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CPR1 Exam 1 > 11- Thoracic Neurology > Flashcards

11- Thoracic Neurology Flashcards

1
Q

This is what joins the Laryngopharynx to the Stomach, is double layered, and is a muscular tube with an internal circular layer and external longitudinal layer.

A

Esophagus

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2
Q

The upper 2/3 of the Esophagus is a combination of both _______ _______ and ________ ________.

A

Smooth Muscle

Skeletal Muscle

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3
Q

What are the different regions of the Esophagus?

A

Cervical Part
Thoracic Part
Abdominal Part

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4
Q

This part of the Esophagus is between T1 and the Esophageal Hiatus of the Thoracic Diaphragm. It travels through the Posterior Mediastinum.

A

Thoracic Part

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5
Q

The esophagus has four points of constriction. When a corrosive substance, or a solid object is swallowed, it is most likely to lodge and damage one of these four points. They are…

A

At the Cricopharyngeus M. (clinically referred to as the Upper Esophageal Sphincter)

At the Aortic Arch

At the Left Bronchus

At the Esophageal Hiatus of the Thoracic Diaphragm (clinically referred to as the Lower Esophageal Sphincter)

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6
Q

What Cranial Nerve is associated with the Thorax?

A

Vagus N.

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7
Q

This branch of the Vagus N. loops under the Aortic Arch and Ligamentum Arteriosum to return to the Larynx.

A

Left Recurrent Laryngeal N.

***Can cause aneurysm due to its location, and often associated with hoarseness.

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8
Q

This branch of the Vagus N. loops around the right Subclavian A.

A

Right Recurrent Laryngeal N.

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9
Q

This is derived from the Left Vagus N. and runs anterior to the Esophagus. It then enters the Abdomen through the Esophageal Hiatus.

A

Anterior Vagal Trunk

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10
Q

This is derived from the Right Vagus N. and runs posterior to the Esophagus. It then enters the Abdomen through the Esophageal Hiatus.

A

Posterior Vagal Trunk

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11
Q

This nerve travels through the Superior Thoracic Aperture, into the space between the Mediastinal Parietal Pleura and Fibrous Pericardium. Innervates the Thoracic Diaphragm.

A

Phrenic N.

***From Anterior Rami C3-5

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12
Q

This nerve conveys sensory information from central Diaphragmatic and Mediastinal Pleura and the Pericardium.

A

Phrenic N.

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13
Q

This nerve is from the 1st-11th pair of Anterior Rami of Thoracic Spinal Nerves. They travel along the inferior edge of the superior Rib in the Intercostal Space between the Internal and Innermost Intercostal Ms.

A

Intercostal N.

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14
Q

This nerve innervates the skin, subcutaneous tissue, musculature, and Costal and Diaphragmatic Parietal Pleura.

A

Intercostal N.

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15
Q

What are the types of Intercostal Ns. and what Anterior Rami are they from?

A

Typical = 3rd-6th

Atypical = 1st and 2nd, 7th-11th

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16
Q

For Typical Intercostal Ns., ________ ________ connects the Intercostal N. to the ipsilateral Sympathetic Trunk.

A

Rami Communicates

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17
Q

For Typical Intercostal Ns., ________ ________ assist in innervating Intercostal M. and travels on the superior edge of the Rib inferior to the Intercostal Space.

A

Collateral Branches

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18
Q

For Typical Intercostal Ns., this becomes anterior and posterior branches and supply the skin of the Thoracic Wall. T4-T6 supply the breast.

A

Lateral Cutaneous Branches

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19
Q

For Typical Intercostal Ns., this branch supplies the anterior aspect of the Thoracic Wall. T4-T6 supply the breast.

A

Anterior Cutaneous Branches

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20
Q

For Typical Intercostal Ns., this branch supplies the Intercostal Ms., Subcostal M., and Transversus Thoracis M.

A

Muscular Branches

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21
Q

For Atypical Intercostal Ns., the ______ nerve has no cutaneous branches and the majority superior portion joins the Brachial Plexus.

A

1st

***From 1st Anterior Ramus of Thoracic Spinal Nerves

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22
Q

For Atypical Intercostal Ns., the ______ nerve mostly travels in the Costal Groove as a Typical Intercostal N. with a small part joining with the Brachial Plexus.

A

2nd

***From 2nd Anterior Ramus of Thoracic Spinal Nerves

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23
Q

The 2nd Intercostal N. (Atypical) has a Lateral Cutaneous Branch that supplies the skin and subcutaneous tissue of the Axilla, but this branch is specifically called the…

A

Intercostobrachial N.

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24
Q

For Atypical Intercostal Ns. 7-11, they begin as Intercostal Ns. but as they travel anteriorly they cease to exist between Ribs and transition over the Abdomen to become…

A

Thoracoabdominal Ns.

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25
Q

Typically, Sympathetic stimulation is (ANABOLIC/CATABOLIC) or “fight or flight”.

A

Catabolic

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26
Q

Typically Parasympathetic stimulation is (ANABOLIC/CATABOLIC) or “rest and digest”. This is normal function and energy conservation.

A

Anabolic

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27
Q

Describe the distribution of the Parasympathetics and Sympathetics to the body.

A

Parasympathetics = Head, Neck, and Trunk Viscera. Never in body wall or extremities

Sympathetics = All vascular areas of the body

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28
Q

Glandular secretion is stimulated by the (SYMPATHETIC/PARASYMPATHETIC) Nervous System, except for sweat glands.

A

Parasympathetic

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29
Q

The Sympathetic Nervous System can indirectly decrease non-sweat gland glandular secretion through __________.

A

Vasoconstriction

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30
Q

Vasoconstriction is stimulated via (SYMPATHETICS/PARASYMPATHETICS), except for Coronary As.

A

Sympathetics

31
Q

Thoracolumbar (T1-L2) is considered the (SYMPATHETIC/PARASYMPATHETIC) division.

A

Sympathetic

32
Q

For the Sympathetic Division (Thoracolumbar), the Presynaptic Fibers are (SHORT/LONG) and the Postsynaptic Fibers are (SHORT/LONG).

A

Short

Long

33
Q

For the Sympathetic Division, the Presynaptic Cell Bodies exist in the _______ _______ of the Spinal Cord (in Thoracic Vertebrae).

A

Lateral Horn

34
Q

Briefly describe the path the Presynaptic Fibers (Sympathetic Division) take to get to the Paravertebral Ganglion.

A

Presynaptic Fibers (Short) start in Lateral Horn –
Travel in Anterior Root –
Travel in Anterior Ramus –
Exit Anterior Ramus via White Ramus Communicans –
Enter the Ganglion

35
Q

In the Sympathetic Division, there are 3 options for Presynaptic Fiber synapsing. What are these options?

A

1) Presynaptic Fibers enter the Paravertebral Ganglion and synapse on Postsynaptic Neuron in the SAME spinal level.
2) Presynaptic Fibers enter the Paravertebral Ganglion and ascend or descend to synapse on a Postsynaptic Neuron of a DIFFERENT spinal level.
3) Presynaptic Fibers enter the Paravertebral Ganglion and exit without synapsing and continue on through an Abdominopelvic Splanchnic Nerve, on their way to a Prevertebral Ganglion to synapse.

36
Q

For the Sympathetic Division, if the Presynaptic Fibers use either option 1 or 2 for synapsing (they synapse in Paravertebral Ganglion at the same or different level) then what are the Postsynaptic Neurons called that are carried to the target organs?

A

Cardiopulmonary Splanchnic Nerves

***In this case, the targets are the viscera in the Thorax – Heart, Larynx, Trachea, Bronchi, and Lungs

37
Q

For Sympathetic Division, the Abdominopelvic Splanchnic Nerves utilize option 3 for synapsing because they are still considered Presynaptic Fibers. What are the Prevertebral Ganglion that these nerves can synapse on?

A

Celiac Ganglion
Aorticorenal Ganglion
Superior Mesenteric Ganglion
Inferior Mesenteric Ganglion

***Also go to certain Plexuses

38
Q

For Sympathetic Division, Postsynaptic Fibers (long) exist in the Paravertebral or Prevertebral Ganglia. Paravertebral Ganglia are linked vertically to form _______ _______ on either side of the Vertebral Column. Three Ganglia also rise in the Cervical, Lumbar, and Pelvic regions.

A

Sympathetic Trunk

39
Q

The _________ Splanchnic Ns. have Presynaptic Cell Bodies in the Lateral Horn of the Spinal Cord at levels _______ that synapse onto Postsynaptic Cells Bodies in the Cervical and Thoracic Sympathetic Trunks which send fibers to the Superficial and Deep Cardiac Plexuses.

A

Cardiac
T1-5/6

***Part of Cardiopulmonary Splanchnic Ns.

40
Q

The __________ Splanchnic Ns. have Presynaptic Cell Bodies in the Lateral Horn of the Spinal Cord at levels _______ that synapse onto Postsynaptic Cell Bodies in the Thoracic Sympathetic Trunk which sends fibers to the Pulmonary Plexus.

A

Pulmonary
T2-3

***Part of Cardiopulmonary Splanchnic Ns.

41
Q

Abdominopelvic Splanchnic Ns. travel from the Thoracic Sympathetic Trunk to corresponding Prevertebral Ganglia in the abdomen. What are the different Abdominopelvic Splanchnic Ns.?

A

Greater Splanchnic N.
Lesser Splanchnic N.
Least Splanchnic N.

***In lab, we’ll only see Greater Splanchnic N.!!

42
Q

The Greater Splanchnic N. is from ________ and sends fibers to the _________ Plexus and to the ________ Ganglion (which then goes on to feed into the _______ Plexus).

A

T5-9/10
Esophageal
Celiac
Celiac

43
Q

The Lesser Splanchnic N. is from ________ and sends fibers to the _______ Ganglion and ________ ________ Ganglion (which then goes on to feed into the ________ ________ Plexus).

A

T10-11
Celiac
Superior Mesenteric
Superior Mesenteric

44
Q

The Least Splanchnic N. is from _______ and sends fibers to the _________ Ganglion.

A

T12

Aorticorenal

45
Q

Craniosacral is (SYMPATHETIC/PARASYMPATHETIC).

A

Parasympathetic

46
Q

For Parasympathetics, what are the spinal nerve levels?

A

CN III, VII, IX, and X

S2-4

47
Q

For the Parasympathetic Nervous System, the Presynaptic Fibers are (SHORT/LONG) and the Postsynaptic Fibers are (SHORT/LONG).

A

Long

Short

48
Q

For Parasympathetics, the Presynaptic Fibers (long) have nuclei in what locations?

A 
Brain Stem (for CNs)
Sacral Spinal Levels
49
Q

For Parasympathetics, the cranial component exits as Cranial Nerves. What are these Cranial Nerves?

A

Oculomotor N. (CN III)
Facial N. (CN VII)
Glossopharyngeal N. (CN IX)
Vagus N. (CN X)

50
Q

For Parasympathetics, the Sacral component exits the Spinal levels as ________ _______ Ns.

A

Pelvic Splanchnic

51
Q

For Parasympathetics, the Postsynaptic Fibers are usually short with their Ganglia or Postsynaptic Neurons near or in the…

A

Target Organ

52
Q

For Parasympathetics, the nuclei of Postsynaptic Fibers can be in four specific Cranial Ganglia, which are…

A

Ciliary Ganglion – receives fibers from CN III
Pterygopalatine Ganglion – receives fibers from CN VII
Submandibular Ganglion – receives fibers from CN VII
Otic Ganglion – receives fibers from CN IX

***Ganglia can also in the walls of the target organ

53
Q

For Parasympathetic presence in the Thorax, the _______ provides Presynaptic Parasympathetic innervation to the Lungs, Bronchi, Pleurae, Heart, and Pericardium.

A

Vagus N.

54
Q

What are the 5 branches of the Vagus N. that provide Parasympathetic innervation to the Thorax?

A 
Superior Cardiac Branch
Middle Cardiac Branch
Inferior Cardiac Branch
Pulmonary Branches
Esophageal Branches
55
Q

These branches of the Vagus N. originate in the Neck and descend through the Superior Thoracic Aperture, and with the Cardiac Splanchnic Ns. they form the Cardiac Plexus.

A

Superior Cardiac Branch

Middle Cardiac Branch

56
Q

This branch of the Vagus N. originates in the Thorax and with the Cardiac Splanchnic Ns. forms the Cardiac Plexus.

A

Inferior Cardiac Branch

***Superior and Middle Cardiac Branches also help form the Cardiac Plexus, but they originate in the Neck!

57
Q

This branch of the Vagus N. originates in the Thorax, and with the Pulmonary Splanchnic Ns. it forms the Pulmonary Plexus.

A

Pulmonary Branches

58
Q

After producing Pulmonary Branches, the Vagus N. becomes indistinguishable from the _______ _______ that covers the inferior 2/3 of the Esophagus.

A

Esophageal Plexus

59
Q

The Pulmonary Plexus is mixed Sympathetic and Parasympathetic and innervates the Lungs, Bronchi, and Pleurae. Where does it receive all its innervations from?

A 
Sympathetic = Pulmonary Splanchnic Ns. 
Parasympathetic = Pulmonary Branches of Vagus N.
60
Q

Describe the Sympathetic function of the Pulmonary Plexus.

A

– Bronchodilator to the Bronchi and Bronchioles

– Inhibitor to the glands of the Bronchi and Bronchioles

– Vasoconstrictor to the Pulmonary Vessels

– Visceral sensory from Lungs, Bronchi, and Pleurae

61
Q

Describe the Parasympathetic function of the Pulmonary Plexus.

A

– Bronchoconstrictor to the Bronchi and Bronchioles

– Secretomotor to the glands of the Bronchi and Bronchioles

– Vasodilator to the Pulmonary Vessels

– Sensory from the Bronchial mucosa (cough reflex) stretch receptors from the Bronchial musculature

– Reflexive from the Interalveolar CT

– Pressure sensory from the Pulmonary A.

– Chemoreceptor from the Pulmonary V.

62
Q

The Cardiac Plexus is mixed Sympathetic and Parasympathetic and its Postsynaptic Fibers terminate near the…

A

SA Node

AV Node

63
Q

What is the Sympathetic and Parasympathetic innervation to the Cardiac Plexus?

A

Sympathetic = Cardiac Splanchnic Ns.

Parasympathetic = Superior, Middle, and Inferior Cardiac Branches of the Vagus N.

64
Q

Describe the Sympathetic function of the Cardiac Plexus.

A

– Increases HR

– Increases force of Heart contractions

– Vasomotor to the Pericardium

65
Q

Describe the Parasympathetic function of the Cardiac Plexus.

A

– Decreases HR

– Decreases force of Heart contractions

– Vasoconstricts Coronary As.

66
Q

The Cardiac Plexus can be subdivided into what two parts?

A

Superficial Cardiac Plexus

Deep Cardiac Plexus

67
Q

This division of the Cardiac Plexus covers the anterior surface of the Aorta.

A

Superficial Cardiac Plexus

68
Q

This division of the Cardiac Plexus exists anterior to the bifurcation of the Trachea, posterior to the Aortic Arch, and superior to the bifurcation of the Pulmonary Trunk.

A

Deep Cardiac Plexus

69
Q

The ________ Plexus is mixed Sympathetic and Parasympathetic, and continues superiorly with the Superficial Cardiac Plexus but continues inferiorly as the _______ Plexus in the Abdomen.

A

Aortic
Aortic

***Aortic Plexus doesn’t really innervate anything! Just a connection.

70
Q

What does the Aortic Plexus feed into inferiorly?

A

Intermesenteric Plexus

71
Q

The Esophageal Plexus is mixed Sympathetic and Parasympathetic. Where does it receive its innervation from?

A 
Sympathetic = Greater Splanchnic N. and Aortic Plexus 
Parasympathetic = Esophageal Branches of Vagus N.
72
Q

Describe the Sympathetic function of the Esophageal Plexus.

A

– Inhibit Peristalsis

– Inhibit Esophageal glands

73
Q

Describe the Parasympathetic function of the Esophageal Plexus.

A

– Stimulate Peristalsis

– Stimulate Esophageal glands

CPR1 Exam 1 (22 decks)

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