Autonomic Innervation Of The HaN

Question 1

Where do most of the sympathetic pre-ganglionic fibres arise from?

Answer 1

First thoracic neural segment

Question 2

Where do the pre-ganglionic sympathetic fibres synapse?

Answer 2

One of the three cervical sympathetic ganglia

-superior, middle or inferior cervical ganglion

Question 3

After synapsing with the pre-ganglionic fibres, where do the post-ganglionic fibres go?

Answer 3

Travel as the internal and external carotid nerves along blood vessels to their target tissues

Question 4

Where do the postganglionic fibres from the superior cervical ganglion travel?

Answer 4

With the internal and external carotid arteries to:

• the pharyngeal plexus
• the upper 4 cervical nerves
• cardiac branch to the cardiac plexus

Question 5

Where do the post-ganglionic fibres of the middle cervical plexus travel to?

Answer 5

With the inferior thyroid artery

• 5th and 6th cervical nerves
• cardiac branch to the cardiac plexus

Question 6

Where do the postganglionic fibres from the inferior cervical ganglia travel to?

Answer 6

With the vertebral artery to

• the 7th and 8th cervical nerves
• cardiac branch to the cardiac plexus

Question 7

What does the small inferior cervical ganglion combine with in 80% of people?

Answer 7

First thoracic ganglion to form the stellate ganglion

Question 8

What are the four pairs of parasympathetic ganglia in the head?

Answer 8

Ciliary ganglion
Pterygopalatine ganglion
Submandibular ganglion
Otic ganglion

Question 9

Which four cranial nerves have brainstem nuclei?

Answer 9

Oculomotor
Facial
Glossopharyngeal
Vagus

Question 10

Which three cranial nerves have branches that reach the parasympathetic head ganglia and to which ones?

Answer 10

Oculomotor - ciliary ganglion
Facial - pterygopalatine or submandibular ganglion
Glossopharyngeal - otic ganglion

Question 11

What is the structure of the parasympathetic nerves of the head?

Answer 11

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

Question 12

Where is the ciliary ganglion and where does it get its parasympathetic fibres from?

Answer 12

Lies in the orbital cavity, lateral to the optic nerve

Oculomotor nerve

Question 13

What does the ciliary ganglion supply?

Answer 13

Sphincter pupillae

Ciliary muscles

Question 14

What fibres other than parasympathetic fibres does the ciliary ganglion have and where do they supply?

Answer 14

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

Question 15

Where does the pterygopalatine ganglion lie and which CN is it supplied by?

Answer 15

In the pterygopalatine fossa

Parasympathetic fibres derived from the facial nerve via the greater petrosal nerve

Question 16

What does the pterygopalatine ganglion supply? (Parasympathetic)

Answer 16

Lacrimal glands

Glands of the nose, palate and nasopharynx

Question 17

What is the pterygopalatine ganglion connected to?

Answer 17

The maxillary nerve (branch of trigeminal)

Question 18

Which sympathetic fibres pass through the pterygopalatine ganglion?

Answer 18

From the superior cervical ganglion via the plexus on the internal carotid artery
Distributed to the nose, palate and nasopharynx

Question 19

Which sensory fibres pass through the pterygopalatine ganglion?

Answer 19

From the nose, palate and nasopharynx to the maxillary nerve

Question 20

Where is the submandibular ganglion?

Answer 20

Suspended from the lingual nerve by small branches

Question 21

Where are the parasympathetic fibres of the submandibular ganglion derived from?

Answer 21

The facial nerve, via the chorda tympani then the lingual nerve

Question 22

Where do the parasympathetic fibres of the submandibular ganglion supply?

Answer 22

Submandibular gland
Sublingual gland
Other glands on the floor of the oral cavity

Question 23

What other fibres can pass though the submandibular ganglion?

Answer 23

Taste fibres

Question 24

Where are the fibres of the otic ganglion derived from?

Answer 24

Glossopharyngeal nerve via the auriculotemporal nerve

Question 25

Where do the parasympathetic fibres supply of the otic ganglion?

Answer 25

Parotid gland

Question 26

Where do sympathetic fibres passing through the otic ganglion come from and go to?

Answer 26

Come from the superior cervical ganglion along the middle meningeal artery
Pass into the parotid gland

Question 27

What motor branches pass through the otic ganglion?

Answer 27

From the mandibular nerve

Pass through without synapsing

Question 28

What is seen if there is injury to the sympathetic trunk or ganglia?

Answer 28

Horner’s syndrome

-absence of sympathetically stimulated function if the ipsilateral side of the head

Question 29

What are the symptoms of Horner’s syndrome?

Answer 29

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

Question 30

Which nerve is part of the Edinger-Westphal nucleus? What does it supply?

Answer 30

Oculomotor

Eye - pupil and ciliary muscles causing pupillary constriction

Question 31

Which nerve is from the superior salivatory nucleus and which organs does it supply?

Answer 31

Facial nerve
Nasal, lacrimal, submandibular and sublingual glands
-serous secretions

Question 32

Which nerve is from the inferior salivatory nucleus and which organs does it supply?

Answer 32

Glossopharyngeal nerve

Parotid gland - serous secretions

Question 33

Which nerve is to the dorsal vagal motor nucleus and where does it supply?

Answer 33

Vagus

Wide distribution - laryngeal function ie neck only

Question 34

What is sympathetic innervation to the head and neck done via and where is it located?

Answer 34

Sympathetic trunk
Anterolateral to the vertebral column
Lies on the prevertebral fascia and muscles
Deep to carotid sheath