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.

1. GOOD MORNING

2. Presented by
DR. D.Venkatesh kumar
1st yr PG

3. CONTENTS
Introduction
Glossopharyngeal nerve
Course & origin
Nuclear columns & Functional components
Branches & Distribution
Applied aspects
Conclusion
References

4. INTRODUCTION
The nervous system is 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 the nerve:
• Epineurium
• Perineurium
• Endoneurium

7. CRANIAL NERVES
The cranial nerves 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

9. Nerve fibers

10. Glossopharyngeal nerve
 Ninth cranial 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 of medulla
oblongata.
posterior cranial fossa.
Central part of jugular
foramen
Between internal jugular vein
and external carotid artery
Course & Origin

12. Deep to styloid pr0cess
Between internal and external
carotid arteries at posterior
border of stylopharyngeus
Reaches pharynx-between
middle and inferior constrictor,
deep to hypoglossus.

13. Course & origin

14. Jugular foramen contents
 CN IX
 CN X
 CN XI
 Internal jugular vein
 Sigmoid sinus
 Meningeal branch from
occipital and ascending
pharyngeal arteries.

15. Nucleus of glossopharyngeal nerve

16. Nuclear columns & functional components

17. Branchiomotor
Special visceral efferent
(Nucleus ambigus )
Supply only one muscle –
stylopharyngeus.
Nuclear columns & functional components

18. Parasympathatic
General visceral efferent
(inferior salivatory
nucleus)
To supply parotid gland
after relay in the otic
ganglion.

19. General somatic afferent
Spinal nucleus of CN V Carries proprioceptive
impulses from pharyngeal
muscle to spinal tract of V.

20. Viscerosensory
(Nucleus of solitary tract)
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
Branch Supply
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 branches Supply to posterior 1/3rd of
the tongue including
circumvallate papillae.
Pharyngeal branches Sensory to mucous
membrane of pharynx.
Muscular branches Stylopharyngeus muscle

23. Branches & Distribution

24. Functions of various branches 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 various branches 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 nerve lesions
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
• Similar to 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 type is 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
• Rarely bilateral 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 scan of head
 CT scan of head
 X rays of arteries with
dye( conventional
angiography)

32. Treatment
Medical :
Anticonvulsant medications-
Carbamazepine,
Oxcarbazepine,
Baclofen,
Phenytoin,
Lamotrigine

33. Surgical
1. Micro vascular
decompression
2. Surgical sectioning of
glossopharyngeal nerve.

34. Glossopharyngeal paralysis
Etiology –
Diphtheria may 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 is a 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’s Human 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