Neurology Book

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Cranial Nerve 7

Aka: Cranial Nerve 7, Cranial Nerve VII, Facial Nerve, CN 7, Geniculate Ganglion, Superior Salivatory Nucleus, Superior Salivary Nucleus
  1. See Also
    1. Cranial Nerve
    2. Neuroanatomy
    3. Head and Neck Anatomy
  2. Causes: Paralysis
    1. Multiple Sclerosis
    2. Neoplasm
    3. Guillain-Barre Syndrome (Infectious polyneuritis)
    4. Syphilis
    5. Bell's Palsy
    6. Lyme Disease
    7. Melkersson's Syndrome (Recurrent Bell's Palsy)
    8. Poliomyelitis
    9. Amyotrophic Lateral Sclerosis (ALS)
    10. Syringomyelia
  3. Anatomy: Course to Geniculate Ganglion
    1. General
      1. Facial Nerve originates in four nucleii in pons and Medulla
      2. All combine to travel via internal auditory meatus into Geniculate Ganglion
      3. Each side of the forehead is innervated by both Cerebral Hemispheres (but only one peripheral Facial Nerve)
        1. Forehead IS involved with a peripheral Facial Nerve lesion (LMN) such as in Bell's Palsy
        2. Forehead IS NOT involved with an UMN deficit from a central lesion such as a CVA
    2. Somatic Motor Nucleii
      1. Most important of the four components
      2. Innervates muscles of facial expression (and stapedius)
      3. Originates in pons at facial nucleus (in the Brainstem somatovisceral region)
        1. First courses medially within the pons (paradoxical)
        2. Circles clockwise around 6th Cranial Nerve Nucleus
        3. Passes anterior to the Fourth Ventricle
        4. Then exits the pons
    3. Visceral Motor Nucleii
      1. Innervates lacrimal glands (via pterygopalatine Ganglion)
      2. Innervates submaxillary glands and Submandibular Glands (via submandibular Ganglion)
      3. Originates in Medulla at Superior Salivatory Nucleus (Superior Salivary Nucleus)
    4. Visceral Sensory Nucleii
      1. Transmits Taste Sensation for anterior two-thirds of Tongue
      2. Originates in Medulla at solitary tract nucleus
    5. Somatic Sensory Nucleii
      1. Transmits signals of External Ear sensation along with CN 9 and 10
      2. Originates in Medulla at spinal nucleus of Cranial Nerve 5
      3. Minimal contribution to head sensation
        1. Facial innervation is primarily CN 5
        2. Posterior scalp is primarily spinal nerve 2
  4. Anatomy: Geniculate Ganglion to motor branches
    1. Ganglion within facial canal between labyrinthine and tympanic segments
    2. Facial Nerve turns 90 degrees to travel inferiorly through stylomastoid foramen
    3. Facial Nerve branches (motor innervation)
      1. Temporal branch (forehead and eye)
      2. Zygomatic branch (vicinity of zygomatic arch)
      3. Buccal branch (cheek)
      4. Marginal mandibular branch (jaw line)
      5. Cervical branch (neck)
      6. Posterior auricular nerve branch (posterior to ear back to occiput)
  5. Anatomy: Innervation
    1. Contains motor, autonomic, and sensory fibers
    2. Motor fibers
      1. Scalp, Face, and Auricula
      2. Buccinator Muscle
      3. Platysma Muscle
      4. Stapedius Muscle (dampens sound waves; hyperacusis results when affected)
      5. Stylohyoid Muscle
      6. Posterior Belly of Digastric Muscle
    3. Autonomic motor fibers
      1. Lacrimation
      2. Vasodilatation and secretion of Salivary Glands (Submaxillary gland, Sublingual Gland)
        1. Parotid Gland is innervated by CN 9
    4. Sensory fibers
      1. Sensation to ear canal and behind ear
      2. Taste for anterior two thirds of Tongue
        1. Posterior one third is innervated by CN 9
  6. Anatomy
    1. Distribution
      1. entFacialNerveDistributionGrayBB784.gifLewis (1918) Gray's Anatomy 20th ed (in public domain at Yahoo or BartleBy)
      2. entFacialNerveBranchesGrayBB790.gifLewis (1918) Gray's Anatomy 20th ed (in public domain at Yahoo or BartleBy)
      3. neuroCn7FacialNerveGrayBB788.gifLewis (1918) Gray's Anatomy 20th ed (in public domain at Yahoo or BartleBy)
      4. neuroCn7FacialNerveInTemporalBoneGrayBB789.gifLewis (1918) Gray's Anatomy 20th ed (in public domain at Yahoo or BartleBy)
    2. Mandibular
      1. entFacialNerveMandibularGrayBB781.gifLewis (1918) Gray's Anatomy 20th ed (in public domain at Yahoo or BartleBy)
      2. entFacialNerveMandibularGrayBB782.gifLewis (1918) Gray's Anatomy 20th ed (in public domain at Yahoo or BartleBy)
  7. Exam
    1. Facial Motor Exam
      1. Forehead and Upper lid Innervation
        1. Eyebrow elevation
        2. Forehead wrinkling
        3. Frowning
        4. Tight closing of the eyes
          1. Contrast with CN 3 which opens the eyes
      2. Lower Face innervation
        1. Showing teeth
        2. Whistling
        3. Puffing cheeks
        4. Natural smile
        5. Test or inquire about Taste Sensation
    2. Distinguish level of Facial Nerve lesion
      1. Upper Motor Neuron (UMN Lesion)
        1. Unless bilateral lesion, does not affect forehead
        2. Mouth paralysis is overcome by emotional expression
      2. Lower Motor Neuron (LMN Lesion)
        1. Ipsilateral forehead and lower face paralysis
  8. References
    1. Gilman (1989) Manter and Gatz Essentials of Neuroanatomy and Neurophysiology, Davis, p. 87-113
    2. Goldberg (2014) Clinical Neuroanatomy, p. 24-39
    3. Netter (1997) Atlas Human Anatomy, ICON Learning, p. 110-129

Facial nerve structure (C0015462)

Definition (NCI_CDISC) The 7th cranial nerve. The facial nerve has two parts, the larger motor root which may be called the facial nerve proper, and the smaller intermediate or sensory root. Together they provide efferent innervation to the muscles of facial expression and to the lacrimal and salivary glands, and convey afferent information for taste from the anterior two-thirds of the tongue and for touch from the external ear. (MeSH)
Definition (NCI) The 7th cranial nerve. The facial nerve has two parts, the larger motor root which may be called the facial nerve proper, and the smaller intermediate or sensory root. Together they provide efferent innervation to the muscles of facial expression and to the lacrimal and salivary glands, and convey afferent information for taste from the anterior two-thirds of the tongue and for touch from the external ear. (MeSH)
Definition (MSH) The 7th cranial nerve. The facial nerve has two parts, the larger motor root which may be called the facial nerve proper, and the smaller intermediate or sensory root. Together they provide efferent innervation to the muscles of facial expression and to the lacrimal and SALIVARY GLANDS, and convey afferent information for TASTE from the anterior two-thirds of the TONGUE and for TOUCH from the EXTERNAL EAR.
Definition (CSP) seventh cranial nerve; has two parts, the larger motor root which may be called the facial nerve proper, and the smaller intermediate or sensory root, which together provide efferent innervation to the muscles of facial expression and to the lacrimal and salivary glands, and convey afferent information for taste from the anterior two-thirds of the tongue and for touch from the external ear.
Concepts Body Part, Organ, or Organ Component (T023)
MSH D005154
SnomedCT 56052001
English Facial Nerve, Nerve, Facial, Cranial Nerve VII, Cranial Nerve, Seventh, Nerve, Seventh Cranial, Seventh Cranial Nerve, cranial nerve VII, Nervus facialis [VII], Facial nerve tree, Branchiomeric cranial nerve, Facial nerve [VII], cranial nerve vii, nervus facialis, Cranial Nerve VIIs, Facial Nerves, Nerves, Seventh Cranial, Seventh Cranial Nerves, Nerves, Facial, Cranial Nerves, Seventh, facial nerve, seventh cranial nerve, 7n, Nervus facialis, FACIAL NERVE, NERVE, FACIAL, Nervus Faciali, Nervus Facialis, Faciali, Nervus, Nerve VII, Nerve VIIs, Facialis, Nervus, Seventh cranial nerve, Facial nerve, Cranial nerve VII, Facial nerve (VII), Facial nerve structure (body structure), Facial nerve structure, Facial nerve, NOS, Seventh cranial nerve, NOS, Nerve (Facial)
French Nerf crânien VII, Septième paire crânienne, Septième nerf crânien, Nerf crânien 7, Nerf facial
Swedish Ansiktsnerv
Czech lícní nerv, nervus facialis
Finnish Kasvohermo
Russian SED'MOI CHEREPNOI NERV, LITSEVOI NERV, VII CHEREPNOI NERV, VII ЧЕРЕПНОЙ НЕРВ, ЛИЦЕВОЙ НЕРВ, СЕДЬМОЙ ЧЕРЕПНОЙ НЕРВ
Japanese 顔面神経
German SIEBTER HIRNNERV, Gesichtsnerv, Hirnnerv VII, Nervus facialis, VII. Hirnnerv
Italian Settimo nervo cranico, Nervo cranico VII, Nervo facciale
Croatian FACIJALIS
Latvian Sejas nervs
Polish Nerw VII, Nerw twarzowy
Norwegian Ansiktsnerve, Hjernenerve 7, 7. hjernenerve, Nervus facialis
Spanish Nervio Craneal VII, VII Par Craneal, Séptimo Par Craneal, nervio facial, VII par craneal, estructura del nervio facial (estructura corporal), estructura del nervio facial, nervio facial, SAI, séptimo nervio craneal, séptimo par craneal, séptimo par craneano, Nervio Facial, Septimo Nervio Craneal, VII Nervio Craneal
Portuguese VII Nervo Craniano, VII Par Craniano, Sétimo Par Craniano, Nervo Craniano VII, Nervo Facial, Sétimo Nervo Craniano
Dutch Aangezichtszenuw, Nervus facialis, VIIe hersenzenuw
Sources
Derived from the NIH UMLS (Unified Medical Language System)


Structure of geniculate ganglion (C0017406)

Definition (MSH) The sensory ganglion of the facial (7th cranial) nerve. The geniculate ganglion cells send central processes to the brain stem and peripheral processes to the taste buds in the anterior tongue, the soft palate, and the skin of the external auditory meatus and the mastoid process.
Concepts Body Part, Organ, or Organ Component (T023)
MSH D005830
SnomedCT 113312001
English Ganglion, Geniculate, Geniculate Ganglion, Geniculate Ganglia, Ganglia, Geniculate, Ganglion geniculatum, Genicular ganglion, Ganglion genicularum, geniculate ganglion of facial nerve, geniculate ganglion, Geniculate ganglion, Facial nerve ganglion, Ganglion geniculi, Structure of geniculate ganglion (body structure), Structure of geniculate ganglion, Facial Nerve Ganglion, Genicular Ganglia, Genicular Ganglion
Swedish Geniculatumganglion
Czech ganglion geniculatum
Finnish Polvekehermosolmu
Russian KOLENCHATYI GANGLII, КОЛЕНЧАТЫЙ ГАНГЛИЙ
Japanese 膝神経節
Polish Zwój kolanka
Norwegian Geniculatumganglier, Ganglion geniculi, Ganglion geniculatum
Spanish estructura del ganglio geniculado (estructura corporal), estructura del ganglio geniculado, ganglio del nervio facial, ganglio geniculado, Ganglio Geniculado
French Ganglion géniculé, Ganglions géniculés
German Ganglion geniculi
Italian Ganglio genicolato
Dutch Ganglion geniculi
Portuguese Gânglio Geniculado
Sources
Derived from the NIH UMLS (Unified Medical Language System)


superior salivatory nucleus (C0175447)

Concepts Body Part, Organ, or Organ Component (T023)
English Superior salivatory nucleus, SuS, superior salivatory nucleus, Nucleus salivarius superior, Nucleus salivatorius cranialis, Nucleus salivatorius superior, Nucleus salivatorius rostralis
Sources
Derived from the NIH UMLS (Unified Medical Language System)


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