Human Neurobiology 910.

217

Brainstem and Cranial Nerves II

Prof. Stuart Bunt

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Patterning of the cranial

nerves

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A reminder about embryology

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Names and Numbers

Understand the names!

Olfactory

Facial

Optic

II

Vestibulocochlear VIII

Oculomotor

III

Glossopharyngeal IX

Trochlear

IV

Vagus

Trigeminal

Accessory

XI

Hypoglossal

XII

Abducens (t) VI
Sensory

Sensory & motor

VII

Motor

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Nerves covered in other lectures

1 Olfactory
2 Optic
3,4,6 Extraocular eye muscles
8 Vestibulo-cochlear

5 Motor and Sensory to the face and

muscles of mastication (sensory, motor and
mesencephalic nucleus for proprioception)

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Note position of nerves on the brainstem

I

Cerebrum

II

Diencephalon

III, IV

Midbrain

Pons

VI, VII, VIII

Junction :
Pons-Medulla

IX, X, XI, XII

Medulla
oblongata

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Nerves run from 1 to 12

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Cranial nerves exit from the skull

except spinal branch of accessory (XI), which has some

spinal roots

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Can use anatomical knowledge

to identify sites of lesions
Remember positions 1-12
Note many pathways
(which you will learn later)
pass nearby
Cranial nerve symptoms
usually pretty obvious
Often serious (brainstem
involvement)

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Sensory cranial nerves

1. Olfactory, only sensation
to enter the cortex without
passing through the thalamus
(old sense?)
Rhinencephalon forms the
cortex?

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Sensory nerves
2. Optic (chiasm)
8. Vestibulo-cochlear

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Motor nerves
3. Occulomotor
extraolcular eye
muscles except:-

4. Trochlear (only one

that emerges dorsally)
trochlear muscle

6. Abducens
lateral rectus

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Motor nerves (cont.)

11. Accessory
12. Hypoglossal

Mixed nerves

5. Trigeminal
7. Facial
9. Glossopharyngeal
10. Vagus

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Facial Nerve (a)

The nerve of the second
arch
Contributes to ear formation
Tongue formation
Facial musculature migrates
up over first arch

A mixed (sensory and

motor) cranial nerve
Sensory from the ear
Special sensory from the
tongue

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Facial Nerve (b)

Motor to the muscles
of facial expression,
stylohyoid, posterior
belly of digastric and
stapedius (to dampen
loud sounds), all
attached to structures
derived from the
second pharyngeal
arch.

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Facial Nerve (c)

Viscero-motor (parasympathetic) to
pterygopalantine ganglion
the glands of the mucosa of the nose and palate
the lacrimal gland

submandibular ganglion
submandibular and sublingual salivary glands

otic ganglion
parotid gland

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Human Neurobiology 910.217

Innervation of the tongue

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Clinical Evaluation
Upper Motor
Neuron
cortex controls lower
opposite face
forehead and eye
closure dual
consensual reflexes

Lower Motor
Neuron
all muscles on one
side affected
taste affected

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7th nerve damage

Bells palsy

pain around ear

no sensory impairment
complete palsy
rapid recovery(2-8wks)
Entrapment in facial
canal after infection?
steroids in severe cases
where taste affected

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Other 7th nerve lesions

Ramsay-Hunt
syndrome
Herpes Zoster of 7th
nerve
very severe pain in ear
vescicles
poor recovery

Hemifacial spasm
irritation of nerve by
blood vessel?

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Glossopharyngeal Nerve (9)

Nerve of the third pharyngeal arch
somatic motor to stylopharyngeus
visceral motor to parotid via otic
ganglion
special sense to the posterior 1/3 of the
tongue
sensory to posterior pharynx, soft
palate, post. 1/3 of the tongue,
tympanum, etc.
Sensory from Carotid sinus (pressure)
and carotid body (pCO2)
Important for swallowing reflex.

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Human Neurobiology 910.217

Vagal Nerve (10)

The wanderer cf vagrantnerve of 4th Arch

Motor to all smooth muscle
Secretory to all glands
Afferent from all mucous surfaces in the gut
and its derivatives as far as the splenic flexure
Motor to all muscles of the larynx, pharynx
and palate (except stylopharyngeus and tensor
veli palatini)
Taste from a few taste buds on the epiglottis
Inhibits cardiac muscle
Sensory to the outer ear drum, external
auditory meatus and behind the auricle

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Human Neurobiology 910.217

Human Neurobiology 910.217

Accessory Nerve (11)

Motor nerve to the
sternocleidomastoid
muscle and trapezius
A somitic, spinal nerve
that re-enters the foramen
magnum to look like a
cranial nerve. (accessory
to the vagus)
Has both spinal and
brainstem origins
Damage leads to trouble
turning the head

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Hypoglossal Nerve
Motor nerve supplies
occipital somite
derivatives
Intrinsic and extrinsic
muscles of the tongue
Leaves the brainstem
above the olive as a series
of small rootlets
Damage leads to
deviation of the tongue
towards the effected side