ANS Head & Neck Flashcards
preganglionic parasympathetic fibers exit the brain (originate) within which cranial nerves?
CN III, VII, IX, X
cranio-sacral ANS
parasympathetic
brainstem nuclei + S2-S4
thoraco-lumbar ANS
sympathetic
T1-L2
preganglionic sympathetic cell bodies are located within
IML cell column of T1-L2
specifically HEAD AND NECK preganglionic sympathetic cell bodies lie within
IML cell columns of T1-T3
HEAD AND NECK preganglionic sympathetic axons enter sympathetic chain/trunk and ascend to the ___________ ganglion
HEAD AND NECK preganglionic sympathetic axons enter sympathetic chain/trunk and ascend to the SUPERIOR CERVICAL ganglion
HEAD AND NECK sympathetic path
preganglionic cell bodies in IML T1-T3
preganglionic axons enter sympathetic chain and
ascend to SUPERIOR CERVICAL GANGLION
preganglionic axons synapse on postganglionic cell bodies w/i superior cervical ganglion
postganglionic axons follow ARTERIES and CRANIAL NERVES to targets
sympathetic chain is deep to which vessel?
common carotid a.
3 named ganglion of the neck (and levels?)
superior cervical ganglion (base of skull, ~C1-C3)
middle cervical ganglion (C6)
inferior cervical ganglion (can fuse w/ T1 ganglion –> “stellate ganglion”)
different routes traveled by postganglionic sympathetic fibers of the head/neck
cardiac/cardiopulmonary splanchnic nerves
gray rami –> cervical spinal nerves
peri-arterial plexuses
post ganglionic fibers traveling from superior cervical ganglion will then form periarterial plexuses on which 2 vessels
CCA or ICA
generalized effects of sympathetics throughout head/neck
arrestor pili m. (goosebumps)
peripheral blood vessels (vasoconstriction)
sweat glands (activation)
Edinger-Westphal nucleus
holds preganglionic parasympathetic cell bodies whose axons will exit brain stem w/ CN III (OCCULOMOTOR)
super salivatory nucleus
holds preganglionic parasympathetic cell bodies whose axons will exit brain with CN VII (FACIAL)
(intermediate n.)
dosal vagal nucleus
holds preganglionic parasympathetic cell bodies whose axons will exit brain with CN X (VAGUS)
inferior salivatory nucleus
holds preganglionic parasympathetic cell bodies whose axons will exit brain with CN IX (GLOSSOPHARYNGEAL)
CN III exits brain stem at
pontomedullary junction
ventral side of brainstem
superior orbital fissure is just lateral to the _________
superior orbital fissure is just lateral to the optic canal
After passing thru the superior orbital fissure, CN III splits into _____ and _____
Parasympathetics follow the _____
After passing thru the superior orbital fissure, CN III splits into SUPERIOR DIVISION and INFERIOR DIVISION
Parasympathetics follow the INFERIOR DIVISION
parasympathetics traveling w/ CN III synapse on the ______ ganglion (held in place by _________ nerves)
postganglionics then innervate which m.?
parasympathetics traveling w/ CN III synapse on the CILIARY ganglion (held in place by SHORT CILIARY N.)
postganglionics then innervate SPHINCTER PUPILLAE M. AND CILIARY M.
See periarterial plexus around ICA in skull, know you’ve passed the ___________ ganglion
See periarterial plexus around ICA in skull, know you’ve passed the SUPERIOR CERVICAL ganglion and so they are POSTGANGLIONIC sympathetic fibers
orbit sympathetic path I
postganglionic sympathetic fibers jump off ICA
go thru superior orbital fissure
pass thru SYMPATHETIC ROOT OF CILIARY GANGLION (do NOT synapse)
travel with SHORT CILIARY N. to targets
(DILATOR PUPILLAE m. and SUPERIOR TARSAL m.)
orbit sympathetic path II
postganglionic sympathetic fibers jump off ICA
go thru superior orbital fissure
travel with nasociliary n. (CN V1)
BYASS ciliary ganglion, travel w/ LONG CILIARY N.
travel to targets (DILATOR PUPILLAE m. and SUPERIOR TARSAL m.)
ciliary m. (relaxed vs. contracted)
relaxed –> zonular fibers are tense and hold the lens flat (for distant vision)
contracted –> zolular fibers relax, lens becomes spherical (for near vision)
PARASYMPATHETIC control
superior tarsal m.
aka Muller’s m.
located in upper eyelid, widens eye
SYMPATHETIC control
levator palpebrae superioris m.
elevates upper eyelid
(defect –> drooping, ptosis)
SOMATIC control (via CN III)
eye smooth muscle parasympathetic response
constriction of pupil –> sphincter pupillae
rounding/thickening of lens for near vision (accommodation) –> ciliary m.
eye smooth muscle sympathetic response
dilation of pupil –> dilator pupillae
widening of eye –> superior tarsal m. AKA Muller’s m.
edinger-westphal nucleus –> ? –> sphincter pupillae/ciliary m
edinger-westphal nucleus –> superior orbital fissure –> inferior div CNIII –> ciliary ganglion –> short ciliary n. –> sphincter pupillae/ciliary m
IML T1-T3 –> ? –> dilator pupillary/Muller’s m.
IML T1-T3 –> superior cervical ganglion –> caroti canal –> superior orbital fissure –>
then either
1. sympathetic root of ciliary ganglion –> short ciliary n. –> dilator pupillary/Muller’s m.
- nasociliary n. –> long ciliary n. –> dilator pupillary/Muller’s m.
just before greater petrosal n. enters the Vidian canal, which n. fibers join it?
Where are they traveling?
postganglionic sympathetic fibers of DEEP PETROSAL N. –> pass thru PTERYGOPALATINE GANGLION –> nasal/nasopharynx/hard,soft palate mucosa glands AND lacrimal gland
(DEEP petrosal is sympathetic, GREATER is parasympathetic)
CN V2 runs through _____ fossa and suspends the _____ ganglion
CN V2 runs through PTERYGOPALATINE fossa and suspends the PTERYGOPALATINE ganglion
Vidian n. carries
preganglionic parasympathetics to synapse in pterygopalatine ganglion
postganglionic sympathetics to pass thru pterygopalatine ganglion
preganglionic parasympathetics synapsing in pterygopalatine ganglion ultimately act to
activate glands of lacrimal/nasal/nasopharynx/hard and soft palate mucosa
postganglionic sympathetics passing thru pterygopalatine ganglion ultimately act to
constrict blood vessels, cause nasal/nasopharynx/hard and soft palate mucosa gland secretions to SLOW/THICKEN
(fibers of the deep petrosal n.)
at pterygopalatine ganglion, postganglionic parasympathetics and sympathetics also ascend up ___ and travel along which branches?
ultimate action?
postganglionic parasympathetics and sympathetics ascend up V2 and travel along branches…
zygomatic n.
br. of zygomatic n.
lacrimal n.
parasympathetics –> lacrimation
sympathetics –> slow tearing (vasoconstriction blood vessels)
petrotympanic fissure is just posterior to which fossa?
MANDIBULAR FOSSA
submandibular ganglion holds which cell bodies?
postganglionic parasympathetic cell bodies
How do sympathetic fibers get to oral cavity?
T1-T3 –> superior cervical ganglion –> jump on external carotid artery to reach target structures, follow facial a./lingual a.
(postganglionic cell bodies are in SUPERIOR CERVICAL GANGLION)
Tongue innervation
general sensory anterior 2/3 tongue
lesion of chorda tympani BEFORE reaching lingual n.
affects. ..
- preganglionic parasympathetic fibers (submandibular secretion)
- taste fibers (ant 2/3 tongue)
can still feel food
lesion of lingual n. AFTER joined by chorda tympani
affects. ..
- preganglionic parasympathetic fibers (submandibular secretion)
- taste fibers (ant 2/3 tongue)
- general sensory (ant 2/3 tongue) by lingual n (br. V3)
which is lateral, groove for greater petrosal n. or groove for lesser petrosal n.?
groove for lesser petrosal n.
where is otic ganglion located?
medial side of CN V3
where is parotid gland located
external side of ramus of mandible
sympathetic stimulation of parotid gland (path)
superior cervical ganglion –> postganglionic fibers –> periarterial plexus –> ECA –> parotid gland –> slow/thicken secretions of parotid gland
where are POSTganglionic parasympathetic cell bodies of CN X located?
adjacent or within effector organ wall
Horner Syndrome
interruption of sympathetic pathway to head, resulting in ipsilateral…
- constriction of pupil (miosis)
- drooping of superior eyelid (ptosis)
- absence of sweating (anhydrosis)
- redness/increased temp of skin (vasodilation)
Pancoast tumor
in apex of lung
can compress sympathetic chain and cause ptosis/constriction of pupil
drooping of superior eyelid (AKA _______) can be seen if innervation to _______ is disrupted
drooping of superior eyelid (AKA ptosis) can be seen if innervation to SUPERIOR TARSAL N. is disrupted
where are POSTganglionic parasympathetic cell bodies of CN III located?
ciliary ganglion
where are POSTganglionic parasympathetic cell bodies of CN IX located?
otic ganglion
