8 - Head & Neck - Autonomic Innervation Flashcards

1
Q

Is the ANS part of the central or peripheral nervous system?

A

Peripheral nervous system

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2
Q

Name the 4 parasympathetic ganglia in the head and neck:

A

1) Ciliary
2) Pterygopalatine
3) Submandibular
4) Otic

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3
Q

Which cranial nerves do the parasympathetic fibres hitch-hike on, to reach their target organs?

A

Preganglionic: III, VII, IX, X
Postganglionic: V

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4
Q

Where do the parasympathetic nerves to the sphincter pupillae and the ciliary body originate from?

A

Edinger-Westphal nuclei

Brainstem

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5
Q

The parasympathetic nerves from the Edinger-Westphal nuclei hitch-hike on which cranial nerves? What are their target tissues?

A
Preganglionic = CN III
Postganglionic = CN V

Ciliary body
Sphincter pupillae

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6
Q

What effect do the parasympathetic nerves have on the eye?

A

1) Constrict pupil

2) Accomadation reflex = allows near vision

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7
Q

Where do the parasympathetic nerves to the lacrimal, nasal, submandibular and sublingual glands originate from?

A

Superior salivary nuclei

Brainstem

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8
Q

The parasympathetic nerves from the Superior salivary nuclei hitch-hike on which cranial nerves?

A
Preganglionic = CN VII
Postganglionic = CN V
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9
Q

Where is the parasympathetic ciliary ganglion located?

A

Bony orbit

- Between lateral rectus + optic nerve

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10
Q

Where is the parasympathetic pterygopalatine ganglion located?

A

Pterygopalatine fossa

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11
Q

Where is the parasympathetic submandibular ganglion located?

A

Inferior to Lingual nerve

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12
Q

Where is the parasympathetic otic ganglion located?

A

Inferior to foramen ovale

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13
Q

What effect do the parasympathetic nerves have on the salivary and lacrimal glands?

A

Increase secretion

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14
Q

Where do the parasympathetic nerves to the parotid gland originate from?

A

Inferior Salivary nuclei

Brainstem

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15
Q

The parasympathetic nerves from the inferior salivary nuclei hitch-hike on which cranial nerves?

A
Preganglionic = CN IX
Postganglionic = CN V
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16
Q

Where do the parasympathetic nerves to the smooth muscle and glands of the trachea, bronchi and GI tract originate from?

A

Dorsal motor nuclei

Brainstem

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17
Q

The parasympathetic nerves from the dorsal motor nuclei hitch-hike on which cranial nerve?

A

CN X

18
Q

The parasympathetic nerves to the head and neck originate from which nuclei in the brainstem?

A

1) Edinger-Westphal nuclei
2) Superior salivary nuclei
3) Inferior salivary nuclei
4) Dorsal motor nuclei

19
Q

The sympathetic fibres to the head and neck originate from which vertebral level? At which ganglion of the sympathetic chain do they synapse?

A

T1
T2

Superior cervical ganglion (C1/2 level)

20
Q

What are the target tissues of the sympathetic nerves to the head and neck?

A
  • Superior tarsal muscle
  • Dilator pupillae
  • Sweat glands
  • Blood vessels
  • Nasal glands
  • Salivary glands
21
Q

Describe the route of the sympathetic nerves from the superficial cervical ganglion to the superior tarsal muscle:

A
  • Wind around internal carotid artery into the skull (to cavernous sinus)
  • Joins CN III to superior tarsal muscle
22
Q

What is the function of the sympathetic nerve which hitch-hikes on CN III?

A

Helps elevate eyelid

- Superior tarsal muscle

23
Q

Describe the route of the sympathetic nerves from the superficial cervical ganglion to the dilator pupillae muscle:

A
  • Wind around internal carotids artery into the skull (to cavernous sinus)
  • Joins on CN V to dilator pupillae muscle
24
Q

What is the function of the sympathetic nerve which hitch-hikes on CN V?

A

Pupillary dilation

- Dilator pupillae muscle

25
Q

Which artery do the sympathetic nerves which innervate structures in/around the eye hitch-hike on?

A

Internal carotid artery

26
Q

Which artery do the sympathetic nerves which innervate blood vessels and sweat glands in the face hitch-hike on?

A

External carotid artery

27
Q

What is the function of the sympathetic nerves which wind around the external carotid artery?

A
  • Vasoconstriction
  • Sweating
  • Decreased secretion of nasal and salivary glands
28
Q

Why may someone with a lung tumour have miosis, partial ptosis and anhydrosis?

A

Due to damaged or stretched sympathetic nerves, which arise in the chest (therefore can be damaged by a growth in the chest)

29
Q

What is the classic presentation of Horner’s syndrome?

A
  • Miosis
  • Partial ptosis
  • Anhydrosis
30
Q

What is miosis?

A

Loss of pupillary dilation = constricted pupil

31
Q

Why is ptosis due to Horner’s syndrome only partial?

A
  • Paralysis of superior tarsal muscle due to loss of sympathetic innervation
  • Levator palpebrae superioris is still functioning, and is able to elevate eyelid partially
32
Q

List some causes of Horner’s syndrome:

A
  • Pancoast (apex) lung tumour
  • Trauma
  • Carotid artery dissection
  • Spinal cord lesion
33
Q

What is Horner’s syndrome?

A

Triad of: Partial ptosis, miosis and anhydrosis affecting 1 side of the face
Due to damaged sympathetic fibres to the head and neck

34
Q

Which cranial nerves ‘carry’ pre-ganglionic parasympathetic fibres, and what are the ganglia associated with each nerve?

A

III - Ciliary ganglion
VII - Pterygopalatine + Submandibular ganglia
IX - Otic ganglion
X - Many small ganglia located in target organs (not in head/neck)

35
Q

Name the nerves which branch off CN VII before it enters the parotid gland:

A
  • Greater petrosal nerve
  • Nerve to stapedius
  • Posterior auricular nerve
  • Chorda tympani
  • Nerve to digastric
  • Nerve to stylohyoid
36
Q

Which 2 canals does the facial nerve pass through, and remain intracranial?

A

1) Internal acoustic meatus

2) Facial canal

37
Q

Via which foramen does the Facial nerve pass through to become extracranial?`

A

Stylomastoid foramen

38
Q

Why does an extradural haemorrhage form a lens shape?

A

The dura mater is tightly adhered to the periosteum

39
Q

In which layer of the scalp do blood vessels (supplying the scalp) run in?

A

Dense connective tissue layer

40
Q

Name the ganglion which is formed by the facial nerve after the greater petrosal nerve has branched off:

A

Geniculate ganglion

41
Q

If a lesion of the facial nerve occurred at the geniculate ganglia, how would the patient present?

A
  • Hyperacusis
  • Dry mouth
  • Loss of taste
  • Paralysed facial muscles

(Greater petrosal nerve has already branched off the facial nerve before the geniculate ganglion)

42
Q

Name the arteries supplying the side of the scalp and forehead:

A
  • Superficial temporal artery
  • Supratrochlear artery
  • Supraorbital artery