Abdominal autonomics and lymphatics Flashcards
what are the 4 major visceral lymph nodes
celiac nodes
superior mesenteric nodes
inferior mesenteric
intestinal lymphatic trunk
where are the celiac nodes?
what part of gut do they collect lymph from?
where is the primary site of their drainage?
a. Around celiac trunk.
b. Collect lymph from foregut.
c. Primary drainage is to intestinal lymph trunk (see below).
where are the superior mesenteric nodes
what part of gut do they collect lymph from?
where do they drain to primarily?
secondarily drain to?
a. Around superior mesenteric artery.
b. Collect lymph from midgut.
c. Primary drainage is to celiac nodes.
d. Secondary drainage is to intestinal trunk.
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?
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.
what is the intestinal lympathic trunk formed from?
from efferent lymphatic channels of celiac lymph nodes
in 70 percent of population, the intestinal lymphatic trunk drains to what?
left lumbar trunk
in 30 percent of population, the intestinal trunk drains to what
cisterna chyli
what does the intestinal lymphatic trunk drain? with the exception of what?
nearly all lymph from abdominal viscera
liver–> some lymph drains to phrenic
kidney, ureter, suprarenal glands–> drain to lumbar lymph nodes
to what do the kidney, ureter, suprarenal glands drain to ?
lumbar lymph nodes
where do the parietal lymph nodes lie?
the lymphatic vessels and nodes that drain the body wall lie along path of aorta and IVC
what are two of the parietal lymph nodes
common iliac nodes
lumbar nodes
from what do the common iliac nodes collect lymph
from pelvis, perineum, lower limb
drain to lumbar lymph nodes
where are the lumbar nodes
what do they collect lymph from
where do they drain to?
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.
what does the left lumbar lymphatic trunk receive?
receives intestinal trunk and sometimes directly receives efferent vessels from the inferior mesenteric nodes
at what vertebral level do the right and left lumbar lymphatic trunks merge to form the thoracic duct?
LV2
in 20 percent of people a dilated sac called the cisterna chyli marks the beginning of the thoracic duct
at what vertebral level does the thoracic duct form and from what
forms anterior to LV2 from a merging of left and right lumbar trunks
at what vertebral level does the thoracic duct enter the thorax and via what?
- Enters thorax via the aorta hiatus at TV12.
- Sympathetic efferents are, in general, involved in what?
vasoconstriction
contraction of sphincter muscles
inhibition of glandular secretions
- Parasympathetic efferents are, in general, involved in what?
vasodilation
increased peristalsis
relaxation of sphincter muscles
what are the aortic plexuses
autonomic nerve fibers (sympathetic and parasympathetic) that distribute by coursing on the surface of the aorta and its major branches
what do the aortic plexus contain?
pre and post ganglionic sympathetic fibers
prevertebral sympathetic ganglia
preganglionic parasympathetic fibers
what are the 6 aortic plexuses
celiac nerve plexus superior mesenteric plexus renal plexus inferior mesenteric plexus intermesenteric plexus superior hypogastric plexus
to what does the renal plexus distribute
kidneys
suprarenals
ureters
where does the intermesenteric plexus course
along aorta between SMA and IMA
where does the hypogastric plexus course
what does this plexus give rise to ?
courses along aorta from IMA to its bifurcation; gives rise to hypogastric nn
what plexus does the hypogastric nn communicate with?
inferior hypogastric plexus of pelvis
parasympathetic innervation of the gut is distributed between what two nerves?
vagus nerve
pelvic splanchnic nerves `
what type of innervation and to what part of the gut does the vagus nerve provide innervation
- Provides parasympathetic innervation to GI tract from esophagus through transverse colon; including accessory digestive organs (foregut and midgut).
where are the preganglionic cell bodies of the vagus
brain stem (dorsal motor nucleus)
where do parasympathetic nerves enter the thorax and as what ?
enter abdomen as anterior and posterior vagal trunks (traveling on esophagus) through esophageal hiatus
distribute via various aortic plexuses to abdominal viscera
where are the postganglionic cell bodies of the vagus nerve and pelvic splanchnic nerves located
within walls of organ
vagus nerve innervates what in the gut overall
foregut and midgut
pelvic splanchnic nerves provide what type of innervation to what part of the gut?
- Provides parasympathetic innervation to GI tract from descending colon to proximal anal canal HINDGUT
where are the preganglionic cell bodies of pelvic splanchnic nerves?
sacral spinal cord S2-S4
the fibers travel with ventral rami S2=S4
what plexus do the pelvic splanchnic nerves hit before distributing to the organs
inferior hypogastric plexus
