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: Nervi Craniales
Bok. DMS. Anatomi Kuliah 3
Fitranto Arjadi .
16/11/2014
Saraf kranialis
Penamaan :
dengan angka
Romawi, berdasarkan
urutan dari anterior ke
posterior,
dengan nama,
menunjukkan
distribusi dari saraf
ataupun fungsinya
Asal
hidung (I),
mata (II),
brainstem (III XII)
dan
medulla spinalis
(sebagian dari XI).
12 Pasang
Saraf Kranialis
Fungsi
Sensorik&
Motorik
Pada Leher
& Kepala
TARGET
EXIT FROM
CRANIAL CAVITY
I. Olfactory
Olfactory
epithelium
Cribiform plate
(ethmoid)
II. Optic
Retina
Optic canal
(sphenoid)
Internal auditory
meatus (temporal)
TARGET
IV. Trochlear
VI. Abducens
Lateral rectus
Sup.,med.,inf.rectus
Inferior Oblique
(Also parasympathetic
to ciliary mm, constrictor Levator palpebrae superioris
III. Oculomotor
pupillae)
XII. Hypoglossal
Hypoglossal canal
(occipital)
TARGET
X: Vagus
N. Olfactorius
Function:
Special sensory (special visceral afferent) ---special sense of smell.
Olfaction : sensation of odors from the detection of odorous substances
aerosolized in the environment
The cell bodies : olfactory organ in the roof of the nasal cavity and along the nasal
septum and medial wall of the superior nasal concha.
Via lamina cribriformis os ethmoid, fibers run through the olfactory bulb and
terminate in the primary olfactory cortex
N. opticus
V2. Maxillary
Exits foramen rotundum through wall of maxillary sinus to inferior orbital
foramina)
Sensory to cheek, upper lip, teeth, nasal cavity
V3. Mandibular
Exits foramen ovale to mandibular foramen to mental foramen
Motor to jaw muscles--Masseter, temporalis, pterygoids, digastric
Sensory to chin
Sensory to tongue
Zygomatic
Mandibular
Lacrimal glands
Motor functions include facial expression,
and the transmittal of autonomic impulses
to lacrimal and salivary glands
Sensory function is taste from the anterior
two-thirds of the tongue
Facial muscles (five branches fan out over
face from stylomastoid foramen)
VII. = N. facialis
3 nuclei in pons
somatomotor branchial (2nd arch) ncl. n. VII
visceromotor (parasympathetic) ncl.
salivatorius superior
ncl. gustatorius (rostral part of ncll. tractus
solitarii) sensory (taste)
n. intermedius = VM fibres + taste fibres
course: pons angulus pontocerebellaris fossa
cranii posterior porus acusticus internus
meatus a.i. fundus m.a.i. (vetrocranial
quadrant) canalis nervi facialis Falloppii
foramen stylomastoideum glandula parotidea
Functions: Sensory (special visceral afferent and general somatic afferent), motor
(branchial motor or special visceral efferent), and parasympathetic (general visceral
efferent). It also carries proprioceptive fibers from the muscles it innervates.
Nuclei: The motor nucleus branchiomotor nucleus in the ventrolateral part of the pons.
The cell bodies = eniculate ganglion. The central processes of those concerned with taste
end in the nuclei of the solitary tract in the medulla. The processes of those concerned
with general sensations (pain, touch, and thermal) from around the external ear end in the
spinal nucleus of the trigeminal nerve.
The facial nerve (CN VII) emerges from the junction of the pons and medulla as two
divisions, the motor root and the intermediate nerve. The larger motor root (facial nerve
proper) innervates the muscles of facial expression, and the smaller intermediate nerve
(L. nervus intermedius) carries taste, parasympathetic, and somatic sensory fibers. During
its course, CN VII traverses the posterior cranial fossa, internal acoustic meatus, facial
canal, stylomastoid foramen of the temporal bone, and parotid gland. After traversing the
internal acoustic meatus, the nerve proceeds a short distance anteriorly within the
temporal bone and then turns abruptly posteriorly to course along the medial wall of the
tympanic cavity. The sharp bend is the geniculum of the facial nerve (L. genu, knee),
sometimes called the external genu of CN VII, the site of the geniculate ganglion (sensory
ganglion of CN VII). While traversing the temporal bone within the facial canal, CN VII
gives rise to the: Greater petrosal nerve. Nerve to the stapedius. Chorda tympani
nerve.
.
Then, after running the longest intraosseous course of any cranial nerve, CN VII emerges from
the cranium via the stylomastoid foramen; gives off the posterior auricular branch; enters the
parotid gland; and forms the parotid plexus, which gives rise to the following five terminal
motor branches: temporal, zygomatic, buccal, marginal mandibular, and cervical.
Branchial Motor As the nerve of the 2nd pharyngeal arch, the facial nerve supplies striated
muscles derived from its mesoderm, mainly the muscles of facial expression and auricular
muscles. It also supplies the posterior bellies of the digastric, stylohyoid, and stapedius
muscles.
Presynaptic Parasympathetic
CN VII provides presynaptic parasympathetic fibers to the pterygopalatine ganglion for
innervation of the lacrimal mucous glands and to the submandibular ganglion for innervation
of the sublingual and submandibular salivary glands. The pterygopalatine ganglion is
associated with the maxillary nerve (CN V2), which distributes its postsynaptic fibers, whereas
the submandibular ganglion is associated with the mandibular nerve (CN V3). Parasympathetic
fibers synapse in these ganglia, whereas sympathetic and other fibers pass through them.
General Sensory Some fibers from the geniculate ganglion supply a small area of the skin of
the concha of the auricle, close to external acoustic meatus.
Taste (Special Sensory) Fibers carried by the chorda tympani join the lingual nerve to convey
taste sensation from the anterior two thirds of the tongue and soft palate
n. stapedius somatomotor
eminetia pyramidalis: m. stapedius
Innervation of tongue
somatosensory x sensory (taste)
Innervation of tongue
somatosensory + sensory (taste)
X. - N. vagus
SM: pharynx (except m. stylopharyngeus), soft palate
(except m. tensor veli palatini), larynx (4th arch),
Cabang
rr. pharyngei mucosa, glands, muscles
n. laryngeus superior mucosa, glands, muscles
n. laryngeus recurrens idem
right is shorter and passes under a. subclavia dextra
left is longer and under arcus aortae
rr. cardiaci cervicales sup.+inf., thoracici
rr. bronchiales
rr. coeliaci, hepatici, renales, gastrici ant.+post.
Innervation of tongue
somatosensory x sensory (taste)
XII. = N. hypoglossus
1 nucleus in medulla
oblongata: ncl. n. XII
course: ventrally to olive
from medulla oblongata
(= sulcus preolivaris)
fossa cranii posterior
canalis nervi hypoglossi
spatium
retrostyloideum
(spatium
parapharyngeum)
trigonum caroticum
trigonum
submandibulare
tongue
7 muscles of tongue
3 extraglossal and 4
intraglossal
16/11/2014
Nerve Plexus
Complex interwoven network of nerves
Occurs in segments that control skeletal
Fig 14.9
Cervical
plexus
Brachial
plexus
C1
C2
C3
C4
C5
C6
C7
C8
T1
T2
T3
T4
T5
T6
T7
T8
T9
T10
T11
Axillary nerve
Musculocutaneous
nerve
Thoracic nerves
T12
L1
Lumbar
plexus
Sacral
plexus
Radial nerve
L2
L3
L4
L5
S1
S2
S3
S4
S5
Co1
Ulnar nerve
Median nerve
Iliohypogastric
nerve
Ilioinguinal
nerve
Lateral femoral
cutaneous nerve
Genitofemoral
nerve
Femoral nerve
Obturator nerve
Superior
Inferior
Gluteal nerves
Pudendal nerve
Saphenous nerve
Sciatic nerve
2012 Pearson Education, Inc.
Cervical Plexus
Consists of cutaneous and muscular branches in the
shoulder
Cervical
Plexus
Branches
Cutaneous branches:
Lesser occipital
Great auricular
Transverse nerve of neck
Supraclavicular nerves
Figure 13.8
to enter thorax
Accompanied by
pericardiophrenic vessels and
passes anterior to lung roots
between mediastinal pleura and
pericardium to supply motor and
sensory innervation to
diaphragm
Sensory fibers supply to pleurae,
pericardium and peritoneum of
diaphragm; usually right phrenic
nerve may be distributed on live,
gallbladder and biliary system.
Brachial Plexus
Larger, more complex innervates pectoral girdle & upper limb
Brachial Plexus
5 ventral rami form
3 trunkus
separate into 6 divisi
then form 3 corda
that give rise to
branches/nerve
a. Musculocutaneous nerve (lateral
cord)
b. Median nerve (lateral and medial
cords)
c. Ulnar nerve (medial cord)
d. Axillary nerve (posterior cord)
e. Radial nerve (posterior cord)
Brachial plexus
Fig 14.12
N. musculocutaneous
Distribusi: Biceps brachii,
brachalis and
coracobrachialis BBC nerve;
skin on anterior aspect of
forearm
Median nerve
Distribusi:
Flexor of forearm except
brachioradialis,
flexor carpi ulnaris and ulnar half
of flexor digitorum profundus,
thenar except adductor pollicis,
first two lumbricals;
skin of thenar, central part of
palm,
palmar aspect of radial three and
one-half fingers, including
middle and distal fingers on
dorsum
Ulnar nerve
Distribusi:
Flexor carpi ulnaris,
ulnar half of flexor digitorum
profundus,
hypothenar muscles,
interossei, 3rd and 4th
lumbricals and adductor
pollicis;
skin of hypothenar, palmar
surface of ulnar one and onehalf fingers,
ulnar half of dorsum of hand,
posterior aspect of ulnar two
and one-half fingers
Injury: clawhand
Ulnar nerve palsy- inability to
Radial
Distribution:
Extensor muscles of arm
and forearm,
brachioradialis;
skin on back of arm,
forearm, and
radial side of dorsum of
hand and radial two and
one-half fingers
Axillary
Distribution:
Fig 14.11
Anterior
Posterior
Radial
nerve
Ulnar
nerve
Median
nerve
limb
- ventral rami of both plexuses are distributed to the lower limb (often
referred to as the lumbosacral plexus)
Lumbar plexus
Formation: formed by
Iliohypogastric
Ilioinguinal
Lateral femoral cutaneous
Genitofemoral
n. femoralis
Berjalan ke bawah dan
n. obturatorius
Masuk ke paha via
foramen obturatorius
Innervasi medial group
otot paha , m.
obturator externus,
dan kulit sisi medial
paha
Plexus Sacral
Formation: formed by anterior rami of L4 and L5
1. Fibular nerve
2. Tibial nerve
.
Spinal Nerves
Forming the
Sacral Plexus
Lumbosacral trunk
L4 nerve
L5 nerve
Nerves of the
Sacral Plexus
S1 nerve
Superior gluteal
S2 nerve
Inferior gluteal
S3 nerve
Sciatic
Posterior femoral
cutaneous
S5
S4 nerve
Co1
Pudendal
N. Sciatica
N. tibialis
N. peroneus communis
Fig 14.13
Fig 14.14
Plexus Coccygeal
Dibentuk oleh rami
Spinal Cord
-Parasimpatis:
S2-S4
/craniosacral
Brain Stem
Parasimpatis
NC X
NC IX
NC VII
NC III
Simpatis
a. Pengeluaran adrenalin& noradrenalin
b. Peningkatan detak jantung & tekanan
c.
d.
e.
f.
g.
h.
Dilates pupil
Stimulates salivation
Relaxes bronchi
Spinal
cord
Salivary
glands
Lungs
Accelerates heartbeat
Inhibits activity
Heart
Stomach
Pancreas
Stimulates glucose
Secretion of adrenaline,
nonadrenaline
Relaxes bladder
Sympathetic Stimulates ejaculation
ganglia
in male
Liver
Adrenal
gland
Kidney
Parasimpatis
PARASYMPATHETIC
Brain
a.
b.
c.
d.
e.
f.
g.
h.
Contracts pupil
Stimulates salivation
Spinal
cord
Constricts bronchi
Slows heartbeat
Stimulates activity
Stimulates gallbladder
Gallbladder
Contracts bladder
Stimulates erection
of sex organs