Hypoglossal nerve
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Hypoglossal nerve

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    Hypoglossal nerve Hypoglossal nerve Presentation Transcript

    • Hypoglossal nerve Dr / Hytham Nafady
    • Introduction
      • hypoglossal nerve has only a somatic motor component (general somatic efferent) that supplies the extrinsic and intrinsic tongue muscles.
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    • Anatomy
    • Segments of the hypoglossal nerve
      • Hypoglossal nucleus.
      • Intracranial segments:
      • Medullary segment.
      • Cisternal segment.
      • Canalicular segment.
      • Extracranial segments:
      • Nasopharyngeal/oropharyngeal carotid space.
      • Sublingual segment.
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    • Hypoglossal nucleus, medullary & cisternal segments
    • Hypoglossal nucleus
      • Location:
      • Hypoglossal colliculus of the medulla oblongata.
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    • 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.
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    • Cisternal segment
      • The hypoglossal nerve course laterally through the premedullary cistern, posterolateral to the vertebral artery.
    • PICA Hypoglossal nerve Vertebral arteries
    • Canalicular segment (hypoglossal canal)
    • Hypoglossal canal axial CT
    • Hypoglossal canal coronal CT
    • Persistent primitive hypoglossal artery
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    • Interpeduncular cistern ICA Sigmoid sinus IJV Cn 12 Cn 10 Cn 9
    • 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.
    • 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.
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    • suprahyoid carotid space segment
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    • platymsa base Intrinsic muscles GG GH
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    • Action of genioglossus in sticking out the tongue
    • Tongue protrusion
    • Pushing the tongue into the cheek against resistance
    • Hypoglossal palsy
    • Medullary glioma
    • Vertebrobasilar dolichoectasia with hypoglossal nerve palsy
    • Meningioma
    • Cisternal hypoglossal schwannoma with tongue atrophy
    • Isolated hypoglossal palsy caused by synovial cyst
    • Hypoglossal schwannoma
    • Occipital condylar fracture
    • Skull base metastasis
    • Carotid artery dissection
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    • Extracranial hypoglossal schwannoma with tongue hemiatrophy
    • Submandibular hypoglossal schwannoma
    • Thank you