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Last 4 cranial nerves
1. The Last 4 Cranial
Nerves
By: Khalid Mohamed Mostafa Mohamed Ibrahim
PROF. Dr. Shirley Hilal Labib El Massarany, M B Ch B, M Sc, Ph D.
Supervisor:
Professor of Human Anatomy, Faculty of Medicine, Alexandria
University
10. Course and
relations
2) It descends
downwards between
IJV and ICA (Upper
part of Carotid Sheath)
deep to styloid
process and muscles
attached to it.
27. Course and
relations:
1) Leaves Cranium
through middle
compartment of
jugular foramen.
Two Sensory Ganglion:
Superior: inside
foramen.
Inferior: Just bellow
foramen.
28. Course and
relations:
2) Cranial root of
accessory nerve
joins inferior
ganglion of Vagus
nerve just bellow
the Jugular
foramen.
33. 2 branches from
inferior ganglion
1)Pharyngeal
Branch: (Motor)
Descends between
ICA and ECA to
reach Middle
Constrictor Muscle
to share in
Pharyngeal Plexus
35. 2 cardiac
branches:
Superior Cardiac Branch
Arises from beginning
of Vagus Nerve
Inferior Cardiac Branch:
Arises at level of root of
neck
(Both cross Subclavian
a. to reach Cardiac
Plexus)
38. XI: Accessory Nerve
Type: Purely Motor
Origin:
First root: Posterolateral sulcus of Medulla
Second root: Upper 5 or 6 Cervical Segments of Spinal
Cord
45. Spinal Branch:
• Descends between IJV and
ICA
• Backwards deep to
posterior belly og digastric
muscle
• Pierces Sternomastoid
• Exits posterior border
above middle of muscle
• Across posterior triangle
of the neck
• Into Trapezius (5 cm above
clavicle)
• Ends there supplying it.
50. XII: Hypoglossal Nerve
Type: Motor to all intrinsic and extrinsic muscle of the tongue
except palatoglossus.
Origin: Anterolateral sulcus of Medulla
52. 1)Exits cranium through
Anterior Condylar
Foramen
2)Half spiral loop around
Vagus Nerve
3)Descends vertically
between IJV and ICA
4)Runs deep to Styloid
Process and Posterior
Belly of Digastric
Muscle
54. • 6) Deep to intermediate
tendon of posterior belly
of digastric
• Runs on Hyoglossus
muscle and disappears
deep into Mylohyoid
• Dips into interval
between Hyoglossus and
Genioglossus
• Breaks into terminal
branches supplying
muscles of the tongue
57. Summary
➢All 4 CN originate in Medulla
➢CN 9 and 10 are mixed; the former to: Tongue and Tonsils and Pharynx.
the latter to: Larynx
➢CN 11 and 12 are motor; the former to: Sternomastoid and Trapezius.
the latter to: intrinsic and extrinsic muscles of tongue