Autonomic Innervation of the Orbit - Learning Objectives and Review Questions

True/False

1. The lacrimal gland is reflexive to trigeminal nerve mediated irritation whereas the accessory lacrimal glands provide continuous lubrication to the globe.
2. The cell bodies that mediate the afferent limb of the corneal blink reflex are located in the oculomotor nucleus.
3. A lesion of the cervical sympathetic trunk is expected to cause mydriasis.
4. A lesion of the inferior division of the oculomotor is expected to cause miosis.
5. A lesion of the superior division of the oculomotor nerve is expected to leave the globe in an elevated position.
6. The site of the preganglionic cell bodies that mediate accommodation is the Edinger-Westphal nucleus.
7. The site of the postganglionic cell bodies that mediate accommodation is the pterygopalatine ganglion.
8. A lesion of the greater superficial petrosal nerve at the lacerate foramen may cause excessive tearing.
9. The ciliary ganglion is a sympathetic ganglion. Nevertheless, parasympathetic fibers pass through the ganglion without synapsing.
10. A lesion of the internal carotid nerve is expected to cause unilateral mydriasis.
11. A tumor at the apex of the lung is expected to cause unilateral pupil constriction.
12. A cavernous sinus infection is expected to cause unilateral pupil constriction given that the inferior division of the oculomotor nerve remains healthy.
13. A mild ptosis in a young person is apt to be caused by an autonomic disturbance whereas a frank ptosis is caused by a somatic disturbance.
14. Sneezing while looking at bright light is thought to be, in part, mediated by the trigeminal nerve and not the optic nerve.
15. The short ciliary nerves host postganglionic parasympathetic fibers and postganglionic sympathetic fibers.
16. The motor root (parasympathetic root) of the ciliary ganglion is derived from the inferior division of the oculomotor nerve.
17. The infraorbital nerve, while in the infraorbital canal, carries postganglionic parasympathetic fibers destined for the lacrimal gland.
18. The zygomaticotemporal nerve leaves the orbit superior the the exit of the zygomaticofacial nerve.
19. A lesion of the lesser superficial petrosal nerve is expected to cause a mild ptosis.
20. The lacrimal nerve proper is GSA only and thus does not mediate lacrimation.
21. Traveling along with the distal parts of the lacrimal nerve are postganglionic parasympathetic fibers whose cell bodies are located in the pterygopalatine ganglion.
22. The sympathetic root of the ciliary ganglion travels through the cavernous sinus before entering the orbit.

Short Answer and Essay

1. Discuss the ciliary ganglion.
2. Discuss the sympathetic root of the ciliary ganglion.
3. Discuss elevation of the superior tarsal plate. Include somatic and autonomic innervations.
4. Discuss mild ptosis versus frank ptosis when each condition is attributable to nerve injury.
5. Discuss the contribution of the facial (VII) nerve to orbital function.
6. Discuss the autonomic innervation of the orbit. Include ganglia, relationships, fascial specializations, trigeminal pathways, muscles and movements, and nerve injury. Include preganglionic and postganglionic pathways leading to the orbit.