Hypoglossal nerve
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The hypoglossal nerve (CN XII) originates in the medulla oblongata and exits the skull through the hypoglossal canal. It innervates all the muscles of the tongue except for the palatoglossus, which is innervated by the vagus nerve. The hypoglossal nerve is responsible for motor control of the tongue muscles to enable all tongue movements. It also transmits some fibers from the C1/C2 spinal nerves to innervate muscles of the neck and hyoid bone.
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Hypoglossal nerve
The hypoglossal nerve originates in the hypoglossal nucleus of the medulla and innervates the muscles of the tongue. It exits the skull through the hypoglossal canal and descends through the neck. Lesions can occur at the supranuclear, nuclear, or peripheral levels. Supranuclear lesions of the corticobulbar tract cause contralateral tongue weakness without atrophy. Nuclear lesions in the medulla result in ipsilateral tongue paresis, atrophy and fasciculations. Peripheral lesions of the hypoglossal nerve cause ipsilateral tongue paresis through the hypoglossal canal.
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There are 12 pairs of cranial nerves that originate from the brain. They are the olfactory, optic, oculomotor, trochlear, trigeminal, abducens, facial, vestibulocochlear, glossopharyngeal, vagus, accessory, and hypoglossal nerves. Each nerve has specific functions, such as carrying sensory information for smell, vision, and taste, or controlling eye and facial muscle movement. Damage to certain cranial nerves can cause issues like Bell's palsy or an inability to speak or swallow.
1.facial nerve
The facial nerve (CN VII) is responsible for facial muscle movement and taste. It originates in the brainstem and travels through the facial canal in the temporal bone. The main branches innervate the muscles of facial expression. Facial paralysis can occur from lesions at different levels and have varying clinical presentations. Bell's palsy is an idiopathic acute facial paralysis that usually resolves over time with treatment. Evaluation and management depends on the severity and cause of injury.
Nerves of the head
This document discusses the sympathetic and parasympathetic innervation of the head. It describes the anatomy and course of the sympathetic nerves, which originate in the thoracic spinal cord and ascend to three cervical ganglia. It details the ganglia and nerves that arise from each, including their target organs. It then discusses the parasympathetic innervation, which originates in cranial nerve nuclei and travels to four head ganglia. It provides information on the ganglia, pre- and post-ganglionic fibers, and target organs for each. Finally, it briefly introduces the trigeminal nerve, its nuclei, ganglion and three terminal divisions.
Vagus nerve
The vagus nerve is the 10th cranial nerve. It has the longest course of all cranial nerves, extending from the head to the abdomen. It is functionally diverse, providing sensory innervation to parts of the ear, head, neck, and internal organs. It also provides motor innervation to muscles of the pharynx, larynx, and soft palate. Additionally, it has parasympathetic functions and helps regulate heart rate and secretions in the gastrointestinal tract.
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5. acid base balance
The document discusses acid-base homeostasis and physiology. It explains that the body tightly regulates blood pH through bicarbonate buffering and the actions of the kidneys and lungs. The kidneys regulate bicarbonate levels over hours to days while the lungs regulate carbon dioxide levels over minutes to maintain pH. Metabolic acidosis occurs when bicarbonate is lost or protons are gained, and can be categorized as respiratory or non-respiratory based on the anion gap. Metabolic alkalosis occurs when acid is lost or base is gained. Respiratory acidosis and alkalosis occur when carbon dioxide is retained or lost, respectively.
4. ion balance
The kidney plays a key role in maintaining the external balance of potassium through regulating its reabsorption and secretion. Most potassium is reabsorbed in the proximal tubule through passive mechanisms. In the thick ascending limb, the NKCC2 channel actively transports potassium into cells, while the distal convoluted tubule uses the H+-K+-ATPase channel to couple potassium reabsorption to hydrogen secretion. Potassium secretion occurs mainly in the collecting duct, driven by the sodium-potassium ATPase pumping sodium out and potassium into cells, creating gradients for potassium to exit into the tubule lumen. Factors such as aldosterone, acid-base status, and luminal flow influence potassium regulation.
3. urinary regulation
The document discusses the renin-angiotensin-aldosterone system (RAAS) which regulates blood pressure and fluid balance. RAAS involves the hormones renin, angiotensin II, and aldosterone. Renin is released by the kidneys in response to low sodium levels, low blood pressure, or sympathetic stimulation. Renin converts angiotensinogen to angiotensin I, which is then converted to angiotensin II by the lungs. Angiotensin II causes vasoconstriction, sodium reabsorption by the kidneys, aldosterone release by the adrenals, and thirst stimulation. This increases blood pressure and volume.
2. micturition
The document discusses the storage and voiding phases of micturition, or urination. During storage, the bladder relaxes and the urethral sphincters contract, allowing urine to be stored. Sympathetic signals relax the bladder and contract the internal urethral sphincter, while somatic signals contract the external sphincter. As the bladder fills, its walls distend to maintain low pressure. During voiding, parasympathetic signals cause the bladder to contract while relaxing the sphincters, allowing urine to be released.
1. the nephron
The nephron is the basic functional unit of the kidney. The nephron consists of a renal corpuscle and renal tubule. The renal tubule can be divided into the proximal convoluted tubule (PCT), Loop of Henle, and distal convoluted tubule. The PCT has a high capacity for reabsorption due to specialized structures like brush borders and transport channels/proteins. It reabsorbs around 65% of water, sodium, potassium and chloride through bulk transport via paracellular and transcellular routes. Transport is powered by the basolateral and apical membrane channels and pumps, and mitochondria provide energy for these processes.
6. immune responses
This document discusses acute inflammation. It begins with an overview, describing acute inflammation as an innate response to tissue injury in the short term. It then discusses the causes and features of acute inflammation, including redness, swelling, heat, pain, and loss of function. Next, it details the tissue changes that occur, such as increased blood flow, fluid exudation, and the roles of mast cells, histamine, and cytokines. It also explains the cellular phase, focusing on the infiltration of neutrophils. Finally, it discusses how acute inflammation helps control infection and restore tissues.
5. adaptive immune system
Antibodies, also known as immunoglobulins, are Y-shaped glycoproteins produced by plasma cells that recognize and bind to antigens. They consist of two heavy chains and two light chains which give the antibody its structure. The variable regions of the heavy and light chains determine antigen specificity. Antibodies function by opsonizing pathogens to promote phagocytosis, neutralizing viruses and toxins, activating the complement system, forming immune complexes, and mediating antibody-dependent cytotoxicity. The different classes of antibodies are IgG, IgA, IgM, IgD, and IgE, which have various roles in immunity.
4. innate immune system
The document discusses the various barriers that the innate immune system uses to prevent infection. It describes physical barriers like the skin and mucous membranes. It also discusses physiological barriers such as diarrhea and vomiting that actively remove pathogens. Additionally, it outlines chemical barriers such as antimicrobial peptides and low pH levels that create an inhospitable environment for microbes. Finally, it examines the biological barrier of normal flora that compete with pathogens for resources. Breaking down these innate barriers can allow pathogens to colonize and cause infection if left unchecked by the adaptive immune response.
3. cells of the immune system
The document provides an overview of the five main types of white blood cells (leukocytes):
1) Neutrophils, which fight bacterial and fungal infections;
2) Monocytes, which fight bacterial infections and differentiate into macrophages;
3) Eosinophils, which fight parasitic infections;
4) Basophils, which are involved in allergic responses; and
5) Lymphocytes, which fight viral infections and are divided into natural killer cells, T cells, and B cells.
2. infections
Penicillins work by inhibiting the cross-linking of peptidoglycans in bacterial cell walls. Cephalosporins and carbapenems also inhibit this process through their beta-lactam ring structure. Glycopeptides prevent cross-linking through binding to cell wall proteins instead of DD-transpeptidase. Aminoglycosides inhibit bacterial protein synthesis by binding to the 30S ribosomal subunit, while macrolides do the same through the 50S subunit.
1. hematology
Erythropoiesis is the process by which red blood cells are produced. It occurs primarily in the bone marrow in adults. The key stages include the production of normoblasts from hematopoietic stem cells, which then mature into reticulocytes and finally erythrocytes. Erythropoiesis is tightly regulated by the hormone erythropoietin, which is produced by the kidneys in response to low oxygen levels and acts in the bone marrow to stimulate red blood cell production. On average, the body produces around 2.5 billion new red blood cells per kilogram per day through this process.
8. the spleen
The spleen filters blood and fights infections. It contains two types of tissues: white pulp contains lymphocytes that help produce antibodies when pathogens are detected, and red pulp contains cords and sinuses that remove old blood cells and filter the blood. The spleen helps fight encapsulated bacteria and stores extra red blood cells. It is not vital but its removal increases risk of certain infections.
7. the pancreas
The pancreas has both exocrine and endocrine functions. The exocrine pancreas secretes digestive enzymes like proteases, lipase, and amylase through acinar cells into ducts. These enzymes are synthesized and stored as inactive zymogens that are activated in the small intestine. The pancreas also secretes bicarbonate through duct cells to neutralize stomach acid. Secretin and cholecystokinin hormones stimulate pancreatic secretions in response to food in the duodenum. Disorders of the exocrine pancreas can cause maldigestion.
6. the gallbladder
The liver produces bile which is stored in the gallbladder and released during digestion to emulsify fats. Bile is composed of bile acids, bilirubin, electrolytes, and other components. Bile acids are produced by hepatocytes and secreted into bile ducts, while other components are added by ductal cells. The hormones cholecystokinin and secretin stimulate gallbladder contraction and bile secretion. Most bile acids are reabsorbed and recirculated to the liver through the enterohepatic circulation.
5. the liver
The liver plays a key role in metabolizing bilirubin. Bilirubin is produced from the breakdown of red blood cells and exists in unconjugated and conjugated forms. The liver conjugates bilirubin, making it water-soluble so it can be excreted in bile. In the intestines, bacteria convert bilirubin to urobilinogen and its byproducts, which are excreted in feces and urine. Clinical conditions can occur if bilirubin is not properly metabolized, such as jaundice.
4. the large intestine
The document discusses absorption in the large intestine. It notes that the large intestine absorbs water and electrolytes like sodium, chloride, and potassium. Short-chain fatty acids, vitamins, and minerals are also absorbed through the large intestine due to digestion by gut bacteria. Absorption is regulated by hormones like aldosterone and the autonomic nervous system. The large intestine propels contents through haustral shuttling and mass movements to facilitate absorption and storage of waste as feces.
3. the small intestine
The small intestine is responsible for digestion and absorption of nutrients. It has a highly folded mucosa layer containing absorptive enterocytes and secretory goblet and enteroendocrine cells. The enteroendocrine cells secrete hormones like CCK, secretin, and GIP in response to nutrients in the lumen. The small intestine receives pancreatic enzymes and bile, which aid in digestion, through the hepatopancreatic duct. Absorbed nutrients then pass into the bloodstream for use by the body.
2. the stomach
The document discusses acid production in the stomach. It outlines that the parietal cells in the stomach lining produce hydrochloric acid through a multi-step process involving carbonic acid, hydrogen ions, and chloride ions. Acid production is increased by the hormone gastrin and acetylcholine released by the vagus nerve. It is decreased by hormones like somatostatin, cholecystokinin, and secretin which are released in response to food in the duodenum. The document also reviews questions about this topic.
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Hypoglossal nerve
- 2. HYPOGLOSSAL NERVE CN XII: OVERVIEW ▸ The hypoglossal nerve is the twelfth paired cranial nerve ▸ Its name is derived from ancient Greek, ‘hypo‘ meaning under, and ‘glossal‘ meaning tongue ▸ The nerve has a purely somatic motor function, innervating all the extrinsic and intrinsic muscles of the tongue (except the palatoglossus, innervated by vagus nerve)
- 3. HYPOGLOSSAL NERVE CN XII: ANATOMICAL COURSE ▸ The hypoglossal nerve arises from the hypoglossal nucleus in the medulla oblongata of the brainstem ▸ It then passes laterally across the posterior cranial fossa, within the subarachnoid space ▸ The nerve exits the cranium via the hypoglossal canal
- 4. HYPOGLOSSAL NERVE CN XII: ANATOMICAL COURSE ▸ Now extracranial, the nerve receives a branch of the cervical plexus that conducts fibres from C1/C2 spinal nerve roots ▸ These fibres do not combine with the hypoglossal nerve – they merely travel within its sheath ▸ It then passes inferiorly to the angle of the mandible, crossing the internal and external carotid arteries, and moving in an anterior direction to enter the tongue
- 6. HYPOGLOSSAL NERVE CN XII: MOTOR FUNCTION ▸ The hypoglossal nerve is responsible for motor innervation of the vast majority of the muscles of the tongue (except for palatoglossus) ▸ These muscles can be subdivided into two groups: ▸ Extrinsic muscles ▸ Genioglossus (makes up the bulk of the tongue) ▸ Hyoglossus ▸ Styloglossus ▸ Palatoglossus (innervated by vagus nerve)
- 7. HYPOGLOSSAL NERVE CN XII: MOTOR FUNCTION ▸ Intrinsic muscles ▸ Superior longitudinal ▸ Inferior longitudinal ▸ Transverse ▸ Vertical ▸ Together, these muscles are responsible for all movements of the tongue
- 8. HYPOGLOSSAL NERVE CN XII: MOTOR FUNCTION Role of the C1/C2 Roots ▸ The C1/C2 roots that travel with the hypoglossal nerve also have a motor function ▸ They branch off to innervate the geniohyoid (elevates the hyoid bone) and thyrohyoid (depresses the hyoid bone) muscles ▸ Another branch containing C1/C2 fibres descends to supply the ansa cervicalis – a loop of nerves that is part of the cervical plexus ▸ From the ansa cervicalis, nerves arise to innervate the omohyoid, sternohyoid and sternothyroid muscles ▸ These muscles all act to depress the hyoid bone
- 13. References ▸ These slide reflect a summary of the contents of TeachMeAnatomy.info and are to be used for educational purposes only in compliance with the terms of use policy. Specific portions referenced in this summary are as follows: ▸ https://teachmeanatomy.info/head/cranial-nerves/ hypoglossal/ Additional sources are referenced on the slide containing that specific content.