The Autonomics of the Head & Neck

Question 1

the parasympathetic system in the head & neck:

the cranial portion of the parasympathetic nervous system leaves the ___ within four cranial nerves (4)

the parasympathetic fibers contained within cranial nerves ___ supply structures within the head (3)

the parasympathetic fibers contained in cranial nerve ___ supply structures in the thorax & abdomen (1)

Answer 1

brainstem
III, VII, IX, & X

III, VII, IX

X

Question 2

the parasympathetic system in the head & neck:

the parasympathetic fibers contained within cranial nerves III, VII, IX, & X are (pre/post-ganglionic) & must relay in parasympathetic ganglia much like the fibers contained within the ___ nerves

Answer 2

preganglionic

pelvic splanchnic nerves

Question 3

the parasympathetic system in the head & neck:

four pairs of parasympathetic ganglia within the head (4)

Answer 3

ciliary
pterygopalatine
submandibular
otic

Question 4

the parasympathetic system in the head & neck:

of the four ganglia:

• the oculomotor nerve (CN III) supplies preganglionic fibers to the ___ ganglion
• the facial nerve (CN VII) supplies preganglionic parasympathetic fibers to both the ___ & ___ ganglia
• the glossopharyngeal nerve (CN IX) supplies preganglionic parasympathetic fibers to the ___ ganglion

Answer 4

• ciliary ganglion
• pterygopalatine & submandibular ganglia
• otic ganglion

Question 5

the parasympathetic system in the head & neck:
the ciliary ganglion:

a small ganglion situated toward the back of the ___ on the lateral side of the ___ nerve

three roots (3)

Answer 5

orbit
optic nerve

sensory root
sympathetic root
parasympathetic (motor, oculomotor) root

Question 6

the parasympathetic system in the head & neck:
the ciliary ganglion:
sensory root:

connects the ciliary ganglion to the ___ nerve

Answer 6

nasociliary

Question 7

the parasympathetic system in the head & neck:
the ciliary ganglion:
sympathetic root:

conveys (pre/postgang) (symp/parasymp) fibers through it form the ___ plexus

Answer 7

postganglionic sympathetic fibers

internal carotid plexus

Question 8

the parasympathetic system in the head & neck:
the ciliary ganglion:
parasympathetic (motor, oculomotor) root:

contains (pre/postgang) (symp/parasymp) fibers which synapse in the ganglion

Answer 8

preganglionic parasympathetic fibers

Question 9

the parasympathetic system in the head & neck:
the ciliary ganglion:

postganglionic parasympathetic fibers exit the ganglion through ___ nerves (along w/ sensory fibers from the ___ nerve & sympathetic fibers from the ___ plexus) to the eyeball

Answer 9

short ciliary nerves
trigeminal nerve
internal carotid plexus

Question 10

the parasympathetic system in the head & neck:
the ciliary ganglion:

postganglionic parasympathetic fibers innervate: (2)

postganglionic sympathetic fibers innervate: (2)

Answer 10

ciliary muscle
sphincter of the pupil

dilator of the pupil
vasculature of the eye

Question 11

the parasympathetic system in the head & neck:
the pterygopalatine ganglion:

lies in the ___ fossa where it is suspended from the ___ division of the ___ nerve by two (___) communicating branches

Answer 11

pterygopalatine fossa
maxillary division of the trigeminal nerve
pterygopalatine

Question 12

the parasympathetic system in the head & neck:
the pterygopalatine ganglion:

receives its preganglionic parasympathetic fibers from the nerve of the ___ canal (a combination of preganglionic parasympathetic & taste fibers from the ___ nerve of cranial nerve ___ & postganglionic sympathetic fibers from the ___ nerve)

Answer 12

pterygoid canal
greater petrosal nerve of cranial nerve VII
deep petrosal nerve

Question 13

the parasympathetic system in the head & neck:
the pterygopalatine ganglion:

postganglionic parasympathetic fibers from the ganglion join seven nerves: (7)

Answer 13

• greater & lesser palatine nerves
• posterior nasal branches
• nasopalatine nerve
• pharyngeal nerve
• orbital branches
• zygomatic nerve (which ultimately passes them off to the lacrimal nerve of V1)
• superior alveolar nerves

Question 14

the parasympathetic system in the head & neck:
the pterygopalatine ganglion:

all of the postganglionic parasympathetic branches also contain sensory fibers from the ___ nerve & postganglionic sympathetic fibers from the ___ nerve

the greater & lesser palatine branches also contain taste fibers from the ___ nerve

Answer 14

trigeminal nerve
deep petrosal nerve

greater petrosal nerve (CN VII)

Question 15

the parasympathetic system in the head & neck:
the submandibular ganglion:

lies medial to the ___ suspended from the ___ nerve & close tot he upper border of the ___ gland

attached to the ___ nerve by communicating branches containing preganglionic & postganglionic (symp/parasymp) fibers

Answer 15

mandible
lingual nerve (V3)
submandibular gland

lingual nerve
parasympathetic fibers

Question 16

the parasympathetic system in the head & neck:
the submandibular ganglion:

its preganglionic parasympathetic fibers reach the ___ nerve of the ___ through the ___ which contains preganglionic parasympaethtic & taste fibers (for taste buds of the anterior two-thirds of the tongue)

Answer 16

lingual nerve
trigeminal
chorda tympani (CN VII)

Question 17

the parasympathetic system in the head & neck:
the submandibular ganglion:

the chorda tympani leaves the ___ nerve in the ___ part of the ___ bone, traverse the ___ cavity, & leaves the skull through the ___ fisure

Answer 17

facial nerve
petrous part of the temporal bone
middle ear cavity
petrotympanic fissure

Question 18

the parasympathetic system in the head & neck:
the submandibular ganglion:

the (pre/postgang) (symp/parasymp) fibers synapse in the submandibular ganglion

some of these fibers proceed directly to the ___ gland

the remainder join the ___ nerve via the communicating branches & proceed forward to the ___ & ___ glands

Answer 18

preganglionic parasympathetic fibers

submandibular gland

lingual nerve
sublingual & lingual salivary glands

Question 19

the parasympathetic system in the head & neck:
the otic ganglion:

lies on the medial side of the ___ branch of the ___ nerve, just outside the ___ & deep in the ___ fossa

receives its (pre/postgang) (symp/parasymp) fibers from the ___ nerve

Answer 19

mandibular branch of the trigeminal nerve
foramen ovale
infratermporal fossa

preganglionic parasympathetic fibers
lesser petrosal nerve

Question 20

the parasympathetic system in the head & neck:
the otic ganglion:

the lesser petrosal nerve is a derivative of the ___ nerve & has a very ___ course

Answer 20

glossopharyngeal nerve

circuitous course

Question 21

the parasympathetic system in the head & neck:
the otic ganglion:

the glossopharyngeal nerve gives off the ___ branch that enters the ___ cavity & contributes to the ___ plexus along w/ sympathetic twigs from the ___ plexus & a twig from the ___ nerve

Answer 21

tympanic branch
middle ear cavity
tympanic plexus
internal carotid plexus
facial nerve

Question 22

the parasympathetic system in the head & neck:
the otic ganglion:

the preganglionic parasympathetic fibers then leave the plexus as the ___ nerve

this nerve exits the ___ bone & enters the ___ fossa via the hiatus of the ___ nerve running lateral & parallel to the ___ nerve

Answer 22

lesser petrosal nerve

petrous temporal bone
middle cranial fossa
hiatus of the lesser petrosal nerve
greater petrosal nerve

Question 23

the parasympathetic system in the head & neck:
the otic ganglion:

the lesser petrosal nerve exits the skull via the ___ & enters the ___ fossa

its (pre/postgang) fibers synapse on (pre/postgang) neurons in the otic ganglion

the postganglionic parasympathetic fibers are then passed on to the ___ nerve which distributes them to the ___ gland

Answer 23

foramen ovale
infratemporal fossa

preganglionic
postganglion

auriculotemporal nerve (V3)

parotid gland

Question 24

the sympathetic system in the head & neck:

all of the sympathetic fibers to the head are derived from the ___ ganglion

the preganglionic sympathetic neurons are located in the ___ horns (intermediolateral gray columns) of the ___ segments of the spinal cord

Answer 24

superior cervical ganglion

lateral gray horns

upper thoracic segments

Question 25

the sympathetic system in the head & neck: the superior cervical ganglion sends fibers along the ___ & ___ arteries (___ & ___ nerves)

Answer 25

external & internal carotid arteries | external & internal carotid nerves

Question 26

the sympathetic system in the head & neck: external carotid nerve: one or several nerves run downward from the ___ ganglion to the base of the ___ artery the nerves form a ___ plexus along the ___ artery & its branches

Answer 26

superior cervical ganglion external carotid artery external carotid plexus external carotid artery

Question 27

the sympathetic system in the head & neck: external carotid nerve: the nerves also send a smaller ___ plexus downward along the ___ artery the external carotid plexus supplies all of the areas of distribution of the ___ arteries including the ___ of the face & neck & the ___ glands

Answer 27

common carotid plexus common carotid artery external carotid arteries sweat glands salivary glands

Question 28

the sympathetic system in the head & neck: internal carotid nerve: the (smallest/largest) branch from the superior cervical ganglion to the head the nerve forms an ___ plexus on the ___ artery & follows its course while it is close to the ___ cavity, this plexus gives off twigs that join the ___ plexus on the medial wall of the ___ cavity

Answer 28

largest internal carotid plexus internal carotid artery middle ear cavity tympanic plexus tympanic cavity

Question 29

the sympathetic system in the head & neck: internal carotid nerve: two main groups of sympathetic fibers leave internal carotid plexus during the course of the internal carotid artery through the ___ sinus (2)

Answer 29

cavernous sympathetic root of the ciliary ganglion deep petrosal nerve

Question 30

the sympathetic system in the head & neck: internal carotid nerve: sympathetic root of the ciliary ganglion: runs forward through the ciliary ganglion w/o ___ the fibers enter the ___ nerves & are distributed to the dilator of the ___ & the vasculature of the ___

Answer 30

synapsing short ciliary nerves dilator of the pupil vasculature of the eye

Question 31

the sympathetic system in the head & neck: internal carotid nerve: deep petrosal nerve: joins the greater petrosal nerve to form the ___ the postganglionic sympathetic fibers of the deep petrosal nerve pass through the ___ ganglion w/o synapsing & are distributed w/ all of the branches of the ___ division of the ___ nerve

Answer 31

nerve of the pterygoid canal pterygopalatine ganglion maxillary division of the trigeminal nerve

Question 32

stimulation of the sympathetic fibers causes the following: dilation of the ___ (mydriasis) elevation of the ___ (smooth muscle component of the levator palpebrae superioris - "superior tarsalmuscle, mueller's muscle") vasoconstrictoin of the ___ of the ___ & ___ sweating of the ___ of the ___ & ___

Answer 32

pupil eyelid blood vessels of the head & neck skin of the face & neck

Question 33

horner's syndrome: interruption of the (symp/parasymp) pathway anywhere along its course to the head & neck induces horner's syndrome symptoms: - ___: drooping of the eyelid due to paralysis of the smooth muscle component of the levator palebrae superioris - ___: constriction of the pupil - ___: inhibition of sweating in face & neck - ___: of face & neck (redness) - ___: receding of the eye into the orbital cavity due to paralysis of the orbitalis muscle the heart rat may also (increase/decrease) b/c the (symp/parasymp) cardiac branches are derived from the cervical (symp/parasymp) ganglia

Answer 33

sympathetic - ptosis - myosis - anhydrosis - vasodilation - enophthalmus decrease sympathetic sympathetic ganglia