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Nervous
system
Central Nervous
Peripheral
system (CNS)
Nervous system
Spina
l
nerve
s
Somatic
(voluntar
y)
Cranial
nerves
(except CN
II)
Autonomi Somatic
(voluntar
c
y)
Brai
n
Autonomi
c
Spinal
cord
1. Olfactory
Nerve
Smell
Senso
ry
Pathway:
Olfactory nerve arise
from the olfactory
receptor nerve cells in
the olfactory mucous
membrane in the
upper part of the
nasal cavity. Fibers
pass through the
opening of cribriform
plate of ethmoid bone
to enter the olfactory
bulb. Olfactory nerve
fibers runs from the
posterior end of
olfactory bulb to end
up in olfactory
Olfactory nerve
Lesion:
Unilate
Caused by lesion in olfactory
ral:
nerve, bulb, or tract:
Bilatera
l:
complete anosmia.
Why??
Olfactory nerve
Lesion:
Commonest
cause is Posttraumatic.
Parosmia: unpleasant
perception of an odour.
2. Optic Nerve
Sens
ory
vision
Pathw
ay:
Optic Nerve
Lesion
a. Total blindness of one
eye
b. Bitemporal Hemianopia
c. Nasal
Hemianopia.
d. Contralateral
Homonymous Hemianopia.
e. Quadrantanopia
(Quadrantic Hemianopia).
f. Contralateral Homonymous
Hemianopia.
Contralateral
Homonymous
Hemianopia with
macular sparing.
Light Reflex:
Exposure of one eye to bright light
leads to pupillary constriction of
the same eye (direct light reflex)
and of the opposite side
(consensual light reflex).
Pathway:
1.Exposure of the eye to bright
light send impulses along the optic
nerve (CN II), optic chiasma, and
optic tract.
2. The fibers do not reach the
lateral geniculate body but leave
optic tract to relay in pretectal
nucleus in the midbrain.
3. Then fibers pass to EdingerWestphal nucleus (CN III nucleus)
of both sides.
4. Preganglionic fibers arise from
EW nucleus and pass through the
oculomotor nerve (CN III) to relay in
Accommodation (Near)
Reflex:
when the eye is directed from a
distant to a near object:
1. Convergence of the eyes due to
contraction of both medial recti
muscles.
2. Thickening of the lens: to
increase its refractive power by
contraction of the ciliary muscle.
3. Miosis (constriction of pupils):
Ciliary
due
to contraction of theCiliary
superior
muscle
muscle
pupillae
contracte muscles. Pupils constrict
tod restrict the light waves to the
thickest part of the lens.
Pathway:
1. Afferent impulses travel
through the optic nerve,
the optic chiasma, the
optic tract, the lateral
geniculate body, and
the optic radiation to
the visual cortex in the
occipital lobe.
2. Cortical fibers descend
to the oculomotor
nuclei of both sides in
the midbrain.
3. Efferent fibers
(oculomotor nerve)
pass to the eye to
supply medial recti
3.
Oculomotor
Motor
(GSE,GV
E)
Upwa
rd
Medial
Up
and
In
Downwa
rd
4.
Trochlear
Dow
an
d
n
In
Mot
or
(GS
E)
Pathway:
The trochlear nucleus which
located in midbrain, received
corticonuclear fibers from both
cerebral hemispheres. The
nerve fiber leaves the nucleus
on the posterior surface of the
brain stem and immediately
decussates with the nerve of
the opposite side. The trochlear
nerve is entirely motor and
supplies
Lesion: the superior oblique
muscle
responsible
Doublewhich
visionison
looking for
turning
thedownward
eye downward
and
straight
e.g. when
medially.
reading or descending the
stairs.
Limitation of movement of
the affected eye on looking
inwards and downwards.
5.
Trigeminal
Sensory
(GSA)
Motor
(SVE)
Motor
nucleus
Trigeminal nerve
branches:
Trigeminal nerve leaves
the pons as a small motor
root and a large sensory
root. The sensory root
expands to form the
crescent-shaped
trigeminal ganglion which
gives rise the ophthalmic,
maxillary, and mandibular
branches. Both ophthalmic
and maxillary nerves are
entirely sensory nerves
while mandibular contains
Sensory
Sensations from the skin of
the face (Except the angle of
the mandible), the anterior
2/3 of the tongue and the
buccal cavity
Motor
supply the muscles of
mastication (temporalis,
masseter, lateral and medial
pterygoids), the tensor
tympani, the tensor veli
palatini, the mylohyid, and the
anterior belly of the digastric
muscle.
Trigeminal neuralgia:
Sever, stabbing pain over
one side of the face along
one or more of the sensory
branches of the trigeminal
nerve, usually mandibular
and maxillary of unknown
cause.
6.
Abducent
Looki
ng
side
to
Mot
or
(GS
E)
Pathway:
The nucleus of the abducent
nerve lies in the lower part of the
pons. It receives corticonuclear
fibers from both cerebral
hemispheres. Abducent nerve
emerge in the groove between
the lower border of the pons and
the medulla oblongata. It pass
forward to supply lateral rectus
muscle which moves the eye
outwards (laterally).
Lesion:
1. Limitation of movement of the
affected eye on looking
laterally.
2. Internal strabismus:
because unopposed medial
7.
Facial
Motor (SVE,
GVE)
Sensory (SVA)
Smile
and
Taste
for the
anterior
2l3 of
sensory
nucleus
Muscles of
the upper
half of the
face receives
corticonuclea
r fibers from
both
cerebral
hemisphere
s while
muscles of
the lower
half of the
face receives
corticonuclea
r fibers from
Lesions:
Upper motor neuron lesion (UMNL): damage affecting the
descending tract above the facial main motor nucleus.
Lower motor neuron lesion (LMNL): damage affecting the facial
motor nucleus or the nerve itself.
UMNL
LMNL
Corneal
Reflex
Light touch of the cornea
of conjunctiva results in blinking of
the eyelids.
Afferent impulses: ophthalmic division of trigeminal nerve
to the sensory nucleus of trigeminal nerve.
Efferent impulses: travel through facial nerve to both
orbicularis oculi muscles which causes closure of the
eyelids.
8.
Sens
vestibulocochlearory
Heari
ng
and
balan
ce
(SSA)
Cochlear nerve:
Cochlear nerve has 2 nuclei (anterior and posterior
neucli). Cochlear nerve conducts nerve impulses
concerned with sound from the organ of Corti in the
cochlea to the primary auditory cortex (area 41 and 42).
Lesion:
1. Tinnitus.
2. Deafness.
9.
Glossopharyngeal
Motor (SVE)
Poster
ior 1/3
of the
tongu
e
Speech
10. Vagus
Motor (GVE,
SVE)
Sensory
(SVA, GVA,
GSA)
Lesion:
In glossopharyngeal nerve lesion: there will be no response when
touching the affected side.
With vagal nerve damage: the soft palate will elevate and pull
toward the intact side regardless of the side of the pharynx that is
touched
If both CN IX and X are damaged on one side (not uncommon),
stimulation of the normal side elicits only a unilateral response,
with deviation of the soft palate to that side; no consensual
response is seen. Touching the damaged side produces no response
at all
11.
Accessory
Should
er
shrug
Moto
r
(SVE)
12.
Hypoglossal
Mot
or
(GSE
)
Tongue
movem
ent
Hypoglossal nerve is
entirely motor and supplies
the intrinsic muscle of the
tongue as well as
genioglossus, styloglossus,
and hypoglossus to control its
movements and shape.
Greater part of the
hypoglossal nucleus receives
corticonuclear fibers from
both cerebral hemispheres.
However, the cells in
hypoglossal nucleus
responsible for supplying the
genioglossus muscle (muscle
that pulls the tongue
forward) only receive
corticonuclear fibers from the
opposite cerebral
hemisphere.
Summary
Cranial
nerve
Branche
s
Compon
ent
Function
(I)
Olfactory
Sensory
Smell
(II) Optic
Sensory
Vision
Motor
Parasymp
athetic
Constricts pupil.
motor
(III)
Oculomot
or
(IV)
Trochlear
(V)
Trigeminal
:
Ophtha
lmic
Sensory
Maxilla
ry
Sensory
Mandib
ular
Sensory
Motor
Muscles of mastication.
Motor
Motor
(VI)
Abducent
(VII)
(VIII)
Vestibulococ
hlear
(IX)
Glossophary
ngeal
(X) Vagus
(XI)
Accessory
(XII)
Vestibu
lar
Cochlea Sensory
r
Sensory
hearing
Motor
Parasymp
athetic
Sensory
Motor
Sensory
Cranial
Motor
Spinal
Motor
Motor