Ciliary ganglion
Citation, DOI & article data
The ciliary ganglion is one of four parasympathetic ganglia of the head and neck. It receives preganglionic parasympathetic fibers from the Edinger-Westphal nucleus via the oculomotor nerve. It supplies the eye via short ciliary nerves not only with parasympathetic fibers, but also with sensory and sympathetic fibers that pass through the ganglion.
Gross anatomy
- smallest of the ganglia (2 mm in size)
- located posterolaterally in the intraconal space of the orbit (towards the orbital apex) between the optic nerve and the lateral rectus muscle
- just lateral to the ophthalmic artery as it crosses the optic nerve from lateral to medial
Roots
Although the ciliary ganglion has parasympathetic, sensory and sympathetic roots, only the parasympathetic ones synapse within the ganglion.
- parasympathetic root
- from the Edinger-Westphal nucleus of the oculomotor nerve (III)
- fibers synapse in the ganglion
- sympathetic root
- from the ICA (from the superior cervical ganglion) via the nasociliary nerve, a branch of the trigeminal nerve
- fibers pass through the ganglion without synapsing
- sensory root
- via the small communicating branch of the ciliary ganglion (from the nasociliary nerve, a branch of the trigeminal nerve)
- fibers pass through the ganglion without synapsing
Branches
-
short ciliary nerves
- ~12 or more branches, termed
- each contains elements from all 3 roots (above), and pierce the back of the sclera around the attachment of the optic nerve to supply the globe
- the vast majority of fibers from ganglionic cells supply the ciliary body (accommodation); only ~3% supply sphincter pupillae
Note: while both long ciliary nerves (branches of the nasociliary nerve) and short ciliary nerves contain sensory/sympathetic supply to the cornea, iris, and ciliary body, only the short ciliary nerves are involved in pupillary constriction and accommodation.
Related pathology
- pathology of the ciliary ganglion can produce a tonic pupil, where the pupil does not react to light and slowly accommodates
- Adie syndrome: when a non-reactive, slowly accomodating pupil is associated with absent deep tendon reflexes and diaphoresis
Quiz questions
References
- 1. Moore KL, Agur AMR, Dalley AF. Clinically oriented anatomy. LWW. ISBN:1451119453. Read it at Google Books - Find it at Amazon
- 2. Last's anatomy, regional and applied. Churchill Livingstone. ISBN:044304662X. Read it at Google Books - Find it at Amazon
- 3. Robert H. Whitaker, Neil R. Borley. Instant Anatomy. ISBN: 9780632054039
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