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Yousun Koh

Nerves of the pharynx (English)

Nerves of the pharynx (English)

In this posterior view we can see the nerves that supply the pharynx and other important nervous structures of the parapharyngeal space. The pharyngeal plexus is mainly composed of pharyngeal branches of the glossopharyngeal and vagus nerves and lies on the external surface of the pharynx. On the right side of the image, superiorly, we have a glimpse of the glossopharyngeal nerve (CN IX) after leaving the skull through the jugular foramen. The vagus nerve (CN X) also leaves the skull through this foramen and has two sensory ganglia in this location - in this image we can see the inferior ganglion. The superior laryngeal nerve arises from the inferior ganglion of the vagus nerve and descends against the lateral wall of the pharynx. It divides into the external and internal branches. The recurrent laryngeal nerve is also a branch of the vagus nerve that supplies the larynx. The right and left nerves are not symmetrical, with the left nerve looping under the aortic arch, and the right nerve looping under the right subclavian artery then traveling upwards. The accessory nerve (CN XI) also passes through the jugular foramen and courses through the neck; it pierces the sternocleidomastoid muscle which it innervates. The hypoglossal nerve (CN XII) leaves the skull, travels down the neck and ends at the base and underside of the tongue, being responsible for its nerve supply. The cervical sympathetic trunk lies behind the carotid sheath (a condensation of deep fascia of the neck in which is embedded the common and internal carotid arteries, internal jugular vein, and the vagus nerve). This trunk contains three interconnected ganglia: the superior, middle and inferior (stellate or cervicothoracic).
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