腦神經(jīng)內(nèi)臟神經(jīng)內(nèi)分泌課件

The Cranial Nerves,齊齊哈爾醫(yī)學(xué)院 解剖教研室 劉富,Names of cranial nerves, Olfactory nerve Optic nerve Oculomotor nerve Trochlear nerve Trigeminal nerve Abducent nerve Facial nerve Vestibulocochlear nerve Glossopharyngeal nerve Vagus nerve Accessory nerve Hypoglossal nerve,Functional components,General somatic afferent fibers (GSA): transmit exteroceptive and proprioceptive impulses from head and face to somatic sensory nuclei Special somatic afferent fibers (SSA): transmit sensory impulses from special sense organs of vision, equilibrium and hearing to the brain General visceral afferent fibers (GVA): transmit interoceptive impulses from the viscera to the visceral sensory nuclei Special visceral afferent fibers (SVA): transmit sensory impulses from special sense organs of smell and taste to the brain General somatic efferent fibers (GSE): innervate skeletal muscles of eye and tongue Special visceral efferent fibers (SVE): transmit motor impulses from the brain to skeletal muscles derived from brachial (gill) arches of embryo. These include the muscles of mastication, facial expression and swallowing General visceral efferent fibers (GVE): transmit motor impulses from the general visceral motor nuclei and relayed in parasympathetic ganglions. The postganglionic fibers supply cardiac muscles，smooth muscles and glands,Classification of cranial nerves,Sensory cranial nerves: contain only afferent (sensory) fibers Olfactory nerve Optic nerve Vestibulocochlear nerve Motor cranial nerves: contain only efferent (motor) fibers Oculomotor nerve Trochlear nerve Abducent nerve Accessory nerv Hypoglossal nerve Mixed nerves: contain both sensory and motor fibers- Trigeminal nerve, Facial nerve, Glossopharyngeal nerve Vagus nerve,Sensory cranial nerves,Olfactory nerve,Olfactory mucosa (SVA) Cribriform foramina Olfactory bulb,Optic nerve,Ganglion cell (SSA) Optic canal Lateral geniculate body,Vestibulocochlear nerve,Vestibular ganglion(SSA) Vestibular nuclei Internal acoustic meatus Cochlear ganglion (SSA) Cochlear nuclei,Motor cranial nerves,Oculomotor nerve,Components General somatic efferent fibers (GSE) General visceral efferent fibers (GVE) Main actionsupplies Superior, inferior and medial recti; inferior obliquus; levator palpebrae superioris Sphincter pupillea and ciliary muscle Ciliary ganglion: lies between optic nerve and lateral rectus,Oculomotor nerve,Accessory nerve,Hypoglossal nerve,Oculamotor paralysis,Abducent nerve injury,Mixed cranial nerves,Trigeminal nerve,Components of fibers SVE fibers: originate from motor nucleus of trigeminal nerve, and supply masticatory muscles GSA fibers: transmit facial sensation to sensory nuclei of trigeminal nerve, the GSA fibers have their cell bodies in trigeminal ganglion, which lies on the apex of petrous part of temporal bone,Branches Ophthalmic nerve 眼神經(jīng) (1, sensory) leave the skull through the superior orbital fissure, to enter orbital cavity Branches Frontal nerve額神經(jīng): Supratrochlear nerve 滑車上神經(jīng) Supraorbital nerve 眶上神經(jīng) Lacrimal nerve 淚腺神經(jīng) Nasociliary nerve 鼻睫神經(jīng),Distribution: Sensation from cerebral dura mater Visual organ Mucosa of nose Skin above the eye and back of nose,Maxillary nerve 上頜神經(jīng)(2, sensory) Leave skull through foramen rotundum Branches Infraorbital nerve 眶下神經(jīng) Zygomatic nerve 顴神經(jīng) Superior alveolar nerve 上牙槽神經(jīng) Pterygopalatine nerve 翼腭神經(jīng),Distribution: Sensation from cerebral dura mater Maxillary teeth Mucosa of nose and mouth Skin between eye and mouth,Mandibular nerve (3, mixed) 下頜神經(jīng) Leave the skull through the foramen ovale to enter the infratemporal fossa Branches Auriculotemporal nerve 耳顳神經(jīng) Buccal nerve 頰神經(jīng) Lingual nerve 舌神經(jīng) Inferior alveolar nerve下牙槽神經(jīng) Nerve of masticatory muscles 咀嚼肌神經(jīng),Distribution: Sensation from cerebral dura mater Teeth and gum of lower jaw Mucosa of floor of mouth Anterior 2/3 of tongue Skin of auricular and temporal regions and below the mouth Motor to masticatory muscles, mylohyoid, and anterior belly of digastric,Facial nerve (),Components of fibers SVE fibers originate from nucleus of facial nerve, and supply facial muscles GVE fibers derived from superior salivatory nucleus and relayed in pterygopalatine ganglion and submandibular ganglion. The postganglionic fibers supply lacrimal, submandibular and sublingual glands SVA fiber from taste buds of anterior two-thirds of tongue which cell bodies are in the geniculate ganglion of the facial nerve and end by synapsing with cells of nucleus of solitary tract GSA fibers from skin of external ear,Course: leaves skull through internal acoustic meatus, facial canal and stylomastoid foramen, it then enters parotid gland where it divides into five branches which supply facial muscles,Branches within the facial canal Chorda tympani 鼓索: joins lingual branch of mandibular nerve To taste buds on anterior two-thirds of tongue Relayed in submandibular ganglion, the postganglionic fibers supply submandibular and sublingual glands,Greater petrosal nerve巖大神經(jīng): GVE fibers pass to pterygopalatine ganglion 翼腭神經(jīng)節(jié) and there relayed through the zygomatic and lacrimal nerves to lacrimal gland Stapedial nerve 鐙骨肌神經(jīng): to stapedius,Branches outside of facial canal Temporal Zygomatic Buccal Marginal mandibular Cervical,Pterygopalatine ganglion 翼腭神經(jīng)節(jié) : lies in pterygopalatine fossa under maxillary nerve Submandibular ganglion 下頜下神經(jīng)節(jié): lies between lingual nerve and submandibular gland,Injury to the facial nerve,Glossopharyngeal nerve (),Components of fibers SVE fibers: originate from nucleus ambiguus, and supply stylopharygeus GVE fibers: arise from inferior salivatory nucleus and ralyed in otic ganglion, the postganglionic fibers supply parotid gland SVA fibers: arise from the cells of inferior ganglion, the central processes of these cells terminate in nucleus of solitary tract, the peripheral processes supply the taste buds on posterior third of tongue GVA fibers: visceral sensation from mucosa of posterior third of tongue, pharynx, auditory tube and tympanic cavity, carotid sinus and glomus, and end by synapsing with cells of nucleus of solitary tract GSA fibers: sensation from skin of posterior surface of auricle and,Course: leaves the skull via jugular foramen Branches Lingual branches 舌支: to taste buds and mucosa of posterior third of tongue Pharyngeal branches 咽支: take part in forming the pharyngeal plexus Tympanic nerve 鼓室神經(jīng): GVE fibers via tympanic and lesser petrosal nerves to otic ganglion, with postganglionic fibers via auriculotemporal (3) to parotid gland Carotid sinus branch 頸動脈竇支: innervations to both carotid sinus and glomus Others: tonsillar and stylophayngeal branches Otic ganglion 耳神經(jīng)節(jié): situated just below foramen ovale,Vagus nerve (),components of fibers GVE fibers: originate from dorsal nucleus of vagus nerve, synapse in parasympathetic ganglion, short postganglionic fibers innervate cardiac muscles, smooth muscles and glands of viscera SVE fibers: originate from ambiguus, to muscles of pharynx and larynx GVA fibers: carry impulse from viscera in neck, thoracic and abdominal cavity to nucleus of solitary tract GSA fiber: sensation from auricle, external acoustic meatus and cerebral dura mater,Course Exits the skull from jugular foramen Descends in the neck in carotid sheath between internal (or common) carotid artery and internal jugular vein Right vagus nerve Enter thoracic inlet on right side of trachea Travels downward posterior to right brachiocephalic vein and superior vena cava Passes posterior to right lung root Forms posterior esophageal plexus Forms posterior vagal trunk at esophageal hiatus where it leaves thorax and passes into abdominal cavity, then divides into posterior gastric and celiac branches,Left vagus nerve Enter thoracic inlet between left common carotid and left subclavian arteries, posterior to left brachiocephalic vein Crosses aortic arch where left recurrent laryngeal nerve branches off Passes posterior to left lung root Forms anterior esophageal plexus Forms anterior vagal trunk at esophageal hiatus where it leaves thorax and passes into abdominal cavity , then divides into anterior gastric and hepatic branches,Branches in neck Superior laryngeal nerve: passes down side of pharynx and given rise to Internal branch, which pierces thyrohyoid membrane to innervates mucous membrane of larynx above fissure of glottis External branch, which innervates cricothyroid Cervical cardiac branches : descending to terminate in cardiac plexus Others: auricular, pharyngeal and meningeal branches,Superior laryngeal nerve,External branch,Internal branch,Branches in thorax Recurrent laryngeal nerves Right one hooks around right subclavian artery, left one hooks aortic arch Both ascend in tracheo-esophageal groove Nerves enter larynx posterior to cricothyroid joint, the nerve is now called inferior laryngeal nerve Innervations: laryngeal mucosa below fissure of glottis , all laryngeal laryngeal muscles except cricothyroid Bronchial and esophageal branches,Branches in abdomen Anterior and posterior gastric branches Run close to lesser curvature and innervate anterior and posterior surfaces of stomach As far as pyloric antrum to fan out into branches in a way like the digits of a crows foot to supply pyloric part Hepatic branches: join hepatic plexus and then supply liver and gallbladder Celiac branches: send branches to celiac plexus to be distributed with sympathetic fibers to liver, pancreas, spleen, kidneys, intestine as far as left colic flexure,The Visceral Nervous System,齊齊哈爾醫(yī)學(xué)院 解剖教研室 劉富,The Visceral Nervous System,Composition Visceral motor nerves (autonomic nervous system) Sympathetic part 交感部 Parasympathetic part 副交感部 Visceral sensory nerves,Visceral motor nerves,Main differences between somatic motor and visceral motor n.,Sympathetic part 交感部,Lower center: located in lateral gray horn of spinal cord segments T1L3 Sympathetic ganglia Paravertebral ganglia 椎旁節(jié) Prevertebral ganglia 椎前節(jié),Paravertebral ganglia 椎旁節(jié),Arranged on either side of vertebral column Consist of 1922 of oval-shaped ganglia Three cervical 1012 thoracic 4 lumbar 23 sacral Ganglion impar奇神經(jīng)節(jié): unpaired on the anterior face of coccyx,Sympathetic trunk 交感干,Formed by paravertebral ganglia and interganglionic branches Lie on either side of vertebral column from base of skull to coccyx The trunks of two side unite in front of the coccyx at a small swelling, the ganglion impar,Prevertebral ganglia 椎前節(jié),Lie anterior to vertebral column and near the arteries for which they are named Celiac ganglion 腹腔神經(jīng)節(jié) Aorticorenal ganglion 主動脈腎節(jié) Superior mesenteric ganglion 腸系膜上神經(jīng)節(jié) Inferior mesenteric ganglion腸系膜下神經(jīng)節(jié),Three fates of preganglionic fibers,Preganglionic fibers,15 pairs white communicating branch,Sympathetic trunk,(only spinal levels T1L3 have white communicating branch),Three fates of preganglionic fibers,Relay in corresponding ganglion Ascend or descend in sympathetic trunk and relay in higher or lower ganglia Pass without synapse to a prevertebral ganglion for relay,Greater splanchnic nerve 內(nèi)臟大神經(jīng) formed by preganglionic fibers from T5T9 ganglia, and relay in celiac ganglion. Lesser splanchnic nerve 內(nèi)臟小神經(jīng) formed by preganglionic fibers from T10T12 ganglia, and relay in aorticorenal ganglion. The postganglionic fibers supply the liver, spleen, kidney and alimentary tract as far as the left colic flexure.,Lumbar splanchnic nerve 腰內(nèi)臟神經(jīng) Formed by preganglionic fibers from L1L4 ganglia, and relay in prevertebral ganglia. The postganglionic fibers supplydescending and sigmoid colon, rectum, pelvic viscera and lower limbs.,Three fates of postganglionic fibers,Back to a spinal nerve along gray communicating branches ( 31 pairs ) to terminate in blood vessels, arrectores pilorum and sweat glands of head, neck, trunk and limbs The fibers from their networks around blood vessels passing to visceral end organs Terminate directly in certain organs,Distribution of sympathetic nerve,Parasympathetic part 副交感部,Lower center: located in four pairs parasympathetic nuclei in brain stem and in sacral parasympathetic nucleus of spinal cord segments S2S4 Parasympathetic ganglia: terminal ganglia are near or within the wall of a visceral organ Para-organ ganglia 器官旁節(jié)： Ciliary ganglion 睫狀神經(jīng)節(jié) Pterygopalatine ganglion 翼腭神經(jīng)節(jié) Submandibular ganglion 下頜下神經(jīng)節(jié) Otic ganglion 耳神經(jīng)節(jié) Intramural ganglia 壁內(nèi)節(jié),Cranial portion顱部,ciliary ganglion,sphincter pupillae and ciliary muscles,pterygopalatine ganglion,lacrimal gland,submandibular ganglion,sublingual gland submandibular gland,otic ganglion,parotid gland,terminal ganglia,heart, lungs, liver, spleen kidneys,alimentary tract as far as left colic flexure,Cranial portion顱部, accessory oculomotor nucleus sphincter pupillae and ciliary muscles ciliary ganglion pterygopalatine ganglion lacrimal gland superior salivatory nucleus sublingual gland submandibular ganglion submandibular gland inferior salivator nucleus parotid gland otic ganglion heart, lungs, liver, spleen, dorsal nucleus of vagus n. kidneys,alimentary tract terminal ganglia as far as left colic flexure,Sacral portion 骶部,Preganglionic fibers from sacral parasympathetic nucleus leave spinal cord with anterior roots of the spinal nerves S2S4, Then leave sacral nerves and form pelvic splanchnic nerve and travel by way of pelvic plexus to terminal ganglia in pelvic cavity Postganglionic fibers terminate in descending and sigmoid colon, rectum and pelvic viscera,Main differences between sympathetic and parasympathetic,Main differences between sympathetic and parasympathetic,Visceral plexuses,Cardiac plexuses Superficial , below aortic arch Deep, anterior to bifurcation on trachea Pulmonary plexus Celiac plexus Abdominal aortic plexus Hypogastric plexus Superior hypogastric plexus Inferior hypogastric plexus (pelvic plexus),Visceral sensory nerves,Enteroceptors,，, ,Nucleus of solitary tract,Sympathetic nerve Pelvic splanchnic nerve,Posterior horn,Thalamus,Hypothalamus,Cerebral cortex,Somatic motor neurons visceral motor neuclei,Effectors,Referred pain 牽涉痛,The Endocrine System,齊齊哈爾醫(yī)學(xué)院 解剖教研室 劉富,The Endocrine System,Composition Endocrine glands: have no ducts, their secretions (hormone) release directly into bloodstream to its target organ Endocrine tissue,Thyroid gland 甲狀腺,Shape and position H-shape Left and right lobes: lie on either side of inferior part of larynx and superior part of trachea, extend from middle of thyroid cartilage to level of sixth trachea cartilage Isthmus: overlies 2nd to 4th tracheal cartilage Pyramidal lobe: some times arises from isthmus Fibrous capsule: a sheath of pretracheal