nucleus (Inferior salivary
nucleus)
supplies parotid gland
Sensory nuclei
GSS from posterior tongue goes to sensory
nucleus of trigeminal nerve
Taste from the posterior tongue goes to the
tractus solitarius
VS from baroreceptors go to nucleus of tractus
solitarius
Vagus Nerve (X)
Branchial motor nucleus (Nucleus ambiguus)
supplies pharyngeal constrictors
Visceral motor nucleus (Dorsal motor nucleus
of vagus)
supplies muscles of heart, bronchi, oesophagus,
stomach and intestines
Visceral sensory nucleus
VS from larynx, heart, lung… goes to nucleus of
tractus solitarius
GSS goes to sensory nucleus of trigeminal nerve
Accessory Nerve (XI)
Branchial motor nerve
Cranial root From nucleus ambiguus
Fibres in the cranial root join the vagus
nerve
Somatic motor nerve
Spinal root Anterior horn cells of upper 5-6
cervical spinal segments
Fibres in the spinal root supply
sternocleidomastoid and trapezius
muscles
Hypoglossal Nerve (XII)
Somatic motor nerve
Leaves cranial cavity through the hypoglossal canal
Supplies all muscles (intrinsic and extrinsic) of tongue except
palatoglossus

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Cranial Nerves Anatomy

  • 2. 12 pairs of cranial nerves III to XII attached to brain stem Their cell bodies form nuclei in the brain stem First cell body of sensory nerves lie out side CNS (form ganglia)
  • 3. Summary of cranial nerves Aspects to study 1. Position of nucleus 2. Emerging point from brain stem 3. Intracranial course 4. Point of exit from the cranial cavity 5. Extracranial course 6. Distribution
  • 4. Few terms: Somatic, branchial and visceral
  • 5. Branchial (Pharyngeal) Arches • Core of mesodermal tissue covered by ectoderm and endoderm • Each of the arch will have its own bone/cartilage, muscles, nerve and artery endoderm ectoderm Branchial
  • 6. Premaxilla, maxilla, zygomatic bone, part of temporal bone and mandible Mandibular branch of trigeminal nerve (V) Facial nerve (VII) Glossopharyngeal nerve (IX) Superior laryngeal branch of vagus nerve (X) Recurrent laryngeal branch of vagus nerve (X)
  • 7. Visceral • In relation to internal organs – Heart – Lung – Intestines ……………… ……………..
  • 9. Posterior horn Lateral horn Anterior horn Motor Sensory Motor Sensory Posterior Spinal cord (thoracic or lumbar) Somatic sensory Visceral sensory Visceral motor Somatic motor
  • 11. Types of sensations Visceral sensory Somatic sensory General Visceral sensory pain, temperature, touch, viration position sense Special Visceral sensory taste General Somatic sensory pain, temperature, touch, vibration position sense Special Somatic sensory hearing
  • 13. Functional components of cranial nerves Somatic Motor Muscles of the orbit (III, IV, VI) Muscles of tongue (XII) III IV VI XII
  • 14. Branchial Motor Muscles of mastication (V) Facial muscles (VII) Pharyngeal and laryngeal muscles (Nucleus ambiguus via IX, X, XI nerves)
  • 15. Visceral Motor Edinger Westphal nucleus (accessory oculomotor) Salivary nuclei (NI part of VII, IX) Dorsal motor nucleus of vagus (for cardiac muscles, smooth muscles of alimentary tract)
  • 16. Sensory Consists of single nuclei for visceral and somatic sensory Visceral sensory with taste Nucleus of tractus solitarious which receives taste fibres from the tongue through VII, IX and sensory from heart, lungs and other viscera through X
  • 17. General somatic sensory Sensory nucleus of trigeminal nerve extending from the midbrain to the cervical spinal cord
  • 18. Special somatic sensory Hearing via VIII (vestibulocochlear nerve)
  • 20. Intracranial course and exit Sanjaya Adikari Department of Anatomy
  • 21.
  • 22. Superior orbital fissure (III, IV, V1, VI) Foramen rotundum (V2) Foramen ovale (V3) Foramen spinosum Foramen lacerum Internal acoustic meatus (VII, VIII) Jugular foramen (IX, X, XI) Hypoglossal canal (XII) Optic canal (II)
  • 23. Olfactory Nerve (I) Olfactory bulb Olfactory tract Anterior perforated substance Uncus Bypass thalamus and goes directly into the taste area Nerve filaments Cribriform plate of ethmoid bone
  • 25. Optic Nerve (II) Optic nerve Optic chiasma Optic tract Superior colliculus (body reflexes) Pretectal nucleus (pupillary reflexes) Lateral geniculate body of thalamus Internal capsule Optic radiation
  • 26. Oculomotor Nerve (III) Somatic motor nucleus Visceral motor nucleus (Edinger westphal nucleus) Nerve emerges from ventral aspect of midbrain travel’s in the lateral wall of the cavernous sinus
  • 27. Oculomotor Nerve… cont. Levator palpabrae superioris Dilator pupillae Superior rectus Medial rectus, inferior rectus, inferior oblique Ciliary muscle Sphincter pupillae Ciliary ganglion Superior division Inferior division Sympathetic from Internal carotid plexus Parasympathetic from EW nucleus
  • 28. Trochlear Nerve (IV) Somatic motor nucleus Emerges from the dorsal aspect of midbrain Travels in the lateral wall of the cavernous sinus Supplies the superior oblique muscle
  • 29. Abducens Nerve (VI) Somatic motor nucleus Nucleus lies in lower pons near midline Emerge between pons and pyramid of medulla Travels through the cavernous sinus Supply the lateral rectus muscle
  • 30. Oculomotor N (III) Ventral midbrain Lateral wall Cavernous S Divide Sup. & Inf. divisions Sup/infrao rbital fissure Trochlear N (IV) Dorsal midbrain Lateral wall Cavernous S Superior orbital fissure Abducent N (VI) Between Pons & pyramid of medulla within Cavernous S Superior orbital fissure
  • 31. Cavernous sinus 1- Oculomotor N 2- Trochlear N 3- Abducent N 4- Ophthalmic branch of TN 5- Maxillary branch of TN 6- Sympathetic plexus of N 7- Internal carotid A 8- Pituitary gland
  • 33. Trigeminal nerve (V) Branchial motor nucleus Somatic sensory nucleus Emerge from the ventral aspect of pons Sensory and motor roots emerge separately
  • 34. Trigeminal nerve… cont. Cell bodies of 1st order SA fibres Trigeminal ganglion Somatic sensory nucleus Branchial motor nucleus Foramen ovale Ophthalmic division Maxillary division Lat. Wall of cavernous sinous Mandibular division Mandibular nerve (mixed)
  • 35. Facial Nerve (VII) Branchial motor nucleus Visceral motor nucleus (Superior salivary nucleus) Taste sensory nucleus (Tractus solitarius) Main facial nerve and the nervous intermedius parts emerge from the cerebellopontine angle
  • 36. Geniculate ganglion (taste 1st order cell bodies) Nucleus of Tractus solitarious Chorda tympani nerve Taste from anterior tongue Nervous intermedius Facial Nerve…cont. Branchial motor nucleus Nerve to stapedius Stylomastoid foramen Pure branchial motor facial nerve Supply muscles of facial expression Ear drum VE to submandibular gland and glands on the mouth floor Greater petrosal nerve Sup. salivary nucleus Internal acoustic meatus
  • 37. Vestibulocochlear Nerve (VIII) Cochlear nerve Vestibular nerve Hair cells of spiral organ Hair cells of utricle, saccule and semilunar canals Spiral ganglion of cochlea Vestibular ganglion Internal acoustic meatus Cerebellopontine angle Cochlear nuclei in pons Vestibular nuclei in medulla
  • 38. Glossopharyngeal Nerve (IX) Branchial motor nucleus (Nucleus ambiguus) supplies stylopharyngeus muscle Parasympathetic nucleus (Inferior salivary nucleus) supplies parotid gland Sensory nuclei GSS from posterior tongue goes to sensory nucleus of trigeminal nerve Taste from the posterior tongue goes to the tractus solitarius VS from baroreceptors go to nucleus of tractus solitarius
  • 39. Vagus Nerve (X) Branchial motor nucleus (Nucleus ambiguus) supplies pharyngeal constrictors Visceral motor nucleus (Dorsal motor nucleus of vagus) supplies muscles of heart, bronchi, oesophagus, stomach and intestines Visceral sensory nucleus VS from larynx, heart, lung… goes to nucleus of tractus solitarius GSS goes to sensory nucleus of trigeminal nerve
  • 40. Accessory Nerve (XI) Branchial motor nerve Cranial root From nucleus ambiguus Fibres in the cranial root join the vagus nerve Somatic motor nerve Spinal root Anterior horn cells of upper 5-6 cervical spinal segments Fibres in the spinal root supply sternocleidomastoid and trapezius muscles
  • 41. Hypoglossal Nerve (XII) Somatic motor nerve Leaves cranial cavity through the hypoglossal canal Supplies all muscles (intrinsic and extrinsic) of tongue except palatoglossus