Wednesday, 3-23-ANS of the Head (Stephens)

Question 1

The sympathetic trunk is located ___ to the common carotid and ___ to the longs colli and capitus muscles

Answer 1

Posterior

Anterior

Question 2

Where are preganglionic sympathetic neurons located?

Answer 2

Preganglionic sympathetic fibers to the head and neck originate in preganglionic sympathetic cell bodies located in the intermediolateral cell column of T1-2

Question 3

Where are postganglionic sympathetic neurons located?

Answer 3

They originate from postganglionic sympathetic neurons located in one of the cervical sympathetic ganglia

Question 4

There are no preganglionic sympathetic fibers in the __.

Answer 4

Head

The preganglionic sympathetic fibers in the neck are restricted to the cervical sympathetic trunk where they synapse upon postganglionic neurons

Question 5

How do preganglionic sympathetic fibers exit the SC?

Answer 5

Via the ventral root, travel through the white ramus to the sympathetic trunk, where they ascend in the sympathetic chain before terminating in 1 of the cervical sympathetic ganglia

Question 6

The ___ ganglion is a large elliptical ganglion located posterior to the internal carotid artery, embedded in the pre vertebral fascia at the level of C1-2 and on the surface of the longus capitus muscle at the level of the 1st cervical vertebra

Answer 6

superior cervical

Question 7

Where does the superior cervical ganglion primarily receive its preganglionic sympathetic fibers from?

Answer 7

Mainly from T1

Question 8

The ___ plexus follows the internal carotid a. into the skull and branches at the level of the carotid siphon

Answer 8

internal carotid

-The internal carotid n. leaves the superior cervical ganglion and forms the internal carotid plexus in the tunica adventitia of the internal carotid

Question 9

What are the 4 branches from the internal carotid plexus?

Answer 9

• Perivascular
• Sympathetic branch to the ciliary ganglion
• Deep petrosal n.
• Carotico-tympanic n.

Question 10

Where does the vertebral ganglion sit?

Answer 10

On the vertebral a.

-The vertebral ganglion is located at the level of C7 anterior to the vertebral a.

Question 11

The __ ganglion sends postganglionic sympathetic fibers to the 6th cervical n. and vertebral plexus

Answer 11

vertebral

Question 12

The vertebral ganglion sends a cord, the ___, which loops around the anterior surface of the subclavian a. and terminates in the inferior cervical or stellate ganglion

Answer 12

ansa subclavia

Question 13

___ is a common sequela of SC and neck trauma. It may caused by interruption of the cervical sympathetic trunk and/or transection of the SC above the level of T1

Answer 13

Horner’s syndrome

Question 14

List signs and symptoms of Horner’s syndrome:

Answer 14

• Slight ptosis (drooping) of the upper lid due to paralysis of the tarsal muscle
• Pupillary constriction
• Anhydrosis (no sweating) and blushing
• Enopthalmos due to paralysis of orbital is muscle of Muller
• Effects of Horner’s is usually transient

Question 15

A SC injury above the level of ___ is usually the main cause of Horner’s syndrome

Answer 15

T1

Question 16

Preganglionic parasympathetic neurons are located in ___ nuclei of the brainstem and SC

Answer 16

craniosacral

Question 17

Regarding the head and neck, the parasympathetic nuclei are comprised of preganglionic parasympathetic axons coursing with these cranial nerves:

Answer 17

III, VII, IX, and X

Question 18

Where does the Ediner-westphal nucleus send preganglionic parasympathetic fibers?

Answer 18

Ciliary ganglion

Question 19

Postganglionic parasympathetic fibers from the ciliary ganglion travel and synapse where?

Answer 19

Ciliary muscles of the lens and the sphincter pupillage muscles of the iris

Question 20

Preganglionic parasympathetic axons from the edinger-westphal nucleus travel on what CN?

Answer 20

III

Question 21

Pupillary constriction and thickening of the lens (near vision) are ___ responses

Answer 21

parasympathetic

Question 22

The sympathetic branch to the ciliary ganglion is a branch of the ___ plexus

Answer 22

internal carotid

Question 23

The sympathetic branch to the ciliary ganglion passes through the cavernous sinus, superior orbital fissure, and the ciliary ganglion before terminating as short ciliary nerves to the eyeball. These postganglionic sympathetic fibers innervate the ___ muscles

Answer 23

dilator pupillae and tarsal muscles

Question 24

Where does the superior salivatory nucleus send preganglionic parasympathetic fibers to?

Answer 24

Sphenopalatine and submandibular ganglia

Question 25

Postganglionic parasympathetic fibers from the submandibular ganglion travel and synapse where?

Answer 25

Postganglionic parasympathetic axons from the submandibuar ganglion will innervate the submandibular and sublingual salivary glands

Question 26

Trace the course of the preganglionic parasympathetic axons arising from the superior salivatory nucleus as they synapse on the submandibular ganglion:

Answer 26

Preganglionic parasympathetic fibers arise from the superior salivatory nucleus –> travel on facial n. –> go through P-T fissure and course through chorda tympani n. (branch of facial n.) –> chorda tympani n. merges with lingual n. –> synapse on submandibular ganglion

Question 27

This plexus distributes postganglionic sympathetic fibers to the submandibular and sublingual salivary glands:

Answer 27

-Facial plexus on the facial a.

Question 28

Where does the inferior salivatory nucleus send preganglionic parasympathetic fibers to?

Answer 28

Otic ganglion

Question 29

The otic ganglion receives preganglionic parasympathetic fibers from the ___, a branch of the glossopharyngeal n. (CN IX)

Answer 29

lesser petrosal n.

Question 30

Postganglionic parasympathetic axons from the otic ganglion innervate the ___ gland

Answer 30

parotid

Question 31

Postganglionic parasympathetic axons from the otic ganglion innervate the parotid gland via the ___ branches of the trigeminal n.

Answer 31

auriculotemporal

Question 32

Postganglionic sympathetic fibers from the __ ganglion coalesce as the internal carotid n., which forms the internal carotid plexus in the tunica adventitia of the internal carotid a. The plexus follows the internal carotid a. into the skull and branches at the level of the carotid siphon.

Answer 32

superior cervical

Question 33

Trace the preganglionic parasympathetic fibers from the superior salivatory nucleus to the sphenopalatine (pterygopalatine) ganglion

Answer 33

Superior salivatory nucleus sends preganglionic parasympathetic axons on the facial n. and travels on the greater petrosal n. (facial n. branch) and then the vidian n then synapses on sphenopalatine ganglion

Question 34

Postganglionic parasympathetic axons from the sphenopalatine ganglion will innervate the lacrimal gland, nasal cavity, nasopharynx, palate and orbit via the __ nerve

Answer 34

zygomatic –> communicating branch between the maxillary/infraorbital and lacrimal nerves

Question 35

After synapsing on the superior cervical ganglion, postganglionic sympathetic fibers travel through the __ nerve before synapsing on the lacrimal gland

Answer 35

Deep petrosal n.