Part 207

THE EIGHTH OR AUDITORY NERVE

The =auditory nerve= (N. acusticus) is connected with the lateral aspect of the medulla just behind and external to the facial (Fig. 499). It has two roots, vestibular and cochlear (Radix vestibularis et cochlearis).

The auditory nerve consists of two distinct parts which might well be regarded as separate nerves. The cochlear part mediates the sense of hearing, while the vestibular part is not auditory in function, but is concerned in the sense of the position of the body and the mechanism of equilibration.

The nerve passes outward to the internal auditory meatus, which it enters behind the facial nerve. In the meatus it divides into two nerves, of which the upper is the vestibular and the lower is the cochlear nerve.

1. The =vestibular nerve= (N. vestibuli) is distributed to the utriculus, the sacculus, and to the ampullæ of the semicircular canals, of the internal ear. In the internal auditory meatus the nerve is connected by filaments with the geniculate ganglion of the facial nerve. At the bottom of the meatus it bears the =vestibular ganglion= (G. vestibulare), from the cells of which the fibers of the nerve arise.

2. The =cochlear nerve= (N. cochleæ) detaches a filament to the sacculus, passes through the lamina cribrosa to the labyrinth, and is distributed to the organ of Corti in the cochlea.

The fibers of the vestibular nerve arise from the vestibular ganglion as central processes (axones) of the bipolar cells of the ganglion. The peripheral processes (dendrites) of the cells form arborizations about the deep ends of the hair cells of the maculæ and cristæ acusticæ of the utriculus, sacculus, and semicircular canals. The fibers enter the medulla, pass between the restiform body and the spinal tract of the trigeminus, and spread out to end in the vestibular nucleus in the floor of the fourth ventricle. Among the central connections of the vestibular nerve are: (1) fibers which connect its nucleus with centers in the cerebellum (chiefly of the opposite side); (2) the vestibulo-spinal tract, which conveys impulses to the motor cells of the ventral columns of the spinal cord; (3) fibers which connect the nucleus with those of the abducent nerve of the same side, the third and fourth nerves, and the motor part of the trigeminus of both sides.

The fibers of the cochlear nerve are the central processes of the bipolar cells of the spiral ganglion of the cochlea. The peripheral processes of these cells end in relation to the hair cells of the organ of Corti. Some of the nerve-fibers enter the ventral cochlear nucleus in the medulla close to the superficial origin of the nerve; others end in the dorsal nucleus of the tuberculum acusticum at the lateral angle of the floor of the fourth ventricle. From the ventral nucleus fibers pass in the corpus trapezoideum to the anterior olivary nucleus of the same and of the opposite side. Thence tracts pass to the nuclei of the motor nerves of the eye, and through the lateral fillet to the posterior quadrigeminal body and the internal geniculate body. The axones of the cells of the dorsal nucleus pass largely (as the striæ acusticæ) over the restiform body and across the floor of the fourth ventricle toward the median plane. They then turn ventrally, cross to the opposite side, and are continued by the lateral fillet. From the mid-brain a tract proceeds to the cortex of the temporal lobe of the hemisphere.

THE NINTH OR GLOSSO-PHARYNGEAL NERVE

The =glosso-pharyngeal nerve= (N. glossopharyngeus) is attached to the anterior part of the lateral aspect of the medulla by several filaments (Fig. 499). The root-bundles enter the furrow ventral to the restiform body; they are separated by a short interval from the origin of the facial nerve, but are not marked off behind from the roots of the vagus. The bundles converge laterally to form a nerve which perforates the dura mater and emerges through the foramen lacerum posterius just in front of the tenth nerve (Fig. 515). As it issues from the cranium the nerve bears a considerable ovoid gray enlargement, the =petrous ganglion= (G. petrosum). It then curves downward and forward over the guttural pouch and behind the great cornu of the hyoid bone, crosses the deep face of the external carotid artery, and divides into pharyngeal and lingual branches (Fig. 437). The collateral branches are as follows:

1. The =tympanic nerve= (N. tympanicus) (Fig. 515) arises from the petrous ganglion and passes upward between the petrous and tympanic parts of the temporal bone to reach the cavity of the tympanum. Here it breaks up into branches to form, along with branches from the carotid plexus of the sympathetic, the =tympanic plexus=. From the plexus branches pass to the mucous membrane of the tympanum and the Eustachian tube. The continuation of the nerve issues from the plexus and unites with a filament from the geniculate ganglion of the facial to form the small superficial petrosal nerve; this runs forward and ends in the otic ganglion.

Filaments also connect the petrous ganglion with the jugular ganglion of the vagus nerve and with the superior cervical ganglion of the sympathetic.

2. A considerable branch runs backward on the guttural pouch, contributes filaments to the pharyngeal plexus, and concurs with twigs from the vagus and the sympathetic in forming the carotid plexus on the terminal part of the carotid artery and on its chief branches. In this plexus is the small ganglion intercaroticum.

The =pharyngeal branch= (R. pharyngeus) (Fig. 437) is the smaller of the two terminal branches. It runs forward across the deep face of the great cornu of the hyoid bone and concurs with the pharyngeal branches of the vagus and with sympathetic filaments in forming the pharyngeal plexus; from this branches pass to the muscles and mucous membrane of the pharynx.

The =lingual branch= (R. lingualis) is the continuation of the trunk (Fig. 437). It runs along the posterior border of the great cornu of the hyoid bone in front of the external maxillary artery and dips under the hyo-glossus muscle. It gives collateral branches to the soft palate, isthmus faucium, and tonsil, and ends in the mucous membrane of the posterior part of the tongue, where it supplies gustatory fibers to the vallate papillæ. A considerable branch unites with a twig from the lingual nerve.

The glosso-pharyngeal is a mixed nerve, containing both motor and sensory fibers. The latter constitute the bulk of the nerve and include those which mediate the special sense of taste. They are processes of the cells of the petrous ganglion. The central processes of the ganglion cells enter the medulla, pass upward and inward through the formatio reticularis, and end in the nucleus of termination in the floor of the fourth ventricle. The motor fibers arise from dorsal and ventral efferent nuclei in the medulla. The glosso-pharyngeal shares these nuclei with the vagus and has practically the same central connections as that nerve (q. v.).

THE TENTH, VAGUS, OR PNEUMOGASTRIC NERVE

The =vagus= or =pneumogastric= (N. vagus) is the longest and most widely distributed of the cranial nerves; it is also remarkable for the connections which it forms with adjacent nerves and with the sympathetic. It is attached to the lateral aspect of the medulla by several filaments which are in series with those of the ninth nerve in front and the eleventh nerve behind (Fig. 499). The bundles converge to form a trunk which passes outward, pierces the dura mater, and emerges from the cranium through the foramen lacerum posterius (Fig. 515). In the foramen the nerve bears on its lateral aspect the elongated flattened =jugular ganglion= (G. jugulare).

The ganglion communicates with (a) the tympanic nerve, (b) the petrous ganglion of the ninth nerve, (c) the spinal accessory, and (d) the hypoglossal. It also gives off the =auricular branch= (R. auricularis), which runs forward below the petrous ganglion and passes through a small canal in the petrous temporal bone to gain the facial canal. Here it gives filaments to the facial and emerges with that nerve through the stylo-mastoid foramen. It ascends behind the external auditory meatus, dips under the rotator longus muscle, and passes through a foramen in the conchal cartilage to ramify in the integument which lines the meatus and the adjacent part of the ear.

Beyond the ganglion the vagus runs backward and downward with the spinal accessory in a fold of the guttural pouch (Fig. 437). Then the two nerves separate, allowing the hypoglossal to pass between them, and the vagus descends with the internal carotid artery and crosses the inner face of the origin of the occipital artery. Here it is joined by the cervical trunk of the sympathetic, and the two nerves continue along the dorsal aspect of the common carotid artery in a common sheath (Fig. 433). At the root of the neck the vagus separates from the sympathetic, and from this point backward the relations of the right and left vagi differ somewhat and must be described separately.

FIG. 517.—CROSS-SECTION OF NECK OF HORSE, PASSING THROUGH POSTERIOR PART OF ATLAS.

The head and neck were extended. 1, Dorsal arch of atlas; 2, odontoid process; 3, odontoid ligament; 4, vertebral sinuses; 5, dura mater; 6, spinal cord; 7, vertebral artery; 8, wing of atlas; 9, atlanto-axial joint cavity; 10, œsophagus; 11, 11, recurrent nerves; 12, 12, ventral branches of spinal accessory nerves. By an oversight the obliquus cap. post. (above wing of atlas) is unmarked. ]

The =right vagus= (Fig. 429) enters the thorax in the angle of divergence of the right brachial artery and the truncus bicaroticus. It then passes backward and slightly upward, crossing obliquely the outer surface of the brachiocephalic artery and the right face of the trachea. Reaching the dorsal surface of the latter near the bifurcation, it divides into dorsal and ventral branches.

The =left vagus= (Fig. 428) enters the thorax on the ventral face of the œsophagus, crosses obliquely under the left brachial artery, and passes back on the external surface of that vessel in company with a large cardiac nerve. Separating from the latter, the vagus continues backward on the left face of the aorta, inclines to the upper surface of the left bronchus, and divides into dorsal and ventral branches.

The dorsal and ventral branches unite with the corresponding branches of the opposite nerve, thus forming =dorsal= and =ventral œsophageal trunks= (Truncus (œsophageus dorsalis, ventralis). These run backward in the posterior mediastinum, above and below the œsophagus respectively, and enter the abdominal cavity through the hiatus œsophageus; they supply branches to the œsophagus and anastomose with each other. The dorsal trunk receives the major part of its fibers from the right vagus. After entering the abdomen it passes to the left of the cardia, gives branches to the visceral surface of the stomach, and ends in the cœliac and subsidiary plexuses. The ventral trunk passes to the lesser curvature of the stomach and ramifies on the parietal surface of the stomach; it forms here the anterior gastric plexus, from which branches are supplied also to the first part of the duodenum and to the liver.

The collateral branches of the vagus are as follows:

1. The =pharyngeal branch= (R. pharyngeus) is given off in relation to the superior cervical ganglion, turns around the internal carotid artery, and runs downward and forward on the guttural pouch to the dorsal wall of the pharynx (Fig. 437). Here its branches concur with the pharyngeal branch of the ninth nerve and with filaments from the spinal accessory and the sympathetic in forming the =pharyngeal plexus=. This supplies numerous twigs to the pharynx, and a larger branch which passes along the side of the œsophagus and ramifies in its cervical part.

According to Ellenberger and Baum the pharyngeal plexus receives filaments also from the digastric, superior laryngeal, hypoglossal, and first cervical nerves. The branches of the plexus form secondary intermuscular and submucous plexuses, in which there are numerous minute ganglia.