Abdominal Autonomics Flashcards

1
Q

Fill out the diagram for the flow of information in the nervous system

A
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2
Q

What is the stress gland that is only innervated by the sympathetic system?

A

adrenal glands

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3
Q

Which spinal nerves contribute to the sympathetic nervous system?

What nervous system components contribute to the parasympathetic nervous system?

A
  • Sympathetic
    • T1-L2
  • Parasympathetic
    • brainstem
    • S2-S4
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4
Q

Sympathetic preganglionic neurons that carry information to the GI system synapse at which ganglion?

Parasympathetic?

A
  • Sympathetic
    • prevertebral or para-aorta
  • parasympathetic
    • intramural
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5
Q

Describe the pathway of sympathetic nerves that woudl reachthe GI

A

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

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6
Q

Describe the route for parasympathetic nerves that innervate the Gi tract

A

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)

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7
Q

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?

A
  • foregut
    • T5-T9
  • midgut
    • T8-T11
  • hindgut
    • T11-L2

This is VERY general

  • liver
    • T5-T9
  • appendix/cecum
    • T10
  • sigmoid colon
    • T12-L2
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8
Q

Why do we think of the kidney being innervated my sympathetically like the hindgut?

A

The kidneys start low and ascend

so, as they do so they drag their nerves with them

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9
Q

What is the breakdown of greater spanchnic nerves, lesser splanchnic nerves, least splanchnic, and lumbar spanchnic ?

Where is each of their destinations?

A
  • 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
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10
Q

Why is L3 spanchnic nerve a thing if the origins end at L2?

A

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

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11
Q

How do post ganglionic sympathetic fibers reach their destination? Provide an example for the liver.

A

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
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12
Q

What is differnet about the sympathetic innervation reaching the adrenal gland?

A

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

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13
Q

What is the breakdown for parasympathetic origination for the foregut, midgut and hindgut?

A
  • vagus
    • foregut and midgut
    • stomach to 2/3 mark transverse colon
  • S2-S4
    • hindgut
    • last 1/3 transverse colon to sigmoid colon/rectum
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14
Q

Which unpaird vascular branches provide arterial supply to the foregut, midgut and hindgut?

A
  • foregut
    • celiac trunk
  • midgut
    • superior mesenteric
  • hindgut
    • inferior mesenteric

Parasympathetic nerves follow these arterial divisions to reach the respective parts of the gut

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15
Q

How does the vagal esophageal plexus form in the abdomen?

A

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

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16
Q

What are the 3 routes that parasympathetic nerves can take to innervate their targe organs?

A
  • 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
17
Q

Pathway of fibers from grey matter to pelvic splanchnic nerves?

Are they part of the sympathetic or parasympathetic system?

A

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

18
Q

What are the two differen types of sensation from the GI tract?

Each generally follows which tract?

A

pain and status

pain follows sympathetics

status follows parasympathetic

not 100%

19
Q

Pain information follows what autonomic archetecture back tot he spinal chord?

What is the transistion point?

A
  • 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
20
Q

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?

A

T5-T9

It is liver with relation to diaphragm

The liver could be irritating the diaphragm, irritating the parietal paritoneum over the diaphragm

21
Q

Describe the route of early appendix pain and then in later appendicitis once it has ruptured

A

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)

22
Q

What general visceral afferent informaiton follows parasympthetic infrastructure?

how can this information be used?

A

gut status

follow vagus distribution

is there material in my stomach? colon?

can use it for a reflex

23
Q

The abdominal wall receives what type of input?

A

sypmathetic

no parasympathetic