CN IX, X, XI Flashcards

1
Q

fiber types in CN IX and X

A

five fiber types

SVE, GVE, GSA, GVA, and SA

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2
Q

fiber type in CN XI

A

just SVE

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3
Q

course of CN XI

A

ascend within the subarachnoid space, enter the cranial cavity through the foramen magnum and course with CN IX and X to reach the jugular foramen

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4
Q

course of CN IX, X and XI

A

from brainstem/spinal cord –> through the posterior cranial fossa

Cn IX and X - from lateral medulla as several rooles that coalesce to form their respective nerves

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5
Q

what goes through jugular foramen

A

CN IX. X and XI

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6
Q

branches of the glossopharyngeal nerve

A

communicating auricular branch (joins auricular branch of X)

Tympanic nerve (tympanic plexus) and lesser petrosal nerve

Carotid branch of IX

Pharyngeal branches (plexus)

nerve to stylopharyngeus muscle

tonsillar branch

lingual branch

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7
Q

tympanic nerve course and branches

A

branch of CN IX which emerges from the inferior ganglion of CN IX and passes through the jugular foramen
then RE-ENTERS the skull (recurrent course) through the tympanic canaliculus

passes into the tympanic cavity and ascends along its MEDIAL WALL where it contributes to the tympanic plexus

the LESSER PETROSAL NERVE emerges at the superior aspect of the tympanic plexus

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8
Q

pharyngeal brnaches and plexus

A

at the level of the middle constrictor, he PHARYNGEAL BRANCHES OF CN IX (GVA) join the pharyngeal branches of CN -X (GVE, SVE) and POSTGANGLIONIC SYMPATHETIC FIBERS (GVE) and together these make the plexus

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9
Q

CN IX contribution to pharyngeal plexus

A

GVA

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10
Q

CN X contribution to pharyngeal plexus

A

GVE and SVE

the GVE are POST-GANGLIONIC

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11
Q

fibers in the pharyngeal plexus

A

GVA - from CN IX

GVE and SVE from CN X

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12
Q

nerve to stylopharyngeus

A

Descends along the posterior aspect of stylopharyngeus muscle, innervating it

good landmark to find CN IX (glossopharyngeal) as it will go right on this muscle

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13
Q

tonsillar and lingual branches

A

from CN IX
after CN IX gives rise to the nerve to stylopharyngeus, carotid and pharyngeal branches, CN IX passes BETWEEN THE SUPERIOR AND MIDDLE PHARYNGEAL CONSTRICTOR MUSCLES to gain access to the pharynx and posterior oral cavity

hence the names of the branches

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14
Q

best way to locate the tympanic canaliculus on the skull?

A

shared wall between the jugular foramen and the carotid canal

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15
Q

course of the tympanic nerve

A

takes a REURRENT COURSE
emerges from the inferior ganglion of CN IX and EXITS JUGULAR FORAMEN –> turns superiorly to RE-ENTER the skull through the tympanic canaliculus –> and enters the tympanic cavity middle ear cavity)

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16
Q

tympanic cavity aka

A

middle ear cavity

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17
Q

fibers in communicating auricular branch

A

GSA

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18
Q

fiber type in nerve to stylopharyngeus

A

SVE

innervating the stylopharyngeus muscle

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19
Q

fiber type in lingual branch of CN IX and course distibution

A

SA fibers - taste from posterior 1/3 of the tongue and the vallate papillae
GVA fibers to posterior 1/3 of tongue

passes between the superior and middle pharyngeal constrictor muscles to reach this area

GVE fibers - the lingual nerve carries PREGANGLIONIC sympathetic fibers to the posterior 1/3 of tongue which goes to LOCAL GANGLION and post-ganglionic parasympathetic fibers leave the ganglia supply the GLANDS ON POSTERIOR 1/3 OF TONGUE

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20
Q

fiber type in tympanic nerve and distribution

A

GVA fibers
general visceral AFFERENT
these fibers contribute to the tympanic plexus and carry sensory information from the tympanic cavity, pharyngotympanic (eustachian/auditory) tube and mastoid air cells.

so from tympanic plexus to the inferior ganglion (synapse here)

Also GVE to Otic ganglion via lesser petrosal nerve
these are preganglionic fibers that contribute to the tympanic plexus and then from the plexus re names to lesser petrosal

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21
Q

fiber type in the tonsillar branch

A

GVA from palatine tonsils and posterior soft palate (with lesser palatine nerve)

22
Q

GVA distribution in CN IX

A
tympanic nerve 
pharyngeal branches
carotid branches
tonsillar branch 
lingual branch
23
Q

fiber type in pharyngeal branches of CN IX

A

GVA which contribute to the pharyngeal plexus and carry sensory information from the mucous membrane of the pharynx

24
Q

fiber type in the carotid branch of CN IX

A

GVA - these branches carry info regarding the chemical state of blood from the carotid body and pressure info from the carotid sinus

25
Q

lesser petrosal nerve
fiber type
course
distribution

A

these are pre ganglionic parasympathetic fibers contributing to the tympanic plexus and this nerve EMERGES from the plexus and then goes through the hiatus for the lesser petrosal nerve and it LEAVES THE SKULL through the FOAMEN OVALE to enter the otic ganglion in the INFRATEMPORAL FOSSA and THEY SYNAPSE HERE

from the otic ganglion the POST - GANGLIONIC GVE fibers travel with the auriculotemporal nerve of V3

26
Q

branches of the vagus nerve in the jugular fossa and where they come from

A

DIRECTLY from the superior vagal ganglion

  • meningeal branch
  • auricular branch
27
Q

branches of the vagus nerve in the neck and where they come from

A

DESCEND from the inferior vagal ganglion
pharyngeal branch
superior laryngeal nerve (internal and external branch)
right recurrent laryngeal nerve

28
Q

which recurrent laryngeal nerve arises from neck? from thorax?

A

RIGHT - in the neck

LEFT - in the thorax

29
Q

branches of vagus in the thorax

A

left recurrent laryngeal nerve - cardiac and pulmonary branches

30
Q

branches of vagus in abdomen

A

A LOT - not discussed in this part of the course

31
Q

meningeal branch of CN X

A

emerges from the superior vagal

32
Q

meningeal branch of CN X

A

emerges from the superior vagal ganglion, and re-enters the cranial cavity via the jugular foramen and is distributed to DURA IN THE POSTERIOR CRANIAL FOSSA

  • note that most of the dura of the posterior cranial fossa is innervated by ascending fibers from cervical nerves
33
Q

auricular branch of CN X

A

emerges from the superior vagal ganglion; along its course this branch will ACQUIRE FIBERS FROM CN IX AND CN VII and carry them to supply the auricle, external acoustic meatus and outer/lateral surface of tympanic membrane

34
Q

pharyngeal branch of CN X

A

descends from the inferior vagal ganglion to reach the middle pharyngeal constrictor, where its branches contribute to the pharyngeal plexus (along with CN IX)

35
Q

superior laryngeal nerve

A

emerges from the inferior vagal ganglion and terminates into two branches - internal branch of the superior laryngeal nerve (internal laryngeal nerve) and external branch of superior laryngeal nerve (external laryngeal nerve)

36
Q

internal branch of superior laryngeal nerve / internal laryngeal nerve

A

pierces the thyrohyoid membrane to gain access to the larynx

37
Q

external branch of superior laryngeal nerve/ external laryngeal nerve

A

innervates the cricothyroid muscle - also contributes motor innervation to the inferior pharyngeal constrictor)

38
Q

left recurrent laryngeal nerve

A

arises from CN - X in the thorax - courses AROUND the aortic arch

39
Q

right recurrent laryngeal nerve

A

arises from CN X in the neck region and COURSES AROUND THE SUBCLAVIAN ARTERY

40
Q

course of the recurrent (L/R) laryngeal nerve

A

both the right and left recurrent laryngeal nerves ascend in the GROOVE BETWEEN THE TRACHEA AND ESOPHAGUS before reaching the INFERIOR PHARYNGEAL CONSTRICTOR

as these nerves ascend, they pass branches to the trachea, esophagus and inferior pharyngeal constrictor, before passing DEEP to the lower margin of the inferior pharyngeal constrictor to GAIN ACCESS TO THE LARYNX

here the nerve may be referred to as the inferior laryngeal nerve - contributes sensory and motor innervation to the larynx

41
Q

GSA fiber distribubtion in CN X

A

Auricular branch and meningeal branch

42
Q

fiber types in auricular branch and distribution

A

GSA - carries sensory info from auricle, external acoustic meatus and tympanic membrane (lateral surface)

43
Q

fiber type in meningeal branch of CN X and distribution

A

GSA from dura in posterior cranial fossa

44
Q

SVE distribution in Cn X

A

superior laryngeal nerve - but ONLY THE EXTERNAL BRANCH
pharyngeal branches
recurrent laryngeal nerve

45
Q

fibers in external laryngeal nerve and distribution

A

SVE - to the cricothyroid and inferior pharyngeal constrictor muscles

46
Q

fibers in pharyngeal branches of CN X and distribution

A

SVE to the muscles of the pharynx - EXCEPT THE STYLOPHARYNGEUS and muscles of the soft palate EXCEPT THE TENSOR VELI PALATINI

47
Q

fibers in recurrent laryngeal nerve and distribution

A

SVE - to intrinsic muscles of larynx (except the cricothyorid) inferior pharyngeal constrictor and upper esophagus

GVA - mucosa of larynx BELOW vocal fold, traches and upper esophagus + thoracic and abdominal viscera (via the vagus proper)

GVE - symp and parasymp to GLANDS in the same areas as above
parasympathetic outflow destined for thoracic and abdominal viscera will reach ganglia in that region

48
Q

fiber type in internal laryngeal nerve and distribution

A

GVA - mucosa of the laynx to the level of the vocal fold/ from level ABOVE THE VOCAL FOLD and vallecula, epiglottis, and priform recess

GVE - symp and parasymp to the GLANDS at the same level listed above

SA - carrying taste information from the epiglottis and vallecula

49
Q

GVE distribution in CN X

A

internal laryngeal nerve
pharyngeal branches
recurrent laryngeal nerve and vagus nerve proper

the GVE parasympathetic and sympathetic fibers course to the same areas

50
Q

SA fiber distribution in CN X

A

internal laryngeal nerve

51
Q

spinal accessory nerve forms from?

A

CN XI formed by motor fibers from the cervical spinal cord around C1-C5

52
Q

course of CN XI

A

ascend within the subarachnoid space and enter the cranial cavity through foramen magnum and course laterally to meet up with CN IX and X

CN XI leaves the cranial cavity via the jugular foramen and courses inferiorly to innervate the sternocleidomastoid and trapezius muscles