The nucleus ambiguus ("ambiguous nucleus" in English) is a group of large

motor neuron A motor neuron (or motoneuron or efferent neuron) is a neuron whose cell body is located in the motor cortex, brainstem or the spinal cord, and whose axon (fiber) projects to the spinal cord or outside of the spinal cord to directly or indirectl ...

s, situated deep in the medullary

reticular formation The reticular formation is a set of interconnected nuclei that are located throughout the brainstem. It is not anatomically well defined, because it includes neurons located in different parts of the brain. The neurons of the reticular formation ...

named by Jacob Clarke. The nucleus ambiguus contains the cell bodies of neurons that innervate the muscles of the

soft palate The soft palate (also known as the velum, palatal velum, or muscular palate) is, in mammals, the soft tissue constituting the back of the roof of the mouth. The soft palate is part of the palate of the mouth; the other part is the hard palate. ...

pharynx The pharynx (plural: pharynges) is the part of the throat behind the mouth and nasal cavity, and above the oesophagus and trachea (the tubes going down to the stomach and the lungs). It is found in vertebrates and invertebrates, though its struc ...

, and

larynx The larynx (), commonly called the voice box, is an organ in the top of the neck involved in breathing, producing sound and protecting the trachea against food aspiration. The opening of larynx into pharynx known as the laryngeal inlet is about ...

which are associated with

speech Speech is a human vocal communication using language. Each language uses Phonetics, phonetic combinations of vowel and consonant sounds that form the sound of its words (that is, all English words sound different from all French words, even if ...

and

swallowing Swallowing, sometimes called deglutition in scientific contexts, is the process in the human or animal body that allows for a substance to pass from the mouth, to the pharynx, and into the esophagus, while shutting the epiglottis. Swallowing i ...

. As well as motor neurons, the nucleus ambiguus contains preganglionic parasympathetic neurons which innervate postganglionic parasympathetic neurons in the

heart The heart is a muscular organ in most animals. This organ pumps blood through the blood vessels of the circulatory system. The pumped blood carries oxygen and nutrients to the body, while carrying metabolic waste such as carbon dioxide t ...

.Machado, BH and Brody, MJ
"Role MJ of the nucleus ambiguus in the regulation of heart rate and arterial pressure."
/ref> It is a region of

histologically Histology, also known as microscopic anatomy or microanatomy, is the branch of biology Biology is the scientific study of life. It is a natural science with a broad scope but has several unifying themes that tie it together as a single ...

disparate

cell Cell most often refers to: * Cell (biology), the functional basic unit of life Cell may also refer to: Locations * Monastic cell, a small room, hut, or cave in which a religious recluse lives, alternatively the small precursor of a monastery ...

s located just

dorsal Dorsal (from Latin ''dorsum'' ‘back’) may refer to: * Dorsal (anatomy), an anatomical term of location referring to the back or upper side of an organism or parts of an organism * Dorsal, positioned on top of an aircraft's fuselage * Dorsal c ...

( posterior) to the

inferior olivary nucleus The inferior olivary nucleus (ION), is a structure found in the medulla oblongata underneath the superior olivary nucleus.Gado, Thomas A. Woolsey; Joseph Hanaway; Mokhtar H. (2003). The brain atlas a visual guide to the human central nervous syste ...

in the

lateral Lateral is a geometric term of location which may refer to: Healthcare *Lateral (anatomy), an anatomical direction *Lateral cricoarytenoid muscle *Lateral release (surgery), a surgical procedure on the side of a kneecap Phonetics *Lateral cons ...

portion of the upper ( rostral)

medulla Medulla or Medullary may refer to: Science * Medulla oblongata, a part of the brain stem * Renal medulla, a part of the kidney * Adrenal medulla, a part of the adrenal gland * Medulla of ovary, a stroma in the center of the ovary * Medulla of t ...

. It receives

upper motor neuron Upper motor neurons (UMNs) is a term introduced by William Gowers in 1886. They are found in the cerebral cortex and brainstem and carry information down to activate interneurons and lower motor neurons, which in turn directly signal muscles t ...

innervation directly via the

corticobulbar tract In neuroanatomy, the corticobulbar (or corticonuclear) tract is a two-neuron white matter motor pathway connecting the motor cortex in the cerebral cortex to the medullary pyramids, which are part of the brainstem's medulla oblongata (also called ...

. This nucleus gives rise to the branchial efferent motor fibers of the

vagus nerve The vagus nerve, also known as the tenth cranial nerve, cranial nerve X, or simply CN X, is a cranial nerve that interfaces with the parasympathetic control of the heart, lungs, and digestive tract. It comprises two nerves—the left and right ...

( CN X) terminating in the laryngeal, pharyngeal muscles, and

musculus uvulae The palatine uvula, usually referred to as simply the uvula, is a conic projection from the back edge of the middle of the soft palate, composed of connective tissue containing a number of racemose glands, and some muscular fibers. It also conta ...

; as well as to the efferent motor fibers of the

glossopharyngeal nerve The glossopharyngeal nerve (), also known as the ninth cranial nerve, cranial nerve IX, or simply CN IX, is a cranial nerve that exits the brainstem from the sides of the upper Medulla oblongata, medulla, just anterior (closer to the nose) to t ...

(CN IX) terminating in the

stylopharyngeus muscle The stylopharyngeus is a muscle in the head that stretches between the temporal styloid process and the pharynx. Structure The stylopharyngeus is a long, slender muscle, cylindrical above, flattened below. It arises from the medial side of the ...

Function

The nucleus ambiguus controls the motor innervation of ipsilateral muscles of the soft palate, pharynx, larynx and upper esophagus. Lesions of nucleus ambiguus results in nasal speech,

dysphagia Dysphagia is difficulty in swallowing. Although classified under "symptoms and signs" in ICD-10, in some contexts it is classified as a disease#Terminology, condition in its own right. It may be a sensation that suggests difficulty in the passag ...

dysphonia A hoarse voice, also known as dysphonia or hoarseness, is when the voice involuntarily sounds breathy, raspy, or strained, or is softer in volume or lower in pitch. A hoarse voice, can be associated with a feeling of unease or scratchiness in the ...

, and deviation of the

uvula The palatine uvula, usually referred to as simply the uvula, is a conic projection from the back edge of the middle of the soft palate, composed of connective tissue containing a number of racemose glands, and some muscular fibers. It also conta ...

toward the contralateral side. Preganglionic parasympathetics to the heart also flow through the external formation of the nucleus.

Areas supplied

The muscles supplied by the

vagus The vagus nerve, also known as the tenth cranial nerve, cranial nerve X, or simply CN X, is a cranial nerve that interfaces with the parasympathetic control of the heart, lungs, and digestive tract. It comprises two nerves—the left and right v ...

(included with this is the cranial root of the accessory nerve), such as

levator veli palatini The levator veli palatini () is the elevator muscle of the soft palate in the human body. It is supplied via the pharyngeal plexus. During swallowing, it contracts, elevating the soft palate to help prevent food from entering the nasopharynx. ...

, are also necessary to swallow properly through integration by the nucleus of the

solitary tract The solitary tract (tractus solitarius, or fasciculus solitarius), is a compact fiber bundle that extends longitudinally through the posterolateral region of the medulla oblongata. The solitary tract is surrounded by the solitary nucleus, and des ...

. The vagus also supplies the upper part of the

esophagus The esophagus (American English) or oesophagus (British English; both ), non-technically known also as the food pipe or gullet, is an organ in vertebrates through which food passes, aided by peristaltic contractions, from the pharynx to the ...

, and other parts of the

and

. As well as motor neurons, the nucleus ambiguus in its "external formation" contains cholinergic preganglionic parasympathetic neurons for the

. These neurons are cardioinhibitory.Localization of vagal cardioinhibitory preganglionic neurons with rat brain stem. Nosaka S et al

/ref> This cardioinhibitory effect is one of the means by which quick changes in

blood pressure Blood pressure (BP) is the pressure of circulating blood against the walls of blood vessels. Most of this pressure results from the heart pumping blood through the circulatory system. When used without qualification, the term "blood pressure" r ...

are achieved by the central nervous system (the primary means being changes in sympathetic nervous system activity, which constricts arterioles and makes the heart pump faster and harder). That is, through integrated and antagonistic system with sympathetic outflow from the

vasomotor center The vasomotor center (VMC) is a portion of the medulla oblongata. Together with the cardiovascular center and respiratory center, it regulates blood pressure. It also has a more minor role in other homeostatic processes. Upon increase in carbon ...

of the brainstem, the parasympathetic outflow arising from the nucleus ambiguus and

dorsal motor nucleus of the vagus nerve The dorsal nucleus of vagus nerve (or posterior nucleus of vagus nerve or dorsal vagal nucleus or nucleus dorsalis nervi vagi or nucleus posterior nervi vagi) is a cranial nerve nucleus for the vagus nerve in the medulla that lies ventral to the f ...

acts to decrease cardiac activity in response to fast increases in blood pressure. The external formation of the nucleus ambiguus also sends bronchoconstrictor fibers to the bronchopulmonary system, which can produce reflexive decreases in pulmonary bronchial airflow. The pathophysiologic relevance of this system, which may act in concert with the cardioinhibitory system, is poorly understood, but likely plays a role in bronchospastic diseases like

COPD Chronic obstructive pulmonary disease (COPD) is a type of progressive lung disease characterized by long-term respiratory symptoms and airflow limitation. The main symptoms include shortness of breath and a cough, which may or may not produce mu ...

emphysema Emphysema, or pulmonary emphysema, is a lower respiratory tract disease, characterised by air-filled spaces ( pneumatoses) in the lungs, that can vary in size and may be very large. The spaces are caused by the breakdown of the walls of the alve ...

(in which inhaled anticholinergic medications such as Spiriva/

tiotropium Tiotropium bromide, sold under the brand name Spiriva among others, is a long-acting bronchodilator (LAMA: long acting muscarinic antagonist) used in the management of chronic obstructive pulmonary disease (COPD) and asthma. Specifically it is ...

ipratropium Ipratropium bromide, sold under the trade name Atrovent among others, is a type of anticholinergic (SAMA: short acting muscarinic antagonist) medication which opens up the medium and large airways in the lungs. It is used to treat the symptoms ...

are standard-of-care treatment) and asthma, particularly for exercise-related asthma exacerbations, which may have a component of autonomic dysregulation.

Additional images

File:Gray694.png, Section of the medulla oblongata at about the middle of the olive. File:Gray696.png, The cranial nerve nuclei schematically represented; dorsal view. Motor nuclei in red; sensory in blue. File:Gray697.png, Nuclei of origin of cranial motor nerves schematically represented; lateral view. File:Gray700.png, The formatio reticularis of the medulla oblongata, shown by a transverse section passing through the middle of the olive.

References

External links

Medical Neurosciences
discuss the nucleus ambiguus. {{DEFAULTSORT:Nucleus Ambiguus Ambiguus Medulla oblongata Vagus nerve