Learning Objectives: Autonomic Nervous System of the Head and Neck 1.

Describe how the ANS is monitored and controlled by structures in the CNS (brainstem and hypothalamus). The hypothalamus gets input on temperature, blood pressure, fluid and electrolyte balance, body weight; it sends neural and hormonal signals to the pituitary gland for endocrine function, and sends neural signasl to ANS to coordinate parasympathetic and sympathetic responses. Hypothalamic nuclei medial forebrain bundle (MFB), dorsal longitudinal fasciculus (DLF), mammillotegmental tract (MTegT), hypothalamo-spinal tract in lateral medulla & lateral spinal cord to symp/pre cell bodies. 2. Describe the basic anatomical characteristics of the ANS to the head and neck Symp/Pre cell bodies in T1-T4 lateral horn, goes out ventral root to white ramus to sympathetic chain ganglia to superior cervical ganglion to internal carotid to other nerves to body parts. Para/Pre cell bodies in brainstem nuclei (vagus X, oculomotor edinger-westphal III, superior salivatory nucleus VII, inferior salivatory nucleus IX). III fibers go with oculomotor nerve to eye, post fibers after ciliary ganglion to short ciliary nerves to sphincter muscles of pupil and ciliary mushcles of lens. VII leave brainstem as nervous intermedius, to greater petrosal nerve, to nerve of pterygioid canal, to synapse in pterygopalatine ganglia, to branches of V2, to lacrimal gland and nasal mucosa. Also from nervous intermedius to chorda tympani to V3 to submandibular ganglia to sublingual and submandibular glads. IX from nucleus to lesser petrosal nerve to otic ganglia to V3 to parotid gland X from nucleus to target organs in body.

3. Describe the clinical deficits associated with autonomic dysfunctions related to cranial nerves III, VII, IX and X. 3: parasympathetic deficit causes mydriasis (dilated pupil), loss of light reflex, loss of accommodation, and usually “big” ptosis due to motor loss of levator palpebrae. 7: Para loss causes dry eye or no crying, and dry mouth. 9: para loss causes no real effect because theres enough saliva from other glands. 10: loss causes difficulty swallowing and speaking (somatomotor to larynx and pharynx). Other deficits uncommon and non effective.

4. Describe the clinical deficits associated with autonomic dysfunction related to lesions of the superior cervical ganglia. Horner’s Syndrome: “little” ptosis, drooping of upper eyelid due to superior tarsal muscle loss. Miosis (pupil constricted), and facial anhydrosis (no sweating).