Cranial Nerve 12 – Hypoglossal Nerve

 

@   GSE

@   Nuclei Related with the Hypoglossal Nerve

1.     Hypoglossal nucleus Þ GSE neurons,其發出的投射纖維穿過Hypoglossal canal,去支配胚胎上源自枕部肌節的舌頭內在肌與外在肌。

 

@   Hypoglossal Nerve in the PNS

1.     Meningeal branch

2.     Terminal branches

(1)  To extrinsic muscles

(a)   Styloglossus m. Þ 縮回、舌後三分之一之上舉(在吸吮與吞嚥時)。

(b)  Hyoglossus m. Þ 縮回、壓下。

(c)   Genioglossus m. Þ 往前往內側突出、壓下。

##  Extrinsic tongue muscles有四對,其中三對由Hypoglossal nerve所支配,而源自鰓弓的Palatoglossus m.(在下嚥時,收縮咽峽部;將舌根往上拉;降下軟腭)Vagus nerve所支配

(2)  To intrinsic muscles

(a)   Superior lingual m. (longitudinal)

(b)  Middle lingual m. (Vertical and transverse)

(c)   Inferior lingual m. (longitudinal)

3.     Descending branch Þ 事實上是由Ventral ramus of the C1 spinal nerve所構成,假道Hypoglossal nerve去支配Thyrohyoid m. Geniohyoid m.

 

@  Inferior Alternating Hemiplegia Þ Lesions with involvement of hypoglossal nerve and pyramid

(1)      Pyramid Þ Contralateral hemiparesis

(2)      Hypoglossal nerve Þ Deviation of tongue to the lesion side

Corticonuclear fibers projecting to hypoglossal motor neurons are generally bilateral. Those motor neurons that innervate the genioglossus muscles receive primarily contralateral corticonuclear input. Each genioglossus muscle pulls its half of the tongue anteriorly and slightly medially. Consequently, an unilateral lesion of the corticonuclear fibers may produce a weakness in the affected genioglossus muscle and result in deviation of tongue toward the side opposite the lesion.

 

@   Oral Cavity分為兩部:

1.     Vestibule (前庭) Þ 外側為唇與頰,內側為牙齒,中間的狹小區域稱之前庭。

2.     Oral cavity proper (固有口腔)

##    蝶骨體(大約懸壅垂的位置)下頜骨的門齒牙根畫一連線,可將口腔分為二部:前部的黏膜源自外胚層(GSA);後部的黏膜源自內胚層(GVEGVA)

 

@   Tongue的解剖構造

1.     Central groove of the tongue

2.     Circumvallate (= Vallate) papillae (輪廓乳頭) Þ 在界溝前形成V字型排列,全部均含味蕾。

3.     Fungiform papillae (蕈狀乳頭) Þ 蕈狀高起,分布於舌前2/3的絲狀乳頭之間,多數存在於舌正中線靠近輪廓乳頭處,大部份含味蕾。

4.     Filiform papillae (絲狀乳頭) Þ 圓錐狀突起,以平行列分布於舌前2/3,不含味蕾。

5.     Foliate papillae (葉狀乳頭) Þ 單一的位於舌外側緣,靠近輪廓乳頭處,其味蕾分布於裂隙中。

6.     von Ebner lingual salivary glands Þ 位於Vallate papillaeFoliate papillae處,可分泌腺液影響PapillaeMicroenvironment

7.     Foramen caecum (盲孔)

8.     Frenulum of the tongue (舌繫帶)

9.     Sublingual caruncle (舌下肉阜)

10. Sublingual fold (舌下皺嬖)

11. Lingual tonsil (舌扁桃腺)

12. Sulcus terminalis (界溝)

13. Intrinsic muscles

(1)  Superior lingual m. (longitudinal)

(2)  Middle lingual m. (Vertical and transverse)

(3)  Inferior lingual m. (longitudinal)

12. Extrinsic muscles

(1)  Styloglossus m.

(2)  Hyoglossus m.

(3)  Genioglossus m.

##  Extrinsic tongue muscles有四對,其中三對由Hypoglossal nerve所支配,而源自鰓弓的一對Palatoglossus m. Vagus nerve所支配

 

@   Nerve Supply of the Tongue Þ Tongue輪廓乳頭的前緣為界,可分為2/3 (其黏膜源自第一與第二咽弓)1/3 (其黏膜源自第三咽弓)

1.     Nerves of general sensation (GSAGVA)

(1)  Lingual branch of the trigeminal nerve Þ 支配舌前2/3的一般感覺。

(2)  Lingual branch of the glossopharyngeal nerve Þ 支配舌後1/3的一般感覺。

2.     Nerves involved with taste (SVA)

(1)  Chorda tympani branch of the facial nerve Þ 支配舌前2/3的味覺。

(2)  Lingual branch of the glossopharyngeal nerve Þ 支配舌後1/3的味覺。

3.     Motor nerves (GSE) Þ 舌頭的內在肌與外在肌乃源自枕部2 - 4肌節,由Hypoglossal nerve支配。

 

@   Blood Supply to the Tongue

1.     Deep lingual a. Þ To the tip of the tongue

2.     Dorsal lingual a. Þ To the dorsum of the tongue

3.     Sublingual a. Þ To the sublingual gland