Anatomy Cranial Nerves

Front 1

Cranial Nerve 1: Olfactory Nerve
arises?

Back 1

Arises from olfactory trigone on inferior surface of the forebrain. Tract moved forward on anterior cranial folla floor and ends as two swelling (olfactory bulbs) atop cribiform plate.
-Pass from bulb through the dura and cribiform plate to roof of nasal cavity below

Front 2

Cranial Nerve 2: optic nerve arises?

Back 2

Originate: lateral geniculate bodies at base of diencephalong. Pass forward and conver at optic chiasma (not all fibers cross). Passing forward are the left and right optic nerves (still tracts).
-pierce dura to pass through optic forament to enter orbit, -enters posterior aspect of eyeball to synapse with rod and cone cells of retina.

Front 3

Cranial Nerve 3: Oculomotor Nerve arises?

Back 3

Emerges from interpenduncular fossa of the midbrain and travels forward to -pierces dura of triangular field to enter cavernous sinus
-travels along lateral sinus wall
-leaves through superior orbital fissurep

Front 4

Cranial Nerve 4: Trochlear Nerve arises?

Back 4

Only one to arise form dorsum of brainstem. Slender thread from below the inferior colliculus of the midbrain and encircles brainstem to pass anteriorly.
-pierces dura of triangular field to enter cavernous sinus
-travels along lateral sinus wall
-leaves through superior orbital fissure

Front 5

Cranial Nerve 5: Trigeminal Nerve arises?

Back 5

Orinates: pons as thick sensory root and a smaller motor root
-travels anteriorly over petrous rid and pushes the dura ahead of it to produce trigeminal (meckel's) dural cave
-within case, stem dilates as broad flat trigeminal ganglion

Front 6

Cranial Nerve V-1: Opthalmic Nerve (branch of trigeminal) arises?

Back 6

-Leaves ganglion and cave to enter cavernous sinus anteriorly
-travels forward along lateral wall of sinus and exits superior orbital fissure to orbit

Front 7

Cranial Nerve V-2: Maxillary Nerve (branch of trigeminal) arises?

Back 7

-Leaves cave and passes anteriorly through posteroinferior portion of cavernous sinus
-leaves sinus by passing through foramen rotundum to area of pterygopalatine fossa

Front 8

Cranial Nerve V-3: Mandibular Nerve (branch of trigeminal) arises?

Back 8

-Leaves cave and drops straight down through foramen ovale to infratemporal region
-motor portion of trigeminal travels only with mandibular division

Front 9

Cranial nerve 6: Abducens Nerve arises?

Back 9

-arise from ventral aspect between Medulla and pons
-ascends on clivus
-pierces dura to run below dura
-passes over petrous temporal ride and enters cavernous sinus
-passes through sinus below internal carotid arter and exits through superior orbital fissure (orbit)

Front 10

Cranial nerve 7: Facial nerve arises?

Back 10

-Leaves lateral aspect of brainstem between pons and medulla
-passes laterally, pierces dura and exits through internal auditory meatus to enter petrous temporal bone
-traverses the bone through winding facial canal
-exits inferiorly at base of skull through stylomastoid foramen

Front 11

Cranial Nerve 8: vestibulocochlear nerve arises?

Back 11

-arises from brainstem lateral to facial nerve
-runs to internal auditory meatus and enters petrous temporal bone to supply inner ear
-within petrous temporal bone divides into cochear portion to cochlea and vestibular potion to semicircular canals

Front 12

Cranial Nerve 9: glossopharyngeal nerve arises?

Back 12

-arises three or four rootlets from lateral aspect of medulla
-converge as one bundle and pass to jugular foramen
-pierces dura and exits through forament to external base of skull

Front 13

Cranial nerve 10: Vagus Nerve arises?

Back 13

-arises as several rootlets from medulla
-in line with and below rootlets of glossopharyngeal
-rootlets combine and pass laterally to pierce dura and exit through jugular foramen to neck below

Front 14

Cranial nerve 11: Accessory Nerve arises?

Back 14

Arises from
-(1) cranial portion arises as several converging rootlets below vagus nerve
-(2) spinal portion arises from motor spinal contribution of spinal cord segments C1 to C6.
-filaments unite as they ascend upward thorugh foramen magnum and join cranial portion
-pierces dura exits through juglar foramen
-cranial portion splits off to join and distributed along with vagus nerve
-spinal portion exits alone through jugular foramen
-

Front 15

Cranial Nerve 12: Hypoglossal Nerve arises?

Back 15

-arises from medulla in cleft between the olive and pyramid as several rootlets
-rootlets combine, pierce dura, and exit through hypoglossal canal

Front 16

Special sensory of olfactory nerve 1?

Back 16

-receptor epithelial cells synapse with neurons in olfactory bulb whcih is connecto to brain by olfactory tract (technically part of brain)

Front 17

Special sensory of olfactory nerve 1 clinical test?

Back 17

-sense of smell, differentiate odors

Front 18

Special sensory of optic nerve 2?

Back 18

-ganglionic cells in retina
-convey information from eye to brain via optic nerve and tracts

Front 19

Special sensory of optic nerve 2 clinical test?

Back 19

-Reading eye chart/color/field of view
-visual field determined by examining when patient observes an object moving from lateral to medial

Front 20

oculomor nerve 3 motor?

Back 20

-contained in cavernous sinus to enter superior orbital fissure
-Motor to all extrensic muscles of eye, excluding lateral rectus and superior oblique
-CN III after entering superior orbital fissure divides into superior and inferior divisions
-superior division serves as motor innervation to superior rectus and levator palpebrae superior muscle
-inferior division motor to inferior rectus, inferior oblique and medial rectus

Front 21

Oculomotor nerve 3 preganglionic parasympathetic?

Back 21

-fibers travel with inferior division and synapse in ciliary ganglion suspended from nasociliary nerve (brach of trigeminal V1)
-post ganglionic fibers pass to the orbit via short ciliary nerves to innervate ciliary muscle and sphincter pupillae muscle of the eye

Front 22

occulomotor nerve 3 perceived dysfunction?

Back 22

-damage may cause paralysis of all extraoccular muscles except superior oblique and lateral rectus
-will result in lateral strabismus which is eye turns out because lateral rectus pulls it laterally; i.e. it is unopposed by medial rectus
-ptosis

Front 23

what is ptosis?

Back 23

-upper eyelid droops, due to dysfunction of levator palpabrae (innervated by occulomotor nerve aka CN 3)

Front 24

Clinical test of oculomotor (CN 3)?

Back 24

-patient asked to follow finger with eyes as it moves up, down, medial, lateral
--watch for crossing of eyes during convergence
-examine pupillary reflex with light shining on and off in each eye
-- compare contractions and dilations
--tests for lack of pupillary light reflex (parasympathetic componenets damaged) so sphincter pupillae msucle does not function and pupil does not decrease in diameter when light shined into eye

Front 25

Trochlear nerve (CN IV)?

Back 25

-motor = courses through cavernous sinus and enters orbit through superior orbital fisure;
-superior oblique
-innervates superior oblique muscle of eye

Front 26

Trochlear nerve (CN IV) clinical test?

Back 26

-if one of the abducens is damaged, eyes do not move in parallel
-have follow finger up, down, medial, lateral

Front 27

Trigeinal nerve three branches?

Back 27

-opthalmic (sensory)
-maxillary (sensory)
-mandibular (sensory and motor)

Front 28

trigeminal major sensory nerve of?

Back 28

-face
-teeth (and supporting structures)
-anterior portion of oral cavity
-mucous membrane of the head with cutaneous sensation

Front 29

Trigeminal provides motor innervation to?

Back 29

-muscles of massication
-tensor tympani
-tensor (veli)palantine
-mylohyoid
-anterior belly of digastric

Front 30

Opthalmic V1 3 sensory branches?

Back 30

-lacrimal nerve
-frontal nerve
-nasociliary nerves

Front 31

Lacrimal nerve

Back 31

from opthalmic V1 (trigeminal)
-sensory information from lateral part of upper eyelid, conjunctiva, and lacrimal gland
-runs posteriorly between lateral rectus muscle and roof of orbit to join the frontal and nasocilliary nerves at superior orbital fissure

Front 32

Frontal nerve

Back 32

-divides into
-supraorbital nerve which carries sensation from forehead and scalp
-supratrochlear nerve carries sensation from bridge of nose, medial part of upper eyelid, medial forehead
-courses along roof of orbite towards superior orbital fissure and joined by lacrimal and naso ciliiary

Front 33

nasociliary nerve branches?

Back 33

-infratrochlear N
-posterior ethmoidal n
-anterior ethmoidal n.
-long ciliary n.
Associationed with ciliary ganglia of CNIII, i.e. ganglion is suspended from nasociliary branch

Front 34

infratorchelar n.?

Back 34

branch of nasociliary nerve
-sensory to skin of upper eyelids, lacrimal sac, and side of nose

Front 35

posterior ethmoidal n?

Back 35

branch of nasociliary nerve
-go through posterior ethmoidal foramen
-distribute to mucous membrane of posterior ethmoidal air cells and sphenoid sinus

Front 36

anterior ethmoidal n?

Back 36

branch of nasociliary nerve (terminal portion)
-passes through anterior ethmoidal foramen, enters nasal cavity and forms two branches internal and external nasal
-supplies anterior ethmoidal cells and then enter anterior fossa of cranium
-terminal brach: external nasal branch, sensory to skin on lower 1/2 of nose

Front 37

long ciliary nerves?

Back 37

brach of nasociliary nerve
-accompany short ciliary n. from ciliary ganglion
-pierce sclera around optic n.
-are sensory to eyeball, eg cornea

Front 38

Perceived dysfunction of opthalmic nerve (CN III)?

Back 38

-damage to V1 will inhibit the corneal reflex and will reduce or inhibit sensation over the area covered by V1

Front 39

Clinical test for opthalmic nerve (CN III)?

Back 39

-test for corneal reflex with wisp of cotton
-prick forehead with pin (pain), apply warm and cold objects (temperature)

Front 40

Maxiilary nerve V2?

Back 40

-purely sensory
-arises from trigeminal ganglion, runs forward in the inferior part of cavernous sinus
-leave middle cranial foss through the foramen rotundum
-enters pterygopalatine fossa, leaves through pterygomaxillary fissure
-in pterygopalatine fossa associates with pterygopalatine ganglia (part of CN 7) which is suspended from maxillary division
-fibers from CN V2 pass through ganglia nad have no role in its function
-enter infratemporal fossa and then the floor of the orbit through the inferior orbital fissure
-contianues as the infraorbital n. which exits through the infraorbital canal and foramen

Front 41

Maxillary nerve V2 sensory informatin from?

Back 41

-maxilla and overlying skin
-nasal cavity
-palate
-nasopharynx
-meninges of anterio and middle cranial fossa carried to CNS by branches of maxillary of trigeminal

Front 42

Maxillary branches of trigeminal?

Back 42

-zygomatic nerve
-infraorbital nerve
-posterior superior alveolar nerve
-middle superior alveolar nerve
-anterior superior alveolar nerve

Front 43

Zygomatic nerve

Back 43

brach of maxillary nerve
-divides into zygomaticofacial nerve providing sensation form the cheek and -zygomaticotemporal nerve distributed to the skin of the side of the face

Front 44

posterior superior alveolar nerves

Back 44

brach of maxillary nerve
-arise from the maintrunk of hte maxillary nerve
-provides branches to the mucous membrane of the cheek and the adjacent gingiva
-enters same named foramen in maxilla to supply maxillary sinus and molar teeth

Front 45

infraorbital nerve

Back 45

brach of maxillary nerve
-after pterygopalatine fossa, maxillary nerve enter the floors of the orbit, thus becoming infraorbital nerve

Front 46

middle superior alveolar nerve

Back 46

brach of maxillary nerve
-innervates maxillary sinus, molar, and premolar teeth

Front 47

anterior superior alveolar nerve

Back 47

brach of maxillary nerve
-maxillary sinus and anterior teeth,

Front 48

dental plexus

Back 48

posterior, middle, and anterior superior alveolar nerves intermingle forming a dental plexus before innervating hte upper teeth
-infraorbital nerve exits skull via same named foramen, -provides innervation to lower eyelid via inferior palpebral branches, side of the nose via external nasal branches, and upper lip via superior labial branches

Front 49

branches through the pterygopalatine ganglion include?

Back 49

-pharyngeal = sensory to pharynx
-greater palatine = sensory to hard palate
-lesser palatine = sensory to soft palate
-nasopalatine = anterior region of hard palate and septum of nose
-nasal branches =nasal cavity
NOTE: will also carry sympathetic and parasympathetic modalities

Front 50

Perceived dysfunction of V2 (maxillary)

Back 50

Will reduce or inhibit sensation over V2 zone

Front 51

Clinical test of V2 (maxillary)

Back 51

stroke sensory zone of V2 as you would for V1, cotton, pin, then hot and cold

Front 52

Mandibular nerve (V3)

Back 52

-sensory and motor
-leave middle cranial fossa through foramen
-anterior division (mainly motor)
-posterior division (mainly sensory)

Front 53

branches from main mandibular trunk?

Back 53

-recurrent meningeal nerve = ascends back into the skull through foramen spinosum with middle meningeal arter, it supplies the dura
-nerve to tensor tympani muscle
-nerve to tensor veli palatini muscle
-nerve to medial pterygoid muscle

Front 54

Branches from anterior mandibular?

Back 54

-motor branches = supply motor innervation to muscle of mastication (temporalis, masseter, and lateral pterygoid muscles)
-Sensory branches
--buccal nerve= only sensory branch from anterior division, sensory to buccal mucosa, does not innervate buccinator msucle (that is done by buccal branch of facial nerve)

Front 55

Branches from posterior mandibular division?

Back 55

Lingual, inferior alveolar n, auriculotemporal nerve

Front 56

lingual n?

Back 56

branch of poster mandibular division
-provides sensory innervation to mucous membrane of anterior 2/3 of tongue, lingual gingiva, and others advjacent to tongue
-joined by chorda tympani brach of CN 7 which serves 2 functions
(1) special sensory fibers carrying taste from anterior 2/3 tongue
(2) preganglionic parasympathetic fibers destined for the submandibular ganglion (secretomotor to submandibular and sublingual and other minor salivary glands)

Front 57

Inerior alveolar nerve?

Back 57

branch of poster mandibular division
-mixed nerve (sensory and motor)
-before entering mandiular forament it gives motor branches to mylohyoid muscle and anterior belly of digastric muscle
-after entering mandibular foramen is only sensory to mandibular teeth, gingiva, chin, and lower lip
-exits mandible as mental nerve

Front 58

auriculotemporal n

Back 58

-purely sensory to temporal regions and TMJ
-has two roots that encircle middle meningeal arter
-carries postganglionic parasympathetic axons (secretomotor) from otic ganglion to parotid gland

Front 59

Perceived dysfunction of mandibular nerve (V3)

Back 59

-loss of senssation on the v3 zone
-paralysis of muscles of mastication

Front 60

clinical test for mandibular nerve (V3)

Back 60

-stroke sensory zone for sensory component
-for motor ask patient to clench jaws, open and move side to side against resistance

Front 61

Abducens N (CN 6)

Back 61

Motor
-enters cavernous sinsu and enters orbit through superior orbital fissure
-innervates lateral rectus muscle of eye
-abducens injury results in paralysis of lateral rectus

Front 62

Perceived dysfunction of Abducens (CN 6)?

Back 62

damage causes double vision and paralysis of lateral rectus msucle, thus eye remains rotated medially
(clincial test follow finger)

Front 63

Facial nerve CN 7 leaves from where?

Back 63

stylomastoid foramen

Front 64

Internal auditory meatus of Facial nerve CN 7 has two roots?

Back 64

1. motor root innervates muscles derived from second branchial arch
2. second (nervus intermedius) contains sensory and autonomic fibers (parasympathetic)
-special sensory fibers for taste anterio 2/3 of tongue
-chordae tympani (parasympathetic and taste

Front 65

Branches of facial nerve before exiting stylomastoid foramen

Back 65

- post auricular brach, occipitofrontalist and auricular muscles
- nerve to stapedius muscle (ear)

Front 66

Branches of facial nerve after exiting stylomastoid foramen

Back 66

-branch to stylohyoid and posterior belly of digastric

Front 67

branches in parotid gland

Back 67

-temporal branch=muscle of external ear and part of frontalis
-zygomatic branch= remainder of frontalis, orbicularis oculi
-buccal branch= buccinator, upper half of orbicularis oris and the dilator msucles inserting into upper lip
- mandibular branch= muscles of lwoer lip
- cervical branch=platysma

Front 68

visceral motor component (parasympathetic) of facial nerve importance?

Back 68

-responsible for control of all major glands of the head except for parotid gland (auricomotor nerve from otic ganglion which preganglion is V3)

Front 69

What do the superior salivatory nucleus of nervus intermedius divide into?

Back 69

-greater petrosal nerve (to lacrimal and nasal glands)
--parasympathetic nerves synapse in pterygopalatine ganglion before innervating lacrimal glands, and of palate and nasal mucosa
-chorda tympani (submandibular and sublingual glands)

Front 70

Pterygopalatine ganglion arises?

Back 70

hangs from maxillary division of trigeminal nerve (V2) in ptergypaltine fossa

Front 71

What three types of nerve fibers does the pterygopalatine ganglion receive?

Back 71

-Sensory branches= from maxillary
-sympathetic branches= postganglionic fibers from superior cervical ganglion as the deep petrosal nerve
-parasympathetic preganglionic fibers from facial N.
ONLY parasympathetic fibers synapse in ganglion

Front 72

Outgoing nerves from pterypalatine ganglion

Back 72

-greater paltine nerves
-lesser palatine nerve
-nasopalatine nerve
-short sphenopalatine
-pharyngeal branches

Front 73

Outgoing nerves from pterygopalatine ganglion: nasopalatine nerve

Back 73

-exits through sphenopalatine foramen to enter the nasal cavity,
-descends to incisive canal and emerges onto hard palate, -branches are nasal to nasal septum and palate to the palatal mucosa

Front 74

Outgoing nerves from pterypalatine ganglion
-lesser palatine nerve

Back 74

exits through lesser palatine canal to supply mucosa and glands of soft palate

Front 75

Outgoing nerves from pterypalatine ganglion
-greater paltine nerves

Back 75

exits greater palatine foramen onto mucosa of hard palate

Front 76

Outgoing nerves from pterypalatine ganglion
-short sphenopalatine

Back 76

-exits through the sphenopaltine foramen to enter the nasal cavity
-supply lateral wall of nasal cavity

Front 77

Outgoing nerves from pterypalatine ganglion
-pharyngeal branches

Back 77

-exits through the sphenopalatine foramen
-supplies roof of the pharynx

Front 78

Modalities in nasal, greater, and lesser palatines and pharyngeal nerves includ:

Back 78

-sensory (via CN V2)
-parasympathetic (CN 7) via greater petrosal nerve
-sympathetic (via deep petrosal nerve; post ganglionic fibers from superior sympathetic ganglion)

Front 79

Chordae tympani nerve (taste)arises

Back 79

-arises from facial nerve within facial canal
-passes through middle ear betwen tympanic membrane and handle of malleus
-leaves skull through petrotympanic fissure to join lingual nerve in infratemporal region
-taste fibers distributed to anterior 2/3's of tongue via the lingual nerve
-sensory fibers convey taste from anterior 2/3 of tongue

Front 80

Chordae tympani nerve (parasympaethic)arises

Back 80

-synapse in submandibular ganglion which is suspended form lingual nerve
-major source of parasympathetic innervation to the glands of the mouth
-sympathetic postganglionic fibers come from superior cervical ganglion via facial artery

Front 81

Perceived dysfunction of facial nerve due to injury of terminal branches?

Back 81

-lesions of terminal branches produce imbalance of the muscles of facial expression
-unilateral expressionless drooping of the face
-paralysis of orbicularis oculis seen by lack of corneal blink
-paralysis of orbilaris oris seen by drooling and problems eating
NOTE: inflammation of nerve withing facial canal is most common cause of bells palsy
-stroke on one side can cause face to sag due to inability to make facial expression

Front 82

Perceived dysfunction of facial nerve due loss of special sensory component?

Back 82

-loss of taste to anterior 2/3's of tongue
-lesion to chorda tympani and lingual nerve result in loss of taste, general sensation, and secretion
and paralysis of muscles of mastication

Front 83

Clinical test for facial nerve

Back 83

-test for sweet and saly on anterior 2/3's of tongue
-observe tearing with pungent fumes (ammonia)
-observe symmetry of face when asked to do facial expressions

Front 84

Vestibulocochlear (CN 8)

Back 84

-vestibular nerve for balance and cochlear nerve for hearing joined as a common nerve entering internal acoustic meatus
-cochlear nerve has its peripheral process in organ of Corti (membranous labyrynth), while cell bodies in spiral ganglion
-

Front 85

Vestibulocochlear (CN 8) perceived dysfunction

Back 85

-loss of hearing by air conduction indicates lesion or damage to middle ear, loss of bone conduction indicates nerve deafness
-clinical test (test with tuning fork for air and bone conduction)

Front 86

Glossopharyngeal Nerve (CN 9) Motor

Back 86

-nerve to stylopharyngeus=innervates only one muscle stylopharyngeus

Front 87

Glossopharyngeal Nerve (CN 9) sensory

Back 87

pharyngeal plexus (composed of CN 9 sensory, CN 10 motor and sympathetics)
-sensory to auditory tube, tympanic cavity, palatine fossa, and nasopharynx
-main trunk ends supplying posterior pharyngeal wall while other continue to posterior 1/3 of tongue

Front 88

Glossopharyngeal Nerve (CN 9) special sensory

Back 88

taste from posterior 1/3 of tongue

Front 89

Glossopharyngeal Nerve (CN 9) parasympathetic

Back 89

tympanic nerve (contains preganglionic fibers) which reenters skull and forms plexus in middle ear cavity
-from plexus arises lesser petrosal nerve which provides preganglion parasympathetic fibers to otic ganglion
-otic ganglion just outside foramen ovale
-postganglionic fibers (secretomotor) and otic ganglion preganglionic synapse and join with auricotemporal n. for distribution into parotid gland

Front 90

Glossopharyngeal Nerve (CN 9) Carotid sinus

Back 90

-small branch of CN 9 descend along with interal carotid arter
-nerve functions as bararoceptor within the carotid sinus
Note: vagus part baroceptor also

Front 91

Glossopharyngeal Nerve (CN 9) perceived dysfunction

Back 91

-damage to this nerve would reduce or inhibit gag reflex and difficulty swallowing
-reduce sensation on posterior 1/3 of tongue
-blood pressure altered

Front 92

Glossopharyngeal Nerve (CN 9) Clinical tests

Back 92

-test gag reflex, swallowing, positions of uvula
-test touch reception on posterior 1/3 of tongue
-neuralgia gives rise to pain, precipitated by swalling or protrusion of tongue

Front 93

Vagus Nerve (CN 10) arises

Back 93

-exits posterior cranial fossa via jugular formane and descends in carotid sheath

Front 94

Vagus Nerve (CN 10) Motor

Back 94

-innervates msucles of pharynx, via pharyngeal plexus, larynx, and palate

Front 95

Vagus Nerve (CN 10) sensory

Back 95

-external auditory meatus, larynx, thorax, and abdomen (visceral afferents)

Front 96

Vagus Nerve (CN 10) special sensory

Back 96

taste to epiglottis

Front 97

Vagus Nerve (CN 10) parasympathetic

Back 97

innervates viscera of neck, thorax, and abdomen (ganglia many within organs)

Front 98

Vagus Nerve (CN 10) recurrent laryngeal nerve

Back 98

-ascends back into the neck on
-supply intrinsic muscles of larynx (except cricothyroid) with motor innervation

Front 99

Vagus Nerve (CN 10) perceived dysfunction

Back 99

-hoarseness due to weakness or paralysis of vocal cord
-paralysis of soft palate results in difficulty in swallowing (regurgitation)

Front 100

Vagus Nerve (CN 10) clinical test

Back 100

-ask patient to say 'ahh', uvula deviates to unapposed (healthy) side due to action of intact healthy side muscles acting on soft palate

Front 101

Spinal accessory (XI) aka 11

Back 101

-Cranial root joins CN 10 and is source of vagal motor fibers
-Spinal root innervates trapezius and sternocleidomastoid msucles

Front 102

Spinal accessory (XI) aka 11 Perceived dysfunction and clinical test

Back 102

-damage would reduce or inhibit the movemend of head and shoulders
-ask patient to shrug shoulder for test of trapeqius, turn head against moderate resistance for test of sterncledomastoid

Front 103

Hypoglossal (CN XII)

Back 103

Motor- innervates all muscles of tongue except palatoglossal
-upper root of ansa cervicalis travels with a portion of CN 12 but is not functionally realted

Front 104

Hypoglossal (CN XII) perceived dysfunction and clinical test

Back 104

-lesion results in paralysis of all glossal muscles (except palatoglossus) affected side becomes atrophic
-when tongue is protruded out it deviates towards the affected sid eand that side appear shrunken and wrinkled
-have patients protrude and retract tongue (if damaged tongue deviates to affected side)