CRANIAL NERVES: Functional Anatomy

163 Pages·2006·1.44 MB·English

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CRANIAL NERVES
Functional Anatomy
Cranial nerves are involved in head and neck function,and
processes such as eating,speech and facial expression.This clinically
orientedsurvey ofcranial nerve anatomy and function was written
for students ofmedicine,dentistry and speech therapy,but will also
beuseful for postgraduate physicians and general practitioners,and
specialists in head and neck healthcare (surgeons,dentists,speech
therapists, etc.). After an introductory section surveying cranial
nerve organization and tricky basics such as ganglia,nuclei and brain
stem pathways,the nerves are considered in functional groups:(1)
for chewing and facial sensation;(2) for pharynx and larynx,swal-
lowing and phonation;(3) autonomic components,taste and smell;
(4) vision and eye movements;and (5) hearing and balance.In each
chapter,the main anatomical features ofeach nerve are followed by
clinical aspects and details of clinical testing.Simple line diagrams
accompany the text.Detailed anatomy is not given.
Stanley Monkhouse is Anatomist at the University ofNottingham
at Derby (Graduate Entry Medicine). He has been an examiner
at the Royal Colleges of Surgeons of England and Ireland; at the
Universities ofNottingham,Leeds,Newcastle-upon-Tyne,London,
Belfast,Dublin (Trinity College),National University ofIreland,King
AbdulAziz University (Jeddah,Saudi Arabia),Amman (Jordan) and
King Faisal University (Dammam,Saudi Arabia).

CRANIAL NERVES
Functional Anatomy
STANLEY MONKHOUSE
MA,MB,BChir,PhD
University ofNottingham Medical School at Derby
Sometime Professor ofAnatomy at the Royal College of
Surgeons in Ireland;Lecturer in Human Morphology at the
University ofNottingham;and Clinical Assistant in Ear Nose
and Throat,Queen’s Medical Centre,Nottingham
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CONTENTS
List ofFigures page vii
List ofTables ix
Acknowledgements xi
A note to the reader xiii
Part I Organization ofthe cranial nerves 1
1 General considerations 3
2 Cranial nerve motor fibres and nuclei 17
3 Cranial nerve motor pathways:upper and
lower motor neurons 24
4 Cranial nerve sensory fibres,brain stem sensory
nuclei and tracts 31
Parts II–V Individual cranial nerves and functional
considerations 39
5 Survey ofcranial nerves and introduction to Parts II–V 41
Part II Trigeminal,facial and hypoglossal nerves 45
6 Cutaneous sensation and chewing 47
7 The trigeminal nerve (V) 50
8 The ophthalmic nerve (Va) 52
9 The maxillary nerve (Vb) 56
10 The mandibular nerve (Vc) 60
11 The facial nerve (VII) 66
12 The hypoglossal nerve (XII) 74
vi Contents
Part IIIGlossopharyngeal,vagus and accessory nerves77
13 Swallowing and speaking,bulbar palsy,
pseudobulbar palsy,Broca’s area 79
14 The glossopharyngeal nerve (IX) 83
15 The vagus nerve (X) 86
16 The accessory nerve (XI) 92
Part IV Autonomic components ofcranial nerves,
taste and smell 95
17 Parasympathetic components and taste sensation 97
18 Smell:The olfactory nerve (I) 106
19 The sympathetic nervous system in the head 109
PartV Vision,eye movements,hearing and balance:
optic,oculomotor,trochlear,abducens and
vestibulocochlear nerves113
20 The optic nerve (II) 115
21 The oculomotor (III),trochlear (IV) and
abducens (VI) nerves121
22 Visual reflexes:the control ofeye movements;
clinical testing ofII,III,IV and VI 128
23 The vestibulocochlear nerve (VIII) and auditory
and vestibular pathways 133
Further reading140
Index 143
FIGURES
1.1 Attachments ofcranial nerves,anterior view page 8
1.2 Attachments ofcranial nerves,lateral view 9
1.3 Ganglia and nuclei 12
2.1 Cranial nerve motor nuclei 23
3.1 Corticonuclear pathways 26
4.1 Trigeminal sensory system 34
7.1 Trigeminal nerve 51
8.1 Ophthalmic nerve 53
9.1 Maxillary nerve 57
10.1 Mandibular nerve 61
11.1 Facial nerve (intracranial) 67
11.2 Facial nerve (extracranial) 68
12.1 Hypoglossal nerve 75
14.1 Glossopharyngeal nerve 84
15.1 Vagus nerve 87
16.1 Accessory nerve 93
17.1 Head and neck parasympathetics 100
17.2 Taste pathways 102
18.1 Olfactory pathways 107
20.1 Visual pathways 116
21.1 Oculomotor nerve 122
21.2 Trochlear nerve 123
21.3 Abducens nerve 124
viii Figures
22.1 Pupillary light reflex 128
23.1 Auditory pathways 134
23.2 Vestibular pathways 136