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This text provides an overview of cranial nerves XI-X-XI-XII, focusing on the Glossopharyngeal, Vagus, Accessory, and Hypoglossal nerves, their functions, pathways, and branches.
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بسم الله الرحمن الرحيم والصلاة والسلام علي اشرف المرسليننبينا محمد وعلي الة وصحبة اجمعين
Cranial nervesXI-X-XI-XII By Essam Eldin Abdelhady Salama
The Glossopharyngeal Nerve (IX) • Mixed nerve • Innervates the tongue,(pos.1/3) pharynx, tonsil. • Test; gag reflex.
Glossopharyngeal nerve • Leave the skull through jugular foramen • Passes forwards between internal jugular vein and external carotid artery. • Deep to styloid process. • Between external and internal carotid arteries at posterior border of stylopharyngeus then lateral to it. • Reaches the pharynx by passing between middle and inferior constrictor, deep to hyoglossus, where it breaks into terminal branches.
Glossopharyngeal nerve • Ganglia • Superior ganglion small, with no branches. • Inferior ganglion, large carries general sensations from pharynx, soft palate and fauces.
Branches. • Of communications: • Inferior ganglion and • superior cervical sympathetic ganglion. • Superior ganglion and auricular branch of vagus. • Its trunk and facial nerve at stylomastoid foramen
Branches. • Of distribution: • Tympanic. • Stylopharyngeus. • Pharyngeal. • Tonsillar. • Lingual .
Gloosopharyngeal nerve • jf--jugular foramen • sg--superior ganglion • ig--inferior ganglion • tp--tympanic plexus • lpn--lesser petrosal nerve • fo--foramen ovale • og--otic ganglion • pg--parotid gland • sp--nerve to stylopharyngeus muscle • pb--pharyngeal branch • ncbcs--nerve to carotid body carotid sinus • Red solid -- motor • Red dotted -- parasympathetic • Yellow -- sensory (afferent)
The Vagus Nerve (X) • Mixed nerve • Vital to autonomic control of visceral function. • Test; check for hoarseness, open wide and say "AH"
Vagus nerve • Leaves the skull through jugular foramen • Descends within carotid sheath • Enters thorax through its inlet • Descends through superior mediastinum. • It has two ganglia • Superior ganglion in the jugular foramen • Inferior ganglion, just below the jugular foramen
Branches • Of communication • Superior ganglion and • inferior ganglion of glossopharyngeal nerve, • superior cervical sympathetic ganglion. • facial nerve. • Inferior ganglion and • cranial part of accessory nerve, • hypoglossal nerve, • superior cervical sympathetic ganglion. • 1st cervical nerve.
Branches • Of distribution: • Meningeal • Auricular • Pharyngeal • To carotid body • Superior laryngeal • Right recurrent laryngeal • Cardiac.
Vagus nerve • jf--jugular foramen • sg--superior ganglion • ig--inferior ganglion • pb--pharyngeal branch • spc--superior pharyngeal constrictor • sl--superior laryngeal nerve • il--internal laryngeal • el--external laryngeal • ct--cricothyroid muscle • mpc--middle pharyngeal constrictor • rl--recurrent laryngeal nerve • pc--pharyngeal constrictors • csn--carotid sinus nerve • Red solid -- motor • Red dotted -- parasympathetic • Yellow -- sensory (afferent)
The accessory nerve (XI) • Internal branch Innervates swallowing muscles • External branch Controls muscles associated with pectoral girdle. • Test; shoulder raise or turning the head
Accessory nerve • Cranial root from medulla oblongata • spinal root upper 5-6 segments of spinal nerves. • They join inside the jugular foramen, just outside it they separate.
Accessory nerve • The cranial part • Joins vagus, distributed along pharyngeal and recurrent laryngeal. • The spinal part • Runs backwards and laterally to sternomastoid and trapezius.
Spinal accessory • Fm; foramen magnum • Jf; jugular foramen
The hypoglossal nerve (XII) Voluntary motor control for tongue movements. Test, stick out the tongue.
Hypoglossal nerve • Leave the skull through hypoglossal canal. • Passes lateral and downwards then • Descends vertically between the internal carotid artery and internal jugular vein . • Turns forwards crossing internal and external carotid arteries and 1st part of lingual artery.
Hypoglossal nerve • Runs on the lateral surface of hyoglossus, related to lingual nerve, deep part of submandibular gland and submandibular duct. • Runs lateral to genioglossus, where it breaks to supply the tongue.
Branches • Of communications • Vagus; • Inferior ganglion. • Auricular branch of vagus. • Cervical nerves; • 1st and 2nd • Sympathetic plexus; • Superior cervical sympathetic ganglion • Lingual nerve.
Branches • Of distribution: • Meningeal. • Thyrohyoid. • Descending. • Muscular.
Hypoglossal nerve • C1--first cervical nerve • hf--hypoglossal canal