Facial Nerve

the facial nerve (CN VII) is one of the most anatomically complex of all the cranial nerves because it
transmits four different types of innovation and its branches take varied courses through the skull
Types of innervation transmitted by the facial nerve
1. special visceral efferent or sve

2. general visceral efferent or gve
3. special visceral a ferrant or sva
4. general somatic afferent or GSa
the first component is special visceral efferent or sve
innervation to the muscles derived from the second pharyngeal arch
this includes all of the muscles of facial expression plus three others
stapedius
stylohyoid
and the posterior belly of the digastric muscle
these are regular striated muscles just as you find in the limbs and trunk
their designation as special visceral efferent simply reflects their origin from the pharyngeal arches….
(rather than from Maya tones)
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the second component of the facial nerve is general visceral efferent or gve
innervation to two pairs of parasympathetic motor ganglia in the head
the submandibular ganglia
and the Terrigal Palatine ganglia
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the third component is special visceral a ferrant or sva
taste sensation from the anterior two-thirds of the tongue
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finally the fourth component of the facial nerve is a small amount of general somatic afferent or GSa
innervation to a patch of skin over the mastoid process and auricle
this innervation is not clinically relevant and is often excluded in descriptions of
the facial nerve
now let's look at the origin of the facial nerve and the routes that these four types of innervation take to
reach their targets
the cell bodies of the sve neurons are located in the brainstem in the motor nucleus of the facial nerve
the cell bodies of the gve neurons are also located in the brainstem within the superior saliva Tori
nucleus
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finally the cell bodies of the GSA and SVA neurons are located in the geniculate ganglion
which is positioned deep within the petrous part of the temporal bone
these sensory neurons send their proximal process to the solitary nucleus in the brainstem
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all of these different components of the facial nerve come together at the brainstem and together
they enter the skull at the internal acoustic meatus
even at its origin the facial nerve proper is anatomically subdivided
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the gve SVA and gsa components are grouped together as the nervous intermedius
the large sve component remains physically distinct from the nervous intermedius
after passing through the internal acoustic meatus all components of the facial nerve travel in a bony
tunnel within the petrous part of the temporal bone called the facial canal
the facial nerve travels a short distance enter or laterally in the facial canal before making a sharp
posterior bend or genu
this bend marks the location of the geniculate ganglion
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as we mentioned the geniculate ganglion is the home of the cell bodies of the sensory neurons that
contribute to the facial nerve
facial nerve axons convey motor innervation travel through the geniculate ganglion as fibers of
passage
that is…. When they pass through the ganglion without making synapses
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distal to the geniculate ganglion is where the facial nerve components begin to diverge
first the tiny gsa component of cranial nerve seven leaves to supply a bit of skin near the ear
again there is no clinical relevance to this innervation and its exact course is not important
one half of the gve innervation leaves to form the greater petrosal nerve which exits the temporal bone
by passing through the greater petrosal foramen
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the greater petrosal nerve then drops inferiorly into foramen lacerum to join with the deep petrosal
nerve
which consists of postganglionic sympathetic fibers ascending on the internal carotid artery
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together the greater and deep petrosal nerve formed the vidian nerve
the vidian nerve then enters the vidian canal at the base of the medial pterygoid plate and continues
anteriorly until it reaches the Pterygopalatine ganglion within the Pterygopalatine Fossa
here preganglionic parasympathetic axons synapse onto post ganglionic parasympathetic neurons
these in turn distribute to the lacrimal gland and submucosal glands of the oral and nasal cavities
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the second half of the gve innervation and the sva taste sensation combined to form the
chordatympani nerve
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chordatympani exits the skull by passing inferiorly through the petrol tympanic fissure to enter the
infra- temporal fossa
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here chorda tympani joins with the lingual branch of cranial nerve 5
and together these nerves travel anteriorly deep to the mandible
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along the way the GVE fibers diverged to terminate in the submandibular ganglion
from here post ganglionic neurons distribute to the submandibular and sublingual salivary glands
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in contrast the SVA a taste component of chorda tympani remains with the lingual nerve until it reaches
the tongue where it distributes to the taste receptors on the anterior two-thirds of the tongue
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finally the large sve component of the facial nerve gives a branch directly to the stapedius muscle
within the temporal bone
then exits the skull via the stylomastoid foramen…… it supplies the stylohyoid and posterior digastric
muscles then pierces through the parotid gland to distribute to the muscles of facial expression
note that the facial nerve does not provide innovation to the parotid gland but merely passes through it
cranial nerve nine provides innervation to the parotid gland

Facial Nerve

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the facial nerve (CN VII) is one of the most anatomically complex of all the cranial nerves because it

Types of innervation transmitted by the facial nerve

1. special visceral efferent or sve

the first component is special visceral efferent or sve

innervation to the muscles derived from the second pharyngeal arch

and the posterior belly of the digastric muscle

innervation to two pairs of parasympathetic motor ganglia in the head

the submandibular ganglia

and the Terrigal Palatine ganglia

the third component is special visceral a ferrant or sva

taste sensation from the anterior two-thirds of the tongue

innervation to a patch of skin over the mastoid process and auricle

this innervation is not clinically relevant and is often excluded in descriptions of

the facial nerve

they enter the skull at the internal acoustic meatus

even at its origin the facial nerve proper is anatomically subdivided

this bend marks the location of the geniculate ganglion

infra- temporal fossa

and together these nerves travel anteriorly deep to the mandible

cranial nerve nine provides innervation to the parotid gland

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