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I. Neuroanatomy > Parasympathetic Autonomic System (M2) > Flashcards

Parasympathetic Autonomic System (M2) Flashcards

1
Q

Where does the parasympathetic system exit the CNS?

A
  1. CN III
  2. CN VII
  3. CN IX
  4. CN X
  5. S2 - S4
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2
Q

What are the fiber types of CN III? 1. What do these fibers innervate? 2

A
  1. General somatic efferent and general visceral efferent
  2. GSE: to LPS, SR, IS, MR, IO
    GVE: to iris sphincter and ciliary body
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3
Q

Where is the CN III parasympathetic preganglionic cell body located? 1. Postganglionic fiber cell body location? 2

A
  1. Edinger Westphal

2. Ciliary ganglion

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4
Q

Describe the pathway of the CN III parasympathetic preganglionic fiber.

A

Edinger Westphal -> III -> IIIi -> branch -> inferior oblique -> motor root -> ciliary ganglion

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5
Q

Describe the pathway of the CN III parasympathetic postganglionic fiber.

A

Ciliary ganglion -> short ciliary nerves -> iris sphincter and ciliary muscle

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6
Q

What branch of nerves provides sensory and sympathetic innervation to the front of the eye?

A

long ciliary

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7
Q

What branch of nerves provides sensory and sympathetic innervation to the back of the eye along with parasympathetic innervation to the front of the eye?

A

short ciliary

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8
Q

What is the most dorsal nucleus of the oculomotor complex?

A

Edinger Westphal

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9
Q

What is the oculomotor complex at the same level of in the brain?

A

superior colliculus

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10
Q

Does the Edinger Westphal provide contralateral or ipsilateral innervation?

A

ipsilateral

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11
Q

What is the sulcus on the ventral surface of the pons called?

A

basilar sulcus

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12
Q

Where does the oculomotor nerve exit the brainstem?

A

interpeduncular fossa

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13
Q

What vessel of the circle of Willis does the CN III run next to?

A

posterior communicating artery

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14
Q

What section of CN III is just lateral to the posterior communicating artery?

A

basilar portion

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15
Q

What section of CN III is just lateral to the basilar artery?

A

root of CN III

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16
Q

What are the names of the sections of CN III from the nucleus to the cavernous portion?

A
  1. nuclear
  2. dorsal fasicular (Benedict’s)
  3. ventral fasicular (Weber’s)
  4. root
  5. basilar
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17
Q

What percentage of intracranial saccular aneurysms affect CN III?

A

30-35%

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18
Q

When is damage to CN III a medical emergency: preganglionic, postganglionic, or both?

A

preganglionic

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19
Q

Where do parasympathetic fibers run along CN III when they exit the brainstem?

A

outside (like insulation of wire)

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20
Q

What does compression of CN III when it exits the brainstem first cause?

A

loss of parasympathetic

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21
Q

What is a CN III palsy with EOM along with sphincter and ciliary body affected called?

A

complete ophthalmoplegia

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22
Q

What fibers are affected if there is a CN III palsy without pupillary involvement? 1. What is the most likely cause of this? 2. Is this an emergency? 3. What is this called? 4

A
  1. GSE (EOM’s)
  2. hypertension, diabetes, other ischemic issues
  3. No, refer to PCP
  4. External ophthalmoplegia
23
Q

What is a compression of CN III which only affects the sphincter and the ciliary body called?

A

internal ophthalmoplegia

24
Q

What is the first sign of compression of CN III at the root section?

A

anisocoria

25
Q

Does CN III firing decrease or increase the ciliary body width?

A

decrease

26
Q

What do the parasympathetic nuclei of CN VII innervate?

A
  1. one nucleus to submandibular and sublingual glands

2. one nucleus to lacrimal gland

27
Q

Where does CN VII exit the brainstem?

A

pontomedullar junction

28
Q

What are the names of the branches that CN VII exits the brainstem as?

A
  1. motor root

2. nervus intermedius

29
Q

What type of fibers does the motor root of the facial nerve have? 1. What do these fibers innervate? 2

A
  1. somatic visceral efferent

2. muscles of facial expression, stapedius, and posterior digastric

30
Q

What type of fibers does the nervus intermedius root of the facial nerve have? 1. What do these fibers innervate? 2

A
  1. general visceral efferent, general somatic efferent, and special visceral afferent
  2. GVE: to lacrimal and submandibular/sublingual
    GSA: to ear canal
    SVA: to taste buds of body of tongue
31
Q

For the parasympathetic CN VII preganglionic fibers to the submandibular ganglion describe the pathway.

A

Superior salivatory nucleus -> nervus intermedius (through geniculate ganglion) -> leaves VII as chorda tympani -> through middle ear and to area below tongue to submandibular ganglion

32
Q

For the parasympathetic CN VII preganglionic fibers to the pterygopalatine ganglion (eventually to lacrimal) describe the pathway.

A

lacrimal nucleus -> nervus intermedius -> Greater superficial petrosal -> vidian (aka Nerve of Pterygoid canal) -> Pterygopalatine ganglion

33
Q

For the parasympathetic CN VII postganglionic fibers to the lacrimal gland describe the pathway.

A

pterygopalatine ganglion -> join maxillary -> infraorbital -> zygomatic -> lacrimal

34
Q

What fiber types does the glossopharyngeal nerve have? 1. What do each of these innervate? 2

A
  1. SVE, GVE, SVA, GSA, GVA
  2. SVE: to stylopharyngeus
    GVE: to parotid
    SVA: from taste of root of tongue
    GSA: from ear canal and pharynx
    GVA: from carotid sinus and body
35
Q

In the brain what is the order from most medial to most lateral of efferent fiber types?

A
  1. GSE
  2. GVE
  3. SVE
36
Q

Where does CN IX exit the brainstem?

A

posterolateral fissure of medulla

37
Q

What nuclei of CN IX and CN X are found in the superior ganglion? 1. In inferior ganglion? 2

A
  1. GSA nucleus

2. GVA and SVA nuclei

38
Q

What is the nucleus of the GVE of CN IX called?

A

Inferior salivatory nucleus

39
Q

What is the nucleus of the SVE of CN IX, X, and XI called?

A

Nucleus ambiguus

40
Q

Describe the pathway of the parasympathetic preganglionic fibers of CN IX that eventually go to the parotid gland.

A

Inferior salivatory nucleus -> pass through jugular foramen -> follow tympanic branch through floor of ear to enter middle ear -> forms promontory plexus on medial wall -> lesser superficial petrosal off plexus pass through anterior wall of ear to middle cranial fossa -> through foramen ovale to enter infratemporal fossa and synapse with otic ganglion

41
Q

Describe the pathway of the parasympathetic postganglionic fibers of CN IX that eventually go to the parotid gland.

A

otic ganglion -> jumps on auriculotemporal of V3 -> follows to parotid gland

42
Q

What fiber types does the vagus nerve have? 1. What do each of these innervate? 2

A
  1. SVE, GVE, SVA, GSA, GVA
  2. SVE: to pharyngeal constrictors and soft palate
    GVE: to heart and GI system above splenic flexure
    SVA: from taste of pharynx
    GSA: from ear canal
    GVA: from GI system and BP in aorta
43
Q

What is the nucleus for GVE fibers of CN X? 1. Where do these fibers go to? 2

A
  1. dorsal nucleus of vagus

2. GI system and heart

44
Q

Because some fibers of parasympathetic system of CN X preganglionic from the dorsal nucleus migrate to the nucleus ambiguus, what is the result of destruction of the ambiguus?

A

flaccid paralysis of pharyngeal constrictors and have tachycardia

45
Q

Where does CN X exit the brainstem?

A

posterolateral fissure of medulla

46
Q

Where is the location of preganglionic parasympathetic cell bodies for CN X to the heart?

A

nucleus ambiguus

47
Q

Where are the postganglionic cell bodies for the parasympathetic CN X?

A

walls of organs (Meissner and Auerbachs, etc)

48
Q

Where and the cell bodies of the sacral parasympathetic fibers?

A

lateral horn of S2. S3, and S4

49
Q

What does the sacral parasympathetics innervate?

A
  1. large intestine after splenic flexure
  2. smooth muscle of bladder
  3. smooth muscle in corpora cavernosum and spongiosum (penis)
50
Q

What does damage to the cauda equina cause?

A
  1. flaccid paralysis of legs

2. loss of defecation, micturition ability (no GVA/GVE loop) so catherterize

51
Q

Where are the cell bodies for the lumbar plexus? 1. What muscles do these innervate? 2

A
  1. L1-L4

2. anteromedial muscles

52
Q

Where are the cell bodies for the sacral plexus? 1. What muscles do these innervate? 2

A
  1. L4-S2

2. posterolateral muscles

53
Q

What does damage just above S2 cause?

A
  1. spastic paralysis of legs

2. rectum and bladder still works but cannot control or be aware of sensation of defication

I. Neuroanatomy (18 decks)

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