Cranial Autonomics

Sympathetic Division

Cervical Chain (Synapse occurs coming from T1)

Superior, Middle, Inferior cervical ganglion

Superior Cervical Ganglion

C1-C2 Vertebral Level

Point of synapse for all head (pre & post)

Middle Cervical Ganglion

C6 Vertebral Level

Inferior Cervical Ganglion 

C7 Vertebral Level

Post-Synaptic Sympathetic Fibers

1. Periarterial branch and/or hitchhiker on CN

2. Gray rami comunicantes (to spinal nerves)

3. Cardiac branch

Presynaptic Sympathetic Fibers

Cell bodies located in levels T1 - T3 for head and neck

PSNS Cranial Nerves

III

VII

IX

X

CN III PSNS

Ciliary ganglia functions with visceral motor to sphincter pupilae & ciliary muscle 

CN III SNS

Associated with superior cervical ganglion, fibers jump to CN branches from internal carotid plexus

Visceral motor to dilator pupillae muscles and superior tarsal & vasoconstriction of vessels

Widens pupil and raises eyelid

Dilator Pupillae Muscles

Dilate the eye through SNS input (Slow)

Sphincter Pupillae Muscles

Constrict eye through PSNS input

Pupillary Light Reflexes

Test PSNS component of CN III (constriction of eye)

Zonular Fibers

No Stimulus → Tight (flat lens) allowing for distant object view

PSNS → Loose (round lens) allowing for close object view

Superior Tarsal M

Facial Nerve PSNS

Pterygopalatine and submandibular ganglia

Visceral motor to submandibular, sublingual, lacrimal glands, and smaller mucous glands in nose, palate, and nasopharynx

Facial Nerve SNS

Superior cervical ganglia with fibers joining  plexuses and hitchhiker on CN V branches to targets

Functions to Vasoconstriction 

ANS to Mucous Glands in Mouth

1. Superior salivatory nucleus with CN VII 

2. Pre synaptic PSNS through greater petrosol n. 

3. Synapse at the pterygopalatine ganglion

4. Postsynaptic PSNS fibers to mucous glands via nerves branching from V2 in pterygopalatine fossa

Lacrimal Gland PSNS

1. Superior salivatory nucleus through facial n.

2. Pre-sympathetic fibers through the pterygoid canal

3. Synapse at pterygopalatine ganglion

4. Post-synaptic PSNS hitchhike ride on maxillary n. (V2)

5. Zygomatic n. (V2)

6. Communicating branch 

7. Lacrimal n. (V1)

8. Lacrimal Gland

Glossopharyngeal PSNS

Otic ganglion

Visceral motor to parotid gland

Glossopharyngeal SNS

Superior cervical ganglion with fibers jumping directly to CN IX targeting structures also receives postsynaptic SNS from periarterial plexus

Vasoconstriction 

Vagus Nerve PSNS

No named ganglia

Visceral motor to mucous glands in the larynx/trachea and pharynx/esophagus

Vagus Nerve SNS

Superior cervical ganglion with fibers jumping directly from the ganglion to X

Vasoconstriction primarily.