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322 Cranial nerves

1Nasociliary nerve. N. nasociliaris. Most medial 1 branch of the ophthalmic nerve. It courses below the superior rectus and between the superior ob-

2lique and medial rectus. A

2Communicating branch of nasociliary nerve

with ciliary ganglion. Ramus communicans

3[cum ganglio ciliari]. Any branch carrying

 

sensory fibers from the eye through the ciliary

4

ganglion to the nasociliary nerve. A

Long ciliary nerves. Nn. ciliares longi. Two long,

3

fine twigs with sympathetic fibers supplying the

5dilatator pupillae muscle and afferent fibers from the iris, ciliary body and cornea. A

64 Posterior ethmoidal nerve. N. ethmoidalis posterior. Thin nerve at the posterior end of the orbit supplying the sphenoidal sinus and poste-

7rior ethmoidal cells. A

5Anterior ethmoidal nerve. N. ethmoidalis ante-

8rior. Nerve that enters the cranial cavity (extradural part) through the anterior ethmoidal foramen. It then courses through the cribriform

9plate of the ethmoid into the nasal cavity. A B C

6Nasal branches of anterior ethmoidal nerve. Rami

10nasales [n. ethmoidalis anterior]. Collective term for the following four branches of the anterior ethmoidal nerve.

117 Internal nasal branches. Rami nasales interni.

 

 

Rami that innervate the nasal mucosa in front of

12

8

the conchae and for the anterior nasal septum. B

 

Lateral nasal branches. Rami nasales laterales. In-

 

13

9

nervate the anterior part of lateral nasal wall. B

Medial nasal branches. Rami nasales mediales. In-

 

nervate the anterior part of the nasal septum. C

1410 External nasal branch. Ramus nasalis externus. Innervates the skin on the tip of the nose and the

15nasal ala; it passes through the ethmoidal sulcus of the nasal bone. B

16

11

Infratrochlear nerve. N. infratrochlearis. It

 

passes below the trochlea of the superior oblique

 

at the inner angle of the eye and supplies the lacri-

17

mal sac, lacrimal caruncle and surrounding skin. A

 

12Palpebral branches. Rami palpebrales. Rami for part of the upper and lower eyelids. A

1813 Maxillary nerve. N. maxillaris. Second division (branch) of trigeminal nerve. It passes through the

19foramen rotundum to the pterygopalatine fossa and subsequently through the inferior orbital fissure into the orbit. A C

2014 Meningeal nerve. Ramus meningeus [medius]. Branch given off in front of the foramen rotundum.

21It supplies the dura in the region of the frontal branch of the middle meningeal artery. A

2215 Ganglionic branches. Rami ganglionici (ganglionares). Usually two rami from the pterygopalatine ganglion. They contain autonomic fibers for the

23lacrimal gland and sensory fibers from the periosteum of the orbit. A

24

16

Pterygopalatine ganglion. Ganglion pterygo-

 

 

palatinum. Parasympathetic ganglion located in

 

 

the corresponding fossa close to the spheno-

25

 

palatine foramen. Their postganglionic fibers in-

 

 

nervate the lacrimal and nasal glands. A B C

16 a

Parasympathetic root. Radix parasympathetica.

 

Communicates with the greater petrosal nerve.

16 b

Sympathetic root. Radix sympathetica. Com-

 

municates with the deep petrosal nerve.

16 c

Sensory root. Radix sensoria. Communicates

 

with the maxillary nerve.

17Orbital branches. Rami orbitales. Two to three fine rami which pass into the orbit through the inferior orbital fissure, then through the bone to the posterior ethmoidal cells and to the sphenoidal sinus. B C

18Lateral posterior superior nasal branches.

Rami nasales posteriores superiores laterales. Up to 10 fine rami which pass through the sphenopalatine foramen to the superior and middle nasal conchae and to the posterior ethmoidal cells. B

19Medial posterior superior nasal branches.

Rami nasales posteriores superiores mediales. Two to three branches which pass through the sphenopalatine foramen to the upper part of the nasal septum. C

20Nasopalatine nerve. N. nasopalatinus [[incisivus]]. It passes between the periosteum and mucosa of the nasal septum, then through the incisive canal to the anterior part of the palatine mucosa and the gingiva of the upper incisor teeth. C

20 a Long nasopalatine nerve. Nervus nasopalatinus longus.

20 b Branches to nasal septum. Rami septales nasales.

20 c Short nasopalatine nerves. Nervi nasopalatini breves.

20 d Lateral nasal branches. Rami nasales laterales.

20 e Branches to maxillary sinus. Rami sinus maxillaris.

21Pharyngeal nerve. Nervus pharyngeus. Fine nerve for the pharyngeal mucosa. B

22Greater palatine nerve. N. palatinus major. After passing through the greater palatine canal, it courses through the corresponding foramen and supplies the mucosa of the hard palate and its glands. B

23Posterior inferior nasal branches. Rami nasales posteriores inferiores. Rami for the middle and inferior nasal meatuses as well as the inferior nasal concha. B

24Lesser palatine nerves. Nn. palatini minores. They travel in their respective, slender canals, exit through the lesser palatine foramina and supply the soft palate. B

24 a Tonsillar branches. Rami tonsillares. Branches to the palatine tonsil.

25Zygomatic nerve. N. zygomaticus. It branches into the pterygopalatine fossa, passes through the inferior orbital fissure to the lateral wall of the orbit and provides an anastomotic branch to the lacrimal gland. A

26Zygomaticotemporal branch. Ramus zygomaticotemporalis. It passes through the respective foramen to the lateral wall of the orbit. A

27Zygomaticofacial branch. Ramus zygomticofacialis. It passes through the corresponding foramen to the skin on the zygomatic bone. A

Cranial nerves 323

5

11

14

320.23

 

 

 

2

3

 

 

 

 

 

 

 

12

 

 

 

 

 

 

 

 

 

 

25

 

13

15

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

16

 

26

14

 

 

 

 

27

 

 

 

 

 

 

 

 

5

 

 

 

 

 

 

A Nasociliary

and maxillary nerves

 

17

7

16

 

10

18

8

 

 

 

 

21

 

 

 

 

23

 

 

 

22

 

 

 

 

 

 

24

 

 

 

 

B Pterygopalatine ganglion and anterior ethmoidal nerve

5

13

 

17

 

 

19

9

 

 

16

 

20

C Nerves of nasal septum

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

 

324

Cranial nerves

 

 

 

1 Infraorbital nerve. N. infraorbitalis. Terminal

17 Nerve to lateral pterygoid. N. pterygoideus

1

 

 

 

branch of maxillary nerve. It passes through the

lateralis. Motor nerve for the corresponding

 

 

 

inferior orbital fissure and corresponding sul-

muscle. It frequently arises together with the

2

 

 

cus and foramen to the skin of the upper eyelid,

buccal nerve. A

 

 

 

nose, upper lip and cheek. C

18 Nerve to medial pterygoid. N. pterygoideus

 

 

 

3

 

2 Superior alveolar nerves. Nn. alveolares super-

medialis. Motor nerve for the corresponding

 

 

iores. Branches to the maxillary teeth.

muscle. It also sends small twigs to the tensor

 

 

 

 

 

3 Posterior superior alveolar branches. Rami

veli palatini and tensor tympani muscles. A

4

 

 

19 Otic ganglion. Ganglion oticum. Parasympa-

 

 

alveolares superiores posteriores. Two to three

 

 

 

branches passing through the alveolar

thetic ganglion located medial to the mandibu-

 

 

 

5

 

 

foramina to the inner surface of the maxilla.

lar nerve below the foramen ovale. It receives

 

 

They supply the maxillary sinus and the molars

tributaries from the glossopharyngeal nerve via

 

 

 

 

 

 

including their buccal gingiva. C

the lesser petrosal nerve and sends secretory

6

 

 

4

Middle superior alveolar branch. R. alve-

fibers to the parotid gland. B

 

 

 

olaris superior medius. It courses through the

20 Ramus communicans [cum nervo ptery-

7

 

 

infraorbital sulcus to the maxilla and passes

goideo mediali]. Branch which communicates

 

 

 

along the lateral wall of the maxillary sinus up

with the nerve to the medial pterygoid muscle.

 

 

 

to the superior dental plexus. C

B

85 Anterior superior alveolar branches. Rami 21 Nerve to tensor veli palatini muscle. N.

 

 

alveolares superiores anteriores. They run in

 

musculi tensoris veli palatini. It sometimes

9

 

their respective canals and via the superior

 

arises from the nerve to the medial pterygoid

 

 

dental plexus to the incisors, canines, pre-

 

muscle. B

 

 

molars and first molar tooth. C

22

Nerve to tensor tympani muscle. N. musculi

10

 

6

Superior dental plexus. Plexus dentalis superior.

 

tensoris tympani. It also sometimes arises from

 

 

 

 

Nerve plexus in the bone above the roots of the

 

the nerve to the medial pterygoid muscle. B

11

 

 

 

teeth formed by the superior alveolar rami. C

23

Buccal nerve. N. buccalis. Sensory nerve for the

 

7 Superior dental branches. Rami dentales super-

 

skin and mucosa of the cheek and the buccal

12

 

iores. Branches to the individual roots of the

 

gingiva in the region of the first molar. A

 

teeth. C

24

Auriculotemporal nerve. N. auriculotem-

 

 

 

 

13

8

Superior gingival branches. Rami gingivales su-

 

poralis. It usually encircles the middle mening-

 

periores. Rami to the gingiva. C

 

eal artery, sends a small branch to the temporo-

 

9

Inferior palpebral branches. Rami palpe-

 

mandibular joint and then passes upward be-

14

 

tween the ear and superficial temporal artery

 

brales inferiores. Rami given off to the lower

 

 

 

eyelid outside of the infraorbital foramen. C

 

to the skin of the temporal region. A

 

 

25

Nerve to external acoustic meatus. N. mea-

15

10

External nasal branches. Rami nasales ex-

 

tus acustici externi. Usually two small branches

 

 

terni. Branches to the outside of the nasal ala. C

 

 

 

 

for the skin of the external acoustic meatus. A

 

11

Internal nasal branches. Rami nasales interni.

 

16

 

26

Fine branches to the tympanic membrane.

 

 

Branches to the skin of the nasal vestibule. C

 

Rami membranae tympani. A

 

12 Superior labial branches. Rami labiales su-

 

17

27

Parotid branches. Rami parotidei. Small

 

periores. Rami to the skin and mucosa of the

 

 

upper lip. C

 

branches supplying the parotid gland. A

 

 

 

18

 

28

Branches communicating with the facial

13

Mandibular nerve. N. mandibularis. Third divi-

 

nerve. Rami communicantes [cum n. faciali].

 

 

sion (branch) of the trigeminal nerve. It passes

 

 

 

 

They carry parasympathetic fibers from the otic

19

 

through the foramen ovale and into the in-

 

 

 

ganglion to the parotid gland via the facial

 

fratemporal fossa. Besides sensory fibers, it

 

 

 

 

nerve. A

 

 

contains motor fibers for the masticatory

 

20

 

muscles. A

29

Anterior auricular nerves. Nn. auriculares

 

14 Meningeal branch (nervus spinosus). Ramus

 

anteriores. They supply the anterior surface of

 

 

the pinna. A

21

 

meningeus (n. spinosus). It passes through the

 

 

 

Superficial temporal rami. Rami temporales

 

foramen spinosum accompanied by both 30

 

 

 

 

branches of the middle meningeal artery and

 

superficialis. Branches supplying the skin of the

22

 

supplies the dura, a part of the sphenoidal sinus

 

temporal region in front of and above the ear. A

 

 

and the mastoid air cells. A

 

 

 

 

 

 

2315 Masseteric nerve. N. massetericus. Motor nerve for the masseter muscle passing above the lateral pterygoid muscle and through the

24mandibular notch. A

16 Deep temporal nerves. Nn. temporales pro-

25fundi. Motor nerves passing to the temporalis muscle from below. A

Cranial nerves 325

30

 

 

 

 

 

13

 

 

26 14

 

16

29

 

 

24

 

 

 

 

 

 

 

 

 

 

 

 

25

 

 

 

 

15

 

17

 

 

 

 

 

 

 

 

 

28

18

 

 

 

 

 

 

 

27

23

 

 

 

 

 

 

20

21

22

19

A Mandibular nerve

B Otic ganglion

10

1

3

 

4

 

 

9

 

 

 

 

 

11

 

 

 

 

 

 

 

 

 

 

 

 

 

5

 

 

66

8

 

 

 

7

 

 

 

 

 

 

12

7

 

8

 

 

 

 

 

 

 

 

C Maxillary nerve

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

 

326

Cranial nerves

 

 

 

 

 

1

Lingual nerve. N. lingualis. A branch of the 17

Otic ganglion. Ganglion oticum. Parasympa-

1

 

 

mandibular nerve that arches anteriorly be-

thetic ganglion located medial to the mandibu-

 

 

 

tween the lateral and medial pterygoid muscles

lar nerve below the foramen ovale. It communi-

2

 

 

to the floor of the mouth where it lies near a

cates with the glossopharyngeal nerve via the

 

 

 

wisdom tooth directly below the mucosa. A B C

lesser petrosal nerve and sends secretory fibers

 

2

Branches to isthmus

of

the fauces. Rami

into the parotid gland. C

3

 

 

 

isthmi faucium (rami fauciales). It also 18

ABDUCENT NERVE (VI). N. abducens [VI]. Sixth

 

 

 

 

 

 

branches to the tonsils. A

 

cranial nerve. It exits the brain in the angle be-

4

 

 

 

3

Communicating rami

to

the hypoglosal

tween the pons and pyramid, penetrates the

 

dura at the level of the middle of the clivus,

 

 

 

nerve. Rami communicantes [cum n. hypo-

5

 

 

glosso]. It lies on the hyoglossus muscle. A

passes laterally into the cavernous sinus and

 

 

then through the inferior orbital fissure into

 

4

Communicating ramus to the chorda tym-

 

the orbit where it supplies the rectus lateralis

6

 

 

pani nerve. Ramus communicans [cum chorda

muscle. D

 

 

 

tympani]. A

 

 

 

75 Sublingual nerve. N. sublingualis. It passes lateral to the sublingual gland into the mucosa of the floor of the mouth and into the gingiva of

8the anterior mandibular teeth. A

6Lingual branches. Rami linguales. Numerous

9rami containing sensory and taste fibers from the anterior two-thirds of the lingual mucosa. A

107 Ganglionic branches. Rami ganglionares. Rami communicating with the submandibular

11

 

ganglion. A

8 Submandibular ganglion. Ganglion subman-

 

 

 

dibulare. Parasympathetic ganglion above or in

12

 

 

front of the submandibular gland. Synaptic sta-

 

 

tion for preganglionic fibers of the chorda tym-

 

 

13

 

pani with postganglionic fibers for the sublin-

 

gual and submandibular glands. A

 

 

 

9 Inferior alveolar nerve. N. alveolaris inferior.

14

 

Largest branch of mandibular nerve with

 

 

 

 

sensory and motor components. It passes 1 cm

15

 

behind the lingual nerve and through the man-

 

 

dibular foramen into the mandibular canal. A B

 

 

 

 

C

16

 

10

Mylohyoid nerve. N. mylohyoideus. Coursing

 

 

in the mylohyoid groove and then below the

17

 

 

mylohyoid muscle, this motor nerve supplies

 

 

the mylohyloid muscle and the anterior belly of

 

 

18

 

the digastric. A B C

11 Inferior dental plexus. Plexus dentalis infe-

 

 

19

 

rior. Plexus of nerves within the mandibular

 

canal. B

 

 

 

12

Inferior dental branches. Rami dentales inferi-

20

 

ores. Rami for the mandibular teeth. B

 

 

 

13 Inferior gingival branches. Rami gingivales inferi-

21ores. Rami for the buccal gingiva of the mandibular teeth (except for the first molar). B

2214 Mental nerve. N. mentalis. Sensory nerve exiting from the mental foramen below the 2nd pre-

23molar tooth. B

15 Mental branches. Rami mentales. Branches

supplying the chin. B

24

16 Labial branches. Rami labiales. Branches sup-

25

plying the lower lip. B

16 a Gingival branches. Rami gingivales. B