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3 - HNN > Autonomic Nervous System > Flashcards

Autonomic Nervous System Flashcards

1
Q

State the origin and location of sympathetic outflow

A
  • Thoracolumbar outflow
  • Segments T1-L2 of spinal cord only
  • Cell bodies within lateral horn of grey matter of spinal cord
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2
Q

State the origin and location of parasympathetic outflow

A
  • Craniosacral outflow
  • Cranial - 4 cranial nerves
  • Sacral - S2-S4 - pelvic splanchnics
  • Discrete collections of parasympathetic cell bodies (nuclei) in brainstem or within grey matter of sacral spinal cord
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3
Q

What are the actions of the sympathetic system on the head

A
  • Smooth muscle of blood vessels, eye lid (tarsal muscle) and iris (dilator pupillae)
  • Sweat glands
  • Arrector pili muscles (hair follicles)
  • Decreases secretions from salivary and lacrimal glands (smaller volume but higher protein - more viscous)
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4
Q

What are the actions of the parasympathetic system on the head

A
  • Smooth muscle of iris (sphincter pupillae) and ciliary body (control thickness of lens)
  • Lacrimal glands
  • Salivary and mucosal glands
  • Smooth muscle of the respiratory and GI system
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5
Q

State the origin and ganglia of the sympathetic innervation to head

A
  • Mainly T1-T2 for head and neck structures
  • Ganglia - ganglia in cervical portion of sympathetic chain
    • Superior cervical ganglion main ganglion
    • Sympathetic chain - collection of cell bodies of postganglionic fibres
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6
Q

Explain the route of the postganglionic sympathetic fibres

A
  • Postganglionic fibres hitchhike blood vessels to reach head and beck
  • Fibres travel along external carotid artery to deliver sympathetic innervation to face and neck
    • Sweat glands, blood vessels
  • Fibres travel along internal carotid artery through carotid canal to the ophthalmic artery
    • Branch off and travel alongside CN III and CN Va as well to orbit
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7
Q

Describe the effector tissues and response of the sympathetic system

A
  • Eye - dilator pupillae muscle in iris
    • Causes pupillary dilation
  • Eyelid - superior tarsal muscle
    • Assists lid retraction (mainly done through CN III)
  • Blood vessels
    • Vasoconstriction
  • Sweat glands
    • Increase sweat production
  • (Decreases secretion in salivary and lacrimal glands)
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8
Q

Explain Horner’s syndrome, including its symptoms

A
  • Sympathetic interruption to 1/2 of face
  • Pathology involving apex of lung (eg. Lung cancer) and internal carotid artery can cause Horner’s syndrome
  • Symptoms:
    • Partial ptosis - occulomotor nerve still innervating LPS
    • Constricted pupil (miosis)
      • Anhidrosis - loss of sweating on damaged side
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9
Q

State the origins of parasympathetic innervation to head and neck

A
  • Arise form brainstem from parasympathetic nuclei

- Edinger Westphal, superior salivary, inferior salivary, dorsal motor

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10
Q

Along which cranial nerves do preganglionic parasympathetic fibres travel alongside

A
  • Oculomotor, facial, glossopharyngeal, vagus

- III, VII, IX, X

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11
Q

State the 4 parasymapthetic ganglia to the head and neck and from which cranial nerve they are related to

A
  • Ciliary - oculomotor
  • Submandibular, pterygopalatine - facial
  • Otic - glossopharyngeal
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12
Q

Where do postganglionic parasympathetic fibres travel alongside

A

Trigeminal nerve

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13
Q

Outline the route of the parasympathetics alongside oculomotor nerve as well as its actions

A
  • Brainstem - Edinger-Westphal nucleus
  • Preganglionic parasympathetic fibres emerge with CN III
  • Enter ciliary ganglion
  • Postganglionic parasympathetic fibres hitchhike on branches from CN Va
  • Enter eye - smooth muscle in iris (constrictor), ciliary muscle (controls lens)
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14
Q

Explain how the pupillary light reflex works

A
  • Both pupils constrict when light shone
  • Eg. Light in left pupil
    1. Sensory afferent from left retina (CN II)
    2. Some branches leave CN II to enter midbrain through optic canal and optic tract
    3. Connect with Edinger-Westphal (EDW) nucleus on both left and right side within brainstem
    4. Parasympathetic fibres from EDW leave brainstem
    5. Hitchhike on CN III on both left and right
    6. Pass via ciliary ganglion
    7. Reach sphincter pupillae
    • Left eye - direct light reflex
      • Right eye - consensual light reflex
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15
Q

Outline the route of the parasympathetics alongside facial nerve

A
  • Preganglionic parasympathetic nerves exit brainstem with the facial nerve
  • Exit through internal auditory meatus into petrous temporal bone
  • Within petrous bone, divides into greater petrosal nerve and chorda tympani
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16
Q

Outline the route of the greater petrosal nerve and its effectors

A
  • At point of geniculate ganglion, greater petrosal nerve leaves to pterygopalatine fossa
  • Enters pterygopalatine ganglion
  • Postganglionic parasympathetics travel along CN V
  • Effectors - lacrimal gland, nasal and oral mucosal glands
17
Q

Outline the route of the chorda tympani nerve and its effectors

A
  • Travels alongside facial nerve past geniculate ganglion until it branches to chorda tympani nerve
  • Crosses through middle ear cavity and exits via base of skull
  • Enters submandibular ganglion
  • Postganglionic parasympathetics travel along CN V
  • Effectors - submandibular and sublingual salivary glands
18
Q

What problems can occur with parasympathetic nerves along facial nerve

A

Dry eye and dry mouth

19
Q

Outline the route of the parasympathetics alongside glossopharyngeal nerve and its effectors

A
  1. Preganglionic parasympathetic fibres arise from brainstem alongside CN IX
  2. Exit skull through jugular foramen
  3. Travel alongside tympanic nerve branch - supplies sensory to middle ear as well as carrying autonomics
  4. Enters petrous bone and travels through tympanic plexus to become lesser petrosal nerve
  5. Leaves petrous bone and travels through foramen ovale to otic ganglion - in infratemporal fossa
  6. Postganglionic parasympathetics then hitchhike on branch of Cn Vc
    - Effector - parotid gland to increase saliva
20
Q

Outline the route of the parasympathetics alongside vagus nerve and its effectors

A
  • Preganglionic travel alongside CN X from medulla of brainstem
  • Meets ganglion at or in target tissue
  • Postganglionic fibres to effectors
    • Glands in laryngopharynx, larynx, glands and smooth muscle of oesophagus and trachea
    • Heart
      • Smooth muscle and glands within respiratory and gastrointestinal tract

3 - HNN (15 decks)

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