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Gross Anatomy > Abdominal Autonomics and Referred Pain > Flashcards

Abdominal Autonomics and Referred Pain Flashcards

1
Q

What is the ventral ramus of the subcostal nerve?

A

T12

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2
Q

Where is the subcostal nerve located?

A

inferior to 12th rib at superior aspect of quadratus lumborum

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3
Q

What does the subcostal n. supply?

A

Abdominal muscles and skin of lower abdomen

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4
Q

What is the ventral ramus of iliohypogastric nerve and ilioinguinal nerve?

A

L1

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5
Q

Where are the iliohypogastric nerve and ilioinguinal nerve located?

A

Cross ~middle of quadratus lumborum; separation may occur as far anterior as ASIS

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6
Q

What does the iliohypogastric nerve supply?

A

skin of lower abdomen

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7
Q

What does the ilioinguinal nerve supply?

A

internal oblique and skin of external genitalia

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8
Q

What are the ventral rami of the lateral cutaneous nerve of the thigh (lateral femoral cutaneous n.)?

A

L2-3

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9
Q

Where is the lateral cutaneous nerve of the thigh (lateral femoral cutaneous n.) located?

A

Courses over iliacus muscle

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10
Q

What does the lateral cutaneous nerve of the thigh (lateral femoral cutaneous nerve) supply?

A

Lateral thigh sensation

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11
Q

What are the ventral rami of the genitofemoral nerve?

A

L1-2

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12
Q

Where is the genitogemoral n. located?

A

Pierces anterior part of psoas major

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13
Q

What does the genitofemoral nerve supply?

A

Genital branch supplies cremaster muscle and external genitalia sensation
Femoral branch supplies upper thigh sensation

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14
Q

What are the ventral rami of femoral nerve?

A

L2-L4

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15
Q

Where is the femoral n. located?

A

Emerges lateral to psoas m.

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16
Q

What does the femoral n. supply?

A

Motor and sensation to lower limb

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17
Q

What are the ventral rami of the obturator n.?

A

L2-L4

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18
Q

Where is the obturator n. located

A

Emerges medial to psoas muscle w/i pelvic cavity

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19
Q

What does the obturator n. supply?

A

motor and sensation to lower limb

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20
Q

Where does the sympathetic chain/trunk extend?

A

Bilaterally on length of vertebral column

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21
Q

Are visceral sensory neurons part of the autonomic nervous system?

A

No

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22
Q

T or F: Autonomic neurons are motor?

A

True

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23
Q

The sympathetic nervous system arises from neurons associated with which spinal nerves:

A

T1-L2/3

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24
Q

What levels of the IML innervate the abdominal viscera?

A

T7-L2/3

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25
Q

The gut from stomach to sigmoid colon is innervated by levels ___

A

T7-T11

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26
Q

The rectum and other pelvic viscera are innervated by levels ___

A

T12-L2/3

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27
Q

In the sympathetic chain, fibers can ____

A

pass through ganglion without synapsing then synapse in prevertebral ganglia

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28
Q

Are abdominopelvic splanchnic nerves formed before or after the sympathetic chain? Do they synapse in the sympathetic chain?

A

They form after and do not synapse

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29
Q

Splanchnic nerves are pre or postganglionic until the prevertebral ganglia?

A

Preganglionic

30
Q

Where are paravertebral ganglia located?

A

Lateral to vertebral column

31
Q

What do paravertebral ganglia form?

A

Sympathetic trunk/chains (bilateral)

32
Q

Where are prevertebral ganglia found?

A

Anterior surface of abdominal aorta (in front of vertebrae)

33
Q

What are prevertebral ganglia associated with?

A

Abdominal viscera

34
Q

T or F: Named prevertebral ganglia separated within plexi

A

False; they are intermixed

35
Q

What are the intermixed prevertebral ganglia within plexi?

A
  • celiac ganglion and plexus
  • aorticorenal ganglia and renal plexus
  • superior mesenteric gangion and plexus
  • intermesenteric plexus
  • inferior mesenteric ganglion and plexus
36
Q

T or F: Plexuses are parasympathetic only.

A

False; they are parasympathetic and sympathetic

37
Q

T or F: Ganglia are (postganglionic) sympathetic

A

True

38
Q

Where are the celiac ganglia and plexus located

A

Superior to celiac artery

39
Q

What gives input to the celiac plexus

A

greater and lesser splanchnic nerves & vagal trunks

40
Q

Where is the superior mesenteric ganglion and plexus?

A

superior to superior mesenteric artery

41
Q

What gives input to the superior mesenteric plexus

A

Greater and lesser splanchnic nerves & vagal trunks

42
Q

Where is the aorticorenal ganglia and renal plexus located?

A

Ganglia are continuous with celiac ganglia and more inferolateral near renal arteries

43
Q

What gives input to the renal plexus?

A

Lesser and least splanchnic nerves & vagal trunks

44
Q

T or F: Parasympathetics go to the trunk or limbs

A

False; no parasympathetics to the trunk or limbs

45
Q

Where will sympathetic innervation in the trunk wall and limbs go to?

A

Blood vessel smooth muscle, sweat glands, and arrector pili muscles

46
Q

Are the postganglionic neurons/axons/fibers going to the trunk wall and limbs gray or white communicating rami?

A

Gray communicating rami

47
Q

What does the vagus nerve innervate?

A

Foregot and midgut

48
Q

What forms the esophageal plexus

A

Parasympathetic fibers from vagus nerves and sympathetic branches

49
Q

L vagus n. recoalesces as ___

A

anterior vagal trunk

50
Q

R vagus n. recoalesces as ____

A

posterior vagal trunk

51
Q

The vagus nerve continues to innervate ___ to ____

A

gut to distal 1/2 of transverse colon

*to descending colon may be more accurate but this delineation follow midgut-hindgut differentiation

52
Q

The pelvis splanchnic nerves arise from which spinal nerves

A

SNs of S2-S4

53
Q

Lumbar and sacral splanchnic nerves arise from

A

sympathetic chain

54
Q

Are pelvic splanchnic nerves pre or postganglionic?

A

Preganglionic

55
Q

What are the effects of parasympathetics on the GI tract?

A

Increase peristalsis, increase secretions (gastrin, HCl), relax sphincters

56
Q

What are the effects of sympathetics on the GI tract?

A

Decrease peristalsis, decrease secretions

57
Q

What do the pelvic splanchnic nerves innervate?

A

Hindgut

58
Q

visceral afferent fibers respond to what stimuli

A

Pressure, tension, stretch like fullness in bladder, stomach

59
Q

T or F: Visceral pain is the same as somatic pain?

A

False; they’re different

60
Q

What does the distribution of visceral pain look like?

A

Diffuse, poorly localized

61
Q

Are there any receptors for cutting, crushing, or burning in viscera?

A

No

62
Q

What do receptors respond to

A

intense mechanical stimuli (overdistention or traction), ischemia, endogenous inflammatory compounds (bradykinin, prostaglandins, and hydrogen and potassium ions

63
Q

What is referred pain?

A

Phenomenon where noxious stimuli from a visceral structure is perceived as arising from a somatic structure

(i.e. chest pain radiating down left arm may indicate heart problem)

64
Q

GVA fibers travel with ___

A

splanchnic nerves

65
Q

What information do GVA fibers convey?

A

Sensory information from viscera that receive ~same motor innervation

66
Q

T or F: DRG at spinal levels/nerves T1-L2/3 have GVA

A

True
(DRG outside of these levels only have GSA)

67
Q

Somatic/parietal pain is conveyed through ___

A

ventral and/or dorsal rami at all spinal levels (exception may be at C1)

68
Q

somatic/parietal pain is sharp/dull and widespread/localized

A

sharp, localized

69
Q

What type of nerve fibers are associated with somatic/parietal pain?

A

general somatic afferent fibers (GSA)

70
Q

What is one possible mechanism for referred pain?

A

Convergence onto ascending pathways in CNS
(synapse of visceral fibers on somatic pathways results in brain perceiving information as coming from somatic source)

Gross Anatomy (2 decks)

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