Extra stuff from sofia: 'overview of HNS'

Question 1

What are the features of horner’s and why these occur

Answer 1

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

Question 2

What could cause horner’s

Answer 2

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)

Question 3

Overview of sympathetic innerbvation to head in terms of ganglia

Answer 3

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

Question 4

Branches form superor cervical ganglion

Answer 4

Internal carotid nerve

External carotid nerve

Nerve to pharyngeal plexus (with vagus and glossopharyngeal)

Nerves to cranial nerves II, III IV, VI and IX.

Question 5

Branches from middle cervical nerve

Answer 5

Thyroid branches – travel along the inferior thyroid artery, distributing fibres to the larynx, trachea, pharynx and upper oesophagus.

Question 6

Branches from inferior cervical ganglion

Answer 6

Branches to the subclavian and vertebral arteries – These innervate the smooth muscle present in the arteries.

Question 7

Outline parasympathetic innervation to head and neck

Answer 7

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

Question 8

What are the 4 PNS ganglia of the head

Answer 8

ciliary, otic, pterygopalatine and submandibular

Question 9

T/f there is no vagus PNS function in head and neck

Answer 9

T

Question 10

Outline ciliary ganglion:

Pre-gang. fibres
Post gang. fibres
Target organs

Answer 10

Pre: Fibres from edinger westphal (from CNIII)

Post: short ciliary nerves

Target: Sphincter pupillae and ciliary muscle (accommodation)

Question 11

Which other fibres are associated with ciliary ganglion

Answer 11

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.

Question 12

Outline PTERYGOPALATINE ganglion:

Pre-gang. fibres
Post gang. fibres
Target organs

Answer 12

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

Question 13

Which other structures are in the pterygopalatine ganglion

Answer 13

Sympathetic fibres from the internal carotid plexus and sensory branches from the maxillary nerve pass through the pterygopalatine ganglion without synapsing.

Question 14

Outline the submandibular ganglion

Pre-gang. fibres
Post gang. fibres
Target organs

Answer 14

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.

Question 15

From which nerve is the submandibular ganglion suspended

Answer 15

Lingual

Question 16

Outline the otic ganglion

Pre-gang. fibres
Post gang. fibres
Target organs

Answer 16

Pre: Inferior salivatory nucleus (CNIX). Travel within lesser petrosal nerve (a branhc of glossopharyngeal) to otic ganglion

Post: hitchhike along the auriculotemporal nerve (branch of the mandibular division of the trigeminal nerve) to provide secretomotor innervation to the parotid gland.

Target: parotid

Question 17

What other structures are associated with otic ganglion

Answer 17

Sympathetic fibres from the superior cervical chain pass through the otic ganglion. They travel with the middle meningeal artery to innervate the parotid gland.