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Cranial Nerve I, II, III,
IV & VI
By Dr. Nimrah Nasir
1
Olfactory
Nerve
2
Olfactory Nerve
– Arise from the olfactory receptor
nerve cells in the olfactory mucous
membrane above superior concha.
– The olfactory receptor cells are
scattered among supporting cells.
3
– Receptor cell consist of
bipolar nerve cell
– The olfactory nerve fibers are
unmyelinated
– They are covered by schwann
cells.
4
• A number of short cilia arise from the
olfactory hairs
• Projecting into the mucus covering
the surface of membrane
• These react to odors and stimulate
olfactory cells
5
• Bundles of these nerve fibers
pass through the cribriform
plate
• Piercing ethmoid bone these
enter the olfactory bulb
6
Olfactory
bulb
7
8
Olfactory bulb
– Is ovoid structure with different nerve cells largest
is mitral cell
– Synapse with dendrites mitral cells to form
synaptic glomeruli are formed
– Tufted cells and granular cells, also synapse with
the mitral cells
– It receives axons from the contralateral olfactory
bulb
Olfactory tract
9
Olfactory Tract
• Band of white matter runs from the
posterior end of the olfactory bulb
• Goes beneath the inferior surface of
frontal lobe
• Consists axons of mitral and tufted cells
of centrifugal fibers of olfactory bulb
10
Olfactory Tract
• It reaches the anterior perforated
substance, it divides into medial and
lateral olfactory striae.
• The lateral stria carries the axons to the
olfactory area of cerebral cortex,
namely, the periamygdaloid and
prepiriform areas
• The medial stria carries fibers in anterior
commissure to pass to olfactory bulb
11
• The periamygdaloid and prepiriform
areas are known as the primary olfactory
cortex
• The entorhinal area (area 28) of the
parahippocampal gyrus
• Areas of cortex are responsible for the
appreciation of olfactory sensations
12
Note:
• The olfactory afferent pathway has
only two neurons and reaches the
cerebral cortex without synapsing in
one of the thalamic nuclei
• The primary olfactory cortex sends
nerve fibers to many other centers
of brain to establish emotional and
autonomic responses to olfactory
sensations
13
14
15
z
OPTIC NERVE
16
z
The Optic Nerve
• 2nd Carnial nerve
• It is the axons of the cells
in the ganglionic layer of
the retina
• Converges on optic disc
• Myelinated fibers
• Formed from
oligodendrocytes
17
z
The Optic Nerve --- Cont
 Starts from optic disc, extends upto optic chiasma
 Backward continuation of nerve fiber layer of retina
(axons of ganglion cells)
 Also contains afferent fibers of light reflex and
some centrifugal fibers Optic Nerve
 An outgrowth of brain, Not covered by neurilemma:
 Fibers of optic nerve are very fine (2-10 µm)
 Surrounded by meninges unlike other peripheral
nerves
 Both primary & secondary neurons are in retina
 Optic nerve is comparable to a sensory tract of
brain (white matter)
18
19
z
Subdivisions
It can be subdivided into four main parts:
1. The optic nerve head (i.e. intraocular
part) measures about 1 mm in length.
2. The intraorbital part is approximately
25 mm in length.
3. The intracanalicular part is most
variable, ranging between 4 – 10 mm
in length.
4. The Intracranial part accounts for
about 10 mm of the total length of the
nerve.
20
z
Optic Chiasma
• Situated at the junction of the
anterior wall and floor of the
third ventricle
• Anterolateral angles are
continuous with the optic
nerves
• Posterolateral angles are
continuous with the optic tracts
21
z
Optic Tract
• Emerge from the optic
chiasma
• Passes posterolaterally
around the cerebral peduncle
• Synapsing with nerve cells in
the lateral geniculate body
• Fibers pass to the pretectal
nucleus
22
z
Lateral geniculate body
Small, oval swelling projecting
from the pulvinar of the thalamus.
It consists of six layers of cells on
which synapse the axons of the
optic tract.
23
z
Optic Radiation
• The fibers of the optic radiation are
the axons of the nerve cells of the
lateral geniculate body.
• The tract passes posteriorly through
the retrolenticular part of the internal
capsule
• Terminates in the visual cortex (area
17), at lips of calcarine sulcus.
• It is responsible for recognition of
objects and perception of color.
24
z
Four neurons conduct visual impulses to the
visual cortex:
(1) rods and cones, which are specialized
receptor neurons in the retina;
(2) bipolar neurons, which connect the rods and
cones to the ganglion cells;
(3) ganglion cells, whose axons pass to the
lateral geniculate body;
(4) neurons of the lateral geniculate body,
whose axons pass to the cerebral cortex.
25 Neurons of the Visual Pathway
and Binocular Vision
z
Visual Reflexes
26
• Direct and Consensual Light
Reflexes
• Accommodation Reflex
• Visual Body Reflexes
• Pupillary Skin Reflex
OCULOMOTOR NERVE
27
28
NUCLEI
The oculomotor nerve has
two motor nuclei:
1. The main motor nucleus
2. The accessory
parasympathetic
nucleus
29
30
THE MAIN MOTOR NUCLEUS
• The main oculomotor nucleus is
situated in the anterior part of the gray
matter that surrounds the cerebral
aqueduct of the midbrain
• It lies at the level of the superior
colliculus.
• The nucleus consists of groups of nerve
cells that supply all the extrinsic muscle
of the eye except the superior oblique
and the lateral rectus.
31
MOTOR NUCLEUS--- CONT
• The outgoing nerve fibers pass anteriorly
through the red nucleus and emerge on the
anterior surface of the midbrain in the
interpeduncular fossa.
• The main oculomotor nucleus receives
corticonuclear fibers from both cerebral
hemispheres.
• It receives tectobulbar fibers from the superior
colliculus and, through this route, receives
information from the visual cortex. It also
receives fibers from the medial longitudinal
fasciculus, by which it is connected to the
nuclei of the fourth, sixth, and eighth cranial
nerves.
32
33
The accessory parasympathetic nucleus (Edinger-
Westphal nucleus) is situated posterior to the main
oculomotor nucleus .
The axons of the nerve cells, which are preganglionic,
accompany the other oculomotor fibers to the orbit.
They synapse in the ciliary ganglion, and
postganglionic fibers pass through the short ciliary
nerves to the constrictor pupillae of the iris and the
ciliary muscles.
34
ACCESSORY PARASYMPATHETIC
NUCLEUS (EDINGER-
WESTPHAL NUCLEUS)
The accessory parasympathetic nucleus
receives corticonuclear fibers for the
accommodation reflex and fibers from the
pretectal nucleus for the direct and
consensual light reflexes.
35
36
COURSE OF OCULOMOTOR NERVE
• The oculomotor nerve emerges on
the anterior surface of the midbrain.
• It passes forward between the
posterior cerebral and the superior
cerebellar arteries. It then continues
into the middle cranial fossa in the
lateral wall of the cavernous sinus.
• Here, it divides into a superior and
an inferior ramus, which enter the
orbital cavity through the superior
orbital fissure.
37
The oculomotor nerve supplies the following
extrinsic muscles of the eye:
• The levator palpebrae superioris, superior rectus,
medial rectus, inferior rectus, and inferior
oblique. It also supplies, through its branch to
the ciliary ganglion and the short ciliary nerves,
• parasympathetic nerve fibers to the following
intrinsic muscles: the constrictor pupillae of the
iris and ciliary muscles.
The oculomotor nerve is entirely motor and is
responsible for lifting the upper eyelid; turning the
eye upward, downward, and medially; constricting
the pupil; and accommodating the eye.
38
39
TROCHLEAR NERVE
40
41
TROCHLEAR NERVE
Purely motor nerve: deliver
general somatic efferent
impulses to the target muscles.
Paired cranial nerve: responsible
for innervating the superior
oblique muscle.
Nucleus is located:
periaqueductal grey matter of the
inferior part of the midbrain.
CN IV course: longest intracranial
course of all the cranial nerves.
42
43
TROCHLEAR NERVE NUCLEUS
The trochlear nucleus is situated in the
anterior part of the gray matter that
surrounds the cerebral aqueduct of the
midbrain .
It lies inferior to the oculomotor nucleus at
the level of the inferior colliculus.
The nerve fibers, after leaving the nucleus,
pass posteriorly around the central gray
matter to reach the posterior surface of the
midbrain.
44
TROCHLEAR NERVE NUCLEUS
The trochlear nucleus receives
corticonuclear fibers from both
cerebral hemispheres.
It receives the tectobulbar
fibers, which connect it to the
visual cortex through the
superior colliculus .
It receives fibers from the
medial longitudinal fasciculus.
It is connected to the nuclei of
the third, sixth, and eighth
cranial nerves.
45
46
COURSE OF THE TROCHLEAR
NERVE
The most slender of the cranial nerve and only to leave the posterior surface
of the brainstem.
It emerges from the midbrain and immediately decussates with the nerve of
the opposite side.
The trochlear nerve passes forward through the middle cranial fossa in the
lateral wall of the cavernous sinus and enters the orbit through the superior
orbital fissure.
The trochlear nerve is entirely motor and assists in turning the eye downward
and laterally.
47
ABDUCENT
NERVE
The abducent
nerve is a
small motor
nerve that
supplies the
lateral rectus
muscle of the
eyeball.
Abducent
nerve
nucleus
• The small motor nucleus is situated beneath the floor
of the upper part of the fourth ventricle, close to the
midline and beneath the colliculus facialis.
• The nucleus receives afferent corticonuclear fibers
from both cerebral hemispheres.
• It receives the tectobulbar tract from the superior
colliculus, by which the visual cortex is connected to
the nucleus.
• It also receives fibers from the
• medial longitudinal fasciculus, by which it is connected
to the nuclei of the third, fourth, and eighth cranial
nerves.
Course of
abducent
nerve
• The fibers of the abducent nerve pass anteriorly
through the pons and emerge in the groove between
the lower border of the pons and the medulla
oblongata .
• It passes forward through the cavernous sinus, lying
below and lateral to the internal carotid artery.
• The nerve then enters the orbit through the superior
orbital fissure.The abducent nerve is entirely a motor
nerve and supplies the lateral rectus muscle and,
therefore, is responsible for turning the eye laterally.
Abducent Nerve
The abducent nerve supplies the lateral
rectus muscle, It rotates the eye laterally
Lateral rectus when paralyzed, unopposed
medial rectus pulls the eyeball medially,
causing internal strabismus.
Lesions of the abducent nerve include:
• damage due to head injuries,
• cavernous sinus thrombosis
• aneurysm of the internal carotid artery
• vascular lesions of the pons

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Cranial nerve i ii iii iv combined presentation

  • 1. Cranial Nerve I, II, III, IV & VI By Dr. Nimrah Nasir 1
  • 3. Olfactory Nerve – Arise from the olfactory receptor nerve cells in the olfactory mucous membrane above superior concha. – The olfactory receptor cells are scattered among supporting cells. 3
  • 4. – Receptor cell consist of bipolar nerve cell – The olfactory nerve fibers are unmyelinated – They are covered by schwann cells. 4
  • 5. • A number of short cilia arise from the olfactory hairs • Projecting into the mucus covering the surface of membrane • These react to odors and stimulate olfactory cells 5
  • 6. • Bundles of these nerve fibers pass through the cribriform plate • Piercing ethmoid bone these enter the olfactory bulb 6
  • 8. 8 Olfactory bulb – Is ovoid structure with different nerve cells largest is mitral cell – Synapse with dendrites mitral cells to form synaptic glomeruli are formed – Tufted cells and granular cells, also synapse with the mitral cells – It receives axons from the contralateral olfactory bulb
  • 10. Olfactory Tract • Band of white matter runs from the posterior end of the olfactory bulb • Goes beneath the inferior surface of frontal lobe • Consists axons of mitral and tufted cells of centrifugal fibers of olfactory bulb 10
  • 11. Olfactory Tract • It reaches the anterior perforated substance, it divides into medial and lateral olfactory striae. • The lateral stria carries the axons to the olfactory area of cerebral cortex, namely, the periamygdaloid and prepiriform areas • The medial stria carries fibers in anterior commissure to pass to olfactory bulb 11
  • 12. • The periamygdaloid and prepiriform areas are known as the primary olfactory cortex • The entorhinal area (area 28) of the parahippocampal gyrus • Areas of cortex are responsible for the appreciation of olfactory sensations 12
  • 13. Note: • The olfactory afferent pathway has only two neurons and reaches the cerebral cortex without synapsing in one of the thalamic nuclei • The primary olfactory cortex sends nerve fibers to many other centers of brain to establish emotional and autonomic responses to olfactory sensations 13
  • 14. 14
  • 15. 15
  • 17. z The Optic Nerve • 2nd Carnial nerve • It is the axons of the cells in the ganglionic layer of the retina • Converges on optic disc • Myelinated fibers • Formed from oligodendrocytes 17
  • 18. z The Optic Nerve --- Cont  Starts from optic disc, extends upto optic chiasma  Backward continuation of nerve fiber layer of retina (axons of ganglion cells)  Also contains afferent fibers of light reflex and some centrifugal fibers Optic Nerve  An outgrowth of brain, Not covered by neurilemma:  Fibers of optic nerve are very fine (2-10 µm)  Surrounded by meninges unlike other peripheral nerves  Both primary & secondary neurons are in retina  Optic nerve is comparable to a sensory tract of brain (white matter) 18
  • 19. 19
  • 20. z Subdivisions It can be subdivided into four main parts: 1. The optic nerve head (i.e. intraocular part) measures about 1 mm in length. 2. The intraorbital part is approximately 25 mm in length. 3. The intracanalicular part is most variable, ranging between 4 – 10 mm in length. 4. The Intracranial part accounts for about 10 mm of the total length of the nerve. 20
  • 21. z Optic Chiasma • Situated at the junction of the anterior wall and floor of the third ventricle • Anterolateral angles are continuous with the optic nerves • Posterolateral angles are continuous with the optic tracts 21
  • 22. z Optic Tract • Emerge from the optic chiasma • Passes posterolaterally around the cerebral peduncle • Synapsing with nerve cells in the lateral geniculate body • Fibers pass to the pretectal nucleus 22
  • 23. z Lateral geniculate body Small, oval swelling projecting from the pulvinar of the thalamus. It consists of six layers of cells on which synapse the axons of the optic tract. 23
  • 24. z Optic Radiation • The fibers of the optic radiation are the axons of the nerve cells of the lateral geniculate body. • The tract passes posteriorly through the retrolenticular part of the internal capsule • Terminates in the visual cortex (area 17), at lips of calcarine sulcus. • It is responsible for recognition of objects and perception of color. 24
  • 25. z Four neurons conduct visual impulses to the visual cortex: (1) rods and cones, which are specialized receptor neurons in the retina; (2) bipolar neurons, which connect the rods and cones to the ganglion cells; (3) ganglion cells, whose axons pass to the lateral geniculate body; (4) neurons of the lateral geniculate body, whose axons pass to the cerebral cortex. 25 Neurons of the Visual Pathway and Binocular Vision
  • 26. z Visual Reflexes 26 • Direct and Consensual Light Reflexes • Accommodation Reflex • Visual Body Reflexes • Pupillary Skin Reflex
  • 28. 28
  • 29. NUCLEI The oculomotor nerve has two motor nuclei: 1. The main motor nucleus 2. The accessory parasympathetic nucleus 29
  • 30. 30
  • 31. THE MAIN MOTOR NUCLEUS • The main oculomotor nucleus is situated in the anterior part of the gray matter that surrounds the cerebral aqueduct of the midbrain • It lies at the level of the superior colliculus. • The nucleus consists of groups of nerve cells that supply all the extrinsic muscle of the eye except the superior oblique and the lateral rectus. 31
  • 32. MOTOR NUCLEUS--- CONT • The outgoing nerve fibers pass anteriorly through the red nucleus and emerge on the anterior surface of the midbrain in the interpeduncular fossa. • The main oculomotor nucleus receives corticonuclear fibers from both cerebral hemispheres. • It receives tectobulbar fibers from the superior colliculus and, through this route, receives information from the visual cortex. It also receives fibers from the medial longitudinal fasciculus, by which it is connected to the nuclei of the fourth, sixth, and eighth cranial nerves. 32
  • 33. 33
  • 34. The accessory parasympathetic nucleus (Edinger- Westphal nucleus) is situated posterior to the main oculomotor nucleus . The axons of the nerve cells, which are preganglionic, accompany the other oculomotor fibers to the orbit. They synapse in the ciliary ganglion, and postganglionic fibers pass through the short ciliary nerves to the constrictor pupillae of the iris and the ciliary muscles. 34
  • 35. ACCESSORY PARASYMPATHETIC NUCLEUS (EDINGER- WESTPHAL NUCLEUS) The accessory parasympathetic nucleus receives corticonuclear fibers for the accommodation reflex and fibers from the pretectal nucleus for the direct and consensual light reflexes. 35
  • 36. 36
  • 37. COURSE OF OCULOMOTOR NERVE • The oculomotor nerve emerges on the anterior surface of the midbrain. • It passes forward between the posterior cerebral and the superior cerebellar arteries. It then continues into the middle cranial fossa in the lateral wall of the cavernous sinus. • Here, it divides into a superior and an inferior ramus, which enter the orbital cavity through the superior orbital fissure. 37
  • 38. The oculomotor nerve supplies the following extrinsic muscles of the eye: • The levator palpebrae superioris, superior rectus, medial rectus, inferior rectus, and inferior oblique. It also supplies, through its branch to the ciliary ganglion and the short ciliary nerves, • parasympathetic nerve fibers to the following intrinsic muscles: the constrictor pupillae of the iris and ciliary muscles. The oculomotor nerve is entirely motor and is responsible for lifting the upper eyelid; turning the eye upward, downward, and medially; constricting the pupil; and accommodating the eye. 38
  • 39. 39
  • 41. 41
  • 42. TROCHLEAR NERVE Purely motor nerve: deliver general somatic efferent impulses to the target muscles. Paired cranial nerve: responsible for innervating the superior oblique muscle. Nucleus is located: periaqueductal grey matter of the inferior part of the midbrain. CN IV course: longest intracranial course of all the cranial nerves. 42
  • 43. 43
  • 44. TROCHLEAR NERVE NUCLEUS The trochlear nucleus is situated in the anterior part of the gray matter that surrounds the cerebral aqueduct of the midbrain . It lies inferior to the oculomotor nucleus at the level of the inferior colliculus. The nerve fibers, after leaving the nucleus, pass posteriorly around the central gray matter to reach the posterior surface of the midbrain. 44
  • 45. TROCHLEAR NERVE NUCLEUS The trochlear nucleus receives corticonuclear fibers from both cerebral hemispheres. It receives the tectobulbar fibers, which connect it to the visual cortex through the superior colliculus . It receives fibers from the medial longitudinal fasciculus. It is connected to the nuclei of the third, sixth, and eighth cranial nerves. 45
  • 46. 46
  • 47. COURSE OF THE TROCHLEAR NERVE The most slender of the cranial nerve and only to leave the posterior surface of the brainstem. It emerges from the midbrain and immediately decussates with the nerve of the opposite side. The trochlear nerve passes forward through the middle cranial fossa in the lateral wall of the cavernous sinus and enters the orbit through the superior orbital fissure. The trochlear nerve is entirely motor and assists in turning the eye downward and laterally. 47
  • 49.
  • 50. The abducent nerve is a small motor nerve that supplies the lateral rectus muscle of the eyeball.
  • 51. Abducent nerve nucleus • The small motor nucleus is situated beneath the floor of the upper part of the fourth ventricle, close to the midline and beneath the colliculus facialis. • The nucleus receives afferent corticonuclear fibers from both cerebral hemispheres. • It receives the tectobulbar tract from the superior colliculus, by which the visual cortex is connected to the nucleus. • It also receives fibers from the • medial longitudinal fasciculus, by which it is connected to the nuclei of the third, fourth, and eighth cranial nerves.
  • 52.
  • 53.
  • 54. Course of abducent nerve • The fibers of the abducent nerve pass anteriorly through the pons and emerge in the groove between the lower border of the pons and the medulla oblongata . • It passes forward through the cavernous sinus, lying below and lateral to the internal carotid artery. • The nerve then enters the orbit through the superior orbital fissure.The abducent nerve is entirely a motor nerve and supplies the lateral rectus muscle and, therefore, is responsible for turning the eye laterally.
  • 55.
  • 56. Abducent Nerve The abducent nerve supplies the lateral rectus muscle, It rotates the eye laterally Lateral rectus when paralyzed, unopposed medial rectus pulls the eyeball medially, causing internal strabismus. Lesions of the abducent nerve include: • damage due to head injuries, • cavernous sinus thrombosis • aneurysm of the internal carotid artery • vascular lesions of the pons