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Cranial Nerves Overview Twelve pairs of nerves originating from the brain; numbered I–XII using Roman numerals. Origin of Cranial Nerves First two pairs (I–II) arise from forebrain; remaining pairs (III–XII) arise from brainstem. Function of Cranial Nerves Primarily serve head and neck structures; one exception (vagus nerve) extends into thoracic and abdominal cavities. Cranial Nerve Numbering Begin anteriorly and move posteriorly along the inferior surface of the brain. Cranial Nerve Naming Names reflect location, innervation, or function. Mnemonic for Cranial Nerve Names Olfactory, Optic, Oculomotor, Trochlear, Trigeminal, Abducens, Facial, Vestibulocochlear, Glossopharyngeal, Vagus, Accessory, Hypoglossal. Fun Mnemonic Phrase (Names) On Occasion Our Trusty Truck Acts Funny — Very Good Vehicle Any How. Mnemonic for Cranial Nerve Functions (Sensory/Motor/Both) Some Say Marry Money But My Brother Says Bad Business Marry Money. CN I: Olfactory Nerve Sensory; responsible for sense of smell; passes through cribriform plate of ethmoid bone. CN II: Optic Nerve Sensory; responsible for vision; exits through optic canal (optic foramen). CN III: Oculomotor Nerve Motor; controls most eye movements and pupil constriction; exits through superior orbital fissure. Oculomotor Somatic Function Controls superior rectus, inferior rectus, medial rectus, and inferior oblique eye muscles. Oculomotor Autonomic Function Controls sphincter pupillae muscle for pupil constriction. CN IV: Trochlear Nerve Motor; controls superior oblique muscle of the eye; exits through superior orbital fissure. Trochlear Function Allows eye to move inferolaterally (downward and outward). CN V: Trigeminal Nerve Both sensory and motor; major sensory nerve of the face with three divisions (V1, V2, V3). Trigeminal Divisions V1 Ophthalmic (superior orbital fissure), V2 Maxillary (foramen rotundum), V3 Mandibular (foramen ovale). Trigeminal Function Sensory input from face, scalp, teeth, and anterior tongue; motor control of muscles of mastication. CN VI: Abducens Nerve Motor; controls lateral rectus muscle of the eye for lateral movement; exits through superior orbital fissure. Eye Movement Coordination Controlled by oculomotor (III), trochlear (IV), and abducens (VI) nerves. Abducens Palsy Results in inability to move eye laterally (damage to lateral rectus muscle). Trochlear Palsy Causes weakness in downward eye movement; patient may tilt head to compensate. Oculomotor Palsy Causes drooping eyelid (ptosis), dilated pupil, and inability to move eye upward, downward, or inward. CN VII: Facial Nerve Both sensory and motor; innervates muscles of facial expression and taste from anterior two-thirds of tongue. Branches of Facial Nerve Five branches: Temporal, Zygomatic, Buccal, Mandibular, and Cervical. Facial Nerve Function Motor control of facial muscles, secretion from salivary and lacrimal glands, and taste sensation. CN VIII: Vestibulocochlear Nerve Sensory; responsible for equilibrium (vestibular branch) and hearing (cochlear branch). Vestibulocochlear Function Transmits sound and balance information from inner ear to brain. CN IX: Glossopharyngeal Nerve Both sensory and motor; innervates pharynx and posterior tongue. Glossopharyngeal Functions Controls swallowing, taste on posterior one-third of tongue, and salivary gland secretion. CN X: Vagus Nerve Both sensory and motor; only cranial nerve extending beyond head and neck into thorax and abdomen. Vagus Nerve Function Regulates heart rate, breathing, digestive activity, and contributes to swallowing and voice production. Vagus Sensory Component Provides visceral sensation and taste from epiglottis and pharynx. CN XI: Accessory Nerve Motor; controls muscles of the larynx, pharynx, and neck; assists in head and shoulder movement. Accessory Nerve Function Innervates sternocleidomastoid and trapezius muscles for head rotation and shoulder elevation. CN XII: Hypoglossal Nerve Motor; controls tongue movements for chewing, swallowing, and speech. Hypoglossal Function Allows food mixing, manipulation, and articulation during speech. Cranial Nerve Functional Summary Sensory: I, II, VIII. Motor: III, IV, VI, XI, XII. Both: V, VII, IX, X. Cranial Nerve Function Mnemonic I–Sensory, II–Sensory, III–Motor, IV–Motor, V–Both, VI–Motor, VII–Both, VIII–Sensory, IX–Both, X–Both, XI–Motor, XII–Motor. Cranial Nerve Testing Used clinically to identify brainstem lesions, neuropathies, or localized nerve damage. Clinical Importance of Cranial Nerves Critical for assessing neurological health and localizing brain or skull base disorders.

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Chapter 4 Skin and Body Membranes Body Membranes Functions of body membranes Cover body surfaces Line body cavities Form protective sheets around organs Classified according to tissue types Body Membranes Two major categories Epithelial membranes Cutaneous membranes Mucous membranes Serous membranes Connective tissue membranes Synovial membranes Epithelial Membranes Epithelial membranes are simple organs Also called covering and lining membranes These membranes contain both: Epithelial tissue layer Connective tissue layer Epithelial Membranes Cutaneous membrane = skin Dry membrane Outermost protective boundary Consists of two layers Epidermis is composed of keratinized stratified squamous epithelium Dermis is mostly dense (fibrous) connective tissue Epithelial Membranes • Mucous membranes (mucosae) • I Moist membranes Some mucosae secrete protective, lubricating mucus Line all body cavities that open to the exterior body surface • Adapted for absorption or secretion • ' Consists of two layers • Epithelium type depends on site • Loose connective tissue (lamina propria) Epithelial Membranes Serous membranes (serosae) Line compartments in the ventral body cavity that are ciosed to the exterior of the body Occur in pairs, separated by serous fluid, with a visceral and parietal layer Consists of two layers Simple squamous epithelium Areolar connective tissue Epithelial Membranes Specific serous membranes Peritoneum Cover organs in the abdominal cavity Pleurae Surround the lungs Pericardia Surround the heart Connective Tissue Membranes Synovial membranes Loose areolar connective tissue only (no epithelial tissue) Line fibrous capsules surrounding joints Line bursae Line tendon sheaths Secrete a lubricating fluid to cushion organs moving against each other during muscle activity Integumentary System Integumentary system consists of the: Skin (cutaneous membrane) Skin appendages Sweat glands Oil glands Hair Nails Functions of the Integumentary System Insulates and cushion deeper body organs Protects the entire body from: Mechanical damage (bumps and cuts) Chemical damage (acids and bases) Thermal damage (heat or cold) Ultraviolet (UV) radiation (sunlight) Microbes (bacteria) • Water loss Functions of the Integumentary System Regulates heat loss as controlled by the nervous system Acts as a mini-excretory system; sweat aids in the loss of Urea Salts Water Synthesizes vitamin D Secretions create a protective acid mantle Structure of the Skin Two kinds of tissue compose the skin Epidermis Dermis Subcutaneous tissue (hypodermis) Anchors the skin to underlying organs Not technically part of the integumentary system Composed mostly of adipose tissue Serves as a shock absorber and insulates deeper tissues Structure of the Skin Epidermisouter layer Composed of stratified squamous epithelium Most cells are keratinocytes which produce a fibrous protein called keratin Keratinization makes the epidermis tough Desmosomes connect keratinocytes together Avascular Composed of five layers (strata) Structure of the Skin Summary of strata (layers) of the epidermis from deepest to most superficial Stratum basale Stratum spinosum Stratum granulosum Stratum lucidum (thick, hairless skin only) Stratum corneum Structure of the Skin Stratum basale (stratum germinativum) Deepest layer of epidermis Lies next to dermis Wavy borderline with the dermis anchors the two together Cells undergoing mitosis Daughter cells are pushed upward to become the more superficial layers Stratum spinosum Cells become increasingly flatter and more keratinized Structure of the Skin Stratum granulosum Stratum lucidum Formed from dead cells of the deeper strata Occurs only in thick, hairless skin of the palms of hands and soles of feet Stratum corneum Outermost layer of epidermis Shingle-like dead cells are filled with keratin (protective protein prevents wat loss from skin Structure of the Skin Melanin Melanin is a pigment produced by melanocytes Melanocytes are mostly in the stratum basale of the epidermis Color is yellow to brown to black Structure of the Skin Epidermal dendritic cells Alert and activate immune cells to a threat (bacterial or viral invasion) Merkel cells Associated with sensory nerve endings Serve as touch receptors called Merkel discs Structure of the Skin Dermis Connective tissue Underlies the epidermis Two regions Papillary Reticular Structure of the Skin Two regions of the dermis Papillary layer (upper dermal region) contain projections called dermal papillae Areolar connective tissue Indent the epidermis above Many projections contain capillary loops, and others house pain and touch receptors On palm and sole surfaces, papillae increase friction and gripping ability Fingerprints are identifying films of sweat Structure of the Skin Two regions of the dermis Reticular layer (deepest skin layer) Dense irregular connective tissue Blood vessels Sweat and oil glands Deep pressure receptors (lamellar corpuscles) Structure of the Skin Other dermal features Cutaneous sensory receptors Phagocytes Collagen and elastic fibers Blood vessels I Nerve supply Skin Color • Three pigments contribute to skin color 1. Melanin • Yellow, reddish brown, or black pigments 2. Carotene • Orange-yellow pigment (also found in some vegetables) 3. Hemoglobin Red coloring from blood cells in dermal capillaries Oxygen content determines the extent of red coloring Skin Color Redness (erythema) due to embarrassment, inflammation, hypertension, fever, or allergy Pallor (blanching) due to emotional stress (such as fear), anemia, low blood pressure, impaired blood flow to an area Jaundice (yellow cast)-indicates a liver disorder • Bruises (black and blue marks)-hematomas Appendages of the Skin Cutaneous glands are all exocrine glands Sebaceous glands Sweat glands Hair and hair follicles Nails Appendages of the Skin Sebaceous (oil) glands Located all over the skin except for palms and soles Produce sebum (oil) Makes skin soft and moist Prevents hair from becoming brittle Kills bacteria Most have ducts that empty into hair follicles; others open directly onto skin surface Glands are activated at puberty with increased androgens Appendages of the Skin Sweat (sudoriferous) glands Produce sweat Widely distributed in skin Two types of sudoriferous glands Eccrine glands Apocrine glands Appendages of the Skin Eccrine glands More numerous, located all over the body Open via duct to sweat pores on the skin's surface Produce acidic sweat Water, salts, vitamin C, traces of metabolic waste Function in body temperature regulation Appendages of the Skin Apocrine glands Ducts empty into hair follicles in the armpit and genitals Begin to function at puberty Release sweat that also contains fatty acids and proteins (milky or yellowish color) • Play a minimal role in body temperature regulation Appendages of the Skin Hair Located body-wide except for palms, soles, nipples, lips Produced by hair follicle Root is enclosed in the follicle Shaft projects from the surface of the scalp or skin Consists of hard keratinized epithelial cells Melanocytes provide pigment for hair color Hair grows in the matrix of the hair bulb in stratum basale Appendages of the Skin Hair anatomy Central medulla Cortex surrounds medulla Cuticle on outside of cortex Most heavily keratinized region of the hair Melanin provides color Appendages of the Skin Associated hair structures Hair follicle Composed of an inner epithelial root sheath andan outer fibrous sheath Dermal region provides a blood supply to the hair bulb (deepest part of the follicle) Arrector pili muscle connects to the hair follicle to pull hairs upright when we are cold or frightened Appendages of the Skin Nails Heavily keratinized, scalelike modifications of the epidermis Stratum basale extends beneath the nail bed, which is responsible for growth Lack of pigment makes nails colorless Appendages of the Skin Parts of a nail Free edge Body is the visible attached portion Nail folds are skin folds that overlap the edges of the nail; the cuticle is the proximal edge Root of nail is embedded in skin Growth of the nail occurs from nail matrix of nail bed Homeostatic Imbalances of Skin Infections and allergies Athlete's foot Caused by fungal infection (Tinea pedis) Itchy, red peeling skin between the toes Boils (furuncles) and carbuncles Caused by inflammation of hair follicles Carbuncles are clusters of boils caused by bacteria Cold sores (fever blisters) Caused by human herpesvirus 1 Blisters itch and sting Homeostatic Imbalances of Skin Infections and allergies Contact dermatitis Caused by exposure to chemicals that provoke allergic responses Itching, redness, and swelling of the skin Impetigo Caused by bacterial infection Pink, fluid-filled raised lesions around mouth/nose Psoriasis Triggered by trauma, infection, hormonal changes, or stress Red, epidermal lesions covered with dry, silvery scales that itch, burn, Crack, or sometimes bleed Homeostatic Imbalances of Skin • Burns Tissue damage and cell death caused by heat, electricity, UV radiation, or chemicals Associated dangers Protein denaturation and cell death Dehydration and electrolyte imbalance Circulatory shock Result in loss of body fluids and infection from the invasion of bacteria Homeostatic Imbalances of Skin Extent of a burn is estimated using the rule of nines Body is divided into 11 areas for quick estimation Each area represents about 9 percent of total body surface area The area surrounding the genitals (the perineum) represents 1 percent of body surface area Homeostatic Imbalances of Skin . First-degree burn (superficial burn) Only epidermis is damaged Skin is red and swollen Second-degree burn (superficial partial-thickness burn) Epidermis and superficial part of dermis are damaged Skin is red, painful, and blistered Regrowth of the epithelium can occur Homeostatic Imbalances of Skin Third-degree burn (full-thickness burn) Destroys epidermis and dermis; burned area is painless Requires skin grafts, as regeneration is not possible Burned area is blanched (gray-white) or black Fourth-degree burn (full-thickness burn) Extends into deeper tissues (bone, muscle, tendons) Appears dry and leathery Requires surgery and grafting May require amputation Homeostatic Imbalances of Skin Criteria for deeming burns critical (if any one is met): Over 30 percent of body has second-degree burns Over 10 percent of the body has third-or fourth-degree burns Third-or fourth-degree burns of the face, hands, feet, or genitals Burns affect the airways Circumferential (around the body or limb) burns have occurred Homeostatic Imbalances of Skin Skin cancer Most common form of cancer in humans Most important risk factor is overexposure to ultraviolet (V) radiation in sunlight and tanning beds Cancer can be classified two ways Benign means the neoplasm (tumor) has not spread Malignant means the neoplasm has invaded other body areas Concept Link Recall that mitosis gone wild is the basis for cancer (Chapter 3, pp. 82-83). These cells lack normal control of cell division and divide quickly, resulting in errors during DNA replication, mitosis, or both. Cells experiencing rapid, uncontrolled growth become cancerous and can metastasize (spread) to other parts of the body. Homeostatic Imbalances of Skin . First-degree burn (superficial burn) Only epidermis is damaged Skin is red and swollen Second-degree burn (superficial partial-thickness burn) Epidermis and superficial part of dermis are damaged Skin is red, painful, and blistered Regrowth of the epithelium can occur Homeostatic Imbalances of Skin Third-degree burn (full-thickness burn) Destroys epidermis and dermis; burned area is painless Requires skin grafts, as regeneration is not possible Burned area is blanched (gray-white) or black Fourth-degree burn (full-thickness burn) Extends into deeper tissues (bone, muscle, tendons) Appears dry and leathery Requires surgery and grafting May require amputation Homeostatic Imbalances of Skin Criteria for deeming burns critical (if any one is met): Over 30 percent of body has second-degree burns Over 10 percent of the body has third-or fourth-degree burns Third-or fourth-degree burns of the face, hands, feet, or genitals Burns affect the airways Circumferential (around the body or limb) burns have occurred Homeostatic Imbalances of Skin Skin cancer Most common form of cancer in humans Most important risk factor is overexposure to ultraviolet (V) radiation in sunlight and tanning beds Cancer can be classified two ways Benign means the neoplasm (tumor) has not spread Malignant means the neoplasm has invaded other body areas Concept Link Recall that mitosis gone wild is the basis for cancer (Chapter 3, pp. 82-83). These cells lack normal control of cell division and divide quickly, resulting in errors during DNA • One or more of the ABCD characteristics is evolving Developmental Aspects of Skin and Body Membranes Lanugo, a downy hair, covers the body by the fifth or sixth month of fetal development but disappears by birth Vernix caseosa, an oily covering, is apparent at birth Milia, small white spots, are common at birth and disappear by the third week Acne may appear during adolescence Pimples, scales, and dermatitis are more common with aging skin Developmental Aspects of Skin and Body Membranes In youth, skin is thick, resilient, and well hydrated With aging, skin loses elasticity and thins Skin cancer is a major threat to skin exposed to excessive sunlight Balding (alopecia) and/or graying occurs with aging; both are genetically determined other factors that may contribute include drugs and emotional stress

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