Extra stuff from sofia: 'overview of HNS' Flashcards
What are the features of horner’s and why these occur
1. Ptosis Paralysis of superior tarsal muscle 2. Anhydrosis paralysis of the dilator pupillae 3. Miosis loss of innervation to the sweat glands of the face
What could cause horner’s
Horner’s syndrome has a multitude of causes. These include spinal cord lesions, traumatic injury and a Pancoast tumour (a cancer affecting the apex of the lung, which can involve the ganglia)
Overview of sympathetic innerbvation to head in terms of ganglia
3 main: superior, middle and inferior cervical
Ganglia within sympathetic chain
They synapse in this chain, and then send long post ganglionic fibres off head and neck, and other areas
Branches form superor cervical ganglion
Internal carotid nerve
External carotid nerve
Nerve to pharyngeal plexus (with vagus and glossopharyngeal)
Nerves to cranial nerves II, III IV, VI and IX.
Branches from middle cervical nerve
Thyroid branches – travel along the inferior thyroid artery, distributing fibres to the larynx, trachea, pharynx and upper oesophagus.
Branches from inferior cervical ganglion
Branches to the subclavian and vertebral arteries – These innervate the smooth muscle present in the arteries.
Outline parasympathetic innervation to head and neck
From CRANIAL part or cranio-sacral outflow
4 parasympathetic nuclei in brainstem
Cranial nerves III, VII, IX and X
Synapse into ganglion NEAR the viscera
What are the 4 PNS ganglia of the head
ciliary, otic, pterygopalatine and submandibular
T/f there is no vagus PNS function in head and neck
T
Outline ciliary ganglion:
Pre-gang. fibres
Post gang. fibres
Target organs
Pre: Fibres from edinger westphal (from CNIII)
Post: short ciliary nerves
Target: Sphincter pupillae and ciliary muscle (accommodation)
Which other fibres are associated with ciliary ganglion
Sympathetic nerves from the internal carotid plexus – innervate the dilator pupillae muscle… FROM SUPERIOR CERVICAL GANGLION
Sensory fibres from the nasociliary nerve (a branch of the ophthalmic division of the trigeminal nerve) – innervate the cornea, ciliary body and iris.
Outline PTERYGOPALATINE ganglion:
Pre-gang. fibres
Post gang. fibres
Target organs
Pre: Fibres from XII (superior slaivaotry nucleus). Travel with greater petrosal nerve (+deep petrosal nerve) in pterygoid canal
Post: hitchhikes on branches of maxillary nerve \
Target:
Lacrimal gland
Nasopharynx
Palate
Nasal cavity
Which other structures are in the pterygopalatine ganglion
Sympathetic fibres from the internal carotid plexus and sensory branches from the maxillary nerve pass through the pterygopalatine ganglion without synapsing.
Outline the submandibular ganglion
Pre-gang. fibres
Post gang. fibres
Target organs
Pre gang. fibres:
From superior salivatory nucleus (CN XII)
Carried within chordatympani along the LINGUAL BRANCH OF V3
Post: fibres travel straight to submandibular and sublingual glands.
Target:
Secretomotor innervation to the submandibular and sublingual salivary glands.
From which nerve is the submandibular ganglion suspended
Lingual