ANS Worksheet Flashcards
1
Q
What are the 2 main divisions of the ANS?
A
Sympathetic and Parasympathetic
2
Q
Where are collateral ganglia located?
A
Groups of ganglia found on surface of major blood vessels forming plexi - sympathetic
Cardiac; -heart centre -
Coeliac - solar plexus - upper abdomen
Superior Hypogastric - sacral area
Pelvic Plexus - root chakra
3
Q
Where do parasympathetic nerve fibres emerge from in the CNS?
A
Cranium or Sacrum (S234)
4
Q
Where do sympathetic nerve fibres emerge from in the CNS?
A
T1 to L2
5
Q
What is a ganglion?
A
Where neurons meet to transmit messages
6
Q
Where are the sympathetic ganglia located?
A
Paravertebral (Sympathetic chain) or Prevertebral (Collateral)
7
Q
Where are parasympathetic ganglia located?
A
Terminal ganglia - on the surface of the target organ eg bladder; stomach; lungs - the organ for which the neuron is supplying.
8
Q
Where is the sympathetic chain?
A
Either side of the spine but only attach to the spinal cord between T1 and L2
9
Q
What are neurons?
A
Cell body - receives information;
nerve fibre - sends information;
nerve ending - synaptic terminal - information from nerve to target organ/ gland/ muscle
10
Q
Where are terminal ganglia located?
A
On the surface of target organs - bladder; lungs; stomach. Synapse on the organ it is targeting.
11
Q
What are glial cells
A
Protect neurons - able to repair
12
Q
What is a nerve?
A
Bundle of nerve fibres travelling together
13
Q
What is a reflex arc?
A
Involuntary response to stimulus.
14
Q
What is the Central Nervous System (CNS)??
A
Brain; brainstem and spinal cord
15
Q
Describe the extent of the sympathetic chain?
A
Either side of the spine but only attach to the spinal cord between T1 and L2. Goes up into head via Superior Cervial Sympathetic Ganglion and down to coccyx where sympathetic chain meets at the ganglion impar.
16
Q
Where is the superior cervical sympathetic ganglia
A
In the neck - C1 to C5
17
Q
Where is the ganglion impar?
A
At the coccyx
18
Q
Are collateral ganglia sympathetic or parasympathetic?
A
Sympathetic
19
Q
What is the name for an aggregation of sympathetic ganglia?
A
Plexus
20
Q
What is homeostasis
A
Sympathetic and Parasympathetic divisions working together to balance each other, changing to the needs of every moment.
21
Q
Which division of ANS prepares the body for action?
A
Sympathetic - brain sends message down spinal cord via sympathetic chain. Pre-ganglionic fibres release Acetyle Choline; Post-ganglionic fibres release Adrenaline.
22
Q
Why/ How does stress affect the sympathetic nervous system?
A
Hypothalamus sends message to adrenals - adrenal medulla to release adrenaline. Overstimulation of adrenals = depletes system = lowered immunity, increase risk of infections, colds, disease.
Body does not get time to repair = poor healing
Emotionally - exhausted; anxious; fatigue.
Physiological changes in body due to adrenal release with longer terms effects of:
Increased heart rate or HBP
Poor digestion = IBS; constipation
23
Q
What physical disturbances could stimulate the sympathetic nervous system?
A
Accident; injury; intense or prolonged labour; parasites; vertebral restrictions; intense exercise.
24
Q
ANS - sympathetic and parasympathetic is how many neuron pathway?
A
2 neuron pathway - pre and post ganglionic
25
What CN do parasympathetic fibres travel with?
List functions of each.
Oculomotor CN III - supply eye and regulate
1) pupil constriction (iris muscles)
2) lens accommodation (cilary muscles)
Facial Nerve VII - from own nucleus in pons - supply glands of face and head & regulate:
1) Lacrimal glands (tears)
2) Nasal glands (mucus)
3) Submandibular (saliva) and Sublingual glands (mucus)
4) Mucosa in frontal; ethmoidal; maxillary; sphenoidal sinuses.
Glossopharangeal CN IX - supply parotid glands & regulate:
1) secretion of saliva
Vagus Nerve CN X - supply viscera of thorax and abdomen to:
1) constrict heart blood vessels
2) reduce heart rate
3) constrict bronchi
4) support digestion - peristalsis; glandular secretion;; sphincter relaxation as far as 1st half of colon.
Sacral Nerves - S2,3,4 - Pelvic Splanchnic Nerves supply and regulate:
1) 2nd half of colon (descending) - peristalsis
2) rectum
3) bladder - emptying; contraction; sphincter relaxation
4) genetalia - erection; vaso-dilation
26
Why does stimulation of the of the sympathetic nervous system affect the body?
Energy resources are shifted to prepare for real or perceived danger. Puts body on high alert and needs equal amount of parasympathetic time to maintain homeostasis. If stimulation is prolonged, body becomes depleted and remains in a state of hyperarousal.
27
What is the Somatic Nervous System?
part of the Peripheral Nervous system. VOLUNTARY - walking; talking; movement; think skeletal.
Motor and sensory neurons.
28
What is the Autonomic Nervous System
INVOLUNTARY - Split into parasympathetic and sympathetic divisions. Part of the PNS (other division being somatic).
Involuntary activities that innervate smooth muscles and glands (can stimulate or inhibit).
Mainly motor neurons (some sensory).
2 neuron system - pre-ganglionic neuron takes to ganglion to synapse and post-ganglionic neuron takes to target organ.
29
Name sympathetic nerve root origin of: Head
T1 to T2
30
Name sympathetic nerve root origin of: Heart
T4 (T1 to T5)
31
Name sympathetic nerve root origin of: Lungs and Heart
T2 to T6
32
Name sympathetic nerve root origin of: Oeseophagus
T4 to T6
33
Name sympathetic nerve root origin of: Abdominal Viscera
T6 to T10
34
Name sympathetic nerve root origin of: Liver
T6 to T10
35
Name sympathetic nerve root origin of: Pancreas
T6 to T10
36
Name sympathetic nerve root origin of: Gallbladder
T6 to T10
37
Name sympathetic nerve root origin of: Stomach
T6 to T10
38
Name sympathetic nerve root origin of: Small Intestine
T8 to T11
39
Name sympathetic nerve root origin of: Large Intestine - colon
T10 to L2
40
Name sympathetic nerve root origin of: Pelvic viscera
T10 to L2
41
Name sympathetic nerve root origin of: Adrenals
T9 (T10 to L2)
42
Name sympathetic nerve root origin of: Kidneys
T10 to L2
43
Name sympathetic nerve root origin of: Ovaries
T10 to L2
44
Name sympathetic nerve root origin of: Uterus
T10 to L2
45
Name sympathetic nerve root origin of: Testes
T10 to L2
46
Name sympathetic nerve root origin of: Ureters
T10 to L2
47
Name sympathetic nerve root origin of: Ileocaecal Valve
T10 to T11
48
Name sympathetic nerve root origin of: blood vessels of upper limb
T2 to T8
49
Name sympathetic nerve root origin of: blood vessels of lower limb
T11 to L2
50
Where does the spinal cord terminate?
L2 adult; L4 newborn
51
Where does CSF terminate in the spinal cord?
CSF continues down from L2 where spinal cord terminates to S2 in the subarachnoid space.
52
Where does the dura mater terminate in spinal cord?
S2
53
Where does arachnoid mater terminate in spinal cord?
S2
54
Where does pia mater terminate in spinal cord?
L2
55
Where does the dural membrane have bony attachments?
ALL cranial bones
C2 and C3
S2
Coccyx
56
What is the Cauda Equina?
Made of nerve roots from ABOVE L2 which continues down past L2 to Coccygeal nerve.
57
What is the Cauda Equina function? Give symptoms of dysfunction?
Nerve supply to pelvic organs and lower limbs.
Communicates sensory and motor nerve messages between CNS and pelvic nerve organs.
Cauda Equina Syndrome = compression; urine retention; constipation; incontinence; back pain; loss of motor skills.
58
What are Cisternae
Areas of accumulated CSF within subarachnoid space.
59
Where are the Cisternae?
There are 6 (5 in cranium) - Cisterna Magna - behind medulla and below cerebellum
and 1 in lumbar spine = Lumbar Cistern - below L2
60
What happens to spinal root nerves at L2 or above?
They leave spinal cord at appropriate spinal cord level and pass out at the next vertebral level.
61
What happens to spinal root nerves at L2 or below?
Have further to travel from their spinal cord exit L2 (because spinal cord terminates at L2) and their bony vertebral exit.
Pass down Lumbar Cistern within dura as Cauda Equina and penetrate dura at or above S2 (where the dura terminates).
They EXIT from bony structure of vertebral column from levels above the coccyx.
62
Why is the health of dura and fascia key to the function of peripheral nerves?
Because nerves penetrate DURAL membrane as they enter or leave the CNS and are covered in a FASCIAL SHEATH called EPINEURIUM throughout their pathway.
63
Name a peripheral nerve and give root origins:
Sciatic Nerve - L45, S123
64
List symptoms of sciatica
Common symptoms of sciatica include:
Lower back pain
Pain in the rear or leg that is worse when sitting
Hip pain
Burning or tingling down the leg
Weakness, numbness, or difficulty moving the leg/foot
A shooting pain that makes it difficult to stand up
Sciatica usually affects only one side of the lower body. Often, the pain extends from the lower back all the way through the back of the thigh and down through the leg. Depending on where the sciatic nerve is affected, the pain may also extend to the foot or toes.
65
Name root origins of peripheral Ulnar Nerve and what Plexus would you associate this with?
C78, T1 - supplies 4,5, fingers. Brachial Plexus.
66
Name 3 parts of brainstem
Midbrain (top); Pons (middle); Medulla (bottom)
67
Where is the 4th Ventricle?
Posterior to pons and medulla
68
Thoracic; Lumbar; Sacral and Coccygeal nerves emerge above or below vertebrae of same level?
Below
69
Cervical nerves emerge above or below vertebrae of same level?
Above
70
Nerve between C7 and T1
C8
71
What are the spinal nerves that emerge between T2 and T12 spinal roots?
Intercostal Nerves and DO NOT form Plexi. All other spinal nerves bunch together to form plexi.
72
Where is the Phrenic Nerve and which Plexus?
Phrenic Nerve C345 - keeps the diaphragm alive in Cervical Plexus (Spinal Nerve Plexi/ Somatic Plexi)
73
What nerve would you associate with Carpel Tunnel?
Median Nerve C678, T1
74
What visceral and other associations would you associate with: T9
Apex of Thoracic curve - subject to strain and postural imbalances
Vertebral associations - Solar plexus; Coeliac ganglia; Adrenal glands
Major sympathetic outflow
Organs - adrenals; abdominal viscera (T6 to T10)
Overstimulation of nervous system & over secretion of adrenaline = excess activity in solar plexus; feelings of high stress - affecting sleep; digestion; mood; behaviours.
75
What is T4 syndrome?
increased neurological activity at T4 where threshold of response is lowered. Facilitated segment may cause surrounding skin to feel sore, or tender muscles. 'Weak spot'. Minor movement = major reaction.
76
What gland in the face would be affected due to mumps?
Parotid
77
What factors would affect overall facial nerve function?
Bony restrictions, imbalances - particularly involving temporal and sphenoid bones, membranous restrictions along pathway and disturbances to nerve root at internal auditory meatus or pons.
78
If facial nerve dysfunction only involve motor branches of the Facial nerve, what would this suggest?
The injury is outside the facial canal, either around the stylomastoid foramen, in the parotid gland (due to mumps) or along pathway to muscles of the face.
79
IF facial nerve dysfunction affects taste only, what might this indicate?
Middle ear infection.
80
If there is disturbed secretions of the lacrimal gland and the glands and mucous membranes of the mouth, nose and sinuses, what would you think?
That the parasympathetic division of the facial nerve is disturbed.
81
If there is a disturbance of taste, what nerve would you think of?
Facial nerve - chorda tympani
82
What are the 3 functions of the facial nerve?
1) MOTOR - to muscles of the face (Bells Palsy dysfunction) & small branch to innervate stapedius (attaches to stapes - dampens noise to protect inner ear) muscle to middle ear.
2) Special Sensory - to the tip of the tongue
3) General Sensory - to external ear and mastoid region
4) Parasympathetic - to glands of the face
83
What is the pterygopalatine ganglion? Describe dysfunction?
Parasympathetic ganglia in the head. Receive parasympathetic fibres from the facial nerve to lacrimal and nasal glands, mucus membranes and sinuses.
Dysfunction of parasympathetic fibres of facial nerve =
Dry eyes or excessive lacrimation
Reduced or excessive secretions of mucus in nose and sinuses and saliva in mouth
84
What is the submandibular ganglion? Also describe dysfunction?
Parasympathetic ganglia in the head. Also receive parasympathetic fibres from facial nerve to submandibular and sublingual glands, to enable mucous to be secreted.
Dysfunction of parasympathetic fibres of facial nerve =
Dry eyes or excessive lacrimation
Reduced or excessive secretions of mucus in nose and sinuses and saliva in mouth
85
What is the otic ganglion? Describe dysfunction?
Parasympathetic ganglion in the head. Located below foramen ovale each side. Site of synapse for glossopharyngeal nerve which travels to parotid gland.
Dysfunction = reduced or excessive saliva secretion
86
What is the cilary ganglion? Describe dysfunction?
Parasympathetic ganglion in the head. To do with the eyes. Parasympathetic fibres travel with the oculo-motor nerve to supply the ciliary muscles and the iris muscles of the eyeball.
Dysfunction to parasympathetic distribution = lens accommodation and pupil constriction and may occur in conjunction with disturbance to extrinsic muscles to eye supplied by oculomotor nerve.
87
How would you address parasympathetic dysfunction to the face and head\>
Parasympathetic ganglia in the head. Receive parasympathetic fibres from the facial nerve to lacrimal and nasal glands, mucus membranes and sinuses.
Dysfunction of parasympathetic fibres of facial nerve =
Dry eyes or excessive lacrimation
Reduced or excessive secretions of mucus in nose and sinuses and saliva in mouthWhole person
Integration of face, cranium and system as a whole.
Consider nerve pathways, location of parasympathetic ganglia, foramina, membranous attachments,
Use cranial or facial contacts
Addressing disturbances to pterygopalatine ganglion = palatines, maxilla, vomer and sphenoid.
88
How would sympathetic disturbance affect the ears?
Sympathetic innervation travels to ears from carotid plexus. Within middle ear it forms tympanic plexus - excessive stimulation may cause tinnitus, hyperacusis.
89
How would sympathetic disturbance affect the nose, mouth, sinuses and face?
Sympathetic overstimulation may inhibit secretions, leading to dryness and irritability of mucous membranes. Excessive sympathetic overstimulation will mean hypersensitivity to irritants, allergens = dry nose, mouth, skin, hay fever, sinusitis. Many of these sympathetic fibres travels with parasympathetic fibres from facial nerve passing through pterygopalatine ganglion.
90
How would sympathetic stimulation affect the eyes?
Over dilated pupils and photophobia. Inhibits lacrimal secretion causing dry eyes, tired eyes, prone to infection.
91
How would you address sympathetic stimulation in head?
Assess and address overall level of stress and trauma
If whole system is overstimulated = psycho-emotional holds
If head and face are specifically affected = address SCSG, sub-occiput, neck, whole sympathetic pathway to head and face.
If symptoms are very local eg ear, eye or sinus = explore local disturbances, bony restrictions, muscular and fascial tensions, mucous and vascular congestion and any restrictions to free fluency of area.
92
What does excessive sympathetic stimulation do?
Leads to dysfunction
Reduces arterial blood supply to brain
Reduces healing
Contributes to HBP
Inhibits bone growth and healing
Inhibits pineal and pituitary function
Reduces blood supply to GIT - digestive disturbances
Heat and lungs - asthma, cardiac conditions
Meninges and fascia are innervated by sympathetic supply = contraction and tightness
32 post ganglionic fibre to each 1 pre ganglionic fibre
93
Do sympathetic fibres travel with most arteries?
Yes - every artery needs sympathetic innervation - form sympathetic plexi eg carotid plexi, tympanic plexus.
