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# Glossopharyngeal nerve (IX)

The glossopharyngeal nerve (cranial nerve IX) gives taste and feeling to the back of the tongue and throat, and senses blood pressure in the carotid.

Official name: Glossopharyngeal nerve

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## What it is

A nerve from the medulla through the jugular foramen to the throat and back of the tongue.

## What it does

Taste and feeling of the back of the tongue and throat (gag reflex); senses carotid pressure.

## Key points

- Afferent limb of the gag reflex (the vagus nerve is the efferent); taste and general sensation of the posterior third of the tongue
- Its carotid sinus branch carries signals from the carotid sinus (blood pressure) and carotid body (blood oxygen): the afferent limb of the baroreceptor reflex
- Glossopharyngeal neuralgia: brief stabbing pain in the throat, tonsil area, back of the tongue or ear, triggered by swallowing, talking or yawning; rarely with slow heart rate or fainting
- Leaves the skull through the jugular foramen with the vagus and accessory nerves, so jugular foramen lesions affect IX, X and XI together (Vernet syndrome)

## Key facts

**Roots**
Nucleus ambiguus, inferior salivatory, solitary nucleus (medulla); jugular foramen

**Moves**
Stylopharyngeus (some texts: also the superior constrictor via the pharyngeal plexus); [parotid gland](https://durgical.com/en/anatomy/parotid-gland/) (parasympathetic: tympanic nerve -> lesser petrosal nerve -> otic ganglion -> auriculotemporal nerve)

**Feeling from**
Posterior third of the tongue (taste and touch), [pharynx](https://durgical.com/en/anatomy/pharynx/) (gag reflex afferent), middle ear, carotid sinus and body; branches: tympanic, carotid sinus, pharyngeal (pharyngeal plexus), tonsillar, lingual

## Relations

**Course**
Leaves the [medulla oblongata](https://durgical.com/en/anatomy/medulla-oblongata/) in the groove behind the olive, above the [vagus nerve](https://durgical.com/en/anatomy/vagus-nerve/) rootlets, exits the [jugular foramen](https://durgical.com/en/anatomy/jugular-foramen/) in front of X and XI, descends between the [internal carotid artery](https://durgical.com/en/anatomy/internal-carotid-artery/) and the [internal jugular vein](https://durgical.com/en/anatomy/internal-jugular-vein/), curves forward around the stylopharyngeus and passes between the superior and middle constrictors to the tonsil bed and the back of the [tongue](https://durgical.com/en/anatomy/tongue/)

**Behind**
In the jugular foramen, the vagus nerve (X) and the [accessory nerve (XI)](https://durgical.com/en/anatomy/accessory-nerve/)

**Deep**
In the tonsil bed it lies deep to the [palatine tonsils](https://durgical.com/en/anatomy/palatine-tonsil/), separated by the superior constrictor; tonsillectomy can stretch it, with taste loss or pain at the back of the tongue

## How to find it

It cannot be felt. In neck surgery it is found passing forward between the internal and external [carotid arteries](https://durgical.com/en/anatomy/common-carotid-artery/) above the [carotid bifurcation](https://durgical.com/en/anatomy/carotid-bifurcation/), winding around the stylopharyngeus.

## Examination

- Gag reflex: each side of the back of the throat is touched in turn; a weaker response when one side is touched suggests a IX lesion on that side, while a palate that does not lift from either side suggests X
- Sensation of the back wall of the pharynx and the tonsil area, compared side to side

## On imaging

High-resolution heavily T2-weighted MRI shows it leaving the medulla behind the olive, above the vagus, toward the front of the jugular foramen. In glossopharyngeal neuralgia, MRI looks for a vessel pressing on its root entry zone, or a tumour. CT with bone windows shows the jugular foramen; a long calcified styloid process (Eagle syndrome) shows on CT or a panoramic radiograph.

## Clinical notes

- Carotid sinus hypersensitivity: pressure over the carotid bifurcation triggers an exaggerated reflex (IX in, X out) with a slow heart rate and fainting
- Jugular foramen tumours (paraganglioma, schwannoma) affect IX, X and XI together: hoarseness, swallowing difficulty, a lost gag on that side and shoulder weakness
- Its tympanic branch supplies the middle ear, so pain from the throat or tonsils, for example after tonsillectomy, can be felt in the ear
- Eagle syndrome: a long styloid process or a calcified [stylohyoid](https://durgical.com/en/anatomy/stylohyoid-muscle/) ligament can irritate the nerve, with throat pain or a feeling of something stuck on swallowing; the tip may be felt in the tonsil bed

## Development

Nerve of the third pharyngeal arch; its only muscle, the stylopharyngeus, comes from that arch.

## Test yourself

Think of the answer, then tap the question to see it.

## What role does the glossopharyngeal nerve (IX) play in the gag reflex?

It is the afferent limb (sensation of the pharynx); the vagus nerve (X) is the efferent limb.

## Which branch of the glossopharyngeal nerve carries the afferent limb of the baroreceptor reflex?

The carotid sinus branch, from the carotid sinus (blood pressure) and carotid body (blood oxygen).

## Through which foramen does the glossopharyngeal nerve leave the skull, and what syndrome follows a lesion there?

The jugular foramen, with X and XI; a lesion there affects IX, X and XI together (Vernet syndrome).

## What is glossopharyngeal neuralgia?

Brief stabbing pain in the throat, tonsil area, back of the tongue or ear, triggered by swallowing, talking or yawning.

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Educational information, not medical advice. For any symptom, see a health professional.

## Its names

**Official Latin (TA2)**
nervus glossopharyngeus TA2 6320

**Official Spanish (DeCS)**
Nervio Glosofaríngeo DeCS D005930

**English (TA2)**
Glossopharyngeal nerve

**Also called**
cranial nerve IX

## Related

- [Jugular foramen](https://durgical.com/en/anatomy/jugular-foramen/)
- [Longitudinal pharynx muscles](https://durgical.com/en/anatomy/stylopharyngeus-muscle/)

Sources: Terminologia Anatomica (TA2); [DeCS](https://decs.bvsalud.org/es/ths/resource/?id=6074); [Neuroanatomy, Cranial Nerve 9 (Glossopharyngeal)](https://www.ncbi.nlm.nih.gov/books/NBK539877/).

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Representative model, for educational purposes only.

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Source: https://durgical.com/en/anatomy/glossopharyngeal-nerve/
License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/anatomy/glossopharyngeal-nerve/