LEC56: Autonomics of the Head & Neck

Question 1

ANS innervates?

Answer 1

fibers innervating smooth m, cardiac m, glands

Question 2

major divisions of the ANS?

Answer 2

1) parasympathetics: initial cell bodies in cranio-sacral portion of spine
2) sympathetics: initial cell body in thoraco-lumbar portion of spine

Question 3

where does sympathetic system begin? how does it synapse?

Answer 3

initial cell body: T1-L2

2nd cell body: outside of T1-L2, likely in **paravertebral **chain ganglia **

Question 4

which type of ganglia is this?

Answer 4

sympathetic ganglia

Question 5

what can postsynaptic nerve fibers do in sympathetic system?

Answer 5

first symapse at presynaptic entrance level then can

1) leave trunk at that level in gray ramus to reach spinal nerve or organ
2) synapse at a higher level and go to head, viscera

Question 6

what spinal cord level must these fibers be leaving at?

Answer 6

black park- in T1 portion

red part- cervical part of cord- note the absense of an IML in the column

Question 7

name the sympathetic ganglia of the face/neck

Answer 7

1) inferior cervical ganglia
2) middle cervical ganglia
3) superior cervical ganglia (big!)

Question 8

what do postganglionics from face/neck sympathetics do?

Answer 8

warap around vessels in the area

Question 9

what do postganglionics of inferior cervical ganglion wrap around?

Answer 9

vertebral artery and its branches

Question 10

what do postganglionics of middle cervical ganglion wrap around?

Answer 10

wrap around external coratid and its branches

Question 11

what do postganglionics of superior cervical ganglion wrap around?

Answer 11

wrap around internal coratid and its branches

Question 12

what does common carotid a split into?

Answer 12

internal & external carotid aa

Question 13

cause of horner’s syndrome?

Answer 13

knock out of sympathetics on a particular sign of face

Question 14

signs of horner’s syndrome?

Answer 14

1) ptosis- lowering of upper lid, due to smooth muscle weakness in part innervated by sympathetics
2) pupil- narrow b/c sympathetics which are dilators are knocked out, parasympathetics which are constrictors are in tact
3) loss of sweating on that side of face
4) retration of eyeball on that side of face

Question 15

cranial nerves of parasympathetic system?

Answer 15

III, VII, IX > cranial ganglia > head- eye, glands, smooth m

X > synapse in or near walls of viscera > pharynx to midgut

Question 16

pelvic splanchnics are?

Answer 16

S2, 3, 4

> hindgut, pelvis

Question 17

name the 4 parasympathetic ganglia in head/neck

Answer 17

1) ciliary
2) pterygopalatine (sphenopalatine)
3) submandibular
4) otic

Question 18

locations of the 4 parasympathetic ganglia in head/neck

Answer 18

1) ciliary- in orbit
2) pterygopalatine- pterygoalatine fossa
3) submandibular- oral cavity
4) otic- foramen ovale

Question 19

4 roots of a parasympathetic ganglion

Answer 19

1) preganglionic parasympathetic (motor) root
2) sensory root
3) sympathetic root
4) distribution root

Question 20

function of preganglionic parasympathetic motor root?

Answer 20

main function entity of parasympathetic of head/neck

tells how fibers get to 2nd cell bodies

Question 21

function of sensory root of parasympathetic ganglion?

Answer 21

somatic afferent fibers

from CN V, trigeminal n

Question 22

function of sympathetic root of parasympathetic ganglion?

Answer 22

postganglionic sympathetics that traverse ganglion

Question 23

function of distribution root of parasympathetic ganglion?

Answer 23

branch of trigeminal n

the 3 other roots - sensory, sympathetic, motor - travel w/ this to target organ

Question 24

fiber types of trigeminal n CN V

Answer 24

SVE

GSA

Question 25

how can something be transmitted to a branch of CN V, trigeminal n, without being a part of CN V, trigeminal n?

Answer 25

CN V is used to convey postganglionic autonomic fibers, besides having its own innervating SVE/GSA fibers so motor root, sensory root, sympathetic roots of parasympathetic ganglion all travel along branch of CN V; it serves as the distribution root

Question 26

where is ciliary ganglion located? what is it suspended from?

Answer 26

located in orbit, later to optic nerve suspended from nasociliary nerve (branch of V₁)

Question 27

target of ciliary ganglion

Answer 27

eye - pupil

Question 28

target of pterygopalatine ganglion

Answer 28

lacrimal gland

Question 29

target of submanidbular ganglion

Answer 29

submandibular gland

Question 30

target of otic ganglion

Answer 30

parotid gland

Question 31

ciliary ganglion: motor root

Answer 31

*(preganglionic parasympathetic fibers carried in)* oculomotor nerve (CN III)

Question 32

ciliary ganglion: sensory root

Answer 32

nasociliary n (V₁)

Question 33

ciliary ganglion: sympathetic root

Answer 33

carotid plexus from superior cervical ganglion, via plexus around opthalmic artery, br of internal carotid a

Question 34

ciliary ganglion: distribution root

Answer 34

nasociliary nerve branches (V₁): 1) postgang. PARASYMPAHETICS via short ciliary nn to phincter pupillae & ciliaris mm 2) postgang. SYMPATHETICS & sensory fibers via short & long ciliary nn to iris (dilatory pupillae), ciliary body, cornea

Question 35

pterygopalatine ganglion: motor root

Answer 35

preganglionic parasympathetic fibers in greater petrosal n (br CN VII) joins w/ deep petrosal n to form n of pterygoid canal

Question 36

pterygopalatine ganglion: sensory root

Answer 36

main trunk V₂

Question 37

pterygopalatine ganglion: sympathetic root

Answer 37

deep petrosal n from superior cervical ganglion, via internal carotid a, through vidians canal

Question 38

pterygopalatine ganglion: distribution root

Answer 38

branchs of V₂ direct or comm to lacrimal gland/secretomotor to palate, nasal cavity, pharynx

Question 39

submandibular ganglion: motor root

Answer 39

preganglionic parasympathetic fibers carried in chorda tympani n (br CN VII) to lingual nerve (V₃)

Question 40

submandibular ganglion: sensory root

Answer 40

lingual n (V₃)

Question 41

submandibular ganglion: sympathetic root

Answer 41

from sympathetic plexus of cervical ganglion, via facial a, branch of external carotid a

Question 42

submandibular ganglion: distribution root

Answer 42

terminal branches of lingual n (V₃) to sublingual & submandibular glands

Question 43

otic ganglion: motor root

Answer 43

pregnglionic paraysmpathetic fibers carred in lesser petrosal nerve (br. CN IX)

Question 44

otic ganglion: sensory root

Answer 44

mandibular n (V₃)

Question 45

otic ganglion: sympathetic root

Answer 45

from plexus on middle cervical ganglion, via middle meningeal artery, br of external carotid a

Question 46

otic ganglion: distribution root

Answer 46

via communicating branches to auriculotemporal n (V₃) to parotid gland

Question 47

clinical manifestation of CNIII damage?

Answer 47

marked ptosis (drooping) of eyelid (b/c of paralysis of levator palpebrae superioris) hugely dialated pupil (b/c parasympathetic constrictors knocked out, sympathetic dialators fxning - opposite of horner's pupil)

Question 48

location of pterygopalatine ganglion

Answer 48

in pterygopalatine fossa ganglion suspended from main trunk of maxillary n (V₂)

Question 49

identify where the pterygopalatine ganglion sits

Answer 49

Question 50

where does pterygopalatine ganglion distribution root go?

Answer 50

lacrimal gland - responsible for lacrimation

Question 51

what is greater petrosal n a branch of

Answer 51

CN VII

Question 52

what nerve is specifically responsible for lacrimation

Answer 52

greater petrosal n brings secretomotor fibers to pterygopalatine gang to lacrimal gland

Question 53

what bone does CN VII come in to

Answer 53

petrous, part of the temporal bone "rock hard"

Question 54

what runs along top of petrous bone?

Answer 54

facial hiatus

Question 55

what type of nerve fibers does greater petrosal n carry? what is it responsible for?

Answer 55

carries both preganglionic parasympathetic fibers & TASTE fibers responsible for tate all over palate

Question 56

what is chorda tympany n a branch of?

Answer 56

CN VII

Question 57

what is fxn of chorda tympani n?

Answer 57

carries preganglionic parasympathetics going to submandibular ganglion carries taste from anterior 2/3 of tongue does secretomotor functions of oral cavity

Question 58

where does chorda tympani n run?

Answer 58

between malleus and incus

Question 59

what does chorda tympani n communicate between?

Answer 59

arch 1 & arch 2 structures

Question 60

where is otic ganglion located re: foramen?

Answer 60

at opening of foramen ovale

Question 61

where is parotid gland

Answer 61

Question 62

what innervates parotid gland?

Answer 62

lesser petrosal n \> otic ganglion \> distributed by auriculotemporal branches \> parotid gland

Question 63

cause of gustatory sweating?

Answer 63

if auriculotemporal n damaged, or hwen have infection or parotid removed

Question 64

what happens if parotid gland is removed?

Answer 64

whereas normally, sympathetics \> sweat glands and parasympathetics \> parotid, if remove parotid, get parasympathetics \> sweat glands that normally don't so when chew, get sweating on side of parotid removal, rather than parotid activity