Autonomic Innervation Of The HaN Flashcards
Where do most of the sympathetic pre-ganglionic fibres arise from?
First thoracic neural segment
Where do the pre-ganglionic sympathetic fibres synapse?
One of the three cervical sympathetic ganglia
-superior, middle or inferior cervical ganglion
After synapsing with the pre-ganglionic fibres, where do the post-ganglionic fibres go?
Travel as the internal and external carotid nerves along blood vessels to their target tissues
Where do the postganglionic fibres from the superior cervical ganglion travel?
With the internal and external carotid arteries to:
- the pharyngeal plexus
- the upper 4 cervical nerves
- cardiac branch to the cardiac plexus
Where do the post-ganglionic fibres of the middle cervical plexus travel to?
With the inferior thyroid artery
- 5th and 6th cervical nerves
- cardiac branch to the cardiac plexus
Where do the postganglionic fibres from the inferior cervical ganglia travel to?
With the vertebral artery to
- the 7th and 8th cervical nerves
- cardiac branch to the cardiac plexus
What does the small inferior cervical ganglion combine with in 80% of people?
First thoracic ganglion to form the stellate ganglion
What are the four pairs of parasympathetic ganglia in the head?
Ciliary ganglion
Pterygopalatine ganglion
Submandibular ganglion
Otic ganglion
Which four cranial nerves have brainstem nuclei?
Oculomotor
Facial
Glossopharyngeal
Vagus
Which three cranial nerves have branches that reach the parasympathetic head ganglia and to which ones?
Oculomotor - ciliary ganglion
Facial - pterygopalatine or submandibular ganglion
Glossopharyngeal - otic ganglion
What is the structure of the parasympathetic nerves of the head?
Preganglionic fibres pass in the four cranial nerves
Synapse in either the four ganglia or in the walls of the organs that they supply (on head, neck, abdomen or thorax)
The ganglia, as well as containing parasympathetic synapses, also give uninterrupted passage to sympathetic and somatic fibres
Where is the ciliary ganglion and where does it get its parasympathetic fibres from?
Lies in the orbital cavity, lateral to the optic nerve
Oculomotor nerve
What does the ciliary ganglion supply?
Sphincter pupillae
Ciliary muscles
What fibres other than parasympathetic fibres does the ciliary ganglion have and where do they supply?
Sympathetic fibres from the superior cervical ganglion via the plexus on the ophthalmic artery - to the eyeball
Sensory fibres from the eyeball pass to the nasociliary nerve
Where does the pterygopalatine ganglion lie and which CN is it supplied by?
In the pterygopalatine fossa
Parasympathetic fibres derived from the facial nerve via the greater petrosal nerve
What does the pterygopalatine ganglion supply? (Parasympathetic)
Lacrimal glands
Glands of the nose, palate and nasopharynx
What is the pterygopalatine ganglion connected to?
The maxillary nerve (branch of trigeminal)
Which sympathetic fibres pass through the pterygopalatine ganglion?
From the superior cervical ganglion via the plexus on the internal carotid artery
Distributed to the nose, palate and nasopharynx
Which sensory fibres pass through the pterygopalatine ganglion?
From the nose, palate and nasopharynx to the maxillary nerve
Where is the submandibular ganglion?
Suspended from the lingual nerve by small branches
Where are the parasympathetic fibres of the submandibular ganglion derived from?
The facial nerve, via the chorda tympani then the lingual nerve
Where do the parasympathetic fibres of the submandibular ganglion supply?
Submandibular gland
Sublingual gland
Other glands on the floor of the oral cavity
What other fibres can pass though the submandibular ganglion?
Taste fibres
Where are the fibres of the otic ganglion derived from?
Glossopharyngeal nerve via the auriculotemporal nerve
Where do the parasympathetic fibres supply of the otic ganglion?
Parotid gland
Where do sympathetic fibres passing through the otic ganglion come from and go to?
Come from the superior cervical ganglion along the middle meningeal artery
Pass into the parotid gland
What motor branches pass through the otic ganglion?
From the mandibular nerve
Pass through without synapsing
What is seen if there is injury to the sympathetic trunk or ganglia?
Horner’s syndrome
-absence of sympathetically stimulated function if the ipsilateral side of the head
What are the symptoms of Horner’s syndrome?
Miosis
- constriction of the pupil
- parasympathetically stimulated sphincter
- papillae of the pupil is unopposed
Ptosis
- dropping of superior eyelid
- paralysis of smooth muscle fibres interdigitated with the aponeurosis of the levator palpebrae superioris that collectively constitute the superior tarsal muscle
Vasodilation
- redness and increased temp of skin
- due to loss of sympathetic tone
Anhydrosis
-absence of sweating
Which nerve is part of the Edinger-Westphal nucleus? What does it supply?
Oculomotor
Eye - pupil and ciliary muscles causing pupillary constriction
Which nerve is from the superior salivatory nucleus and which organs does it supply?
Facial nerve
Nasal, lacrimal, submandibular and sublingual glands
-serous secretions
Which nerve is from the inferior salivatory nucleus and which organs does it supply?
Glossopharyngeal nerve
Parotid gland - serous secretions
Which nerve is to the dorsal vagal motor nucleus and where does it supply?
Vagus
Wide distribution - laryngeal function ie neck only
What is sympathetic innervation to the head and neck done via and where is it located?
Sympathetic trunk
Anterolateral to the vertebral column
Lies on the prevertebral fascia and muscles
Deep to carotid sheath
