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Anatomy Unit II: Head and Neck > ANS of Head and Neck > Flashcards

ANS of Head and Neck Flashcards

1
Q

ANS Control of visceral structures. The visceral targets of the eye include:

A

Constrictor of smooth m. in iris - PS only –> decrease diameter of pupil
Dilator of smooth m. in iris - SS only –> increase diameter of pupil

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2
Q

ANS of Eye:

A

Ciliary body smooth m. - PS only –> serves to change the curvature of the lens during the ACCOMMODATION REFLEX

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3
Q

Accommodation Reflex:

A

Of PS in ciliary body smooth m –> m. contracts –> decreases tension –> lens more convex (fatter) –> accommodation

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4
Q

ANS of Glands - Lacrimal gland:

A

Secretion of tears to maintain corneal moisture

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5
Q

ANS of Nasal, palatine, submandibular, sublingual, and parotid glands:

A

Secrete mucus into nasal and oral cavities –> maintain the moisture in nasal and oral cavities

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6
Q

ANS of sweat glands:

A

Heat dissipation and maintain core temperature

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7
Q

ANS to blood vessels:

A

Cerebral blood vessels, except those in brain tissue (parenchyma) –> uniform blood flow and oxygenation to the brain; SS control (causes vasoconstriction to decrease blood flow)

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8
Q

ANS of larynx:

A

Mucus glands in the larynx –> maintain moisture in airways

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9
Q

PS Innervation of Iris (constrictor of pupil) and ciliary body - Preganglionic cell body is in:

A

Edinger-Westphal nucleus (in brainstem)

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10
Q

PS Innervation of Iris (constrictor of pupil) and ciliary body - Preganglionic fiber follows:

A

CN III

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11
Q

Preganglionic fiber follows III to:

A

Ciliary ganglion (behind eyeball) and terminates –> synapses with postgang neurons in ciliary ganglion

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12
Q

The ciliary ganglion is the PS analogue to the:

A

SS collateral ganglion

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13
Q

PS Innervation of Iris (constrictor of pupil) and ciliary body - POSTganglionic fibers pierce:

A

Sclera and run forward in the perichordial space –> innervate smooth m. of either constrictor pupil in iris or in ciliary body

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14
Q

Summary Pathway of PS innervation of iris/ciliary body:

A

Pregang CB in Edinger-Westphal nucleus (brainstem) –> pregang axons follow III to cilliary ganglion –> synapse here with postgang neurons –> postgang pierce sclera –> run forward in perichordial space –> innervate smooth m. of constrictor pupil or in ciliary body

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15
Q

Activation of PS in sphincter pupil causes:

A

Contraction of sphincter –> narrowing of pupil (MIOSIS). This action sharpens the visual image by allowing LESS light to come into the retina

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16
Q

Activation of PS in ciliary body causes:

A

Contraction of ciliary smooth m. –> LESSENS the tension in the suspensory ligament of the lens –> thickens the lens curvature (enhances its convexity) during accommodation - refocusing of the image on the retina

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17
Q

SS innervation of iris (dilator m): SS Preganglionic neuron:

A

In intermediolateral cell column at T1-T2 spinal cord levels

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18
Q

SS innervation of iris (dilator m): SS pregang. axons follows:

A

The white communicating rami (WCR) and enters the SS chain ganglia –> ascends in SS trunk to superior cervical ganglion (SCG) –> ends by synapsing w postgang neurons in SCG

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19
Q

SS innervation of iris (dilator m): SS postgang fibers follow:

A

Blood vessels (internal carotid a) –> then long ciliary n. to the eyeball –> pierces sclera –> runs forward (in perichordial space) to iris –> innervates pupillary dilator

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20
Q

Summary Pathway of SS innervation of iris:

A

SS pregang neurons in intermediolateral cell column at T1-T2 –> pregang axons follow WCR –> enter SS chain ganglia –> ascends in trunk until the superior cervical ganglion –> synapses here with postgang neurons –> postgang fibers follow internal carotid a –> then follow long ciliary n –> pierce sclera –> run forward thru perichordial space) –> innervates pupillary dilator

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21
Q

Activation of SS causes:

A

Contraction of radially disposed muscle fibers of dilator which increases the diameter of pupil (MYADRISIS) –> allows more light to fall onto retina. This action is seen during a stress reaction or during dark adaptation

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22
Q

SS fibers also innervate the ______. Lesioning of these SS fibers brings about _______.

A

Superior tarsal (smooth) muscle in the upper eyelid, partial ptosis

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23
Q

Location of the superior cervical ganglion:

A

Between vertebrae C1 and C2

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24
Q

Location of the middle cervical ganglion:

A

About the level of C6

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25
Q

Location of the inferior (stellate) cervical ganglion:

A

Anterior to neck of the 1st rib

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26
Q

Unilateral cranial nerve III (oculomotor) lesion:

A

This carries PS fibers to iris and ciliary body. Sxs:

  • ipsilateral (same side of lesion) MYADRISIS - since PS is damaged, SS takes over the the pupil is very large
  • loss of DIRECT light reflex (when the light is shone on lesion’s side) - ipsilateral pupil does not constrict
  • loss of ipsilateral accommodation reflex
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27
Q

Horner’s syndrome:

A

Condition resulting from destruction of central SS pathways or the superior cervical ganglion. Sxs (all ipsilateral to lesion) are:

  • MIOSIS - lack of SS control causes PS to take over, pupil is very small
  • Partial ptosis
  • Dry skin - lack of sweating
  • Flushed skin - due to vasodilation bc of lack of SS vasomotor control
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28
Q

Why not full ptosis with Horner’s syndrome?

A

Still have levator palpebrae superioris innervated by III to hold it up

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29
Q

ANS Innervation of lacrimal, nasal, oral, and salivary glands:

A

Volume secretion of tears and mucus is mainly controlled by PS

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30
Q

ANS Innervation of lacrimal, nasal, oral, and salivary glands: PS preganglionic CB in:

A

Superior salivatory nucleus (level of caudal pons)

31
Q

ANS Innervation of lacrimal, nasal, oral, and salivary glands: Pregang fibers leave CNS with:

A

CN VII and join –> greater petrosal n. and n. of pterygoid canal

32
Q

ANS Innervation of lacrimal, nasal, oral, and salivary glands: Pregang fibers synapse with postgang fibers in:

A

Pterygopalatine ganglion

33
Q

ANS Innervation of lacrimal, nasal, oral, and salivary glands: After PT ganglion, Postgang fibers follow:

A

Branches of maxillary n (V2), zygomatic, and lacrimal n. –> lacrimal gland. (Other branches go to mucus glands in nasal and oral cavities)

34
Q

Summary of ANS Innervation of lacrimal, nasal, oral, and salivary glands:

A

PS pregang CB in superior salivatory nucleus (level of caudal pons) –> PS pregang fibers leave CNS with VII –> join greater petrosal n. and n. to pterygoid canal –> synapse with postgang fibers in pterygopalatine ganglion –> postgang fibers follow branches of V2, zygomatic, and lacrimal nn. to lacrimal gland

35
Q

Activation of PS to lacrimal, nasal, oral and salivory glands causes:

A

Increased secretion of tears from lacrimal gland and mucus from nasal and oral glands. This can occur under conditions of distress and sadness

36
Q

PS Innervation of submandibular and sublingual glands: PS pregang CB in:

A

Superior salivatory nucleus (level of caudal pons)

37
Q

PS Innervation of submandibular and sublingual glands: Pregang fibers follow:

A

CN VII –> then follow chorda tympani (passes close to tympanic membrane in middle ear - hence, lingual branch of mandibular (V3) to submandibular ganglion

38
Q

PS Innervation of submandibular and sublingual glands: Pregang fibers synapse with postgang in:

A

Submandibular ganglion

39
Q

PS Innervation of submandibular and sublingual glands: Postgang fibers leave ganglion and innervate:

A

Submandibular or sublingual gland

40
Q

Summary of PS Innervation of submandibular and sublingual glands:

A

Pregang CB in superior salivatory ganglion –> follow VII –> then follow chorda tympani –> jump on lingual n. (V3) submandibular ganglion –> synapses here with postganglionic neurons –> postgang fibers leave ganglion –> innervate sublingual or submandibular glands

41
Q

PS Activation of submandibular and sublingual glands causes:

A

Increased saliva secretion from the salivary glands (includes from parotid) and increased blood flow within the glands –> increase in blood flow causes a greater metabolic demand in the gland due to its increased secretion. This occurs when food is put into the mouth –> starts the process of digestion, also occurs after olfactory stimuli

42
Q

PS innervation of parotid gland: PS pregang CB:

A

INFERIOR salivatory nucleus (at rostral medulla level)

43
Q

PS innervation of parotid gland: PS pregang axon leaves CNS with:

A

Tympanic branch of CN IX (glossopharyngeal) –> then passes thru tympanic plexus –> joins LESSOR petrosal n.

44
Q

PS innervation of parotid gland: Pregang then synapses with postgang neurons in:

A

Otic ganglion (in the IT fossa on the medial side of V3)

45
Q

PS innervation of parotid gland: Postgang leaves otic ganglion and joins:

A

Auriculotemporal branch of mandibular n (V3) –> innervates parotid gland

46
Q

Summary of PS innervation of parotid gland:

A

PS pregang CB are in the inferior salivatory nucleus (at rostral medulla level) –> leave CNS with tympanic branch of CN iX –> goes thru tympanic plexus –> joins the Lesser petrosal n. –> synapses with postgang neurons in otic ganglion –> leaves otic ganglion and joins the auriculotemporal n. (branch of V3) –> innervates the parotid gland

47
Q

PS activation to parotid gland causes:

A

Increased salivary secretion and blood floow to the gland –> start of digestion

48
Q

SS innervation of ALL head and neck salivary glands:

A

Whereas PS controls the glandular volume secretion, SS has the ability to inhibit such secretions for all glands in head and neck (Ex: during stress, one’s mouth gets dry and swallowing becomes harder

49
Q

SS innervation of ALL head and neck salivary glands: SS pregang CB located in:

A

Intermediolateral cell column at T1-T2 spinal levels

50
Q

SS innervation of ALL head and neck salivary glands: SS pregang fibers enter:

A

SS chain ganglia with WCR –> ascend (in SS trunk) up to superior cervical ganglion

51
Q

SS innervation of ALL head and neck salivary glands: SS pregang fibers synapse with postgang fibers in:

A

Superior cervical ganglion

52
Q

SS innervation of ALL head and neck salivary glands: SS postgang fibers follow:

A

The carotid plexuses (ANS fiber network around the common, external, and internal carotid arteries and their branches) –> target glands

53
Q

Summary of SS innervation of ALL head and neck salivary glands:

A

SS pregang CB in interomediolateral cell column of T1-T2 –> go into SS chain ganglia with WCR –> ascend in SS trunk –> superior cervical ganglion –> synapse with postgang fibers here –> follow the carotid plexus –> innervate target glands

54
Q

SS activation of salivary glands in head and neck causes:

A

Cessation of secretion and decreased blood flow to the glands

55
Q

Unilateral intracranial VII lesion (proximal to stylomastoid foramen):

A
  • Ispilateral dry eye - emergency, cornea is prone to ulcerations
  • Decreased salivary secretion (BUT salivary secretion is normal in ipsilateral parotid gland and all contralateral salivary glands)
  • Regenrating PS fibers may be diverted to LACRIMAL gland –> Crocodile tears (tearing while eating)
56
Q

Penetrating wound to parotid gland:

A
  • Regenerating PS fibers to parotid may be diverted instead to SWEAT glands in overlaying skin
  • Salivation stimulus may produce sweating from a patch of skin over the gland

FREY’s SYNDROME

57
Q

ANS innervation of the head and neck Blood Vessels:

A

Blood vessels of head and neck are innervated ONLY by SS fibers

58
Q

ANS innervation of the head and neck Blood Vessels: SS pregang cell bodies in:

A

Interomediolateral cell column at T1-T3 spinal cord levels

59
Q

ANS innervation of the head and neck Blood Vessels: SS pregang fibers enter:

A

SS chain ganglia and terminate on SS postgang in the superior cervical and inferior (stellate) ganglia

60
Q

ANS innervation of the head and neck Blood Vessels: SS postgang fibers follow:

A

The carotid plexus and innervate smooth muscle around major arterial branches

61
Q

SS postganglionic fibers innervate smooth muscle around major arterial branches including those on the brain surfaces (conducting vessels) but what loses ANS innervation?

A

Penetrating vessels (parenchymal) vessels. Parenchymal reacting arterioles are locally controlled

62
Q

SS activation for blood vessels causes:

A

Vasoconstriction and reduction in blood flow in the conduction branches

63
Q

The intracerebral (parenchymal) vessels are controlled by both:

A

Cerebral autoregulation and by a local control at the level of the blood vessel wall.

64
Q

Brain autoregulation is dependent on:

A

Blood borne concetration of CO2, which increased CO2 levels enhancing vasodilation and blood flow (HYPERCAPNIA - cerebral vessels dilate to ensure appropriate delivery of O2 to the brain)

65
Q

Locally, at the level of the endothelial wall:

A

NO (vasodilator) and endothelin (vasoconstrictor produced by endothelium) maintain appropriate local smooth m. tone in the reacting arteries to control blood flow through the capillary bed. This ensures a constant delivery of blood flow and metabolites to the brain. Also, angiotensin and purines (adenosine, ATP) play a role in regulating cerebral blood flow

66
Q

ANS Innervation of blood vessels and glands in Larynx: PS pregang CB in:

A

DORSAL MOTOR NUCLEUS of CN X (mid-medulla level)

67
Q

ANS Innervation of blood vessels and glands in Larynx: PS pregang fiber follows:

A

Laryngeal branch of X –> pierces wall of larynx –> synapses on PS postgang neurons

68
Q

ANS Innervation of blood vessels and glands in Larynx: PS postgang neurons in:

A

Terminal ganglia within the mucosa of larynx

69
Q

PS activation in blood vessels/glands in larynx causes:

A

Increased mucus secretion and gland vasodilator effects –> moistens and warms the airways

70
Q

ANS Innervation of blood vessels and glands in Larynx: SS pregang CB in:

A

Interomediolateral cell column at T1-T2

71
Q

ANS Innervation of blood vessels and glands in Larynx: SS pregang fibers then ascend:

A

In the SS trunk up the the MIDDLE cervical ganglion –> synapses on postgang neurons

72
Q

ANS Innervation of blood vessels and glands in Larynx: SS postgang fibers follow:

A

External carotid artery to larynx and –> innervates either mucus glands or blood vessels

73
Q

SS activation in blood vessels and glands of larynx causes:

A

Decreased mucus secretion and vasoconstrictor effects (just opposite to those of PS)

Anatomy Unit II: Head and Neck (15 decks)

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