A Variant Origin of the Carotid Sinus Nerve. Kevlian Andrew
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Superior Laryngeal Nerve Identification and Preservation in Thyroidectomy
ORIGINAL ARTICLE Superior Laryngeal Nerve Identification and Preservation in Thyroidectomy Michael Friedman, MD; Phillip LoSavio, BS; Hani Ibrahim, MD Background: Injury to the external branch of the su- recorded and compared on an annual basis for both be- perior laryngeal nerve (EBSLN) can result in detrimen- nign and malignant disease. Overall results were also com- tal voice changes, the severity of which varies according pared with those found in previous series identified to the voice demands of the patient. Variations in its ana- through a 50-year literature review. tomic patterns and in the rates of identification re- ported in the literature have discouraged thyroid sur- Results: The 3 anatomic variations of the distal aspect geons from routine exploration and identification of this of the EBSLN as it enters the cricothyroid were encoun- nerve. Inconsistent with the surgical principle of pres- tered and are described. The total identification rate over ervation of critical structures through identification, mod- the 20-year period was 900 (85.1%) of 1057 nerves. Op- ern-day thyroidectomy surgeons still avoid the EBSLN erations performed for benign disease were associated rather than identifying and preserving it. with higher identification rates (599 [86.1%] of 696) as opposed to those performed for malignant disease Objectives: To describe the anatomic variations of the (301 [83.4%] of 361). Operations performed in recent EBSLN, particularly at the junction of the inferior con- years have a higher identification rate (over 90%). strictor and cricothyroid muscles; to propose a system- atic approach to identification and preservation of this Conclusions: Understanding the 3 anatomic variations nerve; and to define the identification rate of this nerve of the distal portion of the EBSLN and its relation to the during thyroidectomy. -
Cranial Nerve Palsy
Cranial Nerve Palsy What is a cranial nerve? Cranial nerves are nerves that lead directly from the brain to parts of our head, face, and trunk. There are 12 pairs of cranial nerves and some are involved in special senses (sight, smell, hearing, taste, feeling) while others control muscles and glands. Which cranial nerves pertain to the eyes? The second cranial nerve is called the optic nerve. It sends visual information from the eye to the brain. The third cranial nerve is called the oculomotor nerve. It is involved with eye movement, eyelid movement, and the function of the pupil and lens inside the eye. The fourth cranial nerve is called the trochlear nerve and the sixth cranial nerve is called the abducens nerve. They each innervate an eye muscle involved in eye movement. The fifth cranial nerve is called the trigeminal nerve. It provides facial touch sensation (including sensation on the eye). What is a cranial nerve palsy? A palsy is a lack of function of a nerve. A cranial nerve palsy may cause a complete or partial weakness or paralysis of the areas served by the affected nerve. In the case of a cranial nerve that has multiple functions (such as the oculomotor nerve), it is possible for a palsy to affect all of the various functions or only some of the functions of that nerve. What are some causes of a cranial nerve palsy? A cranial nerve palsy can occur due to a variety of causes. It can be congenital (present at birth), traumatic, or due to blood vessel disease (hypertension, diabetes, strokes, aneurysms, etc). -
Cranial Nerves - Iii (Cn Ix, X, Xi & Xii)
CRANIAL NERVES - III (CN IX, X, XI & XII) DR. SANGEETA KOTRANNAVAR ASSISTANT PROFESSOR DEPT. OF ANATOMY USM KLE IMP BELAGAVI OBJECTIVES • Describe the functional component, nuclei of origin, course, distribution and functional significance of cranial nerves IX, X, XI and XII • Describe the applied anatomy of cranial nerves IX, X, XI and XII overview Relationship of the last four cranial nerves at the base of the skull The last four cranial nerves arise from medulla & leave the skull close together, the glossopharyngeal, vagus & accessory through jugular foramen, and the hypoglossal nerve through the hypoglossal canal Functional components OF CN Afferent Efferent General General somatic afferent fibers General somatic efferent fibers Somatic (GSA): transmit exteroceptive & (GSE): innervate skeletal muscles proprioceptive impulses from skin of somatic origin & muscles to somatic sensory nuclei General General visceral afferent General visceral efferent(GVE): transmit visceral fibers (GVA): transmit motor impulses from general visceral interoceptive impulses motor nuclei &relayed in parasympathetic from the viscera to the ganglions. Postganglionic fibers supply visceral sensory nuclei glands, smooth muscles, vessels & viscera Special Special somatic afferent fibers (SSA): ------------ Somatic transmit sensory impulses from special sense organs eye , nose & ear to brain Special Special visceral afferent fibers Special visceral efferent fibers (SVE): visceral (SVA): transmit sensory transmit motor impulses from the impulses from special sense brain to skeletal muscles derived from taste (tounge) to the brain pharyngeal arches : include muscles of mastication, face, pharynx & larynx Cranial Nerve Nuclei in Brainstem: Schematic picture Functional components OF CN GLOSSOPHARYNGEAL NERVE • Glossopharyngeal nerve is the 9th cranial nerve. • It is a mixed nerve, i.e., composed of both the motor and sensory fibres, but predominantly it is sensory. -
Cranial Nerve VIII
Cranial Nerve VIII Color Code Important (The Vestibulo-Cochlear Nerve) Doctors Notes Notes/Extra explanation Please view our Editing File before studying this lecture to check for any changes. Objectives At the end of the lecture, the students should be able to: ✓ List the nuclei related to vestibular and cochlear nerves in the brain stem. ✓ Describe the type and site of each nucleus. ✓ Describe the vestibular pathways and its main connections. ✓ Describe the auditory pathway and its main connections. Due to the difference of arrangement of the lecture between the girls and boys slides we will stick to the girls slides then summarize the pathway according to the boys slides. Ponto-medullary Sulcus (cerebello- pontine angle) Recall: both cranial nerves 8 and 7 emerge from the ventral surface of the brainstem at the ponto- medullary sulcus (cerebello-pontine angle) Brain – Ventral Surface Vestibulo-Cochlear (VIII) 8th Cranial Nerve o Type: Special sensory (SSA) o Conveys impulses from inner ear to nervous system. o Components: • Vestibular part: conveys impulses associated with body posture ,balance and coordination of head & eye movements. • Cochlear part: conveys impulses associated with hearing. o Vestibular & cochlear parts leave the ventral surface* of brain stem through the pontomedullary sulcus ‘at cerebellopontine angle*’ (lateral to facial nerve), run laterally in posterior cranial fossa and enter the internal acoustic meatus along with 7th (facial) nerve. *see the previous slide Auditory Pathway Only on the girls’ slides 04:14 Characteristics: o It is a multisynaptic pathway o There are several locations between medulla and the thalamus where axons may synapse and not all the fibers behave in the same manner. -
The Brain and Cranial Nerves
14 The Brain and Cranial Nerves PowerPoint® Lecture Presentations prepared by Jason LaPres Lone Star College—North Harris © 2012 Pearson Education, Inc. An Introduction to the Brain and Cranial Nerves • Learning Outcomes • 14-1 Name the major brain regions, vesicles, and ventricles, and describe the locations and functions of each. • 14-2 Explain how the brain is protected and supported, and discuss the formation, circulation, and function of cerebrospinal fluid. • 14-3 Describe the anatomical differences between the medulla oblongata and the spinal cord, and identify the main components and functions of the medulla oblongata. © 2012 Pearson Education, Inc. An Introduction to the Brain and Cranial Nerves • Learning Outcomes • 14-4 List the main components of the pons, and specify the functions of each. • 14-5 List the main components of the cerebellum, and specify the functions of each. • 14-6 List the main components of the midbrain, and specify the functions of each. • 14-7 List the main components of the diencephalon, and specify the functions of each. © 2012 Pearson Education, Inc. An Introduction to the Brain and Cranial Nerves • Learning Outcomes • 14-8 Identify the main components of the limbic system, and specify the locations and functions of each. • 14-9 Identify the major anatomical subdivisions and functions of the cerebrum, and discuss the origin and significance of the major types of brain waves seen in an electroencephalogram. • 14-10 Describe representative examples of cranial reflexes that produce somatic responses or visceral responses to specific stimuli. © 2012 Pearson Education, Inc. • In the pre-synaptic neuron, an Synapse electrical signal comes in, opens up to voltage-gated channels, and signals the vesicles containing neurotransmitters (chemical signal) to be released into the synaptic cleft. -
Surgical Anatomy of the Recurrent Laryngeal Nerve
Ann Orol Rhinol Laryngo! 112:2003 SURGICAL ANATOMY OFTHE RECURRENT LARYNGEAL NERVE: IMPLICATIONS FOR LARYNGEAL REINNERVATION EDWARD J. DAMROSE, MD ROBERT Y. HUANG, MD MING YE, MD GERALD S. BERKE, MD JOEL A. SERCARZ, MD Los ANGELES, CALIFORNIA Functional laryngeal reinnervation depends upon theprecise reinnervation ofthe laryngeal abductor and adductor muscle groups. While simple end-to-end anastomosis of the recurrent laryngeal nerve (RLN) main trunk results in synkinesis, functional reinnerva tion canbeachieved byselective anastomosis oftheabductor and adductor RLN divisions. Few previous studies have examined the intralaryngeal anatomy of theRLN to ascertain thecharacteristics that may lend themselves to laryngeal reinnervation. Ten human larynges without known laryngeal disorders were obtained from human cadavers forRLN microdissection. The bilateral intralaryngeal RLN branching patterns were determined, and thediameters and lengths oftheabductor and adductor divisions were measured. The mean diameters of the abductor and adductor divisions were 0.8 and 0.7 rnm, while their mean lengths were 5.7 and 6.1 rnm, respectively. The abductor division usually consisted of one branch to the posterior cricoarytenoid muscle; however, in cases in which multiple branches were seen, at least onedominant branch could usually be identified. We conclude that theabductor and adductor divisions of the human RLN can be readily identified by an extralaryngeal approach. Several key landmarks aid in the identification of the branches to individual muscles. -
Clinical Anatomy of the Cranial Nerves Clinical Anatomy of the Cranial Nerves
Clinical Anatomy of the Cranial Nerves Clinical Anatomy of the Cranial Nerves Paul Rea AMSTERDAM • BOSTON • HEIDELBERG • LONDON NEW YORK • OXFORD • PARIS • SAN DIEGO SAN FRANCISCO • SINGAPORE • SYDNEY • TOKYO Academic Press is an imprint of Elsevier Academic Press is an imprint of Elsevier 32 Jamestown Road, London NW1 7BY, UK The Boulevard, Langford Lane, Kidlington, Oxford OX5 1GB, UK Radarweg 29, PO Box 211, 1000 AE Amsterdam, The Netherlands 225 Wyman Street, Waltham, MA 02451, USA 525 B Street, Suite 1800, San Diego, CA 92101-4495, USA First published 2014 Copyright r 2014 Elsevier Inc. All rights reserved. No part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, recording, or any information storage and retrieval system, without permission in writing from the publisher. Details on how to seek permission, further information about the Publisher’s permissions policies and our arrangement with organizations such as the Copyright Clearance Center and the Copyright Licensing Agency, can be found at our website: www.elsevier.com/permissions. This book and the individual contributions contained in it are protected under copyright by the Publisher (other than as may be noted herein). Notices Knowledge and best practice in this field are constantly changing. As new research and experience broaden our understanding, changes in research methods, professional practices, or medical treatment may become necessary. Practitioners and researchers must always rely on their own experience and knowledge in evaluating and using any information, methods, compounds, or experiments described herein. In using such information or methods they should be mindful of their own safety and the safety of others, including parties for whom they have a professional responsibility. -
The Vestibulocochlear Nerve (VIII)
Diagnostic and Interventional Imaging (2013) 94, 1043—1050 . CONTINUING EDUCATION PROGRAM: FOCUS . The vestibulocochlear nerve (VIII) a,∗ b a F. Benoudiba , F. Toulgoat , J.-L. Sarrazin a Department of neuroradiology, Kremlin-Bicêtre university hospital, 78, rue du Général-Leclerc, 94275 Le Kremlin-Bicêtre, France b Diagnostic and interventional neuroradiology, Laennec hospital, Nantes university hospitals, boulevard Jacques-Monod, Saint-Herblain, 44093 Nantes cedex 1, France KEYWORDS Abstract The vestibulocochlear nerve (8th cranial nerve) is a sensory nerve. It is made up of Cranial nerves; two nerves, the cochlear, which transmits sound and the vestibular which controls balance. It is Pathology; an intracranial nerve which runs from the sensory receptors in the internal ear to the brain stem Vestibulocochlear nuclei and finally to the auditory areas: the post-central gyrus and superior temporal auditory nerve (VIII) cortex. The most common lesions responsible for damage to VIII are vestibular Schwannomas. This report reviews the anatomy and various investigations of the nerve. © 2013 Published by Elsevier Masson SAS on behalf of the Éditions françaises de radiologie. The cochlear nerve Review of anatomy [1] The cochlear nerve has a peripheral sensory origin and follows a centripetal path. It ori- ginates in the cochlear membrane sensory canal, forming the spiral organ (the organ of Corti) and lies on the basilar membrane (Fig. 1). The neuronal fibers of the protoneu- ron connect to the ciliated cells on the spiral lamina (Fig. 2). The axons are grouped together along the axis of the cochlea (modiolus), forming the cochlear nerve which then enters the internal auditory meatus (IAM). Within the internal auditory meatus, the nerve joins the vestibular nerve to form the vestibulocochlear nerve which crosses the cere- bellopontine angle (Figs. -
Lecture 6: Cranial Nerves
Lecture 6: Cranial Nerves Objective: To understand the organization of cranial nerves with respect to their nuclei within the brain, their course through and exit from the brain, and their functional roles. Olfactory Eye Muscles 3, 4 &6 Cranial Nerves 1-7 I overview Table, Page 49 II Lecture notes Cranial Nerves and their Functions V Trigeminal VII Facial VIII IX X XII XI Cranial Nerves 8-12 Overview sternocephalic I. Factors Responsible for the Complex Internal Organization of the Brain Stem-> leads to altered location of cranial nerve nuclei in adult brain stem 1. Development of the Fourth Ventricle a. Medulla and Pons develop ventral to the 4th ventricle cerebellum b. Alar plate is displaced lateral to basal plate 4 Medulla Developing Neural Tube 2. Cranial nerve nuclei form discontinuous columns Rostral 12 SE Page 48 Notes 3. Some cranial nerve nuclei migrate from their primitive embryonic positions (e.g., nuclei of V and VII) Facial N. Factors responsible for the complex internal organization of the brainstem: 4) Special senses develop in association with the brain stem. Nuclei of special senses 5) Development of the cerebellum and its connections Cerebellum II. Cranial Nerve Nuclei: Nucleus = column of neuron cell bodies. Efferent nuclei are composed of cell bodies of alpha or gamma motor neurons (SE) or preganglionic parasympathetic neurons (VE). III. Motor Efferent Nuclei (Basal Plate Derivatives): 1. SE (Somatic Efferent) Nuclei: SE neurons form two longitudinally oriented but discontinuous columns of cell bodies in the brain stem. Neurons that comprise these columns are responsible for innervating all of the skeletal musculature of the head. -
Cranial Nerves
Cranial Nerves Cranial nerve evaluation is an important part of a neurologic exam. There are some differences in the assessment of cranial nerves with different species, but the general principles are the same. You should know the names and basic functions of the 12 pairs of cranial nerves. This PowerPage reviews the cranial nerves and basic brain anatomy which may be seen on the VTNE. The 12 Cranial Nerves: CN I – Olfactory Nerve • Mediates the sense of smell, observed when the pet sniffs around its environment CN II – Optic Nerve Carries visual signals from retina to occipital lobe of brain, observed as the pet tracks an object with its eyes. It also causes pupil constriction. The Menace response is the waving of the hand at the dog’s eye to see if it blinks (this nerve provides the vision; the blink is due to cranial nerve VII) CN III – Oculomotor Nerve • Provides motor to most of the extraocular muscles (dorsal, ventral, and medial rectus) and for pupil constriction o Observing pupillary constriction in PLR CN IV – Trochlear Nerve • Provides motor function to the dorsal oblique extraocular muscle and rolls globe medially © 2018 VetTechPrep.com • All rights reserved. 1 Cranial Nerves CN V – Trigeminal Nerve – Maxillary, Mandibular, and Ophthalmic Branches • Provides motor to muscles of mastication (chewing muscles) and sensory to eyelids, cornea, tongue, nasal mucosa and mouth. CN VI- Abducens Nerve • Provides motor function to the lateral rectus extraocular muscle and retractor bulbi • Examined by touching the globe and observing for retraction (also tests V for sensory) Responsible for physiologic nystagmus when turning head (also involves III, IV, and VIII) CN VII – Facial Nerve • Provides motor to muscles of facial expression (eyelids, ears, lips) and sensory to medial pinna (ear flap). -
The Brain and Cranial Nerves Glioblastoma (Red), a Fast-Growing, Highly Invasive Brain Tumor (MRI) CHAPTER OUTLINE
Saladin: Anatomy & 14. The Brain and Cranial Text © The McGraw−Hill Physiology: The Unity of Nerves Companies, 2003 Form and Function, Third Edition CHAPTER 14 The Brain and Cranial Nerves Glioblastoma (red), a fast-growing, highly invasive brain tumor (MRI) CHAPTER OUTLINE Overview of the Brain 516 The Forebrain 529 • Directional Terms in Neuroanatomy 516 • The Diencephalon 530 INSIGHTS • Major Landmarks of the Brain 516 • The Cerebrum 531 • Gray and White Matter 516 14.1 Clinical Application: • Embryonic Development 517 Higher Brain Functions 536 Meningitis 521 • Brain Waves and Sleep 536 14.2 Medical History: The Accidental Meninges, Ventricles, Cerebrospinal Fluid, • Cognition 538 Lobotomy of Phineas Gage 538 and Blood Supply 519 • Memory 539 14.3 Clinical Application: Some Cranial • Meninges 519 • Emotion 539 Nerve Disorders 556 • Ventricles and Cerebrospinal Fluid 521 • Sensation 540 14.4 Clinical Application: Images of the • Blood Supply and the Brain Barrier • Motor Control 542 Mind 557 System 524 • Language 543 • Cerebral Lateralization 543 The Hindbrain and Midbrain 524 • The Medulla Oblongata 524 The Cranial Nerves 546 • The Pons and Cerebellum 526 • The Cranial Nerves—An Aid to Memory 547 • The Midbrain 526 • The Reticular Formation 528 Chapter Review 558 Brushing Up To understand this chapter, it is important that you understand or brush up on the following concepts: • Anatomy of the cranium (pp. 248–257) • Glial cells and their functions (pp. 450–451) • Tracts of the spinal cord (pp. 486–489) • Structure of nerves and ganglia (pp. 490–492) 515 Saladin: Anatomy & 14. The Brain and Cranial Text © The McGraw−Hill Physiology: The Unity of Nerves Companies, 2003 Form and Function, Third Edition 516 Part Three Integration and Control he mystique of the brain continues to intrigue modern biologists of its major landmarks (figs. -
A Variant Origin of the Carotid Sinus Nerve
Open Access Case Report DOI: 10.7759/cureus.2883 A Variant Origin of the Carotid Sinus Nerve Kevlian Andrew 1 , Joe Iwanaga 2 , Marios Loukas 3 , Rod J. Oskouian 4 , R. Shane Tubbs 5 1. Anatomical Sciences, St. George's University, St. George, GRD 2. Seattle Science Foundation, Seattle, USA 3. Anatomical Sciences, St. George's University, St Georges, GRD 4. Neurosurgery, Swedish Neuroscience Institute, Seattle, USA 5. Neurosurgery, Seattle Science Foundation, Seattle, USA Corresponding author: Joe Iwanaga, [email protected] Abstract The carotid sinus nerve is known to convey baroreceptive fibers from the carotid sinus. Despite studies on the baroreflex pathway and the course and communications of the carotid sinus nerve with the surrounding nervous and vascular structures, there have been scant reports on variations in the origin of the carotid sinus nerve (CSN). We identified an unusual origin of the CSN. On the right side of a cadaveric specimen, the CSN was found to arise from two small rami extending from the external laryngeal nerve. Such a case can help better understand various pathways used to monitor the carotid sinus. Additionally, surgeries that manipulate the superior laryngeal nerve could possibly injure a variant carotid sinus nerve, as seen in the present case. Categories: Neurology, Pathology Keywords: glossopharyngeal nerve, cranial nerve ix, intercarotid plexus, vagus nerve Introduction The carotid body is often found on the posterior wall of the carotid artery at the level of its bifurcation, usually at C4 [1]. The carotid sinus is a small dilatation [2] in the common carotid artery, most commonly at the origin of the internal carotid, but infrequently at the end of the common carotid or the beginning of the external carotid artery [2-3].