Anatomy of the Vessels and Nerves of the Head and Neck (Angioneurology) - Chornokulskyi S.T. 2009

Nerves of the Head and Neck
General morphology of the parasympathetic ganglia of the head

Ciliary ganglion

(ganglion ciliare) (Figs. 32, 33, 33a)

It is one of the parasympathetic ganglia of the HEAD (pterygopalatine, submandibular, sublingual, otic, and tympanic).

The common features of these autonomic ganglia are as follows:

I. The presence of three roots (sensory — radix sensoria, parasympathetic — radix parasympathica, and sympathetic — radix sympathica):

✵ the sensory ROOT of each ganglion originates from Branches of the Trigeminal nerve;

✵ the sympathetic root consists of postganglionic sympathetic fibers from the superior cervical ganglion of the Sympathetic trunk (trunci sympathici), which reach the corresponding parasympathetic ganglion via periarterial plexuses. Thus, the sympathetic root of the ganglion is a branch of the periarterial plexus of the nearest major artery. Preganglionic sympathetic fibers are axons of Neurons located in the lateral horns of the Spinal Cord (from Nucleus intermediolateralis);

✵ the parasympathetic root consists of preganglionic parasympathetic fibers from parasympathetic neurons belonging to the cranial nuclei of the Autonomic Nervous system, which may form distinct nerves.

II. The presence of ganglionic branches containing Three types of fibers: sensory, parasympathetic, and sympathetic.

Among them, only preganglionic parasympathetic fibers synapse within the parasympathetic ganglion, whereas sensory and sympathetic fibers pass through it without synapsing. The branches of the ganglia innervate smooth Muscles and glands, providing general sensitivity, contraction, as well as stimulation or inhibition of secretion.

Ciliary ganglion

(ganglion ciliare) (Figs. 32, 33, 33a)

Roots:

parasympathetic — axons of neurons from the parasympathetic nuclei of the third pair of Cranial Nerves (ramus ad ganglion ciliare); sympathetic — postganglionic sympathetic fibers from the internal carotid plexus or ophthalmic plexus (surrounding the a. ophthalmica); sensory root — the communicating branch from the nasociliary nerve to the ciliary ganglion (ramus communicans n. nasociliaris cum ganglio ciliari).

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Fig. 33. Ciliary ganglion, its roots, and branches (schematic diagram):

1 - accessory and unpaired median nuclei of the Oculomotor nerve

(nuclei accessorius et impar n. oculomotorii);

2 - trigeminal ganglion (ganglion trigeminale);

3 - nasociliary nerve (n. nasociliaris);

4 - ciliary ganglion (ganglion ciliare);

5 - short ciliary nerves (nn. ciliares breves);

6 - postganglionic parasympathetic fibers to the ciliary Muscle and sphincter pupillae muscle (m. ciliaris et m. sphincter pupillae);

7 - postganglionic sympathetic fibers to the dilator pupillae muscle (m. dilatator pupillae);

8 - oculomotor nerve (n. oculomotorius);

9 - intermediolateral nucleus (nuc. intermediolateralis);

10 - superior cervical ganglion of the sympathetic trunk (ganglion cervicale superius trunci sympathici);

11 - internal carotid plexus (plexus caroticus internus)

The branches of the ganglion, the short ciliary nerves (nn. ciliares breves), innervate via postganglionic parasympathetic fibers: the ciliary muscle (accommodation) and the sphincter pupillae muscle (adaptation); via postganglionic sympathetic fibers: the dilator pupillae muscle; and sensory fibers provide general sensation to these structures. Damage to the sympathetic center of the spinal cord (CVIII — ThII centrum ciliospinale) is characterized by a symptom complex known as Horner's syndrome.