DR Medhat MRCP

VIII. Vagus nerve
- Mixed nerve carrying motor,sensory & parasympathetic fibers
- Motor to : soft palate ,pharynx & larynx .
- Sensory from : Skin over the external auditory meatus.
Thoracic & abdominal viscera.
- Parasympathetic to : Heart (inhibitory)
GIT & bronchial tree (secretory & motor).
- Lesions :
1. True bulbar palsy [palate-pharyngeo-laryngeal paralysis]
Bulbar symptoms : dysphagia,dysarthria,dysphonia & nasal regurge.
Ipsilateral loss of palatal & pharyngeal reflexes.
2. Tachycardia & constipation.
IX. Accessory nerve
- Purely motor nerve formed of 2 parts :
- Cranial part : arise in the medulla ,pass with vagus to soft palate & pharynx.
- Spinal part : Arise fom AHC of upper 5 cervical segments
Supplies sternomastoid & trapezius.
- Lesion : ipsilateral paralysis of sternomastoid & trapezius.
X. Hypoglossal nerve :
- Pure motor nerve supplies the intrinsic muscles of the tongue.
- Lesion :
U.M.N.L : Unilateral : deviation of the tongue to opposite side of the lesion.
Bilateral : inability to protrude the tongue (spastic tongue).
L.M.N.L :
Unilateral : deviation of the tongue to same side of the lesion.
Bilateral : inability to protrude the tongue.
In both cases there is wasting & fasciculation
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