Medicine Study Notes p119 Cranial Nerves

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Cranial Nerves Brain Stem Nuclei Name  Action Entry/Exit Test Nuclei Level Column Type Blood Supply 1 Olfactory Smell Cribriform plate of ethmoidSmell (peppermint oil) in each nostril + control. Amnosia = no smell 2 Optic Vision Optic Canal Visual acuity (Snellens Chart) and extent of visual fields Branches of Optic Tract go to Superior Colliculus 3 Oculomotor Superior orbital fissure Extraoc ular muscles Motor to extr aocular musc les except late ral rectus and superior oblique Movement of eyes: diplopia (double vision) Oculomotor Mid brain - Superior foliculus 1 GSE Posterior Cerebral Intraocular muscles Motor to intrinsic smooth muscl es of eye (cons triction of pupil, accommodation) Pupillary light and pupillary accommodation reflex. Pupil diametre in eye and contralateral eye Eding er Westphal Mi d b rain - Superior foliculous 2 GVE Posterior Cerebral 4 Trochlear Motor to superior oblique muscle Superior orbital fissure Difficult – diplopia on looking inwards and downwards Trochlear (NB fibres cross) Mid brain (Inferior Colliculus) 1 GSE Basillar  5 Trigeminal V1 – Opthalmic div Sensory - skin of nose to vertex, nasal mucosa, eyeball incl. Cornea Superior orbital fissure Corneal reflex Mescencephalic  (proprioception) Rostral Pons 6 GSA Basillar  V2 – maxillary div Sensory - cheek, upper lip, teeth of maxilla, dura of middle and anterior cranial fossa (-> headache) for amen r o tu n du m Sen s at i on ( cott on w ool ) and pin prick on cheek Chief/Pontine  (Discrimination) Mid Pons 6 GSA Basillar  V3 – mandibular div Sensory - Skin over jaw to temple, teeth of mandible, anterior tongue foramen ovale Sensat ion ( cott on wool) and pin pr ick over mandible Spinal Trigeminal  (Pain/Temperature) Caudal Pons to Cervical Spine 6 GSA AICA (superior) PICA (inferior) Motor - muscles of mastication & floor of mouth, tensor tymphani for am en ovale Po wer of ja w muscl es (masseter s for closure), jaw jerk Trigeminal Motor Mid Pons 3 BE Basillar  6 Abducent Motor to lateral rectus muscle Superior Orbital fissure Lateral movement of eyes: diplopia Abducens Caudal Pons 1 GSE Basillar  7 Facial Internal auditory meatus & facial canal Mo tor musc les o f f acia l e xpr es s ion ( mi meti c mu scl es), scal p muscles, stylohyloid, platysma, stapedius Facial strength: frown, close eyes tightly, teethy smile Facial Motor Caudal Pons 3 BE Basillar  Taste Taste on anterior two thirds of tongue Taste on anterior tongue Sen so r y con ch a, ex tern a l aud itory mea tus Sali vati on Vi scer al Eff er ent: Submandi bull ar and subli ngal glands, lacrimal glands Superior Salvatory Lacrimal Caudal Pons 2 GVE Basillar  8 Vestibulochochlear Internal auditory meatus Hearing Hearing Dorsal/Ventral Choclear Caudal Pons 5 SSA AICA Balance Balance Lateral/Medial/ Superior/Inferior Vestibular Caudal Pons 5 SSA AICA 9 Glossopharyngeal Back of mouth and throat Jugular foramen Taste Posterior 1/3rd of tongue Solitary tract (superior) Rostral Medulla 4 SVA PICA S en so r y P os t er io r tongu, upper phary n x, e us t ac hi an t u be , middle ear Gag reflex Motor Sylopharyngeal (swallowing) Ambiguous All Medulla 3 BE Vertebral Viseral afferent Carotid sinus Solitary tract (inferior) Open Medulla to closed medulla 4 GVA PICA 10 Vagus Jugular foramen Motor muscles of pharynx & larynx Movement of soft palate (say ahh); vocal chords Viseral efferent motor to thoracic & abdominal viscera dorsal motor nucleus of vagus  All Medulla 2 GVE Vertebral/PICA Viseral aff eren t sensory to t hor acic & abd omin al vi scer a, aorti c body & sinus S en so r y l ow e r phar ynx a nd larynx, external ear, external auditory meatus, tympanic membrane Taste Oropharynx 11 Accessory Motor to st eno mas toid & Trap ez ius Ju gu lar foramen Stre n gt h o f ster no mast oid & trape zie us (turn head & shrug against force) Spinal Acessory C1-5 3 BE Anterior Spinal 12 Hypoglossal Motor to all muscles of tongue Hypoglossal canal Protrusion of tongue Hypoglossal All Medulla 1 GSE Anterior Spinal

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Cranial Nerves Brain Stem Nuclei

Name   Action Entry/Exit Test Nuclei Level Column Type Blood Supply

1 Olfactory Smell Cribriform plate of ethmoid Smell (peppermint oil) in each nostril +

control. Amnosia = no smell

2 Optic Vision Optic Canal Visual acuity (Snellens Chart) and extent

of visual fieldsBranches of Optic Tract go to Superior Colliculus

3 Oculomotor  Superior orbital fissure

Extraocular muscles Motor to extraocular muscles except lateral rectus

and superior oblique

Movement of eyes: diplopia (double

vision)

Oculomotor Mid brain -

Superior foliculus

1 GSE Posterior Cerebral

Intraocular muscles Motor to intrinsic smooth muscles of eye (constriction

of pupil, accommodation)

Pupillary light and pupillary

accommodation reflex. Pupil diametre in

eye and contralateral eye

Edinger Westphal Mid brain -

Superior foliculous

2 GVE Posterior Cerebral

4 Trochlear  Motor to superior oblique muscle Superior orbital fissure Difficult – diplopia on looking inwards and

downwards

Trochlear (NB fibres

cross)

Mid brain (Inferior

Colliculus)

1 GSE Basillar  

5 Trigeminal

V1 – Opthalmic div Sensory - skin of nose to vertex, nasal mucosa,

eyeball incl. Cornea

Superior orbital fissure Corneal reflex Mescencephalic

  (proprioception)

Rostral Pons 6 GSA Basillar  

V2 – maxillary div Sensory - cheek, upper lip, teeth of maxilla, dura of

middle and anterior cranial fossa (-> headache)

foramen rotundum Sensation (cotton wool) and pin prick on

cheek

Chief/Pontine

  (Discrimination)

Mid Pons 6 GSA Basillar  

V3 – mandibular div Sensory - Skin over jaw to temple, teeth of mandible,

anterior tongue

foramen ovale Sensation (cot ton wool ) and pin prick over

mandible

Spinal Trigeminal

  (Pain/Temperature)

Caudal Pons to

Cervical Spine

6 GSA AICA (superior)

PICA (inferior)

Motor - muscles of mastication & floor of mouth,

tensor tymphani

f or amen ov al e P owe r o f j aw mu sc le s ( ma ss ete rs fo r

closure), jaw jerk

Trigeminal Motor Mid Pons 3 BE Basillar  

6 Abducent Motor to lateral rectus muscle Superior Orbital fissure Lateral movement of eyes: diplopia Abducens Caudal Pons 1 GSE Basillar  

7 Facial Internal auditory meatus &

facial canalMot or mus cl es of fa ci al ex pr es si on (m imet ic mu sc le s) , s ca lp

muscles, stylohyloid, platysma, stapedius

Facial strength: frown, close eyes tightly,

teethy smile

Facial Motor Caudal Pons 3 BE Basillar  

Taste Taste on anterior two thirds of tongue Taste on anterior tongue

Sen so ry co nc ha, e xtern al au ditory me atus

Sal ivat ion V iscera l Ef ferent : Submandibul lar and subl ingal

glands, lacrimal glands

Superior Salvatory

Lacrimal

Caudal Pons 2 GVE Basillar  

8 Vestibulochochlear  Internal auditory meatus

Hearing Hearing Dorsal/Ventral

Choclear 

Caudal Pons 5 SSA AICA

Balance Balance Lateral/Medial/

Superior/Inferior

Vestibular 

Caudal Pons 5 SSA AICA

9 Glossopharyngeal Back of mouth and throat Jugular foramen

Taste Posterior 1/3rd of tongue Solitary tract

(superior)

Rostral Medulla 4 SVA PICA

S en so ry P os te ri or t on gu , up pe r ph ar yn x, e us ta ch ia n tu be ,

middle ear 

Gag reflex

Motor Sylopharyngeal (swallowing) Ambiguous All Medulla 3 BE VertebralViseral afferent Carotid sinus Solitary tract (inferior) Open Medulla to

closed medulla

4 GVA PICA

10 Vagus Jugular foramen

Motor muscles of pharynx & larynx Movement of soft palate (say ahh); vocal

chords

Viseral efferent motor to thoracic & abdominal viscera dorsal motor nucleus

of vagus

 All Medulla 2 GVE Vertebral/PICA

Viseral afferent sensory to thoracic & abdominal viscera, aortic body

& sinus

Sensory lower pharynx and larynx, external ear , external

auditory meatus, tympanic membrane

Taste Oropharynx

11 Accessory Motor to s ten oma stoid & Tra pe zius J ug ular fora me n Stre ng th of ste rno mas toid & trap ezie us

(turn head & shrug against force)

Spinal Acessory C1-5 3 BE Anterior Spinal

12 Hypoglossal Motor to all muscles of tongue Hypoglossal canal Protrusion of tongue Hypoglossal All Medulla 1 GSE Anterior Spinal