1

Repeat campaign 2008 A/L

AUTONOMIC NERVOUS SYSTEM
Controlling the necessary adjustment for the optimal internal environment.
Controlled by higher centres hypothalamus.
SYMPATHETIC PARASYMPATHETIC
Action Prepares body for emergency Conserves & restores energy
Outflow T1-L2(3) Cranial nerves III, VII, IX, & X;
S2,3 & 4
Preganglionic fibres Myelinated B Myelinated B
Ganglia Paravertebral (sympathetic
trunks), prevertebral(eg:
celiac,superior
mesenteric,inferior mesenteric)
Small ganglia close to
viscera(eg:otic,cilliary)or
ganglion cells in
plexuses(eg:cardiac,pulmonary)
Neurotransmitter within
ganglia
Acetylcholine Acetylcholine
Postganglionic fibres Long non myelinated C Short non myelinated C
Characteristic activity Wide spread due to many post
ganglionic fibres & liberation of
epinephrine & norepinephrine
from supra renal medulla.
Discrete action with few post
ganglionic fibres
Neurotransmitter at
postganglionic endings
Norepinephrine at most
endings & acetylcholine at few
endings(sweat glands)
Acetylcholine at all endings
Higher control Hypothalamus Hypothalamus



CERVICAL SYMPATHETIC TRUNK
The sympathetic chain continues upwards from thorax by crossing the neck of the first rib
Then ascends embedded in the posterior wall of the carotid sheath to the base of the skull
no white rami communicans from cervical part of sympathetic chain
preganglionic fibres origin from lateral grey horn of T1-T4 & ascend to the cervical ganglia.
3 ganglions Superior, Middle ,Inferior
superior-fusion of C1-C4 ganglia
Middle- fusion of C5-C6 ganglia
Inferior fusion of C7-C8 ganglia

Superior cervical ganglion
Largest
Lies opposite C2 and C3 vertebrae
Sends grey rami communicantes to C1-4 spinal nerves

Middle cervical ganglion
Lies level with C6 vertebra
Sends grey rami to C5 and 6 nerves
2

Repeat campaign 2008 A/L

Inferior ganglion
Lies level with C7
Tucked behing the vertebral artery
Frequently fuses with the first thoracic ganglion to form stellate ganglion at the neck
of the first rib.
Grey rami pass from it to C7 and 8 nerves

Superior Cervical Ganglion




Dilator papillae Lacrimal gland Parotid gland Submandibular &
Sublingual gland

CLINICALS
Horners syndrome
1. Partial ptosis slight drooping of the eyelid partial paralysis of levator palpebrae
2. Meiosis constriction of the pupil due to unopposed parasympathetic innervation via CNIII
3. Anhydrosis loss of sweating sudomotor denervation
4. Enophthalmos retraction of the eyeball

Due to interruption of the sympathetic nerve supply to the head and neck.
Causes
- Lesion in the brain stem or cervical part of the spinal cord- damage to the descending tracts from
hypothalamus ( Reticulospinal tract)
-Lesion of the preganglionic fibre from the T1 spinal segment
Multiple sclerosis, syringomyelia, Compression from a cervical rib, Klumpkes
paralysis
-damage to the postganglionic fibres from the superior cervical ganglion
Argyll Robertson pupil
- Does not contracts in response to the light
- Contracts in accommodation
Due to lesion of the fibres from the pretectal nucleus to the Edinger Westphal nuclei
Otic Ganglion
Cilliary Ganglion Pterygopalatine
ganglion
Internal carotid plexus
Submandibular
Ganglion
External carotid plexus