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November 30, 2016 00:17

A study of the cranial nerves .IX and X pairs : glossopharyngeal and vagus nerves

Motor branch of the glossopharyngeal nerve innervates stylopharyngeus muscle (ie. Stylopharyngeus). Autonomic secretory parasympathetic branches go to ushnomu ganglion, which in turn sends fibers to the parotid gland.Glossopharyngeal nerve sensory fibers provided with the rear third of the tongue, soft palate, pharynx, skin of the outer ear, middle ear mucosa (including the interior surface of the tympanic membrane) and the Eustachian tube;visceral sensory afferents carry impulses from the carotid sinus;gustatory fibers conduct the sense of taste from the posterior third of the tongue.The vagus nerve innervates the striated muscles of the pharynx (except stylopharyngeus muscle), the soft palate (except perfused trigeminal nerve muscles that bend the palatal curtain), language (m. Palatoglossus), larynx, vocal cords and epiglottis.Vegetative branches go to smooth muscles and glands, pharynx, larynx, internal organs of the chest and abdomen.Visceral sensory afferents conduct impulses from the larynx,

trachea, esophagus, internal organs of the chest and abdominal cavities of the baroreceptors of the aortic arch and aortic chemoreceptors.Sensory fibers of the vagus nerve innervate the skin of the outer surface of the ear and ear canal, part of the outer surface of the eardrum, pharynx, larynx, dura mater of the posterior cranial fossa.Glossopharyngeal and vagus nerves have several common nucleus in the medulla oblongata and are close to each other, their functions are difficult to separate, so they examined simultaneously.

When collecting history trying to find out whether the patient has problems with swallowing, speech (voice).

Voice.Pay attention to clarity of speech, timbre and sonority of voice.the voice becomes hoarse and weak (up to aphonia) In violation of vocal cord function.Due to the dysfunction of the soft palate, is not enough covering the entrance to the nasal cavity during phonation, there is a nasal tone of voice (nazolaliya).Impaired function of the larynx (the defeat of the vagus nerve) impact on the pronunciation of the high sounds (and and and) requiring convergence of the vocal cords.In order to eliminate the weakness of the facial muscles (VII pair) and the tongue muscles (XII pair) as a possible cause of speech disorders, patients are encouraged to speak labial (p-n-p, mi-mi-mi) and apicals (la la la)sounds or syllables, they include.Nasal voice reveals the pronunciation of syllables, having in its composition of guttural sounds (ha-ha-ha, kai-kai-kai).The patient is also offered to cough forcefully.A patient with acute unilateral vocal cord paralysis is not able to pronounce the sound "and-and-and" or forcefully cough.

velum.Soft palate inspect when the examinee utters the sound "ah-ah-ah" and "uh-uh".Evaluate how well, strong and soft palate rises symmetrically with phonation;Do not deviate in the direction of the tab of the soft palate.When unilateral paresis of the muscles of the soft palate velum during phonation is behind on the affected side and overtighten healthy muscles on the opposite side of the paresis;wherein the latch is deflected in a healthy direction.

palatine and pharyngeal reflexes.Wooden spatula or strip (tube) of the paper gently touch the mucous membrane of the soft palate alternately on both sides.The normal response is pulling up the soft palate.Then, touch the back wall of the pharynx, and the right and left.Touching causes swallowing, sometimes gagging.Reflex response is expressed to different degrees (in the elderly can be omitted), but normally it is always symmetrical.The absence or reduction of reflections on one side indicates a peripheral lesion IX and X pairs of cranial nerves.