12 Cranial Nerves innervations, functions and abnormalities

Num ber Nerves Innervations Olfactory mucos Function s Smell Abnormalities

Temporary impairment from common cold; head trauma resulting in Parosmia (perversion of sense of smell); compression of

Olfactory

Olfactory bulb by meningiomas or anterior fossa aneurysm; tumor infiltration in frontal lobe; or temporal lobe lesions, resulting in Olfactory hallucinations.

Ganglion cells of retina Vision

Optic neuritis, toxic substances ( fro example, alcohol abuse ), head trauma, chronic nephritis, Diabetes mellitus, anemia,

II

Optic

nutritional deficiencies, multiple sclerosis, chronic hypertension, intracranial tumors or aneurysms, or increased intracranial pressure.

III

Oculomoto r

All extraocular muscles except the lateral rectus and superior oblique Sphincter pupillae muscle Ciliary muscle All extraocular muscles except the lateral rectus and superior oblique

Eye movemen t Pupillary constricti on Lens accommo dation Kinestheti c sens Eye movemen Chewing Tenses tympanic membran e

Lid ptosis, with inability to completely open eye; eyeball deviated outward and slightly downward; pupil dilated and unreactive to light; nystagmus, and accommodation power lost. .

Inability to turn eye downward or outward.

IV V

Trochlear Trigeminal

Superior oblique Muscles of mastication: temporalis masseter medial pterygoid lateral pterygoid

Trauma, tic douloureux ( Trigeminal Neuralgia ), intracranial tumor, menigeal infection, intracranial aneurysm; when only descending tract is affected,

VI

Abducens

Mylohyoid, anterior belly of the digastric Tensor tympani Tens veli palatini Scalp, anterior two-thirds of the dura, cornea, conjunctiva, face, paranasal sinuses, teeth, gingiva, and anterior two-thirds of the tongue Muscles of mastication Periodontal ligament Lateral rectus Superior oblique

Tenses soft palate General sensation Muscle stretch sensation Pressure sensation

syringobulbia ( cavities in medulla oblongata ) and multiple sclerosis. Also, pons lesion produces masticatory muscle paralysis and light touch sensation loss in face. Medulla lesion affecting descending tract causes pain and produces loss of temperature sensation and corneal reflex.

VII

Facial

VIII

VestibuloC ochlear

Muscles of facial expression, platysma, posterior belly of the digastric, and stylohyoid Stapedius Lacrimal gland Glands of the nasal cavity and palate Submandibular and sublingual glands Anterior two-thirds of the tongue Middle ear, nasal cavity, and soft palate External auditory meatus and area posterior to ear Organ of Corti (inner ear) Utricle Saccule Semicircular canal ampullae (inner ear)

Eye movemen t Kinestheti c sense Facial expressio n Tension on stapes Lacrimati on Mucous secretion Salivation Taste Visceral sensation General sensatio Hearing Equilibriu m

Eyeball deviated inward, diplopia, paralysis of lateral gaze.

Trauma to peripheral nerve branches, mastoid surgery complication, temporal bone fracture, intracranial tumor or aneurysm, meningitis, herpes zoster, Pagets disease ( a chronic disease of bones occurring in the elderly and most frequently affecting the skull, back bone, pelvis, and long bones. Affected bones becomes thickened and their structure disorganized: X-ray reveal patchy sclerosis. Severe continuous pain may result, which relieved by a prolonged course of Thyrocalcitonin injections.), and Bells Palsy.

Inflammation; intracranial tumor; drug toxicity, particularly from Aspirin, Quinine, or Streptomycin; middle fossa skull fracture

IX

Glossopha ryngeal

Stylopharyngeus and pharyngeal constrictors Parotid gland Posterior one-third of the tongue and adjacent pharyngeal wall

Swallowin g Salivation Taste Visceral sensation

Intracranial tumor or infection.

Vagus

XI

Spinal Accessory

Middle ear, pharynx, tongue, carotid sinus Posterior one-third of the tongue, soft palate, upper pharynx, and auditory tube Thoracic and abdominal viscera Muscles of the larynx and pharynx Epiglottis Thoracic and abdominal viscera Carotid body Area posterior to the ear, external acoustic meatus, and posterior part of meninges Laryngeal muscles To sternocleidomastoid and trapezius

General sensation

Gland secretion, peristalsis Phonation Taste Visceral sensation General sensation

Acute anterior poliomyelitis, intramedullary lesions; syringobulbia, vascular lesions, amyotrophic lateral sclerosis, multiple sclerosis.

Phonation Head and shoulder movemen ts Tongue movemen t

Extrasmedullary tumors, occipital bone necrosis, inflammation, syringobulbia, amyotrophic lateral sclerosis, demyelinating diseases of the medulla. Syringobulbia, amyotrophic lateral sclerosis, alcoholism, or CVA

XII

Hypogloss al

Muscles of the tongue