N. FACIALIS (Facijalni zivac) - VII. kranijalni zivac

Jedan od najintrigantnijih kranijalnih zivaca, tzv. “promiskuitetni” zivac :-).

Funkcije facijalnog zivca:

1) inervira misice II. skrznog luka

2) daje PARASIMPATICKU inervaciju lakrimalnoj, submandibularnoj, sublingualnoj zlijezdi

3) prenosi OSJET okusa iz prve 2/3 jezika

4) prenosi Opci Visceralni osjet (OVA) iz nosne supljine i mekog nepca

5) prenosi Opci Somatski osjet (OSA) iz podrucjaiza uha i vanjskog slusnog hodnika

Jezgre facijalnog zivca (4):

1) nucleus n. facialis (SVE) - motoricka jezgra

2) nucleus salivatorius superior (OVE) - parasimpaticka jezgra

3) nucleus solitarius (OVA,SVA) - visceralne osjetne jezgre

4) nucleus spinalis n. trigemini (OSA) - opca somatska aferentna jezgra

Izlaziste zivca iz mozga:

Motoricki i osjetni korijen (n. intermedius) izlazi izmedju ponsa i produzene mozdine, pontocerebelarni kut

Put zivca kroz mozdane ovojnice do lubanje:

Porus acusticus internus -> area n. facialis -> canalis n. facialis (temporalna kost)

Put zivca kroz lubanju i izlaziste iz lubanje:

U canalis n. facialis facijalni zivac zavija LATERALNO i natrag, tvori geniculum n. facialis (koljeno)

Tu se nalazi ganglion geniculi (tijela aferentnih neurona n. intermediusa)

Zivac prolazi kroz piramidu sljepoocne kosti, zavija prema dolje i izlazi iz lubanje kroz foramen stylomastoideum.

Put zivca do krajnjih tvorbi:

Iz foramena stylomastoideum ulayi u fossu retromandibularis, gdje pravi treci vanjski zavoj, ulazi u parotidnu zlijezdu (ali ju NE INERVIRA), tu daje ogranke i tvori

PLEXUS INTRAPAROTIDEUS -> inervira mimicne zivce.

Carotid Artery Stenosis (Trigonum Caroticum)

 




I have witnessed this surgical procedure (also known as carotid endarterectomy - CEA) during my clinical skills rotation program and in the case presented at the time, a patient had stenosis of arteria carotis interna (internal carotid) which hindered patient's oxygen transport to the brain and therefore caused serious perfusion consequences.

Removal of atherosclerotic plaques ensued and therefore the lumen of the vessel was restored to more convenient physiological values.



MRI investigation revealed stenosis of the left carotid artery, in a immediate vicinity of arteria carotis communis fork.

The surgery was extremely delicate as many important and vulnerable structures reside in a so called " carotid triangle / trigonum caroticum" and surgeon needs to be incredibly precise and careful to avoid any damage to these structures.

For example, unwanted interaction with sinus caroticus may cause patient to go into bradycardia state.

Marcello Malpighi

During some of my medical studies, I often stumble upon some interesting features in biology that have been discovered by great scientists at a time and usually their name is attributed to that kind of feature. This one specifically I picked up during my medical histology and embryology course…Malpighi has been all over the place…exceedingly busy guy back in a time…that’s for sure

This is what Encyclopedia Britannica claims about him:

Marcello Malpighi,  (born March 10, 1628, Crevalcore, near Bologna, Papal States [Italy]—died Nov. 30, 1694, Rome), Italian physician and biologist who, in developing experimental methods to study living things, founded the science of microscopic anatomy. After Malpighi’s researches, microscopic anatomybecame a prerequisite for advances in the fields of physiology, embryology, and practical medicine.

More info on Marcello Malpighi
http://en.wikipedia.org/wiki/Marcello_Malpighi

Following structures in histology tissues have been named after him:

Renal corpuscle (nephrology) in kidneys


Malphigian corpuscle in lymph node (spleen)