Cranial nerve nuclei

Functional components

1.general somatic afferent,GSA ( from skin)

2.general visceral afferent,GVA( from blood vessels,glands etc)
3.general somatic efferent,GSE(SE) (to skeletal muscles of
somitic origin)
Functional components

4.general visceral efferent,GVE(motor

fibres to smooth muscles and glands)
5.special somatic
afferent,SSA(vision,audition)
6.special visceral
afferent,SVA(taste)(smell)
7.special visceral efferent,SVE(all the
muscles derived from pharyngeal arches)
Olfactory nerve(I)
 Functional component
 It
has only one component
 SVA(special visceral afferent)
 Olfactory nerve
The olfactory system consists of
 the olfactory epithelium, bulb and tract
olfactory areas of the brain collectively
known as the rhinencephalon.
 Olfactory bulb

I. Olfactory:
Sensory
nerves for
smell
The olfactory epithelium is located
in the roof, superior conchae, and
septum of the nasal cavity.
 Olfactory receptor cells are
bipolar neurons

The olfactory bulb

is an enlargement of the rostral
end of the olfactory tract.
the olfactory tract divides into
the lateral, intermediate, and
medial Striae
 Fibers from the pyriform cortex project to the
entorhinalcortex(Brodmann area 28),
which contains an olfactory association area that
sends projections to the hippocampus.
This portion of the limbic system is undoubtedly
associated
with the learning of likes&dislikes of foods.
Olfactory projections
TEST
1.assessment of the patency of the
nostrils.
Each nostril is examined separately.
The test involves occlusion of a single
nostril while the eyes of the patient are
closed.
The patient should inhale gently through
the open nostril in close proximity to a
common odorant
(e.g., vanilla, ground coffee, fresh
orange, etc.).
The patient should be asked first whether
the odorant can be detected.
If detectable, the odorant should be
identified by name.
If the patient fails at the task, the test
should be repeated with at least one
distinct odorant.
The test should be repeated for the
opposite nostril using entirely new
odorants.
Optic nerve(II)
Functional component:
Special somatic afferent(SSA)

Arises from the retina.

Passes through the optic canals
to enter the cranial cavity and
decussates with its fellow
to form the optic chiasm.
It then continues as optic tract
to reach Lateral geniculate
body and from here
it continues as optic radiation
to end in the visual cortex.
 Each optic nerve contains nasal and
temporal fibers.
The nasal fibers decussate in the chiasm
so that
each optic tract contains temporal fibers
of the same side
and nasal fibers of the opposite side.
 sphenoid

Arrows in optic canals

nerve
chiasm
tract
 The Visual Pathway from Below

•Optic nerve
•Optic chiasm
•Optic tract
•Lateral geniculate body
•Optic radiation
•Visual cortex
•Superior colliculus of the
midbrain
•Putamen
•Long association bundle -
inferior occipitofrontal fasciculus
•Pulvinar of the thalamus
•Calcarine fissure
•Poster inferior horn of the
lateral ventricle
Complete blind

hemianopia
Various hemianopias
 The test is completed by asking
the patient to read a Snellen eye
chart viewed at 20 feet.
Oculomotor nerve(III)
 Has a motor nucleus in the midbrain
(at superior colliculus)
which supplies all the extra ocular muscles
except
Lateral rectus and superior oblique.
It also has a parasympathetic
nucleus(Edinger-westphal)
Which supplies sphincter pupillae
and ciliaris mucles.
Functional components;

1. Somatic efferent.(SE)
2.General visceral
efferent(GVE)
 Course;

Passes through the mid brain to emerge

in the interpeduncular fossa.
•Passes through the lateral wall of
• the cavernous sinus
•Enters the orbit through
•superior orbital fissure’s middle compartment.
•Divides into upper and lower
divisions
•Supply
•Levator palpebrae
superioris,superior,inferior,medial recti
• and inferior oblique muscles of the
eye.
 Nucleus of III nerve

Ts of midbrain at the level of superior colliculus

 Middle cranial fossa

Arrow indicates cavernous sinus

 III
IV

V1
V2
V3

Structures in the lateral wall of cavernous sinus

The Cavernous Sinuses

A. Carotid Artery
B. Trochlear
Nerve
C. Maxillary
Nerve
D. Abducens
Nerve
E. Sphenoid
H. Ophthalmic
Sinus
Nerve
F. Pituitary Gland
I. Oculomotor
G. Cavernous
Nerve
Sinus
Superior orbital fissure
Bony orbit(RT) viewed from front
 Clinical aspects( ptosis)

Trochlear nerve (IV)
Functional component: somatic efferent SE
Supply: superior oblique muscle of the eye
Nucleus:
situated in the midbrain
at the level of inferior colliculus
It’s the only cranial nerve to emerge
from the dorsal aspect of the
brain stem(rest all emerge from the
ventral aspect).
It is the only cranial nerve
that decussates with its fellow.
Passes through the lateral wall of the
cavernous sinus
below the III nerve and above the
ophthalmic nerve.
Enters the orbit through the lateral part of
sup.orb.fissure.
It then passes medially to supply
the superior oblique.
 Nucleus of IVnerve in the midbrain
(inferior collicular level)

V
IVnerve in the interpeduncular
fossa(dorsal view)
 IV nerve

Cavernous sinus
Rt orbit(superior view)
Damage to the
Trochlear nerve will
present as:

•Extorsion (outward
rotation) of the affected
eye due to the unopposed
action of the inferior
oblique muscle.
The patient will 
.
compensate by moving 
his head to intort the 
contra lateral eye.
•Vertical diplopia (double vision)
due to the extorted eye.

•Weakness of downward gaze most

noticeable on medially-directed eye.
• This is often reported as difficulty
in descending stairs.
 What is torsion?

 It is defined as rotation of an imaginary

point at 12o clock position on the corneal
margin. If it moves externally(temporally) it
is called extorsion.
 If it moves internally(nasally),it is called
intorsion.
Extorsion of the left eye(IVnerve palsy)
Due to its long peripheral course
around the midbrain
CN IV is particularly susceptible
to head trauma
Abducent nerve(VI)
Functional component: somatic efferent SE
Supplies lateral rectus only.
Nucleus: in the floor of the IV ventricle
deep to facial colliculus
Facial nerve fibers loop around this.
Facial colliculus
Course:

emerges at the interpeduncular

fossa in line with IIInerve.
Passes through the cavernous
sinus inferolateral to ICA.
Enters the orbit through the
middle compartment,between the
two divisions of IIInerve and ends
by supplying lateral rectus.
VI

At the interpeduncular fossa

In the cranial cavity
III

III
 Showing the relationship with
circle of Wills
IIInerve

VI nerve
Injury to Abducens nerve causes
the paralysis of ipsilateral lateral rectus.
The eye is drawn medially due
to
unopposed action of medial
rectus.
This will result in
diplopia(double vision)
Strabismus –
the inability to direct both eyes to the same object.
Rt abducens palsy(no abduction)
 Testing of III,IV,VI nerves

III Oculomotor Eye movement The ability to move each eye

upward, upward, downward, and inward
downward, and is tested by asking the person to
inward; narrowing follow a target moved by the
(constriction) or examiner. The upper eyelid is
widening (dilation) checked for drooping (ptosis).
of the pupil in
response to
changes in light
IV Trochlea Eye The ability to move
r movement each eye downward
downward and inward is tested by
and inward asking the person to
follow a target moved
by the examiner.
VI Abduc Side-to- The ability to move
ens side each eye outward
(lateral) beyond the midline
eye is tested.
movement