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CRANIAL NERVES & MOTOR SYSTEM

LIFE CONTROL MODULE, WEEK FOUR

ANATOMY SPECIFIC LEARNING OBJECTIVES


Following this session, student should
1. Identify all 12 cranial nerves
2. Describe the function, origin, course, and passage through skull for all 12 cranial nerves
3. Identify internal brainstem anatomy relevant to the cranial nerves
4. Identify and describe elements of the motor system (motor areas of the cerebral cortex, thalamus,
brainstem and spinal cord)
5. Identify major parts of a typical spinal nerve, and what types of fibres (sensory, motor or both) are
carried in each part.

PRACTICAL EXERCISES
Gross Anatomy
Firstly, review the anatomy of the brainstem.
Identify parts of the brainstem on an isolated brainstem specimen or model. On a medial view of the brain,
identify the main components of the brainstem.

What is the order of these components from cranial to caudal end?


Moving to the pons, look at a specimen with the cerebellum removed.
Identify the floor of the fourth ventricle.
Identify the facial colliculus, the vagal and the hypoglossal triangles–(all in the floor of the 4th ventricle).
Look at a specimen of the medulla oblongata.
Find the gracile and cuneate tubercles, the pyramids and the olives.
Identify the central canal passing out of the medulla oblongata into the spinal cord.
Examine the brainstem in a whole brain or brain model
On a whole brain, how much of the midbrain is visible?
What structures can you see?
On a dorsal aspect of the midbrain, identify the four colliculi.
On the ventral surface, identify the cerebral peduncles. Note the interpeduncular fossa.

CRANIAL NERVES
Examine skulls + brains with good ventral surfaces to enable you to identify the 12 pairs of cranial nerves

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There are 12 bilaterally paired cranial nerves; these carry afferent (sensory) and efferent (motor)
fibres between the brain and peripheral structures, mainly the head and neck.

Nerves I+II attach directly to forebrain, and the rest to the brain stem.

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Nerve No. + Name Type of Part of CNS Cranial Exit Functions
Axons nerve emerges
from
I. Olefactory Sensory Forebrain: Foramina in Smell (special)
*telencephalon cribriform place of Innervate olfactory epithelium via
*diencephalons ethmoid bone olfactory bulb.
II. Optic Sensory Midbrain Optic Canal Vision
III. Oculomotor Motor Brainstem - Pons Superior Orbital Movements of eye + eyelid.
Fissure Parasympathetic control of pupil size.
IV. Trochlear Sensory Midbrain
(posterior
surface)
V. Trigeminal Sensory + Trigeminal
• Ophthalmic Motor ganglion Superior orbital
• Maxillary fissure
• Mandibular Foramen rotundum
Foramen ovale
VI. Abducens Motor Brainstem: Pons Superior orbital
fissure
VII. Facial Motor Pons Internal acoustic Motor – facial expression / scalp /
(brachial) meatus stapedius
Sensory Facial canal Taste – anterior ⅔ of tongue + palate
Motor Stylomastoid Parasymp – submandibular/sublingual
(visceral) foramen salivary glands + nose/palate glands.
VIII.Vestibulocochlear Sensory Says
IX. Glossopharyngeal Sensory + Big
Motor
X. Vagus Sensory + Breasts
Motor
XI. Accessory (spinal) Motor Matter
XII.Hypoglossal Motor More

Name + Axon-types Mnemonics:


NAME: Oh Oh Oh To Tough And Feel Virgin Girls Vagina And Hymen
AXON TYPE: Some Say Marry Money But My Brother Says Big Breasts Matter More
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Firstly, identify the 3 cranial fossae in the base of the skull, + what parts of the brain are in contact
with these fossae. Then identify the location of the brainstem in relation to the base of the skull.
____________________________________________________________________
Examine the base of the skull to find the following named foramina.
For the foramen lacerum, ask a tutor to demonstrate this on a real skull, and explain why the
foramen lacerum differs in a skull and a living person.
Complete the list of what passes THROUGH each foramen in life.
Structure Contents What passes through each foramen

Cribriform plates and crista galli Olfactory Nerve (CI)


Optic canal Optic Nerve (CII)
Opthalmic Artery + sympathetic nerves
Superior orbital fissure Oculomotor nerve (III) – superior/inferior
Trochlear nerve (IV)
Ophthalmic nerve (V1) - lacrimal, frontal + nasociliary
branches
Abducens nerve (VI)
Ophthalmic vein
sympathetic fibers from cavernous plexus
Foramen rotundum Trigeminal – Maxillary (CV2)
Foramen ovale Mneumonic ‘MALE’
Mandibular nerve (V3) - of trigeminal nerve
Accessory meningeal artery
Lesser superficial petrosal nerve of (CN IX)
Emissary veins
The contents of this foramen neatly form the mnemonic
Foramen lacerum Artery of pterygoid canal
Nerve of pterygoid canal – sym/parasympathetic
Venous drainage.
Foramen spinosum Mandibular nerve (V3) branch
Middle meningeal artery
Foramen magnum Vertebral arteries, the anterior and posterior spinal arteries, the
membrana tectoria and alar ligaments.
Hypoglossal canal It transmits the hypoglossal nerve from its point of entry near the
medulla oblongata to its exit from the base of the skull near the
jugular foramen.
Jugular foramen The anterior compartment - inferior petrosal sinus.
The intermediate - glossopharyngeal, vagus, + accessory nerves.
The posterior - sigmoid sinus (becoming the internal jugular vein)
+ some meningeal branches from occipital + ↑pharyngeal arteries.
Internal auditory meatus Facial nerve (VII)
Vestibulocochlear Nerve (VIII)

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Note that the openings of the skull become important when considering the signs of raised intracranial
pressure.
On the specimens or models, identify the twelve cranial nerves. You should identify their number and
name, starting rostrally and working caudally.
Which cranial nerve originates on the dorsal aspect of the brain?
Which cranial nerves enter the cerebral cortex directly?
Which cranial nerves have fibres that originate in the spinal cord?
All of the cranial nerves, except the trochlear, arise from the ventral aspect of the brainstem. Examine the
relationship of the pituitary gland with CN II, and the relationship of the cavernous sinus with the others.
The accessory (CN XI) has spinal roots from spinal segments C1-5. These pass up through the foramen
magnum, join with the cranial roots and pass out through the jugular foramen then separate.
What do these spinal roots do?
The intracranial course of the facial nerve is long. Examine where it enters the skull and where it exits.

Would the chorda tympani branch of the facial be affected in a lesion of the facial
nerve just outside the skull?
MOTOR SYSTEMS
Using whole and dissected brains and spinal cords, coronal and horizontal sections and images,
identify the following structures:
 Cerebral cortex:
 Basal nuclei:
 Thalamus and midbrain:
 Cerebellum:
 Medulla oblongata and pons:
 Spinal cord:
As an overview of motor control, there are interconnections between cerebral cortex, basal ganglia,
thalamus, cerebellum, vestibular, olivary and reticular nuclei. Motor outputs from cerebral cortex, reticular
& vestibular nuclei. Output ofmotor neurons is determined by conscious intention, "arousal" and control
of balance. The cerebellum connects to brainstem; receives copies of motor and sensory information.

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The cerebellum is an ‘error detector’, hence cerebellar lesions result in errors in range, force & direction of
movement. Basal ganglia are areas of grey matter in the cerebrum involved in motor control. Part of this
motor preplanning involves a loop from cerebral cortex to basal ganglia to thalamus and back to cortex.
The thalamus is an important relay station (and processing centre) for both sensory and motor information.
Lesions of the basal nuclei generally produce dyskinesias; unwanted superfluous movements superimposed
on intended movement. The cerebral cortex is important in the generation of voluntary movement.
On a lateral view of the cerebral cortex find the;
 Central sulcus
 Pre and post central gyri
 Areas of the cortex associated with motor function (premotor, supplementary motor + prefrontal areas)
What is the function of each of these areas?
On coronal sections through the pre-central gyrus, identify the motor homunculus location.
How does it compare with the somatosensory homunculus in the adjacent parietal lobe?
Are they identical?
Corticospinal & Corticonuclear (bulbar) Tracts
These pathways are for control of voluntary movement.

Identify the following components of these systems, while tracing the flow of
information:
 Prefrontal, premotor, primary motor areas in the cortex
 Corona radiata and internal capsule
 Ventral thalamic nuclei
 Crus cerebri/cerebral peduncles
 Pons
 Pyramids of the medulla oblongata
 Decussation of the pyramids
 Spinal cord location of the corticospinal tracts
What occurs at the decussation of the pyramids?
What does the cortionuclear/corticobulbar portion of this tract do? Where is it
located?
Which parts of this tract do the Upper Motor Neurons run in? Lower Motor
Neurons?
Does this differ between the corticospinal and corticonuclear parts of this tract?
MEDULLARY CENTRE AND BASAL GANGLIA
The medullary centre is the white matter of the cerebrum. Some fibres run between areas in the same
hemisphere (association), some between hemispheres (commissural) and some to and from subcortical
structures (projection). The basal nuclei comprises the largest mass of subcortical grey matter and includes
the caudate nucleus, putamen, globus pallidus, subthalamic nucleus and substantia nigra. The latter two are
included because of their reciprocal connections with the other basal nuclei structures and their
involvement in motor control.

During development, the basal nuclei are subdivided into individual components because of axons
coursing to and from the cerebral cortex in the internal capsule. The corpus striatum is incompletely
subdivided into the putamen and caudate. The caudate nucleus looks a little like a tadpole with a large head
and curved tail. At the far extreme of the tail is a small swelling. This is the amygdala or amygdaloid
nucleus, which is part of the limbic system in function, and is only associated with the basal ganglia by
physical proximity. Anteriorly, the caudate nucleus is continuous with the putamen, further posteriorly;
they become separated by the internal capsule. The globus pallidus is located internal to the crescent of the
putamen, and lateral to the thalami.

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On sagittal, coronal and transverse slices of brain, identify first the layer of cortex that covers the
hemispheres. Is it of uniform thickness? If not, why not? Then, identify the following features on
prosected specimens.
 Fornix
 Hippocampus
 Thalamus
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 Internal capsule
o Anterior & posterior limbs, Genu, Retrolentiform/ retrolenticular portion
What fibres are carried in each of these parts? Where do the corticospinal tract fibres run?
Identify the parts of the basal ganglia and medullary centre on both horizontal and coronal sections
of the brain and brainstem, and plastic brain models.
The substantia nigra has a characteristic dark appearance, caused by melanin. It is located in the midbrain,
between the tegmentum and the basis pedunculi (cerebral peduncle). The subthalamic nucleus is located in
the subthalamic region, which is ventral to thalamus, medial to internal capsule in diencephalon
 Caudate nucleus
 Lentiform nucleus
 Putamen
 Globus pallidus
 External capsule
 Claustrum
 Optic radiation
 Corona radiata
On the medial surface identify the cingulate gyrus and the corpus callosum. The corpus callosum can be
divided into four regions: rostrum, genu, body and splenium.
What is the function of the corpus callosum?
Find the anterior and posterior commissures.
What is the purpose of each of the commissures?
What medial structure is separated from the globus pallidus by the internal capsule?
CEREBELLUM
This co-ordinates skilled voluntary movement by influencing muscle activity. It controls equilibrium and
muscle tone via connections to the vestibular system and the spinal cord. The cerebellum appears to act
indirectly by adjusting the output of the major descending motor systems of the brain; it may operate as a
comparator, matching intended movement with actual performance and then relaying signals about any
mismatch to premotor and motor cortices. There is a somatotopic representation of the body within the
cerebellar cortex.
External anatomy of the cerebellum
Within which depression of the skull does the cerebellum lie?
Identify the cerebellar hemispheres and the vermis. Notice how the vermis is continuous with the
hemispheres on either side. Observe all the grooving (folia) on the surface of the cerebellum - Do these
grooves run deep?
 Primary and posterolateral fissures
 Anterior and posterior lobes, flocconodular lobe
 Right and left hemispheres,
 Inferior vermis, superior vermis,
 Cerebellar tonsils
 cerebellar peduncles
There are 3 functional divisions of the cerebellum, each with its own set of connections.
Archicerebellum - Vestibulocerebellum
Paleocerebellum - Spinocerebellum
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Neocerebellum - Cerebrocerebellum
What are the locations of the functional lobes of the cerebellum?
With which structure is the upper surface of the cerebellum in contact?
Anteriorly, the cerebellum presents a wide notch called the anterior cerebellar notch.
What structures reside in this notch?
Identify the primary fissure that separates the anterior lobe from the middle lobe.
Together, what are the anterior and middle lobes called?
Identify the flocculus. What cranial nerve lies immediately above the flocculus?
Identify the superior medullary velum in sagittal specimens. This velum stretches between the superior
cerebellar peduncle and forms the roof of the 4th ventricle. Revise the relationship of the 4th ventricle to
surrounding structures.
Internal anatomy of the cerebellum and the role of the cerebellum in motor control
On sagittal specimens, identify the cortex and white matter.
Can you see deep cerebellar nuclei in the white matter?
Identify the superior, middle and inferior peduncles. What are the principal
structures to which these peduncles connect?
Observe the inferior colliculi that lie above where the superior peduncles merge with the brain.
Observe how the lateral boundary of the 4th ventricle is formed in part by the superior + inferior peduncles.
Identify Cerebellar Features in Sagittal Section
 The cerebellar vermis
 Tonsil
 Cerebellar hemisphere
 4th ventricle
BRAINSTEM
The brainstem integrates motor commands descending from higher levels. It also processes information
ascending from the spinal cord as well as from the special senses. All descending motor pathways to the
spinal cord, with the exception of the corticospinal tract, originate in the brainstem. The brainstem is the
motor system particularly concerned with making postural adjustments, and some stereotyped movement
patterns. (See cranial nerve section for more information on brainstem)
Spinal cord
In the spinal cord, the grey area is the H-shaped central region, surrounded by white matter. Grey matter
contains cell bodies and is related to processing of information, while the white matter contains cell
processes that transport information from one area to another. Descending the spinal cord, the amount of
"motor traffic" decreases, so the cross-sectional area of white matter decreases. Cervical and lumbar
enlargements of the spinal cord are related to the increased cross-sectional area of grey matter involved
with processing of upper and lower limb sensory and motor information.
Spinal Cord
 Dorsal and ventral roots
 Dorsal and ventral rami
 Cervical and Lumbosacral enlargements
 Conus medullaris
 Cauda equina
 Filum terminale
 Dorsal root ganglia
 Spinal nerves
 Sympathetic chain
Note the cervical and lumbar swellings. These swellings hold neurons that supply the limbs.
Examine the conus medullaris, the cauda equina and filum terminale. The filum terminale can be
identified amongst the dull yellow roots of the cauda equina as a whiter strand.
On cross-sections of the spinal cord at several levels, locate the position of the lateral and anterior
(ventro) medial columns (fasciculi).
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Where does the corticospinal tract pass?
Where do the vestibulospinal and reticulospinal tracts lie?
How far does the tectospinal tract extend inferiorly?

Identify the following structures mentioned in these descriptions of these 3 tracts, and trace the flow
of information.
Dorsal Columns
The first order neuron begins distally as a receptor. It travels through a peripheral nerve, then posterior root
into the spinal cord to enter the posterior columns of white matter on the same side (ipsilaterally).
Information from the lower limbs ascends more medially in the gracile fasciculus, while upper limb
information travels in the cuneate fasciculus. Fibres in the gracile and cuneate fasciculi are somatotopically
arranged. First order neurons that enter from below the midthoracic level synapse in the gracile nucleus in
the medulla oblongata, while neurons that enter above the midthoracic level synapse in the cuneate
nucleus. The second order neurons leave the gracile and cuneate nuclei and curve anteriorly as the internal
arcuate fibres then ascend through the brainstem in the medial lemniscus. The second order neuron
synapses in the ventral posterior nucleus of the thalamus. The third order neuron passes through the
posterior limb of the internal capsule to reach the postcentral gyrus (primary somatesthetic area of parietal
lobe).
Spinothalamic Tract
This tract carries pain, temperature, light touch and firm pressure. The first order neuron begins distally as
a receptor. It travels in a peripheral nerve, then the posterior root into spinal cord to synapse in the
posterior horn. The second order neuron decussates, and then forms an ascending tract in the anterolateral
white matter. The tract continues in the brainstem as the spinal lemniscus and the second order neuron
synapses in the ventral posterior thalamic nucleus. The third order neuron passes through the posterior
limb of the internal capsule to the postcentral gyrus. There are interneurons acting upon the secondary and
tertiary neurons of the pathway. In addition, the activity of secondary neurons is influenced by descending
fibres that originate in the cerebral cortex and the brainstem.
Spinocerebellar Tracts
Dorsal and ventral tracts carry information from muscle spindles, Golgi tendon organs and touch receptors
for the control of posture and co-ordination of movement. This is a 2 neuron pathway. Dorsal SCT is
ipsilateral (travels through inferior cerebellar peduncle). Ventral SCT decussates, ascends (through the
superior cerebellar peduncle), and then often decussates again.
SUMMARY
Students should review their lecture notes and practical notes following the session, to
consolidate their learning. All questions should be attempted.

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