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Updated: Sep 18 2021

Cranial Nerves

  • Overview
    • Illustration by Ava Yap

  • Snapshot
    • A 35-year-old woman presents to the emergency department with left eye vision loss and headache. She was in her usual state of health until 3 hours prior to presentation, when she developed vision loss and eye pain that worsened with eye movement. She reports that approximately 8 months ago she had left arm numbness that self resolved. On physical exam, her visual acuity is 20/185, and a sluggish response to light on the left eye with the swinging flash-light test is noted. (Optic neuritis likely secondary to multiple sclerosis.)
  • Introduction
      • Cranial Nerves
      • Cranial Nerve
      • Type
      • Function
      • Cranial Exit
      • Notes
      • Olfactory nerve (I)
      • Sensory
      • Olfaction
      • Cribiform plate
      • Only CN without thalamic relay to the cortex
      • Cribiform plate fracture can lead to anosmia
      • Optic nerve (II)
      • Sensory
      • Vision
      • Optic canal
      • -
      • Oculomotor nerve (III)
      • Motor
      • Eye movement via the
        • superior, inferior, and medial rectus
        • inferior oblique muscle
      • Pupillary constriction
      • Accomodation
      • Eyelid opening via innervation of the
        • levator palpebrae muscle
      • Superior orbital fissure
      • Center contains output to ocular muscles which is affected primarily 1st by vascular disease
      • Periphery contains parasympathetic output which is affected 1st by compression
      • Trochlear nerve (IV)
      • Motor
      • Eye movement via innervation of the superior oblique muscle
      • Superior orbital fissure
      • -
      • Trigeminal nerve (V)
      • Motor and sensory
      • Mastication via the mandibular nerve (V3)
      • Facial sensation via the
        • ophthalmic nerve (V1)
        • maxillary nerve (V2)
        • mandibular (V3)
      • Ophthalmic nerve (V1)superior orbital fissure
      • Maxillary nerve (V2)
        • foramen rotundum
      • Mandibular nerve (V3)
        • foramen ovale
      • Mediates the jaw jerk reflex
      • Abducens nerve (VI)
      • Motor
      • Eye movement via innervation of the
        • lateral rectus
      • Superior orbital fissure
      • -
      • Facial nerve (VII)
      • Motor and sensory
      • Facial movement
      • Taste from the anterior 2/3 of tongue
      • Lacrimation
      • Salivation via innervation of the
        • submandibular gland
        • sublingual gland
      • Eyelid closing via innervation of the
        • orbicularis oculi muscle
      • Stapedius
        • dampens excessive sound
      • Internal auditory meatus
      • Visceral sensation recieved by nucleus solitarius
      • Vestibulocochlear nerve (VIII)
      • Sensory
      • Hearing
      • Balance
      • Internal auditory meatus
      • -
      • Glossopharyngeal nerve (IX)
      • Motor and sensory
      • Taste from posterior 1/3 of tongue
      • Swallowing
      • Salivation
        • parotid gland
      • Monitoring carotid body and sinus chemo- and baroreceptors
      • Stylopharngeus
        • elevates pharynx and larynx
      • Jugular foramen
      • Motor output orginates in nucleus ambiguus
      • Visceral sensation recieved by nucleus solitarius
      • Vagus nerve (X)
      • Motor and sensory
      • Taste from epiglottic region
      • Swallowing
      • Palate elevation
      • Midline uvula
      • Talking
      • Coughing
      • Thoracoabdominal viscera
      • Monitoring aortic arch chemo- and baroreceptors
      • Can cause vasovagal syncope in response to an emotional stimulus
      • Jugular foramen
      • Motor output originates in nucleus ambiguus
      • Visceral sensation recieved by nucleus solitarius
      • Parasympathetic fibers to heart, lungs, and upper GI orginates from dorsal motor nucleus
      • Gives recurrent laryngeal nerve which innervates all laryngeal muscles except cricothyroid
      • Accessory nerve (XI)
      • Motor
      • Head turning and shoulder shrugging
        • sternocleidomastoid muscle
        • trapezius
      • Jugular foramen
      • Motor output originates in nucleus ambiguus
      • Hypoglossal nerve (XII)
      • Motor
      • Tongue movement
      • Hypoglossal canal
      • -
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