Practical 2 - station 4 - autonomics of the head & neck Flashcards
Where does the cervical region of the sympathetic trunk lie?
Anterior and lateral to the vertebral column
Superior to the C1 vertebra and carotid sheath cranial base
What outflow does the sympathetic trunk receive?
Thoracolumbar
What does the cervical portion of the sympathetic trunk consist of?
3 ganglia - superior, middle, inferior which all receive presynaptic fibres and synapse with postsynaptic fibres in ganglia to send fibres to head and viscera of the neck via rami
What happens if there is a lesion to the sympathetic trunk in the neck?
Horner syndrome
What are the symptoms of Horner syndrome?
miosis as paralysis of dilator pupillae muscle
ptosis as paralysis of smooth tarsal muscle with striated levator palpabrae superioris muscle
enopthalmos as paralysis of rudimentary smooth orbital muscle in orbit floor
anhydrosis as lack of sympathetic vasoconstrictive nerve supply to blood vessels and sweat glands
What does miosis mean?
contraction of the pupil
what does ptosis mean?
drooping of superior eyelid
what does enopthalmos mean?
sinking in of the eye
what is anhydrosis?
vasodilation and absence of sweating on face and neck
Which nerves provide the parasympathetic supply to the eye and glands of the face?
Oculomotor
Facial
Glossopharyngeal
What structures does the oculomotor nerve innervate?
Ciliary muscle (accommodation of lens) Sphincter papillae (pupillary constriction)
What structures does the facial nerve innervate?
Secretomotor fibres to lacrimal, submandibular, sublingual glands
What structures does the glossopharyngeal nerve innervate?
Secretomotor to parotid gland
DIfference in symptoms between horners syndrome and oculomotor palsy?
Horners - partial ptosis and constricted pupil (misosis), dry skin as produce less sweat, facial flushing
Occulomotor - full ptosis, dilated pupil (mydriasis), eye down and out
