Sympathetic root of ciliary ganglion

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Nerve: Sympathetic root of ciliary ganglion
Pathways in the Ciliary Ganglion. Green = parasympathetic; Red = sympathetic; Blue = sensory
Latin	ramus sympathetica ganglii ciliaris
Dorlands / Elsevier	r_02/12688108

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Overview

The sympathetic root of ciliary ganglion contains postganglionic sympathetic fibers whose cell bodies are located in the superior cervical ganglion. Their axons ascend with the internal carotid artery as a plexus of nerves, the carotid plexus. Sympathetic fibers innervating the eye separate from the carotid plexus within the cavernous sinus. They run forward through the superior orbital fissure and merge with the long ciliary nerves (branches of the nasociliary nerve) and the short ciliary nerves (from the ciliary ganglion). Sympathetic fibers in the short ciliary nerves pass through the ciliary ganglion without forming synapses.

Preganglionic sympathetic fibers originate from neurons in the intermediolateral column of the thoracic spinal cord, at the level of T1 and T2. They form synapses in the superior cervical ganglion. The ratio of incoming to outgoing fibers (the “convergence”) in this ganglion is approximately 100:1. Sympathetic motor neurons in the spinal cord are controlled by supranuclear pathways that descend through the brainstem and spinal cord. Interruption of the sympathetic chain at any level (from the brainstem to the ciliary ganglion) will produce pupillary constriction (miosis) and eyelid droop (ptosis) – the classic signs of Horner's syndrome.

Sympathetic fibers from the superior cervical ganglion innervate blood vessels (vasoconstriction), sweat glands, and four eye muscles: the dilator pupillae, the superior tarsal muscle, the inferior tarsal muscle and the orbitalis.

The dilator pupillae dilates the pupil; its action is antagonistic to the sphincter pupillae. Pupil size is therefore under the dual control of sympathetic and parasympathetic nerves.

The superior tarsal muscle elevated the upper eyelid. The levator palpebrae superioris, which is innervated by a branch of the oculomotor nerve, also elevates the upper eyelid. Eyelid elevation is therefore under both voluntary and involuntary control. Interruption of either pathway will result in eyelid droop (ptosis).

The other two eye muscles with sympathetic innervation (the inferior tarsal muscle and the orbitalis) are vestigial in humans. They are variable and often incompletely developed.

External links

• http://anatomy.med.umich.edu/modules/head_autonomics_module/autonomics_05.html

Image:Example.jpg

v • d • e The cranial nerves: trigeminal nerve
ophthalmic (V1)	frontal: supratrochlear - supraorbital (lateral branch, medial branch) nasociliary: long ciliary - infratrochlear - posterior ethmoidal - anterior ethmoidal (external nasal, internal nasal) - sensory root of ciliary ganglion (ciliary ganglion) lacrimal
maxillary (V2)	in meninges middle meningeal in pterygopalatine fossa zygomatic (zygomaticotemporal, zygomaticofacial) - pterygopalatine (pterygopalatine ganglion see below for details) - posterior superior alveolar in infraorbital canal infraorbital nerve: superior alveolar (middle, anterior) - internal nasal branches on face inferior palpebral - external nasal - superior labial (infraorbital plexus)
mandibular (V3)	in meninges meningeal anterior to muscles of mastication (medial pterygoid/to tensor veli palatini, lateral pterygoid, masseteric, deep temporal) - buccal posterior auriculotemporal (otic ganglion) - lingual (submandibular ganglion) - inferior alveolar (mylohyoid, mental)

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Acknowledgement and Attribution Regarding Sources of Content

Some of the initial content on this page may be incorporated in part from copyleft sources in the public domain including wikis such as Wikipedia and AskDrWiki. Drug information for patients came from the The National Library of Medicine. Infectious disease information may have come from the Centers for Disease Control (CDC). Differential Diagnoses are drawn from clinicians as well as an amalgamation of 3 sources: 1.The Disease Database; 2. Kahan, Scott, Smith, Ellen G. In A Page: Signs and Symptoms. Malden, Massachusetts: Blackwell Publishing, 2004:3; 3. Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:7 .