Download 19-last 4 cranial nerves

‫بسم هللا الرحمن الرحيم‬
‫والصالة والسالم علي اشرف المرسلين‬
‫نبينا محمد‬
‫وعلي الة وصحبة اجمعين‬
Cranial nerves
XI-X-XI-XII
By
Essam Eldin Abdelhady Salama
Cranial nerves
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.
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Of distribution:
Tympanic.
Stylopharyngeus.
Pharyngeal.
Tonsillar.
Lingual .
Gloosopharyngeal nerve
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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)
Gloosopharyngeal nerve
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
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Of distribution:
Meningeal
Auricular
Pharyngeal
To carotid body
Superior laryngeal
Right recurrent laryngeal
Cardiac.
Vagus nerve
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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)
Vagus nerve
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
Accessory nerve
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
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Of communications
Vagus;
Inferior ganglion.
Auricular branch of
vagus.
Cervical nerves;
1st and 2nd
Sympathetic plexus;
Superior cervical
sympathetic ganglion
Lingual nerve.
Branches
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Of distribution:
Meningeal.
Thyrohyoid.
Descending.
Muscular.
Hypoglossal nerve
• C1--first
cervical nerve
• hf-hypoglossal
canal
Hypoglossal nerve