and backward across the posterior triangle of the neck to enter the trapezius; both these muscles are in part supplied by the nerve.
| From A. M. Paterson, in Cunningham’s Text-Book of Anatomy | |||
| Fig. 4.—The Distribution of the Pneumogastric Nerve. | |||
| Va.R, | Right vagi. | I.C, | Internal, and |
| Va.L, | Left vagi. | E.C, | External carotid arteries. |
| r, | Ganglion of the root and | Ca1, | Superior cervical cardiac |
| connexions with | branch. | ||
| Sy, | Sympathetic, superior | Ca2, | Inferior cervical cardiac branch. |
| cervical ganglion. | R.L, | Recurrent laryngeal nerve. | |
| G.Ph, | Glosso-pharyngeal. | Ca3, | Cardiac branches from |
| Acc, | Spinal accessory nerve. | recurrent laryngeal nerves. | |
| m, | Meningeal branch. | Ca4, | Thoracic cardiac branch |
| Aur, | Auricular branch. | (right vagus). | |
| t, | Ganglion of the trunk | A.P.Pl, | Anterior, and |
| and connexions with | P.P.Pl, | Posterior pulmonary | |
| Hy, | Hypoglossal nerve. | plexuses. | |
| C1, C2 | Loop between the first | Oes.Pl, | Oesophageal plexus. |
| two cervical nerves. | Gast.R, | and Gast.L, Gastric | |
| Sy, | Sympathetic. | branches of vagus (right | |
| Acc, | Spinal accessory nerve. | and left). | |
| Ph, | Pharyngeal branch. | Coe.Pl, | Coeliac plexus. |
| Ph.Pl, | Pharyngeal plexus. | Hep.Pl, | Hepatic plexus. |
| S.L, | Superior laryngeal nerve. | Spl.Pl, | Splenic plexus. |
| I.L, | Internal laryngeal branch. | Ren.Pl, | Renal plexus. |
| E.L, | External laryngeal branch. | ||
The twelfth or hypoglossal nerve is motor, and rises from a nucleus in the floor of the fourth ventricle deep to the trigonum hypoglossi (see Brain, fig. 3). It emerges from the brain between the anterior pyramid and the olive (see fig. 1), and leaves the skull in two bundles through the anterior condylar foramen. Soon after this it is closely bound to the vagus, and, in front of the atlas, receives an important contribution from the loop between the first and second cervical nerves. The nerve then passes downward until it reaches the origin of the occipital artery, round which it loops, and then runs forward on the surface of the hyo-glossus to the muscles of the tongue. As it bends round the occipital artery it gives off its descendens hypoglossi branch, which derives its fibres from the communication with the first cervical already mentioned. This branch runs down and forms a loop with the communicans cervicis branch from the second and third cervical nerves, and from this loop (ansa hypoglossi) many of the depressor muscles of the hyoid bone and larynx are supplied. Farther forward special branches are given off to the thyro-hyoid and genio-hyoid muscles, and these, like the descendens hypoglossi, are derived from the first and second cervical loop, thus leaving all the true muscles of the tongue to be supplied by the medullary part of the nerve.
For the embryology and comparative anatomy of the cranial nerves, see Nervous System.
II. Spinal
The spinal nerves are those which arise from each side of the spinal cord and are distributed to the trunk and limbs, though some of the upper ones supply the lower parts of the head and face. As is shown in the article Nervous System, the division between cranial and spinal nerves is rather one of convenience than of any real scientific difference. There are generally thirty-one pairs of these nerves, which are subdivided according to the part of the vertebral column through which they pass out; thus there are eight cervical (abbreviated C.), twelve thoracic (Th.)—formerly called dorsal,—five lumbar (L.), five sacral (S.) and one coccygeal (Coc.). As the thoracic nerves are the simplest and most generalized in their arrangement, a typical one of these, say the fourth or fifth, will be first described.
| From A. M. Paterson, in Cunningham’s Text-Book of Anatomy |
| Fig. 5.—Scheme of the Distribution of a Typical Spinal Nerve. |
The nerve is attached to the spinal cord by two roots, of which the ventral is purely efferent or motor and the dorsal purely afferent or sensory. On the dorsal root is a fusiform ganglion which lies in the foramen between the vertebrae through which the nerve passes. The two roots then join together to form a mixed nerve (see fig. 5), but very soon divide once more into anterior (ventral) and posterior (dorsal) primary divisions. These, however, each contain sensory and motor fibres. Just before it divides in this way the mixed nerve gives and receives its rami communicantes with the sympathetic (see Nervous System).
The anterior primary division, runs round the trunk, between the ribs, forming an intercostal nerve and giving off a lateral cutaneous branch, when the side of the body is reached, which divides into anterior and posterior secondary branches. The rest of the division runs forward, supplying the intercostal muscles, as far as the edge of the sternum, when it ends in an anterior cutaneous branch to the front of the chest. The dorsal primary division divides into an external (lateral) and internal
