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Dr. Ahmed Fathalla Ibrahim PARASYMPATHETIC GANGLIA • • • • CILIARY GANGLION SUBMANDIBULAR GANGLION OTIC GANGLION SPHENOPALATINE GANGLION CILIARY GANGLION • SITE: in the fat between optic nerve & lateral rectus muscle • NUCLEUS: Edinger Westphal of occulomotor (midbrain) • PREGANGLIONIC FIBERS: along occulomotor through nerve to inferior oblique • POSTGANGLIONC FIBERS: along short ciliary nerves to sphincter pupillae & ciliary muscles CILIARY GANGLION SHORT CILIARY NERVES: • Number: 8 – 10 • Destination: connect ciliary ganglion to eyeball • Type of fibers: 1. Postganglionic parasympathetic fibers to sphincter pupillae & ciliary muscles 2. Postganglionic sympathetic fibers from internal carotid plexus (pass through ganglion without relay) to eyeball 3. Sensory fibers from eyeball (pass through ganglion without relay) to nasociliary nerve SUBMANDIBULAR GANGLION • SITE: superficial to hyoglossus muscle, below lingual nerve, connected to lingual nerve by posterior & anterior roots • NUCLEUS: superior salivatory nucleus (pons) • PREGANGLIONIC FIBERS: along chorda tympani of facial nerve → joins lingual nerve → posterior root → ganglion • POSTGANGLIONC FIBERS: 1. Pass directly to submandibular gland 2. Pass along anterior root → lingual nerve → sublingual gland OTIC GANGLION • SITE: just below foramen ovale, deep to trunk of mandibular nerve • NUCLEUS: inferior salivatory nucleus (medulla) • PREGANGLIONIC FIBERS: along lesser petrosal branch of tympanic of glossopharyngeal nerve → passes through foramen ovale to reach the ganglion • POSTGANGLIONC FIBERS: along auriculotemporal nerve → secretomotor fibers to parotid gland PTERYGOPALATINE GANGLION • SITE: in the pterygopalatine fossa, below maxillary nerve, connected to it by 2 ganglionic branches • NUCLEUS: lacrimatory nucleus (pons) • PREGANGLIONIC FIBERS: along greater petrosal branch of facial nerve → joins deep petrosal (postganglionic sympathetic fibers) → both nerves form nerve to pterygoid canal → ganglion PTERYGOPALATINE GANGLION • POSTGANGLIONC FIBERS: 1.Along ganglionic branches → maxillary nerve → zygomatic branch of maxillary nerve → zygomaticotemporal nerve → lacrimal nerve → lacrimal gland 2.Along greater & lesser palatine branches → palatine glands 3.Along nasal branches → nasal glands PTERYGOPALATINE GANGLION N.B.: • Taste fibers from soft palate pass along lesser palatine nerve → ganglion (without relay) → nerve to pterygoid canal → greater petrosal nerve • Sensory fibers from nose, palate & pharynx pass along nasal, palatine & pharyngeal branches of ganglion → ganglion (without relay) → ganglionic branches → maxillary nerve • Sympathetic fibers from deep petrosal nerve → ganglion (without relay) → orbital branches → orbitalis muscle CERVICAL PART OF SYMPATHETIC TRUNK • Beginning: At the base of the skull, as the superior cervical sympathetic ganglion • Termination: It passes in front of the neck of first rib, and becomes continuous with the thoracic part of sympathetic trunk • Course and relations: 1. It descends, behind the carotid sheath (separating it from common carotid artery), and in front of prevertebral fascia (separating it from longus colli muscle). 2. It has three ganglia (superior, middle and inferior) THE SUPERIOR CERVICAL GANGLION It is the largest ganglion • Site: It lies below the skull, in front of C2 & C3 vertebrae • Branches: 1. Gray rami communicantes: to upper 4 cervical nerves 2. Vascular: internal & external carotid plexus. 3. Visceral: pharyngeal & cardiac • • • 1. THE MIDDLE CERVICAL GANGLION It is the smallest ganglion Site: It lies in front of C6 vertebra Branches: Gray rami communicantes: to upper C5 & C6 nerves 2. Vascular: inferior thyroid plexus & ansa subclavia (it forms a loop around subclavian artery then joins the inferior ganglion 3. Visceral: tracheal, oesophageal & cardiac THE INFERIOR CERVICAL GANGLION • It is also called: cervico-thoracic or stellate ganglion • Site: It lies in front of the neck of first rib • Branches: 1. Gray rami communicantes: to C7 & C8 nerves 2. Vascular: vertebral and subclavian plexus 3. Visceral: cardiac