autonomics and visceral afferents Flashcards
what is innervated by the visceral motor system
cardiac muscle
smooth muscle
glands
how many neurons are involved in the visceral motor system
2- pre and post
what does the visceral sensory system do
interoception (internal environment monitoring)
pain
what are the 2 parts of the visceral motor system
sympathetic
parasympathetic
what levels are sympathetic neurons
where are the cell bodies
where do they go in the brain
thoracolumbar
cell bodies of preganglionic neurons are in the IML horn
lateral and posteiror hypothalamus
what are the functions of the sympathetic nervous system
"fight or flight" dilate pupils piloerection sweating vasoconstriction increase HR, RR decrease gut and bladder mobility central hyperreactivity ejaculation
what are the options for sympathetic pre ganglion axons entering the sympathetic chain
synapse and leave at same level
ascend/descend, synapse and leave at that level
don’t leave at all, form splanchnic nerves that synapse later
where do splanchnic nerves synapse
prevertebral ganglia
where are sympathetic post ganglion cell bodies
paravertebral or prevertebral ganglion
what organs are innervated by sympathetic neurons
heart lungs kidneys ureters GI tract bladder reproductive tract
what is special about the suprarenal gland
preganglionic fibers synapse directly onto chromatin cells
what levels are parasympathetic neurons
where are the cell bodies
where do they go in the brain
cervical and saccral regions
cranial nerves 3,7,8,10 and IML S2-4
anteiror and medial hypothalamus
function of parasympathetic nervous system
"rest and digest" constrict pupil and airway increase secretions decrease HR increase gut motility contract bladder decrease rage reaction errection
where are the parasympathetic post ganglion cell bodies
in or near the target organ
what does the parasympathetic system not innervate
limbs kidneys/ureters adrenal glands uterus and vagina testis/ovary skeletal muscle blood vessels
what blood vessels do receive parasympathetic stimulation
coronary vessels
erectile tissue
sympathetic forgut
greater splanchnic nerve
celiac ganglion
sympathetic midgut
lesser splanchnic nerve
superior mesenteric ganglion
sympathetic kidneys and ureters
least and lumbar splanchnic nerves
aorticorenal ganlgion
sympathetic hindgut
lumbar splanchnic nerve
inferior mesenteric ganglion
sympathetic suprarenal medulla
greater, lesser, least splanchnic
sympathetic suprarenal cortex
greater, lesser, least splanchnic
aorticorenal ganglion
sympathetic pelvic organs
lumbar splanchnics via hypogastric plexuses
sacral splanchnics via inferior hypogastric plexus
parasympathetic foregut and midgut
vagus
parasympathetic hindgut
pelvic splanchnics
visceral pain afferent foregut, midgut, descending colon, 1/2 sigmoid, pelvic pain line, kidneys ureters
sympathetics
visceral pain afferets: distal sigmoid, pelvic organs below pelvic pain line
parasympahtetics
visceral interoceptive afferents- GI to left colic flexure
vagus
visceral interoceptive afferents- kidneys and ureters
vagus
visceral interoceptive afferents- pelvic organs, GI past colic flexure
pelvic splanchnic
“above the pelvic pain line”
structures in contact with the peritoneum
kidney
ovary/tube/upper uterus
superior bladder
“below the pelvic pain line”
viscera not in contact with peritoneum
lower uterus
vagina
inferior bladder
what takes pain from above the pelvic pain line
sympathetic
what takes pain from below the pelvic pain line
parasympathetic
what is referred pain
a noxious stimuli from an organ that is perceived as coming from a region of the body wall corresponding to a specific dermatome level
what does parasympathetic innervate
GI tract spleen pancreas gallbaldder liver
where does parasympathetic innervation come from
vagus nerve
pelvic splanchnic nerves
what does parasympathetic vagus do
foregut and midgut
visceral afferent for heart and referred pain location
thoracic splanchnic T1-T4
upper thorax and medial arm
visceral afferent for foregut and referred pain location
greater splanchnic T5-9
lower thorax and epigastric region
visceral afferent for midgut and referred pain location
lesser splanchnic T10-11
umbilical region
visceral afferent for kidney/upper ureter and referred pain location
least splanchnic T12
flanks
visceral afferent for handgun and lower ureter and referred pain location
lumbar splanchnic L1,2
pubic region
what does the vagus nerve carry
pre parasympathetic
visceral afferent
what do thoracic and lumbar splanchnic nerves carry
pre sympathetic
visceral afferent
what does pelvic splanchnic carry
pre parasympathetic
what does interoception
parasympathetic mostly
what does pain
mostly sympathetic EXCEPT below pelvic pain line (lower uterus, vagina, inferior bladder, last part of sigmoid colon down)
referred pain diaphragm irritation
shoulder
referred pain stomach
below xiphoid process down to the left and in center of back
referred pain duodenum and head of pancreas
under xyphoid process
referred pain gallbladder
right and around to back up
referred pain liver
right and around back down
referred pain appendix
umbilicus
referred pain spleen
left costal
referred pain sigmoid colon
left and right hypogastric
referred pain cecum and ascending colon
hypogasric
referred pain kidney and ureter
traces hip anteriorly and then goes up on the back
how is somatic pain tested
rebound pain- push on it and it hurts when released
