Autonomics Flashcards
bladder
SNS: T10-L2 via lumbar and sacral splanchnic (trigone, sphincter urethrae)
PSNS via pelvic splanchnics S234( detrusor)
TESTES
Testicular plexus
SNS: T1011 via lesser splanchnics (vasomotor
PSNS: pre fibers via Vagus
Internal male gonads
SNS: T12-L2 via lumbar and sacral splanchnic nn. (vasomotor, contraction of smooth mm in wall of ductus deferens ejac ducts and capsule prostate)-EMISSION
PSNS: pelvic splanchnic, S2-4
Vasomotor to erectile tissue, increase gland secretion seminal vesicles and cowper’s glands -ERECTION
POINT and SHOOT
Ovary, uterine tubes
Uterine plexus
SNS: T10-11, vasomotor and pain afferents
PSNS: pre fibers from vagus
mostly for afferents
Uterus Cervix Vagina
SNS: T12-L2
Vasomotor **pain from uterus
PSNS: Pelvic spanchnic nn, vasomotor contraction of smooth mm, pain from cervix and upper vagina
rectum and proximal anal canal
SNS: L1-L2 via lumbar an sacral splanchnic
vasomotor and motor control of internal sphincter m.
PSNS: Pelvic splanchnic S2-4
vasomotor ,, contraction of smooth muscle, pain
SNS innervation sources
lumbar and sacral splanchnic nn.
Pelvic splanchnic nn.
PSNS
Post
S234
distribute to hindgut and pelvic viscera via inferior hypogastric plexus
general actions of the SNS
VC, contraction of sphincters, inhibition of peristalsis and inhibition of glandular secretion
general actions of the PSNS
VD, peristalsis, contraction of the detrusor and myometrial mm.
Lumbar splanchnics
preganglionic neurons T11-L2
enter the intermesenteric and superior hypogastric where they synapse
postganglionic fibers travel in with the hypogastric n. into the inferior hypogastric plexus and into subsidiary pelxi
(**major route of SNS innervation)
Sacral Splanchnics
T12-L2
enter the inf hypogastric plexus where they synapse
postganglionic fibers then spread via subsidiary plexuses
minor route
innervation of ureter
SNS via lumbar ans sacral splanchnics L1-3
PSNS via pelvic splanchnics S2-4
innervation of perineal urethra is via pudendal nn (S2-4)
innervation to the anal canal
superior to pectinate= inferior hypogastric
inferior to pectinate line= inferior rectal
pain fibers superior to pain line
visceral pain fibers travel with SNS nn. to T11-L2
pain fibers below the pain line
visceral pain fibers travel with the PSNS nn. S2-4
referred pain from uterine contractions
pain fibers travel with T12-L2 bc it is above the pain line
refs to the lower back and around to inguinal and groin region
pain from passage of fetus thru birth canal
cervix and vagina are subperitoneal so pain travels with PSNS 2-4 and refs to the perineal region
pain from inferior vagina/penis/perineum
well localized somatic pain from the pudendal n. (2.3.4)
Lumbar epidural
anesthetic delivered LV3/LV4
complete anesthesia of pelvis, perineum, lower limbs
no pain from contraction or passage of infant
caudal epidural
delivered in epidural space of sacral canal
anesthesia of S2-4
still feel uterine contractions, cervix, vagaina, and perineum are painless
Pudendal nerve block
innervates majority of perineum and inferior 1/4 of vagina
still feel pain from uterine contractions and passage thru birth canal
minimize pain from tearing or episiotomy
