The nucleus ambiguus is a column of motor neurons deep in the lateral medulla, named because its boundaries are hard to see. It supplies the muscles of the throat and voice box through cranial nerves IX and X, and it also contains parasympathetic neurons that slow the heart.
| Location | Ventrolateral medulla, deep in the reticular formation, between the inferior olive and the spinal trigeminal nucleus |
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| Parts |
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| Connections |
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| Blood Supply | Posterior inferior cerebellar artery; Vertebral artery branches |
Controls swallowing, speech and voice, the gag and cough reflexes, and contributes to vagal slowing of the heart.
Damage to the nucleus ambiguus, classically in lateral medullary syndrome, causes difficulty swallowing, a hoarse voice and loss of the gag reflex, with the uvula pulled away from the weak side. Patients are at high risk of aspiration and need a swallow assessment before eating. Degeneration of the nucleus contributes to bulbar weakness in motor neuron disease.
Swallowing difficulty and aspiration risk from infarction of the nucleus ambiguus.
Progressive weakness of speech and swallowing from loss of lower brainstem motor neurons, including those of the nucleus ambiguus.
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