Autonomics of the head and neck

Question 1

What are the four parasympathetic ganglia of the head?

Answer 1

The ciliary, the pterygopalatine, the submandubular, and the otic.

Question 2

What are the cranial nerves that carry pre-ganglionic parasympathetics to the four ganglia?

Answer 2

CN III (occulomotor) 
CN VII (facial) 
CN IX (glossopharyngeal)

Question 3

What cranial nerve carries pre-ganglionic parasympathetic fibers to the cililary ganglion?

Answer 3

CN III (occulomotor)

Question 4

What cranial nerve carries pre-ganglionic fibers to the pterygopalatine and submandibular ganglia?

Answer 4

CN VII (facial nerve)

Question 5

What cranial nerve carries pre-ganglionic fibers to the otic ganglion?

Answer 5

CN XI (glossopharyngeal)

Question 6

What branch of the trigeminal nerve does the ciliary ganglion associate with?

Answer 6

CN V1 (ophthalmic)

Question 7

What branch of the trigeminal nerve does the pteryopalatine ganglion associate with?

Answer 7

CN V2 (maxillary)

Question 8

What branch of the trigeminal nerve do the submandibular and otic ganglia associate with?

Answer 8

CN V3 (mandibular)

Question 9

What nerve carries post-ganglionic fibers from the ciliary ganglion?

Answer 9

The nasociliary nerve (branch of CN V1)

Question 10

What nerve carries post-ganglionic fibers from the pterygopalatine ganglion?

Answer 10

The zygomatic nerve (CN V2)

Question 11

What nerve carries post-ganglionic fibers from the otic ganglion?

Answer 11

Auriculotemporal nerve (CN V3)

Question 12

What nerve carries post-ganglionic fibers from the submandibular ganglion?

Answer 12

The lingual nerve (CN V3)

Question 13

What is the parasympathetic innervation of the facial nerve (CN VII)?

Answer 13

Secretomotor to the submandibular, sublingual, and lacimal glands.

Question 14

Which part of the facial nerve do pre-ganglionic fibers to the sublingual ganglion travel with?

Answer 14

The chorda tympani

Question 15

What two structures does the chorda tympani travel between?

Answer 15

It travels between the malleus and incus (ossicles) on its way to the tongue.

Question 16

After exiting the submandibular ganglion what nerve do the post-ganglionic fibers travel with to the submandibular and sublingual glands?

Answer 16

The lingual nerve (CN V3). Keep in mind though that the chorda tympani and lingual nerve travel together, so it’s kinda all the same.

Question 17

What parasympathetic innervation does the glossopharyngeal nerve carry?

Answer 17

Secretomotor to the parotid gland via the otic ganglion.

Question 18

What is the site of synapse for all of the pre-ganglionic sympathetic fibers going to the head?

Answer 18

The superior cervical ganglion (the very top of the sympathetic chain).

Question 19

After exiting the superior cervical ganglion, how do post-ganglionic sympathetic fibers to the head reach their target?

Answer 19

They will hitchhike on blood vessels and then hop off onto cranial nerves.

Question 20

Are all ANS fibers motor?

Answer 20

Yes. This is why they have a set-up similar to the UMN/LMN system that somatic motor units do (Pre and post ganglionic fibers). This is also why both somatic motor and sympathetic fibers will exit via the ventral root (motor).

Question 21

Where is the parasympathetic output located?

Answer 21

Craniosacral (in the brainstem and S2-S4) Found nowhere else.

Question 22

Where is the sympathetic output located?

Answer 22

Thoracolumbar (T1-L2). Found nowhere else.

Question 23

What will happen if there is damage to one of the two superior cervical ganglia?

Answer 23

Sympathetic innervation to the entire ipsilateral side of the face would be lost. (i.e if the left is ganglion is damaged, then the left side of the face would be unable to sweat ect).

Question 24

What nerve carries pre-ganglionic parasympathetics from the facial nerve to the pterygopalatine ganglion?

Answer 24

The greater petrosal nerve.