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GI Final > Abdominal Pelvic Autonomics/ Pain > Flashcards

Abdominal Pelvic Autonomics/ Pain Flashcards

1
Q

Abdomen, pelvis, perineum innervation

A

ANS

- both sympathetic and parasympathetic

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2
Q

Sympathetic fiber components

A

thoracic, lumbar, sacral splanchnic nerves

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3
Q

Parasympathetic fiber components

A

anterior and posterior vagal trunk

pelvic splanchnic nerves

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4
Q

Thoracic splanchnic nerve

  • describe
  • vertebral level
  • parts
A

pre-ganglionic sympathetic

T5-T12

  1. greater splanchnic nerve
  2. lesser splanchnic nerve
  3. least splanchnic nerve
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5
Q

Greater splanchnic nerve

  • vertebral level
  • location
  • organs
A

T5-T9 SYMpathetic ganglia

descend in posterior mediastinum to synapse with celiac ganglion

  • esophagus, stomach, spleen, pancreas, liver, biliary tree, duodenum, greater omentum
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6
Q

Lesser Splanchnic Nerve

  • vertebral level
  • location
  • organs
A

T10-T11 SYMpathetic ganglia

descend in abdomen to synapse with superior mesenteric ganglion

  • branches of SMA to jejunum, ileum, cecum, ascending and transverse colon
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7
Q

Least Splanchnic Nerve

  • vertebral level
  • location
  • organs
A

T12 SYMpathetic ganglia

descends into abdomen to synapse with aorticorenal ganglion

  • renal arteries to kidneys
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8
Q

Lumbar Splanchnic Nerves

  • vertebral levels
  • parts
A

preganglion sympathetic nerve

L1- L5

FOUR lumbar splanchnic nerves

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9
Q

first and second lumbar splanchnic nerves

  • vertebral level
  • location
  • organs
A

L1 and L2 Sympathetic

terminate in intermesenteric plexus on anterior surface of abdominal aorta, btw SMA and IMA

  • IMA to descending colon, sigmoid colon, proximal rectum
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10
Q

third and fourth lumbar splanchnic nerve

  • vertebral level
  • location
  • organs
A
  1. L3
  2. L4 and L5

enter superior hypogastric plexus on anterior surface of distal abdominal aorta

post: superior hypogastric plexus
Pre: hypogastric nerves to inferior hypogastric plexus on anterior surface of sacrum

  • internal iliac artery to organs of pelvic cavity and perineum
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11
Q

Sacral Splanchnic Nerves

    • vertebral level
  • location
  • organs
A

preganglionic sympathetic nerves in inferior hypogastric plexus

S1-5 sympathetic

postganglionic: pudendal nerve and branches of internal iliac artery

organs of pelvic cavity and perineum

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12
Q

Vagus Nerve

    • vertebral level
  • location
  • organs
A

preganglionic parasympathetic nerve:

brain stem (dorsal motor nucleus), enter abdomen via anterior and posterior vagal trunk to terminate in intrinsic (enteric) plexus

stomach, liver, pancreas, SI, cecum, ascending and transverse colon

Postganglionic fibers

  • short
  • smooth muscle and glands –stomach, liver, pancreas, SI, cecum, ascending and transverse colon
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13
Q

Pelvic splanchnic nerves

    • vertebral level
  • location
  • organs
A

Preganglionic parasympathetic:

  • S2-S4
  • synapse in intrinsic (enteric) plexus

descending colon, sigmoid colon, rectum, anal canal, urogenital organ of pelvic cavity, structures in urogenital triangle of perineum

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14
Q

Enteric Nervous System

  • nickname
  • function
  • plexus
A

aka second brain

regulating most of the physiological activity in distal esophagus, stomach, intestine, pancreas, and biliary system

  • myenteric and submucosal plexus
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15
Q

Myenteric Plexus

A

regulates motility, vasomotion of muscle layers, and secretion of gastric glands

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16
Q

Submucosal Plexus

  • organ
  • function
A

SI

  • exocrine/endocrine secretion
  • vasomotion ( blow flow to regulate water and electrolyte movement)
  • micromotility
  • immune activity
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17
Q

Sensory function within ENS

A

detect hunger, satiety, nausea, and pain

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18
Q

ANS

  • controlled by
  • innervates what organs
  • division
A

controlled by hypothalamus

innervates SM, cardiac muscle and glands

  • parasympathetics and sympathetics
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19
Q

Preganglion neuron

  • origin
  • synapse
A

originates in CNS

synapses on ganglion in peripheral nervous system

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20
Q

Postganglionic neuron

A

travels to target orga

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21
Q

Types of Visceral Autonomics

A

Sympathetics

Parasympathetics

22
Q

Sympathetics characteristics

A
  • short presynaptic fiber
  • long postsynaptic fiber

vasoconstriction, reduce bowel motility and secretions

23
Q

Parasympathetic characteristics

A
  • long presynaptic fibers
  • short postsynaptic fibers

increase bowel motility, secretion, blood flow (vasodilation)

24
Q

Visceral Sympathetics

  • pre and post synaptics
  • nerve
A

Presynaptic cell bodies: gray matter of Spinal cord T5- L2

Post Synaptic Cell bodies: in prevertebral ganglia to abdominal viscera via periarterial plexuses

Splanchnic nerves: post synpatic fibers run from prevertebral fanflia to abdominal viscera via periarterial plexuses

25
Q

Greater Splanchnic N

  • vertebral level
  • ganglion
A

T5-T9

celiac ganglion

26
Q

Lesser splanchnic N

  • vertebral level
  • ganglion
A

T10-T11

superior mesenteric ganglion

27
Q

Least splanchnic N

  • vertebral level
  • ganglion
A

T12

aorticorenal ganglion

28
Q

Lumbar Splanchnic nerves

- vertebral level

A

L1-L3

29
Q

Sacral Splanchnic nerves

A

S1-S5

30
Q

Visceral Parasympathetics

- nerves

A
  1. anterior and posterior vagal trunks ( from left and right vagus nerves respectively)
    - conveys presynaptic parasympathetic fibers and visceral affernts
    - innervates smooth muscle and glands of gut up to left colic flexure in GI tract
  2. Pelvic splanchnic nerves (anterior rami of S2-S4)
    - converys presynaptic parasympathetic innervation to inferior hypogastric plexus
    - innervates from left colic flecure to above the pectinate line in the anal canal
31
Q

Extrinsic Autonomic Plexuses

- parts (6)

A

1) Celiac Plexus and ganglia
2) Superior mesenteric plexus and ganglia
3) inferior mesenteric plexus and ganglia
4) intermesenteric plexus
5) superior hypogastric plexus
6) inferior hypogastric plexus

32
Q

Celiac plexus and ganglia

A
  • sympathetic root from greater and lesser splanchnic nerves

- parasympathetic root from posterior vagal trunk

33
Q

Superior mesenteric plexus and ganglia

A
  • median root from branch of celiac plexus

- lateral roots arise from lesser and least splanchnic nerves

34
Q

Inferior mesenteric plexus and ganglia

A
  • medial roots from intermesenteric plexus

- lateral roots from lumbar sympathetic trunk

35
Q

Inter mesenteric Plexus

A
  • part of aortic plexus between SMA and IMA

- gives rise to testicular, ovarian, ureteric, and renal plexuses

36
Q

Superior Hypogastric plexus

A
  • receives only sympathetic fibers
  • anterior to abdominal aortic bifurcation (L4)
  • continuous with intermesenteric and inferior mesenteric plexuses
  • give rise to ureteric, testicular, and common iliac plexuses
37
Q

Inferior Hypogastric plexus

A
  • joined to superior hypogastric plexus via bilateral hypogastric ns
  • receives from superior sacral sympathetic ganglia and pelvic splanchnic ns
  • give rise to plexuses on walls of pelvic viscera (rectal and vesical plexuses)
38
Q

Intrinsic Enteric NS

  • nickname
  • plexus
A

aka second brain

  1. myenteric (auerbach) plexus
  2. Submucosal (meissner) plexus
  3. intrinsic sensory neuron
39
Q

Myenteric (Auerbach) Plexus

  • location
  • function
A
  • in muscular layers of gut wall

- regulates motility, vasomotion of muscle layers and secretion of gastric glands

40
Q

Submucosal (Meissner) Plexus

  • location
  • function
A
  • in submucosa- most prominent in SI

- regulate exocrine/endocrine secretion vasomotion, micromotility, and immune activity

41
Q

Intrinsic sensory neurons

- function

A

locally monitor mechanical and chemical conditions of gut for short reflex response

42
Q

Visceral Sensory Afferents

A
  1. Pain afferents

2. Reflex afferents

43
Q

Pain afferents

A
  • d/t distention, inflammation, ischemia
  • impulses pass retrograde into posterior root to sensory ganglia
  • foregut to midpoint of sigmoid colon -> sympathetic fiber (T5-L2)
  • after midpoint of sigmoid colon-> parasympathetic fibers (S2-S4)
44
Q

Reflex afferents

A
  • unconscious
  • info from chemoreceptors, osmoreceptors, and mechanoreceptors
  • via parasympathetics only ( vagal S2-S4)
45
Q

Types of Pain

A
  1. Organic pain

2. Parietal peritoneum

46
Q

Organ pain

A
  • poorly localized, dull

- radiates to dermatome level-> visceral referred pain

47
Q

Parietal peritoneum

A
  • localized, acute or severe
  • supplied by somatic sensory fibers via thoracic nerves (T7-T12)
  • extremely sensitive to stretching-> rebound tenderness
48
Q

Somatic Nervous System

  • control
  • ganglia
  • sensory input
  • hormone
  • conduction
  • axon
A
  • voluntary or subconscious control single neuron pathway
  • no ganglia involved in pathway
  • sensory input from general and special senses, motor output to skeletal muscle
  • excites using acetylcholine
  • axons are thick and myelinated= fast condition
49
Q

Autonomic nervous system

  • control
  • ganglia
  • sensory input
  • hormone
  • conduction
  • axon
A

involuntary unconscious control two neuron pathway

ganglia involved in pathway

sensory input from general and visceral senses motor output to cardiac, smooth muscle, an glands

can excite or inhibit function using Ach or NE

axons are thin, some are myelinated, slower conduction

50
Q

Sympathetic Presynaptic Neurons

A

cell bodies found only ONE place

  • intermediolateral cell column of spinal cord gray matter
  • somatotopically- arranged from T1- L2

fibers exit CNS via anterior roots of spinal nerves T1-L2 and enter mixed nerve

FIber exit spinal nerves to pass via white rami communicans to sympathetic trunk

51
Q

Pathways of presynaptic sympathetic fibers through sympathetic trunks

A
  1. ascend and then synapse
  2. synapse at level of entry
  3. descend and then synapse
  4. pass through trunk without synapsing to enter abdomino pelvic splanchnic nerve
52
Q

Parietal branches of Sympathetic Trunks

A

1) Gray rami communicans
- to all 31 spinal nerves
- arise as lateral branches
- carry postsynaptic fibers to body wall and limbs for distribution via spinal nerves
2) cephalic arterial rami
- to periartieral plexus of carotid arteries
- arise from cervical ganglia
- postsynaptic fibers to head for distribution via periarterial plexuses
- produce: vasomotion, sudomotion, pilomotion

GI Final (15 decks)

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