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Vagus nerve
The vagus nerve is the 10th cranial nerve that has both motor and sensory components. It arises from the medulla and has an extensive distribution through the head, neck, thorax, and abdomen. It provides both parasympathetic output and visceral sensation. Some key functions include innervating the pharynx, larynx, heart, lungs, esophagus and stomach. Lesions can cause hoarseness of voice, dysphagia, or loss of gag reflex depending on the location along the nerve.
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Vagus nerve
- 1. Vagus Nerve By Dr.Piyush (MBBS, MD)
- 2. Answer Any cranialnerve under following headings: • Introduction • Functional components • Formation • Course • Branches • Distribution: Motor + Sensory • Applied: • Tests of integrity • Lesion
- 3. Introduction • 10th cranialnerve • MIXED mainly motor • Wanderer nerve: extensive distribution (H&N, thorax & abdomen) • Major Parasympathetic path.
- 7. Functional components • SVE(Branchiomotor): Nucleus Ambiguus • GVE (parasympathetic): Dorsal nucleus of Vagus • GVA (viscerosensory): Nucleus Tractus Solitarius / DNV • SVA (gustatory): Nucleus Tractus Solitarius • GSA (somatosensory): Spinal nucleus of trigeminal
- 9. Formation • Approx 10.rootlets from lateral aspect of medulla. • Between olive and inferior cerebellar peduncle • Between rootlets of IX and XIth nerve. • Rootlets unite to form vagal nerve trunk.
- 12. COURSE • Arises fromlateral aspect of medulla. • leaves cranial cavity through intermediate compartment of Jugular foramen. • 2 ganglia: • Superior ganglion (Jugular): small - present in jugular fossa • Inferior ganglion (Nodose): large • Runs downward in carotid sheath
- 15. • @ rootof neck enters thorax • Rt side: front of Rt subclavian artery • Lt side: between lt common carotid & Lt subclavian artery.
- 17. • In thorax: •passes behind respective lung roots • Rt vagus behind oesophagus (posterior vagal trunk) • Lt vagus in front of oesophagus (Anterior vagal trunk) • Crosses diaphragm via oesophageal opening. • In abdomen: • vagal trunks divide into terminal branches.
- 21. Branches: • in neck: •auricular branch • Meningeal branch • Pharyngeal branches • Superior laryngeal nerve: split in external & internal • Right Recurrent laryngeal nerve • Superior and inferior cervical cardiac branches
- 23. • In thorax: •Left recurrent laryngeal nerve • Cardiac branches • oesophageal branches • In abdomen: • gastric branches • Hepatic branches • Coeliac branch
- 28. DIstribution Motor • Pharyngeal branches:muscles of pharynx & soft palate • External laryngeal: supplies cricothyroid • Recurrent laryngeal: intrinsic muscles of larynx • Cardiac branches: parasympathetic & cardioinhibitory Sensory • Auricular : posterior part of external ear and external auditory canal. • Meningeal: dura of posterior cranial fossa • Internal laryngeal: laryngopharynx and upper larynx
- 29. Motor • oesophageal branches •Gastric branches • hepatic branches • coeliac branches
- 30. Applied • Tests ofintegrity of nerve: • Subject is ask to open Mouth and say “AA” (आ): Checking for Palatal palsy • Gag re fl ex
- 34. • Lesions: • Lowerlesions: RLN palsy • Hoarseness of voice • Cadaveric position of vocal cord (paramedian) • Higher lesions: RLN palsy + palatal palsy • nasal regurgitation • Dysphagia • loss of gag & cough re fl ex
- 36. • The Aldermannerve phenomenon: auricular branch behind ear was stimulated to improve loss of appetite. • Vagotomy in peptic ulcer cases. • Vagal nerve stimulation device implantation for management of refractory epileptic seizures.
- 40.