Acute Paralysis of the Facial Nerve.pptVIP

Acute Paralysis of the Facial Nerve Anatomy Physiology Complex motor/sensory nerve. Special visceral afferent. General visceral efferent. Special visceral efferent. Anatomy Physiology Special visceral afferent fibers Taste (anterior 2/3 of the tongue) ? lingual and chorda tympani nerves ? geniculate ganglion ? nervus intermedius ? tractus solitarius. Anatomy Physiology General visceral afferent fibers Parasympathetic system with three subsets of postsynaptic fibers. Superior salivatory nucleus ? facial hiatus ? greater superficial petrosal nerve ? sphenopalatine ganglion ? lacrimal and palatine glands. ? lesser petrosal nerve ? otic ganglion ? parotid gland. ? chorda tympani nerve ? lingual nerve ? submandibular ganglion? submandibular and sublingual glands. Anatomy Physiology Special visceral efferent fibers Facial motor nucleus ? temporal bone (fibers to the stapedius muscle) ? stylomastoid foramen ? auricular, posterior belly of the digastric, stylohyoid, platysma muscles and the superficial facial musculature. Anatomy Physiology Sensory afferent fibers External auditory canal and proprioception from the face. Otalgia ? Bell’s palsy and vesicular eruption in herpes zoster infection. Anatomy Physiology Intracranial segment Meatal segment Labyrinthine segment Tympanic segment Mastoid segment Anatomy Physiology Intracranial segment Facial nerve nervus intermedius ? brainstem ? recess (pons) ? cerebellopontine angle ? medial to the vestibuloacoustic nerve ? internal auditory canal. Anatomy Physiology Meatal segment Anterior-superior quadrant within the canal ? meatal foramen superior to the crista transversa and anterior to the crista verticalis (Bill’s bar) ? fallopian canal. Anatomy Physiology Labyrinthine segment 2 to 4 mm within the narrowest part of the fallopian canal ? geniculate ganglion ? acute turn of 40 to 80 degrees (external genu) ? middle ear (posteriorly and slightly inferiorly above the cochleariform process and oval