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INTRODUCTION

• VII cranial nerve


• Nerve of II pharyngeal arch
• Mixed cranial nerve with sensory & motor
components
• Motor root & sensory root( nervus
intermedius/ nerve of Wrisberg)
Taste
Smile

Cry

Salivate
FUNCTIONAL COMPONENTS
• Special visceral efferent (BM):
Muscles from II pharyngeal arch
• General visceral efferent:(Preganglionic
parasympathetic fibres):
Submandibular, sublingual & lacrimal glands
FUNCTIONAL COMPONENTS
• Special visceral Afferent(Taste):
Anterior 2/3rds of tongue
• General somatic afferent(General
sensations):
Concha of auricle
DEEP ORIGIN (NUCLEI)
• Motor Nucleus (Pons): SVE
• Superior Salivatory Nucleus (Pons): GVE
• Lacrimatory Nucleus (Pons) : GVE
• Nucleus of Tractus Solitarius (Medulla
Oblongata): SVA
• Sensory Nucleus of V Nerve (Pons): GSA
• PONS
• FACIAL
• MEDULLA
COLLICULUS
OBLONGATA
Winding of Facial
nerve around VI
nucleus
CENTRAL CONNECTIONS
• The part of motor nucleus supplying upper
part of face---controlled by corticonuclear
fibres of both sides
• The part of motor nucleus supplying lower
part of face---controlled by corticonuclear
fibres of opposite side (only)
SUPERFICIAL ORIGIN (Attachment to
base of Brain)
• Lower border of Pons
• Between Olive & Inferior cerebellar
peduncle
• Motor root large, medial to Sensory root
• Sensory root between Motor root & VIII
nerve
COURSE AND RELATIONS
• Passes through Internal Acoustic Meatus
• Comes out of Skull through Stylomastoid Foramen

• Stylomastoid Foramen divides its course into [


Intracranial-Intrapetrous part

Extracranial part
INTERNAL ACOUSTIC MEATUS
STYLOMASTOID FORAMEN
Intracranial-Intrapetrous
Course:
• Internal acoustic meatus
• Accompanied by VIII nerve
& Labyrinthine vessels
• Sensory & motor roots
separate
• At bottom of meatus the two
roots fuse
Intracranial-Intrapetrous
Course:
• Passes above vestibule of internal
ear
• Reaches medial wall of middle
ear
• Bends backwards forming Genu
• Geniculate ganglion present here
• Passes above promontory
• Passes vertically downwards
along posterior wall of middle ear
• Comes out through stylomastoid
foramen
Extracranial course:
• Passes superficial to styloid process
of temporal bone
• Enters postero-medial surface of
Parotid gland
• Superficial to Retromandibular vein
& ECA
• Divides into Temporofacial &
Cervicofacial branches
• Form terminal branches
• Come out through anterior border of
Parotid gland
BRANCHES

• Branches of Communication
• Branches of Distribution
BRANCHES OF COMMUNICATION
1. In Internal acoustic meatus
• With VIII nerve
2. At Geniculate ganglion
• With Pterygopalatine ganglion through Greater superficial petrosal
nerve
• With Otic ganglion by a branch joining lesser petrosal nerve
• With Sympathetic plexus around Middle meningeal artery through
External petrosal nerve
BRANCHES OF COMMUNICATION
• In Facial canal
• With auricular branch of Vagus
4. Below Stylomastoid canal
• With IX, X, auriculotemporal, greater auricular nerves
5. In the Face
• With branches of V nerve

6. In the Neck
• With Transverse nerve of neck
BRANCHES OF DISTRIBUTION
• In Facial canal
1. Greater superficial petrosal nerve:-joins
deep petrosal nerve– Nerve of pterygoid
canal– Pterygopalatine ganglion–
Postganglionic fibres– Zygomatic nerve–
Lacrimal nerve– Lacrimal gland
BRANCHES OF DISTRIBUTION
• In Facial canal
2. Nerve to Stapedius
3. Chorda tympani
Preganglionic parasympathetic fibres—submandibular
ganglion—postganglionic fibres—submandibular
gland & through lingual nerve to sublingual gland
Taste fibres from anterior 2/3 of Tongue
• Below Stylomastoid foramen
1. Posterior auricular nerve:Scalp
2. Nerve to Posterior belly of digastric
3. Nerve to Stylohyoid
• In the Face (Terminal branches-Pes
Anserinus)
1. Temporal
2. Zygomatic Muscles
3. Upper & lower Buccal Of

4. Marginal Mandibular Face

5. Cervical
Temporal
Zygomatic

Buccal

Marginal mandibular

Cervical
APPLIED ANATOMY
Clinical Testing of Facial nerve:
Ask patient to
• Raise eyebrows
• To smile
• Close eyes
APPLIED ANATOMY

• Supranuclear Palsy
• Nuclear & Infranuclear Palsy
• Bell’s Palsy
SUPRANUCLEAR PALSY
• Upper part of face escapes paralysis coz of
bilateral representation of upper part of face
in cerebral hemisphere

• Lower part of Opposite side of face


paralysed
Lower Motor Neuron Palsy
• Nuclear: Involves VI nerve & Hemiplegia
• Infranuclear:
1. IAM: Involves VIII nerve
2. Facial canal: Dry eyes
Hyperacusis
Loss of Taste & salivation
Muscles of face paralysed
BELL’S PALSY
Muscles of entire half of face paralysed on the side
of lesion:
• Eyelids cannot be closed-Keratitis, Corneal ulcer
• Absence of wrinkles on forehead
• Food accumulates in the vestibule of mouth
• Nasolabial fold flattened
• Angle of mouth cannot be raised
Lesion after nerve comes out of stylomastoid
foramen
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