Abdominal and Pelvic Autonomics and Pain

Question 1

What is the sympathetic and parasympathetic effect on detrusor vesicae of the bladder?

Answer 1

symp= relaxation
para= contraction

Question 2

What is the sympathetic and parasympathetic effect on the functional bladder sphincter?

Answer 2

symp= contraction
para= inhibit contraction

Question 3

What plexuses are found in the abdominal aorta? What do they control?

Answer 3

Celiac, superior mesenteric, and inferior mesenteric

autonomic control of digestion

Question 4

What does the inf and sup hypogastric plexus innervate? What do they control?

Answer 4

pelvic viscera

autonomic control of urinary and reproduction function

Question 5

What do the rami communicantes connect?

Answer 5

spinal nerves to each sympathetic trunk, carry preganglionic sympathetic axons from T1-L2

Question 6

What is a white ramus?

Answer 6

Pregang axons that are myelinated, “entrance”

Question 7

What is a grey ramus?

Answer 7

postgnag unmyelinated, connect to all spinal nerves so info from thoracolumbar region can be distributed all over the body, “exit”

Question 8

What is the spinal nerve sympathetic pathways?

Answer 8

hop back on spinal nerve and go to skin, induce sweating, dialate vasculature in skin

Ventral ramus –> spinal nerve –> preganglionic –> white ramus –> sympathetic trunk ganglion of same level or ascend descend –> grey ramus on same spinal nerve and travel to skin, “looping”

Question 9

What is the postganglionic sympathetic pathway?

Answer 9

synapsing and then becomes grey ramus that is long and goes to where needs to go, stay at same level or ascend, long splanchnic nerves

Question 10

What is the splanchnic nerve sympathetic pathway?

Answer 10

pre gang white ramus going into sympathetic trunk but no synapsing then still white and goes to prevertebral ganglion then sends out fibers in plexuses

Question 11

What is the adrenal medulla sympathetic pathway?

Answer 11

direct stimulation by pregang on adrenal gland, everything white

Question 12

What terminates in prevertebral ganglia?

Answer 12

greater, lesser, and least thoracic
lumbar splanchnic
sacral splanchnic

Question 13

What innervates the intraperitoneal of the foregut?

Answer 13

sympathetic trunk, posterior and anterior vagal trunk, celiac ganglia, and superior mesenteric ganglia

Question 14

What innervates the intraperitoneal of the mid and hind gut?

Answer 14

sympathetic trunk, posterior and anterior vagal trunk, celiac ganglia, superior and inferior mesenteric ganglion, greater lesser and least splanchnic, lumbar splanchnic, sacral splanchnic, pelvic splanchnic

Question 15

What parasympathetic innervation does pelvic splanchnic (S2-4) provide?

Answer 15

distal gut tube (distal LI, rectum), repor organs, bladder, distal ureters and pelvic viscera

Question 16

What effects does the vagus nerve have?

Answer 16

decrease heart rate, decrease respiration, constrict and excite mucous production in bronchial passages, promote swallowing and peristalsis in esophagus, promote digestion in abdominal viscera

Question 17

Where is pain innervated by sympathetics?

Answer 17

Between thoracic pain line at plane of sternal angle (T4-5) and pelvic pain line at plane of lower extent of peritoneum

Question 18

What is visceral pain?

Answer 18

Diffuse and poorly localized, referred to somatic regions, injury to internal organs and tissues that support them, can be localized by sensory cortex to approximate spinal cord level

Question 19

What is somatic pain?

Answer 19

Well localized, cause by injury to skin muscles bone joint and connective tissue

Question 20

What is parietal pain?

Answer 20

Irritation of fibers that innervate parietal peritoneum, localized to dermatome superficial to site of painful stimulus, visceral can develop into  tenderness, rebound, rigidity, guarding