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 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 (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"
• mucus secretion
  • 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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