G28 Pelvic ANS

Question 0

suprarenal gland

Answer 0

ONLY SYMPATHETIC INNERVATION

preganglionic sympathetic from T10-L1 SCL, travel via greater, lesser and least splanchnic

preganglionic sympathetic innervating suprarenal vasculature synapse in celiac ganglion

postganglionic sympathetics
-vascular tone, increase vasoconstriction, decrease vasodilation

preganglionic sympathetic axons that innervate secretory cells pass though celiac ganglion WITHOUT synapse to innervate chromaffin cells (within suprarenal gland) (chromaffin cells ARE post ganglionic symp cells)

no visceral afferents in suprarenal

Question 1

pelvic pain line

Answer 1

threshhold determining course of visceral pain

structures ABOVE or IN CONTACT with the inferior peritoneum send PAIN via sympathetic chain

not applicable to GI tract…still 1/2 way through sigmoid colon
structures BELOW the inferior peritoneum send PAIN via parasympathetic pathway

Question 2

Kidney

Answer 2

preganglionic sympathetics from least splanchnics
T12 SCL

synapse in aorticorenal ganglion

postganglionic sympathetics distributed via renal plexus
-control of vascular tone increase vasoconsttiction and decrease vasodilation

preganglionic PARAsympathetic from the VAGUS nerve and synapse in the intrinsic ganglia
-function unclear

kidneys superior to pelvic pain line

Visceral PAIN back along least splanchnic nerve
Visceral non pain travels via vagus

Question 3

Ureter

Answer 3

derive from adjacent autonomic plexuses (renal, preaortic, superior and inferior hypogastric )

primarily above pelvic pain line 
Proximal:
-preganglionic symp T11-L2
-post ganglionic sympathetics: renal and intermesenteric plexuses
-vascular tone
-parasympathetic: vagus: peristalsis
-Visc PAIN: back along symp
-non pain: vagus

Abdominal
-superior hypogastric

Pelvic: inferior hypogastric

uteretic colic: visceral pain in the ureter

• refers to ipsalateral dermatome
• pain moves loin to groin
• pain can also occur in genitofemoral

Question 4

Urinary Bladder

Answer 4

preganglionic sympathetics from T11-L2 via lumar and sacral splanchnic nerves

pass through inferior hypogastric plexus and synapse in vesicle plexus
-post ganglionic sympathetics distributed via vesicle plexus

preganglionic parasympathetics from s2-4 via pelvic splanchnic nerves

• course through inferior hypogastric plexus and vesicle plexus
• synapse on intrinsic ganglia

visceral non pain via pelvic splanchnic nerves

visceral pain from superior surface through sacral splanchnic nerves
visceral pain from remainder of bladder through pelvic splanchnic nerves

Question 5

Micturation

Answer 5

Sympathetic: contracttion of the internal urethral sphincter, relaxation of detrusor

visceral non pain: stretch receptors in the bladder detect fullness

parasympathetic: contraction of detrusor , relaxation of internal urethral sphincter

somatic motor: (voluntary) pudendal nerve maintains tonic of external urethral sphincter until voluntary inhibited

Question 6

Rectum

Answer 6

pre sym: L1L2- lumbar splanchnic nerves

• synapse in inferior mesenteric ganglion and superior hypogastric plexus
• postganglionic sympathetics via periarterial plexus of IMA or rectal plexus

preganglionic parasympathetic inn via pelvic splanchnic nerves