II. Anatomy
- Hypoglossal Nucleus
- Originates in Hypoglossal Nucleus, in the Medulla
- Exits anterior to the Inferior Olivary Nucleus
- All other medulla Cranial Nerves (CN 7, CN 8, CN 9, CN 10) exit posterior to the Inferior Olivary Nucleus
- Images
- Lewis (1918) Gray's Anatomy 20th ed (in public domain at Yahoo or BartleBy)
- Course
- As with all other Cranial Nerves (except CN 4), fibers remain ipsilateral (do not cross over)
- Passes through hypoglossal canal beside foramen magnum
- Courses downward with neurovascular structures
- Curves forward behind Mandible to lingual root
III. Physiology
- Motor Nerve to the Tongue
IV. Exam
- Patient protrudes Tongue in midline
- Unilateral paralysis causes deviation to weak side
- Observe for Tremor, atrophy, Fasciculations
- Test lingual speech, by having patient say:
- "Round the rugged rock the ragged rascal ran"
- "Third riding artillery brigade"
V. References
- Gilman (1989) Manter and Gatz Essentials of Neuroanatomy and Neurophysiology, Davis, p. 87-113
- Goldberg (2014) Clinical Neuroanatomy, p. 24-39
- Netter (1997) Atlas Human Anatomy, ICON Learning, p. 110-129