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Medicine 3 > 12 ANS and pelvic viscera > Flashcards

12 ANS and pelvic viscera Flashcards

1
Q

what does the autonomic nervous system consist of?

A

visceral efferent motor fibres

visceral afferent pain fibres

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2
Q

where is the ANS distrubuted?

A

CNS and PNS

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3
Q

what are the differences in the two divisions of ANS?

A

sympathetic and payasympathetic nervous system

  • anatomical
  • neurotransmitters
  • physiological effects
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4
Q

function of sympathetic nervous system

A

prepare body for an emergency

  • increase heart rate
  • redistribution of blood- arterioles of skin and intestines constricted. arteriole of Skm dilated
  • increased in BP
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5
Q

sympathetic nervous system

A

thoracolumbar outflow

  • efferent outflow from spinal cord, sympathetic trunk, branches, plexuses and ganglia
  • Lateral horn (preganglionic cell bodies location) positioned from T1-L3
  • Axons of preganglionic neurones leave lateral horn and enter into paravertebral ganglia of the sympathetic trunk
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6
Q

SNS: Once pre-ganglionic fibres enter sympathetic trunk they can…

A
  1. synapse at entry level
  2. ascend and synapse- travel cranially
  3. descend and synapse- travel caudally
  4. no synpase with ganglia assocaited with sympathetic trunk- form splanchnic nerves

(synapse at ganglia some distance away)

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7
Q

what type of fibres are splanchnic nerves?

A

pre-ganglionic sympathetic fibres

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8
Q

what is the sympathetic chain/ paravertebral column?

A

two ganglionic nerve trunks that extend the whole length of vertebral column

  • Superior cervical ganglion of each sympathetic trunk lies at base of cranium
  • Ganglion impar forms inferiorly where two trunks unite at level of coccyx
  • Associated with spinal cord
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9
Q

how many sympathetic ganglia are associated with:

neck

thorax

abdomen

pelvis

A

3

11/12

4/5

4/5

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10
Q

lower thoracic splanchnic nerve vertebrae

origin

A

greater- T5-T9 (T10)

lesser T10-11

Least T12

thoracic sympathetic trunk

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11
Q

2

6

yellow arrows

12

13

A

azygous vein

SVC

sympathetic chain

lesser splanchnic nerves

greater splanchnic nerves

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12
Q

which plexuses do the thoracic splanchnic nerves form

A

greater- pierces crura of diaphragm to synapse with coeliac plexus

lesser- pierces crura of diaphragm, descends with greater splanchnic nerves to join lower part of coeliac plexus

least- preganglionic fibres of excitatory neurones in ganglia of renal plexus

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13
Q

function of parasympathetic nervous system

A

cranio-sacral outflow

Function to conserve and restore energy

  • Decrease heart rate
  • Peristalsis and glandular activity increased
  • Sphincters are opened
  • Bladder wall is contracted
  • Pupils are constricted
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14
Q

locations of nerve cells of PNS

A

CNIII oculomotor

CNVII facial

CNIX glossopharyngeal

CNX vagus

sacral segments of spinal cord- grey matter

S2-S4 anterior roots of spinal nerves

Efferent fibres of cranio-sacral outflow are pre-ganglionic and synapse in peripheral ganglia located close to viscera they innervate

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15
Q

waht type of nervous system are pelvic splanchnic nerves

A

parasymapathetic S2-S4

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16
Q

hypogastric nerve plexuses

A

superior hypogastric nerve plexus-> sympathetic

splits into R and L hypogastric nerves-> inferior hypogastric plexus -> mixed

17
Q

7

34

A

7 inf mesenteric artery

34 internal iliac artery

18
Q
A
19
Q

enteric nervous system:

what plexuses does it consist of

A

Two important plexuses of nerve cells and fibres extend along/around the GI tract

Meisser plexus (submucosal plexus)

auerbach plexus (myenteric plexus)

  • Capable autonomous (coordination of reflexes)
  • Operate independently of brain and spinal cord
  • Does receive autonomic nervous innervation
20
Q

ENS: function of Meissner’s plexus and location

A
  • Controls glandular secretion of mucosa
  • Located between submucosa and circular muscle layer
  • Also involved in local movement of muscle
21
Q

ENS: function and locaiton of Auerbach’s plexus

A
  • Controls peristalsis
  • Movement of gut wall
  • Between circular and longitudinal muscle layers
22
Q
A
23
Q

myenteric

stimulation

inhibition

A
  • Myenteric: longitudinal chains of neurones
    • Stimulated Plexus increases tone of gut and velocity and intensity of contractions
    • Motility through gut
    • Inhibition: relax sphincters, controls flow of digestive food/ waste
  • Submucosal:
    • Local conditions and controls local secretions and local muscle movements
  • Mucosa and epithelial tissue have sensory nerve endings that feed signals to both layers of enteric plexus
    • Tissues send info back to sympathetic prevertebral ganglia-> spinal cord-> brain stem
24
Q

role of sensory nerves in ENS

A

monitor tension and gut wall and conditions in lumen

feedback to assc nerves

25
Q

functions of ENS

A

Estimated more neurones associated with it than spinal cord

  • Second brain
  • Contains a variety of functional types of neurones and a plethora of neurotransmitters
  • Controls motility and secretory functions
  • Complete reflex circuit
    • Afferent sensory neurones, interneurons and efferent secretomotor neurones
  • Functions autonomously, but modified by sympathetic and parasympathetic nervous systems
26
Q

pathology of ENS

A

Hirschsprung’s disease

  • Congenital birth defect (1:5000)
  • Enteric neurones absent from variable lengths of the distal gut
    • Failure of neural crest cells to colonise region of gut (vs nerves not surviving)
  • Intestinal obstruction or severe constipation

Descending colon: lacking enteric neurones (aganglionic)

  • Contracted and devoid of content
  • Region proximal to aganglionic zone is distended (megacolon) due to accumulation of fecal content

Mutations in identified genes 50% of causes

27
Q

dorsal primary ramus

A

part of spinal nerve (contains motor, sensory and autonomic) innervating back.

28
Q

ventral primary ramus

A

part of spinal nerve innervating everything in front of spinal cord – hence larger than dorsal primary ramus.

29
Q

white ramus

A

preganglionic sympathetic fibres connecting ventral primary ramus with sympathetic chain. Myelinated nerves only found T1 – L2

30
Q

grey ramus

A

post ganglionic sympathetic fibres connecting sympathetic chain to dorsal and ventral primary ramus of spinal nerve. Unmyelinated nerves

Medicine 3 (31 decks)

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