12 - Autonomics of the Head and Neck Flashcards Preview

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Flashcards in 12 - Autonomics of the Head and Neck Deck (19)
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1
Q

What are some responses in the head of the neck that are due to parasympathetics and sympathetics?

A
2
Q

Where in the spinal cord do the parasympathetics and sympathetics arise from?

A
3
Q

Fill in the following table relating to the sympathetic innervation of the head and neck.

A

- Sympathetic plexus on ECA is sweat glands, rest is ICA, especially following the opthalmic artery

  • Top 3 ganglia in the sympathetic chain are cervical ganglion
  • If synapsing at T1-L2 the sympathetics hitchhike on spinal nerves not blood vessels
4
Q

What is Horner’s syndrome and what does it indicate?

A

Pathology in the lung apex or common carotid artery as there is unopposed parasympathetics due to a pathology impinging on the sympathetics

e.g Pancoast’s tumour, CCA aneurysm or dissection

5
Q

When would you a partial ptosis and when would you have a full ptosis?

A

Partial: loss of sympathetic innervation to superior tarsal muscle

Full: CNIII lesion so loss of skeletal part of levator palpebrae superioris

6
Q

Which cranial nerves carry parasympathetics from the brainstem?

A

III, VII, IX and X

7
Q

At what spinal levels are the cervical ganglion?

A
8
Q

How do parasympathetics get from their origin in the brain stem to their target tissues?

A

Run with cranial nerves not blood vessels like the sympathetics

9
Q

What are the names of the following in the parasympathetic system of the head and neck:

  • Nuclei
  • Cranial nerves
  • Autonomic ganglion
  • Target tissues
A
10
Q

How do the parasympathetics that hitchhike with CN III reach their target tissue?

A

- Ciliary is the ganglion associate with oculomotor nerve

  • Remember parasympathetics lay on outside of nerve so they are affect first in raised ICP
11
Q

Describe the pupillary light reflex and why if you shine light into one eye, both pupils constrict in response.

A
12
Q

How do the parasympathetics that hitchhike with CN VII reach their target tissue?

A
  • Hitchhike with greater petrosal and chorda tympani nerve

- Pterygopalatine and Submandibular ganglion

  • Post ganglionics run with trigeminal lingual nerve
13
Q

How would you figure out where a lesion in the facial nerve is?

A
  • Ask about dry eyes, dry mouth, facial expression
  • If parasympathetics spared then must be after it has left stylomastoid foramen
14
Q

How do the parasympathetics that hitchhike with CN IX reach their target tissue?

A
  • Jugular foramen along the tympanic nerve which is sensory to the middle ear
  • Then parasympathetics join lesser petrosal nerve and go to otic ganglion in infratemporal fossa
  • Hitchhikes onto auricotemporal Vc after ganglion to parotid gland
15
Q

How do the parasympathetics that hitchhike with CN X reach their target tissue?

A
16
Q

What target tissue are associated with the four named parasympathetic ganglia?

A
17
Q

What do the middle and superior cervical ganglia go on to innervate?

A
18
Q
A
  • Hyperthyroidism
  • Raised thyroid increases the sensitivity of sympathetics so overstimulation of sympathetics has lead to increased activity of the superior tarsal muscle
  • Exophthalmus only associated with Grave’s
19
Q

What has happened to the ventricles and why are the patient’s pupils dilated?

A
  • There has been midline shift due to increased ICP
  • Increased ICP is pushing on parasympathetics sitting on periphery of oculomotor nerve damaging it
  • Need to do a craniotomy