CP Neurology

Question 1

Where are the four primary restriction points of the esophagus?

Answer 1

At the…

Cricopharyngeus muscle

Arch of the aorta

Left main bronchus

Passage of the esophagus through the diaphragm

Question 2

What major nerve does the left recurrent laryngeal nerve come off of?

Answer 2

The left vagus nerve

Question 3

What nerve contributes to the anterior vagal trunk?

Answer 3

Left vagus nerve

Question 4

What nerve contributes to the posterior vagal trunk?

Answer 4

Right vagus nerve

Question 5

What three cervical nerves supply the phrenic nerve?

Answer 5

C3, C4, C5

Question 6

Where will you find the phrenic nerve near to the heart?

Answer 6

Almost “buried in the heart.”

Between the fibrous pericardium and the mediastinal parietal pleura

Question 7

What are the atypical intercostal nerves?

Answer 7

1-2

7-11

Question 8

What are the three major branches of the intercostal nerves?

Answer 8

Lateral cutaneous branches

Muscular branches

Anterior cutaneous branches

(rami communicans and collaterals, too)

Question 9

Why does the anterior ramus of the 1st thoracic spinal nerve make an atypical intercostal nerve?

Answer 9

Because most of the 1st thoracic spinal nerve joins with the brachial plexus.

Question 10

Why is the second intercostal nerve atypical?

Answer 10

Because it makes a cutaneous branch that joins with “a brachial component” to make the intercostobrachial nerve

Question 11

Why are intercostal nerves 7-11 atypical?

Answer 11

As they run around the ribs, they continue past the ribs and become thoracoabdominal nerves

Question 12

Where is the lateral horn of the spinal cord found?

Answer 12

T1-L2

Question 13

What do we call a presynaptic nerve fiber heading to a prevertebral ganglion?

Answer 13

A Splanchnic nerve

Question 14

What are the five major divisions of the parasympathetic element of the vagus nerve in the thorax?

Answer 14

Superior cardiac branch

Middle cardiac branch

Inferior cardiac branch

Pulmonary branches

Esophageal branches

Question 15

What are the sympathetic and parasympathetic contributions to the:

Pulmonary plexus

Answer 15

Sympathetic: Pulmonary splanchnic nerves

Parasympathetic: Pulmonary branch of the vagus nerve

Question 16

What are the sympathetic and parasympathetic contributions to the:

Superficial and Deep Cardiac Plexus

Answer 16

Sympathetic: Cardiac Splanchnic Nerves

Parasympathetic: Superior, Middle, and Inferior Cardiac branches of the vagus nerve.

Question 17

The aortic plexus has the same sympathetic and parasympathetic contribution as what other plexus?

Answer 17

The cardiac plexus

(Cardiac splanchnic nerves / Superior, middle, and inferior cardiac branches of the vagus nerve.)

Question 18

What are the sympathetic and parasympathetic contributions to the:

Esophageal Plexus

Answer 18

Sympathetic: Greater splanchnic nerve

Parasympathetic: Esophageal branches of the vagus nerve

Question 19

What are the regions of the esophagus?

Answer 19

Cervical Part

Thoracic Part: T1-esophageal hiatus of diaphragm

Abdominal Part

Question 20

What are the upper and lower sphincters of the esophagus?

Answer 20

At the Cricopharyngeus M. (Upper esophageal constrictor)

At the Esophageal Hiatus of the Thoracic Diaphragm (Lower esophageal sphincter)

Question 21

What are three other branches off of the Vagus N.?

Answer 21

Left Recurrent Laryngeal N. (Loops under Lig. Arteriosum)

Anterior Vagal Trunk

Posterior Vagal Trunk

Question 22

The PNS has limited distribution in the head/neck/trunk, whereas sympathetic innervation

Answer 22

distributes to all vascular areas of the body and contributes indirectly to non-sweat gland secretions through vasoconstriction

Question 23

Glandular secretion is stimulated by

Answer 23

PNS (except sweat glands)

Question 24

Are the coronary arteries sympathetically stimulated to vasoconstrict?

Answer 24

NO

Question 25

What paravertebral sympathetic ganglia that contains presynaptic sympathetic nerve fibers is presence in the thorax?

Answer 25

Thoracic Sympathetic Trunk

Question 26

What are the presynaptic cell bodies in the lateral horn of the SC at T1-5/6 synapsing in the cervical and thoracic sympathetic trunks called?

Answer 26

Cardiac Splanchnic N. (send fibers to the superficial and deep cardiac plexus)

Question 27

what are the presynaptic cell bodies in the lateral horn of the spinal cord at levels T2-3 that synapse onto the postsynaptic cell bodies in the thoracic sympathetic trunk called?

Answer 27

Pulmonary splanchnic N. (send fibers to the pulmonary plexus)

Question 28

What are the spinal levels and associations of the Greater Splanchnic N?

Answer 28

T5-9/10 sends fibers to esophageal plexus and celiac ganglion/plexus

Question 29

What are the spinal levels for the Lesser Splanchnic N. and where do its fibers go?

Answer 29

T10-11 sends fibers to the celiac and superior mesenteric ganglion/plexus

Question 30

What is the spinal level of the Least Splanchnic N. and where do its fibers go?

Answer 30

T12 sends fibers to the aorticorenal ganglion

Question 31

What does the superior cardiac branch originate and where does it go?

Answer 31

originates in neck and goes through the superior aperture with the cardiac splanchnic nerves to form the cardiac plexus

Question 32

Where does the middle cardiac branch originate and where does it go?

Answer 32

originates in neck and goes through superior throacic aperture with cardiac splanchnic to make cardiac plexus

Question 33

Where does the inferior cardiac branch originate and where does it go?

Answer 33

originates in the thorax and goes with cardiac splanchnic Ns. to make cardiac plexus

Question 34

Where doe the esophageal branches come from and where do they go?

Answer 34

after making pulmonary branches, the vagus nerve becomes indistinguisable from the esophageal plexus that covers the inferior 2/3 of the esophagus

Question 35

What is the function of the pulmonary plexus?

Answer 35

innervates lungs, bronchi and pleura Symp: dilates bronchi, inhibits glands, vasoconstricts, visceral sensor Parasymp: constricts bronchi, glands, vasodilates, cough reflex, sensor, chemoreceptor

Question 36

What is the function of the Cardiac Plexus?

Answer 36

symp: nodal tissue in heart, contraction force, vasomotor to pericardium Parasymp: decrease HR, reduces the force of heart contraction and vasoconstricts arteries

Question 37

What is the function of the esophageal plexus?

Answer 37

Symp: inhibit peristalsis and esophageal glands Parasymp: stimulates peristalsis and esophageal glands

Question 38

Are cardiopulmonary splancnic N. post-synaptic or pre-synaptic

Answer 38

POST synaptic presynaptic descend before synapsing

Question 39

Are abdominopelvic splanchnic N. pre-synaptic or post-synaptic?

Answer 39

pre-synaptic (includes great, lesser and least splanchnic nerves)

Question 40

Overview of the autonomic elements in the thorax: Sympathetic

Answer 40

presynaptic cell bodies: lateral horn of Spinal Cord presynaptic cell fibers: go to paravertebral ganglion at same level and become abdominopelvic splanchnic N. post-synaptic cell bodies: at paravertebral ganglion in same or different level and prevertebral ganglion

Question 41

Overview of the autonomic elements of the thorax: Parasympathetic

Answer 41

presynaptic cell bodies: cranial part (brain stem) and sacral part Presynatic cell fibers: cranial nerves or pelvic splanchnic N. postsynaptic cell bodies: 4 cranial ganglia **in the target organ**