Wednesday, 13 March 2019

Parasympathetics

Parasympathetics


FeatureSympathetic NSParasympathetic NS
Summary of responsesFight or flightRest and digest
Spinal cord distributionThoracolumbarCraniosacral
Preganglionic neuroneShortLong
Preganglionic neurotransmitterAcetylcholine (Ach, cholinergic)Acetylcholine (Ach, cholinergic)
Postganglionic neuroneLongShort
Postganglionic neurotransmitterNoradrenaline (NA, adrenergic) in most cases*Acetylcholine (Ach, cholinergic)

*Sweat being an exception 

Efferent i.e. motor
Afferent i.e. towards the CNS so sensory 

Parasympathetic motor efferents—This system is divided into cranial and sacral components, and parasympathetic efferents only synapse with postganglionic cells close to or within target viscera (allowing local discrete responses)

4 main parasympathetic nuclei (III, VII, IX, X) with synapses in 4 ganglia (NB ganglia are outside CNS)



NB Most ganglia are associated with some sensory and sympathetic nerves – these do not synapse in the ganglia, they merely travel through it. 

1. Cilliary (parasympathetic eye) 

Supplied by fibres from Edinger-Westphal nucleus (a/w CNIII) 
Function: pupil constriction and accommodation 

Image result for ciliary ganglion

2. Pterygopalatine Ganglion (aka sphenopalatine) in pterygopalatine fossa (cries/lubricates nasopharynx) 

Supplied by superior salivatory nuclues (a/w CN VII)  via GSPN and Vidian nerve. 
Function: secretomotor innervation to lacrimal gland, mucous glands of nasal cavity, nasopharynx and palate. 

Image result for pterygopalatine ganglion

3. Submandibular ganglion (salivates) 

Suspended from lingual nerve 
Supplied by superior salivatory nucleus (a/w CN VII) 
Function: Secretomotor innervation to the submandibular and sublingual salivary glands 

Image result for submandibular ganglion

4. OTic Ganglion (parOTid - salivates) 
Inferior to foramen ovale 
Supplied by inferior salivatory nuclues (a/w CN IX)
Innervates parotid 

Image result for otic ganglion


NB Vagus (X) does not innervate head and neck structures - only thorax and abdomen. 

NucleusPre-ganglionicGanglionPost-ganglionicTarget organs
Edinger-Westphal (Oculomotor nerve)Travels with the motor root of the oculomotor nerveCiliary ganglionTravels via the short ciliary nervesSphincter pupilliae
Ciliary muscles
Superior salivatory nucleus (Facial nerve)

NB VII above IX hence sup and inf (both salivate) 
Travels with the greater petrosal nerve and the nerve of the pterygoid canalPterygopalatine ganglionHitchhikes on branches of the maxillary nerveLacrimal gland
Nasopharynx
Palate
Nasal cavity
Travels within the chorda tympani, a branch of the facial nerveSubmandibular ganglionFibres travel directly to target organsSublingual and submandibular glands
Inferior salivatory nucleus (Glossopharyngeal nerve)Travels within the lesser petrosal nerveOtic ganglionHitchhikes on the auriculotemporal nerveParotid gland
Dorsal vagal motor nucleus (vagus nerve)Travels within the vagus nerveMany – located within the target organsn/aSmooth muscle of the trachea, bronchi and gastro-intestinal tract

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