Autonomics

Question 1

bladder

Answer 1

SNS: T10-L2 via lumbar and sacral splanchnic (trigone, sphincter urethrae)

PSNS via pelvic splanchnics S234( detrusor)

Question 2

TESTES

Answer 2

Testicular plexus
SNS: T1011 via lesser splanchnics (vasomotor
PSNS: pre fibers via Vagus

Question 3

Internal male gonads

Answer 3

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

Question 4

Ovary, uterine tubes

Answer 4

Uterine plexus
SNS: T10-11, vasomotor and pain afferents
PSNS: pre fibers from vagus

mostly for afferents

Question 5

Uterus Cervix Vagina

Answer 5

SNS: T12-L2
Vasomotor **pain from uterus
PSNS: Pelvic spanchnic nn, vasomotor contraction of smooth mm, pain from cervix and upper vagina

Question 6

rectum and proximal anal canal

Answer 6

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

Question 7

SNS innervation sources

Answer 7

lumbar and sacral splanchnic nn.

Question 8

Pelvic splanchnic nn.

Answer 8

PSNS
Post
S234
distribute to hindgut and pelvic viscera via inferior hypogastric plexus

Question 9

general actions of the SNS

Answer 9

VC, contraction of sphincters, inhibition of peristalsis and inhibition of glandular secretion

Question 10

general actions of the PSNS

Answer 10

VD, peristalsis, contraction of the detrusor and myometrial mm.

Question 11

Lumbar splanchnics

Answer 11

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)

Question 12

Sacral Splanchnics

Answer 12

T12-L2

enter the inf hypogastric plexus where they synapse

postganglionic fibers then spread via subsidiary plexuses

minor route

Question 13

innervation of ureter

Answer 13

SNS via lumbar ans sacral splanchnics L1-3
PSNS via pelvic splanchnics S2-4
innervation of perineal urethra is via pudendal nn (S2-4)

Question 14

innervation to the anal canal

Answer 14

superior to pectinate= inferior hypogastric

inferior to pectinate line= inferior rectal

Question 15

pain fibers superior to pain line

Answer 15

visceral pain fibers travel with SNS nn. to T11-L2

Question 16

pain fibers below the pain line

Answer 16

visceral pain fibers travel with the PSNS nn. S2-4

Question 17

referred pain from uterine contractions

Answer 17

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

Question 18

pain from passage of fetus thru birth canal

Answer 18

cervix and vagina are subperitoneal so pain travels with PSNS 2-4 and refs to the perineal region

Question 19

pain from inferior vagina/penis/perineum

Answer 19

well localized somatic pain from the pudendal n. (2.3.4)

Question 20

Lumbar epidural

Answer 20

anesthetic delivered LV3/LV4

complete anesthesia of pelvis, perineum, lower limbs

no pain from contraction or passage of infant

Question 21

caudal epidural

Answer 21

delivered in epidural space of sacral canal

anesthesia of S2-4

still feel uterine contractions, cervix, vagaina, and perineum are painless

Question 22

Pudendal nerve block

Answer 22

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