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GI Exam #2 > Autonomics And Pain > Flashcards

Autonomics And Pain Flashcards

1
Q

What cranial nerves are part of the PSNS?

A

CN III, VII, IX, X

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2
Q

PSNS is which part of the spinal cord?

A

Craniosacral (cranial ns and pelvic splanchnic ns)`

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3
Q

What are the vertebral levels of the SNS?

A

T1-L2(3)

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4
Q

Sympathetics come off of which part of the spinal cord itself? (Which horn)

A

Lateral horn and intermediolateral columns

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5
Q

Parietal structures from the head, UE, and chest come from which levels?

A

T1-T6

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6
Q

Sympathetics to the head, salivary gland and eyes come from which levels?

A

T1-T3(4) (eyes T1-T2)

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7
Q

SNS to the heart, lungs and esophagus come from which levels?

A

T4-T6

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8
Q

Parietal structures of the abdominal body wall are innervated by SNS at which levels?

A

T7-T11

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9
Q

SNS to the stomach, liver, GB and spleen are at which levels?

A

T6-T9

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10
Q

SNS to the SI are from which levels?

A

T7-T10

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11
Q

SNS to the colon and appendix are at which levels?

A

T10-T11

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12
Q

Parietal SNS to the LE are at which levels?

A

T11-L2(3)

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13
Q

SNS to the kidney are at which levels?

A

T10-L1

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14
Q

SNS too the suprarenal gland is at which levels?

A

T6-L2

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15
Q

Path of presynaptic neurons from SC (4):

A

IML —> anterior motor root of spinal n —>white rami communicants —> paravertebral ganglion

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16
Q

Sympathetic trunk includes (2):

A

Paravertebral ganglia and interganglionic connections

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17
Q

4 options for presynaptic fibers entering the sympathetic chain

A
  1. Ascend to higher level
  2. Descend to lower level
  3. Synapse at level of entry
  4. Continue as abdominopelvic splanchnic n w/o synapsing
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18
Q

What is the path for postsynaptic fibers that synapse at the sympathetic ganglia at level of cell body (parietal SNS)?

A

Exit paravertebral ganglia via the gray rami communicant and continue as a spinal n to body wall/limbs.

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19
Q

Functions of parietal SNS (3)

A

Vasomotion
Sudomotion
Pilomotion

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20
Q

What are the levels of SNS innervation of the UE?

Where does it synapse (2)?

A

C5-T1

Middle and inferior cervical ganglia.

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21
Q

Superior cervical ganglia is near which structure(s)?

A

Bifurcation of carotid as.

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22
Q

Middle cervical ganglia is near which structure?

A

Thyroid

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23
Q

Stellate ganglia =

A

Inferior cervical and T1 ganglia

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24
Q

Horner syndrome

A

Disruption of nervous pathway near the superior cervical ganglia that results in pupillary constriction, ptosis, anhydrosis, flushing.

25
Q

2 options for parietal innervation of the SNS

A
  1. Gray rami communicants to all spinal ns.

2. Cephlic arterial rami to periarterial plexuses of carotid as.

26
Q

Prevertebral (preaortic) ganglia (4)

A

Celiac
Superior mesenteric
Inferior mesenteric
Aorticorenal

27
Q

Vertebral levels that form:
Greater splanchnic n
Lesser splanchnic n
Least splanchnic n

A

Greater - T5-9
Lesser - T10-11
Least - T12

28
Q

Visceral branches of sympathetic trunks (2) and where do they synapse?

A

Cardiopulmonary splanchnic ns. - paravertebral ganglia

Abdominovisceral splanchnic ns. - prevertebral ganglia

29
Q

Innervation of the suprarenal glands

A

Travel all the way w/o synapsing until it reaches the cells of the adrenal gland. The cells of the adrenal gland act as the postsynaptic neurons.

30
Q

4 PSNS ganglia in the head

A

Ciliary ganglia
Otic
Pterygopalatine
Submandibular

31
Q

Where does PSNS innervation transition from the vagus n to the pelvis splanchnic ns?

A

Splenic flexure

32
Q 
Overall what does the sympathetic system do to:
Pupils
Bronchioles
HR
Vessels
Peristalsis
Adrenal glands
Erection
A 
Overall what does the sympathetic system do to:
Pupils - dilates
Bronchioles - dilates
HR - increase
Vessels - vasoconstriction
Peristalsis - inhibits
Adrenal glands - actiivates
Erection - ejaculation/remission of erection
33
Q 
Overall what does the parasympathetic system do to:
Pupils
Bronchioles
HR
Vessels
Peristalsis
Adrenal glands
Erection
A 
Overall what does the parasympathetic system do to:
Pupils - constricts
Bronchioles - constricts 
HR - decrease
Vessels - dilates
Peristalsis - activates
Adrenal glands - inhibits
Produces erection
34
Q

Which system is most active controlling vision, GI tract and elimination?

A

PSNS

35
Q

What 2 kinds of fibers exist in splanchnic ns?

A

Visceral afferents (sensory) and visceral efferents (autonomic)

36
Q

What percentage of vagus fibers are afferent?

Splanchnic ns?

A

80% of vagus n fibers are afferent

20% of splanchnic fibers are afferent

37
Q

Pain travels with which part of the ANS?

What are the exceptions?

A

SNS, except for below the pelvic pain line (middle of sigmoid colon).

38
Q

Where is the thoracic pain line and what are the vertebral levels?

A

Plane of sternal angle

T4-5

39
Q

Duration of pain:
Acute abdomen
Chronic abdominal pain
Subacute abdomen

A

Acute abdomen: <3 days
Chronic abdominal: >3 wks
Subacute abdomen: 3 days to 3 wks

40
Q

Visceral pain

A

Diffuse and poorly localized.

Problems w/ internal organs or supportive tissues.

41
Q

Somatic pain

A

Well localized.

Caused by injury to somatic tissues.

42
Q

What is the cause for parietal pain?

A

Irritation of fibers that innervation the parietal peritoneum.
It follows the Dermatomal pattern.

43
Q

Vertebral levels for visceral pain of the liver and stomach

A

T6-T9

44
Q

Vertebral levels for parietal pain of the pancreas

A

T6-T9

45
Q

Vertebral levels for parietal pain of the small intestine

A

T8-T10

46
Q

Vertebral levels for parietal pain of the kidneys

A

T10-L1

47
Q

Vertebral levels for parietal pain of the spleen

A

T6-T8

48
Q 
Vertebral levels for parietal pain  of the colon:
Ascending colon
Transverse colon
Descending colon
Sigmoid colon
Rectum
A 
Ascending: T10
Transverse: T11
Descending: T12-L1, distal descending L2
Sigmoid: S2
Rectum: S4
49
Q

Right hypochondriac pain could be (4)

A

Gallstones
Cholangitis
Hepatitis
Liver abscess

50
Q

Pain in the epigastric region could be (3)

A

Esophagitis
Ulcers
Pancreatitis

51
Q

Pain in the umbilical region could be (4)

A

Appendicitis (early)
Mesenteric amenities
Meckel’s
Lymphoma

52
Q

Pain in the flank region could be (2)

A

Ureteric colic

Pyelonephritis

53
Q

Pain in the right inguinal region could be (6)

A 
Late appendicitis
Crohn’s
Cecum obstruction
Ovarian cyst
Ectopic pregnancy
Hernias
54
Q

Pain in the left inguinal region could be (5)

A 
Diverticulitis
Ulcerative colitis
Constipation
Ovarian cyst
Hernia
55
Q

Pain in the hypogastric/pubic region could be (4))

A

Testicular torsion
Urinary retention
Cystitis
Placental abruption

56
Q

Liver, GB, duodenum and diaphragm can refer pain:

A

To the right shoulders

57
Q

Stomach can refer pain to:

A

Middle upper back

58
Q

What kind of pain can retroperitoneal pain cause?

A

Back pain

59
Q

Colicky pain

A

Cramp-like pain caused by obstruction of hollow muscular viscus (bowel obstruction, stones in ureter/GB). Usually presents in middle of abdomen.

GI Exam #2 (9 decks)

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