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Structural Basis of Medical Practice
(21 Nov 2019,
Autonomic Nervous System for the Head and Neck
Cell Body Locations for the Sympathetic division of the autonomic NS
preganglionic cell bodies - intermediolateral cell column of T1 - T4
postganglionic cell bodies - superior cervical sympathetic trunk ganglion
Cell Body Locations for the Parasympathetic division of the autonomic NS
preganglionic cell bodies - located in the CNS
Edinger-Westphal nucleus (fibers travel in oculomotor n.)
lacrimal nucleus (greater superficial petrosal nerve of facial n.)
superior salivatory nucleus (chorda tympani of fascial n.)
inferior salivatory nucleus (lesser superficial petrosal n. of CN IX via recurrent tympanic branch)
postganglionic cell bodies (listed in order as postganglionic to the preganglionic locations above)
ciliary ganglion (fibers follow trigeminal short ciliary nn.)
pterygopalatine ganglion (follow branches of maxillary n.)
submandibular ganglion (follow lingual n.)
otic ganglion (follow auriculotemporal n.)
Sympathetic GVE functions (disruption causes Horner's syndrome)
Pupil dilation - pupil dilator m.
loss of pupil dilator results in pupil constriction (parasympathetic GVE to pupil constrictor m. is unopposed)
elevate superior tarsal plate - superior tarsal m. (Mueller's muscle) (if paralyzed - mild ptosis results)
loss of Mueller's muscle causes ptosis
Vasoconstriction - vessel smooth m.
loss of vasoconstriction causes, red eye (conjunctival injection), flushing, warm skin, nasal congestion (engorged erectile tissue of nasal cavity)
Sudomotor activity - sweating (exception to pharmacology - cholinergic)
loss of sudomotor causes dry skin
Viscous saliva secretion from submandibular gland
loss of viscous saliva reduces protection from trigeminal irritants
Parasympathetic GVE functions (CNs III, VII, IX)
pupil constriction - pupillary sphincter.
loss of pupil constrictor muscle causes pupil dilation by the unopposed dilator papillae muscle
accommodation - ciliary m.
loss of ciliary m. causes failure to focus on near objects
lacrimal secretion - tears
loss of lacrimation causes "dry eye"
loss of mucus secretion causes dry mucosa of nasal cavity and of air sinuses leading to epistaxis (nose bleed)
salivation - submandibular gland, sublingual gland, parotid gland
loss of salivation causes difficulty in deglutition and digestion
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Topic revision: r4 - 21 Nov 2019,
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