Cranial Nerve

Aka: Cranial Nerve, Cranial Nerve Anatomy

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II. Anatomy: General

  1. Twelve Cranial Nerves arise from nucleii spread throughout the Brainstem and innervate the head and neck
    1. Numbered from the most superior (CN 1 and CN 2) above the Midbrain
    2. Proceed in near numerical order to CN 12 (low Medulla) and CN 11 (upper c-spine)
  2. General anatomy of Cranial Nerves
    1. Cranial Nerves exit the Brain Stem at the anterior aspect (except CN 4)
    2. Cranial Nerves do not cross the midline (except CN 4)
  3. Function (differ from spinal nerves which carry both motor and sensory)
    1. Eight of the 12 Cranial Nerves carry only motor (CN 3,4,6,11,12) OR sensory (CN 1,2,8) signals
    2. Remaining 4 nerves are mixed motor and sensory (CN 5,7,9,10)
  4. Lesion localization
    1. Brainstem lesions may be localized, knowing the distribution of Cranial Nerves and their nucleii

III. Anatomy: Cranial Nerve Nucleii by Location

  1. Images
    1. neuroCNnucleii.png
  2. Diencephalon nucleii
    1. CN 1: Olfactory Nerve (sensory, smell)
    2. CN 2: Optic Nerve (sensory, eye)
  3. Midbrain nucleii
    1. CN 3: Oculomotor Nerve (motor, eye, Extraocular Movement)
    2. CN 4: Trochlear Nerve (motor, eye, Extraocular Movement)
  4. Pons nucleii (CN 5 nucleus extends into Midbrain, CN 7 and CN 8 nucleii extend into Medulla)
    1. CN 5: Trigeminal Nerve (mixed, face Sensation)
    2. CN 6: Abducens Nerve (motor, eye, Extraocular Movement)
    3. CN 7: Facial Nerve (mixed, face movement)
    4. CN 8: Acoustic Nerve (sensory, ear, Hearing and balance)
  5. Medulla nucleii
    1. CN 9: Glossopharyngeal Nerve (mixed, mouth, taste, Swallowing)
    2. CN 10: Vagus Nerve (mixed, mouth/autonomic, taste, Swallowing, speech)
    3. CN 12: Hypoglossal Nerve (motor, Tongue protrusion)
  6. Upper Cervical Spine nucleii
    1. CN 11: Spinal Accessory nerve (motor, neck/Shoulders, head rotation)

IV. Anatomy: Cranial Nerves by Function

  1. Pure motor Cranial Nerves
    1. CN 3: Oculomotor Nerve (eye)
    2. CN 4: Trochlear Nerve (eye)
    3. CN 6: Abducens Nerve (eye)
    4. CN 11: Spinal Accessory nerve (neck/Shoulders)
    5. CN 12: Hypoglossal Nerve (motor, Tongue)
  2. Pure sensory Cranial Nerves
    1. CN 1: Olfactory Nerve (nose - smell)
    2. CN 2: Optic Nerve (eye - Vision)
    3. CN 8: Acoustic Nerve (ear - Hearing)
  3. Mixed Cranial Nerves
    1. CN 5: Trigeminal Nerve (face)
    2. CN 7: Facial Nerve (face)
    3. CN 9: Glossopharyngeal Nerve (mouth)
    4. CN 10: Vagus Nerve (mouth/autonomic)
  4. Autonomic functions (parasympathetic)
    1. CN 3: Oculomotor Nerve
    2. CN 7: Facial Nerve
    3. CN 9: Glossopharyngeal Nerve
    4. CN 10: Vagus Nerve

V. Anatomy: Bilateral Representation of Cranial Nerve Function

  1. Unilateral peripheral lesions of Cranial Nerves typically results in unilateral deficits
  2. Unilateral cerebral Cranial Nerve lesions often do not result in deficits
    1. Most peripheral Cranial Nerves are innervated by both hemispheres (redundant innervation)
    2. CN 7 lesion affects the forehead when peripheral (Bell's Palsy) but not in a unilateral cerebral lesion
      1. However, CN 7 lesion causes contralateral lower face weakness in both central and peripheral lesions
    3. CN 10 lesion causes Hoarseness when a peripheral lesion, but not in a unilateral cerebral lesion
    4. CN 8 lesion causes Deafness when peripheral (Cochlear Nerve), but not unilateral cerebral lesion
  3. Unilateral cerebral lesions do result in deficits in some cases
    1. Central CN 1 lesions cause ipsilateral Anosmia
    2. Central CN 2 lesions cause unilateral or bilateral Vision Loss depending on cerebral lesion location
    3. Central CN 3, 4 and 6 lesions result in oculomotor deficits in both eyes (e.g. both eyes look to the lesion)
    4. Central CN 5 lesions cause Sensation loss in the contralateral face
    5. Central CN 7 lesions cause contralateral lower face weakness (but spare the forehead, see above)

VI. Anatomy: Images

  1. See Oculomotor Nerve (Cranial Nerve 3)
  2. See Trigeminal Nerve (Cranial Nerve 5)
  3. See Facial Nerve (Cranial Nerve 7)
  4. See Hypoglossal Nerve (Cranial Nerve 12)
  5. Cranial Nerve Nucleii
    1. neuroCnNucleiiMotorRedSensBlueGrayBB696.gifLewis (1918) Gray's Anatomy 20th ed (in public domain at Yahoo or BartleBy)
    2. neuroCnNucleiiMotorGrayBB697.gifLewis (1918) Gray's Anatomy 20th ed (in public domain at Yahoo or BartleBy)
    3. neuroCnNucleiiSensoryGrayBB698.gifLewis (1918) Gray's Anatomy 20th ed (in public domain at Yahoo or BartleBy)
  6. Cranial Nerves Brainstem exits
    1. neuroBrainInferiorGrayBB724.gifLewis (1918) Gray's Anatomy 20th ed (in public domain at Yahoo or BartleBy)

VII. References

  1. Gilman (1989) Manter and Gatz Essentials of Neuroanatomy and Neurophysiology, Davis, p. 87-113
  2. Goldberg (2014) Clinical Neuroanatomy, p. 24-39
  3. Netter (1997) Atlas Human Anatomy, ICON Learning, p. 110-129

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Related Studies

Ontology: Cranial nerve diseases (C0010266)

Definition (NCI) A neoplastic or non-neoplastic disorder that affects one of the cranial nerves.
Definition (MSH) Disorders of one or more of the twelve cranial nerves. With the exception of the optic and olfactory nerves, this includes disorders of the brain stem nuclei from which the cranial nerves originate or terminate.
Concepts Disease or Syndrome (T047)
MSH D003389
ICD9 352.9
ICD10 G52.9
SnomedCT 267598004, 193104009, 267709002, 276379008, 73013002
English Cranial Nerve Diseases, Unspecified disorder of cranial nerves, Cranial nerve disorder NOS, Cranial nerve disorder, unspecified, CRANIAL NERVE DIS, Cranial Nerve Disorders, CRANIAL NERVE Z DISEASES, NERVUS CRANIALIS DIS, Cranial Neuropathies, Cranial Neuropathy, Neuropathies, Cranial, Neuropathy, Cranial, Nervus Cranialis Disorder, Nervus Cranialis Disorders, Cranial nerve dis NOS, Cranial neuropathy NOS, Cranial Nerve Diseases [Disease/Finding], cranial disorders nerves, cranial nerve disease, cranial nerve diseases, cranial disease nerve, cranial neuropathies, cranial nerve disorder, cranial neuropathy, cranial nerve disorders, disorder cranial nerve, disorder of cranial nerve, disorder of cranial nerve (diagnosis), Cranial nerve disorder NOS (disorder), Other cranial nerve dis, Cranial nerve disorders NOS, Disorder of cranial nerve (disorder), Disorder of Cranial Nerve, Disorder of cranial nerve, Cranial neuropathy, Cranial nerve disorder, Cranial nerve disorder (disorder), Cranial nerve diseases, disease (or disorder); cranial nerve, Cranial nerve disorder, NOS, Cranial Nerve Disease, Cranial Nerve Disorder
Italian Patologia di nervo cranico, Patologia di nervo cranico, NAS, Disturbi dei nervi cranici non specificati, Neuropatie craniche, Neuropatia cranica NAS, Neuropatia cranica, Malattie dei nervi cranici
Dutch niet-gespecificeerde aandoening van hersenzenuwen, hersenzenuwaandoening NAO, hersenzenuwneuropathie, hersenzenuwneuropathie NAO, aandoening; hersenzenuw, Aandoening van hersenzenuw, niet gespecificeerd, hersenzenuwaandoening, Aandoening, hersenzenuw-, Aandoeningen, hersenzenuw-, Craniale neuropathie, Hersenzenuwaandoening, Hersenzenuwaandoeningen, Neuropathie, craniale, Zenuwaandoening, hersen-
French Atteinte des nerfs crâniens SAI, Atteinte non précisée des nerfs crâniens, Neuropathie des nerfs crâniens, Neuropathie des nerfs crâniens SAI, Atteinte des nerfs crâniens, Affections des nerfs crâniens, Atteintes des nerfs crâniens, Atteintes des paires crâniennes, Neuropathies par atteinte des nerfs crâniens, Pathologie des nerfs craniens
German Affektion der Hirnnerven NNB, unspezifische Erkrankungen der Hirnnerven, Krankheit eines Hirnnerven, nicht naeher bezeichnet, kranielle Neuropathie NNB, Neuropathie eines Hirnnerven, Hirnnervenerkrankung, Hirnnervenkrankheiten, Kranielle Neuropathien, Neuropathien, kranielle
Portuguese Afecção NE dos nervos cranianos, Lesão de nervo craniano NE, Neuropatia craniana, Neuropatia craniana NE, Lesão de nervo craniano, Doenças dos Nervos Cranianos, Neuropatias Cranianas
Spanish Trastorno no especificado de los pares craneales, Trastorno de los pares craneales NEOM, Neuropatía craneal NEOM, Neuropatía craneal, trastorno de par craneal, SAI, trastorno de par craneal, SAI (trastorno), trastorno de los nervios craneales (trastorno), trastorno de los nervios craneales, trastorno de los nervios craneanos, trastorno de nervio craneal (trastorno), trastorno de nervio craneal, Trastorno de los pares craneales, Enfermedades de los Nervios Craneales, Neuropatías Craneales
Japanese 脳神経障害, 脳神経障害ＮＯＳ, 詳細不明の脳神経障害, ﾉｳｼﾝｹｲｼｮｳｶﾞｲNOS, ﾉｳｼﾝｹｲｼｮｳｶﾞｲ, ｼｮｳｻｲﾌﾒｲﾉﾉｳｼﾝｹｲｼｮｳｶﾞｲ, 脳神経麻痺, 脳神経疾患, ﾉｳﾆｭｰﾛﾊﾟﾁｰNOS, 脳ニューロパチー, 脳ニューロパチーＮＯＳ, ﾉｳﾆｭｰﾛﾊﾟﾁｰ
Swedish Hjärnnervsjukdomar
Finnish Aivohermojen sairaudet
Russian CHEREPNYE NEIROPATII, CHEREPNYKH NERVOV BOLEZNI, CHEREPNYE NEIROPATII MNOZHESTVENNYE, CHEREPNO-MOZGOVYKH NERVOV BOLEZNI, ЧЕРЕПНО-МОЗГОВЫХ НЕРВОВ БОЛЕЗНИ, ЧЕРЕПНЫЕ НЕЙРОПАТИИ, ЧЕРЕПНЫЕ НЕЙРОПАТИИ МНОЖЕСТВЕННЫЕ, ЧЕРЕПНЫХ НЕРВОВ БОЛЕЗНИ
Czech Porucha hlavového nervu, Porucha hlavového nervu NOS, Blíže neurčená porucha hlavových nervů, Kraniální neuropatie NOS, Kraniální neuropatie, kraniální neuropatie, nemoci kraniálních nervů, neuropatie hlavových nervů, kraniální nervy - onemocnění, nemoci hlavových nervů
Korean 상세불명의 뇌신경 장애
Croatian KRANIJALNI ŽIVAC, BOLESTI
Polish Choroby nerwów czaszkowych
Hungarian Agyideg betegség k.m.n., Cranialis neuropathia, Agyideg betegség, Az agyidegek nem meghatározott betegsége, Cranialis neuropathia k.m.n.
Norwegian Hjernenervesykdommer, Kranial nevropati, Sykdommer i hjernenervene
Derived from the NIH UMLS (Unified Medical Language System)

Ontology: Cranial Nerves (C0010268)

Definition (FMA) Neural tree organ which is continuous with the brain. Examples: Trochlear nerve, facial nerve.
Definition (NCI) Any of the 12 paired nerves that originate in the brain stem.
Definition (NCI_CDISC) Any of the 12 paired nerves that originate in the brain stem. (NCI)
Definition (MSH) Twelve pairs of nerves that carry general afferent, visceral afferent, special afferent, somatic efferent, and autonomic efferent fibers.
Definition (CSP) twelve pairs of nerves that carry general afferent, visceral afferent, special afferent, somatic efferent, and autonomic efferent fibers.
Concepts Body Part, Organ, or Organ Component (T023)
MSH D003391
SnomedCT 25238003
LNC LP30533-1, MTHU014006
English Cranial Nerves, Nerve, Cranial, CN - Cranial nerve, Set of cranial nerves, Cranial nerves set, Nervus cranialis, Cranial nerves, Cranial neural tree organ, Structure of cranial nerves, Nerves.cranial, cns cranial nerves, cranial nerve, Cranial neural tree (organ), cranial nerves, Nervi encephalici, Nervi craniales, Nerves, Cranial, CRANIAL NERVE, NERVE, CRANIAL, Cranial nerve, Cranial nerve structure, Cranial nerve structure (body structure), Cranial nerve, NOS, Nerves (Cranial), Cranial Nerve
French Nerfs crâniens, Nerf crânien
Swedish Hjärnnerver
Czech kraniální nervy, mozkové nervy
Finnish Aivohermot
Russian CHMN, CHEREPNYE NERVY, CHEREPNO-MOZGOVYE NERVY, ЧЕРЕПНО-МОЗГОВЫЕ НЕРВЫ, ЧЕРЕПНЫЕ НЕРВЫ, ЧМН
Croatian KRANIJALNI ŽIVCI
Latvian Galvas smadzeņu nervi
Spanish par craneal, nervio craneano, estructura de un par craneal (estructura corporal), estructura de un par craneal, estructura de nervio craneano, estructura de nervio craneano (estructura corporal), par craneano, nervio craneal, Nervios Craneales
Polish Nerwy czaszkowe
Norwegian Hjernenerver, Nervi craniales
German Hirnnerven
Italian Nervi cranici
Dutch Hersenzenuw, Hersenzenuwen, Nervi craniales, Zenuw, hersen-
Portuguese Nervos Cranianos
Derived from the NIH UMLS (Unified Medical Language System)

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