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Ocular Block 5 > Autonomics Of The Eye And Orbit > Flashcards

Autonomics Of The Eye And Orbit Flashcards

1
Q

Preganaglionic neuron cell body of sympathetic nervous system

A

T1-L2

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2
Q

Postganglionic neuron of sympathetic

A

Close by in the sympathetic chain

-longest fiber

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3
Q

NT for sympathetic

A

Epi/norepi

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4
Q

Where do all of the head and neck sympathetic synapse?

A

Superior cervical ganglion

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5
Q

Preganglionic nerve cell body in parasympathetic

A

Brainstem or sacral spinal cord

-long

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6
Q

What are the parasympathetic cranial nerves

A

3,7,9,10

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7
Q

Where is the postganglionic cell body in parasympathetic

A

In a ganglion near the target organ

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8
Q

Length of parasympathetic postganglionic fibers

A

Short

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9
Q

What is the NT of parasympathetic

A

Ach

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10
Q

Ocular structures innervated by the autonomic nervous system

A
  • iris muscles (iris sphincter and iris dilator muscles)
  • ciliary muscles
  • smooth muscles of the eyelids (Mullers Muscle)
  • choroidal and conjunctival blood vessels
  • lacrimal glands
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11
Q

What are the main parasympathetic CN that innervate the eye

A

3,7

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12
Q

Where does the sympathetic nervous system originate

A

In the lateral gray column of the thoracic and upper lumbar segments of the spinal cord

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13
Q

Where doe sympathetic innervation for ocular structures originate?

A

Segments T1-T3

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14
Q

Where does the parasympathetic innervation of ocular structures originate

A

In the midbrain and pons (CN III and VII)

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15
Q

Where is the preganglionic neuron of the efferent pathway located of the ANS

A

In the brain or spinal cord

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16
Q

Where is the cell body of the second neuron in the ANS efferent pathway located

A

In a ganglion outside the CNS

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17
Q

Where does the preganglionic fiber of the ANS efferent pathway terminate?

A

Myelinated, terminates in an autonomic ganglion, where synapse occurs

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18
Q

Where does the postganglionic fiber of the ANS efferent pathway go

A

Nonmyelinated

-exits the ganglion and innervates the target structure

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19
Q

Sympathetic ganglia usually are located __________, whereas parasympathetic ganglia are located ________

A
  • near the spinal column

- near the target structure

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20
Q

Ocular structures supplied by the sympathetic system

A 
Iris dilator
Ciliary muscle
Smooth muscle of lids
Lacrimal gland
Choroidal and conjunctival blood
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21
Q

Ocular structures innervated by the parasympathetic

A

Iris sphincter
Ciliary muscle
Lacrimal gland
Blood vessels

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22
Q

What is the main difference between the structure that are innervated by the parasympathetic and the sympathetic

A

Iris muscles

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23
Q

Where do the sympathetic preganglionic fibers synapse that are going to ocular structures

A

Superior cervical ganglion

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24
Q

What do the postganglionic sympathetic fibers do after they leave the superior cervical ganglion?

A
  • form the carotid plexus and the internal carotid artery

- and enter the skull through the carotid canal

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25
Q

How do the network of fine sympathetic fibers destined for ocular structures leave hte plexus?

A

In the cavernous sinus and take multiple pathways to the target structures

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26
Q

Where do all postganglionic sympathetic fibers go before they branch off to where they need to go?

A

Cavernous sinus

27
Q

What is the first sympathetic pathway

A

Some travel with the ophthalmic division of trigeminal nerve
-once in orbit, they follow the nasociliary nerve, then travel with the long ciliary nerves to innervate the iris dilator and the ciliary muscle

28
Q

What is the second sympathetic pathway

A
  • other fibers follow same as #1 to nasociliary nerve and then branch to the ciliary ganglion as the sympathetic root
  • these pass through ciliary ganglion without synapsing. Enter globe as the short ciliary nerves to innervate the choroidal blood vessels
29
Q

What innervates the choroidal blood vessels

A

Short ciliary nerves

30
Q

What is the pathway to the conjunctival vasculature through?

A

May be through either the long or shirt ciliary nerves

31
Q

What is the 3rd sympathetic pathway in the ocular structures

A
  • others fibers join the oculomotor nerve and go into orbit to innervate the smooth muscle of the upper eyelid (Mullers)
  • follow same path as superior division of CN III as it supplies the levator muscle
32
Q

What innervates the smooth muscle of the upper eyelid (Mullers muscle)

A

CN III

33
Q

Alternate route to mullers muscle

A

From the infratrochlear or lacrimal nerve has been suggested but not confirmed

34
Q

Activates the iris dilator, causing pupillary dilation and thereby increasing retinal illumination

A

Sympathetic

35
Q

Causes vasoconstriction of the choroidal and conjunctival vessels

A

Sympathetic

36
Q

Widens the palpebral fissure by stimulating the smooth muscle of the eyelids (mullers muscle)

A

Sympathetic

37
Q

Exhibits a small inhibitory effect on the ciliary muscle

A

Sympathetic

38
Q

What size are pupils when you sleep

A

Tiny

39
Q

Where is the preganglionic neuron in the parasympathetic pathway to the intrinsic ocular muscles located?

A

In the midbrain in the parasympathetic accessory third nerve nucleus, also called the ending ER-westphal nucleus

40
Q

What happens to the preganglionic parasympathetic neuron fibers going to ocular structures after it leave the nucleus?

A

With the motor fibers of the oculomotor nerve and follow the inferior division of that nerve into the orbit
-they leave the inferior division and enter the ciliary ganglion as the parasympathetic root

41
Q

Where do the parasympathetic preganglionic fibers synapse that are headed to ocular structures?

A

Ciliary ganglion

42
Q

Where is the ciliary ganglion located

A

Within the muscle cone between the lateral rectus muscle and the optic nerve, approximately 1cm anterior to the optic canal

43
Q

What are the three roots located at the posterior edge of the ciliary ganglion?

A
  1. parsympathetic root
  2. Sensory root, carries fibers from globe and joins with nasociliary nerve
  3. Sympathetic root, which supplies the blood vessels
44
Q

What kind of fibers synapse in the ganglion

A

Parasympathetic

45
Q

What do the short ciliary nerves located at the anterior edge of the ciliary ganglion carry?

A
  1. Sensory
  2. Sympathetic
  3. Parasympathetic fibers
46
Q

How do the postganglionic parasympathetic fibers exit the ganglion

A

In the short ciliary nerves, enter the globe, and travel to the anterior segment of the eye to innervate the sphincter and ciliary muscles

47
Q

What do most of the parasympathetic fibers that enter the globe through the shirt ciliary nerves innervate

A

The ciliary body

48
Q

Parasympathetic stimulation causes _____________, thus decreasing retinal illumination and reducing chromatic and spherical aberrations

A

Pupillary constriction

49
Q

Parasympathetic stimualtion causes __________ enabling the eye to focus on near objects in accommodation

A

Contraction of the ciliary muscle

50
Q

The iris contains muscles innervated by

A

Both autonomic systems

51
Q

The PNS and SNS nerves are in some state of balance in the normal, healthy, awake individual, and the size of the pupil changes constantly and rhythmically, reflecting this balance, this is called what

A

Pupillary unrest called hippus

52
Q

Pupils during sleep

A

Small because the SNS shuts down and the PNS predominates

53
Q

The efferent autonomic pathway to the lacrimal gland

A

Lacrimal nucleus—facial nerve—-grater petrosal nerve—-Vivian nerve—-pterygopalatine ganglion—-maxillary nerve—–zygomatic nerve—–lacrimal nerve—-lacrimal gland

54
Q

Fibers controlling the parasympathetic innervation originate in the pons in an area within the nucleus for cranial nerve VII designated as the

A

Lacrimal nucleus

55
Q

Preganglionic fibers from the lacrimal nucleus exit the pons with the motor fibers of the facial nerve and enter

A

The internal auditory canal, and pass through the geniculate ganglion of the facial nerve without synapsing

56
Q

How do the parasympathetic fibers to the lacrimal gland leave the geniculate ganglion of the facial nerve?

A

S the greater petrosal nerve, which exits the petrous portion of the tmpeoral bone

57
Q

What is the Vivian nerve

A

The greater petrosal nerve is joined by the deep petrosal nerve, composed of sympathetic postganglionic fibers from the carotid plexus

58
Q

Where does the Vivian nerve go once it is formed?

A

Enters the pterygopalatine ganglion, where the parasympathetic fibers synapse, sympathetic fibers pass through without synapsing

59
Q

What do the autonomic fibers do once they leave the pterygopalatine ganglion?

A

Join with the maxillary branch of the trigeminal nerve, pass into the zygomatic nerve and then form a communicating branch to the lacrimal nerve

Alternate pathway bypasses the zygomatic nerve and travels from the ganglion directly to the gland

60
Q

The parasympathetic fibers that innervate the lacrimal gland are of the secretomotor type and thus

A

Increase secretion

61
Q

Sympathetic innervation of lacrimal gland

A

Sympathetic fibers innervate the blood vessels of the gland and might indirectly cause decreased production of lacrimal gland secretion by restricting blood flow

62
Q

Sympathetic fibers to the lower eyelid

A

Sympathetic fibers from the zygomatic nerve also branch into the lower eyelid and innervate mullers muscle of the lower lid (opens eye larger)

63
Q

Reflex tearing

A

Irritation of any branch of the trigeminal nerve activates a reflex afferent pathway, precipitating increased lacrimation

64
Q

Corneal touch initiates the three part corneal reflex

A
  1. Lacrimation
  2. Miosis (shrinking pupil)
  3. Protective blink

Done by interneurons, no cerebral processing

Ocular Block 5 (8 decks)

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