LEC56: Autonomics of the Head & Neck Flashcards
ANS innervates?
fibers innervating smooth m, cardiac m, glands
major divisions of the ANS?
1) parasympathetics: initial cell bodies in cranio-sacral portion of spine
2) sympathetics: initial cell body in thoraco-lumbar portion of spine
where does sympathetic system begin? how does it synapse?
initial cell body: T1-L2
2nd cell body: outside of T1-L2, likely in **paravertebral **chain ganglia **
which type of ganglia is this?
sympathetic ganglia
what can postsynaptic nerve fibers do in sympathetic system?
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
what spinal cord level must these fibers be leaving at?
black park- in T1 portion
red part- cervical part of cord- note the absense of an IML in the column
name the sympathetic ganglia of the face/neck
1) inferior cervical ganglia
2) middle cervical ganglia
3) superior cervical ganglia (big!)
what do postganglionics from face/neck sympathetics do?
warap around vessels in the area
what do postganglionics of inferior cervical ganglion wrap around?
vertebral artery and its branches
what do postganglionics of middle cervical ganglion wrap around?
wrap around external coratid and its branches
what do postganglionics of superior cervical ganglion wrap around?
wrap around internal coratid and its branches
what does common carotid a split into?
internal & external carotid aa
cause of horner’s syndrome?
knock out of sympathetics on a particular sign of face
signs of horner’s syndrome?
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
cranial nerves of parasympathetic system?
III, VII, IX > cranial ganglia > head- eye, glands, smooth m
X > synapse in or near walls of viscera > pharynx to midgut
pelvic splanchnics are?
S2, 3, 4
> hindgut, pelvis
name the 4 parasympathetic ganglia in head/neck
1) ciliary
2) pterygopalatine (sphenopalatine)
3) submandibular
4) otic
locations of the 4 parasympathetic ganglia in head/neck
1) ciliary- in orbit
2) pterygopalatine- pterygoalatine fossa
3) submandibular- oral cavity
4) otic- foramen ovale
4 roots of a parasympathetic ganglion
1) preganglionic parasympathetic (motor) root
2) sensory root
3) sympathetic root
4) distribution root
function of preganglionic parasympathetic motor root?
main function entity of parasympathetic of head/neck
tells how fibers get to 2nd cell bodies
function of sensory root of parasympathetic ganglion?
somatic afferent fibers
from CN V, trigeminal n
function of sympathetic root of parasympathetic ganglion?
postganglionic sympathetics that traverse ganglion
function of distribution root of parasympathetic ganglion?
branch of trigeminal n
the 3 other roots - sensory, sympathetic, motor - travel w/ this to target organ
fiber types of trigeminal n CN V
SVE
GSA
how can something be transmitted to a branch of CN V, trigeminal n, without being a part of CN V, trigeminal n?
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
where is ciliary ganglion located?
what is it suspended from?
located in orbit, later to optic nerve
suspended from nasociliary nerve (branch of V1)
target of ciliary ganglion
eye - pupil
target of pterygopalatine ganglion
lacrimal gland
target of submanidbular ganglion
submandibular gland
target of otic ganglion
parotid gland
ciliary ganglion: motor root
(preganglionic parasympathetic fibers carried in)
oculomotor nerve (CN III)
ciliary ganglion: sensory root
nasociliary n (V1)
ciliary ganglion: sympathetic root
carotid plexus from superior cervical ganglion,
via plexus around opthalmic artery, br of internal carotid a
ciliary ganglion: distribution root
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
pterygopalatine ganglion: motor root
preganglionic parasympathetic fibers in greater petrosal n (br CN VII) joins w/ deep petrosal n to form n of pterygoid canal
pterygopalatine ganglion: sensory root
main trunk V2
pterygopalatine ganglion: sympathetic root
deep petrosal n from superior cervical ganglion, via internal carotid a, through vidians canal
pterygopalatine ganglion: distribution root
branchs of V2 direct or comm to lacrimal gland/secretomotor to palate, nasal cavity, pharynx
submandibular ganglion: motor root
preganglionic parasympathetic fibers carried in chorda tympani n (br CN VII) to lingual nerve (V3)
submandibular ganglion: sensory root
lingual n (V3)
submandibular ganglion: sympathetic root
from sympathetic plexus of cervical ganglion, via facial a, branch of external carotid a
submandibular ganglion: distribution root
terminal branches of lingual n (V3) to sublingual & submandibular glands
otic ganglion: motor root
pregnglionic paraysmpathetic fibers carred in
lesser petrosal nerve (br. CN IX)
otic ganglion: sensory root
mandibular n (V3)
otic ganglion: sympathetic root
from plexus on middle cervical ganglion, via middle meningeal artery, br of external carotid a
otic ganglion: distribution root
via communicating branches to auriculotemporal n (V3) to parotid gland
clinical manifestation of CNIII damage?
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)
location of pterygopalatine ganglion
in pterygopalatine fossa
ganglion suspended from main trunk of maxillary n (V2)
identify where the pterygopalatine ganglion sits
where does pterygopalatine ganglion distribution root go?
lacrimal gland - responsible for lacrimation
what is greater petrosal n a branch of
CN VII
what nerve is specifically responsible for lacrimation
greater petrosal n
brings secretomotor fibers to pterygopalatine gang to lacrimal gland
what bone does CN VII come in to
petrous, part of the temporal bone
“rock hard”
what runs along top of petrous bone?
facial hiatus
what type of nerve fibers does greater petrosal n carry? what is it responsible for?
carries both preganglionic parasympathetic fibers & TASTE fibers
responsible for tate all over palate
what is chorda tympany n a branch of?
CN VII
what is fxn of chorda tympani n?
carries preganglionic parasympathetics going to submandibular ganglion
carries taste from anterior 2/3 of tongue
does secretomotor functions of oral cavity
where does chorda tympani n run?
between malleus and incus
what does chorda tympani n communicate between?
arch 1 & arch 2 structures
where is otic ganglion located re: foramen?
at opening of foramen ovale
where is parotid gland
what innervates parotid gland?
lesser petrosal n > otic ganglion > distributed by auriculotemporal branches > parotid gland
cause of gustatory sweating?
if auriculotemporal n damaged, or hwen have infection or parotid removed
what happens if parotid gland is removed?
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
