Autonomics Flashcards
Describe the components of the nervous system.
Central Nervous system
Peripheral Nervous system
Autonomic Nervous system (parasympathetic and sympathetic)
Describe the differences in parasympathetic vs sympathetic.
Originate?
parasympathetic- (rest and digest) originate from brain and sacral cord. Brainstem cranial nerves III, VII, IX, X, S2 to S4 spinal segments
sympathetic (fight or flight) originate from thoracic cord. T1 to L2
Describe parasympathetic vs sympathetic bodily functions.
(Sympathetics have dominance over parasym. effects)
eye heart lung digestive tract kidney penis
parasympathetic - stimulates flow of saliva, slows heartbeat, constricts bronchi, stimulates peristalsis and secretion, stimulates release of bile, contracts bladder
sympathetic- dilates pupil, inhibits flow of saliva, accelerates heartbeat, dilates bronchi, inhibits peristalsis and secretion, conversion of glycogen to glucose, secretion of adrenaline and noradrenaline, inhibits bladder contraction, increases renin secretion, promotes ejaculation
“point and shoot”
Describe the sympathetic division, preganglionic/postganglionic
Location of preganglionic neurons: T1-L2
preganglionic fibers are short and myelinated
postganglionic fibers and long and unmyelinated
“short arms, long fingers” SYMPATHETIC
preganglionic fibers may synapse with one or more neurons in the sympathetic trunk directly across from them
they can directly stimulate the release of epi and norepi from the adrenal medulla
responsible for vasomotor (sympathetic tone)
Describe parasympathetic division.
Location of preganglionic neurons
location of preganglionic neurons - brain stem and S2, S3 and S4
preganglionic fibers travel through CN III, VII, IX, X and spinal nerves S2-S4 and synapse with peripheral ganglia located very near or directly on the effector organ… not on chain.
Long arms, short fingers… PARASYMPATHETIC
preganglionic fibers are long and myelinated
postganglionic fibers and short and unmyelinated
Sympathetic and parasympathetic pre/post ganglionic release what?
sympathetic
from lateral horn of spinal cord, preganglionic (cholinergic) releases Ach. Postganglionic (adrenergic) releases NE
parasympathetic
preganglionic cholinergic releases Ach. Postganglionic Cholinergic rel. Ach…
Ach is present at both pre and post ganglionic in parasympathetic or sympathetic?
Parasympathetic.
Which are the parasympathetic autonomic nerves?
3, 7, 9, 10 (GVE)
Key sympathetic stuff?
dilator pupillae, tarsal muscle of eyelid, sweating of face
What syndrome is characterized by miosis, ptosis, and anhydrosis and describe the etiology.
anhidrosis- lack of sweating. due to loss of sympathetic stimulation of the sweat glands. redness/warm skin
redness is due to loss of sympathetic vasoconstriction of blood vessels which allows increased blood flow.
ptosis- drooping eyelid, caused by loss of sympathetic stimulation of the superior tarsal muscle, a small band of smooth muscle which helps levator palebrae superioris elevate the eyelid
miosis- right pupil smaller than left … dilator pupillae muscle is innervated by sympathetic fibers that enter the orbit via the nasociliary, long ciliary and sometimes short ciliary nerves. when this innervation is interrupted the pupillae constrictor muscle which is innervated by parasympathetic nerves has no antagonist to balance its action and it constricts the pupil
HORNER’S SYNDROME
Ptosis 30 percent closure?
Ptosis full closure?
30 percent- results from loss of sympathetic stimulation
full- loss of oculomotor nerve (CNIII) to levator palpebrae superioris.
What could cause Horner’s syndrome?
tumor of apex of lung which would put pressure on the inferior cervical sympathetic ganglion (Pancoast tumor)
What can Pancoast’s tumor cause?
When should it be suspected in patients?
Horner’s syndrome bc the tumor of apex of lung can put pressure on inferior cervical sympathetic ganglion
should be suspected in patients suffering from shoulder and upper extremity pain who have a history of smoking
Where is the superior cervical ganglion?
In the neck/sympathetic chain.
right next to Vagus, between carotid and internal jugular.
What is IML?
What area has no IML? What are the implications of this?
Intermedial lateral cell column.
dorsal horn, lateral horn (presynaptic sympathetic nerve cell bodies), ventral horn
(sympathetic chain/sympathetic trunk)
no lateral horn (no IML) in cervical cord so sympathetic preganglionics travel up from the thoracic cord to synapse in the superior, middle, and inferior cervical chain ganglia
Preganglionic neurons of the sympathetic division are located where?
Ganglionic neurons?
Postganglionic neurons?
T1-L2 in lateral horns of the gray matter of the spinal cord.
Preganglionic neurons send fibers out the ventral root. They leave the spinal nerves through the white rami (myelin) and enter the sympathetic trunk.
Ganglionic neurons are located within the sympathetic chain ganglia or in collateral ganglia outside of the sympathetic trunk.
Postganglionic fibers leave the sympathetic trunk through the gray rami and pass through the spinal nerve again before terminating on the effector organ.
What is exception to preganglionic/sympathetic division?
Exceptions—splanchnics (greater, lesser, and least) are long SNS preganglionics that synapse on ganglia on or near the aorta and are near their target organs.
Which cranial nerves have parasympathetic function and which ganglion do they use?
III, VII, IX, X
CPOS (ciliary, pterygopalatine, otic, submandibular)
What do pelvic splanchnics do? Where do they come from? Are they para or sympathetic?
What do sacral splanchnics do? Are they para or sympathetic?
pelvic(parasympathetic) splanchnics (from nuclei in the sacral cord) help you pee, poop, and point.
sacral (sympathetic) splanchnics help you stop pee, stop poop, and shoot.
Describe the Ciliary ganglion.
Location:
Parasympathetic fibers:
Chief distributions:
Location: lateral to optic nerve
Parasympathetic fibers: III (oculomotor nerve and its inferior division)
Chief distributions: ciliary muscle and sphincter pupillae (parasym.) dilator pupillae and tarsal muscles (sym.)
Describe the Pterygopalatine ganglion.
Location:
Parasympathetic fibers:
Chief distributions:
Location: in pterygopalatine fossa
Parasympathetic fibers: facial nerve, greater petrosal nerve, and nerve of pterygoid canal
Chief distributions: lacrimal gland and glands in palate and nose
Describe the Submandibular ganglion.
Location:
Parasympathetic fibers:
Chief distributions:
Location: on hyoglossus
Parasympathetic fibers: facial nerve, chorda tympani, and lingual nerve
Chief distributions: submandibular and sublingual glands
Describe the Otic ganglion.
Location:
Parasympathetic fibers:
Chief distributions:
Location: below foramen ovale
Parasympathetic fibers: glossopharyngeal nerve, its tympanic branch, and lesser petrosal nerve
Chief distributions: partoid gland
Which ganglion do III, VII, IX, X use?
III- ciliary
VII- pterygopalatine and submandibular
IX- otic
X- ganglia located in or near wall of heart and gut/ located near the target
Which nerve is the “taxi” for parasympathetics of 7 and 9? Describe the “taxi” functions of 7 and 9.
7 hitches a ride on the lingual branch of 5 to get to the submandibular ganglion and drive the sublingual and submandibular glands. It also synapses in the pterygopalantine ganglion and uses branches of 5 (zygomatic- V2) to cause tearing of the lacrimal gland and dripping of the nasal mucosa.
9 uses the auriculotemporal branch of 5 to get to the otic ganglion and the parotid gland.
Describe how one comes to “cry and snot”
preganglionics parasympathetics of 7 (greater petrosal nerve) run with the postganglionic sympathetics to become the nerve of the pterygoid canal (Vidian nerve).
Parasympathetics from 7 then synapse in the pterygopalantine ganglion and the postganglionics of 7 then take branches of 5 to the lacrimal and nasal glands to make you cry and snot. The sympathetics do not synapse in the pterygopalantine ganglion while travelling to the lacrimal gland to oppose its function.
What do sympathetics do to the eye?
dilate the pupil , flatten the lens, and open the eyes wide (tarsal muscle of muller)
Describe the GVE Function of VII.
The chorda tympani hitches a ride on the lingual branch of 5 to supply taste to the anterior 2/3 rds of the tongue and to drive the submandibular and sublingual glands.
greater petrosal nerve - pterygopalatine ganglion - lacrimal gland
chorda tympani - submandibular ganglion - submandibular, sublingual salivary glands
Describe the GVE function of IX.
Glossopharyngeal nerve to lesser petrosal nerve to otic ganglion to auriculotemporal nerve (5) to parotid–GLOAP
