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semester 2

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Question
Answer
What does the sympathetic system generally innervate?   Innervate VASCULAR smooth muscle, sweat glands & arrector pili muscles. Will innervate superior tarsal muscle & dilator pupillae in the head.  
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What does the parasympathetic system generally innervate?   Mucous gland in general. 3 pairs of salivary glands, lacrimal gland, and sphincter pupillae & cilliary muscles.  
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Where is the source of all preganglionic sympathetic fibers?   LATERAL HORN T1-L2  
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Where do the pregang sympathetic fibers go once they leave the spinal cord?   They leave via ventral root, then spinal nerve, then ventral rami, then with rami to whichever level it needs to go btwn T1 & L2 OR up into neck into cervical sympathetic trunk.  
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Where do these pregang sympathetic fibers synapse?   In the sympathetic trunk or one of the 3 cervical sympathetic chain ganglia if they are going to head.  
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Where do these postgan sympathetic fibers go after synapsing?   1.) go out gray rami to get to a cervical ventral rami 2.)go out to chest as cervical cardiac branches to make cardiac plexus 3.)travel as external/internal carotid nerves to jump on corresponding arteries & make plexuses to get to target tissue.  
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What is the exception in terms of getting on a plexus to get to a target tissue to provide sympathetic innervation?   The Deep Petrosal Nerve. Here, some fibers come off internal carotid plexus and form ONE nerve to get to the target.  
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How many pairs of parasympathetic ganglia do you have in the head? What are the name of these ganglia?   4 pairs. Ciliary ganglion, pterygopalatine ganglion, submandibular ganglion & otic ganglion.  
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Which parasympathetic nerve has no named, discrete ganglion associated with it? What does it have instead?   VAGUS. It has diffuse ganglia to synapse in organ walls instead of a named ganglion.  
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Which nerve is associated with the ciliary ganglion?   CN3  
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Which nerve is associated with pterygopalatine ganglion?   CN7  
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Which nerve is associated with submandibular ganglion?   CN7  
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Which nerve is associated with otic ganglion?   CN9  
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What ganglion is associated with CN5/trigem?   NONE. It has no preganglion nuclei of its own, but it will still carry pre & post around the head.  
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How does CN3 carry pregang parasympath fibers into the orbit to the ciliary ganglion?   These fibers go through INFERIOR division of CN3 then branch into a short motor root to ciliary ganglion (just 2-4 mm), where they synapse.  
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Where is the ciliary ganglion located?   Laterally to optic nerve near apex of orbit.  
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What else passes through the ciliary ganglion? Do they synapse there?   Sensory root from nasociliary (V1) & a postsynaptic sympathetic root from cavernous sinus too. Neither of them synapse in the ganglion.  
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Where do postgang parasympathetic fibers from CN3 go?   Unite with fibers from other 2 roots (sensory & sympathetic) to form SHORT ciliary nerves, then pierce back of eyeball to get to eyeball musles.  
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What eyeball muscles do the SHORT ciliary nerves reach & innervate?   The parasympathetic fibers get the ciliary muscles & sphincter pupillae. The sympathetic fibers get the dilator pupillae.  
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What other eye muscle in the orbit gets sympathetic innervation? What is supplying that innervation?   The superior tartsal muscle. Innervation is from internal carotid plexus used to hold eye lid up.  
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What nerves are the preganglionic parasympathetic fibers from CN7 going through?   Greater Petrosal & Chorda Tympani  
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How does the greater petrosal nerve get to the pterygopalatine ganglion?   Branches off CN7 at geniculate ganglion (sensory ganglion) w/in petrous temporal bone. It exits anteriorly toward foramen lacerum & past its cartilage into pterygoid canal & becomes nerve to pterygoid canal & fossa where the ganglion is.  
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Where is the pterygoid canal?   It is hidden by cartilage in the anterior margin of the foramen lacerum.  
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What joins the Greater Petrosal as it goes down to the pterygoid canal? What do they form all together?   Deep Petrosal nerve (which is postgang sympath off internal carotid plexus). Together they form nerves to pterygoid canal.  
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Where do postgang parasympath fibers go after synapsing in pterygopalatine ganglion?   Leaves via V2 to mucous memb in nose, paranasal sinuses, palate & upper pharynx & eventually lacrimal glands & upper eyelid skin too.  
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How do postgang parasympath fibers reach the lacrimal gland & upper eyelid skin?   After V2, some branches come off & become zygomatic nerve that goes thru inferior orbital fissure & splits into zygomaticotemporal & zygomaticofacial in orbit. Zygomaticotemporal reaches lacrimal nerve to lacrimal gland & skin of upper eyelid.  
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How does the facial nerve get to the submandibular ganglion?   CN7 gives off chorda tympani toward the end just before leaving stylomastoid foramen. Chorda tympani comes back into middle ear & passes anteriorly across tympanic membrane & handle of malleus out the middle ear at base of skull thru petrotympanic fissure  
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Where is the petrotympanic fissure leading chorda tympani to?   Chorda tympani goes out the fissure to infratemporal fossa where it goes down and anteriorly to join lingual nerve from behind & runs with it to submandibular ganglion.  
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Where is the submandibular ganglion?   In paralingual space near deep part of submandibular gland.  
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Where do the postsynaptic parasympathetic fibers go after submandibular ganglion?   They can either synapse & run back to lingual nerve to go further anteriorly to sublingual gland for secretomotor action. OR they can pass thru to reach submandibular gland & synapse in THERE instead & do secretomotor stuff.  
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What else does chorda tympani carry? Where does that go?   Besides pregang parasympath, it also carries sensory for taste from anterior 2/3 of tongue. Those fibers go into tongue w/lingual nerve to reach taste buds.  
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How does CN9 get to the otic ganglion?   It goes through the jugular foramen & gives off tympanic branch that goes up thru inferior tympanic canaliculus to go into middle ear. Then forms a plexus on promontory & pierces anterior wall of middle ear to become lesser petrosal nerve to otic ganglion  
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How does lesser petrosal nerve get to the otic ganglion?   Lesser petrosal runs on anterior surface of petrous temporal bone just lateral to Greater petrosal & goes thru foramen ovale. Just below skull, it get to otic ganglion on medial surface of V3 to synapse there.  
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Where do postganglionic fibers from the otic ganglion go?   They go to auriculotemportal nerve (V3) and runs posteriorly on medial side of TMJ, then encircles MMA. Then curves laterally behind TMJ to get to parotid gland to do secretomotr stuff.  
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What does CN9 innervate again?   Posterior 1/3 of tongue & parotid gland.  
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Where do preganglionic parasympathetic fibers of vagus go? What do they do?   The visceral walls. They innervate the mucous glands lining those walls. Basically glands in the pharynx, larynx & esophagus. Will also act as brakes to the heart via 2 cervical cardiac nerves going down into chest & join sympath cardiac branches too.  
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Where do skeletal motor fibers from vagus go?   In the head, it goes to soft palate (except tensor veli) & most of pharynx (except stylopharyngeus) all of larynx & upper esophagus (b/c that's skeletal).  
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