Unit I: Nerves of the Neck Flashcards
This nerve emerges from the medulla oblongata and passes through the jugular foramen
Glossopharyngeal nerve (CN IX)
The SIX branches of the glossopharyngeal nerve
1) Tympanic nerve
2) Branch to the Carotid sinus
3) Pharyngeal branch
4) Branch to the Stylopharyngeus
5) Tonsillar branch
6) Lingual branch
This branch of the glossopharyngeal nerve supplies SENSORY input to the tympanic cavity and secretomotor (parasympathetic) to the parotid gland
Tympanic nerve
This branch of the glossopharyngeal nerve supplies SENSORY input both the Carotid sinus and the Carotid body
Branch to the Carotid sinus
This branch of the glossopharyngeal nerve UNITES with branches from the Vagus and Sympathetic trunk to form the Pharyngeal plexus. It also supplies SENSORY input to the pharynx
Pharyngeal branch
The three branches that form the Pharyngeal plexus
1) Pharyngeal branch of Glossopharyngeal nerve
2) Pharyngeal branch of Vagus nerve
3) Branches to the Pharyngeal plexus from the branch of the Superior cervical ganglion of the Cervical sympathetic ganglia of the sympathetic trunk
This nerve branch can:
1) sense pain in acute pharyngitis (sore throat)
2) Afferent (sensory) limb of gag reflex
Pharyngeal branch of Glossopharyngeal nerve
This branch of the glossopharyngeal nerve supplies MOTOR input to the stylopharyngeus muscle
Branch to the Stylopharyngeus
This branch of the glossopharyngeal nerve supplies SENSORY input to the mucous membrane over the TONSIL and soft palate
Tonsillar branch
This nerve branch can sense pain in Tonsillitis
Tonsillar branch of Glossopharyngeal nerve
This branch of the glossopharyngeal nerve supplies TASTE and general sensations to the POSTERIOR third of the tongue (oropharyngeal part)
Lingual branch
This nerve is the LONGEST cranial nerve in the body with an extensive distribution in the head, neck, thorax, and abdomen
Vagus nerve (CN X)
It is called the “wanderer”
Vagus nerve
This nerve emerges from the medulla oblongata and EXITS the skull through the jugular foramen along with the glossopharyngeal and accessory nerves.
Vagus nerve
This is where the Vagus, Accessory, and Glossopharyngeal nerves and the Internal Jugular vein EXIT the skull
Jugular foramen
Two ganglia of the Vagus in the NECK
1) Superior (jugular) ganglion
2) Inferior (Nodose) ganglion
This is located INSIDE of the Jugular foramen
Superior (jugular) ganglion
Branches of the Vagus in the HEAD and NECK
1) Meningeal branch
2) Auricular branch
3) Pharyngeal branch
4) Superior laryngeal nerve
5) Recurrent laryngeal nerve
This branch of the Vagus nerve arises from the SUPERIOR ganglion and supplies SENSORY input to the DURA mater
Meningeal branch
This nerve branch may be involved in Cervicogenic headaches
Meningeal branch of the Vagus nerve
This branch of the Vagus nerve arises from the SUPERIOR ganglion and supplies SENSORY input to the:
- Auricle
- floor of the external auditory meatus
- tympanic membrane
Auricular branch
This nerve branch may be involved in sensing pain in the Otitis externa (swimmer’s ear)
Auricular branch of the Vagus nerve
This branch of the Vagus nerve arises from the INFERIOR ganglion. It is the chief MOTOR nerve to the muscles of the pharynx and soft palate.
Pharyngeal branch
Most of the fibers that form the Pharyngeal branch of the Vagus nerve original from this nerve.
Cranial part of the Accessory nerve
This plexus is the MOTOR supply to all the muscles of the pharynx EXCEPT the stylopharyngeus (innervated by glossopharyngeal nerve) and to all the muscles of the soft palate EXCEPT for the tensor veli palatini (innervated by trigeminal nerve)
Pharyngeal plexus
This branch of the Vagus nerve arises from the INFERIOR ganglion and then divides into 2 branches.
Superior Laryngeal nerve
The two branches of the Superior laryngeal nerve
1) internal laryngeal nerve
2) external laryngeal nerve
This branch of the Superior laryngeal nerve (of Vagus) supplies SENSORY input to mucous membrane of the larynx SUPERIOR to the true vocal folds.
Internal Laryngeal nerve
This branch of the Superior laryngeal nerve (of Vagus) supplies MOTOR input to the cricothyroid and inferior constrictor muscles
External laryngeal nerve
This branch of the Vagus nerve arises from the Vagus WITHIN the thorax and then ascends back into the neck. It ascends in the groove between the trachea and the esophagus, and is closely related to the POSTERIOR surface of the thyroid gland.
Recurrent Laryngeal nerve
This nerve branch is associated with the EFFERENT limb of gag reflex
Pharyngeal branch of Vagus nerve
This branch of the Vagus is SENSORY to the mucous membrane of the Larynx BELOW the true vocal folds and to the trachea.
-MOTOR to all of the muscles of the larynx EXCEPT the cricothyroid
Recurrent Laryngeal nerve
Clinical consequences of damage to Recurrent Laryngeal nerve
1) Unilateral damage
- respiratory distress
- hoarseness (partial aphonia)
2) Bilateral damage
- complete aphonia may result in suffocation
Causes of Recurrent Laryngeal nerve damage
1) Thyroid surgery (trauma)
2) Goiter or thyroid tumor
3) Lung tumor
4) Aortic anuerysm (left only)
- aortic arch developmentally at risk for aneurysm
This nerve is formed from the union of TWO parts:
- Cranial part
- Spinal part
Accessory nerve (CN XI)
This part of the Accessory nerve originates from the Medulla oblongata. It joins with the Vagus nerve ABOVE the inferior vagal ganglion and EXITS through the jugular foramen.
Cranial part
This part of the Accessory nerve originates from the SIDES of the spinal cord. It ascends through the foramen magnum and joins the other part of the accessory nerve for a short distance. Exits through the jugular foramen
Spinal part
This part of the Accessory nerve supplies the Vagus with MOTOR fibers that travel in two areas.
Cranial part
The motor fibers of the Accessory nerve travel in these TWO areas
1) Pharyngeal branch of the Vagus
2) Recurrent laryngeal nerve
Motor fibers from the cranial part of the accessory nerve traveling in the Pharyngeal branch of the Vagus go to these two groups of muscles
Muscles of the Pharynx and Soft palate
Motor fibers from the cranial part of the accessory nerve traveling in the Recurrent laryngeal nerve go to these muscles
Muscles of the Larynx
The SPINAL part of the Accessory nerve is MOTOR to these two muscles
SCM and Trapezius
This nerve is the MOTOR nerve to the tongue. It originates from the medulla oblongata and EXITS the skull through the hypoglossal canal.
Hypoglossal nerve (CN XII)
This nerve loops DOWNWARD and forward deep to the POSTERIOR belly and intermediate tendon of the digastric
Hypoglossal nerve
Branches of the Hypoglossal nerve
1) Meningeal branches
2) Superior root of the Ansa Cervicalis
3) Nerves to the Thyrohyoid and Geniohyoid
4) Lingual branches
This branch of the Hypoglossal nerve supplies the dura mater
Meningeal branches
This branch of the Hypoglossal nerve consists mainly of C1 fibers and UNITES with the inferior root (C2 and C3) to form the Ansa cervicalis, which is the MOTOR to the infrahyoid muscles (sternohyoid, sternothyroid, omohyoid)
Superior root of the Ansa Cervicalis
These branches of the Hypoglossal nerve consist of C1 fibers. They are the MOTOR supply to the thyrohyoid and geniohyoid muscles
Nerves to Thyrohyoid and Geniohyoid
These branches of the Hypoglossal nerve are MOTOR to the extrinsic and intrinsic muscles of the tongue
Lingual branches
This part of the Sympathetic trunk begins at the BASE of the skull and is continuous with the thoracic part of the trunk
Cervical part of the Sympathetic trunk
These fibers supply the head and neck and originate from T1-T3. They then travel up the trunk to one of several cervical ganglia where they synapse
Preganglionic sympathetic fibers
These fibers are distributed from the ganglia to the blood vessels, smooth muscle, and glands of the head and neck.
Postganglionic sympathetic fibers
The four major branches of the Cervical sympathetic ganglia
1) Superior cervical ganglion
2) Middle cervical ganglion
3) Vertebral ganglion
4) Cervicothoracic (Stellate) Ganglion
This branch of the cervical sympathetic ganglia lies from C1 to C3 immediately BELOW the base of the skull. It has 3 branches (internal carotid nerve, superior cervical cardiac nerve, branches to the pharyngeal plexus)
Superior cervical ganglion
This branch of the Superior cervical ganglion is a relatively LARGE nerve that accompanies the internal carotid artery into the skull
Internal Carotid nerve
This branch of the Superior cervical ganglion goes to the Cardiac plexus
Superior Cervical Cardiac nerve
This branch of the superior cervical ganglion gives off its supply to the pharyngeal plexus
Branches to the Pharyngeal Plexus
Branches of the Superior Cervical ganglion
1) Internal Carotid nerve
2) Superior cervical cardiac nerve
3) Branches to the Pharyngeal plexus
This branch of the Cervical sympathetic ganglia lies at C6 level and has one branch (Middle cervical cardiac nerve)
Middle cervical ganglion
This branch of the Middle cervical ganglion goes to the Cardiac plexus
Middle cervical cardiac nerve
This branch of the Cervical sympathetic ganglia is found at the level of C7 and is fused with the middle or inferior cervical ganglion. It gives off one branch to the plexus along the vertebral artery.
Vertebral ganglion
This branch of the Cervical sympathetic ganglia is formed from the fusion of the inferior cervical ganglion to the first thoracic ganglion. It lies from C7 to T1.
Cervicothoracic (Stellate) ganglion
This branch of the cervical sympathetic ganglia is located POSTERIOR to the vertebral artery and ANTERIOR to the transverse process of C7 and the neck of the first rib
Cervicothoracic (stellate) ganglion
This branch of the Cervicothoracic ganglion goes to the Cardiac plexus
Inferior cervical cardiac nerve
This is a nerve bundle that loops ANTERIOR to the subclavian artery connecting the vertebral ganglion to the cervicothoracic ganglion.
Ansa Subclavia
