The accessory nerve (eleventh cranial nerve) and hypoglossal nerve (12th cranial nerve)

The accessory nerve (eleventh cranial nerve) is a purely motor nerve and has two roots cranial and spinal column. Hypoglossal nerve is also a pure motor nerve and provides intrinsic muscles of the tongue.

The accessory nerve

This is a purely motor nerve. It has two roots-cranial and spinal column. Spinal root stems from the previous five upper cervical segments horn cells and enters the skull of the foramen magnum. These fibres are joined by the cranial root that emerges from the part flow together and ambiguous kernel leave the skull of the hole jugular with the vague.Into the hole jugular, cranial root fibres bind the vague to be distributed together with the vague pharynx and laringe.Esta fibres part of nerve cannot test separately. The part of the spinal column supplies the esternocleidomastoideo and the top of the Trapeze.

Testing: This is limited to the assessment of the esternocleidomastoideo engine power and the sternocleidomastoid trapecio.El is evaluated by the inspection and palpation while patient turns his head against the muscular paralysis resistencia.La is flat and not prominently highlighted on the head to the opposite side. Trapeze is tried asking the patient to tap or shrugging.

Hypoglossal nerve (12th cranial nerve)

This is also a pure motor nerve and supplies the intrinsic muscles of the tongue. Arises from a series of rootlets cord between pyramid and inferior olive and arises skull through hypoglosal hole of providing language.

Tests: You must ask the patient to open the mouth without stick out tongue. In unilaterla paraysis, the language for the healthy side curves sliughtly.The protruding tongue, is diverted to the paralysed side.Look for any loss or the lengua.Esto fibrillations should always be reviewed without protrusion of the tongue and indicates a lower motor neuron nerve injury XII.In injuries to the upper motor neuron, the language is short and speastic.

Bulbar paralysis: this is a syndrome characterized by weakness or paralysis of the muscles supplied by lower brianstem motor cores i.e. the motor nerves in ninth to twelfth cores.Acute injuries as siphetheria or polio, no time for muscle atrophy.Chronic as paralysis bulbar progressice or brain stem tumors are marked wasting and atrophy of the mouth, tongue and the sternocleidomastoids.Esto shapes must be differentiated from pseudobulbar palsy is caused by the paralysis of upper motor neuron muscles bulbar in vascular lesions of the upper brainstem and motor neuron disease.

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