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Neuro clinics 25- glossopharyngeal and vagus

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Pratyush Chaudhuri

The document discusses the glossopharyngeal and vagus nerves (cranial nerves IX and X). It describes their functions including motor control of swallowing muscles and the soft palate, and sensory innervation. It also outlines their parasympathetic roles in regulating the heart and gastrointestinal tract. The document lists clinical tests used to examine the functions of these nerves and conditions that may arise from nerve damage or irritation.

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Neuro-clinics 25 Dr Pratyush Chaudhuri Supported by Mankind Pharmaceuticals and Nirmal clinics
Glossopharyngeal & Vagus IX & X cranial nerve
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Function of glossupharyngeal Stylopharyngeus muscle Autonomic supply to parotid gland Sensory supply
Reflexes Pharyngeal or gag reflex Carotid sinus reflex
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Vagus Nerve Also called pneumogastric nerve Longest cranial nerve Responsible for the functioning of the swallowing muscles of the pharynx and the laryngeal muscle
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Parasympathetic function are numerous Largest and most important parasympathetic nerve Essential for regulation of the heart. Predominantly inhibitory in nature Vagus stimulation - bradycardia
Vagal parasympathetic cause broncho-spasm and increased secretion. It is a stimulant of the GIT up to the colon Special somatic sensory, general somatic sensory, general visceral sensation
Clinical examination of vagus Motor function Examination of the soft palate Difficulty in swallowing more for liquids Difficulty in palatal phonation K, q, Ch sound similar to cleft palate
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Observe the pharyngeal muscle movement rideau phenomenon curtain movement - movement of the the pharyngeal wall to the nonparalysed side. Paralysis of cough Hoarseness of voice +/- dyspnoea
Autonomic function Aschners ocular phenomenon or oculocardiac reflex. ( absent in vagal paralysis) Vomiting reflex Swallowing reflex Cough reflex Sneeze (sternutatory) reflex Sucking reflex. (normal in neonates. If occurs in adults known as atz or wolfing reflex)
Singultus Yawning reflex Carotid sinus reflex : vagal type , cerebral type and the depressor type. Responses may be in the form of Hyperactive carotid sinus reflex Carotid sinus syncope.
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Clinical presentation Glossopharyngeal neuralgia Trigger points- tonsillar fossa and the tonsillar pillers Pain during eating and swallowing
Irritation of vagus Bradycardia, vomiting, hypertonus of GIT (basis of projectile vomiting of raised ICT) Explains the cushing reflex Vagus also responsible for kussmaul breathing, cheyne stokes respiration etc
Pharyngismus Palatal myoclonus Vaso-vagal syncope
Paralytic involvement of vagus Supra-nuclear - in pseudobulbar palsy Results in spastic dysarthria or dysphagia Nuclear involvement - in bulbar polio, GB syndrome, other lesions affecting the brainstem Infra nuclear most common is the recurrent laryngeal nerve paresis
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Neuro clinics 25- glossopharyngeal and vagus

  • 1. 油
  • 2. Neuro-clinics 25 Dr Pratyush Chaudhuri Supported by Mankind Pharmaceuticals and Nirmal clinics
  • 3. Glossopharyngeal & Vagus IX & X cranial nerve
  • 4. 油
  • 5. Function of glossupharyngeal Stylopharyngeus muscle Autonomic supply to parotid gland Sensory supply
  • 6. Reflexes Pharyngeal or gag reflex Carotid sinus reflex
  • 7. 油
  • 8. Vagus Nerve Also called pneumogastric nerve Longest cranial nerve Responsible for the functioning of the swallowing muscles of the pharynx and the laryngeal muscle
  • 9. 油
  • 10. Parasympathetic function are numerous Largest and most important parasympathetic nerve Essential for regulation of the heart. Predominantly inhibitory in nature Vagus stimulation - bradycardia
  • 11. Vagal parasympathetic cause broncho-spasm and increased secretion. It is a stimulant of the GIT up to the colon Special somatic sensory, general somatic sensory, general visceral sensation
  • 12. Clinical examination of vagus Motor function Examination of the soft palate Difficulty in swallowing more for liquids Difficulty in palatal phonation K, q, Ch sound similar to cleft palate
  • 13. 油
  • 14. Observe the pharyngeal muscle movement rideau phenomenon curtain movement - movement of the the pharyngeal wall to the nonparalysed side. Paralysis of cough Hoarseness of voice +/- dyspnoea
  • 15. Autonomic function Aschners ocular phenomenon or oculocardiac reflex. ( absent in vagal paralysis) Vomiting reflex Swallowing reflex Cough reflex Sneeze (sternutatory) reflex Sucking reflex. (normal in neonates. If occurs in adults known as atz or wolfing reflex)
  • 16. Singultus Yawning reflex Carotid sinus reflex : vagal type , cerebral type and the depressor type. Responses may be in the form of Hyperactive carotid sinus reflex Carotid sinus syncope.
  • 17. 油
  • 18. Clinical presentation Glossopharyngeal neuralgia Trigger points- tonsillar fossa and the tonsillar pillers Pain during eating and swallowing
  • 19. Irritation of vagus Bradycardia, vomiting, hypertonus of GIT (basis of projectile vomiting of raised ICT) Explains the cushing reflex Vagus also responsible for kussmaul breathing, cheyne stokes respiration etc
  • 20. Pharyngismus Palatal myoclonus Vaso-vagal syncope
  • 21. Paralytic involvement of vagus Supra-nuclear - in pseudobulbar palsy Results in spastic dysarthria or dysphagia Nuclear involvement - in bulbar polio, GB syndrome, other lesions affecting the brainstem Infra nuclear most common is the recurrent laryngeal nerve paresis
  • 22. 油