Cranial Nerves XI-XII
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Cranial Nerves
Cranial Nerves (1,5,7,8,9,10,11 and 12) Slides not included 9th and 10th Cranial 11th and 12th Cranial 8th Cranial Nerve 5th and 7th Cranial 1st Cranial Nerve Nerves Nerves Nerves (3,7,11,12,13,21,23,24) - (10,16) (12,23) Slides included: (14 to 17) *Slides that are not included mostly are slides of summaries or pictures. Nouf Alabdulkarim. Med 435 Olfactory Nerve [The 1st Cranial Nerve] Special Sensory Olfactory pathway 1st order neuron Receptors Axons of 1st order Neurons Olfactory receptors are specialized, ciliated nerve cells The axons of these bipolar cells 12 -20 fibers form the that lie in the olfactory epithelium. true olfactory nerve fibers. Which passes through the cribriform plate of ethmoid → They join the olfactory bulb Preliminary processing of olfactory information It is within the olfactory bulb, which contains interneurones and large Mitral cells; axons from the latter leave the bulb to form the olfactory tract. nd 2 order neuron • It is formed by the Mitral cells of olfactory bulb. • The axons of these cells form the olfactory tract. • Each tract divides into 2 roots at the anterior perforated substance: Lateral root Medial root Carries olfactory fibers to end in cortex of the Uncus & • crosses midline through anterior commissure adjacent part of Hippocampal gyrus (center of smell). and joins the uncrossed lateral root of opposite side. • It connects olfactory centers of 2 cerebral hemispheres. • So each olfactory center receives smell sensation from both halves of nasal cavity. NB. Olfactory pathway is the only sensory pathway which reaches the cerebral cortex without passing through the Thalamus . -
The Use of Cholinesterase Techniques to Study Topographical Localization in the Hypoglossal Nucleus of the Rat
J. Anat. (1971), 110, 2, pp. 203-213 203 With 1O figures Printed in Great Britain The use of cholinesterase techniques to study topographical localization in the hypoglossal nucleus of the rat P. R. LEWIS*, B. A. FLUMERFELTt AND C. C. D. SHUTE* Department ofAnatomy, University of Cambridge (Accepted 4 August 1971) INTRODUCTION The hypoglossal nucleus is perhaps the most suitable motor nucleus for the experi- mental study of the cytological changes occurring in cholinergic neurons following axotomy. The cells are large and the nucleus is easy to find even in a fresh unfixed brain; furthermore, the nucleus is so close to the midline that it is possible to use one side as a control for the other with complete confidence and to view equivalent control and experimental neurons simultaneously at quite high magnifications. An added advantage is that the hypoglossal nerve trunk in the neck region is almost purely motor; the central effects of axotomy are therefore not complicated by any significant loss of sensory fibres. Our interest in the nucleus was heightened by the discovery that in the rat a group of neurons at the caudal end contained a high concentration of an enzyme resembling in its histochemical reactions pseudocholin- esterase (Shute & Lewis, 1963). The enzyme will hydrolyse acetylthiocholine and is inhibited by ethopropazine, but its most characteristic property is a rapid hydrolysis of butyrylthiocholine; BuChE would thus seem an appropriate abbreviation to distinguish it from true cholinesterase (AChE), the enzyme typically present in motor neurons. It was shown originally by Schwarzacher (1958) that there is a marked decrease in AChE activity in hypoglossal neurons during the second and third weeks following axotomy (although he also looked at the response of pseudocholinesterase he did not comment on the specifically staining group of cells). -
Exä|Xã Tüà|Väx the Accessory Nerve Rezigalla AA*, EL Ghazaly A*, Ibrahim AA*, Hag Elltayeb MK*
exä|xã TÜà|vÄx The Accessory Nerve Rezigalla AA*, EL Ghazaly A*, Ibrahim AA*, Hag Elltayeb MK* The radical neck dissection (RND) in the management of head and neck cancers may be done in the expense of the spinal accessory nerve (SAN) 1. De-innervations of the muscles supplied by SAN and integrated in the movements of the shoulder joint, often result in shoulder dysfunction. Usually the result is shoulder syndrome which subsequently affects the quality of life1. The modified radical neck dissections (MRND) and selective neck dissection (SND) intend to minimize the dysfunction of the shoulder by preserving the SAN, especially in supra-hyoid neck dissection (Level I-III±IV) and lateral neck dissection (level II-IV)2, 3. This article aims to focus on the SAN to increase the awareness during MRND and SND. Keywords: Spinal accessory, Sternocleidomastoid, Trapezius, Cervical plexus. he accessory nerve is a motor nerve The Cranial Root: but it is considered as containing some The cranial root is the smaller, attached to the sensory fibres. It is formed in the post-olivary sulcus of the medulla oblongata T 8,10 posterior cranial fossa by the union of its (Fig.1) and arises forms the caudal pole of 4, 7, 9 cranial and spinal roots 4-8 (i.e. the internal the nucleus ambiguus (SVE) and possibly 11, 14 and external branches respectively9,10) but also of the dorsal vagal nucleus , although 11 these pass for a short distance only11. The both of them are connected . cranial root joins the vagus nerve and The nucleus ambiguus is the column of large considered as a part of the vagus nerve, being motor neurons that is deeply isolated in the branchial or special visceral efferent reticular formation of the medulla 11 nerve4,5,9,11. -
Hemisus Marmoratum
Neuroscience Letters 244 (1998) 5–8 Distribution of hypoglossal motor neurons innervating the prehensile tongue of the African pig-nosed frog, Hemisus marmoratum Curtis W. Andersona,*, Kiisa C. Nishikawab, Joyce Keifera aDepartment of Anatomy and Structural Biology, University of South Dakota School of Medicine, Vermillion, SD 57069, USA bDepartment of Biological Sciences, Physiology and Functional Morphology Group, Northern Arizona University, Flagstaff, AZ 86011, USA Received 15 December 1997; received in revised form 28 January 1998; accepted 28 January 1998 Abstract Using retrograde neuronal tracers, a study of the distribution of hypoglossal motor neurons innervating the tongue musculature was performed in the African pig-nosed frog, Hemisus marmoratum. This species is a radically divergent anuran amphibian with a prehensile tongue that can be aimed in three dimensions relative to the head. The results illustrate a unique rostrocaudal distribution of the ventrolateral hypoglossal nucleus and an unusually large number of motor neurons within this cell group. During the evolution of the long, prehensile tongue of Hemisus, the motor neurons innervating the tongue have greatly increased in number and have become more caudally distributed in the brainstem and spinal cord compared to other anurans. These observations have implications for understanding neuronal reconfiguring of motoneurons for novel morphologies requiring new muscle activation patterns. 1998 Elsevier Science Ireland Ltd. Keywords: Anuran amphibian; Hypoglossal nerve; Motor nuclei; Tongue Recent studies of feeding in anurans have revealed a hylidae [12,15]. In hydrostatic elongation, the tongue diversity of tongue morphologies and feeding mechanisms protractor muscle (M. genioglossus) has two types of mus- [1,5,7,8,10,11,15]. -
Surgical Outcomes of 156 Spinal Accessory Nerve Injuries Caused by Lymph Node Biopsy Procedures
SPINE CLINICAL ARTICLE J Neurosurg Spine 23:518–525, 2015 Surgical outcomes of 156 spinal accessory nerve injuries caused by lymph node biopsy procedures Sang Hyun Park, MD, PhD,1 Yoshua Esquenazi, MD,2 David G. Kline, MD,3 and Daniel H. Kim, MD2 1Department of Anesthesiology and Pain Medicine, Jeju National University Medical School, Jeju, Korea; 2Department of Neurosurgery, The University of Texas Health Science Center at Houston Medical School, Houston, Texas; and 3Department of Neurosurgery, Louisiana State University Health Sciences Center, New Orleans, Louisiana OBJECT Iatrogenic injuries to the spinal accessory nerve (SAN) are not uncommon during lymph node biopsy of the posterior cervical triangle (PCT). In this study, the authors review the operative techniques and surgical outcomes of 156 surgical repairs of the SAN following iatrogenic injury during lymph node biopsy procedures. METHODs This retrospective study examines the authors’ clinical and surgical experience with 156 patients with SAN injury between 1980 and 2012. All patients suffered iatrogenic SAN injuries during lymph node biopsy, with the vast majority (154/156, 98.7%) occurring in Zone I of the PCT. Surgery was performed on the basis of anatomical and electro- physiological findings at the time of the operation. The mean follow-up period was 24 months (range 8–44 months). RESULTs Of the 123 patients who underwent graft or suture repair, 107 patients (87%) improved to Grade 3 functional- ity or higher using the Louisiana State University Health Science Center (LSUHSC) grading system. Neurolysis was performed in 29 patients (19%) when the nerve was found in continuity with recordable nerve action potential (NAP) across the lesion. -
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. -
A Rare Case of Collett–Sicard Syndrome After Blunt Head Trauma
Case Report Dysphagia and Tongue Deviation: A Rare Case of Collett–Sicard Syndrome after Blunt Head Trauma Eric Tamrazian 1,2 and Bijal Mehta 1,2,* 1 Department of Neurology, David Geffen School of Medicine, Harbor-UCLA Medical Center, Torrance, CA 90502, USA; [email protected] 2 Los Angeles Biomedical Institute, Los Angeles, CA 90095, USA * Correspondence: [email protected] Received: 28 October 2019; Accepted: 14 November 2019; Published: 21 December 2020 Abstract: The jugular foramen and the hypoglossal canal are both apertures located at the base of the skull. Multiple lower cranial nerve palsies tend to occur with injuries to these structures. The pattern of injuries tend to correlate with the combination of nerves damaged. Case Report: A 28-year-old male was involved in an AVP injury while crossing the highway. Exam showed a GCS of 15 AAOx3, with dysphagia, tongue deviation to the right, uvula deviation to the left and a depressed palate. Initial imaging showed B/L frontal traumatic Sub-Arachnoid Hemorrhages (tSAH), Left Frontal Epidural Hematoma and a Basilar Skull Fracture. On second look by a trained Neuroradiologist c At 3 month follow up, patient’s tongue normalized to midline and his dysphagia resolved. Discussion: Collette-Sicard syndrome is a rare condition/syndrome characterized by unilateral palsy of CN: IX, X, XII. This condition has been rarely described as a consequence of blunt head trauma. In most cases, the condition is self-limiting with patients regaining most to all of their neurological functions within 6 months. Nerve traction injuries and soft tissue edema compressing the cranial nerves are the leading two hypothesis. -
Painful Polio Our Fight Against Polio—A Vaccine- Preventable Infectious Disease—Is at Its Peak
Feature Article UNMET HEALTH NEEDS Painful Polio Our fight against polio—a vaccine- preventable infectious disease—is at its peak. Ensuring complete immunization of every child is the key to oust the deadly polio virus from our planet.. P. CHEENA CHAWLA HILDREN are beautiful gifts of Nature. Sheer neglect of hygiene in the early days of life can play havoc in the Cinfant body, letting germs of a wide Although polio was well the capsid. Besides protecting the variety make home in the tiny organs recognized as a human affliction for genetic material of poliovirus, the playing a dangerous game of life and long, it was only in 1908 that the culprit capsid proteins enable this virus to death. The aftermath of an infectious bug for this disease, the polio virus, infect certain types of cells. childhood illness is most appalling if was identified by Karl Landsteiner. Three different serotypes of polio survival is at the cost of living with a Polio spread widely in Europe and the virus are known to cause the disease — crippled body for whole life. This United States in late 1880s and as the poliovirus type 1 (PV1), type 2 (PV2), exactly happens when the deadly virus, virus circulated rampantly around the and type 3 (PV3) — each having a known to cause polio, strikes! globe, polio cases dramatically slightly different capsid protein. One of the most dreaded childhood increased. It was in the face of such Although all these viral serotypes are diseases, polio mostly strikes children epidemics in early 1900s, paralyzing extremely dangerous and result in the under five years of age. -
Neuromuscular Ultrasound of Cranial Nerves
JCN Open Access REVIEW pISSN 1738-6586 / eISSN 2005-5013 / J Clin Neurol 2015;11(2):109-121 / http://dx.doi.org/10.3988/jcn.2015.11.2.109 Neuromuscular Ultrasound of Cranial Nerves Eman A. Tawfika b Ultrasound of cranial nerves is a novel subdomain of neuromuscular ultrasound (NMUS) Francis O. Walker b which may provide additional value in the assessment of cranial nerves in different neuro- Michael S. Cartwright muscular disorders. Whilst NMUS of peripheral nerves has been studied, NMUS of cranial a Department of Physical Medicine nerves is considered in its initial stage of research, thus, there is a need to summarize the re- and Rehabilitation, search results achieved to date. Detailed scanning protocols, which assist in mastery of the Faculty of Medicine, techniques, are briefly mentioned in the few reference textbooks available in the field. This re- Ain Shams University, view article focuses on ultrasound scanning techniques of the 4 accessible cranial nerves: op- Cairo, Egypt bDepartment of Neurology, tic, facial, vagus and spinal accessory nerves. The relevant literatures and potential future ap- Medical Center Boulevard, plications are discussed. Wake Forest University School of Medicine, Key Wordszz neuromuscular ultrasound, cranial nerve, optic, facial, vagus, spinal accessory. Winston-Salem, NC, USA INTRODUCTION Neuromuscular ultrasound (NMUS) refers to the use of high resolution ultrasound of nerve and muscle to assess primary neuromuscular disorders. Beginning with a few small studies in the 1980s, it has evolved into a growing subspecialty area of clinical and re- search investigation. Over the last decade, electrodiagnostic laboratories throughout the world have adopted the technique because of its value in peripheral entrapment and trau- matic neuropathies. -
Landmark for Identifying Spinal Accessory Nerve in Anterior Triangle of Neck-Surgeon’S Perspective
Global Journal of Otolaryngology ISSN 2474-7556 Short Communication Glob J Otolaryngol - Volume 10 Issue 3 September 2017 Copyright © All rights are reserved by Ameya Bihani DOI: 10.19080/GJO.2017.10.555787 Landmark for Identifying Spinal Accessory Nerve in Anterior Triangle of Neck-Surgeon’s Perspective Ameya Bihani* Tata Memorial Hospital, India Submission: September 06, 2017; Published: September 13, 2017 *Corresponding author: Ameya Bihani, Fellowship in head and neck oncosurgey, Tata Memorial Hospital, Mumbai, India, Tel: Email: Abstract There have been multiple studies on defining landmarks for spinal accessory nerve but most of them have stressed upon the identification of nerve in the posterior triangle of the neck. I have highlighted few landmarks that are less known for identification of spinal accessory nerve and their importance. The five landmarks which were analysed are posterior belly of digastric, transverse process of atlas, internal jugular vein, sternocleidomastoidKeywords: Spinal accessory muscle andnerve; small Posterior calibre belly veins of present digastrics; superficial Transverse to spinal process accessory of atlas nerve. Introduction nerve passing within 1 cm distance. In 40 cases out of 50, the nerve Identifying the spinal accessory nerve is of utmost importance went on the anterior surface of the process and rest 10 cases it went lateral to it. With surgery point of view, the nerve went deeper to shoulder dysfunction with limited overhead abduction and in neck dissection. The injury to the nerve results in significant the posterior belly of digastric in all 50 cases and in 48 cases out of progressive winging of scapula. There have been multiple studies 50 , it crossed the posterior belly of digastric at its midpoint. -
Is Essential for the Development, Survival and Function of Hypoglossal
© 2019. Published by The Company of Biologists Ltd | Development (2019) 146, dev174045. doi:10.1242/dev.174045 RESEARCH ARTICLE Teashirt 1 (Tshz1) is essential for the development, survival and function of hypoglossal and phrenic motor neurons in mouse Charlotte Chaimowicz1, Pierre-Louis Ruffault1, Cyril Chéret1,*, Andrew Woehler2, NiccolòZampieri3, Gilles Fortin4, Alistair N. Garratt5 and Carmen Birchmeier1,‡ ABSTRACT the phrenic motor column located in the mid-cervical spinal cord. Feeding and breathing are essential motor functions and rely on the The tongue has crucial functions in feeding and is innervated by activity of hypoglossal and phrenic motor neurons that innervate the the hypoglossal motor neurons in the lower brainstem. The activity tongue and diaphragm, respectively. Little is known about the genetic of phrenic and hypoglossal motor neurons has to be tightly programs that control the development of these neuronal subtypes. coordinated to avoid maladaptive outcomes such as the swallowing The transcription factor Tshz1 is strongly and persistently expressed of air or the blockage of airways (Moore et al., 2014). Hence, in developing hypoglossal and phrenic motor neurons. We used hypoglossal and phrenic motor neurons and the circuitry that conditional mutation of Tshz1 in the progenitor zone of motor neurons coordinates their activity are essential for animal survival. (Tshz1MNΔ) to show that Tshz1 is essential for survival and function of Nevertheless, relatively little is known about the formation of the hypoglossal and phrenic motor neurons. Hypoglossal and phrenic motor neurons that relay breathing and feeding commands. motor neurons are born in correct numbers, but many die between All motor neurons that innervate skeletal muscle, i.e. -
Cranial Nerve Disorders: Clinical Manifestations and Topographyଝ
Radiología. 2019;61(2):99---123 www.elsevier.es/rx UPDATE IN RADIOLOGY Cranial nerve disorders: Clinical manifestations and topographyଝ a,∗ a b c M. Jorquera Moya , S. Merino Menéndez , J. Porta Etessam , J. Escribano Vera , a M. Yus Fuertes a Sección de Neurorradiología, Hospital Clínico San Carlos, Madrid, Spain b Servicio de Neurología, Hospital Clínico San Carlos, Madrid, Spain c Neurorradiología, Hospital Ruber Internacional, Madrid, Spain Received 17 November 2017; accepted 27 September 2018 KEYWORDS Abstract The detection of pathological conditions related to the twelve cranial pairs rep- Cranial pairs; resents a significant challenge for both clinicians and radiologists; imaging techniques are Cranial nerves; fundamental for the management of many patients with these conditions. In addition to knowl- Cranial neuropathies; edge about the anatomy and pathological entities that can potentially affect the cranial pairs, Neuralgia; the imaging evaluation of patients with possible cranial pair disorders requires specific exami- Cranial nerve palsy nation protocols, acquisition techniques, and image processing. This article provides a review of the most common symptoms and syndromes related with the cranial pairs that might require imaging tests, together with a brief overview of the anatomy, the most common underlying processes, and the most appropriate imaging tests for different indications. © 2018 SERAM. Published by Elsevier Espana,˜ S.L.U. All rights reserved. PALABRAS CLAVE Sintomatología derivada de los pares craneales: Clínica y topografía Pares craneales; Resumen La detección de la patología relacionada con los doce pares craneales representa Nervios craneales; un importante desafío, tanto para los clínicos como para los radiólogos. Las técnicas de imagen Neuropatía de pares craneales; son fundamentales para el manejo de muchos de los pacientes.