This document provides details on the cranial nerves V, VII, IX, and X, including their nuclei, branches, areas of innervation, and connections. It discusses the first, second, and third branches of the trigeminal nerve (V), their innervation areas, and connections with ganglia. It also describes the facial nerve (VII) including its nuclei and course through the facial canal, as well as its branches like the chorda tympani. Details are given on the glossopharyngeal nerve (IX) and its fibers.

1. V, VII, IX, X pairs of cranial
nerves, branches, areas of
innervation
Dr. Sarina
Astana, 2023

2. QOT:
1. The first branch of the V pair of CN, branches, areas of innervation
2. The second branch of the V pair of CN, branches, areas of
innervation and connection with the vegetative ganglia of the head
3. The third branch of the V pair of CN, branches, areas of innervation
and connection with the ganglia of the autonomic nervous system
4. VII pair of CN, nuclei, topography, branches, areas of innervation
5. IX pair of CN, nuclei, topography, branches, areas of innervation
6. X pair of CN, nuclei, topography, branches, areas of innervation

3. The first branch of the V pair of CN, branches, areas
of innervation
• N. ophthalmicus, the ocular nerve, exits the cranial cavity into the
orbit through the fissura orbitalis superior, but before entering it is
still divided into three branches: n. frontalis, n. lacrimalis and n.
nasociliaris.
• N. ophthalmicus performs sensitive (proprioceptive) innervation of
the eye muscles by means of connections with the III, IV and VI
nerves

5. 1.N. frontalis, the frontal nerve, is directed directly anteriorly under the roof of the
eye socket through the incisura (or foramen) supraorbitalis into the skin of the
forehead, here it is called n. supraorbitalis, giving branches along the way into the
skin of the upper eyelid and medial corner of the eye.
2. N. lacrimalis, the lacrimal nerve, goes to the lacrimal gland and, passing through
it, ends in the skin and conjunctiva of the lateral corner of the eye. Before entering
the lacrimal gland, N. lacrimalis connects with N. zygomaticus (from the second
branch of the trigeminal nerve). Through this "anastomosis" N. lacrimalis receives
secretory fibers for the lacrimal gland and supplies it with sensitive fibers as well.
3. N. nasociliaris, the nasopharyngeal nerve, innervates the anterior part of the
nasal cavity (nn. ethmoidales anterior et posterior), the eyeball (nn. ciliares longi),
the skin of the medial corner of the eye, conjunctiva and lacrimal sac (N.
infratrochlearis). A connecting branch to the ganglion ciliare also departs from it.

6. The second branch of the V pair of CN, branches,
areas of innervation and connection with the
vegetative ganglia of the head
• N. maxillaris, the maxillary nerve, exits the cranial cavity through the
foramen rotundum into the pterygoid-palatine fossa; hence its
immediate continuation is N. infraorbitalis, going through the fissura
orbitalis inferior in the sulcus and canalis infraorbitalis on the lower
wall of the eye socket and then exiting through the foramen
infraorbitale to the face, where it disintegrates on a bunch of
branches.
• These branches, connecting partly with the branches of N. facialis,
innervate the skin of the lower eyelid, the lateral surface of the nose
and the upper lip.

8. • The following branches also depart from n. maxillaris and its
continuation, n. infraorbitalis:
1. N. zygomaticus, the zygomatic nerve, to the skin of the cheek and
the anterior part of the temporal region.
2. Nn. alveolares superiores in the maxilla thickness form a plexus,
plexus dentalis superior, from which rami dentales superiores depart to
the upper teeth and rami gingivales superiores to the gums.
3. Rr. ganglionares connect n. maxillaris with ganglion
pterygopalatinum.

9. • Ganglion pterygopalatinum, the pterygopalatinum node, is located in
the pterygopalatine fossa medially and downwards from P. maxillaris.
In the node belonging to the autonomic nervous system,
parasympathetic fibers are interrupted, going from the vegetative
nucleus of the N. intermedius to the lacrimal gland and the glands of
the mucous membrane of the nose and palate as part of the nerve
itself and further in the form of the N. petrosus major (a branch of
the facial nerve).

11. • Ganglion pterygopalatinum gives the following (secretory) branches:
1) rami nasales posteriores go through foramen sphenopalatinum to
the glands of the nasal mucosa; the largest of them, N. nasopalatinus,
passes through canalis incisivus, to the glands of the mucous
membrane of the hard palate;
2) nn. palatini descend the canalis palatinus major and, exiting through
the foramina palatina majus et minus, innervate the glands of the
mucous membrane of the hard and soft palate.

12. • In addition to secretory fibers, sensitive (from the second branch of
the trigeminal nerve) and sympathetic fibers pass through the nerves
departing from the wing node. Thus, the fibers of the n. intermedius
(parasympathetic part of the facial nerve) passing through the N.
petrosus major through the pterygoid node innervate the glands of
the nasal cavity and palate, as well as the lacrimal gland. These fibers
go from the wing node through n. zygomaticus, and from it to n.
lacrimalis.

13. The third branch of the V pair of CN, branches,
areas of innervation and connection with the
ganglia of the autonomic nervous system
• N. mandibularis, the mandibular nerve, has in its composition, in
addition to the sensitive, the entire motor root of the trigeminal
nerve, coming from the said motor nucleus, nucleus motorius, to the
musculature that arose from the mandibular arch, and therefore
innervates the muscles attached to the lower jaw, the skin covering it,
and other derivatives of the mandibular arch. Upon exiting the skull
through the foramen ovale, it divides into two groups of branches.

15. • Muscle branches:
• To the named muscles: N. massetericus, nn. temporales profundi, nn.
pterygoidei medialis et lateralis, n. tensoris tympani, n. tensoris veli
palatini, n. mylohyoideus; the latter departs from N. alveolaris
inferior, branches of N. mandibularis, and innervates also the anterior
abdomen of M. digastricus.

16. • Sensitive branches:
1. N. buccalis to the mucous membrane of the cheek.
2. N. lingualis lies under the mucous membrane of the bottom of the oral
cavity. Having given N. sublingualis to the mucous membrane of the bottom
of the oral cavity, it innervates the mucous membrane of the back of the
tongue throughout its anterior two-thirds. At the place where N. lingualis
passes between both pterygoid muscles, a thin branch of the facial nerve —
chorda tympani - coming out of the fissura petrotympanica joins it. It passes
outgoing from the nucleus salivatorius superior n. intermedia
parasympathetic secretory fibers for the sublingual and submandibular
salivary glands. It also carries in its composition the taste fibers from the
front two-thirds of the tongue. The fibers of N. lingualis itself, spreading in
the language, are the conductors of general sensitivity (touch, pain,
temperature sensitivity).

17. 3. N. alveolaris inferior through the foramen mandibulae, together with the
artery of the same name, goes into the canal of the lower jaw, where it gives
branches to all the lower teeth, having previously formed a plexus, plexus
dentalis inferior. At the anterior end of the canalis mandibulae, N. alveolaris
inferior gives a thick branch, N. mentalis, which exits from the foramen
mentale and spreads in the skin of the chin and lower lip. N. alveolaris
inferior is a sensitive nerve with a small admixture of motor fibers that exit
from it in the foramen mandibulae as part of N. mylohyoideus (see above).
4. N. auriculotemporalis penetrates into the upper part of the parotid gland
and goes to the temporal region, accompanying a. temporalis superficialis. It
gives secretory branches to the parotid salivary gland (see below for their
origin), as well as sensitive branches to the temporomandibular joint, to the
skin of the anterior part of the auricle, the external auditory canal and to the
skin of the temple.

18. • In the area of the third branch of the trigeminal nerve, there are two nodules
belonging to the vegetative system, through which the innervation of the salivary
glands mainly occurs. One of them is ganglion oticum, the ear node is a small
roundish body located under the foramen ovale on the medial side of the n.
mandibularis. Parasympathetic secretory fibers come to it as part of N. petrosus
minor, which is a continuation of N. tympanicus, originating from the pharyngeal
nerve. These fibers are interrupted at the node and go to the parotid gland
through the medium of n. auriculotemporalis, with which ganglion oticum is in
conjunction. Another nodule, the ganglion submandibular submandibular node,
is located at the anterior edge of the m. pterygoideus medialis, on top of the
submandibular salivary gland, under the n. lingualis. The node is connected by
branches to n. lingualis. Through the medium of these branches, the fibers of the
chorda tympani go to the node and end there; they are continued by fibers
originating from the ganglion submandibularis, innervating the submandibular
and sublingual salivary glands.

20. VII pair of CN, nuclei, topography, branches, areas
of innervation
• N. facialis (n. intermedio-facialis), the facial nerve, is a mixed nerve; as
the nerve of the second gill arch, it innervates the muscles developed
from it — all mimic and part of the sublingual and contains efferent
(motor) fibers coming from its motor nucleus to these muscles and
afferent (proprioceptive) fibers coming from the receptors of the
latter. It also contains gustatory (afferent) and secretory (efferent)
fibers belonging to the so-called intermediate nerve, n. intermedius
(see below). Accordingly, the components that make up it, n. facialis
has three nuclei embedded in the bridge: motor — nucleus motorius
nervi facialis, sensitive — nucleus solitarius and secretory — nucleus
salivatorius superior. The last two cores belong to the nervus
intermedius.

22. • N. facialis comes to the surface of the brain from the side along the
posterior edge of the bridge, on the linea trigeminofacialis, next to N.
vestibulocochlearis. Then, together with the last nerve, it penetrates into
the porus acusticus internus and enters the facial canal (canalis facialis). In
the canal, the nerve first goes horizontally, heading outward; then in the
hiatus canalis n. petrosi majoris area, it turns at right angles back and also
passes horizontally along the inner wall of the tympanic cavity in its upper
part. After passing the limits of the tympanic cavity, the nerve bends again
and descends vertically down, leaving the skull through the foramen
stylomastoideum. In the place where the nerve, turning back, forms an
angle (knee, geniculum), the sensitive (gustatory) part of it forms a small
nerve nodule, ganglion geniculi (knee node). When exiting the foramen
stylomastoideum, the facial nerve enters the thickness of the parotid gland
and divides into its terminal branches.

23. • On the way in the eponymous channel of the temporal bone, n. facialis gives the
following branches:
1. The great stony nerve, N. petrosus major (secretory nerve) originates in the area of the
knee and exits through the hiatus canalis n. petrosi majoris; then it goes along the groove
of the same name on the anterior surface of the pyramid of the temporal bone, sulcus N.
petrosi majoris, passes into the canalis pterygoideus together with the sympathetic nerve,
P. petrosus profundus, forming a common n. canalis pterygoidei with it, and reaches
ganglion pterygopalatinum. The nerve is interrupted at the node and its fibers are
composed of rami nasales posteriores and nn. palatini go to the glands of the mucous
membrane of the nose and palate; part of the fibers in the composition of N. zygomaticus
(from N. maxillaris) through connections with N. lacrimalis reaches the lacrimal gland.
2. N. stapedius (muscular) innervates M. stapedius.
3. The drum string, chorda tympani (mixed branch), separating from the facial nerve in the
lower part of the facial canal, penetrates into the tympanic cavity, lies there on the medial
surface of the tympanic membrane, and then leaves through the fissura petrotympanica.
Coming out of the slit to the outside, it descends down and anteriorly and joins P. lingualis.

25. • After leaving the foramen stylomastoideum, the following muscle branches depart from n. facialis:
1. N. auricularis posterior innervates M. auricularis posterior and venter occipitalis m. epicranii.
2. Ramus digastricus innervates the posterior abdomen of M. digastricus and m. stylohyoideus.
3. Numerous branches to the facial muscles of the face form a plexus in the parotid gland, plexus
parotideus. These branches have in general a radial direction from back to front and, leaving the gland, go
to the face and upper part of the neck, widely anastomosing with the subcutaneous branches of the
trigeminal nerve. They distinguish: a) rami temporales to mm. auriculares anterior et superior, venter
frontalis m. epicranius and m. orbicularis oculi; b) rami zygomatici to m. orbicularis oculi and m.
zygomaticus; c) rami buccales to muscles in the circumference of the mouth and nose; d) ramus
marginalis mandibulae — a branch running along the edge of the lower jaw to the muscles of the chin
and lower lip; e) ramus colli, which descends to the neck and innervates m. platysma.
• N. the intermedius, the intermediate nerve, is a mixed nerve. It contains afferent (gustatory) fibers going to
its sensitive nucleus (nucleus solitarius), and efferent (secretory, parasympathetic) fibers coming from its
vegetative (secretory) nucleus (nucleus salivatorius superior). N. intermedius leaves the brain with a thin
stem between n. facialis and n. vestibulocochlearis; after passing some distance between with both of these
nerves, it joins the facial nerve, becomes an integral part of it, which is why n. intermedius is called portio
intermedia n. facialis. Then he moves on to chorda tympani and N. petrosus major. Its sensitive fibers arise
from the processes of pseudonipolar ganglion geniculi cells. The central processes of these cells go as part of
the n. intermedius to the brain, where they end in the nucleus solitarius.

26. IX pair of CN, nuclei, topography, branches,
areas of innervation
• N. glossopharyngeus, the lingopharyngeal nerve, the nerve of the 3rd
gill arch, in the process of development separated from the X pair of
nerves, n. vagus. It contains three kinds of fibers:
1. afferent (sensitive), coming from the pharyngeal receptors, the
tympanic cavity, the mucous membrane of the tongue (posterior third),
tonsils and palatine arches;
2. efferent (motor), innervating one of the pharyngeal muscles (m.
stylopharyngeus);
3. efferent (secretory), parasympathetic, for glandula parotis.

28. • Responsibly, with the help of the component, three nucleuses can be
distinguished: the nucleus solitarius, to which the peripheral processes of the
cells of 2 peripheral nodes — the ganglia superius and inferius (see below) are
adjacent. Vegetative (secretory), parasympathetic, nucleus, lower salivary nucleus
(lower salivary nucleus), a cluster of cells scattered in the reticular formation of
the eye of the third venom, two-headed, common with n. vagus nerve,
ambiguous nucleus.
• N. glossopharyngeus is out of control by the roots due to the medulla oblongata,
above the n. vagus nerve, and simultaneously with subsequent penetration
through the jugular foramen. In the redistribution, apparently, the sensitive part
of the nerve processes a node, the upper ganglion, and apparently, due to
rejection, another node, the lower ganglion, lying on the lower surface of the
pyramid of the temporal bone. It never goes down, connected me to the internal
jugular vein and internal carotid artery, and then wraps around the posterior m.
shilopharyngeus and along the lateral fused muscle, which leads to gentle
breathing. The indigenous language, where it was divided into two main parts.

30. • Branches of the pharyngeal nerve:
1. N. tympanicus departs from ganglion inferius and penetrates into the tympanic cavity (cavitas tympani),
where it forms a plexus, plexus tympanicus, to which branches also approach from the sympathetic plexus of
the internal carotid artery. This plexus innervates the mucous membrane of the tympanic cavity and the
auditory tube. Upon exiting the tympanic cavity through the upper wall in the form of N. petrosus minor, the
nerve passes in the groove of the same name, sulcus n. petrosi minoris, on the anterior surface of the pyramid
of the temporal bone and reaches the ganglion oticum. Through this nerve, parasympathetic secretory fibers
for the parotid gland emanating from the nucleus salivatorius inferior are brought to the ganglion oticum. After
a break in the node, secretory fibers approach the gland as part of N. auriculotemporalis from the third branch
of the trigeminal nerve.
2. Ramus m. stylopharyngei to the muscle of the same name.
3. Rami tonsillares to the mucous membrane of the palatine tonsils and arches.
4. Rami pharyngei to the pharyngeal plexus (plexus pharyngeus).
5. Rami liguales, the terminal branches of the pharyngeal nerve to the mucous membrane of the posterior
third of the tongue, supplying it with sensitive fibers, among which taste fibers pass to papillae vallatae.
6. R. sinus carotidi — sensitive nerve to sinus caroticus (glomus caroticum)

32. X pair of CN, nuclei, topography, branches, areas of
innervation
• N. vagus, the vagus nerve, developed from the 4th and subsequent
gill arches, is so called due to the vastness of its distribution. This is
the longest of the cranial nerves. With its branches, the vagus nerve
supplies the respiratory organs, a significant part of the digestive tract
(up to colon sigmoideum), and also gives branches to the heart,
which receives fibers from it that slow down the heartbeat.

34. • N. vagus contains a threefold kind of fiber:
1. Afferent (sensitive) fibers coming from the receptors of the named viscera and vessels,
as well as from some part of the dura mater of the brain and the external auditory canal
with the auricle to the sensitive nucleus (nucleus solitarius).
2. Efferent (motor) fibers for the voluntary muscles of the pharynx, soft palate and larynx
and efferent (proprioceptive) fibers emanating from the receptors of these muscles. These
muscles receive fibers from the motor nucleus (nucleus ambiguus).
3. Efferent (parasympathetic) fibers emanating from the vegetative nucleus (nucleus
dorsalis n. vagi). They go to the myocardium of the heart (slow down the heartbeat) and
the muscular lining of the vessels (dilate the vessels). In addition, the cardiac branches of
the vagus nerve include the so-called n. depressor, which serves as a sensitive nerve for the
heart itself and the initial part of the aorta and manages the reflex regulation of blood
pressure. Parasympathetic fibers also innervate the trachea and lungs (narrow the
bronchi), esophagus, stomach and intestines to colon sigmoideum (enhance peristalsis),
the glands and glands of the abdominal cavity embedded in these organs — liver, pancreas
(secretory fibers), kidneys.

35. • Fibers of all kinds, connected to the three main nuclei of the vagus nerve, exit the
medulla oblongata into its sulcus lateralis posterior, below the lingual nerve, 10-15 roots,
which form a thick nerve trunk, leaving together with the lingual and accessory nerves
the cranial cavity through foramen jugulare. In the jugular foramen, the sensitive part of
the nerve forms a small node — ganglion superius, and at the exit from the hole —
another ganglion thickening of the fusiform shape — ganglion inferius. Both nodes
contain pseudonipolar cells, the peripheral processes of which are part of the sensitive
branches going to the named nodes or receptors of the viscera and vessels (ganglion
inferius) and the external auditory canal (ganglion superius), and the central ones are
grouped into a single bundle that ends in the sensitive nucleus, nucleus solitarius. Upon
exiting the cranial cavity, the trunk of the vagus nerve descends down to the neck behind
the vessels in the groove, first between v. jugularis interna and A. sarotis interna, and
below — between the same vein and a. carotis communis, and it lies in the same vagina
with the named vessels. Next, the vagus nerve penetrates through the upper aperture of
the thorax into the thoracic cavity, where its right trunk is located in front of a. subclavia,
and the left one is on the anterior side of the aortic arch. Going down, both vagus nerves
bypass the lung root from behind on both sides and accompany the esophagus, forming
plexuses on its walls, with the left nerve passing along the front side and the right one
along the back. Together with the esophagus, both vagus nerves penetrate through the
hiatus esophageus of the diaphragm into the abdominal cavity, where they form plexuses
on the walls of the stomach. The trunks of the vagus nerves in the uterine period are
located symmetrically on the sides of the esophagus. After turning the stomach from left
to right, the left vagus moves forward, and the right one moves back, as a result of which
the left vagus branches on the front surface, and the right one on the back.

36. motor
sensitive
parasympathetic

37. • The following branches depart from N. vagus:
A. In the head part (between the beginning of the nerve and ganglion inferius):
1. Ramus meningeus to the dura mater of the brain in the region of the posterior cranial fossa.
2. Ramus auricularis to the back wall of the external auditory canal and part of the skin of the auricle. This is
the only cutaneous branch of cranial nerves that does not belong to the N. trigeminus.
B. In the cervical part:
1. Rami pharyngei together with the branches of N. glossopharyngeus and truncus sympathicus form a plexus,
plexus pharyngeus. The pharyngeal branches of the vagus nerve innervate the constrictors of the pharynx, the
muscles of the palatine arches and the soft palate (with the exception of m. tensor veli palatini). The
pharyngeal plexus also gives sensitive fibers to the mucous membrane of the pharynx.
2. N. laryngeus superior supplies sensitive fibers to the mucous membrane of the larynx above the glottis, part
of the root of the tongue and epiglottis, and motor fibers — part of the laryngeal muscles and the lower
constrictor of the pharynx.
3. Rami cardiaci cervicales superiores et inferiores, which can partially exit from N. laryngeus superior, form the
cardiac plexus.

38. C. In the thoracic part:
1. N. laryngeus recurrens, the recurrent laryngeal nerve, departs at the place where N. vagus lies in
front of the aortic arch (left) or subclavian artery (right). On the right side, this nerve wraps around
the a. subclavia from below and behind, and on the left — also from below and behind the aortic
arch and then rises upwards in the groove between the esophagus and trachea, giving them
numerous branches, rami esophagei and rami tracheales. The end of the nerve, called n. laryngeus
inferior, innervates part of the muscles of the larynx, its mucous membrane below the vocal cords,
the area of the mucous membrane of the tongue root near the epiglottis, as well as the trachea,
pharynx and esophagus, thyroid and thymus glands, neck lymph nodes, heart and mediastinum.
2. Rami cardiaci thoracici originate from N. laryngeus recurrens and the thoracic part of N. vagus
and go to the cardiac plexus.
3. Rami bronchiales et tracheales together with the branches of the sympathetic trunk form a
plexus on the walls of the bronchi, plexus pulmonalis. Due to the branches of this plexus, the
muscles and glands of the trachea and bronchi are innervated, and in addition, it contains sensitive
fibers for the trachea, bronchi and lungs.
4. Rami esophagei go to the wall of the esophagus.

39. D. In the abdominal part:
• Plexuses of vagus nerves running through the esophagus continue to the stomach,
forming pronounced trunks, trunci vagales (anterior and posterior). Each truncus vagalis
is a complex of nerve conductors not only of the parasympathetic, but also of the
sympathetic and afferent animal nervous system and contains fibers of both vagus
nerves. The continuation of the left vagus nerve, descending from the anterior side of
the esophagus to the anterior wall of the stomach, forms a plexus, plexus gastric
anterior, located mainly along a small curvature, from which rami gastri anteriores,
mixing with sympathetic branches, depart to the stomach wall (to muscles, glands and
mucous membrane). Some branches are sent through the small omentum to the liver.
The right N. vagus on the posterior wall of the stomach in the area of small curvature
also forms a plexus, plexus gastricus posterior, giving rami gastri posteriores; in addition,
most of its fibers in the form of rami coeliaci go along the a. gastrica. sinistra tract to
ganglion coeliacum, and from here along the branches of the vessels along with
sympathetic plexuses to the liver, spleen, pancreas, kidneys, small and large intestine to
colon sigmoideum.

44. • https://youtu.be/gpIDVyM8V4U