EXAM3_G24_Visceral_innervation_Thorax Flashcards
Sympathetic “Thoracolumbar” Where are preganglionic cell bodies and postganglionic cell bodies located?
Preganglionic - IMLCC of T1-L2
Postganglionic- Paravertebral/prevertebral ganglia
Parasympathetic “craniosacral” where are preganglionic and postganglionic cell bodies located?
Preganglionic - brain stem nuclei and S2-S4 spinal cord segments
Postganglionic- intrinsic ganglia (in/near wall of target organ)
The Sympathetic NS affects the Heart, Lungs, Esophagus, and Thoracic Wall (piloerection, sweat glands, blood flow to skin and skeletal muscles) In contrast, the Parasympathetic system has no innervation of the ____.
Thoracic wall-
Piloerection
Sweat/Sebaceous glands
Blood flow to skin and skeletal muscles
The Sympathetic NS maximizes gas exchange in the lungs by increasing ______, and decreasing ________.
Increasing Bronchial Diameter
Decreasing Bronchial secretion
Cardiopulmonary splanchnic nerves derived from the ______chain. What gives the parasympathetic innervation to the heart? and where?
Sympathetic chain (cardiopulmonary splanchnic nerve)
CNX VAGUS gives rise to the cardiac branch of vagus that gives PSNS innervation at the CARDIAC PLEXUS
The inferior ganglion of the vagus nerve is called the ____.
Nodose ganglion (pseudounipolar) - non-pain pathway via PSNS
Pain travels back to the brain via what type of pathways?
Sympathetic via cardiopulmonary splanchnic nerves
Non pain sensory information (chemo/baro ceptors) travel back to the brain via what pathway?
PSNS- Nodose ganglion- pseudounipolar neuron
Several paravertebral ganglion fuse together in the upper neck forming a certain structure of the sympathetic chain called the?
Superior cervical ganglion
Innervation of the heart and lungs only come from what specific vertebral levels?
Sympathetic Innervation of T1- T5 and the cell bodies of the multipolar neurons reside in the Intermediolateral Cell column IMLCC
Targets of the sympathetic innervation of the heart?
- SA/AV nodes,
- Coronary arteries,
- cardiac muscle
Parasympathetic innervation travels from preganglionic cell bodies located in the ____ through the preganglionic axons of the ____ nerve CNX and contribute to the cardiac plexus. They synapse on postganglionic cell bodies located in _____ _____ (near/on target wall). The postganglionic axons travel short distance to targets (sa/av nodes, Coronary arteries, cardiac muscle)
pregang body in brainstem
pregang axon in vagus nerve
postgang body in intrinsic ganglia
Visceral afferent (sensory) PAIN travels via ____ ____ nerves which are pseudounipolar which have cell bodies located in the posterior root ganglion of vertebral levels ___ - ____. and enter the spinal cord via the posterior root
Pain travels via cardiopulmonary splanchnic nerves
T1-T5 vertebral levels
Visceral afferent (sensory) NON-PAIN travels via CNX (vagus nerve) via pseudounipolar neurons with cell body located in the ___ ____. The central processes enter the brainstem via CNX
nodose ganglion
Sensory Pain enters spinal cord via-
Sensory Non-pain enters brainstem via-
- Cardiopulmonary splanchnic nerves
- CNX and (cell body in nodose ganglion)
What 4 types of fibers are found in the Cardiac plexus?
- Postganglionic sympathetic
- Preganglionic Parasympathetic
- Peripheral process of visceral pain and non-pain fibers
Cardiopulmonary Splanchnic nerves contain What 2 types of fibers ?
- sympathetic Postganglionic axons
2. Peripheral processes of visceral pain
The bronchial tree is innervated by SNS sympathetic chain -Cardiopulmonary splanchnic nerves. The PSNS innervation is via ___ ___ of vagus nerve.
Pulmonary branch
What’s the difference between SNS and PSNS nerves that innervate the bronchial tree?
SNS Pulmonary nerves (cardiopulmonary splanchnic nerves)
PSNS pulmonary branches of vagus nerve
What type of fibers are in the Anterior pulmonary plexus?
SNS cardiopulmonary splanchnic nerves
PSNS pulmonary branch of vagus nerve
What vertebral levels innervate (sympathetic) of bronchial tree?
T1-T5 IMLCC
How does Sympathetic signal reach target?
- Cell body in IMLCC spinal cord (enter WRC)
- Synapse in sympathetic chain SUPERIOR CERVICAL GANGLION
- Peripheral processes travel to target via Cardiopulmonary splanchnic nerves
Post gang axons contribute to cardiopulmonary splanchnic nerves
What are the targets of SNS innervation of bronchial tree?
- Smooth muscle,
2. respiratory mucosa
PSNS innervation of bronchial tree-
where is pregang cell body, axon?
postgang cell body, axon?
Pregang cell body in brainstem
pregang axon in Pulmonary branches of VAGUS nerve
Postgang cell body in intrinsic ganglia (near target)
postgang axon- short distance to target
-smooth muscle and respiratory mucosa
PSNS - Non Pain- Bronchial tree- How does it travel back?
peripheral process travels via CNX to pseudounipolar body in NODOSE ganglion into the central processes to enter the brainstem
SNS- Pain_ Bronchial tree- How does signal travel back?
Nociceptor in target
Peripheral process via cardiopulmonary splanchnic nerves
Cell body in PRG of T1-T5
Central processes enter spinal cord via posterior root
Baroreceptors (bp), Chemoreceptors (Po2, Pco2, pH), and visceral mechanoreceptors (stretch, pressure) are examples of what type of sensors?
VISCERAL AFFERENT- 1 neuron- no synapsing
-NON PAIN Receptors
travel via PSNS from target to brain (ONE NEURON ONLY)
Baro/Chemo receptors in the Aortic heart send signals back to the brain via ____ nerve.
Vagus- Autonomic regulation (sensory afferent information)
Baroreceptors in carotid sinus and chemoreceptors in the carotid body send signals back to the brain via _____ Nerve. CNIX
CNIX- Glossopharyngeal Nerve
Autonomic regulation using sensory afferent information of PSNS
Somatic vs Visceral noci-ceptors
Visceral nociceptors respond to: (distention, ischemia, chemical irritaition, inflammation)
- No response to mechanical tissue damage (crushing, cutting, burning)
Visceral pain can be described as diffuse, poorly-localized discomfort, and also may be perceived as originating from a dermatomal origin. This is known as?
Referred pain
The CNS interprets visceral afferent pain signals from the heart as a somatic pain signal (that corresponds with the same dermatome level). The pseudounipolar neurons conveying the visceral and somatic pain converge on neurons in the ___ ___ of the spinal cord
posterior horn and the signal presents on a pool of nerves
Referred pain of angina pectoris- Where does it present?
Classic-
1. LEFT SIDE sternum across clavicle to shoulder down medial arm
other- across chest/nipples
shoulders up lateral parts of neck
Fibrous and serous parietal pericardium are innervated by ___ nerves (pain signals from somatic innervation)
Phrenic nerves
Visceral serous pericardium is innervated by ____ ___ nerves (pain), and ____ nerve (nonpain)
(pain signals from visceral innervation)
Cardiopulmonary splanchnic nerve (pain) Vagus nerve (non-pain)
The lungs and visceral pleura contain relatively few nociceptors. Combined with the fact that the viscera are insensitive to mechanical damage, tumors or other neoplasms of the lung may go undetected until they reach the _____ _____ and induce _____ pain.
If reaches Parietal pleura– induces SOMATIC pain
What does sympathetic innervation (sympathetic trunk) of the esophagus affect?
Inhibits peristalsis
Decreases blood flow (vasoconstriction)
PSNS (vagus nerve) innervation of the esophagus has what affect?
simulates peristalsis
Increases blood flow
Cervical esophagus receives somatic motor and somatic sensory innervation via the ___ ___ nerves
recurrent laryngeal nerves
somatic motor/sensory of esophagus
What is the visceral innervation of esophagus from?
note SNS and PSNS innervation
SNS- sympathetic trunk
PSNS- Vagus nerve
Describe pathway for sympathetic targets in abdominal viscera
- Signal from cell body in IMLCC travels via anterior root
- Enters WRC & travels via Abdominopelvic splanchnic n.
- Synapses in Prevertebral ganglion and travels out to target
Three abdominopelvic splanchnic nerves originate in the posterior mediastinum:
Greater splanchnic n. (what thoracic levels)?
Lesser splanchnic n.
Least splanchnic n.
Greater T5-T9
Lesser T10-T11
Least T12