CRANIAL NERVES

- 12 pairs of cranial nerves

- Origins from brain / brainstem

- Special senses, Sensory,

Motor, Mixed, Parasympathetics
pre and postganglionic

- Foramina in skull for exit of

nerves

- Cranial fossae associated with

nerves
cranial nerves – spinal nerves
motor (efferent) systems and sensory (afferent) systems

motor nerve cell bodies in nuclei (within the CNS)

sensory nerve cell bodies in ganglia (outside the CNS)

Trigeminal
ggl.

Trigeminal
motor
nucleus

Nucleus
ambiguus
(motor
nucleus for
sensory ganglia of Vagus n. Vagus n.
cranial nerves – spinal nerves

4 cranial nerves carry preganglionic parasympathetic fibers out of the CNS –

cell bodies found in nuclei inside the CNS

Edinger Westphal
nucleus (CN III)

Superior salivatory
nucleus (CN VII)

Inferior salivatory
nucleus (CN IX)

Dorsal motor
nucleus of the
Vagus (CN X)
Caudal view of the base of the brain / brainstem

CN I (bulb
and tract)

CN II
Pons CN III
CN IV
CN VII CN V (sensory)
CN VIII CN V (motor)
CN IX CN VI
CN X CN XII
CN XI
Brain Stem

CN III
CN IV
Midbrain
CN V
CN VI
CN VII
Pons
CN VIII
CN IX
CN X
CN XI
Medulla

CN XII
 sphenoid
(lesser wing)
CN I
Ant. CN II - VI
Mid. petrous ridge

Post.
CN VII-XII

Cranial
Vault
Cranial nerves exiting cranial vault through foramina in skull

CN I - Cribriform
Olfactory bulb plate of ethmoid
CN II – optic
canal V1 – superior
orbital fissure
CN III V2 – f. rotundum
V3 – f. ovale
+ CN VI CN V ganglion
CN IV
CN VII
superior orbital CN VIII – internal
fissure (along acoustic meatus
with V1)

CN IX
CN V
CN X – jugular
CN XI – jugular foramen
foramen (along CN XII –
with IX and X) hypoglossal
canal
CN I (Olfactory) – special sense of smell (olfaction)
Peripheral processes and cell bodies located in olfactory epithelium
in upper part of nasal cavity (shown in blue)

Central processes pass

through cribriform plate
of ethmoid in multiple
small bundles on both
right and left

Olfactory bulb and tract

 CN II (Optic) – special sense of vision
Photoreception from retina – optic nerve fibers come together at the
optic disc where the optic nerve leaves the back of the eyeball.
High density of photoreceptors at the fovea centralis of the macula
lutea.

Macula lutea with fovea centralis

Optic nerve
Layers of retina
Optic nerves enter the cranial
vault through the optic canals

At the optic chiasm, Rt nasal retinal

fibers cross to the Left side and left
temporal retinal fibers do not cross
such that visual information from
the right visual field is represented
in the left visual cortex and visual
information from the left visual field
is represented in the right visual
cortex.
CN III (Oculomotor – exits cranial vault and enters orbit
through superior orbital fissure)
Motor to elevator of upper eyelid and 4 extraocular muscles
Parasympathetic preganglionic fibers  synapse at ciliary
ganglion  postganglionic fibers to ciliary muscle and pupillary
constrictor
 Pupillary light reflex (direct and consensual)

CN II (afferent limb) and CN III, PS component (efferent limb)

Light in R eye  R pupil constricts (direct light reflex) AND

L pupil constricts (consensual reflex)

Eyesimulator

http://cim.ucdavis.edu/EyeRelease/Interface/TopFrame.htm
 Accomodation reflex (for near vision)

CN II (afferent limb) and CN III, PS component (efferent limb)

Attempt to focus on near object  pupil constricts

(pupillary constrictor muscle)
AND
the lens “rounds up” (ciliary muscles) for increased
refraction
CN IV (Trochlear) – motor to one extraocular muscle, the superior
oblique (SO4)

CN VI (Abducens) – motor to one extraocular muscle, the lateral

rectus (LR6)
CN III (Oculomotor)– motor to 4 extraocular muscles and levator
palpebrae superioris
(LR6SO4)3

These 3 nerves (plus branches of CN V i) pass through the superior

orbital fissure to the orbit
Injury to any of these will result in disruption of eye movements and
can lead to diplopia (double vision)
 CN V (Trigeminal) Foramina
3 divisions: ophthalmic (V1) V1 – superior orbital fissure
maxillary (V2) V2 – foramen rotundum
mandibular (V3) V3 – foramen ovale

Trigeminal ganglion
(sensory)
Cavernous
sinus

V1
V2
V3
CN V (Trigeminal)

General sensation for face/scalp, oral and nasal cavities, paranasal

sinuses, eyes and conjunctiva, part of tympanic membrane, dura of
anterior and middle cranial fossae.

There is a separate motor branch that joins V3 near the foramen

ovale for muscles of the 1st pharyngeal arch (MAST MATT).

V1

V2

V3

Sensory innervation of face and scalp by CN V

temporalis

masseter
 Auriculotemporal n. Eustachian tube
V3 F. ovale
?
TMJ – double
synovial jt.

Articular disc

Spheno-
lateral
mandibular
pterygoid
ligament

medial
pterygoid
CN VII (Facial) - exits cranial vault through internal
acoustic meatus along with CN VIII
- exists skull through stylomastoid
foramen

1) Motor to muscles of 2nd pharyngeal arch

a) stapedius
b) stylohyoid
c) digastric (post. belly)
d) muscles of facial expression
2) Preganglionic parasympathetic fibers for all glands in the head
EXCEPT parotid gland
3) Special sense (taste) from anterior 2/3 of tongue
4) General sensation from a small part of the outer ear
CN VII (Facial) –
motor branch exits the temporal bone at the stylomastoid foramen
and passes THROUGH the parotid gland (TZBMC)

innervates posterior belly of digastric and stylohyoid muscle and

muscles of facial expression
CN VII (Facial) - 2 branches carrying preganglionic
parasympathetic fibers and taste fibers

1) Greater petrosal n.
 pterygopalatine
ganglion

2) Chorda tympani 
submandibular
ganglion
CN VIII (Vestibulocochlear) – internal acoustic meatus
Special senses
• Hearing (cochlear nerve)
• Aiding balance - head rotation/movement sense (vestibular nerve)

Cochlea

Vestibulocochlear
nerve

Vestibular apparatus

Internal acoustic
meatus
 Cochlear n. and
spiral ganglion

Vestibulocochlear
nerve

Vestibular n. and ganglion

Internal acoustic
meatus
 Cochlear duct and
hair cells

Cochlear n. Region of spiral

ganglion
CN IX (Glossopharyngeal) – jugular foramen with CN X and CN XI

1) General sensation from most

of pharynx, posterior 1/3 of
tongue, palatine tonsil, middle
ear mucosa and tympanic
membrane. Special sense of
taste from posterior 1/3 of
tongue.
2) Parasympathetic
(preganglionic) fibers for
parotid salivary gland
3) Motor for stylopharyngeus
muscle
4) Visceral afferents from carotid
sinus and carotid body
CN X (Vagus) – jugular foramen with CN IX and CN XI

1) General sensation from larynx and part of laryngopharynx, and a

small part of external auditory meatus

2) Visceral afferents from esophagus, foregut and midgut, bronchi

and lungs, heart, carotid body

3) Parasympathetic (preganglionic) fibers for smooth muscles and

glands of larynx, pharynx, airway, foregut and midgut

4) Motor for muscles of pharynx (EXCEPT stylopharyngeus), larynx,

one tongue muscle (palatoglossus) and muscles of soft palate
(EXCEPT tensor veli palatini)

5) Special sense of taste from epiglottis

CN XI (Spinal Accessory)
motor nuclei in upper cervical cord, NOT
brainstem
CN XI ENTERS the cranial vault through foramen
magnum and then EXITS the cranial vault
through the jugular foramen along with CN IX
and CN X

Motor for sternocleidomastoid (SCM)

and trapezius muscles
CN XII (Hypoglossal)
- exits cranial vault through hypoglossal canal
- motor to intrinsic and extrinsic muscles of tongue (EXCEPT
palatoglossus muscle, CN X)
Muscles of the Tongue All are paired, separated by a
median fibrous septum

Intrinsic – superior longitudinal, inferior longitudinal, transverse &

vertical

Extrinsic – genioglossus, hyoglossus, styloglossus & palatoglossus

Intrinsic muscles are confined to the tongue [no bony

attachments]; alter the shape of the tongue

Extrinsic muscles are attached to mandible [genial tubercles] /

hyoid / styloid process / palate  move the tongue

All extrinsic & intrinsic muscles of the tongue are innervated by the
hypoglossal nerve (CN XII), except for palatoglossus – vagus
[cranial accessory]
Coronal Section – Intrinsic muscles
Superior
longitudinal

Median Vertical &

fibrous transverse
septum

Inferior
H M longitudinal

Lingual
artery
Hyoid bone Lingual
nerve

Hypoglossal nerve
Extrinsic muscles Paralysis of genioglossus – tongue
tends to fall backwards  may obstruct
the respiratory passage [safety muscle]
Palatoglossus [elevates the tongue, depresses the
soft palate & approximates the palatoglossal folds]

Genioglossus – protrusion &

depression; prevents the
tongue from sinking back

Styloglosssus [draws the

tongue up & backwards]

Hyoglossus
[depression]

Genioglossus Geniohyoid
 Innervation of the tongue

MOTOR
all tongue muscles by
hypoglossal (CN XII)
except
palatoglossus (CN X)
SENSORY SENSORY
anterior 2/3 of tongue
posterior 1/3 of tongue
general sensation: V3 (mandibular) via general sensation AND taste:
lingual n. CN IX
special sensation (taste): CN VII 
chorda tympani branch  lingual n.
 Cranial Nerves with PS
CN # Name CNS nucleus Ganglion Target organ(s)

III Oculo- Edinger- Ciliary Pupil constrictor

motor Westphal Ciliary muscle
VII Facial Superior Pterygo- All glands of
salivatory palatine & head EXCEPT
submandib. parotid (and
sweat glands)
IX Glosso- Inferior Otic Parotid
pharyngeal salivatory
X Vagus Dorsal nucleus (no names)Larynx (glands)
of the Vagus bronchi, heart,
esophagus,
foregut, midgut
No discrete ganglia – scattered
ganglion cells near or in the walls
of target organs
Parasympathetic nerves
– CNs III, VII, IX, X leave the brain nuclei as preganglionic fibers
to synapse in ganglia in the head and neck. ( CN X also supplies
preganglionic parasympathetics to the thorax and most of the
G. I. tract).

While CN V does not carry any preganglionic parasympathetic

fibers, and is therefore NOT one of the “parasympathetic cranial
nerves”, ALL parasympathetic ganglia in the head and ALL
postganglionic parasympathetic fibers in the head travel on
branches of the trigeminal nerve.

Sympathetics to the head and neck leave the chain

ganglia in the cervical part of the sympathetic chain as
postganglionic fibers, then form a plexus around the
carotid arteries and are carried throughout the head and
neck.
 Parasympathetic schematic for head innervation

Preganglionic axons in Postganglionic axons

cranial nerves III, VII, IX along with branches of V
Brainstem Target tissue
intrinsic eye muscles
lacrimal glands
salivary glands
mucous membranes

Parasympathetic
ganglion (named)

Preganglionic neuron
Postganglionic neuron
Cranial nerve Ganglion Branch of V Target tissue

Ciliary V1
III Intrinsic mm of eye

V2 and

Pterygopalatine V2  V1 Lacrimal gland,

VII nasal/paranasal
mucous glands

Submandibular V3 Submandibular &

VII sublingual glands

Otic V3
IX Parotid gland
Parasympathetic ganglia

Ciliary
ganglion
?

V1
V2
V3

Otic Pterygopalatine
ganglion ganglion

Submandibular
ganglion
Somatic motor - to skeletal muscle in head

III, IV, V, VI, VII, IX, X, XI, XII

Muscles moving the eye (extraocular mm) - III, IV, VI

Muscles moving the mandible (mm of mastication) - V3

Muscles moving facial skin (mm of facial expression) - VII

Stylopharyngeus muscle - IX

Muscles of palate, pharynx, larynx (deglutition/phonation) - X

Trapezius and sternocleidomastoid mm - XI

Muscles moving the tongue - XII

Somatic sensory - general sensation from skin and cavities of face/head

V, VII, IX, X

V - from face, anterior 2/3rds of scalp, mucous membranes of oral and nasal
cavities, nasopharynx, ant 2/3rds of tongue, external auditory meatus

VII - external auditory meatus (small area)

IX - from middle ear, most of nasopharynx, oropharynx, post 1/3rd of tongue and
part of laryngopharynx

X – small area of external auditory meatus, laryngopharynx, larynx

Special sensory - smell, vision, taste, balance, hearing

I, II, VII, VIII, IX, X

I - smell from olfactory epithelium

II - vision from retina

VII - taste from ant 2/3rds of tongue

IX - taste from post 1/3rd tongue

X - small area for taste at tongue base and epiglottis

VIII - equilibrium (vestibular portion)

hearing (cochlear portion)