CRANIAL NERVES IN SPEECH

1. V (5) TRIGEMINAL
A. Maxillary Nerve (Sensory)
i. Side of nose; upper lip; upper teeth; roof of mouth.
B. Mandibular
i. Sensory: Chin; lower teeth; lower gums; lower lip; tongue; anterior 2/3 of
tongue (NO TASTE, JUST SENSORY). **Pain from the tip of your tongue is
mediated by the V Trigeminal Nerve.
ii. Motor: Muscles of mastication.
C. Lesions:
i. UMN: Face will be intact given UNILATERAL lesion due to bilateral innervation.
ii. LMN: Atrophy on affected side; when mouth is closed, jaw will deviate to side of
lesion if unilateral damage; jaw will hang open if bilateral damage.

2. VII (7) FACIAL NERVE

A. Motor:
i. Facial muscles of expression, e.g., smiling, squinting, frowning.
ii. Innervates salivary glands.
B. Lesion:
i. Weak Pucker=Lips deviated/weakness resides on side of deviation.

3. IX (9) GLOSSOPHARYNGEAL (RUNS WITH X VAGUS)

A. Motor:
i. Muscles of pharynx.
B. Sensory:
i. Pharynx—pharyngeal gag.
ii. Taste for posterior 1/3 of tongue.
C. Lesions:
i. Loss of sensation to back of tongue and pharynx.
4. X (10) VAGUS
A. Inferior Ganglion: The point at which the X Vagus Nerve branches out into sub
branches.
B. Pharyngeal Nerve:
i. Responsible for retraction of muscles; closing off the nose from the mouth
(raising of the velum/soft palate) towards the posterior pharyngeal wall.
ii. Mediates taste sense and sensation from the base of the tongue and upper
pharynx.
iii. Lesions: Unilateral: Failure to elevate soft palate on the INVOLVED SIDE,
producing hypernasality; Bilateral: Absent or reduced movement of the soft
palate, causing hypernasality, nasal regurgitation, paralysis of pharyngeal
musculature.
C. Superior Laryngeal Nerve:
i. External branch: (Pitch Elevation/Motor) Provides efferent information of
cricothyroid muscle.
ii. Internal branch: (Sensory) Regarding everything ABOVE the vocal folds, e.g., If
liquid enters the vocal folds, the detection comes from the Superior Laryngeal
Internal Branch.
iii. Lesions: Result in loss of sensation of upper larynx mucous membrane, stretch
receptors, and cricothyroid muscles.
D. Recurrent Laryngeal Nerve:
i. Innervates all muscles of larynx EXCEPT cricothyroid; Innervates vocal folds;
controls opening and closing of folds; sensation for everything BELOW vocal
folds.
ii. Lesions: Unilateral lesion typically results in a flaccid (loose-hanging) vocal fold,
accompanied by a hoarse voice.
E. Lesions to X Vagus:
i. Decreased Palatal Elevation.
ii. Laryngeal Paralysis.
iii. Loss of Pitch Range.
iv. Swallowing Difficulties.

5. XI (11) ACCESSORY
A. Runs with IX and X; innervates muscles in your neck.

6. XII (12) HYPOGLOSSAL

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A. Motor:
i. Innervates all muscles of the tongue responsible for all movements.
ii. Principal motor nerve; sensory is not Hypoglossal.
iii. Innervates one side of the tongue or the other.
B. Testing:
i. Unilateral weakness causes the tongue to deviate to the side of the lesion when
protruded.