Abdominal Autonomics Flashcards
Fill out the diagram for the flow of information in the nervous system
What is the stress gland that is only innervated by the sympathetic system?
adrenal glands
Which spinal nerves contribute to the sympathetic nervous system?
What nervous system components contribute to the parasympathetic nervous system?
- Sympathetic
- T1-L2
- Parasympathetic
- brainstem
- S2-S4
Sympathetic preganglionic neurons that carry information to the GI system synapse at which ganglion?
Parasympathetic?
- Sympathetic
- prevertebral or para-aorta
- parasympathetic
- intramural
Describe the pathway of sympathetic nerves that woudl reachthe GI
cell bodies in lateral horn grey matter
out ventral roots
to spinal nerve
to ventral rami
throuh white rami
into sympathetic trunk
up/down
exit on spanchnic nerves (organ nerves)
through diaphragm
synapse in ganglia (prevertebral or paraaorta)
perivascular plexus to organs
Describe the route for parasympathetic nerves that innervate the Gi tract
Vagus (nuclei in brainstem ) or S2-S4 (intermediate gray matter in spinal chord
directly to guts, or using sympathetic archeticture – might go through a sympathetic ganglion to get to the gut w/ out synapsing
to organs (synapse)
What is the general brakdown of vertebral levels that sympathetically innervate the foregut, midgut and hindgut?
More specifically, what is the innervation to the liver, appendix, and sigmoid colon?
- foregut
- T5-T9
- midgut
- T8-T11
- hindgut
- T11-L2
This is VERY general
- liver
- T5-T9
- appendix/cecum
- T10
- sigmoid colon
- T12-L2
Why do we think of the kidney being innervated my sympathetically like the hindgut?
The kidneys start low and ascend
so, as they do so they drag their nerves with them
What is the breakdown of greater spanchnic nerves, lesser splanchnic nerves, least splanchnic, and lumbar spanchnic ?
Where is each of their destinations?
- greater
- T5-T9
- celiac ganglion
- lesser
- T10-T11
- superior mesenteric
- aorticorenal (paired)
- least (right next to the diaphragm)
- T12
- Renal plexus (synapsing occurring inside them)
- Lumbar splanchnic nerves directly off the sympathetic drunk
- L1-3
- intermesenteric plexus
- inferior mesenteric ganglion
Why is L3 spanchnic nerve a thing if the origins end at L2?
fibers from L2 continue down the trunk and exit at the level of L3 onto the L3 spanchnic nerve to make its way into the intermesenteric plexus & inferior mesenteric ganglion
How do post ganglionic sympathetic fibers reach their destination? Provide an example for the liver.
follow as a plexus covering on the vasculature to organs
- liver
- greater splanchnic to celiac ganglion
- this is next to celiac trunk,
- takes common hepatic
- to proper hepatic
- to the liver
What is differnet about the sympathetic innervation reaching the adrenal gland?
will take sympathetic archetecture, like celiac ganglion, but it will not synapse in the ganglion
the medulla of the adrenal glands is the ganglion
chromuffin cells are what receive information from the preganglionic sympathetic fibers
once stimulated the chromuffin cells will release their epinephrine/norepinephrine
Sympathetics additionally control the adrenal gland by controling the vasculature surrounding the gland
What is the breakdown for parasympathetic origination for the foregut, midgut and hindgut?
- vagus
- foregut and midgut
- stomach to 2/3 mark transverse colon
- S2-S4
- hindgut
- last 1/3 transverse colon to sigmoid colon/rectum
Which unpaird vascular branches provide arterial supply to the foregut, midgut and hindgut?
- foregut
- celiac trunk
- midgut
- superior mesenteric
- hindgut
- inferior mesenteric
Parasympathetic nerves follow these arterial divisions to reach the respective parts of the gut
How does the vagal esophageal plexus form in the abdomen?
esophageal plexus reforms into vagal trunks that run on the anterior and posterior aspect of the esophagus as it enters the hiatus in the diaphragm
the anterior is formed more from the left vagus nerve whereas the posterior is formed more from the right vagus nerve
formed more so from the left vagus nerve, will sit on the anterior aspect of the esophagus at it enters the hiatus in the diaphragm
What are the 3 routes that parasympathetic nerves can take to innervate their targe organs?
- Directly from vagal trunk into target organ
- could form proper nerves off of the vagal trunk making their way to an organ
- can jup on sympathetic archetecture at a sympathetic ganglion (not synapsing) to the target ganglion
Pathway of fibers from grey matter to pelvic splanchnic nerves?
Are they part of the sympathetic or parasympathetic system?
Parasympathetic
Pelvic splanchnic nerves that come off of ventral rami
to inherior hypogaastric plexus
make their way to the hingut organs in with own unique neural system in various mesentary– will not pass through sympathetic ganglion, not following perivascular plexuses
What are the two differen types of sensation from the GI tract?
Each generally follows which tract?
pain and status
pain follows sympathetics
status follows parasympathetic
not 100%
Pain information follows what autonomic archetecture back tot he spinal chord?
What is the transistion point?
- general visceral afferents with sympathetics
- pain from foregut to mid-sigmoid
- back through the ganglia
- to the sympathetic chain
- through white ramus
- into spinal nerve
- cell bodies in dorsal root ganglion
- make their way into the spinal column
- with parasympathetics
- from mid-sigmoid to rectum
- back to S2-S4
What nerve roots innervate the livere and therefore could be associated with referred pain?
Why could you feel pain in your upper shoulder if your liver is upset?
T5-T9
It is liver with relation to diaphragm
The liver could be irritating the diaphragm, irritating the parietal paritoneum over the diaphragm
Describe the route of early appendix pain and then in later appendicitis once it has ruptured
appendix is upset
T10
takes sympathetic archetecture back to the level T10 in the spinal chord
lose a lot of spacial relatinoship; vague general pain b/c not innervated well (visceral pain)
but if it bursts & starts to irritate parietal peritoneum–> sharp directed pain & know appendix is affecting other structures (parietal pain)
What general visceral afferent informaiton follows parasympthetic infrastructure?
how can this information be used?
gut status
follow vagus distribution
is there material in my stomach? colon?
can use it for a reflex
The abdominal wall receives what type of input?
sypmathetic
no parasympathetic
