Facial Nerve Cranial Nerve VII

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The facial nerve controls the muscles of facial expression. However, a smaller branch of the facial nerve, the nervus intermedium, carries fibers for the para-sympathetic nervous system (tears and salivation), taste, and general somatosensory functions.

The facial nucleus is located in the branchial motor column, more caudally in the pons than is the trigeminal motor nucleus. The nerve exits

23 Supraorbital 19 Infraorbital

17 Lateral pectoral

4 Saphenous

6 Tibial

23 Supraorbital 19 Infraorbital

17 Lateral pectoral

7 Greater occipital

3 Spinal accessory 13 Dorsal scapular

8 Suprascapular (infraspinatus)

9 Lateral antebrachial cutaneous

1 Deep radial

14 Superior cluneal

15 Inferior gluteal

12 Superficial radial

4 Saphenous

24 Common fibular (peroneal)

6 Tibial

- 5 Deep fibular (peroneal) g

16 Iliotibial 11 Lateral popliteal 10 Sural

7 Greater occipital

3 Spinal accessory 13 Dorsal scapular

8 Suprascapular (infraspinatus)

12 Superficial radial

2 Great auricular

21 Posterior cutaneous of T6 20 Spinous process of T7

15 Posterior cutaneous of L2

22 Posterior cutaneous of L5

Figure 8-12 Twenty-four acu-reflex points. A, Anterior view. B, Posterior view.

2 Great auricular

21 Posterior cutaneous of T6 20 Spinous process of T7

15 Posterior cutaneous of L2

22 Posterior cutaneous of L5

Figure 8-12 Twenty-four acu-reflex points. A, Anterior view. B, Posterior view.

Neural Origin and TABLE 8-1 Segmentation of Acu-Reflex Points

Anatomic Location of Acu-Reflex Points

Neural Origins

Face

Neck

Lateral and anterior neck

Posterior neck (paravertebral acu-reflex points)

Torso

Lateral and anterior Posterior (paravertebral acu-reflex points) Shoulder and upper limb

Low back, hip, and lower limb

Cranial nerves, particularly the trigeminal (V) and facial (VII)

Cervical plexus (C1-C4), anterior rami C1-C8, posterior rami

Anterior rami of T1-T12 Posterior rami of T1-S4

Brachial plexus (C5-T1), anterior rami Lumbosacral plexus (L2-S3), anterior rami the brainstem ventrolaterally at the pontomedul-lary junction. The main portion of the facial nerve exits the skull at the stylomastoid foramen. It then passes through the parotid gland and divides into five major branchial motor branches to control the muscles of facial expression: the temporal, zygo-matic, buccal, mandibular, and cervical branches (see Fig. 8-5). Other smaller branchial motor branches innervate the stapedius and occipitalis muscles, the posterior belly of the digastric muscle, and the stylohyoid muscle.

The preganglionic parasympathetic fibers of the facial nerve arise from the superior salivatory nucleus and travel in two small branches off the main trunk of the facial nerve. At the genu of the facial nerve, the greater petrosal nerve branches to reach the sphenopalatine (pterygopalatine) ganglion, where postganglionic parasympathetic neurons innervate the lacrimal glands and nasal mucosa. The chorda tympani leaves the facial nerve and exits the skull at the petrotympanic fissure just medial and posterior to the temporoman-

dibular joint. The chorda tympani then joins the lingual nerve (a branch of the trigeminal nerve) to reach the submandibular ganglion, where post-ganglionic parasympathetic pathways arise to supply the submandibular and submaxillary salivary glands.

A small branch of the facial nerve provides general somatic sensation near the external auditory meatus, and the glossopharyngeal nerve (IX) and vagus nerve (X) also innervate this region. The somatosensory fibers for trigeminal, facial, glossopharyngeal, and vagus nerves all synapse in the trigeminal nuclei.

About 20 muscles of facial expression are known. Each muscle has at least one neuromuscular attachment point. Thus when practitioners treat facial conditions such as sinusitis or Bell's palsy, the affected muscles in each case should be carefully detected. Because all neuromuscular attachments of the muscles of facial expression can become sensitized if the muscles are affected, these points can be used for needling therapy.

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