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CPR Exam 1 > 11. Thoracic Neurology > Flashcards

11. Thoracic Neurology Flashcards

1
Q

what is the thoracic esophagus and where is it located

A

tube joining laryngopharynx to stomach

T1 & esophageal hiatus or diaphragm (travel thru post mediastinum)

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2
Q

what are the 4 constriction sites of the esophagus & why are they significant

A
  1. @ cricopharyngeus M - right below larynx (upper esophageal sphincter)
  2. @ aortic arch
  3. @ L. bronchus
  4. @ esophageal hiatus of diaphragm (lower esophageal sphincter)

-where food can get stuck if not small enough

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3
Q

what are the branches of the vagus N

A

recurrent laryngeal Ns

cardiac branches

pulmonary branches

esophageal branches

vagal trunks

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4
Q

how do R & L recurrent laryngeal Ns differ

A

R = off the neck, under subclavian A then back u

L = goes down and loops around aortic arch & ligamentum arteriosum & then back to larynx (prob at arch/ligamentum - hoarse voice)

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5
Q

where do the cardiac branches come off the vagus N

A

superior & middle @ neck

inferior @ thorax

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6
Q

where do anterior and posterior vagal trunks come from & where to they go

A

L vagus N –> ant

R vagus N –> post

==> both go to abd via esophageal hiatus

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7
Q

where does the phrenic N travel

what does it do

A

thru superior thoracic aperature and into space btn the mediastinal parietal pleura & fibrous pericardium

= sensory info from central diaphragm, mediastinal pleura & pericardium

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8
Q

what do the thoracic spinal Ns make

A

intercostal Ns

(=anterior rami of thoracic spinal Ns)

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9
Q

where do intercostal Ns travel

A

inf edge of superior rib in intercostal space

& btn internal and inner most intercostal Ms

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10
Q

what do the intercostal Ns innervate

A

skin

subcutaneous tissue

intercostal Ms

costal/diaphragmatic parietal pleura

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11
Q

which intercostal Ns are atypical & typical

A

atypical = 1-2 & 7-11

typical = 3-6

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12
Q

what are the branches of the typical intercostal Ns

A
  1. rami comunicates
  2. collateral branches
  3. lateral cutaneous branches
  4. anterior cutaneous branches
  5. muscular branches
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13
Q

what do rami communicates of the intercostal N do

A

connect intercostal N to ipsi thoracic sym trunk

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14
Q

where are the collateral branches of the intercostal Ns

A

sup edge of the inf rib in the intercostal space

-innervate intercostal Ms

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15
Q

what do the lateral & anterior cutaneous branches of the intercostal N supply

A

lateral: skin of thoracic wall
ant: ant skin of thoracic wall
both: T4-6 breast

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16
Q

what Ms are supplied by the muscular branches of the intercostal N

A

intercostal Ms

subcostal Ms

transverse thoracic Ms

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17
Q

why is the 1st intercostal N different

A

no cutaneous branches

majority of the superior part blends with the brachial plexus

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18
Q

what is the intercostobrachial N

A

2nd intercostal N cutaneous branch

-supplies skin & subcutaneous tissue of axilla

19
Q

why are intercostal Ns 7-11 different

A

begin as intercostal N and travel anteriorly

but run out of rib to run along –> so become thoracoabdominal Ns

20
Q

what does thoracolumbar mean

A

sym ANS (T1-L2)

21
Q

describe the presynaptic fibers of the sym system

A

= short

cell bodies in lateral horns of T & upper L

travel in ant root –> ant ramus –> paravertebral ganglia at their own level

22
Q

what are the options the presynaptic sym fibers can do after reaching the paravertebal ganglion

A
  1. synapse at same level –> go to heart/lungs
  2. ascend/descend –> then synpase
  3. exit w/o synapsing –> continue as abdominopelvic splanchnic Ns into corresponding prevertebral ganglia in abd
23
Q

what are cardiopulmonary splanchnic Ns

A

=post synaptic fibers

cardio part (T1-5/6)

pul part (T1-2)

presyn - synapse in cervical/thoracic sym trunk –> postsyn (these fibers)

24
Q

what type of fibers are abdominopelvic splanchnic Ns

A

presynaptic

25
Q

what is the greater splanchnic N

A

T5-9/10

send fibers to esophageal plexus & celiac ganglion in abd

-feed into celiac plexus

26
Q

what is the lesser splanchnic N

A

T10-11

send fibers to celiac & sup mesenteric ganglion in abd

-feed into sup mesenteric plexus

27
Q

what is the least splanchnic N

A

T12

send fibers to aorticorenal ganglion in abd

28
Q

Sympathetic innervation is sent …

A

EVERYWHERE

-even smooth Ms, skin, sweat glands, etc

29
Q

what does craniosacral mean

A

parasym ANS

30
Q

describe the parasym presynaptic fibers

A

long

-nuclei in brainstem & sacral spinal cord

cranial component exit as CNs 3, 7, 9, 10

sacral component exit spinal level as pelvic splanchnic Ns

31
Q

what 4 ganglion are associated with the parasym ANS

A
  1. celiac (CN 3)
  2. pterygopalatine (CN 7)
  3. submandibular (CN 7)
  4. otic (CN 9)

cell bodies of parasym postsyn fibers (close to target organ -short)

32
Q

where are the cell bodies of the parasym postsyn fibers

A

in or near traget organ

33
Q

what makes up the thoracic autonomic plexuses

A

postsyn fibers of both sym and parasym fibers

34
Q

what does the pulmonary plexus innervate

A

lungs, bronchi & pleura

35
Q

pulmonary plexus sympathetic contribution

A

pulmonary splanchnic Ns

36
Q

pulmonary plexus parasym contribution =

A

pulmonary branches of the vagus N

37
Q

what does the cardiac plexus innervate

A

nodal tissue (heart)

superficial - cover ant surface of aorta

deep - ant to bifurcation of trachea, post to aortic arch & sup to bifurcation of pul trunk

38
Q

cardiac plexus sym contribution

A

cardiac splanchnic Ns

39
Q

cardiac plexus parasym contribution =

A

superior, middle & inferior cardiac branches

of vagus N

40
Q

what is the purpose of the aortic plexus

A

conduit of cardiac plexus into intermesenteric plexus

41
Q

aortic plexus sym contribution =

-what is the fxn

A

continuous w superficial cardiac plexus

= bronchodilator, vasoconstrictor & visceral sensory

42
Q

aortic plexus parasym contribution =

what is its fxn

A

continuous w/ superficial cardiac plexus

=bronchoconstrictor, secretomotor to glands of bronchi/ioles, vasodilator, sensory from brachial mucosa)

43
Q

esophageal plexus sym contribution

A

greater splanchnic N & aortic plexus

-inhibt peristalis & esophageal glands

44
Q

esophageal plexus parasym contribution

A

esophageal branches of the vagus N

=stimulate peristalsis & esophageal glands

CPR Exam 1 (27 decks)

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