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Cranial Nerves
 
 

CN VII: Facial Nerve

 
 
 
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Overview

  • Roles

  • Special sensory (taste) - anterior â…” of tongue
  • Somatic sensory - external ear, posterior auricle (Ramsay-Hunt zone)
  • Somatic motor - facial expression, eye closing
  • Visceral motor (parasympathetic) - submandibular & sublingual salivary glands, lacrimal glands, nasal & palatine glands

Facial Nerve Palsy

  • Abnormalities

  • Facial droop / weakness
  • Inability to close eye
  • Loss of taste
  • Dry eyes / mouth
  • Causes of Facial Nerve Palsy

  • Supranuclear
  • Ischaemic stroke (lacunar or superior cerebellar artery)
  • Tumour - primary / secondary
  • Nuclear / Infranuclear
  • Bell’s palsy (idiopathic)
  • Ramsay-Hunt syndrome (Herpes zoster)
  • Tumour - primary / secondary
  • Parotid gland pathology
  • Otitis media / externa
  • Skull fracture
  • Guillain-Barre
  • Ischaemia
  • Lyme disease
  • Leprosy

Motor Pathway

Cortical Centre
Primary motor cortex (precentral gyrus)
 
 
Facial Motor Nucleus
Pons
 
Foramen
Internal auditory meatus
 
Geniculate Ganglion
 
Division
Temporal, zygomatic, buccal, marginal mandibular and cervical branches
 
 
Muscles
Facial expression, orbicularis oculi

Special Sensory Pathway

Gustatory Cortex
Insula
 
 
Thalamus
 
 
Facial Sensory Nucleus
Pons
 
 
Foramen
Internal auditory meatus
 
Geniculate Ganglion
 
Chorda Tympani Nerve
Sensory and parasympathetic fibres
 
 
Receptors
Anterior â…” of tongue

Parasympathetic Pathway

Visceral Nuclei
Superior salivatory & lacrimal nuclei (pons)
 
Pathway
Tegmentum, red nucleus, medial substantia nigra
Foramen
Internal auditory meatus
 
Geniculate Ganglion
 
 
Muscle
Lacrimal glands, salivary glands, nasal & palatine glands
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