系统解剖学英文版教学课件：cranial nerves

SectiontwothecranialnervesI.Introduction1.Thenamesandordersofthecranialnerves

IolfactoryNIIopticNIIIoculomotorNIVtrochlearNVtrigeminalNVIabducentNVIIfacialNVIIIvestibulocochlearNIXglossopharyngealNXvagusNXIaccessoryNXIIhypoglossalN

2.Functionalcomponentsofthecranialnerves

(1)Somaticefferent(motor)fibers:involvedineyeandtonguemovements

(2)Specialvisceralefferentfibers:involvedinchewing,makingfacialexpressions,swallowing,producingvocalsounds,andturningthehead

(3)Generalvisceralefferentfibers:involvedinmovementsofsmoothmusclesoftheinnereye,glandsandthemusclesoftheheart,lung,andbowelthatinvolvedinmovementandsecretion(4)Generalsomaticafferent(sensory)fibers:conveysensationfromtheskinandthemucousmembraneofthehead

(5)Specialsomaticafferent(sensory)fibers:involvedwiththevision,hearingandequilibrium

(6)Generalvisceralafferentfibers:conveysensationfromtheviscera,heart,vessels,andglands(7)Specialvisceralafferentfibers:involvedwiththesenseoftasteandsmell

II.12pairsofthecranialnerves

CranialnerveI:olfactorynerve

Theolfactorynerves(olfactoryfilaments)arethecentralprocessesoftheolfactorycellsintheolfactorymucosaofthenoseandperforatethecribriformplate,endintheolfactorybulb.CranialnerveII:opticnerveArisefromtheganglioncellsintheretinaandconvergeontheopticdisc,passthroughtheopticcanalintothecranialfossa.Afterformingtheopticchiasm,itchangesitsnametotheoptictract.

CranialnerveIII:oculomotornerve

Arisefromtheoculomotornucleusandtheaccessoryoculomotornucleus(Edinger-Westphalnucleus).Itenterstheorbitthroughthesuperiororbitalfissureandsuppliesthelevatorpalpebraesuperioris,superior,medial,andinferiorrectusmuscles,andtheinferiorobliquemuscle,theciliaryandtheconstrictorpupillaemuscles.Oculomotornerve

Ciliary

ganglionTheciliaryganglion

isaparasympatheticganglion.Thepreganglionicfibersoftheoculomotornervearerelayedintheganglion.Thecellsinthegangliongiverisetofiberswhichsupplytheciliaryandtheconstrictorpupillaemuscles.OculomotornervelesionCranialnerveIV:trochlearnerve

Originatesfromthetrochlearnucleus.Itenterstheorbitthroughthesuperiororbitalfissureandsuppliesthesuperiorobliquemuscle.TrochlearnervelesionCranialnerveVI:abducentnerve

Originatesfromtheabducentnucleus.Itenterstheorbitthroughthesuperiororbitalfissureandsuppliesthelateralrectusmuscle.AbducentnervelesionCranialnerveV:trigeminalnerve

1Rootsofthetrigeminalnerve:containsalargesensoryroot,whichoriginatesinthetrigeminalganglion,andasmallermotorroot,whichoriginatesinthemotornucleusofV.2Threedivisions:theophthalmic,maxillaryandmandibularnerves.Trigeminalnerve(1)Theophthalmicnerve:sensorydistributioninthefaceabovethefissureoftheeye.LacrimalNFrontalNNasocilliaryNLacrimalN

FrontalNNasocilliaryNLacrimlNFrontalN(2)Themaxillarynerve:

sensorydistributioninthefacebetweenthefissuresoftheeyeandthemouth

InfraorbitalNZygomaticNPterygopalatineN

Superioralveolarnerves:upperteethandgumInfraorbitalNZygomaticNPterygopalatineNSuperioralveolarN(3)ThemandibularN:sensorydistributioninthefacebelowthefissureofthemouth,themotorfiberstosupplythemasticatorymuscles,mylohyoid,tensortympanimuscleAuriculotemporalN:receivefibersfromCNIXBuccalNLingualN:receivethechordatympani(facialnerve)InferioralveolarN:lowerteethandgumNervesofmasticatorymusclesClinicalanatomyTrigeminalneuralgia(atypeoffacialpain)CranialnerveVIIthefacialnerve1Components:(l)Somaticefferentfibers:fromthefacialnucleusandsupplythemusclesofexpression

(2)Visceralefferentfibers:fromthesuperiorsalivatorynucleusandcontrolthesecretionofthelacrimalgland,thesubmandibularandsublingualsalivaryglandsandthemucousmembraneofthenoseandpalate(3)Visceralafferentfibers:fromthecellsofthegeniculateganglion.Theperipheryprocessesoftheganglioniccellsaredistributedtothetastebudsontheanterior2/3ofthetongue.2.Course:Thefacialnervepassesthroughtheinternalacousticmeatus,andentersthefacialcanal.Thenerveleavesthefacialcanalthroughthestylomastoidforamen,thenrunsforwardintotheparotidgland.Finally,itisdistributedtomusclesofexpression.FacialNwithinthefacialcanalFacialNoutsidefacialcanal3.ThebrancheswithinthefacialcanalGreaterpetrosalnerve:distributedtothelacrimalglandandtheglandsofthenoseandpalate.Chordatympani:distributedtothemucousmembranecoveringtheanterior2/3ofthetongue,thesubmandibularandsublingualglands.Stapedialnerve

GreaterpetrosalN.

Chordatympani(medialview)Chordatympani(lateralview)ChordatympaniFacialnerve4.Thebranchesoutsidethefacialcanalsupplythemusclesofexpression:TemporalbranchesZygomaticbranchesBuccalbranchesMarginalmandibularbranchCervicalbranchFacialN.outsidethefacialcanal5Theparasympatheticganglia

(l)Pterygopalatineganglion:Thefibersofthegreaterpetrosalnervearerelayedintheganglion.Thecellsintheganglionsendthepostganglionicfiberstothelacrimalglandandthemucousmembraneofthenasalcavityandpalate.

Pterygopalatineganglion(2)Thesubmandibularganglion

Thefibersofthechordatympanienterandarerelayedintheganglion.Thecellsintheganglionsendthepostganglionicfiberstodistributetothesubmandibularandsublingualglandsandcontroltheirsecretions.Submandibularganglion6TheclinicalfeaturesofthefacialnervelesionLesioninthefacialcanalwrinklesontheforeheadaresmoothedout,theeyecannotshutvoluntarily,thenasolabialfoldbecomessmooth;theangleofmouthdrawtotheunaffectedside;lossoftasteintheanterior2/3ofthetongue;reducedsalivation;soundsareveryloudduetotheparalysisofthestapedius.(2)Lesionoutsidethefacialcanal:paralysisofthemusclesofexpressiononly.CranialnerveVIIIThevestibulocochlear(acoustic)nerveItconsistsofchoclearnerveandvestibularnerve.1Thecochlearnerve(forhearing):Fibersfrombipolarcellsinthecochlear(spiral)ganglionconsistofperipheralprocessesthataredistributedtothespiralorgan(organofhearing).Andcentralprocessesformthecochlearnerveandendintheventralanddorsalcochlearnuclei.

2Thevestibularnerve(forequilibrium):Fibersfrombipolarcellsinthevestibularganglionconsistoftheperipheralprocessesthataredistributedtotheampullaeofthesemicircularcanalsandthemaculasoftheutricleandsaccule(organofbalance),andthecentralprocessesformthevestibularnerveandendinthevestibularnuclei.Vestibularnerve

CranialnerveIX

Theglossopharyngealnerve1Components:①Somaticefferentfibers:fromtheambiguousnucleusandsupplythestylopharyngeus;②Visceralefferentfibers:frominferiorsalivatorynucleusandcontrolthesecretionoftheparotidgland;③Visceralafferentfibers:fromtheinferiorgangliontosupplythemucousmembraneofthepharynx,thetonsil,themiddleear,theposterior1/3ofthetongue,andthecarotidglomusandthecarotidsinus;④Somaticafferentfibers:fromthesuperiorganglionandsupplytheskinoftheposteriorsurfaceoftheauricle.GlossopharyngealN2Course:Thenerveleavestheskullthroughthejugularforamen,andpassesforwardsbetweentheinternaljugularveinandinternalcarotidarterytoreachtherootofthetongue.GlossopharyngealN3ThemainbranchesTympanicnerve:

entersthetympaniccavitytoformthetympanicplexus.Theplexusgivesoffmanybranchestothemucousmembraneofthemiddleear.Thelesserpetrosalnervearisesfromthisplexusandenterstheoticganglionandisrelayedintheganglion.Thecellsintheganglionsendthepostganglionicfiberstodistributetotheparotidgland.TympanicnerveCarotidsinusbranch(oftendouble):descendsalongtheinternalcarotidarterytothewallofcarotidsinusandthecarotidglomus.Lingualbranches:distributedtotheposterior1/3ofthetongue.Theycontainsbothfibersofspecialsense(taste)andofgeneralsensations.Pharyngealbranches:distributedtothepharynxandthestylopharyngeus.

CarotidsinusbranchLingualbranch4Theoticganglion:

itspreganglionicfiberscomefromthelesserpetrosalnerve.Thepostganglionicfiberspassthroughacommunicatingbranchtotheauriculotemporalnervewhichsuppliestheparotidgland.

CranialnerveXThevagusnerve

1Components:①Visceralefferentfibers:fromthedorsalnucleusofvagusnerve,andendintheparaorganicorinterorganicparasympatheticganglionsinthethroacicandabdominalcavities.Thepostganglionicfiberssupplythesmoothmuscles,cardiacmusclesandglandsoftheviscera.②Visceralafferentfibers:fromtheinferiorganglionofvagusnerveandterminateinthenucleusofsolitarytract.Theperipheralprocessesofthisganglioniccellsaredistributedtothevisceraoftheneck,thoraxandabdomen.③Somaticafferentfibers:fromthesuperiorganglionofvagusnerveandendinthespinalnucleusoftrigeminalnerve.Theperipheralprocessesofthisganglioniccellssuppliestheskinoftheauricleandexternalacousticmeatusandcerebralduramater.④Somaticefferentfibers:fromtheambiguousnucleusandsupplythemusclesofthelarynxandthepharynx.2Course:leavestheskullthroughthejugularforamenanddescendswithinthecarotidsheath.Thevagusnerveentersthethoraxandformsthepulmonaryplexusandtheesophagealplexus.Leftvagusdescendsinfrontoftheesophagustoformtheanteriorvagaltrunk,rightvagusdescendsbehindtheesophagustoformtheposteriorvagaltrunk.Thevagaltrunksentertheabdominalcavitythroughtheesophagealhiatusofthediaphragmanddivideintotheirterminalbranches.

Theanteriorvagaltrunk:

dividesintotheanteriorgastricbranchesandthehepaticbranches;Theposteriorvagaltrunk:dividesintotheposteriorgastricbranchesandtheceliacbranches.3Thebranchesofthevagusnerve(1)ThebranchesintheneckSuperiorlaryngealnerve:distributedtothemucousmembraneofthelarynxabovethelevelofthefissureofglottisandthecricothyroid.Cervicalcardiacbranches:

formthecardiacplexusesanddistributedtotheheartandthewalloftheaorta.Pharyngealbranch

vaguscervicalcardiacbranchesVagusNs(2)ThebranchesinthethoraxRecurrentlaryngealnerve:entersthelarynxandthenisnamedtheinferiorlaryngealnerve.Thenervesuppliesallthemusclesoflarynxexceptforthecricothyroid,andisdistributedtothemucousmembraneofthelarynxbelowthelevelofglottis.Bronchealbranchesandtheesophagealbranches.RecurrentlaryngealN.VagusN.Posteriorview(3)Thebranchesintheabdomen

Anteriorgastricbranchesandposteriorgastricbranches:aredistributedtothestomach.Thebranchreachingtothepyloriccanalandpylorusisnamedthe“crowlsfoot".Hepaticbranches:

jointhehepaticplexusandsupplytheliverandgallbladdertoregulatethebilesecretion.

Celiacbranches:

jointheceliacplexusandsupplymostvisceraoftheabdomenandalimentarytractanteriortotransversecolon.