Abdominal autonomics and lymphatics

Question 1

what are the 4 major visceral lymph nodes

Answer 1

celiac nodes
superior mesenteric nodes
inferior mesenteric
intestinal lymphatic trunk

Question 2

where are the celiac nodes?
what part of gut do they collect lymph from?
where is the primary site of their drainage?

Answer 2

a. Around celiac trunk.
b. Collect lymph from foregut.
c. Primary drainage is to intestinal lymph trunk (see below).

Question 3

where are the superior mesenteric nodes
what part of gut do they collect lymph from?
where do they drain to primarily?
secondarily drain to?

Answer 3

a. Around superior mesenteric artery.
b. Collect lymph from midgut.
c. Primary drainage is to celiac nodes.
d. Secondary drainage is to intestinal trunk.

Question 4

where are the inferior mesenteric nodes
from what part of the gut do they collect lymph from?
primarily drain to what?
secondarily drain to what?

Answer 4

a. Around inferior mesenteric artery.
b. Collect lymph from hindgut.
c. Primary drainage is to superior mesenteric nodes.
d. Secondary drainage is to left lumbar trunk.

Question 5

what is the intestinal lympathic trunk formed from?

Answer 5

from efferent lymphatic channels of celiac lymph nodes

Question 6

in 70 percent of population, the intestinal lymphatic trunk drains to what?

Answer 6

left lumbar trunk

Question 7

in 30 percent of population, the intestinal trunk drains to what

Answer 7

cisterna chyli

Question 8

what does the intestinal lymphatic trunk drain? with the exception of what?

Answer 8

nearly all lymph from abdominal viscera

liver–> some lymph drains to phrenic
kidney, ureter, suprarenal glands–> drain to lumbar lymph nodes

Question 9

to what do the kidney, ureter, suprarenal glands drain to ?

Answer 9

lumbar lymph nodes

Question 10

where do the parietal lymph nodes lie?

Answer 10

the lymphatic vessels and nodes that drain the body wall lie along path of aorta and IVC

Question 11

what are two of the parietal lymph nodes

Answer 11

common iliac nodes

lumbar nodes

Question 12

from what do the common iliac nodes collect lymph

Answer 12

from pelvis, perineum, lower limb

drain to lumbar lymph nodes

Question 13

where are the lumbar nodes
what do they collect lymph from
where do they drain to?

Answer 13

a. Lie along aorta (aortic nodes) and IVC (caval nodes).
b. Collect lymph from common iliac nodes, abdominal wall, kidney, ureter, suprarenal glands, some diaphragm, gonads, part of uterus, uterine tubes.
c. Drain to left and right lumbar lymphatic trunks.

Question 14

what does the left lumbar lymphatic trunk receive?

Answer 14

receives intestinal trunk and sometimes directly receives efferent vessels from the inferior mesenteric nodes

Question 15

at what vertebral level do the right and left lumbar lymphatic trunks merge to form the thoracic duct?

Answer 15

LV2

in 20 percent of people a dilated sac called the cisterna chyli marks the beginning of the thoracic duct

Question 16

at what vertebral level does the thoracic duct form and from what

Answer 16

forms anterior to LV2 from a merging of left and right lumbar trunks

Question 17

at what vertebral level does the thoracic duct enter the thorax and via what?

Answer 17

2. Enters thorax via the aorta hiatus at TV12.

Question 18

1. Sympathetic efferents are, in general, involved in what?

Answer 18

vasoconstriction
contraction of sphincter muscles
inhibition of glandular secretions

Question 19

2. Parasympathetic efferents are, in general, involved in what?

Answer 19

vasodilation
increased peristalsis
relaxation of sphincter muscles

Question 20

what are the aortic plexuses

Answer 20

autonomic nerve fibers (sympathetic and parasympathetic) that distribute by coursing on the surface of the aorta and its major branches

Question 21

what do the aortic plexus contain?

Answer 21

pre and post ganglionic sympathetic fibers
prevertebral sympathetic ganglia
preganglionic parasympathetic fibers

Question 22

what are the 6 aortic plexuses

Answer 22

celiac nerve plexus
superior mesenteric plexus
renal plexus
inferior mesenteric plexus
intermesenteric plexus
superior hypogastric plexus

Question 23

to what does the renal plexus distribute

Answer 23

kidneys
suprarenals
ureters

Question 24

where does the intermesenteric plexus course

Answer 24

along aorta between SMA and IMA

Question 25

where does the hypogastric plexus course

what does this plexus give rise to ?

Answer 25

courses along aorta from IMA to its bifurcation; gives rise to hypogastric nn

Question 26

what plexus does the hypogastric nn communicate with?

Answer 26

inferior hypogastric plexus of pelvis

Question 27

parasympathetic innervation of the gut is distributed between what two nerves?

Answer 27

vagus nerve

pelvic splanchnic nerves `

Question 28

what type of innervation and to what part of the gut does the vagus nerve provide innervation

Answer 28

1. Provides parasympathetic innervation to GI tract from esophagus through transverse colon; including accessory digestive organs (foregut and midgut).

Question 29

where are the preganglionic cell bodies of the vagus

Answer 29

brain stem (dorsal motor nucleus)

Question 30

where do parasympathetic nerves enter the thorax and as what ?

Answer 30

enter abdomen as anterior and posterior vagal trunks (traveling on esophagus) through esophageal hiatus

distribute via various aortic plexuses to abdominal viscera

Question 31

where are the postganglionic cell bodies of the vagus nerve and pelvic splanchnic nerves located

Answer 31

within walls of organ

Question 32

vagus nerve innervates what in the gut overall

Answer 32

foregut and midgut

Question 33

pelvic splanchnic nerves provide what type of innervation to what part of the gut?

Answer 33

1. Provides parasympathetic innervation to GI tract from descending colon to proximal anal canal HINDGUT

Question 34

where are the preganglionic cell bodies of pelvic splanchnic nerves?

Answer 34

sacral spinal cord S2-S4

the fibers travel with ventral rami S2=S4

Question 35

what plexus do the pelvic splanchnic nerves hit before distributing to the organs

Answer 35

inferior hypogastric plexus