II. Causes: Paralysis
- Multiple Sclerosis
- Neoplasm
- Guillain-Barre Syndrome (Infectious polyneuritis)
- Syphilis
- Bell's Palsy
- Lyme Disease
- Melkersson's Syndrome (Recurrent Bell's Palsy)
- Poliomyelitis
- Amyotrophic Lateral Sclerosis (ALS)
- Syringomyelia
- Brainstem CVA
III. Anatomy: Course to Geniculate Ganglion
-
General
- Facial Nerve originates in four nucleii in pons and Medulla
- All combine to travel via internal auditory meatus into Geniculate Ganglion
- Each side of the forehead is innervated by both Cerebral Hemispheres (but only one peripheral Facial Nerve)
- Forehead IS involved with a peripheral Facial Nerve lesion (LMN) such as in Bell's Palsy
- Forehead IS NOT involved with an UMN deficit from a central lesion such as a CVA
-
Somatic Motor Nucleii
- Most important of the four components
- Innervates Muscles of facial expression (and stapedius)
- Originates in pons at facial nucleus (in the Brainstem somatovisceral region)
- First courses medially within the pons (paradoxical)
- Circles clockwise around 6th Cranial Nerve Nucleus
- Passes anterior to the Fourth Ventricle
- Then exits the pons
-
Visceral Motor Nucleii
- Innervates lacrimal glands (via pterygopalatine Ganglion)
- Innervates submaxillary glands and Submandibular Glands (via submandibular Ganglion)
- Originates in Medulla at Superior Salivatory Nucleus (Superior Salivary Nucleus)
-
Visceral Sensory Nucleii
- Transmits Taste Sensation for anterior two-thirds of Tongue
- Originates in Medulla at solitary tract nucleus
-
Somatic Sensory Nucleii
- Transmits signals of External EarSensation along with CN 9 and 10
- Originates in Medulla at spinal nucleus of Cranial Nerve 5
- Minimal contribution to head Sensation
- Facial innervation is primarily CN 5
- Posterior scalp is primarily spinal nerve 2
IV. Anatomy: Geniculate Ganglion to motor branches
- Ganglion within facial canal between labyrinthine and tympanic segments
- Facial Nerve turns 90 degrees to travel inferiorly through stylomastoid foramen
- Facial Nerve branches (motor innervation)
- Temporal branch (forehead and eye)
- Zygomatic branch (vicinity of zygomatic arch)
- Buccal branch (cheek)
- Marginal mandibular branch (jaw line)
- Cervical branch (neck)
- Posterior auricular nerve branch (posterior to ear back to occiput)
V. Anatomy: Innervation
- Contains motor, autonomic, and sensory fibers
- Motor fibers
- Autonomic motor fibers
- Lacrimation
- Vasodilatation and secretion of Salivary Glands (Submaxillary gland, Sublingual Gland)
- Parotid Gland is innervated by CN 9
- Sensory fibers
VI. Anatomy
- Central
- Distribution
Lewis (1918) Gray's Anatomy 20th ed (in public domain at Yahoo or BartleBy)
Lewis (1918) Gray's Anatomy 20th ed (in public domain at Yahoo or BartleBy)
Lewis (1918) Gray's Anatomy 20th ed (in public domain at Yahoo or BartleBy)
Lewis (1918) Gray's Anatomy 20th ed (in public domain at Yahoo or BartleBy)
- Mandibular
Lewis (1918) Gray's Anatomy 20th ed (in public domain at Yahoo or BartleBy)
Lewis (1918) Gray's Anatomy 20th ed (in public domain at Yahoo or BartleBy)
VII. Exam
- Facial Motor Exam
- Forehead and Upper lid Innervation
- Eyebrow elevation
- Forehead wrinkling
- Frowning
- Tight closing of the eyes
- Contrast with CN 3 which opens the eyes
- Lower Face innervation
- Showing teeth
- Whistling
- Puffing cheeks
- Natural smile
- Test or inquire about Taste Sensation
- Forehead and Upper lid Innervation
- Distinguish level of Facial Nerve lesion
- Upper Motor Neuron (UMN Lesion)
- Unless bilateral lesion, does not affect forehead
- Mouth paralysis is overcome by emotional expression
- Lower Motor Neuron (LMN Lesion)
- Ipsilateral forehead and lower face paralysis
- Upper Motor Neuron (UMN Lesion)
VIII. References
- Gilman (1989) Manter and Gatz Essentials of Neuroanatomy and Neurophysiology, Davis, p. 87-113
- Goldberg (2014) Clinical Neuroanatomy, p. 24-39
- Netter (1997) Atlas Human Anatomy, ICON Learning, p. 110-129
Calculation (FPnotebook.com: DrBits) Open in New Window
Images: Related links to external sites (from Bing)
Related Studies
| Definition (NCI_CDISC) | The 7th cranial nerve. The facial nerve has two parts, the larger motor root which may be called the facial nerve proper, and the smaller intermediate or sensory root. Together they provide efferent innervation to the muscles of facial expression and to the lacrimal and salivary glands, and convey afferent information for taste from the anterior two-thirds of the tongue and for touch from the external ear. (MeSH) |
| Definition (NCI) | The 7th cranial nerve. The facial nerve has two parts, the larger motor root which may be called the facial nerve proper, and the smaller intermediate or sensory root. Together they provide efferent innervation to the muscles of facial expression and to the lacrimal and salivary glands, and convey afferent information for taste from the anterior two-thirds of the tongue and for touch from the external ear. (MeSH) |
| Definition (MSH) | The 7th cranial nerve. The facial nerve has two parts, the larger motor root which may be called the facial nerve proper, and the smaller intermediate or sensory root. Together they provide efferent innervation to the muscles of facial expression and to the lacrimal and SALIVARY GLANDS, and convey afferent information for TASTE from the anterior two-thirds of the TONGUE and for TOUCH from the EXTERNAL EAR. |
| Definition (CSP) | seventh cranial nerve; has two parts, the larger motor root which may be called the facial nerve proper, and the smaller intermediate or sensory root, which together provide efferent innervation to the muscles of facial expression and to the lacrimal and salivary glands, and convey afferent information for taste from the anterior two-thirds of the tongue and for touch from the external ear. |
| Concepts | Body Part, Organ, or Organ Component (T023) |
| MSH | D005154 |
| SnomedCT | 56052001 |
| English | Facial Nerve, Nerve, Facial, Cranial Nerve VII, Cranial Nerve, Seventh, Nerve, Seventh Cranial, Seventh Cranial Nerve, cranial nerve VII, Nervus facialis [VII], Facial nerve tree, Branchiomeric cranial nerve, Facial nerve [VII], cranial nerve vii, nervus facialis, Cranial Nerve VIIs, Facial Nerves, Nerves, Seventh Cranial, Seventh Cranial Nerves, Nerves, Facial, Cranial Nerves, Seventh, facial nerve, seventh cranial nerve, 7n, Nervus facialis, FACIAL NERVE, NERVE, FACIAL, Nervus Faciali, Nervus Facialis, Faciali, Nervus, Nerve VII, Nerve VIIs, Facialis, Nervus, Seventh cranial nerve, Facial nerve, Cranial nerve VII, Facial nerve (VII), Facial nerve structure (body structure), Facial nerve structure, Facial nerve, NOS, Seventh cranial nerve, NOS, Nerve (Facial) |
| French | Nerf crânien VII, Septième paire crânienne, Septième nerf crânien, Nerf crânien 7, Nerf facial |
| Swedish | Ansiktsnerv |
| Czech | lícní nerv, nervus facialis |
| Finnish | Kasvohermo |
| Russian | SED'MOI CHEREPNOI NERV, LITSEVOI NERV, VII CHEREPNOI NERV, VII ЧЕРЕПНОЙ НЕРВ, ЛИЦЕВОЙ НЕРВ, СЕДЬМОЙ ЧЕРЕПНОЙ НЕРВ |
| Japanese | 顔面神経 |
| German | SIEBTER HIRNNERV, Gesichtsnerv, Hirnnerv VII, Nervus facialis, VII. Hirnnerv |
| Italian | Settimo nervo cranico, Nervo cranico VII, Nervo facciale |
| Croatian | FACIJALIS |
| Latvian | Sejas nervs |
| Polish | Nerw VII, Nerw twarzowy |
| Norwegian | Ansiktsnerve, Hjernenerve 7, 7. hjernenerve, Nervus facialis |
| Spanish | Nervio Craneal VII, VII Par Craneal, Séptimo Par Craneal, nervio facial, VII par craneal, estructura del nervio facial (estructura corporal), estructura del nervio facial, nervio facial, SAI, séptimo nervio craneal, séptimo par craneal, séptimo par craneano, Nervio Facial, Septimo Nervio Craneal, VII Nervio Craneal |
| Portuguese | VII Nervo Craniano, VII Par Craniano, Sétimo Par Craniano, Nervo Craniano VII, Nervo Facial, Sétimo Nervo Craniano |
| Dutch | Aangezichtszenuw, Nervus facialis, VIIe hersenzenuw |
Ontology: Structure of geniculate ganglion (C0017406)
| Definition (MSH) | The sensory ganglion of the facial (7th cranial) nerve. The geniculate ganglion cells send central processes to the brain stem and peripheral processes to the taste buds in the anterior tongue, the soft palate, and the skin of the external auditory meatus and the mastoid process. |
| Concepts | Body Part, Organ, or Organ Component (T023) |
| MSH | D005830 |
| SnomedCT | 113312001 |
| English | Ganglion, Geniculate, Geniculate Ganglion, Geniculate Ganglia, Ganglia, Geniculate, Ganglion geniculatum, Genicular ganglion, Ganglion genicularum, geniculate ganglion of facial nerve, geniculate ganglion, Geniculate ganglion, Facial nerve ganglion, Ganglion geniculi, Structure of geniculate ganglion (body structure), Structure of geniculate ganglion, Facial Nerve Ganglion, Genicular Ganglia, Genicular Ganglion |
| Swedish | Geniculatumganglion |
| Czech | ganglion geniculatum |
| Finnish | Polvekehermosolmu |
| Russian | KOLENCHATYI GANGLII, КОЛЕНЧАТЫЙ ГАНГЛИЙ |
| Japanese | 膝神経節 |
| Polish | Zwój kolanka |
| Norwegian | Geniculatumganglier, Ganglion geniculi, Ganglion geniculatum |
| Spanish | estructura del ganglio geniculado (estructura corporal), estructura del ganglio geniculado, ganglio del nervio facial, ganglio geniculado, Ganglio Geniculado |
| French | Ganglion géniculé, Ganglions géniculés |
| German | Ganglion geniculi |
| Italian | Ganglio genicolato |
| Dutch | Ganglion geniculi |
| Portuguese | Gânglio Geniculado |
Ontology: superior salivatory nucleus (C0175447)
| Concepts | Body Part, Organ, or Organ Component (T023) |
| English | Superior salivatory nucleus, SuS, superior salivatory nucleus, Nucleus salivarius superior, Nucleus salivatorius cranialis, Nucleus salivatorius superior, Nucleus salivatorius rostralis |
