Session 4 - Autonomic innervation of the head and neck Flashcards
What supplies sympathetic innervation to the head and neck?
The sympathetic trunk
Where can the sympathetic trunk be found?
o Anterolateral to the vertebral column
o Lying on the prevertebral fascia and muscles
o Deep to the carotid sheath.
Where do pre-ganglionic sympathetic fibres arise
In the first thoracic neural segment
Where do pre-ganglionic neural segments synapse?
In one of the three cervical sympathetic ganglia (Superior, middle or inferior)
In what form do the post ganglionic sympathetic nerve fibres travel after synapsing?
As the internal and external carotid nerves
What do the post-ganglionic fibres from the superior cervical ganglion travel with?
THe internal and external carotid arteries
Where does the sympathetic superior cervical ganglion innervate?
o The Pharyngeal Plexus
o The Upper 4 Cervical Nerves
o Cardiac Branch to the Cardiac Plexus
What do the post-ganglionic fibres of the middle cervical ganglion travel with?
Inferior thyroid artery
Where does the middle cervical ganglion travel to?
5th and 6th cervical nerves
Cardiac branch ofthe cardiac plexus
What does the inferior cervical ganglion travel with? What does it combine with later on?
Vertebral artery
1st thoracic ganglion to form the stellate ganglion
Where does the inferior cervical ganglion innervate?
7th and 8th Cranial nerves
Cardiac branch to the cardiac pexus
What are the four parts of parasympathetic ganglia in the head?
Ciliary ganglion
Pterygopalatine ganglion
Submandibular ganglion
Otic ganglion
What are the four cranial nerves with brainstem nuclei?
Oculomotor (CN III)
Facial (CN VII)
Glossopharyngeal (CN IX)
Vagus (CN X)
What three crainial nerves reach a parasympathetic ganglion, and give their identities
Oculomotor Ciliary Ganglion
Facial Pterygopalatine / Submandibular Ganglion
Glossopharyngeal Otic Ganglion
Where do preganglionic parasympathetic fibres synapse?
Either in four ganglia or in the walls of the organs they supply in the neck, thorax and abdomen
Where does the ciliary ganglion lie?
In the orbital cavity, next to the optic nerve
What are the parasympathetic neve fibres of the ciliary ganglion derived from?
Oculomotor nerve
Sphincter papillae
Ciliary muscles
Where do sympathetic nerve fibres of the ciliary ganglion come from?
The plexus of the opthalmic artery (first branch of the internal carotid artery) which is distributed to the eyeball
Sensory fibres from the eyeball pass to the nasociliary nerve
Where do the pterygopalantine ganglion lie?
In the pterygopalantine fossa
Where are the parasympathetic fibres of the pterygopalantine ganglion derived from?
Facial nerve via the greater pterosal nerve
What does the greater pterosal nerve, derived from the ptergopalantine ganglion, innervate
Lacrimal glands
Glands of the nose, palate and nasopharynx
Where do the sympathetic fibres of the pterygopalantine ganglion come from?
THe superior cervical ganglion via the plexus on the internal carotid artery
Where are the sympathetic fibres from the superior cervical ganglion distributed to?
Nose, palate and nasopharynx
Where is the submandibular ganglion found?
Suspended from the lingual nerve by small branches
Where are parasympathetic fibres of the submandibular ganglion derived from?
Facial nerve via the chorda tympani and then the lingual nerve
What do the parasympathetic branches of the submandibular ganglion innervate?
Submandibular Gland
Sublingual Gland
Other glands on the floor of the oral cavity
Where do sympatehetic fibres of the submandibular cervical ganglion spring from and along?
Along the facial artery
Taste fibres may also pass through ganglion
Where do parasympathetic fibres of the otic ganglion come from?
Glossopharngeal nerve via the auriculotemporal nerve, branch into the parotid gland
Where do the sympathetic fibres of the otic ganglion come from?
Sympathetic fibres come from the superior cervical ganglion
What route do the sympathetic fibres of the otic ganglion follow
Along the middle meningeal artery, passing into the parotid gland
Outline some direct autonomic supply of the head and neck
o Glossopharyngeal Nerve (CN IX) (Direct or via Pharyngeal plexus) Glands of the oropharynx Posterior Third of the Tongue o Vagus Nerve (CN X) Glands of the laryngopharynx, larynx, oesophagus and trachea Ganglion cells are on the viscus
Give nucleus, organs innervated and action for following nerves
III
Edinger-Westphal Eye. Pupil, Ciliary Pupillary constriction
Give nucleus, organs innervated and action for following nerves
VII
Superior Salivatory Nasal, Lactrimal, Submandibular and Sublingual Glands Serous Secretions
Give nucleus, organs innervated and action for following nerves
IX
Inferior Salivatory Parotid Serous Secretions
Give nucleus, organs innervated and action for following nerves
X
Dorsal Vagal Motor Nucleus Wide distribution Laryngeal function
(I.e. Neck only)
What is Horner’s syndrome?
Interruption of a cervical sympathetic trunk results in Horner’s Syndrome. It is manifested by the Absence of Sympathetically Stimulated functions on the Ipsilateral side of the head.
What is miosis?
Constriction of the pupil
Parasympathetically stimulated Sphincter Papillae of the pupil is unopposed
What is ptosis?
Drooping of superior eyelid
Paralysis of smooth muscle fibres interdigitated with the aponeurosis of the Levator Palpebrae Superioris that collectively constitute the Superior Tarsal muscle (innervated by Sympathetic fibres)
What is vasodilation?
Redness and increased temperature of the skin
Loss of sympathetic tone
What is anhydrosis?
Absence of sweating
