Abdominopelvic Autonomics Flashcards by Lauren M

Q

sympathetic parietal structures innervation

head, upper limb, chest

A

T1-T6

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Q

sympathetic parietal structures innervation

abdominal body wall

A

T7-T11

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Q

sympathetic parietal structures innervation

lower limb

A

T11-L2 (3)

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Q

sympathetic visceral structures innervation

head, salivary glands

A

T1-T3 or T4

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Q

sympathetic visceral structures innervation

eye

A

T1-T2

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Q

sympathetic visceral structures innervation

heart, lungs, esophagus

A

T4-T6

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Q

sympathetic visceral structures innervation

stomach, liver, GB, pancreas

A

T6-T9

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Q

sympathetic visceral structures innervation

appendix, colon

A

T10-T11

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Q

sympathetic visceral structures innervation

small bowel

A

T7-T10

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Q

sympathetic visceral structures innervation

rectum, bladder, uterus

A

T12-L2 (L3)

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Q

sympathetic visceral structures innervation

kidney

A

T10-L1

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Q

sympathetic visceral structures innervation

suprarenal gland

A

T6-L2

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Q

sympathetic presynaptic neuron path

A

1) cell body of presynaptic neuron in IML
2) anterior (motor) root of spinal nerve
3) mixed spinal nerve
4) anterior ramus of spinal nerve
5) white ramus communicans
6) autonomic (paravertebral ganglion)

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Q

sympathetic postsynaptic neuron path

A

postsynpatic fibers exit sympathetic trunks laterally via gray rami communicans

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Q

sympathetic innervation lower limb

A

1) IML (T12-L2/3)
2) sympathetic trunk
3) fibers take descend option
4) synapses occur in lower lumbar and sacral portions of sympathetic trunk
5) postsynaptic fibers via gray rami communicans to adjacent L2-S3 anterior rami (roots of lumbosacral plexus

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Q

sympathetic innervation lower limb functions

A

vasomotion (constriction)
sudomotion (sweat)
pilomotion (goosebumps)

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Q

sympathetic innervation upper limb

A

1) IML T1-T6
2) sympathetic trunk
3) fibers take ascend option
4) synpase in middle and inf cervical ganglion
5) postsynpatic fibers pass via gray rami communicans to adjacent C5-T1 anterior rami (roots of brachial plexus)

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Q

superior cervical ganglion location

A

bifurcation of common carotid into internal and external carotid

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Q

middle cervical ganglion location

A

near level of thyroid

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Q

stellate ganglion

A

-fusion of inf cervical and T1 ganglion

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Q

Horner syndrome

A

inhibit sympathetic innervation to head (superior cervical ganglion-> internal and external carotid plexus)
1) pupillary constriction
2) ptosis
3) anhydrosis
4) flushing

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Q

gray rami communicans

A

to all 31 spinal nerves
• arise as lateral branches
• carry postsynaptic fibers to body

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Q

cephalic arterial rami

A

to periarterial plexuses of carotid arteries
• arise from cervical ganglia
• postsynaptic fibers to head for distribution via periarterial plexuses
– produce: vasomotion, sudomotion, and
pilomotion

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Q

Cardiopulmonary splanchnics: Functions in Lung

A

• Inhibitory to bronchial
muscle (bronchodilator)
• Motor to the pulmonary
vessels (vasoconstrictor)
• Inhibitory to the alveolar
glands

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Cardiopulmonary splanchnics: Functions in Heart

``` • Increases heart rate • Increases impulse conduction • Increases force of contraction ```

Cardiopulmonary splanchnics:Functions in Coronary Blood Vessels

• Beta-2 receptors cause relaxation of smooth muscle

Abdominopelvic splanchnic nerve

- pass through paravertebral ganglia without synapsing | - synapse on prevertrebral ganglia

Prevertebral ganglia for abdominopelvic splanchnics (post synaptic fibers)

1) celiac ganglia 2) sup. mesenteric 3) inf. mesenteric 4) aorticorenal

abdominopelvic splanchnic nerves (pre synaptic)

1) greater splanchnic (T5-9) 2) lesser (T10-T11) 3) least (T12)

what does greater splanchnic synapse with?

celiac ganglion

what does lesser splanchnic synapse with?

sup. mesenteric ganglion

what does least splanchnic synapse with?

aorticorenal ganglion

what does lumbar splanchnic synapse with?

inf. mesenteric ganglion

where do cardiopulmonary splanchnic nerves synapse?

-paravertebral ganglia

where do abdominopelvic splanchnic nerves synapse?

-prevertebral ganglia

where are cell bodies of sympathetic post synaptic fibers found?

1) paravertebral ganglia- except abdmoinopelvic viscera 2)prevertebral ganlgia- fibers distributed to abdominopelvic viscera

innervation of suprarenal glands

- pass through paravertebral and prevertebral ganglia without synapsing - synapse directly on secretory cells of medulla - release NE

what is the embryo origin of medulla and postsynaptic neurons

neural crest cells

what does the parasympaethic (craniosacral) NS consist of?

- presynaptic neurons through cranial nerves, and ant roots of s2-s4, and postsynaptic neurons - CN 3,7,9,10 and pelvic splanchnic nerves

what are the presynaptic fibers of the parasympathetic NS

1) cranial nerves (3,7,9,10) | 2) ant roots of spinal nerves (S2-S4) (pelvic splanchnics)

what are the post synaptic fibers of parasympathetic NS

1) trunk (intrinsic/ enteric) | 2) head (ciliary, otic, pterygopalatine, submandibular)

what does CN III synapse with?

ciliary ganglion- in orbit (accommodation)

what does CN IX synapse with?

otic ganglion- to parotid salivary gland

what does CN VII synapse with?

- pterygopalatine ganglion- to nasal and palate | - submandibular ganglion (to submandibular/sublingual salivary glands)

functions of postsynaptic parasympathetics

``` • Constriction of the pupil • Accommodation • Serous secretions from the lacrimal gland (tears) • Serous secretions from the salivary glands ```

Distribution of Parasympathetic Nervous System

– internal organs and glands of head & body cavities – except for the erectile tissue of the external genitalia, does NOT go to body wall or limbs. – except for the initial parts of S2 - S4, parasympathetics are never components of spinal nerves or their peripheral branches

the sympathetic NS produces

1) vasomotion 2) sudomotion 3) pilomotion

The parasympathetic system:

* is most active in controlling vision * is the primary stimulator of the GI tract * is active in elimination (defecation, urination)

Visceral afferent (sensory) fiber

Receptors for | pain and reflexes

Visceral motor (autonomic) fibers

Smooth muscle Mod. cardiac mm. Glands

what does Physiologic receptors (innocuous input) (homeostasis) travel with?

parasympathetics

what does pain travel with above pelvic pain line?

sympathetics

what does pain travel with below pelvic pain line?

parasympathetics

what is boundary of pelvic pain line?

middle of sigmoid colon

what is boundary of thoracic pain line?

plane of sternal angle (T4-5)

what does pain travel with above thoracic pain line?

parasympathetics

Acute abdomen pain duration

<3 days duration

Chronic abdominal pain duration

>3 weeks

Subacute abdomen pain duration

3 days to 3 weeks

Visceral pain

* Diffuse and poorly localized * Often referred to somatic regions * Injury to internal organs and tissues that support them

Somatic pain

• Well localized • Caused by injury to skin, muscles, bone, joint and connective tissues -Also get somatic pain if organ starts to irritate parietal peritoneum **** Ex= gallbladder and appendix

Parietal Pain

-caused by irritation of fibers that innervate the parietal peritoneum -can be localized to the dermatome superficial to the site of the painful stimulus.

Visceral Pain

can be localized by the sensory cortex to an approximate spinal cord level determined by the embryologic origin of the organ involved.

where do foregut organs cause pain

epigastric region T6-9 T8-T10 for Small intestine

where do midgut organs cause pain?

periumbilical pain T8-10 some of T11

where do hindgut organs cause pain?

``` suprapubic or hypogastric area. T11 T12-L1 L2(3) S2 S4 ```

where does pain from liver, gallbladder, duodenum refer to?

shoulder (right) if they irritate diaphragm

where does liver and gallbladder pain refer to?

RUQ or can go to back

where does appendix pain refer to?

starts at umbilical region to RLQ

where can pain from retroperitoneal structures refer to?

back

Colicky Pain

• Intermittent cramp-like pain • Caused by obstruction of hollow muscular viscus