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Glossopharyngeal nerve & its pathology ppt
The glossopharyngeal nerve is the ninth cranial nerve. It is a mixed nerve that originates in the medulla oblongata and exits through the jugular foramen. It carries both sensory and motor fibers and innervates the middle ear, tonsils, back of the tongue, pharynx, and the stylopharyngeus muscle. Damage to the glossopharyngeal nerve can result in loss of sensation in these areas as well as difficulties swallowing and reduced salivation. Glossopharyngeal neuralgia is a condition characterized by severe pain in the throat and ear caused by compression of the nerve.
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Glossopharyngeal nerve & its pathology ppt
- 1.
- 2. Presented by DR. D.Venkateshkumar 1st yr PG
- 3. CONTENTS Introduction Glossopharyngeal nerve Course &origin Nuclear columns & Functional components Branches & Distribution Applied aspects Conclusion References
- 4. INTRODUCTION The nervous systemis an organ system containing a network of specialized cells called neurons that transmit signals between different parts of the body & co-ordinate the actions.
- 5. Structure of Nerve: •Dendrites: Receptor segments that receive impulses from other neurons. • Axons: Projecting segments that transmit impulses to other neurons.
- 6. Parts of thenerve: • Epineurium • Perineurium • Endoneurium
- 7. CRANIAL NERVES The cranialnerves are a group of 12 paired nerves originating from the brain. The twelve cranial nerves are: I – Olfactory nerve II –Optic nerve III – Occulomotor nerve IV –Trochlear nerve V – Trigeminal nerve VI – Abducent nerve VII –Facial nerve VIII–Vestibulocochlear or Auditory nerve IX – Glossopharyngeal nerve X – Vagus nerve XI – Spinal accessory nerve XII– Hypoglossal nerve
- 8. Pure sensory • I,II, VIII cranial nerves Pure motor • III, IV, VI, XII Cranial nerves mixed • V, VII, IX, X, XI Cranial nerves
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- 10. Glossopharyngeal nerve Ninthcranial nerve. Mixed nerve. Motor root-basal plate of the embryonic medulla oblongata. Sensory root-cranial neural crest. Nerve of III branchial arch.
- 11. Ventral surface ofmedulla oblongata. posterior cranial fossa. Central part of jugular foramen Between internal jugular vein and external carotid artery Course & Origin
- 12. Deep to styloidpr0cess Between internal and external carotid arteries at posterior border of stylopharyngeus Reaches pharynx-between middle and inferior constrictor, deep to hypoglossus.
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- 14. Jugular foramen contents CN IX CN X CN XI Internal jugular vein Sigmoid sinus Meningeal branch from occipital and ascending pharyngeal arteries.
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- 16. Nuclear columns &functional components
- 17. Branchiomotor Special visceral efferent (Nucleusambigus ) Supply only one muscle – stylopharyngeus. Nuclear columns & functional components
- 18. Parasympathatic General visceral efferent (inferiorsalivatory nucleus) To supply parotid gland after relay in the otic ganglion.
- 19. General somatic afferent Spinalnucleus of CN V Carries proprioceptive impulses from pharyngeal muscle to spinal tract of V.
- 20. Viscerosensory (Nucleus of solitarytract) General visceral afferent &special visceral afferent Recives general sensations from post 1/3rd of tongue, tonsil, pharynx, carotid body, taste sensation from post 1/3rd of tongue.
- 21. Branches & Distribution BranchSupply Tympanic branch Middle ear, auditory tube,lesser petrosal nerve relay in otic ganglion join auriculotemporal nerve and supplies parotid gland. Sinocarotid branch Carries Baroreceptors : carotid sinus Chemoreceptors : carotid body Tonsilary & palatal branches Supply sensory fibers to Palatine tonsil & soft palate.
- 22. Branches Supply Lingual branchesSupply to posterior 1/3rd of the tongue including circumvallate papillae. Pharyngeal branches Sensory to mucous membrane of pharynx. Muscular branches Stylopharyngeus muscle
- 23.
- 24. Functions of variousbranches of IX cranial nerve Auriculotemporal nerve provides various sensory innervations on the side of head. Baroreceptors are maintains blood pressure. Chemoreceptors are maintains chemical concentrations in blood.
- 25. Functions of variousbranches of IX cranial nerve Tonsil produce antibodies to kill germs and help to prevent throat and lung infections. Soft palate is responsible for closing of the nasal passage during act of swallowing and also for closing of the airway. Stylopharyngeous muscle elevates both pharynx and larynx
- 26. Applied aspects Glossopharyngeal nervelesions Glossopharyngeal neuralgia Glossopharyngeal nerve paralysis.
- 27. Glossopharyngeal nerve lesions Difficulty in swallowing Loss of general sensation over posterior 1/3rd of tongue, palate, pharynx. Loss of taste sensation over posterior 1/3rd of the tongue. Dysfunction of tongue. Loss of gag reflux. Glossopharyngeal nerve lesions produce:
- 28. Glossopharyngeal neuralgia • Similarto trigeminal neuralgia except the location. • Pain is present on tonsil and ear. • Pain is radiating from throat to ear because of tympanic branch of IX nerve. • It is two types 1.Classical 2.Symptomatic
- 29. • Classical typeis obtained by arterial compression of the nerve at courses through jugular foramen • Symptomatic type is obtain by under lying cause such as oropharyngeal tumors pagetic bone or calcified stylohyoid ligament.
- 30. Clinical features • Rarelybilateral involvement. • Episodic pain ,sharp, lancinating, and extreme intense. • Pain during talking ,chewing, yawning, swallowing, touching a blunt instrument to tonsil. • No definite trigger zone. • Pt difficulty to localize the pain in oropharynx.
- 31. Diagnosis MRI scanof head CT scan of head X rays of arteries with dye( conventional angiography)
- 32.
- 33. Surgical 1. Micro vascular decompression 2.Surgical sectioning of glossopharyngeal nerve.
- 34. Glossopharyngeal paralysis Etiology – Diphtheriamay cause IX nerve paralysis( Reversible) Diseases to lower brainstem Surgical procedures to tonsil. Symptoms – Loss of sensation from pharynx Decreased salivation Loss of taste sensation at post 1/3rd of the tongue.
- 35. Conclusion Glossopharyngeal nerve isa ninth cranial nerve, which carries both sensory and motor functions. Any damage to this nerve leads to abnormalities in its function. So, proper care must be taken during surgical procedures to prevent these complications.
- 36. References 1. B.D.Chaurasia’sHuman Anatomy, vol 3: 4th edition 2. Burket’s Oral Medicine- Diagnosis & Treatment – 10th ed. Martin S Greenberg & Michael Glick 3. Internet source 4. Gray’s anatomy– The anatomical basis of clinical practice 5. Shafer’s-A textbook of Oral Pathology. 6. Neville –A textbook of Oral and Maxillofacial Pathology, 1st south asia edition 7. Thieme - Textbook of head and neck anatomy for dental medicine
Editor's Notes
- #11 The glossopharyngeal nerve, known as the ninth cranial nerve (CN IX), is a mixed nerve that carries afferent sensory and efferent motor information . Motor division is derived from the basal plate of the embryonic medulla oblongata, while sensory division originates from the cranial neural crest.
- #12 3rd arch -Lower part of body of hyoid bone 3rd pouch –inferior parathyroid gland, thymus
- #13 BDeep to the styloid process. Between the internal and external carotid arteries at posterior border of stylopharyngeus then lateral to it. Reaches the pharynx by passing between middle and inferior constrictor, deep to hyoglossus, where it breaks into terminal branches.
- #21 Motor-All muscles except palatoglossus are suppied by hypoglossal nerve. PG is supplied by cranial root of accessory nerve. Sensory – chorda tympani ant 2/3rd ,post 1/3rd IX nerve (both sensory and motor) Lingual nerve is nerve of general sensations.
- #25 2. Baroreceptors are sensors which locates in the blood vessels of all vertebrate animals. They sense the blood pressure and relay the information to the brain, so that a proper blood pressure to be maintained. Chemoreceptors are sensory extensions of the peripheral nervous system in to blood vessels where they detect changes in chemical concentrations.
- #26 3. Tonsil: Antibodies produce by the immune cells in the tonsils help to kill germs and help to prevent throat and lung infections. Soft palate is responsible for closing of the nasal passage during act of swallowing and also for closing of the airway.
- #31 Middle and old age group. No sex predilection.