9, 10 & 11 cranial nerves

1. Glossopharyngeal, vagus &
accessory nerve complexes
Dr / Hytham Nafady

2. Introduction

3. Nuclei
•The glossopharyngeal & vagus nerves arise from 3
nucleus columns.
Special visceral motor
column of the medulla
Nucleus ambiguus
Preganglionic
parasympathetic column
Dorsal motor nucleus of
vagus
Visceral sensory columnSolitary nucleus

5. 3-nucleus
ambiguus
1-solitary
nucleus
2-dorsal
motor
nucleus
Vagus nerve

6. 3-nucleus
ambiguus
2-dorsal
motor
nucleus
1-solitary
nucleus
Vagus nerve

7. Jugular foramen

12. Sphenoid
spine
Vaginal
process
Hypoglossal
canal
Stylomastoid
foramen

13. Carotico-
jugular spine
Facial nerve
canal
Sigmoid
sinus

14. Facial
nerve
canal
Petro-
occipital
fissure
Jugular
spine

15. Cochlear
aqueduct
Hypotympanum
Petro-occipital fissure
Petro-occipital fissure
Foramen
lacerum

23. Cn10&11
Interjugular
process
septum
Cn9
Sigmoid
sinus
ICA
IPS
Cn9

24. IPS

25. Cn9
IPS IPS
Sigmoid
sinus

28. Vagus
nerve
Vagus
nerve
Pharyngeal
plexus
Pharyngeal
plexus
Superior
Laryngeal
nerve
Superior
Laryngeal
nerve
Recurrent
Laryngeal
Nerve
Recurrent
Laryngeal
Nerve
External
Laryngeal
nerve
External
Laryngeal
nerve
Internal
Laryngeal
nerve
Internal
Laryngeal
nerve

29. A.Pharyngeal plexus
B.superior laryngeal N.
C.internal laryngeal N.
D.external laryngeal N.
E.recurrent laryngeal N.

30. Ultrasound imaging of Vagus N.

31. Vagus N.
Recurrent
laryngeal
N.

33. Vagus N.
CCA
IJV

34. Plexiform neurofibroma of the vagus
nerve in patient with NF1

35. Perineural tumor spread along 9, 10 &
11 cranial nerves from left parotid
acinic cell carcinoma

36. Glomus vagale

37. Ultrasound imaging of spinal
accessory N.

41. Inferior tympanic canaliculus

42. Inferior tympanic canaliculus

43. Aberrant internal carotid artery with
enlarged inferior tympanic canaliculus

44. Vascular loop compression
VA
Vagus N
VA

45. Vascular loop compression of the
glossopharyngeal N.
•Glossopharyngeal neuralgia in a 56-year-
old woman due to neurovascular contact
between the left CN IX and the vertebral
artery

47. GP hiatus
GP N.
GP N.
GP N.
PICA A
VA

52. Atrophy of posterior crico-arytenoid
muscle

53. Rt posterior
cricoarytenoid
Lt posterior
cricoarytenoid

54. Atrophy of thyro-arytenoid muscle

56. Thyro-arytenoid
Ligament

57. Trapezius muscle atrophy

59. Atrophy of trapezius muscle &
hypertrophy of levator scapulae muscle
after radical neck dissection