Sympathetics of head and neck Flashcards

1
Q

Where does the sympathetic innervation to the head and neck arise from?

A

T1-L2 of spinal cord

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2
Q

How does the sympathetic pre-ganglionic nerve fibre reach the superior cervical ganglion?

A

Travels to the sympathetic chain at its spinal level

then travels up the sympathetic chain

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3
Q

Where does the sympathetic pre-ganglionic nerve fibre synapse with the sympathetic post-ganglionic nerve fibre?

A

In the superior cervical ganglion

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4
Q

What is the superior cervical ganglion?

A

Most superior ganglion of sympathetic chain

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5
Q

What structures in the head and neck are innervated by the sympathetic nervous system?

A

Smooth muscle of blood vessels

Superior tarsal muscle

Dilator pupillae muscle

Sweat glands

Arrector pili muscles

Lacrimal and salivary glands

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6
Q

What type of muscle is the superior tarsal muscle made up of?

A

Smooth muscle

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7
Q

Where is the superior tarsal muscle located?

A

Eyelid

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8
Q

What is the action of the superior tarsal muscle?

A

Retracts the eyelid

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9
Q

What type of muscle is the dilator pupillae muscle?

A

Smooth muscle

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10
Q

What is the action of the dilator pupillar muscle?

A

Dilates the pupil

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11
Q

What effect does sympathetic innervation have on the lacrimal and salivary glands?

A

Decreases volume of secretions

makes them more viscous

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12
Q

How do the sympathetic post-ganglionic nerve fibres reach the blood vessels in the head and neck that they supply?

A

From the superior cervical ganglion, run around the carotid arteries, forming the carotid plexus

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13
Q

How do the sympathetic post-ganglionic nerve fibres reach the sweat glands in the head and neck that they innervate?

A

Run around the external carotid artery

which supplies the face and scalp

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14
Q

How do the sympathetic post-ganglionic nerve fibres reach the muscles in the eye that they innervate?

A

Run around internal carotid artery, opthalmic artery
which supplies the eye

May also join the CN3 oculomotor nerve and the opthalmic branch of the CN5 trigeminal nerve
which supply the eye

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15
Q

What is Horner syndrome?

A

Group of signs and symptoms that result due to damage to the sympathetic trunk

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16
Q

What are the signs and symptoms of Horner’s syndrome?

A

Partial ptosis - droopy eyelid

Miosis - constricted pupil

Anhydrosis - decreased sweating

17
Q

Why is partial ptosis seen with Horner’s syndrome?

A

Loss of sympathetic innervation to superior tarsal muscle
loss of retraction of eyelid

Partial because levator palpabrae superioris muscle which is innervated by the CN3 oculomotor nerve are both still functional

18
Q

Why is miosis seen with Horner’s syndrome?

A

Loss of sympathetic innervation to dilator pupillae muscle

loss of dilation of pupil

19
Q

Why is anhydrosis seen with Horner’s syndrome?

A

Loss of sympathetic innervation to sweat glands in face

loss of sweat production

20
Q

What are some the causes of Horner’s syndrome?

A

Lung apex pancoast tumour

Internal carotid artery dissection