Anatomy of chest pain Flashcards
What is meant by a visceral afferent?
sensory nerve from an organ
What is a plexus?
Intertwining of nerves
What is a ganglion?
Collection of nerve cell bodies outside th CNS
Where are sympathetic ganglion located?
Along the sympathetic chain
What are the two fibres used to get from CNS to organs?
presynaptic fibres and post synaptic fibres
Where does presynaptic outflow occur in sympathetic signalling?
T1-L2/3
How do sympathetic signals go from CNS to organs?
- travel down spinal cord
- exit spinal cors in one of the T1-L2/3 spinal nerves
- then do one of 5 options
What are the 5 options in sympathetic signalling from CNS to organs?
- go into the ganglion of that level & synapse
- travel superiorly in the sympathetic chain to another ganglion & synapse
- travel inferiorly in the sympathetic chain to another ganglion & synapse
- pass straight through the sympathetic chain ganglion without synapsing, as abdominopelvic splanchnic nerves ,to synapse in one of the prevertebral ganglia of the abdomen (e.g. celiac ganglion)
- pass straight to the adrenal medulla without synapsing as an abdominopelvic splanchnic nerve (directly stimulating adrenaline release)
What do Cardiopulmonary splanchnic nerves do?
send sympathetic signals to heart and lungs
Where are Cardiopulmonary splanchnic nerves located?
behind the great vessels. They feed into the cardiac plexus
What are the three fibres of the cardiac plexus?
parasympathetic, sympathetic and visceral afferent fibres
Where are parasympathetic ganglia located?
isolated from chain
Where is th parasympathetic ganglia for the heart located?
On the heart wall
How do parasympathetic signals reach the organs?
cranial nerves 3,7,9,10 and sacral spinal nerves
What accompany the sympathetic nerves to the heart?
cardiac visceral afferent accompany the sympathetic nerves which are carried together in the cardiopulmonary splanchnic nerves
What are baroreceptors carried through?
The vagus nerve
What pain characters are associated with somatic pain?
sharp, stabbing and well localised
What pain characters are associated with visceral pain?
dull, aching, nauseating, poorly localised
What does somatic refer to?
anything associated with body wall
How does a painful prod to the chest become what we feel as pain?
- action potential passing through anterior ramus
- then pass through posterior root and rootlets
- to get to spinal cord
- pain pathway crosses in spinal cord to oposite side of brain where it then gets processed as consciousness
What occurs at the precentral gyrus?
action potentials that originate here bring about contractions of skeletal muscles
What occurs at the postcentral gyrus?
Action potentials that arrive here are brought into consciousness
What does the sensory homunculus show?
Shows where APS arises
Where can somatic central chest pain sources come from?
-shingles, muscle joint and bone, parietal pleura and fibrous pericardium
Where does the vagus nerve sit?
on trachea and passes posterior to the route of the lung and then follows the oesophagus down
Where do azygous veins drain into?
vena cava
What nerve crosses the trachea?
right vagus nerve
What nerve crosses the aorta?
left vagus nerve
