بسم الله الرحمن الرحيم والصلاة والس م 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. 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)

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. 1 st 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)

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 1 st 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; 1 st and 2 nd Sympathetic plexus; Superior cervical sympathetic ganglion Lingual nerve.

Branches Of distribution: Meningeal. Thyrohyoid. Descending. Muscular.

Hypoglossal nerve C1--first cervical nerve hf-- hypoglossal canal

Hypoglossal nerve