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HNN > Autonomic Innervation Of Head And Neck > Flashcards

Autonomic Innervation Of Head And Neck Flashcards

1
Q

What is the sympathetic nerve outflow?

A

Thoracolumbar outflow

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2
Q

What is the parasympathetic outflow?

A

Craniosacral outflow
Brainstem via III, VII, IX + X
S2-S4 pelvic splanchnics

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3
Q

Outline the sympathetic innervation of the head and neck

A
  • pre ganglionic sympathetic nerves exit at T1/T2
  • enter sympathetic chain + ascends up
  • reach cervical ganglion + synapse to a post ganglionic sympathetic neurone
  • run on outside of CCA + then outside of ICA + ECA
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4
Q

What type of nervous system is the autonomic nervous system part of?

A

Peripheral nervous system

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5
Q

What do sympathetic nerves to the eye + orbit run with?

A

Internal carotid artery > ophthalmic artery
Distal branches of Va

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6
Q

Where do sympathetic nerves for the head and neck exit the spinal cord?

A

T1/T2

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7
Q

What do sympathetic nerves to sweat glands on face + neck run with?

A

Branches of external carotid artery

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8
Q

Where can sympathetic innervation to the head and neck be damaged?

A
  • 1st order neurone: within CNS e.g. spinal cord injury
  • 2nd order neurone: pre-ganglionic neurone - exiting CNS + within sympathetic chain
  • 3rd order neurone: post ganglionic neurone - running with blood vessels
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9
Q

Which cranial nerves carry parasympathetic fibres with them?

A

Oculomotor III
Facial VII
Glossopharyngeal IX
Vagus X

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10
Q

What muscles are innervated by the sympathic nervous system in the eye and orbit?

A

Dilator pupillae
Levator palpebrae superioris

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11
Q

Clinical manifestations of interruption of sympathetic innervation to face + eye

A

Horner’s syndrome
- partial ptosis
- miosis
- anhidrosis
- (enophthalamus)

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12
Q

What neurones connect the sympathetic nerves to the hypothalamus?

A

1st order neurone (within CNS)

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13
Q

What are 1st order neurones?

A

Within CNS

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14
Q

What are 2nd order neurones?

A

Pre ganglionic neurones
(Exiting CNS + within sympathetic chain)

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15
Q

What are 3rd order neurones?

A

Post ganglionic neurones
(Running with blood vessel)

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16
Q

What is the innervation of the smooth + skeletal muscle of levator palpebrae superioris?

A

Skeletal: Oculomotor III | majority
Smooth: sympathetics |minority

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17
Q

What is Horner’s syndrome?

A

Ptosis (partial)
Miosis - constricted pupil
Anhidrosis - lack of sweating
(Enophthalmos - apparent sinking of eye)

Doesn’t effect the muscles of the eye

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18
Q

What is miosis?

A

Constricted pupil

19
Q

What is anhidrosis?

A

Lack of sweating

20
Q

Outline the parasympathetic innervation to head and neck

A
  • parasympathetic nuclei in brainstem
  • pre ganglionic axon exit with CNs III, VII, IX or X
  • parasympathetic ganglia
  • post ganglionic exit ganglia + run with distal branches of CN Va,b,c (except vagus X)
21
Q

What do the parasympathetic post ganglionic neurones run with?

A

Distal branches of trigeminal nerve Va,b,c,

(Except vagus nerve X)

22
Q

Parasympathetic target tissue of Oculomotor nerve II

A
  • Sphincter pupillae: constricts pupil
  • Ciliary muscle: flattens lens
23
Q

Parasympathetic target tissue of facial nerve VII

A
  • lacrimal glands: tears
  • nasal + mucosal gland: mucus
  • salivary glands (not parotid): saliva
24
Q

Parasympathetic target tissue of glossopharngeal nerve IX

A

Parotid gland: saliva

25
Q

Parasympathetic target tissue of vagus nerve X

A
  • mucosal glands + smooth muscle in resp + GI tracts
  • cardiac muscle
26
Q

Name the parasympathetic nuclei (pre-ganglionic) of the Oculomotor nerve III

A

Edinger Westphal nucleus

27
Q

Name the parasympathetic nuclei (pre-ganglionic) of the facial nerve VII

A

Superior salivary nucleus

28
Q

Name the parasympathetic nuclei (pre-ganglionic) of the glossopharyngeal nerve IX

A

Inferior salivary nucleus

29
Q

Name the parasympathetic nuclei (pre-ganglionic) of the vagus nerve X

A

Dorsal motor nucleus

30
Q

Name the parasympathetic ganglion (post-ganglionic) of the Oculomotor nerve III

A

Ciliary ganglion

31
Q

Name the parasympathetic ganglion (post-ganglionic) of the facial nerve VII

A

Pterygopalatine ganglion
Submandibular ganglion

32
Q

Name the parasympathetic ganglion (post-ganglionic) of the glossopharyngeal nerve IX

A

Otic ganglion

33
Q

Name the parasympathetic ganglion (post-ganglionic) of the vagus nerve X

A

No named ganglia
Sit within target tissues

34
Q

What are the types of pupillary reflexes?

A

Direct: same pupil constricts
Consensual: opposite pupil constricts

35
Q

What are the sensory + motor innervation of the pupillary reflex?

A

Sensory: optic nerve II
Motor: Oculomotor nerve III PNS

36
Q

Outline the pupillary light reflex

A
  • light in left eye
  • sensory afferent from left retina from optic nerve II
  • some branches leave CN II + enter midbrain on left
  • synapse on pre-rectal nucleus
  • connection with edingar-westphal nuceli on left and right
  • pre-ganglionic parasympathetic fibres from EDW leaves brainstem as part of CN III on left and right
  • synapse in ciliary ganglion
  • post ganglionic axon reaches sphincter pupillae muscle + ciliary body **
37
Q

Parasympathetic of Oculomotor nerve
- parasympathetic nuclei/ pre ganglionic
- parasympathetic ganglion/ post ganglionic
- target tissues

A
  • Edinger Westphal nucleus
  • ciliary ganglion
  • sphinchter pupillae + ciliary muscle
38
Q

Parasympethic of facial nerve
- parasympathetic nuclei/ pre ganglionic
- parasympathetic ganglion/ post ganglionic
- target tissues

A
  • superior salivary nucleus
  • Pterygopalatine (greater petrosal) + submandibular (chordae tympani)
  • lacrimal (GP), nasal + mucosal glands + salivary glands (not parotid) (CT)
39
Q

Parasympathetic of glossopharyngeal nerve
- parasympathetic nuclei/ pre ganglionic
- parasympathetic ganglion/ post ganglionic
- target tissues

A
  • inferior salivary nucleus
  • Otic ganglion
  • parotid gland
40
Q

Parasympathetic of vagus nerve
- parasympathetic nuclei/ pre ganglionic
- parasympathetic ganglion/ post ganglionic
- target tissues

A
  • dorsal motor nucleus
  • no named ganglia | sit very close to target tissue
  • cardiac muscle + mucosal glands + smooth muscle in respiratory + GI tract
41
Q

What is the organisation of the autonomic nervous system?

A
  • craniosacral outflow for parasymathic fibres
  • thoracolumbar outflow for sympathetic fibres
42
Q

What is a Pancoast tumour?

A

Non small cell lung cancer located at apex of lung

43
Q

What could cause disruption to sympathetic nervous supply to head and neck?

A

Pancoast tumour
Carotid artery pathology

HNN (24 decks)

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