Autonomic Innervation Flashcards
what are the three roots of the ciliary ganglion
parasympathetic, sympathetic, sensory
post- ganglion lacrimal gland pathway sympathetic
internal carotid artery plexus –> deep petrosal nerve –> vidian nerve –> pterygiodpalatine ganglion (symp passes through) –> maxillary nerve –> follows zygomatic branch –> communicating branch –> lacrimal nerve
parasympathetic innervation iris sphincter
pupil constriction- 3%
direct acting agonist
cholinergic agonist aka parasympathomimetics
pilocarpine
pupil constriction + acc
ciliary ganglion sympathetic pathway
passes through –> BV of conj + choroid
cav sin –> nasociliary nerve –> ciliary ganglion
short ciliary nerves, choroidal (vasoconstriction) + conj bv
damage to cilairy ganglion causes
- numbness
- horner’s syndrome
- blown pupil
- lack of acc
- damage NT in ganglia (only parasympathetic involved –> dilated pupil)
sympathetic innervation
ciliary muscle
inhibition of acc
-no clinical significance
agonist
replicates the action of the neurotransmitter
lacrimal gland (preganglion) parasympathetic
CN& nucleus (pons) –> travel w/ facial nerve –> geniculate ganglion (sensory) –> greater petrosal nerve –> vidian nerve –> pterygopalatine ganglion –> synaose
lacrimal gland (preganglion) sympathetic
T1-T3 spinal –> superior cervical ganglia –>
what is the preganglionic pathway in the parasympathetic pathway
cn3 –SOF–> inferior division –> ciliary ganglion–> synapse –>
cav sin –> oculomotor cn3 –>
superior branch cn3 –> muller muscle –> widening of palpebral fissure
clinical correlate: hippus (pupillary unrest)
sympathetic + parasympathetic balancing out
-causes pupil to continuously move slightly
abberent regeneration tonic pupil
accommodative fibers can grow to the sphincter
indirect acting agonist
adrenergic agonist
aka sympathomimetics
- hydroxyamphetamine
- cocaine
- pupil dilation
what is the central pathway in the parasympathetic pathway
hypothalamus –> midbrain (ew-nucleus- cn 3)
autonomic lacrimal innervation parasympathetic
increase lacrimal secretion
pupil dilation
phenylephrine: direct acting on dilator muscle
tropicamide: dilation, pupil not to constrict
adrenergic antagonist
aka sympatholytic
dapiprazole
reversal of mydriasis from phenylephrine
where do the sympathetic and parasympathetic join in autonomic pathway to the lacrimal gland
vidian nerve
what two sections does the cav sin break into
ophthalmic nerve + oculomotor cn 3
what is the post- ganglion pathway in the sympathetic pathway
-internal carotid artery plexus –> carotid canal –> cav sin
autonomic lacrimal innervation sympathetic
constricting blood vessels –> decrease gland secretion
cholinergic –>
acetylcholine
parasympathetic innervation ciliary muscle
accommodation - 97%
clinical correlate: corneal reflex - afferent
cn5 –> afferent
-senses something on cornea via nasociliary branch
what is a tonic pupil
pupil doesn’t constrict well, inability to acc (same fibers)
direct acting agonist
acts directly at the receptor site
what does the sympathetic pathway supply
- iris (dilator + sphincter)
- cb
- muller muscle
- lacrimal gland
- blood vessels (choroid, conj)
what is the pre-ganglion pathway in the sympathetic pathway
- sympathetic chain ganglion (on either side)
- superior cervical ganglion –> synpase
sympathetic innervation muler muscle
raising of eyelid, widening of palpebral fissure
ciliary ganglion sensory pathway
–> passes through (opp direction) –> nasociliary nerve –> v1 –> trigeminal
indirect acting agonist
cholinergic agonist
aka parasympathomimetics
physostigmine
-pupil constriction + acc
cav sin –> nasociliary nerve –>
long ciliary nerve + ciliary ganglion
what is the postganglionic pathway in the parasympathetic pathway
short ciliary nerves –> iris sphincter, cb
cav sin –> nasociliary nerve –> long ciliary nerve
iris (dilation) , ciliary body (non- inhibitory non-clinical)
adrenergic –>
norepinephrine
where is the ciliary ganglion located
within the muscle cone between optic nerve and LR muscle
- 1 cm anterior to the optic canal
sympathetic post-ganglionic fibers release
norepinephrine (adrenergic)
sympathetic innervation choroidal vasculature
vasoconstriction
cholinergic antagonist
aka parasympatholytic
atropine, tropicamide, cyclopentolate
-pupil dilation + inhibition of acc
cav sin –> ophthalmic nerve –>
long ciliary + ciliary ganglion
indirect acting agonist
causes release of NT or prevents removal of NT from synapse
post- ganglion lacrimal gland pathway parasympathetic
travels w/ maxillary nerve –> follows zygomatic branch –> communicating branch –> lacrimal nerve
antagonist
block the receptor sites or the release of the neurotransmitter
ciliary ganglion parasympathetic pathway
–> synapse –> sphincter –> CB
sympathetic innervation
iris dilator
dilation
what is the central pathway in the sympathetic pathway
hypothalamus –> brainstem –> spinal cord (T1-T3) –>synapse
direct acting agonist
adrenergic agonist aka sympathomimetics
phenylephrine, epinephrine,
pupil dilation
what does abberent regeneration in tonic pupil cause
constriction w/ near target (+acc)
- no response to light
clinical correlate: corneal reflex - efferent
cn7–> efferent
- closes the eye, blink
- increases lacrimation
- miosis
parasympathetic pre-ganglionic fibers release
acetylcholine (cholinergic)
parasympathetic post-ganglionic fibers release
acetylcholine (cholinergic)
tonic pupil happens bc
issue w/ postganglionic system (suprachoroidal space, rd surgery, idiopathic)
sympathetic preganglionic gibers release
acetylcholine (cholinergic)
