PNS Structure of Nerves Cranial Nerves Spinal Nerves Sensory receptors Motor control.
: Cranial Nerves V-VII (Trigeminal & Facial Nerves)ksumsc.com/download_center/2nd/1) Neuropsychiatry...
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Please view our Editing File before studying this lecture to check for any changes. Nerve Supply of Face : Cranial Nerves V - VII (Trigeminal & Facial Nerves) Color Code Important Doctors Notes Notes/Extra explanation
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Transcript of : Cranial Nerves V-VII (Trigeminal & Facial Nerves)ksumsc.com/download_center/2nd/1) Neuropsychiatry...
PleaseviewourEditingFile beforestudyingthislecturetocheckforanychanges.
NerveSupplyofFace:CranialNervesV-VII(Trigeminal&FacialNerves)
ColorCodeImportantDoctorsNotesNotes/Extraexplanation
ObjectivesBytheendofthelecture,studentsshouldbeableto:ü Listthenucleiofthedeeporiginofthetrigeminalandfacial
nervesinthebrainstem.ü Describethetypeandsiteofeachnucleus.ü Describethesuperficialattachmentoftrigeminalandfacial
nervestothebrainstem.ü Describethe maincourseanddistributionoftrigeminalandfacial
nervesintheface.ü Describethemainmotor&sensorymanifestationincaseof
lesionofthetrigeminal&facialnerves.
Trigeminal(V)5th CranialNerve
o Type:Mixed (sensory&motor).o Fibers:1.Generalsomaticafferent:afferentà sensory
Carryinggeneralsensationsfromface,andanteriorpartofscalp.
2.Specialvisceralefferent:efferentàmotor
Supplyingmusclesdevelopedfromthe1stpharyngealarch,(8muscleswillbementionedinslide5).
Extra
TrigeminalGangliono Site:Occupiesadepression inthemiddlecranialfossa.o Importance:Containscellbodies:1. Whosedendritescarrysensationsfromtheface.2. Whoseaxonsformthesensoryrootoftrigeminal
nerve.
seenextslide
Trigeminal(V)5thCranialNerveNuclei(deeporigin)
3 sensory + 1 Motor Extra
Motornucleus(pons):supplies:• FourMusclesofmastication*
(temporalis,masseter,medial&lateralpterygoid).
• Otherfourmuscles(Anteriorbellyofdigastric,mylohyoid,tensorpalati &tensortympani).
Trigeminal(V)5thCranialNerveNuclei
Fournuclei:(3sensory+1Motor). *chewing
Forthediagramsseenextslide
Specialvisceralefferent:
3. Spinalnucleus(pons,medulla&upper2-3cervicalsegmentsofspinalcord):receivespain&temperaturesensationsfromface&scalp.
2. Principal(main)sensorynucleus(pons):receivestouchfibersfromface&scalp
1. Mesencephalicnucleus(midbrain&pons):receivesproprioceptivefibersfrommusclesofmastication*.
Generalsomaticafferent:
theothernameofitistractus nucleus.لتحتنازلةالتراكتزيالنھا
Extra
Extra
Extra
Extra
Extra
Trigeminal(V)5thCranialNerve
o Emergesfromthemiddleoftheventralsurfaceoftheponsby2roots(LargeLateralsensoryroot&smallmedialmotorroot)*.
o Dividesinto3divisions(dendritesoftrigeminalganglion):1. Ophthalmic,CV12. Maxillary,CV23. Mandibular,CV3
o Axonsofcellsofmotornucleusjoinonly themandibulardivision.
Extra
*Toremember:MotoràmedialLargeà Lateral
Motor &Sensory
PureSensory
Extra
Trigeminal(V)5thCranialNerve1.Ophthalmicnerve
o PURESENSORYo Dividesinto3brancheswhichpass
throughsuperiororbitalfissuretotheorbit:1. Frontal: suppliesskinofface&
scalp.2. Lacrimal:suppliesskinofface&
lacrimalgland.3. Nasociliary:suppliesskinofface,
nasalcavity&eyeball.
1
23
Extra
اعرفھا من اسمھا +supplyskinoftheface
Trigeminal(V)5thCranialNerve2.Maxillarynerve
o PURESENSORYo Supplies:• Upperteeth,gums&maxillaryairsinus(posterior,middle&anteriorsuperioralveolarnerves).
• Face:(zygomaticofacial &infraorbitalnerves).
Extra
Extra
Trigeminal(V)5thCranialNerve3.Mandibular
MIXED(sensoryandmotor) MotorBranches
1. Lingual:receivesGeneralsensationsfromanterior2/3theoftongue.
2.Inferioralveolar:suppliesLowerteeth,gums&face.Throughmandiblebonethroughmandibularcanal
3.Buccal:supplies Face(cheekonupperjaw)
to8muscles(4musclesofmastication&other4muscles).
4.Auriculotemporal:supplies auricle,temple,parotidgland&TMJtempromendibular joint.
SensoryBranches ولیس التذوق حار وبارد
o Compression,degenerationorinflammationofthe 5th cranialnervemayresultinaconditioncalledtrigeminalneuralgiaorticdouloureux (spasmodiccontractionofthemuscles,mostoftenintheface)
o Thisconditionischaracterizedbyrecurringepisodesofintensestabbingexcruciatingpainradiatingfromtheangleofthejawalongabranchesofthetrigeminalnerve.
o Usuallyinvolvesmaxillary&mandibularbranches,rarelyintheophthalmicdivision.
Extra
Trigeminal(V)5thCranialNerveTrigeminalNeuralgia
لمریض یجي یشتكي من الم رھیب عند وضع المشط زي الدبابیس في الوجھا
taste sensation
Parasymp.
motor
Facial(VII)7th CranialNerve
o Type:Mixed (Motor,specialsensory,parasympathetic).
o Fibers:
1. Specialvisceralafferent: carryingtastesensationfromanterior2/3ofthetongue.
2. Specialvisceralefferent:supplyingmusclesdevelopedfromthe2nd pharyngealarch.(musclesoffacialexpression)
3. Generalvisceralefferent:supplyingparasympatheticsecretoryfibers(secretomotor) tosubmandibular,sublingual,lacrimal,nasal&palatineglands.
Facial(VII)7thCranialNerveNuclei
1
2 3
3Nuclei:
o Specialvisceralafferent:(nucleussolitarius):receivestastefromtheanterior2/3oftongue.
o Specialvisceralefferent: (motornucleusoffacialnerve):supplies:Musclesoftheface,
Musclesofscalp,(Occipitofrontalis).Musclesoftheauricle.Posteriorbellyofdigastric,Platysma,Stylohyoid,Stapedius,
o Generalvisceralefferent:(superiorsalivatory nucleus):sendspreganglionicparasympatheticsecretoryfiberstosublingual,submandibular,lacrimal,nasal&palatineglands.
ھي اللي تتذوق
Facial(VII)7thCranialNerveCourseo Emergesfromthecerebellopontineangle
by2roots:1. Medialmotorroot:containsmotor
fibers.2. Lateralroot(nervousintermedius):
containsparasympathetic&tastefibers.
o Course:• Passesthroughinternalauditorymeatustoinnerearwhereitrunsinfacialcanal.
• Emergesfromthestylomastoid foramen&enterstheparotid gland whereitends.
Toremember:Motoràmedial
3.Nervetostapedius:controltheamplitudeofsoundwavesfromtheexternalenvironmenttotheinnerear.
Branches
1. Greaterpetrosalnerve:carries preganglionicparasympatheticfiberstopterygopalatineganglionthenpostganglionictolacrimal,nasal&palatineglandsتخلیك تعیط.
Facial(VII)7thCranialNerve
Asitemergesfromthestylomastoidforamen
Inside parotidgland
N.B.:Geniculateganglion:containscellbodiesofneurones ;itsfibres carryingtastesensationsfromanterior2/3oftongue;endinginsolitarynucleusinM.O.Liesininternalacousticmeatus.
InfacialCanal
2.Chordatympani:carriesa)preganglionicparasympatheticfibers
tosubmandibular&sublingualglands.
b)tastefibersfromanterior2/3oftongue.
Extra
BranchesFacial(VII)7thCranialNerve
InfacialCanal
1. Posteriorauricular:tooccipitofrontalis muscle.
posteriorbellyofdigastric
stylohyoid
Asitemergesfromthestylomastoidforamen
2.Muscular branchesto:
gives5terminalmotor branchestothemusclesoftheface:
Inside parotidgland
Temporal Zygomatic
Buccal Mandibular
Cervical
PathwayofSensationfromtheFaceandScalp
ProprioceptiveSensations
Pain,Temperature,andTouchSensations
Neuron1:Mesencephalicnucleusinmidbrain
Neuron2:CellsofPMVNT
SensoryCortex
Neuron1:Cellsoftrigeminalganglion
Neuron2:Forpain andtemperature:thecellsofspinalnucleusofthetrigeminalinthemedulla.
Fortouch cellsofmainsensorynucleus.
Neuron3:CellsofPMVNT
SensoryCortex
Onlyontheboys’slides
PMVNT:nucleusinthalamus
Facial(VII)7thCranialNerveBell’sPalsyo Damageofthefacialnerveresultsinparalysisof
musclesoffacialexpressions:Facial(Bell’s)palsy;alsocalled lowermotorneuronlesion(wholefaceaffected)
o NB.Inuppermotorneuronlesion(upperfaceisintact).
o Faceisdistorted:(effectisonthesamesideofinjury)• Droopingoflowereyelid,• Saggingofmouthangle,• Dribblingofsaliva,• Lossoffacialexpressions,• Lossofchewing,• Lossofblowing,• Lossofsucking,• Unabletoshowteethorclosetheeyeonthatside.
یا انو اكل خبطة على وشو او یكون من جو حار وبارد ویلتھب
زي اللي تصیر في الجلطات یكون الجزء العلوي شغال النو یاخذ سبالي من الجھتین.
Onlyonthegirls’slides
LowerMotorNeuronLesion UpperMotorNeuronLesionResultsfrominjuryoffacialnervefibres:ininternalacousticmeatus;inthemiddleear;inthefacialcanal,orinparotidgland.
Thisoccursafterinjurytothepyramidaltract(corticonuclear)abovefacialnucleus...
Manifestedbycompleteparalysisoffacialmuscles onthesamesideoflesion.
Leadstoparalysisoffacialmusclesoflower½offaceofoppositeside buttheupper½ofthefacenotaffectedbecausethelowerpartoffacialnucleus&Ms.of lower½offacereceivepyramidalfibresfromoppositecerebralcortexonly,whileMs..of upper½offacearenormalbecausetheyreceivepyramidalfibresfrombothcerebralhemispheres.
Iflesionoffacialnerveabovetheoriginofchordatympaniandnervetostapedius, theparalysisoffacialmuscleswillbeassociatedwith:1- Hyperacusis:soundsareheardmoreacuteduetoparalysisofstapediusms.2- Lossoftastesensationfromanterior2/3oftongue.
ForYourInformationThisslideisextrafromDr.Sanaatodifferentiatebetweenupperandlowermotorlesions.
Fibers
GSA SVE
nuclei
Mesencephalicnucleus
(midbrain&pon)
Mainsensorynucleus(pons)
Spinalnucleus(pons,M.O,upper
2-3cervicalsegments)
Motornucleus(pons)
division
Ophthalmic(sensory)
frontal
lacrimal
nasociliary
Maxillary(sensory)
Post.,middle,anter.Superioralveolar
nerves
Zygomaticofacial&infraorbital
Mandibular(mixed)
Sensory:lingual,inferioralveolar,
buccal,auriculotemporal
Motor:To4masticationMS&4otherMS
Trigeminal nerve (mixed : sensory & motor)
Fibers
SVA SVE
GVE
nuclei
Nucleussolitarius Motor nucleus
Superiorsalivatorynucleus
branches
In facialcanal
Chordatympani
Nerve tostapedius
Greaterpetrosal
Asitsemergefrom
stylomastoidforamen
Posterior auricular
Muscular branches
Insideparotidgland
1.Temporal2.Zygomatic3.Buccal
4.Mandibular5.cervical
Facial nerve (mixed: motor,sensory,parasympathetic)
Summary
o Bothtrigeminal&facialnervesaremixed.
o Nucleioftrigeminalnervearefoundinmidbrain,pons&medulla.Theyareofthegeneralsomaticafferent&specialvisceralefferenttypes.
o Thetrigeminalnerveemergesfromtheponsanddividesinto:ophthalmic,maxillary&mandibulardivisionsthatreceivesensorysupplyfromtheface(withanexceptionofasmallareaoverramusofmandible).
o Allmotorfibersareincludedinthemandibulardivision&supplymusclesofmastication.
o Nucleioffacialnervearefoundinpons.Theyareofthespecialvisceralafferent&efferent,aswellasgeneralvisceralefferenttype.
o Thefacialnerveemergesfromthecerebellopontine angle,givesmotorfiberstomusclesoffacialexpression,secretoryfiberstosubmandibular,sublingual,lacrimal,nasal&palatineglands&receives tastefibersfromanterior2/3oftongue.
1-Thespecialvisceralefferentfibersof thetrigeminalnervesupplies:A- temporalismuscleB- posteriorbellyofdigastricC- omohyoidD- ventralpterygoidAnswer:A
2- whichofthefollowingtrueabouttheTRIGEMINALnerveistrue:A- theaxonsofthecellsofmotornucleusjoinonlymaxillarydivision
B- itemergesthemiddleofthedorsalsurfaceoftheponsC- theTRIGEMINALGANGLIONoccupiesthemiddlecranialfossaD- alltheaboveAnswer:C
3-TRIGEMINALNEURALGIArarelyinvolves:A-maxillarybranchB-mandibularbranchbranch C- ophthalmicD-alltheaboveAnswer:C
4- theposterioraulicular branchoftheFACIALnervesupply:A- posteriorbellyofdigastricB-stylohyoidC-occipitofrontalis muscleD-A&BAnswer:C
5-DamageoftheFACIALnervewillleadtowhichofthefollowingdeformities:A-Erb-Duchenne palsyB-Klumpke palsyC-Bell’spalsyD-CerebralpalsyAnswer:C
Questions
6-Listthebranchesoftheophthalmicdivisionofthetrigeminalnerve.FRONTAL,LACRIMAL,NASOCILIARY
7- listthebranchesofthefacialnerveinsideparotidglandandwhatdotheysupply.TEMPORAL,ZYGOMTIC,BUCCAL,MANDIBULAR,CERVICALàmusclesoftheface
Leaders:Nawaf AlKhudairyJawaherAbanumy
@anatomy436
Feedback
AnatomyTeam
References:1- Girls’&Boys’Slides2- GreysAnatomyforStudents3- TeachMeAnatomy.com
Members:Alanoud AbuhaimedAnwarAlajmiNourah AlHogailNouf Aloqaili
