The nucleus ambiguus is a column of large motoneurons situated dorsal to the inferior olive. Axons arising from cells in this nucleus course in the ninth and tenth cranial nerves. The component to the ninth nerve is insignificant. In the tenth nerve, these fibers supply muscles of the soft palate, larynx, pharynx, and upper esophagus. A unilateral lesion will produce ipsilateral paralysis of the soft palate causing the uvula to deviate away from the lesioned nerve and nasal regurgitation of liquids, weakness of laryngeal muscles causing hoarseness, and pharyngeal weakness resulting in difficulty in swallowing.
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