Hypoglossal nerve
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  • 1. Hypoglossal nerve Dr / Hytham Nafady
  • 2. Introduction
    • hypoglossal nerve has only a somatic motor component (general somatic efferent) that supplies the extrinsic and intrinsic tongue muscles.
  • 3.  
  • 4.  
  • 5. Anatomy
  • 6. Segments of the hypoglossal nerve
    • Hypoglossal nucleus.
    • Intracranial segments:
    • Medullary segment.
    • Cisternal segment.
    • Canalicular segment.
    • Extracranial segments:
    • Nasopharyngeal/oropharyngeal carotid space.
    • Sublingual segment.
  • 7.  
  • 8. Hypoglossal nucleus, medullary & cisternal segments
  • 9. Hypoglossal nucleus
    • Location:
    • Hypoglossal colliculus of the medulla oblongata.
  • 10.  
  • 11. Medullary segment
    • The fibers of the hypoglossal nerve course anteriorly lateral to the medial leminscus & lateral to the olive.
    • The hypoglossal nerve exits the medulla at the pre-olivary sulcus.
  • 12.  
  • 13. Cisternal segment
    • The hypoglossal nerve course laterally through the premedullary cistern, posterolateral to the vertebral artery.
  • 14. PICA Hypoglossal nerve Vertebral arteries
  • 15. Canalicular segment (hypoglossal canal)
  • 16. Hypoglossal canal axial CT
  • 17. Hypoglossal canal coronal CT
  • 18. Persistent primitive hypoglossal artery
  • 19.  
  • 20. Interpeduncular cistern ICA Sigmoid sinus IJV Cn 12 Cn 10 Cn 9
  • 21. Suprahyoid carotid space segment
    • The hypoglossal nerve lies deep to the IJV , ICA & 9 & 10 cranial nerves.
    • It become superficial as it courses anteriorly.
    • At the level of angle of the mandible it loops anteriorly around the root of the occipital artery and lying deep to the posterior belly of digastric muscle.
  • 22. Sublingual segment
    • The hypoglossal nerve enters the sublingual space by crossing the lingual artery at the level of hyoid bone.
    • The hypoglossal nerve lies superfical to the hyoglossus muscle & deep to the myelohyoid muscle.
  • 23.  
  • 24.  
  • 25. suprahyoid carotid space segment
  • 26.  
  • 27.  
  • 28.  
  • 29.  
  • 30.  
  • 31. platymsa base Intrinsic muscles GG GH
  • 32.  
  • 33.  
  • 34. Action of genioglossus in sticking out the tongue
  • 35. Tongue protrusion
  • 36. Pushing the tongue into the cheek against resistance
  • 37. Hypoglossal palsy
  • 38. Medullary glioma
  • 39. Vertebrobasilar dolichoectasia with hypoglossal nerve palsy
  • 40. Meningioma
  • 41. Cisternal hypoglossal schwannoma with tongue atrophy
  • 42. Isolated hypoglossal palsy caused by synovial cyst
  • 43. Hypoglossal schwannoma
  • 44. Occipital condylar fracture
  • 45. Skull base metastasis
  • 46. Carotid artery dissection
  • 47.  
  • 48. Extracranial hypoglossal schwannoma with tongue hemiatrophy
  • 49. Submandibular hypoglossal schwannoma
  • 50. Thank you