Lacrimal, nasal and salivary glands

Target & receptor · M3 watery α1 / β viscous

Parasympathetic M3 stimulation (with VIP-mediated vasodilatation) produces copious watery secretion; sympathetic fibres from the superior cervical ganglion produce a small volume of viscous protein-rich saliva and constrict gland vessels. Unusually, both divisions stimulate secretion — they differ in volume and composition.

Traced from the start

  1. Parasympathetic (craniosacral) outflow
  2. Superior and inferior salivatory nuclei (CN VII and IX)
  3. Pterygopalatine (sphenopalatine) ganglionSubmandibular ganglionOtic ganglion
  4. Sympathetic (thoracolumbar) outflow
  5. Intermediolateral cell column T1–L2 via white rami communicantes
  6. Superior cervical ganglion
  7. Secretomotor fibres carried on trigeminal branchesInternal and external carotid plexuses (oculosympathetic pathway)
  8. Lacrimal, nasal and salivary glands

Detail

Parasympathetic
M3 → high-volume, low-protein saliva and tears; cholinergic vasodilatation increases gland blood flow
Sympathetic
α1 vasoconstriction and β1 amylase-rich thick saliva — the dry, sticky mouth of anxiety
Daily output
About 1–1.5 L of saliva; submandibular glands contribute most at rest, parotid on stimulation

When it goes wrong

Antimuscarinic drugs — tricyclics, oxybutynin, hyoscine, antipsychotics, antihistamines

Dry mouth, dry eyes and blurred vision; the same effect is exploited with hyoscine or glycopyrrolate for drooling and end-of-life secretions

Cholinesterase inhibitors (organophosphates, neostigmine overdose)

Drooling, tearing and rhinorrhoea as part of the cholinergic crisis, alongside bronchorrhoea and bradycardia

Practise this structure

1 question in the bank tagged Autonomic.