1. Dr. Ahmed Fathalla Ibrahim

2. PARASYMPATHETIC GANGLIA CILIARY GANGLIONCILIARY GANGLION SUBMANDIBULAR GANGLIONSUBMANDIBULAR GANGLION OTIC GANGLIONOTIC GANGLION SPHENOPALATINE GANGLIONSPHENOPALATINE GANGLION

3. CILIARY GANGLION SITE: betweenSITE: in the fat between optic nerve & lateral rectus muscle NUCLEUS: Edinger WestphalNUCLEUS: Edinger Westphal of occulomotor (midbrain) PREGANGLIONIC FIBERS: nerve to inferior obliquePREGANGLIONIC FIBERS: along occulomotor through nerve to inferior oblique POSTGANGLIONC FIBERS: sphincter pupillae & ciliary musclesPOSTGANGLIONC FIBERS: along short ciliary nerves to sphincter pupillae & ciliary muscles

4. CILIARY GANGLION SHORT CILIARY NERVES: Number:Number: 8 – 10 Destination:Destination: connect ciliary ganglion to eyeball Type of fibers:Type of fibers: 1.Postganglionic parasympathetic fibers 1.Postganglionic parasympathetic fibers to sphincter pupillae & ciliary muscles 2.Postganglionic sympathetic fibers 2.Postganglionic sympathetic fibers from internal carotid plexus (pass through ganglion without relay) to eyeball 3.Sensory fibers 3.Sensory fibers from eyeball (pass through ganglion without relay) to nasociliary nerve

5. SUBMANDIBULAR GANGLION SITE: superficial to hyoglossus muscleSITE: superficial to hyoglossus muscle, below lingual nerve, connected to lingual nerve by posterior & anterior roots NUCLEUS: superior salivatory nucleusNUCLEUS: superior salivatory nucleus (pons) PREGANGLIONIC FIBERS: chorda tympani of facial nerve→ → →PREGANGLIONIC FIBERS: along chorda tympani of facial nerve → joins lingual nerve → posterior root → ganglion POSTGANGLIONC FIBERS:POSTGANGLIONC FIBERS: submandibular gland 1.Pass directly to submandibular gland → → sublingual gland 2.Pass along anterior root → lingual nerve → sublingual gland

6. OTIC GANGLION SITE: deep to trunk of mandibular nerveSITE: just below foramen ovale, deep to trunk of mandibular nerve NUCLEUS: inferior salivatory nucleusNUCLEUS: inferior salivatory nucleus (medulla) PREGANGLIONIC FIBERS: lesser petrosal branch glossopharyngeal nerve→PREGANGLIONIC FIBERS: along lesser petrosal branch of tympanic of glossopharyngeal nerve → passes through foramen ovale to reach the ganglion POSTGANGLIONC FIBERS: → secretomotor fibers to parotid glandPOSTGANGLIONC FIBERS: along auriculotemporal nerve → secretomotor fibers to parotid gland

7. PTERYGOPALATINE GANGLION SITE: in the pterygopalatine fossaSITE: in the pterygopalatine fossa, below maxillary nerve, connected to it by 2 ganglionic branches NUCLEUS: lacrimatory nucleus (pons)NUCLEUS: lacrimatory nucleus (pons) PREGANGLIONIC FIBERS: greater petrosal branchfacial nerve → → nerve to pterygoid canal→PREGANGLIONIC FIBERS: along greater petrosal branch of facial nerve → joins deep petrosal (postganglionic sympathetic fibers) → both nerves form nerve to pterygoid canal → ganglion

8. PTERYGOPALATINE GANGLION POSTGANGLIONC FIBERS:POSTGANGLIONC FIBERS: ganglionic branches→ maxillary nerve→ zygomatic branch of maxillary nerve → zygomaticotemporal nerve → lacrimal nerve → lacrimal gland 1.Along ganglionic branches → maxillary nerve → zygomatic branch of maxillary nerve → zygomaticotemporal nerve → lacrimal nerve → lacrimal gland greater & lesser palatine branches → palatine glands 2.Along greater & lesser palatine branches → palatine glands nasal branches → nasal glands 3.Along nasal branches → nasal glands

9. PTERYGOPALATINE GANGLION N.B.: Taste fibers from soft palate lesser palatine nerve → ganglion (without relay) → nerve to pterygoid canal → greater petrosal nerveTaste 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 nasal, palatine & pharyngeal branches of ganglion → ganglion (without relay) → ganglionic branches → maxillary nerveSensory 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 muscleSympathetic fibers from deep petrosal nerve → ganglion (without relay) → orbital branches → orbitalis muscle

10. CERVICAL PART OF SYMPATHETIC TRUNK Beginning:Beginning: At the base of the skull, as the superior cervical sympathetic ganglion Termination:Termination: It passes in front of the neck of first rib, and becomes continuous with the thoracic part of sympathetic trunk Course and relations: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). (superior, middle and inferior) 2.It has three ganglia (superior, middle and inferior)

11. THE SUPERIOR CERVICAL GANGLION It is the largest ganglion Site:Site: It lies below the skull, in front of C2 & C3 vertebrae Branches:Branches: 1.Gray rami communicantes: 1.Gray rami communicantes: to upper 4 cervical nerves 2.Vascular: 2.Vascular: internal & external carotid plexus. 3.Visceral: 3.Visceral: pharyngeal & cardiac

12. THE MIDDLE CERVICAL GANGLION It is the smallest ganglionIt is the smallest ganglion Site:Site: It lies in front of C6 vertebra Branches:Branches: 1.Gray rami communicantes: 1.Gray rami communicantes: to upper C5 & C6 nerves 2.Vascular: 2.Vascular: inferior thyroid plexus & ansa subclavia (it forms a loop around subclavian artery then joins the inferior ganglion 3.Visceral: 3.Visceral: tracheal, oesophageal & cardiac

13. THE INFERIOR CERVICAL GANGLION It is also called: cervico-thoracic or stellate ganglionIt is also called: cervico-thoracic or stellate ganglion Site:Site: It lies in front of the neck of first rib Branches:Branches: 1.Gray rami communicantes: 1.Gray rami communicantes: to C7 & C8 nerves 2.Vascular: 2.Vascular: vertebral and subclavian plexus 3.Visceral: 3.Visceral: cardiac