DOCSLIB.ORG

1. Sensory & Motor Functions 2. Anatomical Landmarks 3. Imaging

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
1. Sensory & Motor Functions 2. Anatomical Landmarks 3. Imaging CHRISTINE GLASTONBURY UCSF NEURORADIOLOGY Lingual branches: Taste and Sensation posterior 1. Sensory & motor functions 1/3 tongue Tonsillar & Pharyngeal branches: Sensation 2. Anatomical landmarks Motor: Stylopharyngeus for swallowing Jacobsen Nerve: sensory to middle ear & 3. Imaging findings parasympathetic to parotid [via LSPN + ATN] Hering nerve: Parasympathetic to carotid sinus (baroreceptors) and carotid body (chemoreceptors) Motor: Pharynx and larynx muscles except SP & TVP; + palatoglossus. Sensory (Arnold nerve): External auditory canal, post fossa dura, larynx. Taste: epiglottis, soft palate, pharynx Visceral Sensory & Parasympathetic Motor CHEST and ABDOMEN: Heart [detects aortic BP, slows heart] Esophagus, Stomach, Gut to Splenic Flexure [increases peristalsis & secretions] Sensation of pharynx and middle ear. Sensation of pharynx and middle ear. Taste, Salivation, stylopharyngeus muscle. Taste, Salivation, stylopharyngeus muscle. Carotid body/sinus chemo & baroreceptors Carotid body/sinus chemo & baroreceptors Pharynx and larynx muscles except SP & TVP Pharynx and larynx muscles except SP & TVP Sensation: EAC, post fossa dura, larynx Sensation: EAC, post fossa dura, larynx Taste: epiglottis, soft palate, pharynx Taste: epiglottis, soft palate, pharynx CH/ABD: Increase peristalsis & secretions CH/ABD: Increase peristalsis & secretions MOTOR: MOTOR: All tongue muscles Sternomastoid – rotates head Intrinsic ‐ Longitudinal, transverse, vertical away Extrinsic ‐ Hyoglossus, Genioglossus and Cleidomastoid – tilts head Styloglossus down but not Palatoglossus [CN10] Trapezius –retracts head, elevates, rotates and retracts scapula INTRINSIC & EXTRINSIC MUSCLES EXCEPT ONE PALATOGLOSSSUS MUSCLE POST 1/3 TASTE & SENSATION ANT 2/3 TASTE ANT 2/3 SENSATION Parasympathetic Inferior salivary [9] Dorsal motor nucleus [10] Sensory Solitary nucleus [9,10] Spinal tract nucleus of CN5 Motor CN9‐11 COMPLEX & CN9‐11 SHARE JUG. CN9‐12 ALONG Ambiguus nucleus SHARED NUCLEI IN FORAMEN. CAROTID SHEATH TO Hypoglossal nucleus [12] THE MEDULLA. CN9‐12 ALL NERVES HYOID LEVEL. CN12 OWN NUCLEUS POST SKULL BASE CN10 TO ABDOMEN + spinal accessory nucleus [11] Dorsal CN10, CN9 CN9 Motor Vagal CN11 CN12 Inferior Olivary CN12 Hypoglossal PARS NERVOSA CN9 Inferior petrosal sinus PARS VASCULARIS CN10, CN11 Internal jugular vein HYPOGLOSSAL CANAL CN9‐11 SHARE JUG. CN12 FORAMEN. CN9‐12 ALL NERVES POST SKULL BASE 1: CN9‐11 neuropathy due to pathology arising from jug foramen to hyoid frequently affects more than one nerve! ‐ This may or may not have been detected CN9‐12 ALONG clinically! CAROTID SHEATH TO HYOID LEVEL. CN10 TO ABDOMEN CN9‐11 = VERNET or jugular foramen syndrome CN9‐12 = COLLET‐SICCARD or lacerocondylar syndrome 2: Vagal Neuropathy CN9‐12 + Horner ±CN7 = VILLARET or retroparotid synd. [CN10] divided into UPPER & LOWER by involvement of motor branches! UPPER VAGAL: MR BoS LOWER VAGAL: CT NECK CN9‐12 ALONG CAROTID SHEATH TO HYOID LEVEL. Skull Base Osteomyelitis presenting as Villaret syndrome CN10 TO ABDOMEN UPPER VAGAL PHARYNG. PLEXUS NEUROPATHY Motor:Gag Reflex palate, S&M constrictor Palate elevation Hoarseness plus SUP. LARYNG N. Loss of gag reflex, M: inf constrictor, HYOID HYOID cricothyroid. palatal elevation S: HoPh & SG Lx LOWER VAGAL RECURRENT NEUROPATHY LARYNGEAL N. TVCM: Endolarynx Function Hoarseness only! S: subglottis, cx esop MUST IMAGE VAGUS AND RLN BOTH CN10 Right: to CONTINUE SUBCLAVIAN ART. TO ABDO Left: to AP WINDOW Hoarseness. Hoarseness On further exam: loss DL showed left true plus loss of gag reflex. of taste and sensation vocal cord paralysis MR skull base posterior tongue CT NECK: JUGULAR FORAMEN MASS JUGULAR FORAMEN MASS Smooth remodeling = schwannoma Smooth remodeling = schwannoma Moth‐eaten = paraganglioma Moth‐eaten = paraganglioma Dural tail ± hyperostosis = meningioma Dural tail ± hyperostosis = meningioma ‐‐Mets can mimic last 2‐‐ ‐‐Mets can mimic last 2‐‐ JUGULAR FORAMEN MASS Smooth remodeling = schwannoma Moth‐eaten = paraganglioma Dural tail ± hyperostosis = meningioma ‐‐Mets can mimic last 2‐‐ ManySkull causes base to met consider: Cisternal segment: Perineural tumor Hypoglossal canal: Bony disease, mets, PNT, schwannoma… Upper neck: ICA dissection, PNT, post‐operative, post‐XRT… Tongue base: infiltrating tumor… Lower motor neuron lesion of medullary [motor] nuclei resulting in impaired function of CN9‐12, 7 Dysphagia, Dysphonia, Dysarthria Difficulty chewing Slurring of speech Nasal regurg., choking liquids Upper motor neuron lesion affects the corticobulbar 55yM R CN12 and headaches tracts; emotional lability also 66yM 1 yr speech & swallowing difficulties “which were mainly lingual”. Slurred speech, facial pain. Evaluated by ALS treatment center neurologist. MAIN SENSORY PHARYNX. MAY BE CLUE THAT “RLNP” TASTE POST TONGUE. IS REALLY UPPER VAGAL UNCOMMON ALONE. NEUROPATHY. GRAPHICS: 9 PARS NERVOSA OF 11 L/F JUG FORAMEN MASS JUGULAR FORAMEN. OR PRIOR MND/RND. KENHUB.COM ‐best anatomy website! ART: MAIN MOTOR PHARYNX/LX MOTOR FOR TONGUE Juan Orestes Gatti IF LOWER VAGAL THEN CT DENERVATION = ATROPHY ‐extraordinary Argentinian BoS TO AP WINDOW & RV AND FASCICULATIONS. 10 ENTIRE VAGUS & RLN. 12 MIMICS BoT MASS. artist DON’T FORGET CJCDD!.
Load more

Recommended publications
  • A Morphological Study of Jugular Foramen
    Vikas. C. Desai et al /J. Pharm. Sci. & Res. Vol. 9(4), 2017, 456-458 A Morphological Study of Jugular Foramen Vikas. C. Desai1, Pavan P Havaldar2 1. Asst. Prof, Department of Dentistry, BLDE University’s,Shri. B. M. Patil Medical College Hospital and Research Centre,Bijapur – 586103, Karnataka State. 2. Assistant Professor of Anatomy, Gadag Institute of Medical Sciences, Mallasamudra, Mulgund Road, Gadag, Karnataka, India. Abstract Jugular foramen is a large aperture in the base of the skull. It is located behind the carotid canal and is formed by the petrous part of the temporal bone and behind by the occipital bone. The jugular foramen is the main route of venous outflow from the skull and is characterised by laterality based on the predominance of one of the sides. Sigmoid sinus continues as internal jugular vein in posterior part of jugular foramen. Ligation of the internal jugular is sometimes performed during radical neck dissection with the risk of venous infarction, which some adduce to be due to ligation of the dominant internal jugular vein. It is generally said that although the Jugular foramen is larger on the right side compared to the left, its size as well as its height and volume vary in different racial groups and sexes. The foramen’s complex shape, its formation by two bones, and the numerous nerves and venous channels that pass through it further compound its anatomy. The present study was undertaken in 263(526 sides) different medical and dental institutions in Karnataka, India. Out of 263 skulls in 61.21% of cases the right foramina were larger than the left, in 13.68% of cases the left foramina were larger than the right and in 25.09% cases were equal on both sides.
    [Show full text]
  • Biomechanical Analysis of Skull Trauma and Opportunity In
    Distriquin et al. European Radiology Experimental (2020) 4:66 European Radiology https://doi.org/10.1186/s41747-020-00194-x Experimental NARRATIVE REVIEW Open Access Biomechanical analysis of skull trauma and opportunity in neuroradiology interpretation to explain the post- concussion syndrome: literature review and case studies presentation Yannick Distriquin1, Jean-Marc Vital2 and Bruno Ella3* Abstract Traumatic head injuries are one of the leading causes of emergency worldwide due to their frequency and associated morbidity. The circumstances of their onset are often sports activities or road accidents. Numerous studies analysed post-concussion syndrome from a psychiatric and metabolic point of view after a mild head trauma. The aim was to help understand how the skull can suffer a mechanical deformation during a mild cranial trauma, and if it can explain the occurrence of some post-concussion symptoms. A multi-step electronic search was performed, using the following keywords: biomechanics properties of the skull, three-dimensional computed tomography of head injuries, statistics on skull injuries, and normative studies of the skull base. We analysed studies related to the observation of the skull after mild head trauma. The analysis of 23 studies showed that the cranial sutures could be deformed even during a mild head trauma. The skull base is a major site of bone shuffle. Three-dimensional computed tomography can help to understand some post-concussion symptoms. Four case studies showed stenosis of jugular foramen and petrous bone asymmetries who can correlate with concussion symptomatology. In conclusion, the skull is a heterogeneous structure that can be deformed even during a mild head trauma.
    [Show full text]
  • The Interperiosteodural Concept Applied to the Jugular Foramen and Its Compartmentalization
    LABORATORY INVESTIGATION J Neurosurg 129:770–778, 2018 The interperiosteodural concept applied to the jugular foramen and its compartmentalization Florian Bernard, MD,1 Ilyess Zemmoura, MD, PhD,2–4 Jean Philippe Cottier, MD, PhD,2,5 Henri-Dominique Fournier, MD, PhD,1,6 Louis-Marie Terrier, MD, MSc,2–4 and Stéphane Velut, MD, PhD2–4 1Department of Neurosurgery, CHU Angers; 2Université François–Rabelais de Tours, Inserm, Imagerie et Cerveau, UMR U930, Tours; 3Anatomy Laboratory, Faculté de Médecine, Tours; Departments of 4Neurosurgery and 5Neuroradiology, CHRU de Tours; and 6Anatomy Laboratory, Faculté de Médecine, Angers, France OBJECTIVE The dura mater is made of 2 layers: the endosteal layer (outer layer), which is firmly attached to the bone, and the meningeal layer (inner layer), which directly covers the brain and spinal cord. These 2 dural layers join together in most parts of the skull base and cranial convexity, and separate into the orbital and perisellar compartments or into the spinal epidural space to form the extradural neural axis compartment (EDNAC). The EDNAC contains fat and/or venous blood. The aim of this dissection study was to anatomically verify the concept of the EDNAC by focusing on the dural layers surrounding the jugular foramen area. METHODS The authors injected 10 cadaveric heads (20 jugular foramina) with colored latex and fixed them in formalin. The brainstem and cerebellum of 7 specimens were cautiously removed to allow a superior approach to the jugular fora- men. Special attention was paid to the meningeal architecture of the jugular foramen, the petrosal inferior sinus and its venous confluence with the sigmoid sinus, and the glossopharyngeal, vagus, and accessory nerves.
    [Show full text]
  • Glossopharyngeal & Vagus Nerves
    Cranial Nerves 1X-X (Glossopharyngeal & Vagus Nerves) By Dr. Jamela Elmedany Dr. Essam Eldin Salama Objectives • By the end of the lecture, the student will be able to: • Define the deep origin of both Glossopharyngeal and Vagus Nerves. • Locate the exit of each nerve from the brain stem. • Describe the course and distribution of each nerve . • List the branches of both nerves. GLOSSOPHARYNGEAL (1X) CRANIAL NERVE • It is principally a Sensory nerve with preganglionic parasympathetic and few motor fibers. • It has no real nucleus to itself. Instead it shares nuclei with VII and X. Superficial attachment • It arises from the ventral aspect of the medulla by a linear series of small rootlets, in groove between olive and inferior cerebellar peduncle. • It leaves the cranial cavity by passing through the jugular foramen in company with the Vagus , Acessory nerves and the Internal jugular vein. COURSE • It Passes forwards between Internal jugular vein and External carotid artery. • Lies Deep to Styloid process. • Passes between external and internal carotid arteries at the posterior border of Stylopharyngeus then lateral to it. • It reaches the pharynx by passing between middle and inferior constrictors, deep to Hyoglossus, where it breaks into terminal branches. • Component of fibers & Deep origin • SVE fibers: originate from nucleus NST ISN ambiguus (NA), and supply stylopharyngeus muscle. Otic G • GVE fibers: arise from inferior salivatory nucleus (ISN), relay in otic ganglion, the postganglionic fibers supply parotid gland. • SVA fibers: arise from the cells of inferior ganglion, their central NA processes terminate in nucleus of solitary tract (NST), the peripheral processes supply the taste buds on posterior third of tongue.
    [Show full text]
  • Study of Jugular Foramen – a Case Report
    IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) e-ISSN: 2279-0853, p-ISSN: 2279-0861.Volume 13, Issue 8 Ver. IV (Aug. 2014), PP 63-67 www.iosrjournals.org Study of Jugular Foramen – A Case Report 1Mr. K. M. Sakthivel, 2Dr. T. K. Balaji, 3Dr. A. S. Moni, 4Dr. G. Narayanan, 5Dr. K. Sathish Kumar, 1Lecturer, Rajas Dental College and Hospital, Nagercoil 2Professor, Chettinad Hospital and Research Institute, Kelambakkam. 3Professor, Rajas Dental College and Hospital, Nagercoil 4Associate Professor, Sivaraj Homoeopathic Medical College, Salem 5Associate Professor, Sivaraj Homoeopathic Medical College, Salem Abstract: The jugular foramen at the base of the skull varies in shape and size the foramen lies at the petrous part of temporal bone and behind by the occipital bone. It’s irregular in shape. Usually the right foramen is larger than the left. The variation in the foramen is observed in different racial group and sexes. The shape and size of foramen is inversely related to size of sigmoid sinus. Petrosal portion contains the inferior petrosal sinus. Sigmoid portion receives the sigmoid sinus. Intrajugular portion contains cranial nerves IX, X and XI. AIM: To analyze the length and width of jugular foramen. To determine the side dominance of the foramen. MATERIALS AND METHODS: A total of 32 jugular foramen in dry adult skulls from Department of Anatomy, CHRI were used for the present study. Sagittal and transverse diameters were measured using digital vernier caliper. OBSERVATIONS: The overall dimensions of Jugular foramen were recorded on both sides. The mean transverse diameter (width) on the right and the left side were 11.779mm and 10.901mm respectively.
    [Show full text]
  • The Five Diaphragms in Osteopathic Manipulative Medicine: Neurological Relationships, Part 1
    Open Access Review Article DOI: 10.7759/cureus.8697 The Five Diaphragms in Osteopathic Manipulative Medicine: Neurological Relationships, Part 1 Bruno Bordoni 1 1. Physical Medicine and Rehabilitation, Foundation Don Carlo Gnocchi, Milan, ITA Corresponding author: Bruno Bordoni, [email protected] Abstract In osteopathic manual medicine (OMM), there are several approaches for patient assessment and treatment. One of these is the five diaphragm model (tentorium cerebelli, tongue, thoracic outlet, diaphragm, and pelvic floor), whose foundations are part of another historical model: respiratory-circulatory. The myofascial continuity, anterior and posterior, supports the notion the human body cannot be divided into segments but is a continuum of matter, fluids, and emotions. In this first part, the neurological relationships of the tentorium cerebelli and the lingual muscle complex will be highlighted, underlining the complex interactions and anastomoses, through the most current scientific data and an accurate review of the topic. In the second part, I will describe the neurological relationships of the thoracic outlet, the respiratory diaphragm and the pelvic floor, with clinical reflections. In literature, to my knowledge, it is the first time that the different neurological relationships of these anatomical segments have been discussed, highlighting the constant neurological continuity of the five diaphragms. Categories: Medical Education, Anatomy, Osteopathic Medicine Keywords: diaphragm, osteopathic, fascia, myofascial, fascintegrity,
    [Show full text]
  • Morphometric Aspects of the Jugular Foramen in Dry Skulls of Adult Individuals in Southern Brazil
    Original article Morphometric aspects of the jugular foramen in dry skulls of adult individuals in Southern Brazil Pereira, GAM.*, Lopes, PTC., Santos, AMPV. and Krebs, WD. Human Anatomy Laboratory, Brazilian Lutheran University, Av. Farroupilha, 8001, CEP 92425-900, Canoas, RS, Brazil *E-mail: [email protected] Abstract The jugular foramen (JF) lies between the occipital bone and the petrosal portion of the temporal bone, and it allows for the passage of important nervous and vascular elements, such as the glossopharyngeal vagus and accessory nerves, and the internal jugular vein. Glomic tumors, schwannomas, metastatic lesions and infiltrating inflammatory processes are associated with this foramen, which can account for injuries of related structures. Variatons of the JF were already reported regarding shape, size and laterality in one only skull, besides differences related to sex, race and laterality domain, which makes the study of these parameters in the population of southern Brazil significant. Objective: this paper wants to conduct the morphometric analysis of the JF of 111 dry skulls belonging to males and females. Results: the latero-medial the anteroposterior measurements showed significant differences when genera were compared and side was compared, respectively. Of the total amount of the investigated skulls, 0.9% showed a complete septum on both sides; 0.9% showed incomplete septum, and 83.8% lacked the septum. The presence of a domed bony roof was noticed in 68.5% of skulls on both sides. Conclusion: the obtained results presented variations regarding some parameters when compared to previous studies, thus making it evident the significance of race in the morphometric measurements and characteristics of the JF, besides the relevance of studying the kind of impairment which can jeopardize important functions, as the cardiac innervation of the vagus nerve.
    [Show full text]
  • Fetal Anatomy of the Upper Pharyngeal Muscles with Special Reference to the Nerve Supply: Is It an Enteric Plexus Or Simply an Intramuscular Nerve?
    Original Article http://dx.doi.org/10.5115/acb.2013.46.2.141 pISSN 2093-3665 eISSN 2093-3673 Fetal anatomy of the upper pharyngeal muscles with special reference to the nerve supply: is it an enteric plexus or simply an intramuscular nerve? Shinichi Abe1,2, Masayuki Fukuda1, Shigeki Yamane1, Hideki Saka1,2, Yukio Katori3, Jose Francisco Rodríguez-Vázquez4, Gen Murakami5 1Department of Anatomy, 2Oral Health Science Center hrc8, Tokyo Dental College, Chiba, 3Division of Otoralyngology, Sendai Municipal Hospital, Sendai, Japan, 4Department of Anatomy and Embryology II, School of Medicine, Complutense University, Madrid, Spain, 5Division of Internal Medicine, Iwamizawa Kojin-kai Hospital, Iwamizawa, Japan Abstract: We examined pharyngeal nerve courses in paraffin-embedded sagittal sections from 10 human fetuses, at 25–35 weeks of gestation, by using S100 protein immunohistochemical analysis. After diverging from the glossopharyngeal and vagus nerves at the level of the hyoid bone, the pharyngeal nerves entered the constrictor pharyngis medius muscle, then turned upward and ran superiorly and medially through the constrictor pharyngis superior muscle, to reach either the levator veli palatini muscle or the palatopharyngeus muscle. None of the nerves showed a tendency to run along the posterior surface of the pharyngeal muscles. Therefore, the pharyngeal nerve plexus in adults may become established by exposure of the fetal intramuscular nerves to the posterior aspect of the pharyngeal wall because of muscle degeneration and the subsequent rearrangement of the topographical relationship between the muscles that occurs after birth. Key words: Pharyngeal nerve plexus, Glossopharyngeal nerve, Constrictor pharyngis superior muscle, Levator veli palatini muscle, Human fetus Received December 17, 2012; 1st Revised January 24, 2013, 2nd Revised January 30, 2013; Accepted February 6, 2013 Introduction human anatomy (Fig.
    [Show full text]
  • Hydrocephalus and Chiari Malformation Pathophysiology In
    Neurochirurgie 65 2019 264–268 Disponible en ligne sur ScienceDirect www.sciencedirect.com Craniosynostosis: State of the Art 2019 Hydrocephalus and Chiari malformation pathophysiology in FGFR2-related faciocraniosynostosis: A review a,b,∗ a a c a,d e,f G. Coll , Y. El Ouadih , F. Abed Rabbo , V. Jecko , L. Sakka , F. Di Rocco a Service de Neurochirurgie, CHU Clermont-Ferrand, 63000 Clermont-Ferrand, France b Université Clermont Auvergne, CNRS, SIGMA, Institut Pascal, Clermont-Ferrand, France c Service de Neurochirurgie, CHU Bordeaux, Bordeaux, France d Laboratoire d’Anatomie et d’Organogenèse, Laboratoire de Biophysique Sensorielle, NeuroDol, Faculté de Médecine, Université Clermont Auvergne, 63000 Clermont-Ferrand, France e Service de Neurochirurgie Pédiatrique, Hôpital Femme Mère Enfant, Lyon, France f Université Claude Bernard, INSERM 1033, Lyon, France a r t i c l e i n f o a b s t r a c t Article history: Background. – Patients with syndromic faciocraniosynostosis due to the mutation of the fibroblast growth Received 22 June 2019 factor receptor (FGFR) 2 gene present premature fusion of the coronal sutures and of the cranial base Received in revised form 25 August 2019 synchondrosis. Cerebrospinal fluid (CSF) circulation disorders and cerebellar tonsil prolapse are frequent Accepted 3 September 2019 findings in faciocraniosynostosis. Objective. – We reviewed the medical literature on the pathophysiological mechanisms of CSF disorders Keywords: such as hydrocephalus and of cerebellar tonsil prolapse in FGFR2-related faciocraniosynostosis. Complex craniosynostosis Discussion. – Different pathophysiological theories have been proposed, but none elucidated all the symp- Hydrocephalus toms present in Apert, Crouzon and Pfeiffer syndromes. The first theory that addressed CSF circulation Chiari Crouzon disruption was the constrictive theory (cephalocranial disproportion): cerebellum and brain stem are Apert constricted by the small volume of the posterior fossa.
    [Show full text]
  • Morphometric Analysis of the Foramen Magnum and Jugular Foramen in Adult Skulls in Southern Nigerian Population
    AMERICAN JOURNAL OF SCIENTIFIC AND INDUSTRIAL RESEARCH © 2012, Science Huβ, http://www.scihub.org/AJSIR ISSN: 2153-649X, doi:10.5251/ajsir.2012.3.6.446.448 Morphometric analysis of the foramen magnum and jugular foramen in adult skulls in southern Nigerian population Osunwoke E.A, Oladipo G.S, Gwunireama I.U, Ngaokere J.O. Department of Anatomy, Faculty of Basic Medical Sciences, College of Health Sciences, University of Port Harcourt: Nigeria. ABSTRACT A morphometric analysis of the foramen magnum and jugular foramen of adult skulls in southern Nigeria was carried out to demonstrate the anatomical variations in morphology. A total number of 120 dry skulls were used for this study. Measurements were performed by using a digital vernier caliper to span across the lengths and widths of the two foramina. Results revealed that the mean length and width of the foramen magnum was 36.11±0.24mm and 29.65± 0.24mm respectively. The mean length of the right and left jugular foramen was 15.76±0.22mm and 13.39±0.23mm respectively, while the mean width of the right and left jugular foramen was 9.34±0.18mm and 7.54±0.20mm respectively. There was a significant difference between the right and the left jugular foramen. The right jugular foramen was found to be larger than the left in Southern Nigeria. Key words: Morphometry, Foramen magnum, Jugular foramen, Southern Nigeria. INTRODUCTION found bony bridges in 20% and tripartite jugular foramen in 0.7%. The skull forms the skeleton of the head. It is rounded in shape.
    [Show full text]
  • Tracking the Glossopharyngeal Nerve Pathway Through Anatomical References in Cross-Sectional Imaging Techniques: a Pictorial Review
    Insights into Imaging (2018) 9:559–569 https://doi.org/10.1007/s13244-018-0630-5 PICTORIAL REVIEW Tracking the glossopharyngeal nerve pathway through anatomical references in cross-sectional imaging techniques: a pictorial review José María García Santos1,2 & Sandra Sánchez Jiménez1,3 & Marta Tovar Pérez1,3 & Matilde Moreno Cascales4 & Javier Lailhacar Marty5 & Miguel A. Fernández-Villacañas Marín4 Received: 4 October 2017 /Revised: 9 April 2018 /Accepted: 16 April 2018 /Published online: 13 June 2018 # The Author(s) 2018 Abstract The glossopharyngeal nerve (GPN) is a rarely considered cranial nerve in imaging interpretation, mainly because clinical signs may remain unnoticed, but also due to its complex anatomy and inconspicuousness in conventional cross-sectional imaging. In this pictorial review, we aim to conduct a comprehensive review of the GPN anatomy from its origin in the central nervous system to peripheral target organs. Because the nerve cannot be visualised with conventional imaging examinations for most of its course, we will focus on the most relevant anatomical references along the entire GPN pathway, which will be divided into the brain stem, cisternal, cranial base (to which we will add the parasympathetic pathway leaving the main trunk of the GPN at the cranial base) and cervical segments. For that purpose, we will take advantage of cadaveric slices and dissections, our own developed drawings and schemes, and computed tomography (CT) and magnetic resonance imaging (MRI) cross-sectional images from our hospital’s radiological information system and picture and archiving communication system. Teaching Points • The glossopharyngeal nerve is one of the most hidden cranial nerves. • It conveys sensory, visceral, taste, parasympathetic and motor information.
    [Show full text]
  • Pharynx, Larynx, Nasal Cavity and Pterygopalatine Fossa
    Pharynx, Larynx, Nasal cavity And Pterygopalatine Fossa Mikel H. Snow, Ph.D. Dental Anatomy [email protected] July 29, 2018 Pharynx Food & Air Passage Pharynx The pharynx is a skeletal muscle tube that opens anteriorly with 3 regions. The upper part communicates with nasal cavity, the middle communicates with oral cavity, and the lower communicates with the larynx. Nasal cavity Nasal Oral cavity cavity Larynx Air Nasopharynx: between Oral sphenoid sinus & uvula Food/ cavity Oropharynx: between uvula & epiglottis drink Laryngopharynx: between epiglottis & esophagus Esophagus Trachea The posterior and lateral walls are 3 skeletal muscles (constrictors) that propel food/liquid inferiorly to the esophagus. Constrictors innervated by CNX. Additional muscles elevate the pharynx (stylopharyngeus is external). Stylopharyngeus innervated by CNIX. Stylopharyngeus Superior constrictor Middle constrictor Inferior constrictor Two additional internal muscles we’ll get to later… Key relationship: Glossopharyngeal nerve wraps around stylopharyngeus muscle. CN IX wraps around stylopharyngeus muscle and Stylopharyngeus innervates it. Pharyngeal constrictors Pharynx Interior 1 Nasopharynx: 1. Pharyngeal tonsils 2. Auditory tube ostia 2 3 3. Salpingopharyngeal fold 4 4 Oropharynx: 4. Palatine tonsils 5 5 Laryngopharynx: Slit open 5. Piriform recess constrictors to examine interior Lateral Wall of Pharynx 5. Salpingopharyngeus muscle 6. Levator veli palatini muscle 1. Pharyngeal tonsils 7. Tensor veli palatini muscle 2. Torus tubarius 8. Palatine tonsil 3.
    [Show full text]