9. Abdominopelvic Autonomics and Pain

Question 1

Are presynaptic or postsynaptic neurons myelinated?

Answer 1

Presynaptic neurons are myelinated.

Question 2

Which division of the nervous system, somatic or autonomic, have no ganglia involved in their pathway?

Answer 2

The somatic nervous system.

(Single neuron pathway)

Question 3

Where does constipation typically present pain?

Answer 3

Left inguinal region.

Question 4

Which division of the autonomic nervous system inhibits sphincters?

Answer 4

The parasympathetic nervous system.

Question 5

In what ganglia do the parasympathetic cranial nerves synapse?

Answer 5

Ciliary ganglion.

Pterygopalatine ganglion.

Submandibular ganglion.

Otic ganglion.

Question 6

Which cranial nerves carry parasympathetic nerve fibers?

Answer 6

Cranial nerves III, VII, IX, X.

Question 7

Where do the sympathetic nerve fibers destined from the lower limb originate?

Answer 7

T12-L2

Question 8

What are the four main symptoms of Horner syndrome?

Answer 8

Ptosis.

Anhydrosis.

Miosis.

Flushing.

Question 9

Generally speaking, where to the organs of the foregut, midgut, and hindgut produce pain?

Answer 9

Foregut organs produce pain in the epigastric region, midgut organs produce pain in the periumbilical region, hindgut organs produce pain in the suprapubic/hypogastric area.

Question 10

What are the only parasympathetic nerves that travel with spinal nerves?

Answer 10

The pelvic splanchnics, which run with S2-S4.

Question 11

Which division of the autonomic nervous system helps you read things up close?

Answer 11

The parasympathetic nervous system.

Question 12

With what nerve fibers do the postsynaptic sympathetic nerve fibers destine for the upper limb run?

Answer 12

C5-T1’s anterior rami.

These are also the roots of the brachial plexus.

Question 13

Where do all sympathetic nerves originally come from?

Answer 13

The intermediolateral cell column of T-1-L2

Question 14

Which ganglia are the points of synapse for the sympathetic nerve fibers destined for the upper limb?

Answer 14

The middle and inferior cervical ganglia.

Question 15

Which division of the nervous system, somatic or autonomic, has a two neuron pathway?

Answer 15

The autonomic nervous system.

Question 16

With what nerves do the postsynaptic sympathetic nerve fibers destined for the lower limb run?

Answer 16

L2-S3’s anterior rami.

These are also the roots of the lumbosacral plexus.

Question 17

What is controlled by sympathetic nerve fibers that exit the internal carotid plexus?

Answer 17

Mucus secretions and blood vessels of the oral and nasal passages.

Pupillary dilation.

Elevation of the eyelid.

Question 18

What is controlled by the sympathetic nerve fibers that exit the external carotid plexus?

Answer 18

Mucus secretions from salivary glands.
Sweat glands of the face.

Blood vessels of the face.

Question 19

Where does appendicitis cause pain in the late stages?

Answer 19

In the right inguinal region.

Question 20

Which fibers of the autonomic nervous system, preganglionic or postganglionic, are myelinated?

Answer 20

Preganglionic fibers.

Question 21

Which spinal nerves make up the sympathetic nervous system?

Answer 21

T-1-L2 (3)

Question 22

Where is the thoracic pain line?

Answer 22

The sternal angle – T4-T5.

Question 23

Which abdominal structures are likely to refer pain to the back and why?

Answer 23

The pancreas, kidney, and aorta.

Because they are retroperitoneal.

Question 24

Where do sympathetic nerves bypass both the paravertebral ganglia and the prevertebral ganglia to synapse at the target organ?

Answer 24

In the suprarenal gland.

Question 25

Where do sympathetic nerves running through the internal and external carotid plexuses synapse?

Answer 25

In the superior cervical ganglia.

Question 26

Which sympathetic splanchnic nerves synapse in prevertebral ganglia?

Answer 26

Abdominopelvic splanchnic nerves.

(Greater, lesser, least splanchnic.)

Question 27

Where does Crohn’s disease typically present pain?

Answer 27

Right inguinal region.

Question 28

What glands are innervated by parasympathetic fibers from the submandibular ganglion?

Answer 28

Both the submandibular and sublingual salivary glands.

Question 29

What areas of the head are innervated by nerves from the pterygopalatine ganglion?

Answer 29

The nasal passage and palate.

Question 30

What are the given definitions for acute, subacute, and chronic abdominal pain?

Answer 30

Acute – less than three days.

Subacute – three days to three weeks.

Chronic – greater than three weeks.

Question 31

Which sympathetic splanchnic nerves synapse in paravertebral ganglia?

Answer 31

Cardiopulmonary splanchnics.

Question 32

An organ irritating the parietal peritoneum will cause what kind of pain?

Answer 32

Somatic pain.

Question 33

What are the basic functions of the sympathetic nerves to the body wall and limbs?

Answer 33

Vasomotion, sudomotion, pilomotion.

Question 34

What are the functions of the ciliary ganglion?

Answer 34

Constriction of the pupil.

Serous secretions from the lacrimal gland (tears).

Accommodation.

Question 35

What is the basic cause of Horner syndrome?

Answer 35

Damage to the sympathetic trunk superior to T1-T4 or damage to the superior cervical ganglion itself.

Question 36

What is colicky pain?

Answer 36

Intermittent cramp like pain caused by an obstruction of a hollow muscular viscous.

Bowel obstruction, stone in ureter, stone in neck of gallbladder.

Question 37

Where do the sympathetic fibers destined for the head exit the IML?

Answer 37

T1-T4

Question 38

Generally speaking, the sympathetic’s afferents nerves carry pain. What is typically carried by the parasympathetic afferents nerves?

Answer 38

“Innocuous input.” E.g. homeostatic information.

Question 39

Which division of the nervous system, somatic or autonomic, uses only acetylcholine as an excitatory molecule?

Answer 39

The somatic nervous system.

Question 40

Which division of the nervous system, somatic or autonomic, has only myelinated axons?

Answer 40

Somatic nervous system.

Question 41

Where do ectopic pregnancies typically present pain?

Answer 41

Right inguinal region.

Question 42

What two types of nerve fibers comprise every splanchnic nerve?

Answer 42

Visceral afferent and visceral motor fibers.

Question 43

Where do presynaptic fibers of the sympathetic nervous system destined for the lower limb synapse?

Answer 43

In the lower lumbar and sacral portions of the sympathetic trunk.

Question 44

Which division of the nervous system, somatic or autonomic, can be both excitatory and inhibitory?

Answer 44

The autonomic nervous system.

Question 45

Where does appendicitis cause pain in the early stages?

Answer 45

In the umbilical region.

Question 46

What is the primary difference between somatic and visceral pain?

Answer 46

Visceral pain is poorly localized and is often referred to somatic regions.

Somatic pain is well localized and is caused by injury to skin, muscles, bone, joints, and connective tissues.