cranialnerve

目錄二、腦神經(jīng)：(一) 數(shù)目：(二)順序和名稱：(三)纖維成分：(四)分布：1、嗅神經(jīng)(Ⅰ)olfactorynerve2、視神經(jīng)(Ⅱ)opticnerve3、動眼神經(jīng)(Ⅲ)oculomotornerve4、滑車神經(jīng)(Ⅳ)trochlearnerve5、三叉神經(jīng)(Ⅴ)trigeminalnerve6、展神經(jīng)(Ⅵ)abducentnerve7、面神經(jīng)(Ⅶ)facialnerve8、前庭蝸神經(jīng)(Ⅷ)vestibulocochlearnerve9、舌咽神經(jīng)(Ⅸ)glossopharyngealnerve10、迷走神經(jīng)(Ⅹ)vagusnerve11、副神經(jīng)(Ⅺ)accessorynerve12、舌下神經(jīng)(Ⅻ)hypoglossalnerve1.順序和名稱Ⅰ

嗅神經(jīng)Ⅱ

視神經(jīng)Ⅲ

動眼神經(jīng)Ⅳ

滑車神經(jīng)Ⅴ

三叉神經(jīng)Ⅵ

展神經(jīng)Ⅶ

面神經(jīng)Ⅷ

前庭蝸神經(jīng)Ⅸ

舌咽神經(jīng)Ⅹ

迷走神經(jīng)Ⅺ

副神經(jīng)Ⅻ

舌下神經(jīng)二、腦神經(jīng)2.纖維成分共4種

軀體運(yùn)動纖維

軀體感覺纖維

內(nèi)臟運(yùn)動纖維（副交感纖維）

內(nèi)臟感覺纖維每對腦神經(jīng)纖維數(shù)目、種類不同

一嗅二視三動眼，四滑五叉六外展，七面八前九舌咽，十迷一副舌下全。腦神經(jīng)概況嗅神經(jīng)

視神經(jīng)

動眼神經(jīng)

滑車神經(jīng)

三叉神經(jīng)

展神經(jīng)

面神經(jīng)

前庭蝸神經(jīng)

舌咽神經(jīng)

迷走神經(jīng)

副神經(jīng)

舌下神經(jīng)

按腦神經(jīng)纖維成分和功能分類(1)感覺神經(jīng):Ⅰ、Ⅱ、Ⅷ(2)運(yùn)動神經(jīng):

Ⅲ、Ⅳ、Ⅵ、Ⅺ、Ⅻ(3)混合神經(jīng):Ⅴ、Ⅶ、Ⅸ、ⅩNamesofcranialnervesⅠOlfactorynerveⅡOpticnerveⅢOculomotornerveⅣTrochlearnerveⅤTrigeminalnerveⅥAbducentnerveⅦFacialnerveⅧVestibulocochlearnerveⅨGlossopharyngealnerveⅩVagusnerveⅪAccessorynerveⅫHypoglossalnerveCranialnervesSensorycranialnervesN.LocationofcellbodyandaxoncategoriesCranialexitTerminalnucleiMainactionⅠOlfactorycells(SVA)CribrifomforaminaOlfactorybulbSmellⅡGanglioncells(SSA)OpticcanalLateralgeniculatebodyVisionⅧVestibularganglion(SSA)InternalacousticmeatusVestibularnucleiEquilibriumCochlearganglion(SSA)CochlearnucleiHearingOlfactorynerveOlfactorymucosa→Cribriformforamina→OlfactorybulbOpticnerveGanglioncell→Opticcanal→LateralgeniculatebodyVestibulocochlearnerveVestibularganglion

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↗

VestibularnucleiInternalacousticmeatus

Cochlearganglion↗

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Cochlearnuclei MotorcranialnervesN.NucleusoforiginandaxoncategoriesCranialexitMainactionⅢNucleusofoculomotor(GSE)SuperiororbitalfissureMotottosuperior,inferiorandmedialrecti;inferiorobliquus;levatorpalpebraesuperiorisAccessorynucleusofoculomotor(GVE)ParasympathetictosphincterpupilleaandciliarymusclⅣNucleusoftrochlearnerve(GSE)SuperiororbitalfissureMotortosuperiorobliquusⅥNucleusofabducentnerve(GSE)SuperiororbitalfissureMotortolateralrectusⅪNucleusofaccessorynerve(SVE)JugularforamenMotortosternocleidomastoidandtrapeziusⅫNucleusofhypoglossalnerve(GSE)HypoglossalcanalMotottomusclesoftongue3.分布Ⅰ嗅神經(jīng)

分布——鼻腔嗅部粘膜。組成——嗅細(xì)胞的中樞突，組成嗅絲。Olfactorynerves(NI)OlfactoryNerve(CNI)TheOlfactorynervecontainsspecialsensoryafferentfibersthattransmitthesensationofsmellfromtheolfactoryepitheliumtotheolfactorybulblocatedsuperiortothecribriformplateoftheethmoidbone.Theolfactorybulbtransmitssecondarysensoryneuronsbacktotheolfactoryareasofthebrainviatheolfactorytract.1、嗅神經(jīng)(olfactorynerve)(Ⅰ)：嗅神經(jīng)是由嗅細(xì)胞（雙極神經(jīng)元）的中樞突集合成的20多條嗅絲。(1)連接腦的部位：大腦半球額葉下面的嗅球。(2)進(jìn)入顱腔的孔裂：篩孔。(3)分布與功能：鼻腔嗅部粘膜，傳導(dǎo)嗅覺。LocationofCranialNervesThecranialnervesastheyemergefromthebrainandspinalcordOpticnerves(NII)NasalcrossingOpticNerve(CNII)Notalltheopticnervefiberscrossattheopticchiasma,ratherthereispartialdecussationofopticfibers.Fibersfromthenasalhalfofeachretinacrosstotheoppositeside;thosefromthetemporalhalfofeachretinaareuncrossed.Thisdecussationofnervefibersresultsintherightoptictractconveyingimpulsesfromtheleftvisualfieldandviseversa.2、視神經(jīng)(opticnerve)(Ⅱ)：視神經(jīng)是視網(wǎng)膜神經(jīng)節(jié)細(xì)胞的軸突在視神經(jīng)盤處集合而成。(1)連接腦的部位：間腦的外側(cè)膝狀體。(2)進(jìn)入顱腔的孔裂：視神經(jīng)管。(3)分布與功能：視網(wǎng)膜視部，傳導(dǎo)視覺。OpticNerves:IIFibersarisefromretinatoformsensorynerveConvergetoformopticchiasmawithpartialcrossoverEnterthalamusandsynapsethereThalamicfibersrunsasopticradiationtovisualcortexforinterpretation視覺visual傳導(dǎo)通路感受器視錐、桿細(xì)胞周圍突第一級N元視網(wǎng)膜雙極細(xì)胞中樞突第二級N元視網(wǎng)膜神經(jīng)節(jié)細(xì)胞交叉視交叉第三級N元兩側(cè)外側(cè)膝狀體投射纖維兩側(cè)視輻射(內(nèi)囊后肢)兩側(cè)距狀溝兩側(cè)皮質(zhì)大腦皮質(zhì)視N兩側(cè)視束視網(wǎng)膜雙極細(xì)胞周圍突視網(wǎng)膜雙極細(xì)胞中樞突睫狀N節(jié)外側(cè)膝狀體OpticNerve(CNII)Lesions3、動眼神經(jīng)(oculomotornerve)(Ⅲ)：(1)連接腦的部位：中腦的腳間窩。(2)出顱腔的孔裂：眶上裂。(3)分布與功能：①軀體運(yùn)動纖維：起自動眼神經(jīng)核，支配提上瞼肌、上直肌、內(nèi)直肌、下直肌和下斜肌。②副交感纖維：起自動眼神經(jīng)副核，在眶內(nèi)進(jìn)入睫狀神經(jīng)節(jié)內(nèi)換神經(jīng)元，其節(jié)后纖維支配瞳孔括約肌和睫狀肌。(4)一側(cè)動眼神經(jīng)損傷的表現(xiàn)：上瞼下垂，眼外斜視，瞳孔擴(kuò)大，瞳孔對光反射消失。(三)動眼神經(jīng)軀體運(yùn)動纖維：支配除外直肌、上斜肌外所有眼球外肌內(nèi)臟運(yùn)動副交感纖維——睫狀神經(jīng)節(jié)

:支配瞳孔括約肌，睫狀肌Oculomotornerves(NIII,IV,VI)動眼神經(jīng)損傷表現(xiàn)上瞼下垂，眼外斜視，瞳孔散大，對光反射消失。OculamotorparalysisAbducentnerveinjury瞳孔對光反射pupillaryreflexes通路視錐細(xì)胞視桿細(xì)胞雙極細(xì)胞周圍突雙極細(xì)胞中樞突節(jié)細(xì)胞視N視交叉兩側(cè)視束

兩側(cè)上丘臂頂蓋前區(qū)兩側(cè)動眼N副核兩側(cè)動眼N兩側(cè)睫狀N節(jié)兩側(cè)睫狀短N(yùn)兩側(cè)睫狀肌？瞳孔括約肌雙極細(xì)胞光線睫狀N節(jié)外側(cè)膝狀體OculomotorNerve:IIIFibersextendfrommidbraintoeyeMixednervethatcontainsafewproprio-ceptors,butischieflymotorSuppliesfourofsixextrinsicmusclesthatmovetheeyeinitsorbit(四)滑車神經(jīng)---軀體運(yùn)動N:支配上斜肌(六)展神經(jīng)---軀體運(yùn)動N:支配外直肌Oculomotor,Trochlear&AbducentNerves(CNIII,IV,&VI)5、三叉神經(jīng)(trigeminalnerve)(Ⅴ)：

(1)連接腦的部位：腦橋。是最粗大的腦神經(jīng)。(2)出入顱腔的部位：第一支（眼神經(jīng)）眶上裂第二支（上頜神經(jīng)）圓孔第三支（下頜神經(jīng)）卵圓孔(3)分布與功能：頭面部皮膚，眼，鼻腔和口腔的大部分粘膜，牙齒，咀嚼肌和腦膜等處。①軀體感覺纖維：是三叉神經(jīng)節(jié)細(xì)胞（假單極神經(jīng)元）的突起，中樞突終止于三叉神經(jīng)腦橋核和三叉神經(jīng)脊束核；周圍突分成三支——眼神經(jīng)、上頜神經(jīng)和下頜神經(jīng)。傳導(dǎo)一般感覺。②軀體運(yùn)動纖維：起自三叉神經(jīng)運(yùn)動核，進(jìn)入下頜神經(jīng)內(nèi)隨其分布到咀嚼肌，支配其運(yùn)動。4、滑車神經(jīng)(trochlearnerve)(Ⅳ)：(1)連接腦的部位：中腦背面下丘的下方。(2)出顱腔的孔裂：眶上裂。(3)分布與功能：支配上斜肌的運(yùn)動。6、展神經(jīng)(abducentnerve)(Ⅵ)：(1)連接腦的部位：腦橋與延髓之間的溝。(2)出顱腔的孔裂：眶上裂。(3)分布與功能：支配外直肌的運(yùn)動。TrochlearNerves:IVFibersemergefrommidbraintoenterorbitsMixednerve;primarilymotorInnervatesextrinsicmusclesintheorbitAbducensNerves:VIFibersleaveinferiorponsandenterorbittoruntoeyeMixednerve;butprimarilymotorThisnervecontrolstheextrinsiceyemusclesthatabducttheeye(turnitlaterally)TrigeminalNerve(CNV)Trigeminalnerve(NV)１）眼神經(jīng)(ophthalmicnerve)：為感覺性，分布于淚腺、結(jié)膜、眼球、部分鼻腔粘膜，以及鼻背、上瞼和額、頂部的皮膚。其分布于額頂部皮膚的分支從眶上孔穿出，稱眶上神經(jīng)(supraorbitaln.)。２）上頜神經(jīng)(maxillarynerve):為感覺性，分布于上頜牙齒及牙齦、上頜竇和鼻腔的粘膜。出眶下孔延續(xù)為眶下神經(jīng)(infraorbitaln.),分布于瞼裂與口裂之間的皮膚。３）下頜神經(jīng)(mandibularnerve)：為混合性，感覺纖維分布于下頜牙齒及牙齦、頰和舌體的粘膜（管理一般感覺）以及耳顳部和口裂以下的面部皮膚。運(yùn)動纖維支配咀嚼肌的運(yùn)動。下頜神經(jīng)分布于舌體的分支，叫舌神經(jīng)(lingualn.)，它還接受面神經(jīng)味覺纖維和副交感纖維的加入。三叉神經(jīng)---混合神經(jīng)TrigeminalNerve(CNV)TheTrigeminalnervereferstoitsthreemajordivisions.Thesesdivisionsincludetheophthalmic(CNV1),themaxillary(CNV2),andthemandibular(CNV3).Thetrigeminalnervecontainsbothmotorandsensoryfibersbutisgenerallythoughtofastheprimarysensorynerveoftheface.Itisalsothenerveofthefirstbranchialarch.(五)三叉神經(jīng)眼N：眼、鼻、眶以上皮膚上頜N：上牙、鼻、上頜竇，

眶與口間皮膚下頜N：下牙、頰、舌前2/3

粘膜，口以下皮膚——下頜N：咀嚼肌

軀體感覺軀體運(yùn)動AbducensNerves:VIFibersleaveinferiorponsandenterorbittoruntoeyeMixednerve;butprimarilymotorThisnervecontrolstheextrinsiceyemusclesthatabducttheeye(turnitlaterally)7、面神經(jīng)(facialnerve)(Ⅶ)：

(1)連接腦的部位：腦橋與延髓之間的溝。(2)出入顱腔的孔裂：內(nèi)耳門→內(nèi)耳道→面神經(jīng)管→莖乳孔。(3)分布與功能：①軀體運(yùn)動纖維：起自面神經(jīng)核，支配面?。ū砬榧。?。②內(nèi)臟感覺纖維：經(jīng)下頜神經(jīng)的舌神經(jīng)分布于舌體的味蕾，司味覺。③副交感纖維：起自上泌涎核，一部分在翼腭神經(jīng)節(jié)內(nèi)換神經(jīng)元，其節(jié)后纖維分布于淚腺和鼻腔粘膜腺；另一部分加入舌神經(jīng)，在下頜下神經(jīng)節(jié)內(nèi)換神經(jīng)元，其節(jié)后纖維分布于下頜下腺和舌下腺。Facialnerve(NVI)FacialNerve(CNVII)FacialNerve(CNVII)Thefacialnerverootsemergefromthejunctionbetweentheponsandthemedulla.Itisthenervetothemusclesoffacialexpression.Inadditionitcarriestastefibersfromtheanteriortwo-thirdsofthetongueviathechordatympaninerve.Thefacialnervealsosendsparasympatheticfibersthatinnervatethesubmandibularandsublingualglands.Thefacialnervealsotransmitssensoryfibersfromasmallregionofskinaroundtheexternalacousticmeatus.FacialNerve(CNVII)(七)面神經(jīng)--混合神經(jīng)軀體運(yùn)動纖維——表情肌

（大部分）副交感纖維——淚腺,下頜下腺,

舌下腺的分泌內(nèi)臟感覺纖維——舌前2/3味覺面神經(jīng)損傷表現(xiàn)額紋鼻唇溝(4)一側(cè)面神經(jīng)損傷的表現(xiàn)：顱外損傷：患側(cè)額紋消失，鼻唇溝變淺或消失，口角偏向健側(cè)，患側(cè)不能閉眼，角膜反射消失。面神經(jīng)管內(nèi)損傷：除上述表現(xiàn)外，還有舌體味覺喪失，唾液和淚液分泌減少。FacialNerves:VIIFibersissuefromthepons,enterstemporalbone,emergesfrominnerearcavitytoruntothelateralaspectofthefaceMixednervewithfivemajorbranchesTemporal,zygomatic,buccal,mandibular,andcervicalInnervatesmusclesoffacialexpression8、前庭蝸神經(jīng)(vestibulocochlearnerve)(Ⅷ)：又稱位聽神經(jīng)，由蝸神經(jīng)和前庭神經(jīng)兩部分組成。(1)連接腦的部位：腦橋與延髓之間的溝。(2)進(jìn)入顱腔的孔裂：內(nèi)耳門←內(nèi)耳道。(3)分布與功能：前庭神經(jīng)(vestibularnerve)是前庭神經(jīng)節(jié)細(xì)胞（雙極神經(jīng)元）的中樞突，其周圍突分布于內(nèi)耳的橢圓囊斑、球囊斑和壺腹嵴。傳導(dǎo)平衡覺。蝸神經(jīng)(cochlearnerve)是蝸神經(jīng)節(jié)細(xì)胞（雙極神經(jīng)元）的中樞突，其周圍突分布于螺旋器。傳導(dǎo)聽覺。(八)位聽神經(jīng)

---軀體感覺

*前庭N節(jié)中樞突—平衡覺*蝸N節(jié)中樞突—聽覺Acousticnerve(NVIII)VestibulocochlearNerves:VIIIFibersarisefromhearingandequilibrumapparatustoenterbrainstematponsmedullaborderPurelysensoryThisnerveprovidesforhearingandbalance9、舌咽神經(jīng)(glossopharyngealnerve)(Ⅸ)：(1)連接腦的部位：延髓的側(cè)面。(2)出入顱腔的孔裂：頸靜脈孔。(3)分布與功能：①內(nèi)臟感覺纖維：分布于舌根（司味覺和一般感覺）、軟腭、咽、咽鼓管和鼓室等處的粘膜，以及頸動脈竇和頸動脈小球。②軀體運(yùn)動纖維：起自疑核，支配咽肌的運(yùn)動。③副交感纖維：起自下泌涎核，在耳神經(jīng)節(jié)內(nèi)交換神經(jīng)元，其節(jié)后纖維經(jīng)下頜神經(jīng)分支至腮腺，司分泌。(九)舌咽神經(jīng)---混合性軀體運(yùn)動纖維——咽肌副交感受纖維——腮腺內(nèi)臟感覺纖維——舌后1/3粘膜味覺咽、咽鼓管、鼓室粘膜頸內(nèi)動脈竇CranialNervesIX,X,&XIGlossopharyngealnerve(NVIII)GlossopharyngealFibersemergefrommedullaandruntothroatMixednerveprovidemotorcontroloftongueandpharynxSensoryfibersconducttasteandgeneralsensoryinfo10、迷走神經(jīng)(vagusnerve)(Ⅹ)：是行程最長、分布最廣的腦神經(jīng)。(1)連接腦的部位：延髓的側(cè)面。(2)出入顱腔的孔裂：頸靜脈孔。(3)分布與功能：①副交感纖維：起自迷走神經(jīng)背核，分布到咽、喉的腺體，胸、腹腔內(nèi)臟的平滑肌、心肌和腺體。②軀體運(yùn)動纖維：起自疑核，支配咽喉肌的運(yùn)動。③內(nèi)臟感覺纖維：分布于咽、喉和胸、腹腔內(nèi)臟。④軀體感覺纖維：分布于耳郭背側(cè)和外耳道的皮膚，中樞突止于三叉神經(jīng)脊束核。(十)迷走神經(jīng)---混合性內(nèi)臟運(yùn)動副交感纖維——咽、喉腺體，

(主要纖維成分)胸膜腔內(nèi)臟運(yùn)動軀體運(yùn)動纖維——咽喉肌軀體感覺纖維——外耳道，耳廓背側(cè)皮膚內(nèi)臟感覺纖維——咽、喉和胸腹腔內(nèi)臟CourseExitstheskullfromjugularforamenDescendsintheneckincarotidsheathbetweeninternal(orcommon)carotidarteryandinternaljugularveinRightvagusnerve

EnterthoracicinletonrightsideoftracheaTravelsdownwardposteriortorightbrachiocephalicveinandsuperiorvenacavaPassesposteriortorightlungrootFormsposterioresophagealplexusFormsposteriorvagaltrunkatesophagealhiatuswhereitleavesthoraxandpassesintoabdominalcavity,thendividesintoposteriorgastricandceliacbranchesLeftvagusnerveEnterthoracicinletbetweenleftcommoncarotidandleftsubclavianarteries,posteriortoleftbrachiocephalicveinCrossesaorticarchwhereleftrecurrentlaryngealnervebranchesoffPassesposteriortoleftlungrootFormsanterioresophagealplexusFormsanteriorvagaltrunkatesophagealhiatuswhereitleavesthoraxandpassesintoabdominalcavity,thendividesintoanteriorgastricandhepaticbranchesBranchesinthoraxRecurrentlaryngealnervesRightonehooksaroundrightsubclavianartery,leftonehooksaorticarchBothascendintracheo-esophagealgrooveNervesenterlarynxposteriortocricothyroidjoint,thenerveisnowcalledinferiorlaryngealnerveInnervations:laryngealmucosabelowfissureofglottis,alllaryngeallaryngealmusclesexceptcricothyroidBronchialandesophagealbranchesBranchesinabdomenAnteriorandposteriorgastricbranchesRunclosetolessercurvatureandinnervateanteriorandposteriorsurfacesofstomachAsfaraspyloricantrumtofanoutintobranchesinawaylikethedigitsofacrow’sfoottosupplypyloricpartHepaticbranches:joinhepaticplexusandthensupplyliverandgallbladderCeliacbranches:sendbranchestoceliacplexustobedistributedwithsympatheticfiberstoliver,pancreas,spleen,kidneys,intestineasfarasleftcolicflexureVagusNerves:XFibersemergefromm