Glossopharyngeal, vagus, accessory and hypoglossal nerve Dr Gallatz Katalin

BRAIN EXIT OF THE CRANIAL NERVES

GLOSSOPHARYNGEAL NERVE IX.

GLOSSOPHARYNGEAL NERVE IX. LEAVES THE SKULL THROUGH THE JUGULAR FORAMEN. THE FIST BRANCH – TYMPANIC NERNE ORIGINATES IN THE PETROSAL FOSSULA IT HAS TWO SENSORY GANGLION: SUPERIOR (JUGULAR) AND (PSEUDOUNIPOLAR CELLS) INFERIOR (PETROSAL)

NUCLEI OF GLOSSOPHARYNGEAL NERVE: ambiguus nucleus SVM inferior salivatory nucleus GVM nucleus of the solitary tract SVS nucleus of the spinal trigeminal tr. GSS

Sensory ganglia of the glossopharyngeal nerve PETROSAL GANGLION (INFERIOR) JUGULAR GANGLION (SUPERIOR) Vegetative (parasympathetic) ganglion: OTIC GANGLION

GLOSSOPHARYNGEAL NERVE INNERVATES WITH SOMATOSENSORY FIBERS: posterior 1/3 of the tongue palatine tonsil WITH SPECIAL VISCEROSENSORY FIBERS: taste buds of the circumvallate papillas WITH GENERAL VISCEROSENSORY FIBERS: mucous membrane of the pharynx receptors of thecarotid sinus WITH GENERAL VISCEROMOTOR (parasympathetic) FIBERS: parotid gland WITH SPECIAL VISCEROMOTOR FIBERS: levator veli palatini muscle stylopharyngeus muscle constrictor muscles (pharyngeal plexus)

BRANCHES OF GLOSSOPHARYNGEAL NERVE: TYMPANIC NERVE GVM, GSS TYMPANIC PLEXUS LESSER PETROSAL NERVE GVM PHARYNGEAL BRANCHES PHARYNGEAL PLEXUS SVM, GVM, GSS NERVE FOR CAROTID SINUS GVS TONSILLARY BRANCH GVS LINGUAL BRANCHES SVS, GVM, GSS

TYMPANIC NERVE GVM, GSS TYMPANIC PLEXUS LESSER PETROSAL NERVE GVM

TYMPANIC PLEXUS tympanic nerve (IX.) communicating ramus of VII n. caroticotympanic nerves: (postganglionar sympathetic fibers from the carotid plexus)

LESSER PETROSAL NERVE contains parasympathetic preganglionic fibers. These fibers terminate in the otic ganglion (just beneath the oval foramen). The postganglionis fibers join to the auriculotemporal nerve and provide the Secretomotor innervation of the parotid gland

NERVE FOR CAROTID SINUS (HERING’S) GVS

TONSILLARY BRANCH GVS LINGUAL BRANCHES SVS, GVM, GSS PHARYNGEAL BRANCHES PHARYNGEAL PLEXUS SVM, GVM, GSS

VAGUS NERVE X.

Nuclei of the vagus nerve: ambiguus nucleus SVM dorsal nucleus of the vagus nerve GVM lateral nucleus of ala cinerea GVS nucleus of the solitary tract SVS nucleus of the spinal trigeminal tr. GSS

Vegetative (parasympathetic) ganglia can be found in the wall Sensory ganglia of the vagus nerve superior (jugular) ggl. inferior (nodose) ggl Vegetative (parasympathetic) ganglia can be found in the wall of the viscera intramural ganglia

Vagus nerve innervates With branchialmotor SVM fibers - levator veli palatini, - middle constrictor of the pharynx - inferior constrictor pharynx - muscles of the larynx and esophagus With somatosensory fibers - mucous membrane of the larynx, - mucous membrane of the inferior part of the pharynx - epiglottic vallecules - posterior part of the dura mater - posterior part of the skin of the external acustic meatus

With special viscerosensory fibers - the taste buds around the epiglottic vallecules and around the aditus laryngis General viscerosensory and visceromotor fibers the larynx, trachea, oesophagus, bronchi, lungs, heart and abdominal viscera from the stomach to the left colic flexura

Branches of the vagus nerve Cranio-cervical part 1. posterior meningeal branch 2. auricular branch 3. pharyngeal 4. superior laryngeal nerve 5. superior cardiac nerves 6. recurrant laryngeal nerve: - inferior laryngeal nerve, - inferior cardiac nerves, - tracheales branches, - esophageal branches

Branches of the vagus nerve Thoracic part - cardiac branches - bronchial branches - pericardiac branches - oesophageal branches Adominal part - branches for the viscera gastric plexus hepatic plexus coeliac plexus renal plexus

Submandibular ggl. Otic ggl Branches of trigeminal nerve n. facialis nucl. saliv. sup Zygomatic n./lacrimal n. Lacrimal gland Pterygopalatine ggl. Greater petrosal n. Post.nasal nerves, nasopalatine n.,greater and lesser palatine nerves Palatine and nasal glands Submandibular ggl. Lingual n. submandibular, sublingual and anterior lingual gl. chorda tympani Glossopharyngeal n. inf. salivatory n. Otic ggl auriculotemporal n. Parotid gland tympanic n. /lesser petrosal n.

Nuclei of the accessory nerve: ambiguus nucleus SVM cranial root motoneurons of the C1-6 SM spinal root

Branches of the accessory nerve 1. External branch SM innervates the sternocleidomastoid and trapezius 2. Internal branch SVM joins to the vagus helps in the innervation of the arytenoideid muscle

Spinal root of the accessory nerve

PHARYNGEAL PLEXUS

Hypoglossal nerve Innervates: all the extrinsic and intrinsic muscles of the tongue :

DEEP ANSA CERVICALIS

Parapharyngeal region Nerves: glossopharyngeal n., sympathetic trunk vagus n., hypoglossal n. accessory nerve

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