Cranial nerves XI-X-XI-XII

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Cranial nervesXI-X-XI-XII

• By
• Essam Eldin Abdelhady Salama

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Cranial nerves
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The Glossopharyngeal Nerve (IX)

• Mixed nerve
• Innervates the tongue,(pos.1/3) pharynx, tonsil.
• Test gag reflex.

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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.

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Glossopharyngeal nerve

• Ganglia
• Superior ganglion small, with no branches.
• Inferior ganglion, large carries general
  sensations from pharynx, soft palate and fauces.

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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

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Branches.

• Of distribution
• Tympanic.
• Stylopharyngeus.
• Pharyngeal.
• Tonsillar.
• Lingual .

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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)

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Gloosopharyngeal nerve
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The Vagus Nerve (X)

• Mixed nerve
• Vital to autonomic control of visceral function.
• Test check for hoarseness, open wide and say
  "AH"

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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

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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.

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Branches

• Of distribution
• Meningeal
• Auricular
• Pharyngeal
• To carotid body
• Superior laryngeal
• Right recurrent laryngeal
• Cardiac.

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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)

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Vagus nerve
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The accessory nerve (XI)

• Internal branch Innervates swallowing muscles
• External branch Controls muscles associated with
  pectoral girdle.
• Test shoulder raise or turning the head

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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.

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Accessory nerve

• The cranial part
• Joins vagus, distributed along pharyngeal and
  recurrent laryngeal.
• The spinal part
• Runs backwards and laterally to sternomastoid and
  trapezius.

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Spinal accessory

• Fm foramen magnum
• Jf jugular foramen

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Accessory nerve
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The hypoglossal nerve (XII)

• Voluntary motor control for tongue movements.
• Test, stick out the tongue.

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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.

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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.

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Branches

• Of communications
• Vagus
• Inferior ganglion.
• Auricular branch of vagus.
• Cervical nerves
• 1st and 2nd
• Sympathetic plexus
• Superior cervical sympathetic ganglion
• Lingual nerve.

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Branches

• Of distribution
• Meningeal.
• Thyrohyoid.
• Descending.
• Muscular.

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Hypoglossal nerve

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

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Hypoglossal nerve
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