1) The document discusses several cranial nerves including their origin, course, and branches. It focuses on the glossopharyngeal nerve, vagus nerve, accessory nerve, and hypoglossal nerve. 2) It also discusses the cervical sympathetic trunk, including the three cervical ganglia (superior, middle, inferior) and their branches for communication, cardiac nerves, and blood vessels. 3) Horner's syndrome is mentioned as resulting from injury to the cervical sympathetic chain, causing ptosis, miosis, anhydrosis, and flushing.

1. Head and Neck
Lower four cranial nerves
Professor Dr. Mohamed El Fiky
Professor of anatomy and embryology

2. Cranial Nerves
Motor Sensory mixed
3,4,6,11&12 1,2&8 5,7,9,10
Cranial nerves contain parasympathetic fibers
3,7,9&10
Attachment of Cranial nerves to brain stem
3&4
midbrain
5,6,7&8
pons
9,10,11&12
Medulla
oblongata
Mohamed el fiky

3. Rootlets of the
Hypoglossal Nerve
Olive
Preolivary Fissure
Pyramid
oculomtor
trochlear
abducent
facial
vestibulocochlear
glossopharyngeal
vagus
accessory
trigeminal
Attachment of Cranial nerves to brain stem
Mohamed el fiky

4. Vagus Nerve
Facial Nerve
Glossopharyngeal
Nerve
qOrigin : It is a mixed cranial nerve attached to
medulla oblongata
qCourse : The glossopharyngeal Nerve Leaves
The Skull Through jugular foramen .
Course and Distribution :
qLeaves the skull thorough the jugular formen.
qPasses with the stylopharyngeus between the
external and internal carotid arteries
qPasses deep to the hyoglossus muscle.
q Enters the pharynx between the superior and
middle constrictor muscles of the pharynx.
Branches:
1. Tympanic nerve (nerve of jacopson): carry
parasympathetic to to the parotid gland.
2. Carotid branch : to the carotid sinus and
the carotid body.
3. Pharyngeal branches : forms the sensory part
of the of the pharyngeal plexus;
carrying sensations from the pharynx.
4. Muscular branch : supplies the
stylopharyngeus muscle.
5. Tonsillar branches : to the palatine tonsil
6. Lingual branches : convey taste and general
sensations from the posterior 1/3 of the tongue.
Glossopharyngeal nerve
Mohamed el fiky

5. qOrigin : It is mixed cranial nerve attached to medulla
oblongata
qCourse : The vagus Nerve Leaves The Skull Through The
jugular foramen
qCourse and Distribution : It is present in the carotid
sheath and it inter the thorax . It gives the follwing
branches in the neck :
1- auricular branch .
2- meningeal branch
3- pharyngeal branch to share in the pharyngeal plexus
4- superior laryngeal nerve which is subdivided into :
a. internal laryngeal which is sensory to cavity of
larynx above vocal cord .
b. external laryngeal which is motor to cricothyroid
muscle
Vagus Nerve
5- branch to carotid body
6- cardiac branches to
cardiac plexus
7- right recurrent
laryngeal ( the left one
arise in the thorax)
Mohamed el fiky

6. Unilateral Paralysis
Accumulation
of
Saliva and Food
Paralyzed Side During Phonation
Removal of Arytenoid Cartilage
Injury of Vagus Nerves
Mohamed el fiky

7. Accessory nerve
Accessory Nerve
Cranial Part
C1
C2
C3
C4
C5
Nucleus Ambiguous
Spinal Part
qIt is a purely motor attached to medulla oblongata
qIt leave the skull through jugular foramen .
qIt has two roots :
qCranial root from medulla oblongata
qSpinal root from upper five cervical spinal segments
qThe cranial root : joins the vagus and is
distributed through its pharyngeal , laryngeal
branches.
qThe spinal root Descends in the neck to supply
both sternomastoid and trapezius muscle
Branches :
(A) Cranial accessory: joins the vagus and is
distributed through its:
1. Pharyngeal branch : to supply all the muscles
of the pharynx except the stylopharyngeus and
all muscles of palate except the tensor palati
2. Laryngeal branches : to the muscles of the
larynx.
(B) Spinal accessory : supplies 2 muscles:
a. Sternomastoid muscle.
b. Trapezius muscle.
Mohamed el fiky

8. Thyro-
hyoid
Hypoglossal Nucleus
Omohyoid
Sternothyroid
Hypoglossal Nerve
Hypoglossal nerve
qOrigin : It is a motor cranial nerve attached to medulla oblongata
qCourse : The Hypoglossal Nerve Leaves The Skull Through The Anterior Condylar Canal
(Hypoglossal Canal)
qDistribution : It is the motor nerve of all muscles of the tongue EXCEPT The Palatoglossus
Muscle Which is supplied by Vagus Nerve
Intrinsic Muscles of The Tongue:
1-Longutudinal
2-Horizontal
3- Oblique
Genioglossus
styloglossus
Mohamed el fiky

9. The Tongue Points to The Affected Side
Tongue
Healthy
Genioglissus
Mandible
Paralysed
Genioglissus
Mohamed el fiky

10. The Cervical Sympathetic Trunk
Superior Cervical Ganglion
(At The Level of C2 and C3 Vertebrae)
Middle Cervical Ganglion
(At The Level of C6 Vertebra)
Inferior Cervical Ganglion
(Lies Between Transverse Process of C7
and First Rib)
Fused with The First Thoracic Ganglion
(Stellate Ganglion)
The cervical portion of the sympathetic
trunk consists of three ganglia,
distinguished, according to their
positions, as the superior, middle,and
inferior ganglia, connected by
intervening cords. This portion receives
no white rami communicantes from the
cervical spinal nerves; its spinal fibers
are derived from the white rami of the
upper thoracic nerves, and enter the
corresponding thoracic ganglia of the
sympathetic trunk, through which they
ascend into the neck.
Mohamed el fiky

11. 1-Communicating
C1
C2
C3
C4
9TH
10TH
11TH
2- Cardiac
(Superior Cervical Cardiac Nerve)
3- Vascular
To
Internal Carotid
And
External Carotid
4- Visceral
To
Pharynx and Larynx
A- Superior Cervical Ganglion
q The superior cervical ganglion the
largest of the three, is placed opposite the
second and third cervical vertebræ.
qBranches :
1- communicating with upper four
cervical nerves
2- cardiac superior cervical cardiac
nerve
3- vascular to internal carotid and
external carotid
4- visceral to pharynx and larynx
Mohamed el fiky

12. C5
C6
1- Communicating
2- Cardiac
(Middle Cervical Cardiac Sympathetic Nerve
3- Vascular
Around Inferior Thyroid Artery
4- Visceral
To Trachea and EsophagusTrachea
Esoph.
B- Middle Cervical Ganglion
The middle cervical ganglion is the
smallest of the three cervical ganglia,
and is occasionally wanting. It is placed
opposite the sixth cervical vertebra,
qBranches :
1- communicating with C5 &C6
2- cardiac ( Middle cervical cardiac nerve )
3- Vascular around inferior thyroid artery
4- visceral to trachea and esophagus
Mohamed el fiky

13. C- Branches of Inferior Cervical Ganglion
C7
C8
1- Communicatintg
2- Cardiac
Inferior Cervical
Cardiac Sympathetic Nerve
3- Vascular
Around
Subclavian Artery
and
Vertebral Artery
Ansa Subclavia
The inferior cervical ganglion is situated
between the base of the transverse
process of the last cervical vertebra and
the neck of the first rib,
qBranches :
1- communicating with C7&C8
2- cardiac ( Inferior cervical cardiac nerve )
3- Vascular around subclavian and vertebral
Mohamed el fiky

14. Horner’s Syndrome
Ptosis
Miosis
Anhydrosis
Flushing
(Redness)
Injury of Cervical Sympathetic Chain
Mohamed el fiky