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Head and Neck > ANS of head and neck > Flashcards

ANS of head and neck Flashcards

1
Q

Where does the autonomic nervous system originate from?

A

the peripheral nervous system

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2
Q

Where is the central control of ANS?

A

the hypothalamus

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3
Q

What does the ANS affect?

A

internal organs and glands

  • body functions that are not under conscious control (smooth muscle in viscera)
  • eye, salivary and lacrimal glands
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4
Q

What is the main overall role of the ANS?

A

maintaining and regulating the body internal enviornment

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5
Q

What is the main functions of sypathetic nervous system?

A
  • pupillary dilation
  • assists eyelid retraction
  • vaso-constriction
  • sweating
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6
Q

What are the main functions of parasympathetic nervous system?

A
  • smooth muscle of iris (sphincter pupillae)
  • muscles in cilliary body (control thickness of lens)
  • lacrimal glands
  • salivary and mucosal glands
  • smooth muscles of resp and GI tract
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7
Q

Where does the sympathetic outflow to the whole body arise from?

A

the thoracolumbar portion (T1-L2)

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8
Q

Where are the cell bodies found?

A

in the lateral horn of the grey matter

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9
Q

Where does the parasympathetic outflow to the whole body arise from?

A

-craniosacral portion
cranial (4 cranial nerves)
sacral (s2,3,4) - pelvic splanchnics

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10
Q

At what spinal level do pre-ganglionic sympathetics destined for the head and neck arise from?

A

T1/2

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11
Q

What do the pre-ganglionic sympathetics have to do before they can synapse?

A

they must ascend the sympathetic chain to reach the neck before synapsing

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12
Q

Where do they synapse?

A

in the superior cervical ganglion

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13
Q

What is in the superior cervical ganglion?

A
  • located opposite the 2nd and 3rd cervical vertebrae

- cell bodies of the post-ganglionic sympathetic nerve

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14
Q

What happens after the sympathetics have synapsed?

A

They join to the common cartoid artery and follow its 2 branches

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15
Q

What follows the ECA?

A

the nerves that have branches to distribute across the face.g. sweat glands and hair follicles

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16
Q

What follows the ICA?

A

the nerves that need to supply the eye (into the orbit)

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17
Q

What branch of the ICA will the nerve follow to get to the orbit?

A

the opthalmic branch of the ICA - can then supply eye lid and pupil

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18
Q

What is myosis?

A

contraction of the pupil

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19
Q

What does “unopposed pasrasympathetics” mean?

A

normally have sympathetic and parasympathetic to balance out - if you lose sympathetic innervation, you get “unopposed parasympathetic” - causing it to constrict

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20
Q

What does pathology in the apex of the lung or the CCA cause?

A

autonomic dysfunction in the eye and face

21
Q

What would a person with a tumour in the apex of their lung present with and why?

A
  • compression of the CCA and therefore the cranial nerves
  • Partial ptosis and myosis and anhydrous (lack of sweating)
  • unapposed parasympathetics causing contraction of the eye
22
Q

Why only partial ptosis?

A

most of LPS works (as result of oculomotor nerve) but a part of it uses sympathetic innervation hence only partial

23
Q

What are the triad of symptoms caused by?

A

horners syndrome - think about neck and chest

24
Q

What cranial nerves carry parasympathetics out from the brain stem?

A

oculomotor
vagus
facial
glossopharyngeal

25
Q

Where do parasympathetics arise from?

A

2 regions of the spinal cord (cranial region and sacral region)

26
Q

Where does the parasympathetic innervation to the head and neck arise from?

A

parasympathetic nuclei

27
Q

What is parasympathetic nuclei?

A

collections of pre ganglionic parasympathetic nerve cell bodies

28
Q

What is different about the parasympathetic preganglionic nerves compared to sympathetic preganglionic?

A

they are longer and travel a longer distance before reaching their associated ganglia as the ganglia lie closer to their effector tissues - note that once they synapse within their ganglia, their post ganglionic neurone is comparatively shorter

29
Q

What are the parasympathetic ganglia?

A

4 discrete ganglia (unlike the chain of ganglia with the sympathetics)

  • ciliary
  • submandibular
  • pterygopalatine
  • otic
30
Q

How do the parasympathetics reach the ganglia?

A

they hitch hike on CN’s 3,7,9,10

31
Q

What happens once the parasympathetics reach the ganglia?

A

they ALL hitch hike onto the branches of the trigeminal nerve

32
Q

What are the 4 parasympathetic nuclei?

A
  • edinger westphal!!!!!!
  • superior salivary
  • inferior salivary
  • dorsal motor
33
Q

What are the target tissues of the parasympathetics?

A
  • sphincter pupillae (pupil constrictor)
  • cilliary muscle (controls lens)
  • lacrimal gland
  • mucosal glands (nasal, resp, oral mucosa)
  • salivary glands
34
Q

What is the rough of parasympathetics on CN III?

A
  • parasympathetic arise from EWN (nucleus)
  • parasympathetic fibres emerge with CN III fibres
  • synapses at the ciliary ganglion (at the back of the orbit) where the parasympathetics hitch hike onto CN Va
35
Q

What does the parasympathetics do to the eye?

A
  • acts on the ciliary muscle to alter the shape of the lens

- acts on sphincter pupillae muscle to constrict the pupil

36
Q

What nerve senses light?

A

the optic nerve - sends signals to the optic chiasm and the optic tract

37
Q

DRAW OUT THE PUPILLARY LIGHT REFLEX

A

-why do both of the eyes constrict when light is shone in 1 of the eyes

38
Q

What is anisocoria?

A

a condition characterised by an unequal size of the eyes pupils

39
Q

What branches of the facial nerve do the parasympathetics reach their targets via?

A

-chorda tympani and greater petrosal

40
Q

Where are the ganglia for the facial nerves parasympathetics?

A
  • pterygopalatine ganglia (pterygopalatine fossa)

- submandibular ganglia

41
Q

After synapsing, where do the post-ganglionic parasympathetics go?

A

-run with the distal branches of the trigeminal (lingual) nerve

42
Q

What else does the chord tympani supply?

A

-taste to the anterior 2/3 of the tongue

its ganglia is sensory so will be found in the geniculate ganglion

43
Q

Which of the branches of CN IX does the parasympathetic run along?

A

-tympanic nerve (which supplies the middle ear)

44
Q

Where does the parasympathetics go after running with the tympanic nerve?

A

the parasympathetics exit the middle ear as the lesser petrosal nerve

45
Q

Where does the lesser petrosal nerve synapse?

A

in the otic ganglion in the infra temporal fossa

46
Q

Where do the post-ganglionic parasympathetics go?

A

hitch hike on the CN Vc -auriculotemporal nerve to the parotid gland

47
Q

Where do CNX pre-ganglionic parasympathetics run?

A

within CNX and its branches

48
Q

Where are the ganglia?

A

at or in the target tissue

49
Q

What is the target tissue for parasympathetics on CNX?

A
  • mucosal glands in pharynx/larynx
  • smooth muscle of oesophagus and trachea
  • smooth muscle and mucosal glands within rest of respiratory and GI tract
  • Heart

Head and Neck (13 decks)

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