Last 4 cranial nerve Flashcards
بسم الله الرحمن الرحيم وبه نستعين
“ ولو آمن أهل الكتاب لكان خيرا لهم “ ^_^
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Describe glossophayngeal nerve
CN9 mixed
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From 3rd Pahryngeal arch
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Has superior and inferior ganglia
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supply:
=Motor to sylophayngeus
=Proprioceptive General somatic afferent to stylopharyngeus
=General Visceral efferent secromotor to parotid gland
=General visceral afferent from pharynx larynx and post 1/3 of tongue
=Special visceral afferent taste from post 1/3 of tongue
Exit of CN9 FROM ?
Middle part of Jugular foramen
Extracranial course of CN9
Descends between…….&…….
deep to ………….
then turn around ………..
passing between ……..&………….
curving forward ………. to pass between ……&.,……. of pharynx and deep to …………. to be distruibuted to ……. &……….(….) and ……(…..)
ICA &IJV
Styloid apparatus
Stylopharyngus !
ICA &ECA
Medially
Superior & Middle constrictors
Deep to Hyoglossus
Tongue (post 1/3 and vallate papillae) and Tonsils and pharynx mucous membrane
Mention branches of glossopharyngeal CN9
PCTM Lingual
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=Pharyngeal For pharyngeal pleux
=Carotid : for carotid siuns and body
=Tympanic : for tympanic pleux for grater and lesser pertosal of parotid + sensory to mucosa of middle ear auditory tube + mastoid cells
=Tonsillar for tonsillar pleux to supply palatine tonsil + soft palate
=Musclear for stylophayngus
=Lingual for special and general of post 1/3 of tongue
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How to test CN9 ?
Trickling of posteiror wall of pharynx causing throat muscle contraction
this is lost if paralysed
______________________
it is affected with CN10
As they pass through middle juglar foramen
vaugs nerve describe
CN10 MIX
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2 sensory ganglis superior and inferior
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Types of fibers
GSE= Motor to pharynx and larynx and palate with CN11
=General Visceal efferents : inhibtory to heart + motor and secremotor to bronchi + foregut below pharynx and midgut and liver and pancreas
=General visceral afferents: mucosa fo respiratory and digestive tracts
=Special visceal afferents gustatory to epiglottis
=General somatic afferent : Sensory from external ear
desribre extracranl course of Vagus
It passes throug middle part of juglar foramen to be joined with cranial accessory distributed to its pharyngeal and recurrent pharyngeal branches then
downwards in carotid sheath first between ICA&IJV THEN CCA&IJV
then
Right side: cross first part of subclavian artery to enter thorax
Left side: move between left sublclavian and CCA to enter thorax
Mucosa of larynx supplied by?
above vocal cord: internal laryngeal
below vocal cord :
Reurrent laryngeal right
nerve accomanying
1-superior thyroid aretry
2-inferior thyorid aretery?
1-External laryngeal
2-Right recurrent laryngeal
Mention branches of Vagus CN10
2 superior ganglia & 2inferior ganglia & 3Neck& 2 thorax
________________________
=Superior ganglia :
-Meningeal for dura in poster fossa
-Auricular from tympano mastoid fissure to ?
Chonca + Post 1/2 External auditory meatus +Root of auricle + tympanic membrane
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=Inferior ganglia : ps
-Pharyngeal mostly from accessory between ICA And ECA to middle constrictor to share in pharyngeal pluex
-Superior Laryngeal :-
-Internal Laryngeal : peircing thyrohyoid membrane to supply mucosa of larynx above vocal cord
-External laryngeal along The superior thyorid art to pirece inferior constricitor supplying it and Ciricothyroid
_____________________
Neck CR
-Carotid: for carotid body and sinus
-Cardica: sup and inf from each side the left inferior share in superficial cardiac pleux the other 3 in deep pleux
-Right recuurent laryngral winding around firs part of subclavian artery to be in TracheoEsophageal groove to supply muscles and muscosa of larynx below Vocal Cord
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Thorax:
-Left recurrent laryngeal nerve winding around aortic arch
-Pulmonary and Cardiac branches
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How to test vaugs or its branches
Examination of palatal arches on both sides if paralysed there is no arch
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auricular branche irritation by Wax in external ear or
Wash
Casuing
Reflex Cough
Describe CN11 accessory nerve
Pure motor formed of Spinal and cranial part with no ganglia
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Cranial part : from nucleus ambigous in medulla leaving it between Olive and inferior cerebellar peduncle then to juglar foramen uniting with its spinal part exiting with vagus and glosspharyngeal
Extracranially: its is separated from spinal part to join vagus to supply Parynx &larynx& palate
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Spinal part From Axons of nerve cells in the spinal accessoy nucleus in upper 5 cervical segments to reach foramne magnum then to juglar foramen to unit with cranial part then separtes to supply ? StrenoMastoid + Trapezius
how to test CN 11
Examination to Trapezius : by elevating shoulder against resistance
Sternomastoid : moving neck to opposite side
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I
Irritation OF CN11 nerve by Enlarged LNs
produces ?
Torticolis
Desceibe hypoglossal nerve
CN12 pure motor
With somatic effetents fibers exiting skull through Hypoglossal canal called anteiro condylar canal
______________
deep to ICA and 9 10 11 CNs between ICA & IJV
Then crossing ICA &ECA &Lingual artery to reach posterior belly of digastric to digastric triangle to reach anterior hyoglossus to reach TONGUE
