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GI Final > Autonomics + Pain > Flashcards

Autonomics + Pain Flashcards

1
Q

Which division of the motor (efferent) nervous system has NO ganglia and is under single neuron control?

A

Somatic N.S. (voluntary)

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2
Q

What part of the motor (efferent) nervous system has ganglia, and is under two neuron control?

A

ANS (involuntary)

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3
Q

What two senses does the SNS have?

A

general + special senses

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4
Q

What 2 senses does the ANS have?

A

general + visceral senses

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5
Q

ANS sends motor output to __________ via _____________.

A

Cardiac muscle, smooth muscle, + glands

ACh + NE

(only pre-ganglionic = myelinated)

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6
Q

The SNS sends motor output to ___________ via ________.

A

Skeletal muscle

ACh

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7
Q

The ANS is broken into parasympathetics and sympathetics. What are the 4 crainal nerves that carry the parasympathetic crainial-sacral division?

A

3, 7, 9 ,10

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8
Q

In the brain, the pre-ganglionic cell bodies of nerves 3, 7, and 9 synapse with what post-ganglionic cell bodies?

In the sacrum (nerve 10?)

A

Ciliary ganglion

Pterygopalatine ganglion

Submandibular ganglion

Otic ganglion

Wall of organ (pelvic splanchnic)

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9
Q

What receptors are parasympathetic?

A

Nicotinic + muscarinic (ACh)

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10
Q

The sympathetic division of T1-L2 (pre-ganglionic cell bodies) synapse with what?

A

Superior Cervical ganglion

Sympathetic chain ganglion

Prevertebral ganglion

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11
Q

What receptors are sympathetic?

A

Alpha + beta receptors

ACh = pre

NE = post

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12
Q

For sympathetics, at what level are the head, upper limb, and thoracic viscera?

A

T1-T6

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13
Q

For the sympathetics, at what level are the abdominal body wall and viscera?

A

T7-T11

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14
Q

In the sympathetics, at what level are the lower limb and pelvic viscera?

A

T12-L3

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15
Q

Where are the cell bodies of the sympathetic presynaptic neurons found?

A

Intermediolateral (IML) cell column

Yhe lateral hord of spinal cord gray matter

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16
Q

In the sympathetics, the paravertebral ganglia range from _____ to _________.

A

cervial —> sacrum

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17
Q
A
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18
Q

As one of the options for a presynaptic fiber in the sympathetics, what can it pass through without having to synapse that will allow it to enter the sympathetic trunk?

A

paravertebral ganglion

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19
Q

True or false, postsynaptic fibers of the sympathetic trunks exit at the level of the cell body laterally via gray rami communicans?

A

True

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20
Q

What are the 3 functions of sympathetic neurons?

*fight or flight* what would happen?

A
  1. Vasomotion –> constriction of blood vessels
  2. Sudomotion –> sweat glands
  3. Pilomotion –> muscles that give you goose bumps
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21
Q

Where is the superior cervical ganglion located?

sympathetic

A

By the bifurcation of the aorta into internal and external coratid A.’s

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22
Q

From the superior cervical ganglion, through the external carotid plexus, what do the sympathetics control?

A

Salivary gland (mucus)

Sweat gland

Blood vesseld

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23
Q

From the superior cervical ganglion, to the internal carotid plexus, what does the sympathetics control?

A

Orbit:

  1. diliate the pupil
  2. Keeps the eye elevated (affected in horner syndrome)
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24
Q

Coming off of the internal coratid artery, the deep petrosal nerve controls?

A

Blood vessels, nasal, + oral cavity

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25
Q

If a person had a lesion at the superior cervical ganglion, what would be the outcome?

A

Horner Syndrome

Symptoms: pupils constrict, ptosis (droopy eye), anhydrosis (no sweat), flushed

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26
Q

What goes to all 31 spinal nerves providing parietal stimulation of the sympathetics?

A

gray rami communicans

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27
Q

What supplies the periarterial plexuses of the parietal sympathetics?

A

Cephalic arterial rami (head)

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28
Q

What are the 4 prevertebal (preaortic) ganglia in the abdominal cavity?

A
  1. Celiac ganglion
  2. Superior mesenteric ganglion
  3. Inferior mesenteric ganglion
  4. Aortaco-renal ganglion
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29
Q

In the sympathetic abdominal viscera, they pass through _____vertebral and synapse at _____vertebral.

A

PARA

PRE

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30
Q

Greater splanchnic nerves synapse w/ ________.

A

Celiac ganglia

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31
Q

Lesser + least splanchnic nerves synapse with ________.

A

Superior mesenteric ganglion

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32
Q

Aorticorenal ganglia synapses with ________.

A

All the splanchnics

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33
Q

Inferior mesenteric ganglion synapse with ________.

A

Lumbar splanchnics

34
Q

Where do cardiopulmonary splanchnic nerves synapse at?

A

PARA vertebral ganglia

35
Q

Where fo abdominopelvic splanchnic nerves synapse at?

A

PRE vertebral ganglia

36
Q

Where do parasympathetics traveling in the vagus nerve stop?

A

splenic flexure

37
Q

In the sympathetics, cell bodies are for PARA vertebral ganglia are found in all parts of the body EXCEPT

A

abdominopelvic viscera (organs)

38
Q

Where do the abdominal viscera (organs) of the sympathetics synapse?

A

PRE vertebral ganglia

pre = pretty organs

39
Q

Why are suprarenal glands special?

A

Cause they do not synapse with anything! they are directly stimulated by pre-synaptic fibers as the gland actually functions are post-synaptic neurons.

Come from NC cells

40
Q

In the parasympathetics (w/ the enteric nervous system), which is longer the pre or post synaptic fiber?

A

Pre! because the post is directly on the gut!

41
Q

Cranial nerve 3 goes to which ganglia?

A

Ciliary

42
Q

Crainial nerve 9 goes to which ganglia?

A

otic

43
Q

Crainal nerve 7 goes to which ganglia?

A

Pterygopalatine + submandibular

44
Q

ciliary ganglia sends nerves to ______.

A

orbit (eyes)

45
Q

Otic ganglia sends nerves to _______.

A

paratid salivary gland

46
Q

Pterygopalatine ganglia sends nerves to _______.

A

Nasal + palate

47
Q

Submandibular ganglia sends nerves to ______.

A

Oral region (submandibular + sublinguial salivary glands)

48
Q

True or False:

Parasympathetics only go to internal organs + glands (NEVER body wall + limbs)

A

True

49
Q

Where do the cranial parasympathetic fibers stop innervating the abdominal organs, and the sacral fibers begin?

A

At the splenic flexure (between transverse and descending colon)

50
Q

What are the 3 functions of the parasympathetic system crainial part?

A
  1. Constriction of pupil
  2. Accomodation (adjusting the eye)
  3. Tears
51
Q

What are 3 functions of the parasympathetic system overall?

A
  1. Control vision
  2. Stimulate GI tract
  3. Eliminate waste
52
Q

What type of nerves are composed of BOTH afferents and efferents?

A

Splanchnic nerves

53
Q

Pain travels with the ________ from the stomach to the sigmoid colon.

A

sympathetics

54
Q

What parts of the body produce pain via parasympathetics?

A

Above thoracic pain line (vagus N. ) –> above esophagus

And below the middle of the sigmoid colon (pelvic pain line) via the pelvic splanchnics

55
Q

Pain is what type of transmitted via what type of fiber?

A

viscera afferents

56
Q

Time:

Acute abdominal pain

Chronic abdominal pain

A

3 days

3 weeks

57
Q

Describe visceral (organ) pain.

A

Diffuse + poorly localized

58
Q

Describe somatic pain (body wall).

A

Well localized (can point to specific spot)

In gallbladder + appi you can get somatic pain if the organ starts to irritate the peritoneum.

59
Q

Where do foregut organs (stomach, duodenum, biliary tract) produce pain?

A

epigastric region

60
Q

Where do midgut organs (small bowel, appendix, cecum) produce pain?

A

Periumbilical region

61
Q

Where fo hindgut organs (most of colon, sigmoid, rectum) produce pain?

A

Suprapubic or hypogastric area

62
Q

Visceral pain from the liver, stomach, pancreas, and proximal duodenum come from what level of the spinal cord?

A

T6-T9

63
Q

The spleen has pain from what level of the spinal cord?

A

T6-8

64
Q

The kidneys have pain from what level of the spinal cord?

A

T10 - L1

65
Q

The small intestine has pain from what level of the spinal cord?

A

T8-T10

66
Q

The ascending colon has pain from what level of the spinal cord?

A

T10

67
Q

The transverse colon has pain from what level of the spinal cord?

A

T11

68
Q

The descending colon has pain from what level of the spinal cord?

A

T12-L1

69
Q

The sigmoid colon has pain from what level of the spinal cord?

A

S2-S4 (S4 = rectum)

70
Q

MEMORIZE

A
71
Q

MEMORIZE

A
72
Q

Referred pain for irritation of the diaphragm via the liver/gallbladder/duodenum is where?

A

right shoulder pain

73
Q

MEMORIZE

A
74
Q

What type of pain does a patient have when it is retroperitoneal (kidney, aorta, pancreas)?

A

back pain

75
Q

What is colicky pain?

A

Cramp-like

When a hollow structure becomes obstructed (like a kidney stone, or bowel obstruction)

76
Q

Perforated gastric ulcer

A

Gastric contents now spreading all over –> foregut chronic visceral pain, sever pain spreading over abdomen

77
Q

Acute cholecystitis

A

refers pain to right shouler, somatic pain in RUQ

78
Q

What type of pain is adhesive small bowel obstruction?

A

History of previous abdominal surgery

Midgut visceral colicky pain, no gas, distension

79
Q

Passage of kidney stone pain

A

Sudden onset of very sever colicky pain from loin to groin, patient writhing in pain w/ no fever

80
Q

Cancer of descending colon pain

A

hindgut visceral colicky pain, distended abdomen

81
Q

Ruptured ectopic pregnancy pain

A

Sudden onset of sever pain in hypogastrium radiating to sacrum

no fever

localized peritonitis

Do a rectal finger exam (DRE) - tender

82
Q

Leaking aortic aneuryseum pain

A

history of male w/ atherosclerotic disease (hypertension)

sever sudden back pain

palapable impulse from aneurysm in epigastrium

GI Final (12 decks)

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