Cranial Nerves I-VI

Neuroanatomy
 Learning Outcomes
• To enumerate the first 4 cranial nerves
• To describe the origin, course and distribution of cranial
nerves
• To described the structures innervated by the cranial
nerves
• To correlate the structure innervated with the clinical
conditions of cranial nerve palsies
 Organization of the Cranial Nerves
Motor Nuclei of the Cranial Nerves
1. Somatic motor and Branchiomotor nuclei
2. General Visceral Motor nuclei
a. Edinger-Westphal nucleus of the Oculomotor nerve
b. Superior salivatory and lacrimal nuclei of the facial nerve
c. Inferior salivatroy nucleus of the glossopharyngeal nere
d. DOrsal motor nucleus of the vagus
3. Sensory Nuclei of the Cranial nerves
 Functional components
• General somatic afferent fibers (GSA): transmit exteroceptive
and proprioceptive impulses from head and face to somatic sensory
nuclei
• Special somatic afferent fibers (SSA): transmit sensory impulses
from special sense organs of vision, equilibrium and hearing to the
brain
• General visceral afferent fibers (GVA): transmit interoceptive
impulses from the viscera to the visceral sensory nuclei
• Special visceral afferent fibers (SVA): transmit sensory impulses
from special sense organs of smell and taste to the brain
• General somatic efferent fibers (GSE): innervate skeletal
muscles of eye and tongue
• Special visceral efferent fibers (SVE): transmit motor impulses
from the brain to skeletal muscles derived from brachial (gill) arches
of embryo. These include the muscles of mastication, facial
expression and swallowing
• General visceral efferent fibers (GVE): transmit motor impulses
from the general visceral motor nuclei and relayed in
parasympathetic ganglions. The postganglionic fibers supply
cardiac muscles ， smooth muscles and glands
Classification of cranial nerves
• Sensory cranial nerves: contain only afferent (sensory) fibers
– ⅠOlfactory nerve
– ⅡOptic nerve
– Ⅷ Vestibulocochlear nerve
• Motor cranial nerves: contain only efferent (motor) fibers
– Ⅲ Oculomotor nerve
– Ⅳ Trochlear nerve
– ⅥAbducent nerve
– Ⅺ Accessory nerv
– Ⅻ Hypoglossal nerve
• Mixed nerves: contain both sensory and motor fibers---
– ⅤTrigeminal nerve,
– Ⅶ Facial nerve,
– ⅨGlossopharyngeal nerve
– ⅩVagus nerve
 General somatic efferent nuclei
• Nucleus of oculomotor n.

• Nucleus of trochlear n.

• Nucleus of abducent n.

• Nucleus of hypoglossal n.
 Special visceral motor nuclei
• Motor nucleus of trigeminal
n.

• Nucleus of facial n.

• Nucleus ambiguous

• Accessory nucleus
 Special visceral efferent nuclei
Nucleus Site Cranial n. Function

Motor nucleus of Pons Ⅴ Masticatory muscles,

trigeminal n. tensor palati & t. tympani
Nucleus of facial n. Pons Ⅶ Facial m., platysma,
posterior belly of digastric,
stylohyoid, stapedius

Nucleus ambiguus Medulla Ⅸ,Ⅹ.Ⅺ Skeletal m. of pharynx,

larynx and upper part of
esophagus
Accessory nucleus Medulla- Ⅺ Sternocleidomastoid,
cervical cord trapezius
 General visceral motor nuclei

• Accessory oculomotor
nucleus
• Superior salivatory nucleus
• Inferior salivertory nucleus
• Dorsal nucleus of vagus n.
General visceral efferent nuclei
Nucleus Site Cranial Function
nerve

Accessory Midbrain Ⅲ Sphincter pupillae and

oculomotor nucleus ciliary m.

Superior salivatory Pons Ⅶ Submandibular,

nucleus sublingual and lacrimal
glands

Inferior salivertory Medulla Ⅸ Parotid gland

nucleus

Dorsal nucleus of medulla Ⅹ Many cervical,

vagus n. thoracic and abdominal
viscera
Visceral sensory nuclei ( general and special )

• Nucleus of solitary tract

Visceral sensory nuclei ( general and special )

Nucleus Site Cranial n. Function

Nucleus of Medulla Ⅶ,Ⅸ,Ⅹ Taste and visceral

solitary tract sensation
 General somatic afferent
nuclei
• Mesencephalic
nucleus of trigeminal
n.

• Main sensory nucleus

of trigeminal n.

• Spinal nucleus of
trigeminal n.
General somatic sensory nuclei
Nucleus Site Cranial Function
n.
Mesencephalic Midbrain Ⅴ Proprioception
nucleus of of head
trigeminal n.
Main sensory Pons Ⅴ Tactile sensation
nucleus of of face
trigeminal n.
Spinal nucleus of Medulla Ⅴ Pain and
trigeminal n. upto 2nd temperature
cx. seg. sense of face
Special somatic afferent nuclei
• Cochlear nuclei 2
- Dorsal
- Ventral
• Vestibular nuclei 4
- Superior
- Inferior
- Medial
- Lateral
Special somatic afferent nuclei

Nucleus Site Cranial n. Function

Cochlear Pons and Ⅷ Sense of hearing

nuclei medulla

Vestibular Pons and Ⅷ Sense of

nuclei medulla equilibrium
OLFACTORY
NERVE

OLFACTORY
BULB

OLFACTORY
TRACT
OLFACTORY
NERVE

OLFACTORY
BULB

OLFACTORY
TRACT
OLFACTORY
NERVE

OLFACTORY
BULB

OLFACTORY
TRACT
OLFACTORY
NERVE

OLFACTORY
BULB

OLFACTORY
TRACT
PRIMARY OLFACTORY
CORTEX

SECONDARY
OLFACTORY CORTEX

AMYGDALA
How to Test?
OPTIC NERVE

OPTIC CHIASM

OPTIC TRACT
LATERAL
GENICULATE BODY

OPTIC
RADIATION
Visual Pathway
Optic Nerve
 VISUAL REFLEXES
Direct and • Afferent impulses travel through the optic nerve, optic
chiasm, and optic tract
Consensual • Optic tract --> pretectal nucelus --> Edinger Westphal
Light Reflexes nuclei of CN III on both sides --> ciliary ganglion
• Postganglionic parasympathetic fibers pass through
the short ciliary nerves to the eyeball and the
constrictor pupillae muscle of the iris
• BOTH PUPILS constrict in the consensual light reflex
beause the pretecta nucleus sends fibers to the
parasympathetic nuclei on both sides of the midbrain
 VISUAL REFLEXES
• Afferent impulses travel through the optic nerve --> optic
Accommo- chiasma --> optic tract --> the lateral geniculate body --> optic
dation Reflex radiation --> visual cortex --> to the frontal eye fields
• Cortical fibers descend through the internal capsule to the
oculomotor nuclei in the midbrain --> medial recti muscles
• Some of the descending cortical fibers synapse with the
Edinger-Westphal nuclei of CN III on BOTH sides --> travel
though the third cranial nerve tot he ciliary ganglion --> orbit
• Postganglionc parasympathetic fibers pass through the short
ciliary nerves to the ciliary muscle and the constrictor pupillae
muscle of the iris.
 VISUAL REFLEXES

Corneal Refex

• Afferent impulses from the cornea or conjunctiva --> the ophthalmic division of the trigeminal nerve
--> sensory nucleus of the trigeminal nerve
• Internuncial neurons connect with the motor nucleus of the facial nerve on both sides through the
medial longitudinal fasciculus.
• The facial nerve and its branches supply the orbicularis oculi muscle, which causes closure of the
eyelids.
 VISUAL REFLEXES
Visual body
reflex: The
automatic scanning
movements of the eyes
and head that are
made when reading,
the automatic
movement of the eyes,
head, and neck toward
the source of the visual
stimulus, and the
protective closing of the
eyes and even the
raising of the arm for
The visual impulses follow the optic nerves, optic chiasma, and optic tracts to the
protection superior colliculi. Here, the impulses are relayed to the tectospinal and tectobulbar
(tectonuclear) tracts and to the neurons of the anterior gray columns of the spinal
cord and cranial motor nuclei.
 VISUAL REFLEXES
• The afferent sensory fibers are believed to have connections
Pupillary with the efferent preganglionic sympathetic neurons in the
Skin lateral gray columns of the first and second thoracic segments
of the spinal cord.
Reflex: • The white rami communicantes of these segments pass to the
The pupil will sympathetic trunk, and the preganglionic fibers ascend to the
dilate if the skin superior cervical sympathetic ganglion.
is painfully • The postganglionic fibers pass through the internal carotid
stimulated by plexus and the long ciliary nerves to the dilator pupillae muscle
pinching. of the iris.
 OCULOMOTOR NERVE
• Entirely motor in function
– Supplies the following extrinsic muscles of the eye: the levator palpebrae superioris, superior
rectus, medial rectus, inferior rectus, and inferior oblique
– Supplies, through its branch, to the ciliary ganglion and the short ciliary nerves
– Supplies parasympathetic nerve fibers to the following intrinsic muscles: the constrictor pupillae of
the iris and ciliary muscles.
• Therefore, the oculomotor nerve is entirely motor and is responsible for lifting the upper eyelid; turning the eye
upward, downward, and medially; constricting the pupil; and accommodating the eye.

• Two motor nuclei:

– Main motor nucleus
– Accessory parasympathetic nucleus
OCULOMOTOR NERVE: Main Motor Nucleus
• Situated in the anterior part of the gray matter that
surrounds the cerebral aqueduct of the midbrain.
• It lies at the level of the superior colliculus.
• The nucleus consists of groups of nerve cells that
supply all the extrinsic muscles of the eye except the
superior oblique and the lateral rectus.
• The outgoing nerve fibers pass anteriorly through the
red nucleus and emerge on the anterior surface of
the midbrain in the interpeduncular fossa.
• The main oculomotor nucleus receives
corticonuclear fibers from both cerebral
hemispheres.
• It receives tectobulbar fibers from the superior
colliculus and, through this route, receives
information from the visual cortex.
• It also receives fibers from the medial longitudinal
fasciculus, by which it is connected to the nuclei of
the fourth, sixth, and eighth cranial nerves.
OCULOMOTOR NERVE:
Accessory Parasympathetic Nucleus
• Situated posterior to the main oculomotor
nucleus
• The axons of the nerve cells, which are
preganglionic, accompany the other
oculomotor fibers to the orbit.
• Here, they synapse in the ciliary ganglion, and
postganglionic fibers pass through the short
ciliary nerves to the constrictor pupillae of the
iris and the ciliary muscles.
• The accessory parasympathetic nucleus
receives corticonuclear fibers for the
accommodation reflex and fibers from the
pretectal nucleus for the direct and consensual
light reflexes