66
The Cranial Nerves

The Cranial Nerves 脑 神 经

Embed Size (px)

DESCRIPTION

Names of cranial nerves Ⅰ Olfactory nerve Ⅱ Optic nerve Ⅲ Oculomotor nerve Ⅳ Trochlear nerve Ⅴ Trigeminal nerve Ⅵ Abducent nerve Ⅶ Facial nerve Ⅷ Vestibulocochlear nerve Ⅸ Glossopharyngeal Ⅹ Vagus nerve Ⅺ Accessory nerve Ⅻ Hypoglossal nerve

Citation preview

Page 1: The Cranial Nerves 脑 神 经

The Cranial Nerves

脑 神 经

Page 2: The Cranial Nerves 脑 神 经

Names of cranial nerves

Ⅰ Olfactory nerve Ⅱ Optic nerve Ⅲ Oculomotor nerve Ⅳ Trochlear nerve Ⅴ Trigeminal nerve Ⅵ Abducent nerve Ⅶ Facial nerve Ⅷ Vestibulocochlear

nerve Ⅸ Glossopharyngeal

nerve Ⅹ Vagus nerve Ⅺ Accessory nerve Ⅻ Hypoglossal nerve

Page 3: The Cranial Nerves 脑 神 经

Fiber components of cranial n.

General somatic afferent(sensory) fibers 一般躯体感觉纤维 : transmit exteroceptive and proprioceptive impulses from head and face to somatic sensory nuclei of the brain stem;

Special somatic afferent (sensory) fibers 特殊躯体感觉纤维 : transmit sensory impulses from special sense organs of vision, equilibrium and hearing to the brain ;

Page 4: The Cranial Nerves 脑 神 经

Fiber components of cranial n.

General visceral afferent (sensory) fibers 一般内脏感觉纤维 : transmit interoceptive impulses from the viscera to the visceral sensory nuclei-nucleus of solitery tract;

Special visceral afferent (sensory) fibers 特殊内脏感觉纤维 : transmit sensory impulses from special sense organs of smell and taste to the brain;

Page 5: The Cranial Nerves 脑 神 经

Fiber components of cranial n.

General somatic afferent (motor) fibers 一般躯体运动纤维 : arises from the General somatic motor nuclei and innervate skeletal muscles of eye and tongue.

Special visceral afferent (motor) fibers 特殊内脏运动纤维 : arises from the Special visceral motor nuclei in the brain and to skeletal muscles derived from gill arches ( 腮弓 ) of embryo : such as the m. of mastication, facial expression and swallowing.

Page 6: The Cranial Nerves 脑 神 经

Fiber components of cranial n.

General visceral afferent (motor) fibers 一般内脏运动纤维 : arise from the general visceral motor nuclei and relayed in parasympathetic ganglions,e postganglionic fibers supply cardiac muscles , smooth muscles and glands.

Page 7: The Cranial Nerves 脑 神 经

Classification of cranial nerves

Sensory cranial nerves 感觉性脑神经 : contain only sensory fibers

Ⅰ. Olfactory nerve

Ⅱ. Optic nerve

Ⅷ. Vestibulocochlear nerve

Page 8: The Cranial Nerves 脑 神 经

Classification of cranial nerves

Motor cranial nerves 运动性脑神经 : contain only motor fibers

Ⅲ. Oculomotor nerve

Ⅳ. Trochlear nerve

Ⅵ. Abducent nerve

Ⅺ. Accessory nerve

Ⅻ. Hypoglossal nerve

Page 9: The Cranial Nerves 脑 神 经

Classification of cranial nerves

Mixed nerves 混合性脑神经 : contain both sensory and motor fibers Ⅴ. Trigeminal nerve Ⅶ. Facial nerveⅨ. Glossopharyngeal nerveⅩ. Vagus nerve

Page 10: The Cranial Nerves 脑 神 经

感觉性脑神经Sensory cranial nerves

I . Olfactory nerve II. Optic nerveVIII.Vestibulocochlear nerve

Page 11: The Cranial Nerves 脑 神 经

Olfactory nerveOlfactory cell → Olfactory nerve → Cribriform foramina

筛孔 → Olfactory bulb 嗅球

Olfactory nerve

Function: conduct the smell

Page 12: The Cranial Nerves 脑 神 经

Optic nerveGanglion cell of retina → Optic nerve → Optic canal →optic chiasma→optic tract → lateral geniculate body.

Page 13: The Cranial Nerves 脑 神 经

Vestibulocochlear nerve 前庭蜗神经

Cochlear ganglion

Vestibular ganglionInternal acoustic meatus

Vestibular nuclei

Cochlear nucleiVestibulocochlear nerve

Page 14: The Cranial Nerves 脑 神 经

Sensory cranial nerves

N. Location of cell body

Cranial exit

Terminal nuclei

Main action

Ⅰ Olfactory cellsCribrifomforamina

Olfactory bulb

Smell

Ⅱ Ganglion cells of retina

Optic canal

Lateral geniculate body

Vision

ⅧVestibular ganglion of internal ear

Internal acoustic meatus

Vestibular nuclei

Equilibrium

Cochlear ganglionof internal ear

Cochlear nuclei

Hearing

Page 15: The Cranial Nerves 脑 神 经

运动性脑神经 Motor cranial nerves

III.Oculomotor nerve 动眼神经IV. trochlear nerve 滑车神经 VI. Abducent nerve 展神经XI. accessory nerve 副神经XII. hypoglossal nerve 舌下神经

Page 16: The Cranial Nerves 脑 神 经

Oculomotor nerve

supplies : Superior, inferior and medial recti; inferior obliquus; levator palpebrae superioris

Sphincter pupillae and ciliary muscleNucleus of oculomotor n.

Accessory nucleus of oculomotor n.

ComponentsGeneral somatic motor ( efferent ) fiber arises from nucleus occulomotorGeneral visceral motor ( efferent ) fiber arises from accessory nucleus of Ⅲ

Page 17: The Cranial Nerves 脑 神 经

Oculomotor nerve

Oculomotor nerve

Course:

•Leave the brain at the interpeduncular fossa;

•Pass through the lateral wall of cavernous sinus

•Via superior orbital fissure enter the orbita

Page 18: The Cranial Nerves 脑 神 经

Oculamotor paralysis

The injury of the oculomotor n. may lead to:

Droping of the upper eyelid;

lateral strabismus 外斜视 ;

Dilation of the pupil;

The pupillary reflexes disappear 瞳孔光反射消失

Page 19: The Cranial Nerves 脑 神 经

trochlear nerve

Trochlear n. arises from the nucleus of trochlear nerve,

and pass through the superior orbital fissure to supply the superior obliquus

Page 20: The Cranial Nerves 脑 神 经

Abducent nerve

abducent n. arises from the nucleus of abducent nerve, and pass through the superior orbital fissure to supply the lateral rectus

Page 21: The Cranial Nerves 脑 神 经

Accessory nerve

Accessory nerveCranial root 脑根: arises from nucleus ambiguus;Spinal root 脊髓根 arises from the accessory nucleus pass through jugular foramen,and supplies 2 muscles

sternocleidomastoid

trapezius

Page 22: The Cranial Nerves 脑 神 经

Hypoglossal nerve 舌下神经

Hypoglossal nerve

Nucleus of hypoglossal nerve

Hypoglossal canal

Page 23: The Cranial Nerves 脑 神 经

Function of Cranial Nerve 12

supplies the intrinsic and extrinsic muscles of the Tongue genioglossus 颏舌肌

extend the tongue with Contraction

So what happens if the CN12 has been

damaged ?

Page 24: The Cranial Nerves 脑 神 经

Motor cranial nerves

N. Nucleus of origin Cranial exit supply

Nucleus of oculomotorSuperior orbital fissure

superior, inferior and medial recti; inferior obliquus; levator palpebrae superioris

Accessory nucleus of oculomotor (Parasympathetic )

sphincter pupillea and ciliary muscl

Ⅳ Nucleus of trochlear nerve

Superior orbital fissure

superior obliquus

Ⅵ Nucleus of abducent nerve

Superior orbital fissure

lateral rectus

Ⅺ Nucleus of accessory nerve

Jugular foramen sternocleidomastoid and trapezius

Ⅻ Nucleus of hypoglossal nerve

Hypoglossal canal muscles of tongue

Page 25: The Cranial Nerves 脑 神 经

Mixed cranial nerves

混合性脑神经V. Trigeminal nerveVII.Facial nerveIX. Glossopharyngeal nerveX. Vagus nerve

Page 26: The Cranial Nerves 脑 神 经

Trigeminal nerve

Components of fibers

General somatic afferent fibers: transmit facial sensation to sensory nuclei of trigeminal nerve, the fibers have their cell bodies in trigeminal ganglion,

Special viceral efferent fibers: originate from motor nucleus of trigeminal nerve, and supply masticatory muscles

Page 27: The Cranial Nerves 脑 神 经
Page 28: The Cranial Nerves 脑 神 经

Branches Frontal nerve 额神经 :

Supratrochlear nerve

滑车上神经Supraorbital nerve 眶上神经

Branches

Ophthalmic nerve 眼神经 (Ⅴ1, sensory)

leave the skull through the superior

orbital fissure 眶上裂 , to enter orbital cavity

Lacrimal nerve 泪腺神经 :→lacrimal gland Nasociliary nerve 鼻睫神经 ; → eyeball

Page 29: The Cranial Nerves 脑 神 经

Distribution:

Visual organ Part of mucosa of nose Skin above the palpebral fisure and back of nose cerebral dura mater

Page 30: The Cranial Nerves 脑 神 经

Infraorbital nerve 眶下神经 Zygomatic nerve 颧神经 Superior alveolar ner

ve 上牙槽神经 Pterygopalatine nerve

翼腭神经

Maxillary nerve 上颌神经 ( 2, sensory)Ⅴ Leave skull through foramen rotundum 圆孔

Branches

Page 31: The Cranial Nerves 脑 神 经

Distribution: Maxillary teeth Mucosa of nose and mouth

Skin between the palpebral fissure and oral fissure. cerebral dura mater

Page 32: The Cranial Nerves 脑 神 经

Auriculotemporal nerve 耳颞神经

Buccal nerve 颊神经 Lingual nerve 舌神经 Inferior alveolar nerve

下牙槽神经 Nerve of masticatory mu

scles 咀嚼肌神经

Mandibular nerve 下颌神经 (Ⅴ3, mixed)

Leave the skull through the foramen ovale 卵圆孔 to enter the infratemporal fossa 颞下窝Branches

Page 33: The Cranial Nerves 脑 神 经

Distribution: cerebral dura mater; Mandibular teeth and gum; Mucosa of floor of mouthAnterior 2/3 of tongue; Skin of auricular and temporal regions and below the oral fissure; masticatory muscles, mylohyoid, and anterior belly of digastric m.

Page 34: The Cranial Nerves 脑 神 经

Facial nerve (Ⅶ)

Components of fibers

Special visceral efferent fiber: fibers originate from nucleus of facial nerve, and supply facial muscles.

General visceral efferent fiber: fibers arise from superior salivatory nucleus and relayed in pterygopalatine ganglion 翼腭神经节 and submandibular ganglion 下颌下神经节 . The postganglionic fibers supply lacrimal, submandibular and sublingual glands.

Page 35: The Cranial Nerves 脑 神 经

Facial nerve (Ⅶ)

Components of fibers.

Special visceral afferent fiber: fiber from taste buds of anterior 2/3 of tongue which cell bodies are in the geniculate ganglion 膝节 of the facial nerve and end the nucleus of solitary tract.General somatic afferent fiber: fibers distribute the skin of external ear.

Page 36: The Cranial Nerves 脑 神 经

Course: leaves skull through internal acoustic meatus, facial canal and stylomastoid foramen, it then enters parotid gland where it divides into five Branches which supply facial Muscles.

Page 37: The Cranial Nerves 脑 神 经

Chorda tympani 鼓索 : joins lingual branch of mandibular nerve To taste buds on anterior two-thirds of tongue. Relayed in submandibular ganglion( 下颌下神经节 ), the postgangli

onic fibers supply submandibular and sublingual glands

Branches within the facial canal

Page 38: The Cranial Nerves 脑 神 经

Greater petrosal nerve 岩大神经 : fibers pass to pterygopalatine ganglion 翼腭神经节 and the postganglionic fibers through the zygomatic and lacrimal nerves to lacrimal gland

Stapedial nerve 镫骨肌神经 : to stapedius

Page 39: The Cranial Nerves 脑 神 经

Temporal branch Zygomatic branch Buccal branch Marginal mandibular branch Cervical branch

Branches outside of facial canal

Page 40: The Cranial Nerves 脑 神 经

Pterygopalatine ganglion 翼腭神经节 : lies in pterygopalatine fossa under maxillary nerveSubmandibular ganglion 下颌下神经节 : lies between lingual nerve and submandibular gland

Page 41: The Cranial Nerves 脑 神 经

Injury to the facial nerve

?2. How to distinguish the supranuclear paralysis and infranuclear paralysis

1. Is this paralysis belong to supranuclear paralysis and infranuclear paralysis

Page 42: The Cranial Nerves 脑 神 经

Glossopharyngeal nerve ( )Ⅸ

Special visceral efferent fiber: originate from nucleus ambiguus, and supply stylopharygeus.general visceral efferent fiber: arise from inferior salivatory nucleus and ralyed in otic ganglion, the postganglionic fibers supply parotid gland.Special visceral afferent fiber: transmit the taste of posterior third of tongue to the nucleus of solitary tract.

Components of fibers

Page 43: The Cranial Nerves 脑 神 经

Glossopharyngeal nerve ( )Ⅸ

general visceral afferent fiber: transmit the visceral sensation from mucosa of posterior third of tongue, pharynx, auditory tube and tympanic cavity, carotid sinus and glomus, to the nucleus of solitary tract.general somatic afferent fiber: conduct the sensation from skin of posterior surface of auricle.

Components of fibers

Page 44: The Cranial Nerves 脑 神 经

BranchesLingual branches 舌支 : to taste buds and mucosa of posterior third of tonguePharyngeal branches 咽支 : take part in forming the pharyngeal plexusTympanic nerve 鼓室神经 : → tympanic cavity and auditory tube, and its general visceral motor fibers via lesser petrosal nerves to end the otic ganglion 耳神经节 , the postganglionic fibers via auriculotemporal n.( 3) Ⅴto parotid gland

Course: leaves the skull via jugular foramen

Page 45: The Cranial Nerves 脑 神 经

Carotid sinus branch 颈动脉窦支 : →carotid sinus and glomus

Others: tonsillar and stylophayngeal branches

Otic ganglion 耳神经节 : situated

just below foramen ovale

Branches

Page 46: The Cranial Nerves 脑 神 经

Lingual branches

Carotid sinus branch

Pharyngeal branches

Page 47: The Cranial Nerves 脑 神 经

Vagus nerve (Ⅹ)general visceral efferent fiber: originate from dorsal nucleus of vagus nerve, synapse in parasympathetic ganglion, short postganglionic fibers innervate cardiac muscles, smooth muscles and glands of visceraSpecial visceral efferent fiber: originate from the nucleus ambiguus, to muscles of pharynx and larynx

components of fibers

Page 48: The Cranial Nerves 脑 神 经

Vagus nerve (Ⅹ)

general visceral afferent fiber: carry impulse from viscera in neck, thoracic and abdominal cavity to nucleus of solitary tract general somatic afferent fiber: conduct the sensation from auricle, external acoustic meatus and cerebral dura mater to the spinal nucleus of trigeminal n.

components of fibers

Page 49: The Cranial Nerves 脑 神 经

Right vagus nerve Enter thoracic cavity on right side of trachea and infront of right subclavian a. and passes posterior to right lung root Forms posterior esophageal plexus

and posterior vagal trunk Passes though the esophageal hiatus into abdominal cavity, then divides into posterior gastric 胃后支 and celiac branches 腹腔支

Course•Exits the skull from jugular foramen

•Descends in the neck in carotid sheath between internal (or common) carotid artery and internal jugular vein

Page 50: The Cranial Nerves 脑 神 经

Left vagus nerveEnter thoracic cavity between left common carotid and left subclavian arteries, Descends infront of the aortic archPasses posterior to the root of left lung Forms anterior esophageal plexus and anterior vagal trunk Passes though the esophageal hiatus into abdominal cavity, and divides into anterior gastric and hepatic branches.

Page 51: The Cranial Nerves 脑 神 经

External branch

Internal branch which pierces thyrohyoid

membrane to innervates mucous membrane of larynx above fissure of glottis

External branch, which innervates cricothyroid

Branches in neck

Superior laryngeal nerve 喉上神经

Internal branch

Cervical cardiac branches 颈心支 descending to terminate in cardiac plexus

Page 52: The Cranial Nerves 脑 神 经

Recurrent laryngeal nerves 喉返神经 Right one hooks around right subcla

vian artery, left one hooks aortic arch

Both ascend in tracheo-esophageal groove

Nerves enter larynx posterior to cricothyroid joint, the nerve is now called inferior laryngeal nerve

Innervations: laryngeal mucosa below fissure of glottis , all laryngeal muscles except cricothyroid

Branches in thorax

Bronchial and esophageal branches

Page 53: The Cranial Nerves 脑 神 经

Anterior and posterior gastric branches Run close to lesser curvature and

innervate anterior and posterior surfaces of stomach

Branches in abdomen

Celiac branches:

send branches to celiac plexus whose fibers distribute with sympathetic fibers to liver, pancreas, spleen, kidneys, intestine as far as left colic flexure

Hepatic branches 肝支 : supply liver and gallbladder

Page 54: The Cranial Nerves 脑 神 经

Nucleus of oculomotor n.

Accessory nucleus of oculomotor n.

Page 55: The Cranial Nerves 脑 神 经
Page 56: The Cranial Nerves 脑 神 经

Inferior alveolar nerve 下牙槽神经

Auriculotemporal nerve

Page 57: The Cranial Nerves 脑 神 经
Page 58: The Cranial Nerves 脑 神 经
Page 59: The Cranial Nerves 脑 神 经
Page 60: The Cranial Nerves 脑 神 经
Page 61: The Cranial Nerves 脑 神 经
Page 62: The Cranial Nerves 脑 神 经
Page 63: The Cranial Nerves 脑 神 经

The nerve distribution of tongue 舌的神经分布• Hypoglossal n. → the musels of tongue;

• Mandibular n. → anterior 2/3 mucosa of tongue;

• Facial n. → anterior 2/3 teste buds of tongue;

• Glossopharygeal n. →the mucosa and teste buds of the root of tongue

Page 64: The Cranial Nerves 脑 神 经

The nerve distribution of the eyeball?III →sup. Inferior and medial rectus,inferior obliquus IV→ superior obliquus VI→lateral rectusOptic n. → visual sense;Ophthalmic n. →general sense of eyeball;sympathetic n. →dilator pupillae;parasympathetic n. →sphincter pupillae and ciliary m.

Page 65: The Cranial Nerves 脑 神 经
Page 66: The Cranial Nerves 脑 神 经