Block 2: Abdominal and Pelvis Nerve Overview

Question 1

Paravertebral plexus extends from

Answer 1

thorax to abdomen

Question 2

Paravertebral plexus

# of ganglia 
type of ganglia

Answer 2

4 ganglia

sympathetic

Question 3

Lumbar Splanchnic Nerves carry what fibers?

Answer 3

preganglionic sympathetic & visceral afferents

Question 4

Gray Rami Communicantes carry what fibers?

Answer 4

postganglionic sympathetic fibers

Question 5

Function of the prevertebral plexus

Answer 5

innervates the digestive, urinary, and reproductive systems

Question 6

Types of fibers you can find in prevertebral plexus

Answer 6

sympathetic and parasympathetic fibers

Question 7

Splanchnic Nerve Fibers: afferent or efferent; parasympathetic or sympathetic

Answer 7

visceral afferents and efferentes

mainly sympathetic except for the pelvic splanchnic nerves, which are parasympathetic only

Question 8

Thoracic Splanchnic Nerve contributions to prevertebral plexus

Answer 8

contribute preganglionic sympatethetic & visceral afferent fibers to the prevertebral plexus

Question 9

Vagus Nerve contribution to prevertebral plexus

Answer 9

preganglionic parasympathetic and visceral afferent

Question 10

Pelvic Splanchnic Nerve contribution to prevertebral plexus

Answer 10

preganglionic parasypathetic

Question 11

What is responsible for parasympathetic innervation of the abdomen?

Answer 11

the vagus nerve (to the splenic flexure)

the rest is the pelvic splanchnic nerves (distal colon, pelvic organs)

Question 12

What is responsible for sympathetic innervation of the abdomen

Answer 12

thoracic splanchnic nerves (greater lesser least)

lumbar splanchnic nerves

Question 13

What is responsible for parasympathetic innervation of the abdomen?

Answer 13

CN X

Pelvic Splanchnic Nerves S2-S4

Question 14

How do the pelvic splanchnic nerve fibers get up into the abdomen for parasympathetic innervation?

Answer 14

inferior hypogastric plexus

Question 15

Greater Splanchnic Nerve Contents, Location

Answer 15

T5-T9

celiac & superior mesenteric ganglia

Question 16

Lesser Splanchnic Nerve Contents, Location

Answer 16

T10-T11

aorticorenal ganglia

Question 17

Least Splancnic Nerve Contents, Location

Answer 17

T12

Renal Plexus

Question 18

Celiac Plexus Fibers

Answer 18

sympathetic, parasympathetic

Question 19

Superior Mesenteric Plexus Fibers

Answer 19

sympathetic, parasympathetic

Question 20

Renal Plexus Fibers

Answer 20

sympathetic, parasympathetic

Question 21

Inferior Mesenteric Plexus Fibers

Answer 21

Sympathetic

Question 22

Superior Hypogastric Plexus Fibers

Answer 22

Sympathetic

Question 23

Why does parasympathetic innervation of the abdomen stop after the renal plexus?

Answer 23

b/c the vagus nerve doesn’t innervate past the splenic flexure

Question 24

Greater splanchnic nerve innervates

Answer 24

foregut (supplies postsynaptic fibers to foregut)

Question 25

Lesser splanchnic nerve innervates

Answer 25

midgut (postsynaptic fibers to midgut and renal plexus)

Question 26

Parasympathetic Innervation of the Abdomen

Answer 26

vagus nerve (foregut and midgut); pelvic splanchnic nerves (hindgut)

Question 27

Foregut Referred pain caused by: location:

Answer 27

caused by: greater splanchnic nerve (T5-T9) | location: lower thorax & epigastric

Question 28

Midgut Referred pain caused by: location:

Answer 28

caused by: lesser splanchnic nerve (T9-T10) | location: umbilical region

Question 29

Kidneys & Proximal Ureter Referred Pain caused by: location:

Answer 29

caused by: least splanchnic nerve (T12) | location: flank

Question 30

Hindgut and Distal Ureter Referred Pain caused by: location:

Answer 30

caused by: lumbar splanchnic nerves (L1, L2) | location: pubic region, lateral and anterior thigh, groin

Question 31

What are the visceral plexuses?

Answer 31

Prevertebral and Paravertebral Plexus

Question 32

What are the somatic plexuses of the abdomen?

Answer 32

Lumbar Plexus

Question 33

Lumbar plexus is formed by

Answer 33

anterior rami L1-L3 some of anterior rami L4 contribution from T12

Question 34

What are the branches of the lumbar plexus?

Answer 34

``` Contribution from T12 (subcostal nerve) Iliohypogastric Nerve (L1) Ilioinguinal Nerve (L1) Genitofemoral Nerve (L1, L2) Lateral Cutaneous Nerve of Thigh (L2, L3) Femoral Nerve (L2-L4) Obturator Nerve (L2-L4) ```

Question 35

Where does the lumbar plexus form?

Answer 35

deep to and within the psoas major muscle

Question 36

How to identify the subcostal nerve

Answer 36

just below the 12th rib | *typically* the shortest

Question 37

How to identify the iliohypogastric nerve

Answer 37

travels obliquely across quadratus lumborum, pierces the transverse abdominis superior to the iliac crest

Question 38

How to identify the ilioinguinal nerve

Answer 38

travels obliquely across quadratus lumborum, travels along iliac crest, then travels w/ the spermatic cord/round ligament of the uterus to reach the superficial inguinal reing

Question 39

Is the ilioinguinal nerve considered part of the inguinal canal? Why or why not?

Answer 39

no does not pass through the deep inguinal ring

Question 40

How to identify the genitofemoral nerve

Answer 40

pierces the psoas major (originates deep to the psoas then splits into 2

Question 41

Genital Branch of Genitofemoral Nerve Location

Answer 41

deep inguinal ring to the inguinal canal

Question 42

Femoral branch of the genitofemoral nerve npathway

Answer 42

travels deep to inguinal ligament to enter anterior thigh

Question 43

How to identify the lateral femoral cutaneous nerve

Answer 43

lateral border of psoas major, deep to inguinal ligament and goes to the thigh

Question 44

What is the biggest branch of the sacral plexus?

Answer 44

femoral nerve

Question 45

How to identify obturator nerve

Answer 45

only one to emerge medially from psoas major | only branch that travels inferiorly (to the obturator canal)

Question 46

What are the somatic plexuses of the pelvis?

Answer 46

``` sacral plexus (mainly somatic, some autonomic) coccygeal plexus ```

Question 47

What are the visceral plexuses of the pelvis?

Answer 47

paravertebral sympathetic chain pelvic extension of superior hypogastric plexus parasympathetic fibers visceral afferent fibers

Question 48

Where is the sacral plexus?

Answer 48

anterior to the piriformis muscle

Question 49

Sacral plexus contents

Answer 49

formed by ventral rami of S1-S4 and the lumbosacral trunk (L4-L5) pelvic splanchnic nerves

Question 50

Pelvic Splanchnic Nerve Fibers

Answer 50

preganglionic parasympathetic fibers

Question 51

What are the paths fo the sacral plexus nerves?

Answer 51

exit superiorly to piriformis: superior gluteal exit inferiorly to piriformis: inferior gluteal, nerve to quadratus femoris and inferior gemellus, posterior femoral cutaneous nerve, sciatic nerve

Question 52

``` Pudendal Nerve motor f(x) sensory f(x) ```

Answer 52

motor: skeletal muscles in peritoneum, external urethral and anal sphincter, levator ani muscles sensory: penis and clitoris, skin of perineum

Question 53

Coccygeal Plexus Contents

Answer 53

S5 and coccygeal nerve

Question 54

Visceral Plexuses of the Pelvis

Answer 54

paravertebral sympathetic chain parasympathetic fibers pelvic extensions of superior hypogastric plexus visceral afferent fibers

Question 55

Paravertebral Sympathetic Chain characteristics

Answer 55

inferior ends of sympathetic trunk w/ 4 ganglia | forms a single terminal ganglion (ganglion impar)

Question 56

What types of fibers do the paravertebral sympathetic chain provide?

Answer 56

postganglionic sympathetic fibers

Question 57

Pelvic Splanchnic Nerve Fibers

Answer 57

preganglionic parasympathetic fibers only

Question 58

Pelvic Splancnic Nerves f(x)

Answer 58

erection of the penis and clitoris

Question 59

Superior Hypogastric Plexus location fibers

Answer 59

location: anterior to bifurcartion of aorta and sacral promontory fibers: sympathetic fibers

Question 60

Inferior Hypogastric Plexus formed by

Answer 60

pelvic splanchnic nerves (parasympathetic) and superior hypogastric nerves (sympathetic)

Question 61

Inferior Hypogastric Plexus carries what type of fibers

Answer 61

sympathetic parasympathetic visceral afferent fibers

Question 62

Function of inferior hypogastric plexus

Answer 62

innervates pelvic viscera and erectile tissues

Question 63

Pelvic Splanchnic Nerves receive contributions from what levels?

Answer 63

S2-S4

Question 64

Gray Rami Communciantes f(x) (in pelvis)

Answer 64

connect sympathetic trunk and the sacral ventral rami

Question 65

Sacral Splanchnic Nerve contents

Answer 65

pre and post ganglionic fibers, mostly pre-ganglionic

Question 66

Hypogastric Nerve Fibers

Answer 66

pre and postganglionic sympathetic fibers

Question 67

Inferior Hypogastric Fiber Types

Answer 67

parasympathetic sympathetic visceral afferents

Question 68

Where does the inferior hypogastric plexus get its sympathetic innervation from?

Answer 68

hypogastric nerves | sacral splanchnic nerves

Question 69

Where does the inferior hypogastric plexus get its parasympathetic innervation from?

Answer 69

pelvic splanchnic nerves

Question 70

Where does the inferior hypogastric plexus get its visceral afferents from?

Answer 70

they travel with the sympathetic and parasympathetic fibers to the spinal cord

Question 71

Inferior Hypogastric Plexus role in erection and ejaculation

Answer 71

Pelvic Splanchnic Nerves (parasympathetic): erection Hypogastric Nerves (sympathetic): emission Somatic Motor Nerves: ejaculation

Question 72

Pain from abdominal part of foregut is referred to

Answer 72

epigastric region

Question 73

Pain from the midgut is referred to

Answer 73

umbilical region

Question 74

Pain from the hindgut is referred to

Answer 74

pubic region