The document summarizes the anatomy and clinical features of the facial nerve (CN VII). It discusses the nuclei, course, and branches of the nerve. The facial nerve is a mixed nerve that is predominantly motor. It has motor nuclei in the brainstem and carries preganglionic fibers to the submandibular ganglion. The nerve exits the skull via the internal acoustic meatus and stylomastoid foramen, dividing into 5 terminal branches in the face. Lesions can occur at different levels, causing varying patterns of facial paralysis that are assessed during physical exams of the nerve branches.

1. Facial Nerve
Presentor- Rahul Sharma
M.Sc. 2nd Year, Anatomy
AIIMS, Rishikesh
Moderator: Dr Pooja Bhadoria
Monday, November 21, 2022 1

2. Contents
• Introduction
• Components
• Nuclei location
• Fibres
• Extra cranial course
• Summary
• MCQs
• References
Monday, November 21, 2022 2

3. Introduction
• Facial nerve (CN
VII)  Seventh
cranial nerve 
Paired.
• Mixed nerve 
Predominantly
Motor.
Monday, November 21, 2022 3

4. Facial nerve nucleus
Monday, November 21, 2022
4

5. Components
Functional components:
• Special Visceral Efferent(SVE)  Motor Nucleus
 Post. Belly of Digastric, Post. auricular,
Stylohyoid muscle.
• General Visceral Efferent(GVE)  Sup.
Salivatory nucleus  Preganglionic fibres  Sub-
mandibular ganglion  Post-ganglionic fibres 
Sub-mandibular & Sub-lingual salivary gland.
Monday, November 21, 2022 5

6. • Special Visceral Afferent(SVA)  Nucleus
tractus solitarious(NTS)  chorda tympani
taste sensation (gustatory).
• General Somatic Afferent(GSA)  Spinal
nucleus of trigeminal  from skin of external
ear.
Monday, November 21, 2022 6

7. Course of Nerve fibers
Monday, November 21, 2022 7

8. Fibres
Monday, November 21, 2022 8

9. Middle ear
Monday, November 21, 2022 9

10. Monday, November 21, 2022 10

11. Monday, November 21, 2022 11

12. Monday, November 21, 2022 12

13. Monday, November 21, 2022 13

14. Monday, November 21, 2022 14

15. Extra cranial course

16. Monday, November 21, 2022 16

17. Monday, November 21, 2022 17

18. At the exit from the stylomastoid foramen
Within the facial canal:
• Nerve to stapedius: supplies the stapedius muscle.
• Greater superficial petrosal nerve
Extracranial
• Posterior Auricular Nerve
• Digastric nerve
• Stylohyoid nerve
The five terminal branches
• Temporal branch
• Zygomatic branch
• Buccal branch
• Marginal mandibular branch
• Cervical branch

19. Monday, November 21, 2022 19

20. Monday, November 21, 2022 20

21. Monday, November 21, 2022 21

22. Monday, November 21, 2022 22

23. Chorda Tympani
Monday, November 21, 2022 23

24. Monday, November 21, 2022 24

25. Summary
Monday, November 21, 2022 25

26. Nuclear Lesion
• Facial muscle on same side of lesion 
paralysed.
• Other components will not be affected 
nuclei are not located very close.
Monday, November 21, 2022 26

27. Clinical
Paralysis of facial nerve:
Due to lesion  in course of upper or lower
motor neurons.
• Supranuclear Lesion (Upper Motor Neuron
Lesion)
• Infranuclear Lesion (Lower Motor Neuron
Lesion)  Bell’s palsy
Monday, November 21, 2022 27

28. Monday, November 21, 2022 28

29. Bell’s Palsy
Monday, November 21, 2022 29

30. Testing of Facial Nerve
Branches

31. Temporal Branch Of Facial
Nerve
patient is asked to frown and wrinkle his or

32. Zygomatic branch of facial
nerve
Patient is asked to close the eyes tightly.

33. Buccal Branch of Facial Nerve

34. Marginal Mandibular

35. Cervical Branch

36. MCQs
1.) Sub-mandibular parasympathatic ganglion is having
preganglionic fibre from chorda tympani. Which of given
functional component receive these fibers?
a.) Special Visceral Efferent(SVE)
b.) General Visceral Efferent(GVE)
c.) Special Visceral Afferent(SVA)
d.) General Somatic Afferent(GSA)
Monday, November 21, 2022 36
Ans: b

37. 2.) Hyperacusis is result of paralysis of stapedius
muscle in which patient will hear loud sound
even in normal sound & other function is normal.
Possible location of lesion in such patient is:
a.) Cerebral cortex
b.) Ponto-medullary junction
c.) Internal acoustic meatus.
d.) Facial canal
Ans: d
Monday, November 21, 2022 37

38. 3.) If patient is having upper motor neuron lesion,
which side of face will be affected?
a.) Ipsilateral
b.) Contra-lateral
c.) ipsilateral 1/4th lower of face
d.) Contralateral 1/4th lower face
Ans: d
Monday, November 21, 2022 38

39. 4.) A 49 year old patient reach to hospital having
ability to close left eyelid with drooping of mouth
on same side. Patient is not having any problem
in eye movement. What could be the location of
lesion in such patient?
a.) lesion on left cerebral cortex
b.) Lesion on left motor nucleus of facial nerve
c.) Lesion on course of facial nerve in left side
d.) Lesion on right motor nucleus of facial nerve
Ans: c
Monday, November 21, 2022 39

40. 5.) A patient who is having paralysis on right side
of face and he is also not able abduct his right
eye. Which category of lesion will show such
symptoms?
a.) Right lower motor neuron lesion without motor
nucleus involving
b.) Right lower motor neuron lesion with motor
nucleus involved
c.) Right upper motor neuron lesion
d.) Left upper motor neuron lesion
Ans: b
Monday, November 21, 2022 40

41. References
• Inderbir Singh. Textbook of anatomy:
Head & Neck. 6th ed. New Delhi:
Jaypee:2016;3:378-382.
• Gray's Anatomy-The Anatomical Basis of
Clinical Practice 41st Edition - 2015
Monday, November 21, 2022 41

42. Thank You
Monday, November 21, 2022 42