5i. The Glossopharyngeal Nerve

(N. Glossopharyngeus; Ninth Nerve)

The glossopharyngeal nerve (Figs. 791, 792, 793) contains both motor and sensory fibers, and is distributed, as its name implies, to the tongue and pharynx. It is the nerve of ordinary sensation to the mucous membrane of the pharynx, fauces, and palatine tonsil, and the nerve of taste to the posterior part of the tongue. It is attached by three or four filaments to the upper part of the medulla oblongata, in the groove between the olive and the inferior peduncle. 1 The sensory fibers arise from the cells of the superior and petrous ganglia, which are situated on the trunk of the nerve, and will be presently described. When traced into the medulla, some of the sensory fibers, probably sympathetic afferent, end by arborizing around the cells of the upper part of a nucleus which lies beneath the ala cinerea in the lower part of the rhomboid fossa. Many of the fibers, probably the taste fibers, contribute to form a strand, named the fasciculus solitarius, which descends in the medulla oblongata. Associated with this strand are numerous nerve cells, and around these the fibers of the fasciculus end. The somatic sensory fibers, few in number, are said to join the spinal tract of the trigeminal nerve. 2

FIG. 791– Plan of upper portions of glossopharyngeal, vagus, and accessory nerves. (See enlarged image) The somatic motor fibers spring from the cells of the nucleus ambiguus, which lies some distance from the surface of the rhomboid fossa in the lateral part of the medulla and is continuous below with the anterior gray column of the medulla spinalis. From this nucleus the fibers are first directed backward, and then they bend forward and lateralward to join the fibers of the sensory root. The nucleus ambiguus gives origin to the motor branches of the glossopharyngeal and vagus nerves, and to the cranial part of the accessory nerve. 3 The sympathetic efferent fibers from the nucleus beneath the ala cinerea, the dorsal nucleus, are probably both preganglionic motor fibers and preganglionic secretory fibers of the sympathetic system. The secretory fibers pass to the otic ganglion and from it secondary neurons are distributed to the parotid gland. Some authors describe these fibers as arising from a distinct nucleus the inferior salivatory nucleus, which lies near the dorsal nucleus. 4 From the medulla oblongata, the glossopharyngeal nerve passes lateralward across the flocculus, and leaves the skull through the central part of the jugular foramen, in a separate sheath of the dura mater, lateral to and in front of the vagus and accessory nerves (Fig. 792). In its passage through the jugular foramen, it grooves the lower border of the petrous part of the temporal bone; and, at its exit from the skull, passes forward between the internal jugular vein and internal carotid artery; it descends in front of the latter vessel, and beneath the styloid process and the muscles connected with it, to the lower border of the Stylopharyngeus. It then curves forward, forming an arch on the side of the neck and lying upon the Stylopharyngeus and Constrictor pharyngis medius. Thence it passes under cover of the Hyoglossus, and is finally distributed to the palatine tonsil, the mucous membrane of the fauces and base of the tongue, and the mucous glands of the mouth. 5 In passing through the jugular foramen, the nerve presents two ganglia, the superior and the petrous (Fig. 791). 6 The Superior Ganglion (ganglion superius; jugular ganglion) is situated in the upper part of the groove in which the nerve is lodged during its passage through the jugular foramen. It is very small, and is usually regarded as a detached portion of the petrous ganglion. 7 The Petrous Ganglion (ganglion petrosum; inferior ganglion) is larger than the superior and is situated in a depression in the lower border of the petrous portion of the temporal bone. 8

FIG. 792– Upper part of medulla spinalis and hind- and mid-brains; posterior aspect, exposed in situ. (See enlarged image) Branches of Communication.—The glossopharyngeal nerve communicates with the vagus, sympathetic, and facial. 9 The branches to the vagus are two filaments which arise from the petrous ganglion, one passing to the auricular branch, and the other to the jugular ganglion, of the vagus. The petrous ganglion is connected by a filament with the superior cervical ganglion of the sympathetic. The branch of communication with the facial perforates the posterior belly of the Digastricus. It arises from the trunk of the glossopharyngeal below the petrous ganglion, and joins the facial just after the exit of that nerve from the stylomastoid foramen. 10

Branches of Distribution.—The branches of distribution of the glossopharyngeal are: the tympanic, carotid, pharyngeal, muscular, tonsillar, and lingual. 11 The Tympanic Nerve (n. tympanicus; nerve of Jacobson) arises from the petrous ganglion, and ascends to the tympanic cavity through a small canal on the under surface of the petrous portion of the temporal bone on the ridge which separates the carotid canal from the jugular fossa. In the tympanic cavity it divides into branches which form the tympanic plexus and are contained in grooves upon the surface of the promontory. This plexus gives off: (1) the lesser superficial petrosal nerve; (2) a branch to join the greater superficial petrosal nerve; and (3) branches to the tympanic cavity, all of which will be described in connection with the anatomy of the middle ear. 12 The Carotid Branches (n. caroticotympanicus superior and n. caroticotympanicus inferior) descend along the trunk of the internal carotid artery as far as its origin, communicating with the pharyngeal branch of the vagus, and with branches of the sympathetic. 13 The Pharyngeal Branches (rami pharyngei) are three or four filaments which unite, opposite the Constrictor pharyngis medius, with the pharyngeal branches of the vagus and sympathetic, to form the pharyngeal plexus; branches from this plexus perforate the muscular coat of the pharynx and supply its muscles and mucous membrane. 14 The Muscular Branch (ramus stylopharyngeus) is distributed to the Stylopharyngeus. 15 The Tonsillar Branches (rami tonsillares) supply the palatine tonsil, forming around it a plexus from which filaments are distributed to the soft palate and fauces, where they communicate with the palatine nerves. 16

FIG. 793– Course and distribution of the glossopharyngeal, vagus, and accessory nerves. (See enlarged image) The Lingual Branches (rami linguales) are two in number; one supplies the papillæ vallatæ and the mucous membrane covering the base of the tongue; the other supplies the mucous membrane and follicular glands of the posterior part of the tongue, and communicates with the lingual nerve. 17

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