-
Cranial Nerves Carrying sympathetics
- Cranial nerves III, VII, IX, X
- Ciliary: CN III
- Pterygopalantine: CNVII lacrimal gland/tears
- Otic: CN IX parotid gland
- Submandibular: CNVII innervation of submandibular and sublingual glands
-
Olfactory Nerve [I]
- Test: smell coffee or soap
- Injury: patient can't smell
- Traverses cribiform plate and can be damaged in head trauma
- Tumors can compress olfactory bulb resulting in ipsilateral anosmia
-
Optic Nerve [II]
- Emerges from ganglion cells of retina, nerve ends in optic chiasm, becomes optic tract
- Testing: Ophthalmoscope
- Injury: blindness, abnormal pupillary light reflex
- Marcus Gunn pupil: if light is shown into unaffected eye, both pupils constrict, when light is shown into affected eye, both eyes appear to dilate
-
Oculomotor Nerve [III]
- Somatic component: CNIII nuclei in midbrain
- Visceral component: Nucleus of Edinger Westphal
- Somatic joins visceral at junction of midbrain and pons, traverses cavernous sinus
- Innervates 4/6 muscles that control eye movement
- Controls levator palpebrae muscle to lift upper eyelid
- Visceral motor nerve controls constriction of pupil (ciliary and constrictor pupillae muscles)
- Testing: H pattern
- Injury: ptosis (drooping of eye) if levator palpebrae is damaged
- partial ptosis (horner syndrome) if superior toursal muscle damaged
-
Trochlear Nerve [IV]
- Somatic Motor
- Innervates 1/6 muscles that controls eye muscles (superior oblique)
- Causes eye to rotate inward, and move both down and laterally
- (inferior oblique externally rotates eyes)
- Testing: Look in and down
- Injury: diplopia (double vision, patient tilts head towards unaffected side)
-
Trigeminal Nerve [V]
- General Sensory: arising from CN V nuclei in pontine area
- Branchial Motor: arises form motor nucleus from CN V
- Major trigeminal ganglion
- V1- ophthalmic - transmits all pain, temp, proprioceptive information from eye, cornea, forehead, frontal and ethmoid sinses
- V2- maxillary - transmits "..." from maxilla, nasal cavity, palate, nasopharynx, meningies of anterior and middle cranial fossa, exits via foramen rotundum
- V3- mandibular - transmits "..." from buccal region (mucous membranes of mouth), side of head and scalp, lower jaw, teeth, anterior 2/3rds of tongue, exits via foramen ovale
-
Branches of V1
- Lacrimal
- Frontal
- Nasociliary
- Meningeal
-
Branches of V2
- Zygomatic
- Infraorbital
- Pterygopalatine
- Meningeal
-
Branches of V3
- Buccal
- Auriculotemporal - hugs middle meningeal artery
- Lingual - Sensory ant 2/3rds of tongue
- Meningeal
- Inferior Alveolar
Branchial Motor component branches: medial pterygoid, masseteric, deep temporal, lateral pterygoid, nerve to mylohyoid, nerve to anterior belly of digastric
-
Trigeminal Nerve Branchial motor component
- Exits skull via foramen ovale with V3
- Runs in mandibular nerve
- Casts of tensor palatini and tensor tympani
- Medial pterygoid continues to medial pterygoid muscle
- Masseteric nerve branches off of mandibular nerve to innervate masseter
- 2-3 branches of mandibular nerve run ot deep surface of temporalis muscle
- Lower motor neuron injury results in paralysis of muscles of mastication
|
|
