Cranial Nerves: Afferents and Efferents

I. Cranial Nerves - Pons

Cranial Nerve Type Location (cell body) Location (axon/projection) Function Cortical Supply Lesion

CN VIII SSA Comes from inner ear Neuron 1 projects onto vestibular Head Equilibrium
Bilateral LMN lesion = lost of balance
(Vestibular) and forms vestibular nuclei located next to inferior 1) Controlling postural and gait; can’t control posture
ganglion in internal cerebellar peduncle (ICP); it is where head movement
or conjugate eye movements
acoustic meatus neuron 2 starts and projects to:
2) Controlling conjugate
(neuron 1) - Spinal cord (MLF)
eye movement
- Spinal cord (lateral)

- Cerebellum (via ICP)

- Reticular Formation (and dorsal

motor nucleus of X)

- CN IV, IV, III

- Thalamus

CN VIII SSA Comes from cochlea Neuron 1 projects onto dorsal and Audition (hearing) Major: Hearing loss but never total
(Cochlear) (organ of corgi) and ventral cochlear nuclei in upper Contralateral (depending on extent of the
forms spiral ganglion medulla and lower pons; after that:
supply
lesion due to this smaller
ipsilateral component)
(major pathway) neuron 2 projects on Minor: Ipsilateral
ipsilateral superior olivary complex, supply
then neuron 3 crosses midline and
projects on contralateral superior
olivary complex, neuron 4 then
projects on nucleus of lateral
lemniscus, neuron 5 continues to
ascend the pathway through inferior
colliculus and medial geniculate
body (thalamus) before projecting
onto primary auditory cortex
(contralateral to origin)
Cranial Nerve Type Location (cell body) Location (axon/projection) Function Cortical Supply Lesion

CN VII SVA Geniculate ganglion Rostral 1/3 of NTS before Supply taste to anterior 2/3 Bilateral
(Facial) decussating and ascending to of tongue and soft palate
contralateral VPM

GSA Geniculate ganglion Spinal trigeminal nucleus Supply crude touch and Bilateral
pain to ear (external surface
of tympanic membrane +
external acoustic meatus)

SVE Motor nucleus of V Axons loop around abducens nucleus 1) Controls muscles of Bilateral - except If UMN lesion

(equivalent to nucleus (via facial colliculus) and project onto

facial expression
for the peri-oral Mouth would deviate
ambiguous b/c 1) muscles of facial expression
2) Controls stapedius muscles which TOWARDS the side of injury
supplies muscles of 2) stapedius muscle of middle ear muscle I.e. regulation of receive but not eye drop

branchial origin) response to loud contralateral

sounds cortical fibers only If LMN lesion in branches to
facial muscles (buccal…)

Ipsilateral paralysis, drooping

of eyelids.. (Bell’s Palsy)

If LMN lesion to nerve w/ fiber

going to stapedius:

Hyperacusis (heightened
sensitiviyu to particular sounds)

GVE Superior salivatory Preganglionic parasympathetic 1) Salivation

Bilateral Crocodile tears - fibers
nucleus (equivalent to neurons projecting onto:
2) Lacrimation (tears) mismatch and there’s lacrimal
dorsal motor nucleus 1) mandibular ganglion (via corda secretion during chewing
of X or inferior tympani) supplying submandibular
salivatory nucleus) and sublingual glands

2) Pterygopalatine ganglion (via

greater petrosal nerve) supplying
lacrimal glands and glands of
nasal mucosa

CN VI GSE Abducens nucleus Axons travel dorsoventral before Lateral abduction of the eye Bilateral LMN lesion = strabismus and
(Abducens) (located beneath exiting ventral pons and projecting on (horizontal gaze) diplopia due to loss of
facial colliculus) lateral rectus muscle
abduction of ipsilateral eye (in
response to horizontally
This nucleus receives vestibular moving object)
efferents via MLF
Cranial Nerve Type Location (cell body) Location (axon/projection) Function Cortical Supply Lesion

CN V GSA Comes from all over Neuron 1 projects onto:

All sensations from the face Bilateral DREZ surgery might be used to
(Trigeminal) (conscious) the face via 1) main sensory nucleus in upper relieve trigeminal neuralgia
trigeminal ganglion pons (fine touch, vibration, 2 pt.
discrimination) - large, myelinated

2) Spinal trigeminal nucleus - STN

in lower pons (pain and
temperature); has small
descending component —
ipsilateral face and mouth - small,
unmyelinated

Neuron 2 axons (via trigeminal

lemniscus) cross the midline (except
for small descending part) and project
to VPM nucleus of thalamus

GSA (un- EXCEPTIONALLY

Project to cerebellum Carry proprioceptive Bilateral Ataxia
conscious) Located in mesen- information form
cephalic nucleus of V masticatory, facial, and
(CNS) periorbital muscles)

SVE Motor nucleus of V Projects onto masticatory muscles Mastication (+ chewing) Bilateral
at the upper pontine
level
Cranial Nerves - Midbrain

Cranial Nerve Type Location (cell body) Location (axon/projection) Function Cortical Supply Lesion

CN IV GSE Trochlear nucleus 2 exceptional features:

Assist in rotating the Bilateral Vertical diplopia and difficulties
(Trochlear) (located at - axons/projections exit from dorsal (contralateral) eyeball in walking down stairs
ventrolateral tip of aspect of brain
downward and outward
PAG with arching - Projections innervate the
axons around PAG contralateral superior oblique m.
crossing dorsally)

CN III GSE Lateral somatic Motor axons supplying 4/6 of extra Assist in rotating (ipsilateral) Bilateral Strabismus and others
(Oculomotor) motor column of the
ocular muscles
eyeball upward, downward,
oculomotor nuclei - Medial rectus
upward and outward,
(located at ventral tip - Inferior rectus
inward
of PAG and dorsal to - Superior rectus

MLF) - Inferior oblique

GVE Medial visceral cell Preganglionic parasympathetic Papillary constriction
Bilateral Lesion of optic tract —> no
column of the
neurons project onto the ciliary (+ reflex) direct or consensual p. reflex

oculomotor nuclei
ganglion in the eye - postganglionic
i.e. Edinger-Westphal parasympathetic neurons supply Lesion of unilateral CN III —>

nucleus papillae of iris and ciliary muscles Loss of direct pupillary reflex
(receive impulses from (sphincter pupillae) (ipsilateral to lesion) but
pretectal area neurons consensual remains
that go through
posterior comissure)