Extends past the back of your throat until it reaches the floor of your mouth. Functions The hypoglossal nerve supplies all the intrinsic muscles of the tongue. The clinical examination of hypoglossal nerve function consists of evaluating the strength, bulk, and dexterity of the tonguelooking especially for weakness, atrophy, abnormal movements (particularly fasciculations), and impairment of rapid movements. The hypoglossal nerve, also known as the twelfth cranial nerve, cranial nerve XII, or simply CN XII, is a cranial nerve that innervates all the extrinsic and intrinsic muscles of the tongue except for the palatoglossus, which is innervated by the vagus nerve. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Runs down the neck past important blood vessels (. After noting the position and appearance of the tongue at rest in the mouth, Hypoglossal nerves (XII) Each hypoglossal nerve exits the cranium and curves, reaching the skeletal tongue muscles. The Brainstem: Myelencephalon (fifth Vesicle) Basal Motor Plate Review of Medical Embryology Book LifeMap Discovery", "Isolated Hypoglossal Nerve Palsy: A Diagnostic Challenge", "A case with unilateral hypoglossal nerve injury in branchial cyst surgery", "Physical and Neurologic Examinations Nervous System Veterinary Manual", "Evolutionary and developmental understanding of the spinal accessory nerve", https://en.wikipedia.org/w/index.php?title=Hypoglossal_nerve&oldid=1105839227, This page was last edited on 22 August 2022, at 01:51. Each hypoglossal nerve exits the cranium and curves, reaching the skeletal tongue muscles. [15][16] Damage can be on one or both sides, which will affect symptoms that the damage causes. To test the nerves function, a patient would be asked to stick out their tongue. The information we provide is grounded on academic literature and peer-reviewed research. This segment of the pathway, from the hyoglossus muscle and the greater horn of the hyoid bone, is the part of the nerve that forms the superior edge of the Pirogov triangle (also known as the Pirogoff triangle), and it is covered by the submandibular gland. He is president of the American Board of Facial Plastic and Reconstructive Surgery and treats skin cancer patients as part of his practice. Reading time: 10 minutes. The glossopharyngeal nerve has both motor and sensory functions, including: sending sensory information from your sinuses, the back of your throat, parts of your inner ear, and the back part of. [26], The size of the hypoglossal nerve, as measured by the size of the hypoglossal canal, has been hypothesised to be associated with the progress of evolution of primates, with reasoning that larger nerves would be associated with improvements in speech associated with evolutionary changes. It is mainly an efferent nerve for the tongue musculature. Merk Manual Consumer Version. Symptoms of impaired function of the hypoglossal nerve include: Nerve damage from ALS often causes small twitching movements on the surface of the tongue. Genioglossus muscles, which push the tongue forward. The hypoglossal nerve beneath the internal jugular vein is exposed at the level of the axis and dissected as proximally as possible. It is also called, The fimbriae of the uterine tube, also known as fimbriae tubae, are small, fingerlike projections at the end of the fallopian tubes, through which. The Hypoglossal nerve is the twelfth cranial nerve, and innervates all the extrinsic and intrinsic muscles of the tongue, except for the palatoglossus which is innervated by the vagus nerve. [2] The hypoglossal nerve is of a general somatic efferent (GSE) type. The path of the nerve starts in the hypoglossal nucleus of the brainstem, which is located near the. The nerve arises from the hypoglossal nucleus in the brain stem as a number of small rootlets, passes through the hypoglossal canal and down through the neck, and eventually passes up again over the tongue muscles it supplies into the tongue. What would happens if the hypoglossal nerve is damaged? The hypoglossal nerve leaves the brainstem through the anterolateral sulcus of the medulla oblongata. Hypoglossal nerve<br />The hypoglossal nerve is the twelfth cranial nerve (XII), leading to the tongue. Hypoglossal nerve palsy. HYPOGLOSSAL NERVE<br />PALSY<br />. It is an ipsilateral, predominantly motor nerve. Our engaging videos, interactive quizzes, in-depth articles and HD atlas are here to get you top results faster. The central system is the primary, The accessory nerve is a cranial nerve that controls the movement of certain neck muscles. Bone abnormalities at the base of the skull, Complications of surgery to remove a blockage from an artery in the neck, Weakness of the tongue on the affected side, Atrophy of the tongue on the affected side. Its rostral portion belongs to an area called the hypoglossal trigone. The name hypoglossus springs from the fact that its passage is below the tongue, from hypo (Greek: "under") and glossa (Greek: "tongue"). Finsterer J, Grisold W. Disorders of the lower cranial nerves. All the intrinsic and extrinsic muscles of tongue except palatoglossus. [6], The hypoglossal nerve carries lower motor neurons that synapse with upper motor neurons at the hypoglossal nucleus. As your nerves run through your body, they split off and send branches out everywhere. In this way it is included in reflex movements of the tongue such as swallowing or chewing. [2], Reports of damage to the hypoglossal nerve are rare. To make a diagnosis, a doctor will consider all of your symptoms and perform a physical exam. INTRODUCTION. It innervates all the muscles of the tongue except palatoglossus muscle which . We got you covered with great video tutorials. Function The hypoglossal nerve is purely a motor nerve; it doesn't send any sensory information to and from the brain. Author: This complex nerve network enables sensation and movement in the neck and trunk. This hypothesis has been refuted.[27]. The treatment of hypoglossal nerve dysfunction depends on the cause. Laryngoscope. The hypoglossal nerve is the twelfth paired cranial nerve.. Its name is derived from ancient Greek, 'hypo' meaning under, and 'glossal' meaning tongue.The nerve has a purely somatic motor function, innervating all the extrinsic and intrinsic muscles of the tongue (except the palatoglossus, innervated by vagus nerve).. It initially spans the length of the upper arm, as it, The oculomotor nerve is the third of 12 pairs of cranial nerves in the brain. The prefix hypo is of Greek origin and means "under." Finsterer J, Grisold W. Disorders of the lower cranial nerves. Read our, The Anatomy of the Glossopharyngeal Nerve, Neuroanatomy, cranial nerve 12 (Hypoglossal), Hypoglossal nerve stimulation for treatment of obstructive sleep apnea (OSA): a primer for oral and maxillofacial surgeons. Hong Kong Med J. The hypoglossal nerve is the twelfth cranial nerve. The hypoglossal nerve is a motor nerve that supplies the tongue muscles. We therefore examined whether a correlation existed between the number of axons in the hypoglossal nerve, which is known to vary in humans (12), and the size of the hypoglossal canal in our cadaver sample. Hyoglossus muscles that pull the tongue back and flatten it. There, the nerve changes to a horizontal orientation, turning anterior, curving around the sternocleidomastoid branch of the occipital artery, and coursing towards the tongue. [6] Damage to the hypoglossal nucleus will lead to wasting of muscles of the tongue and deviation towards the affected side when it is stuck out. It's a motor nerve. [1] . 2015;6(3):377-391. It controls the hyoglossus, intrinsic, genioglossus and styloglossus muscles. Stimulating lead This lead is placed around the medial branches of the hypoglossal nerve (discussed below) and initiates contraction of the tongue muscles thus opening the upper airway. The hypoglossal nucleus receives input from both . Contents. Jana Vaskovi MD Maintaining a healthy weight to avoid sleep apnea or prevent it from worsening. [19][20] If the damage is to the nerve pathway (an upper motor neuron lesion) the tongue will curve away from the side of damage, due to action of the affected genioglossus muscle, and will occur without fasciculations or wasting,[19] with speech difficulties more evident. This article will discuss the anatomy and function of the hypoglossal nerve. 2022 Dotdash Media, Inc. All rights reserved. Gross anatomy Nucleus and intraparenchymal portion Learning anatomy is a massive undertaking, and we're here to help you pass with flying colours. The cases of hypoglossal nerve palsy following impacted tooth extraction . Nerve damage can result from injury to the back of the head or neck. The nerve originates from the . From cases reported in the literature, complete recovery of hypoglossal nerve function is expected within the first six months. It travels down your neck and branches out, ending at the base and underside of your tongue. Hope it helps you. It innervates all the extrinsic and intrinsic muscles of the tongue, except for the palatoglossus which is innervated by the vagus nerve. [23], The hypoglossal nerve is one of twelve cranial nerves found in amniotes including reptiles, mammals and birds. Normal function of CN XII is verified by having a patient stick out the tongue. You can find out more about our use, change your default settings, and withdraw your consent at any time with effect for the future by visiting Cookies Settings, which can also be found in the footer of the site. Travels down the spinal cord to the cervical plexus. Learn more about the infrahyoid muscles in a more fun and engaging way with our article and video tutorial.When it comes to the terminal lingual branches, the nerve literally diverges into these branches after it passes through the aforementioned intermuscular crack between the hyoglossus muscle and the mylohyoid muscle. These muscles help you speak, swallow and move substances around in your mouth. These fibres travel with the tympanic nerve to the middle ear.From the ear, the fibres continue as the lesser petrosal nerve, before synapsing at the otic ganglion.. Is hypoglossal motor or sensory? Living a healthy lifestyle to prevent stroke. [26] The nerve is regarded as arising evolutionarily from nerves of the cervical spine,[2] which has been incorporated into a separate nerve over the course of evolution. C Match the following cranial nerve with its appropriate function: Hypoglossal. Beginning as about a dozen small "rootlets" that combine to form two branches, the hypoglossal nerve passes through an area of the brain called the subarachnoid space, then runs through an opening in the occipital bone, which forms the back and base of the skull. A 66-year-old man presented to our hospital with dysphagia and neck pain. It first crosses over the carotid triangle, and then over the submandibular triangle of the neck. The path of the nerve starts in the hypoglossal nucleus of the brainstem, which is located near the midline of the medulla oblongata, and then travels between the carotid artery and jugular vein to end up on the underside of the tongue. The two lateral branches are the meningeal branch and the superior root of the ansa cervicalis, whereas the terminal branches are the terminal lingual nerves. [16] For example, damage to the left and right hypoglossal nerves may occur with damage to the facial and trigeminal nerves as a result of damage from a clot following arteriosclerosis of the vertebrobasilar artery. Parasympathetic Functions. Hypoglossal nerve is a motor nerve which, like the vagus and glossopharyngeal, is involved in the movement of tongue muscles, swallowing and speech. Hypoglossal nerve: want to learn more about it? [9][10] The nerve is first visible as a series of roots in the fourth week of development, which have formed a single nerve and link to the tongue by the fifth week. Official Ninja Nerd Website: https://ninjanerd.orgNinja Nerds!In this lecture Professor Zach Murphy will be teaching you about the hypoglossal nerve (cranial. The hypoglossal nerve holds this relation until it reaches the beginning of the occipital artery. Its a motor nerve that carries signals to and from the brain to control muscle movement. Get instant access to this gallery, plus: Introduction to the musculoskeletal system, Nerves, vessels and lymphatics of the abdomen, Nerves, vessels and lymphatics of the pelvis, Infratemporal region and pterygopalatine fossa, Meninges, ventricular system and subarachnoid space, Meningeal branch, superior root of the ansa cervicalis, and terminal lingual nerves, Dura mater on the floor of the posterior cranial fossa, Three extrinsic muscles of the tongue: the genioglossus, hyoglossus andstyloglossus muscles, Neck(cadaveric dissection) - Prof. Carlos Surez-Quian. The hypoglossal nucleus is a thin and long nucleus lies in the ventral portion of the medulla, near the midline. Sensing lead Kim Bengochea, Regis University, Denver. If the damage is to the nerve itself (a lower motor neuron lesion), the tongue will curve toward the damaged side, owing to weakness of the genioglossus muscle of affected side which action is to deviate the tongue in the contralateral side . It then continues on and supplies the genioglossus muscle, and towards the tip of the tongue, where it divides into branches supplying the tongue muscles. The superior root of the ansa cervicalisactually carries the fibers from the cervical plexus that joined the nerve outside the cranium. [5] It continues deep to the genioglossus muscle and continues forward to the tip of the tongue. See Appendix 3-5. Hypoglossal Nerve. [2] Because of the close proximity of the nerve to other structures including nerves, arteries, and veins, it is rare for the nerve to be damaged in isolation. The Neurological Institute is a leader in treating and researching the most complex neurological disorders and advancing innovations in neurology. 2015 May;125(5):1254-64. doi:10.1002/lary.25032. In some people, the two branches of the hypoglossal nerve don't join together until after exiting the hypoglossal canal, which, in those people, includes two openings instead of one. (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4481793/) J Neurosci Rural Pract. It was listed in 1778 as nerve hypoglossum magnum by Soemmering. Hypoglossal nerve stimulation (HGNS) therapy was designed to recruit genioglossus activity and relieve airflow obstruction in sleeping patients with obstructive sleep apnea, (17, 27). Accessed 6/24/2021. Our website services, content, and products are for informational purposes only. They're called cranial nerves and they emerge, as symmetrical pairs, from the brain itself. Contents Origin Course and relations Branches Clinical aspects Sources + Show all It provides voluntary motor control of tongue movements. The hypoglossal nucleus interacts with the reticular formation, involved in the control of several reflexive or automatic motions, and several corticonuclear originating fibers supply innervation aiding in unconscious movements relating to speech and articulation. The examination of the hypoglossal canal is helpful in the diagnosis of a number . Hypoglossal Nerve Disorders. The glossopharyngeal nerve provides parasympathetic innervation to the parotid gland.These fibres originate in the inferior salivatory nucleus of CN IX. It is mainly an efferent nerve for the tongue musculature. Our website is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Each hypoglossal nerve exits the cranium and curves, reaching the skeletal tongue muscles. It is divided into spinal and, In the upper arm and near the shoulder, the median nerve branches off of the brachial plexus. To test the function of the hypoglossal nerve, a physician should ask their patient to protrude their tongue. This means that the damage of the corticobulbar fibers manifests as paralysis of the muscles of the contralateral side of the tongue. Register now FInd information about the trigeminal nerve, including its functions, how doctors test it, and the conditions associated. This nerve and the muscles it serves are at least responsible for several important functions, including:. The hypoglossal nerve communicates with several other nerves as well, including: The hypoglossal nerve and its associated functions can be compromised by disease or injury. 1. The hypoglossal nerve arises as a number of small rootlets from the front of the medulla, the bottom part of the brainstem,[1][2] in the anterolateral sulcus which separates the olive and the pyramid. The hypoglossal nerve provides motor control of the extrinsic muscles of the tongue: genioglossus, hyoglossus, styloglossus, and the intrinsic muscles of the tongue. The hypoglossal nerve enables tongue movement. The muscles, attached to the underside of the top and back parts of the tongue, cause the tongue to protrude and deviate towards the opposite side. Content is reviewed before publication and upon substantial updates. The hypoglossal nerve is the twelfth cranial nerve and controls movements of the tongue. So the hypoglossal nerve, its CN XII, aka TWELVE. [1] The hypoglossal nucleus receives input from both the motor cortices but the contralateral input is dominant; innervation of the tongue is essentially lateralized. The first recorded description of the nerve is by Herophilos in the third century BC. Transcribed image text: Match the cranial nerve with its name or function. The hypoglossal nerve is purely motor nerve, which innervates extrinsic tongue muscles and geniohyoid muscle. This article will discuss the anatomy and function of the hypoglossal nerve. It controls the hyoglossus, intrinsic, genioglossus and styloglossus muscles. . Olfactory nerve. The nerve is then tested by sticking the tongue out. hypoglossal nerve palsy. On emerging from the hypoglossal canal, the nerve picks up a branch from the anterior ramus of C1. It is a nerve with a solely motor function. Specifically, the hypoglossal nerve emerges from the hypoglossal nucleus, which is about at the midline of the medulla oblongata. 2019;27(4):231-236. doi:10.1097/MOO.0000000000000543. Update on hypoglossal nerve stimulation in children with down syndrome and obstructive sleep apnea. Some causes, like trauma and surgical complications, can be difficult to avoid. [17], The hypoglossal nerve is tested by examining the tongue and its movements. The hypoglossal nerve helps you move your tongue. 2020;130(4):E263-E267. This nerve and the muscles it serves are at least responsible for several important functions, including: 1 Talking and singing Chewing Swallowing One-half of the hypoglossal nerve is transected: use of less than one-half of the hypoglossal nerve is adequate for approximation to the distal stump of the atrophic facial nerve. The nerve arises from the hypoglossal nucleus in the medulla as a number of small rootlets, passes through the hypoglossal canal and down through the neck, and eventually passes up again over the tongue muscles it supplies into the tongue. The Hypoglossal Nerve Photo: Public Domain The twelfth and final cranial nerve, the hypoglossal nerve, is responsible for innervating the intrinsic and extrinsic tongue muscles. The nucleus of the hypoglossal nerve also gets a portion of its sensory fibers through many of its synaptic relations with the solitary nucleus and the sensory nuclei of the trigeminal nerve (CN V). Once the cause is determined, the doctor can look for suitable treatments to restore functionality to the nerve. The function of each muscle/muscle group is as follows: Genioglossus- Draw the tongue forward from the root In the . This nerve is responsible for eyeball and eyelid movement. Its functions include tongue movements in relation to swallowing, food manipulation, and speech. The superficial peroneal nerve branches off from the sciatic nerve, or the common peroneal nerve, which ultimately winds around the head of the fibula, The nervous system has two major parts: the central nervous system (CNS) and the peripheral nervous system (PNS). However, if a nerve defect cannot be repaired by direct neurorrhaphy, it has been suggested that an interposition nerve graft is superior to a hypoglossal nerve transfer (Malik et al., 2005; Wang et al., 2013). After this, the hypoglossal nerve passes over the superficial side of the hyoglossus muscle, and passes above the greater horn of the hyoid bone. Hypoglossal nerve monitoring can be achieved by head and neck surgeons familiar with neuromonitoring of the facial and recurrent nerves, by following the procedures of other . The hypoglossal nerve is used for daily functions most people take for granted, like. There are two hypoglossal nerves in the body: one on the left, and one on the right. [6][19] When the nerve is damaged, the tongue may feel "thick," "heavy," or "clumsy." Hypoglossal nerve stimulation in the treatment of obstructive sleep apnea: A systematic review and meta-analysis. It provides voluntary motor control of tongue movements. Hypoglossal and recurrent laryngeal nerve function was completely recovered after 5 and 7 months, respectively, and no complication was remained. hypoglossal nerve the twelfth cranial nerve; its modality is purely motor, serving the intrinsic muscles of the tongue and other muscles beneath the tongue. That's where it meets up with the cervical plexus. Contents What would happens if the hypoglossal nerve is damaged? Taking care of yourself can help you avoid disruption to hypoglossal nerve function. [3] The nerve passes through the subarachnoid space and pierces the dura mater near the hypoglossal canal, an opening in the occipital bone of the skull. The hypoglossal nerve is divided into those territories of muscles it supplies, i.e., dorsal and ventral laminae. William Truswell, MD, is a board-certified facial plastic surgeon and otolaryngology (head and neck) surgeon. Expert Answers: The Hypoglossal Nerve is the 12th Cranial Nerve (Cranial Nerve XII). It eventually comes up to the floor of the mouth and connects with the muscles of your tongue. When it comes to the innervation of the head and neck, we know its all about the cranial nerves. This may cause difficulty with tongue movements, speech, chewing and swallowing caused by dysfunction of several cranial nerve nuclei. Neurons of the hypoglossal nucleus are derived from the basal plate of the embryonic medulla oblongata. [2][4], After emerging from the hypoglossal canal, the hypoglossal nerve gives off a meningeal branch and picks up a branch from the anterior ramus of C1. Copyright The nerve originates from the medulla and travels caudally and dorsally to the tongue. Expert Answers: The rootlets of the hypoglossal nerve arise from the hypoglossal nucleus near the bottom of the brain stem. 2. Because of its proximity to other cranial nerves, damage to the hypoglossal nerve alone is rare. Mark as brainliest. Normal It was then named as the great hypoglossal nerve by Cuvier in 1800 as a translation of Winslow and finally named in English by Knox in 1832. The fibres then hitchhike on the auriculotemporal . You can protect cranial nerve 12 from some of these conditions by living a healthy lifestyle. Intrinsic muscles that change the tongues shape, including curving and narrowing. In mammals, the hypoglossal canal is developed during embryonic stages. The Hypoglossal Nerve is the 12th Cranial Nerve (Cranial Nerve XII). The hypoglossal nerve arises as a series of rootlets, from the caudal brain stem, here seen from below. In the neck, the hypoglossal nerve sheath receives a hitch-hiking branch of the cervical plexus containing fibers from the C1 and C2 spinal roots. The glossopharyngeal nerve (/ l s o f r n (d) i l,- f r n d i l /), also known as the ninth cranial nerve, cranial nerve IX, or simply CN IX, is a cranial nerve that exits the brainstem from the sides of the upper medulla, just anterior (closer to the nose) to the vagus nerve.Being a mixed nerve (sensorimotor), it carries afferent sensory and efferent . It originates from it motor nucleus found in the ventral medulla oblongata. All rights reserved. Most of the nerves in your body originate in the spinal cord. The type of modality is sensory, of the special visceral sensory variety. The hypoglossal nerve supplies all of the motor function to your tongue. 2009 Jun;15(3):234. Dimitrios Mytilinaios MD, PhD The hypoglossal nerve leaves the skull through the hypoglossal canal, which is situated near the large opening for the spinal cord, the foramen magnum. Doctors usually do magnetic resonance imaging and/or a spinal tap to identify the cause. [25] The evolutionary origins of the nerve have been explored through studies of the nerve in rodents and reptiles. Several causes are attributed to its aetiology, like, intracranial or extracranial space occupying lesions, head and neck injury, vascular injury, infection , neuropathy or autoimmune disease, or idiopathic [ 1 ]. Discussion There have been many reports of often unilateral and in some cases bilateral lingual, hypoglossal, and recurrent laryngeal nerve paralysis following endotracheal intubation or LMA insertion . The nerve originates from its motor nucleus, simply called the nucleus of the hypoglossal nerve, or hypoglossal nucleus. At rest, if the nerve is injured a tongue may appear to have the appearance of a "bag of worms" (fasciculations) or wasting (atrophy). In order to preserve this important function, the hypoglossal nerve can be partial cut on its side and connected to the facial nerve (see Figure 1). [2] These represent all muscles of the tongue except the palatoglossus muscle. _____. Hypoglossal nerves control tongue movements during speech and swallowing. What does the hypoglossal nerve control? [a] CN XII is a nerve with a solely motor function. The hypoglossal nerve supplies: Find out more about these muscles with these great articles. You can protect cranial nerve 12 from some of these conditions by living a healthy lifestyle. The main function of the hypoglossal canal is the supply of the hypoglossal nerve from its origin near the medulla oblongata to its exit point near the jugular foramen at the base of the skull. Cranial XII: Motor. An injury of the nerve manifests as flaccid paralysis and atrophy of the ipsilateral muscles of the tongue followed with speech impairment. The hypoglossal nerve is the 12th cranial nerve. In this space, the nerve is closely related to all lateral pharyngeal elements, such as: The hypoglossal nerve descends vertically through the retrostyloid space. [2] Motor neuron disease is the most common disease affecting the hypoglossal nerve. [4] It then loops around a branch of the occipital artery and travels forward into the region beneath the mandible. Somatic motor to all the intrinsic muscles of the tongue (longitudinal, transverse, and vertical muscle bundles) and all of the extrinsic muscles of the tongue (hyoglossus, genioglossus, styloglossus) except palatoglossus (innervated by cranial nerve [CN] X). The hypoglossal nerve doesn't branch off until it reaches the muscles of the tongue, at which time it sends off numerous small branches to innervate those muscles. [2], The hypoglossal nerve may be connected (anastomosed) to the facial nerve to attempt to restore function when the facial nerve is damaged. (https://www.ncbi.nlm.nih.gov/books/NBK532869/), (https://www.merckmanuals.com/home/brain,-spinal-cord,-and-nerve-disorders/cranial-nerve-disorders/hypoglossal-nerve-disorders), (https://radiopaedia.org/articles/hypoglossal-nerve?lang=us), Visitation, mask requirements and COVID-19 information. hypoglossal nerve. What is the normal function of the hypoglossal nerve XII? Hypoglossal nerve stimulation has been found to be a safe and effective treatment for obstructive sleep apnea in cases where people haven't been successful with other treatments. It's also being researched for children who have both Down syndrome and obstructive sleep apnea. Leaves the cranial cavity by passing through the hypoglossal canal. The hypoglossal nerve enables tongue movement. The hypoglossal nerve helps you move your tongue. [24] As with humans, damage to the nerve or nerve pathway will result in difficulties moving the tongue or lapping water, decreased tongue strength, and generally cause deviation away from the affected side initially, and then to the affected side as contractures develop. The nerve allows the muscles to move and protrude the tongue, though this nerve only has a motor function. Another test monitors the strength of the tongue by having the patient press their tongue against the side of their cheek. Grounded on academic literature and research, validated by experts, and trusted by more than 2 million users. Glossal, also from the Greek, mean "tongue.". If paralysis were present, the tongue would point in the direction of the affected side. Treasure Island, FL: StatPearls Publishing. Last medically reviewed on January 19, 2018. A branch of the cervical plexus runs inside the sheath of the hypoglossal nerve, but the fibers of these two nerves don't join together in any way. Hypoglossal nerve palsy (HNP) is a potential cause of dysphagia. Update on hypoglossal nerve stimulation in children with down syndrome and obstructive sleep apnea. Hypoglossal nerve disorders may be caused by tumors, strokes, infections, injuries, or amyotrophic lateral sclerosis. Want to recall the dura mater and cranial anatomy? Cookies collect information about your preferences and your devices and are used to make the site work as you expect it to, to understand how you interact with the site, and to show advertisements that are targeted to your interests. Its also known as the 12th cranial nerve, cranial nerve 12 or CNXII. Hypoglossal nerve stimulation (HNS) therapy has emerged as a viable option for treating obstructive sleep apnea (OSA) that is refractory to conventional therapies, such as positive airway pressure (PAP) and oral appliance therapy. Hypoglossal nerves (XII) is only motor, controlling tongue movements. Once a diagnosis is made, treatment can begin. What Is the Hypoglossal Nerve? doi:10.1002/lary.28138, Certal VF, Zaghi S, Riaz M, et al. Isolated hypoglossal nerve palsy is a very rare condition. 2) inferior longitudinal, which contract to shorten the tongue, making its dorsum convex. Last reviewed by a Cleveland Clinic medical professional on 06/04/2021. Hypoglossal nerve issues can impact your ability to eat, speak or swallow. Cranial nerve XII is the hypoglossal nerve, a somatic motor nerve so named for its literal translation of "under" and "tongue." In this article, we discuss the structure and function of the hypoglossal nerve, before describing the clinical relevance of this nerve. The 12 nerves in your head are different. [11][12], The hypoglossal nerve provides motor control of the extrinsic muscles of the tongue: genioglossus, hyoglossus, styloglossus, and the intrinsic muscles of the tongue. [6] Signals from muscle spindles on the tongue travel through the hypoglossal nerve, moving onto the lingual nerve which synapses on the trigeminal mesencephalic nucleus.[2]. When you visit the site, Dotdash Meredith and its partners may store or retrieve information on your browser, mostly in the form of cookies. Laryngoscope. The hypoglossal nerve functions includes supplying all intrinsic and extrinsic muscles of the tongue except the palatopharyngeus (vagus). The hypoglossal nucleus receives information from the precentral gyrus from the opposite cerebral hemisphere via the corticonuclear tract. In order to restore the resting symmetry or "tone" of the face, the hypoglossal nerve may be used as a donor nerve. [4], At a point at the level of the angle of the mandible, the hypoglossal nerve emerges from behind the posterior belly of the digastric muscle. Inspire Hypoglossal Nerve Stimulator Components Has 3 components that are placed in 2 incisions (previously 3 incisions were used). 2003 by Saunders, an imprint of Elsevier, Inc. All rights reserved. [14] The most common causes of injury in one case series were compression by tumours and gunshot wounds. The ilioinguinal nerve branches off the first lumbar nerve, which is near the lower back. [4] The hypoglossal nerve moves forward lateral to the hyoglossus and medial to the stylohyoid muscles and lingual nerve. Attempts at repair by either wholly or partially connecting nerve fibres from the hypoglossal nerve to the facial nerve may be used when there is focal facial nerve damage (for example, from trauma or cancer). This nerve provides somatic motor innervation to the intrinsic and extrinsic muscles of tongue (except palatoglossus). Facial reanimation: an update on nerve transfers in facial paralysis. The hypoglossal nerve controls muscles that move the tongue, enabling you to: The hypoglossal nerve starts in the base of the brain near the top of the spinal cord (brain stem). This nerve starts at the base of your brain. The nerve is involved in controlling tongue movements required for speech and swallowing, including sticking out the tongue and moving it from side to side. General sensation to the anterior two-thirds of the tongue is by innervation from the lingual nerve, a branch of the mandibular branch of the trigeminal nerve (CN V3). (https://www.ncbi.nlm.nih.gov/books/NBK532869/) Accessed 6/24/2021. The corticobulbar fibers intended for this connection to innervate the contralateral nucleus of the hypoglossal nerve. A lot of research is focusing on direct nerve repair as well as nerve transfers to correct problems such as facial paralysis, and surgical techniques are improving regarding the hypoglossal nerves as well as several other nerves of the face. One set is extrinsic (on the exterior of the tongue) while the other set is intrinsic (fully contained within the tongue). It enables you to speak, swallow and push substances around in your mouth. Here, learn about its anatomy, functions, and the kinds of health problems that can occur. It spreads through the middle of the arm, also known as the medial brachial area. The smell molecules in the nasal cavity trigger nerve impulses that pass along this nerve to the olfactory bulb, then on to limbic areas. Course Therefore, injuries to this nerve have the potential to affect a patient's articulation and swallow substantially. If there is damage to the nerve or its pathways, the tongue will usually but not always deviate to one side. [2] The left and right genioglossus muscles in particular are responsible for protruding the tongue. Although the partial hypoglossal transfer produces less impairment of tongue function than the standard hypoglossal transfer, the motion it produces is often weaker. Due to this progressive pattern of . First, lets see which structures the hypoglossal nerve (CN XII) innervates, and then well follow the nerve all the way from the brainstem to see how does it get to its target structure. The hypoglossal nerve or twelfth cranial nerve (CNXII) innervates all of the intrinsic and extrinsic muscles of the ipsilateral tongue, except palatoglossus. [21][22], The first recorded description of the hypoglossal nerve was by Herophilos (335280 BC), although it was not named at the time. 9500 Euclid Avenue, Cleveland, Ohio 44195 |, (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4481793/). The tongue should then be palpated to check the tone of the muscles as well as the ability of sensation.

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