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CP-1 > GI and Neurology of Thorax > Flashcards

GI and Neurology of Thorax Flashcards

1
Q

What are the regions of the esophagus?

A 
cervical part
thoracic part (btw T1 and esophageal Hiatus of diaphragm)
abdominal part
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2
Q

What/where are the constrictions of the esophagus? (4)

A

at the cricopharyngeus M.
at the aortic arch
at the left bronchus
at the esophageal hiatus of the thoracic diaphragm

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3
Q

What cranial nerve is the vagus N?

What type of nerve is it?

A

CNX

parasympathetic

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4
Q

What artery does the vagus N initially run with?

A

common corotid A

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5
Q

What are the main branches of the vagus N in the thorax? (6)

A 
Left recurrent laryngeal N
pulmonary branches
cardiac branches (3)
esophageal branches
anterior vagal trunk (from L vagus n)
posterior vagal trunk (from r vagus N)
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6
Q

What spinal rami make up the phrenic N?

A

anterior rami of C3-C5

C3 to 5 keep the diaphragm alive

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7
Q

What do you do to remember where the anterior and posterior vagal trunks arise from?

A

put hands on steering wheel –> turn right
left vagus N –> anterior vagal trunk
R vagus N –> posterior vagal trunk

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8
Q

What is the difference btw the right and left recurrent laryngeal Ns?

A

right arises much earlier in the neck

left arises in the thorax and loops under aortic arch and ligamentum arteriosum to return to larynx

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9
Q

What two structures do the right and left phrenic Ns run between?

A

mediastinal parietal pleura and fibrous pericardium

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10
Q

What spinal nerves to the intercostal nerves arise from?

A

1st-11th thoracic anterior rami

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11
Q

If you found a typical intercostal nerve btw ribs, where would you find it?

A

on the inferior edge of the superior rib

btw internal and innermost intercostal Ms

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12
Q

What are the typical intercostal Ns?

A

3rd-6th

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13
Q

What are the rami communicates?

A

connect intercostal N to thoracic sympathetic trunk

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14
Q

What are the typical branches of intercostal Ns?

A

rami communicates
collateral branches
lateral cutaneous branches –> anterior and posterior branches
muscular branches

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15
Q

What anterior cutaneous branches or the intercostal Ns supply the breast?

A

T4-T6

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16
Q

What makes the 1st intercostal N atypical?

A

no cutaneous branches and majority of superior portion joins the brachial plexus

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17
Q

What makes the 2nd intercostal N atypical?

A

small part joins w/ brachial plexus

lateral cutaneous branch supplies skin of axilla = intercostobrachial N

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18
Q

What is the intercostobrachial N?

A

cutaneous N of the axilla that arises from the 2nd intercostal N

19
Q

What makes intercostal Ns 7-11 atypical?

A

begin as intercostal, but as the go anteriorly, turn into thoracic abdominal Ns

20
Q

What does the sympathetic NS control?

what is its distribution?

A

“fight or flight”
distribution is widespread
controls sweat (all other glandular secretions are parasympathetic)

21
Q

What is the parasympathetic NS distribution like?

A

limited

Head, neck and trunk viscera, never in body wall or extremities

22
Q

What NS branch controls glandular secretion?

A

parasympathetic

except sweat = sympathetic

23
Q

What stimulates vasoconstriction?

A 
sympathetic NS
(except coronary As)
24
Q

What spinal levels involve sympathetic division?

A

T1-L2

25
Q

Where are the cell bodies of presynaptic sympathetic Ns?

Where do they travel?

A

lateral horn of spinal cord –> anterior root to anterior ramus –> paravertebral ganglia

26
Q

What are the 3 synaptic options for sympathetic preganglionic neurons?

A
  1. can enter paravertebral ganglion –> synapse to postsynaptic neuron on same level
  2. Can enter paravertebral ganglion –> ascend or descend to synapse on diff spinal level
  3. Can enter paravertebral ganglion and exit w/out synapsing and go on thru splanchnic N to postsynaptic neuron in PREvertebral ganglion
27
Q

What are the pre and post synaptic neurons like in the sympathetic NS?

A 
pre = short
post = long
28
Q

What makes up the sympathetic trunks?

A

paravertebral ganglia linked vertically

29
Q

What are the 4 prevertebral ganglion you should know?

A

celiac ganglion
superior mesenteric ganglion
aorticorenal ganglion
inferior mesenteric ganglion

30
Q

What characterizes the cardiac splanchnic N?

A

presynaptic cell bodies in lateral horn of T1-5 or 6 –> synapse onto postsynaptic bodies in cervical and thoracic sympathetic trunk –> pulmonary plexus

31
Q

What characterizes the pulmonary splanchnic N?

A

preynaptic Cell bodies in lateral horn of T2-3 –> synapse in thoracic sympathetic trunk –> fibers to pulmonary plexus

32
Q

What are the 3 abdominopelvic splanchnic Ns and what do they generally do?

A

greater splanchnic N
Lesser splanchnic N
Least splanchnic N
travel from sympathetic trunk –> prevertebral ganglia in abdomen

33
Q

What characterizes the greater splanchnic N?

A

T5-9 or 10 –> fibers to esophageal plexus and celiac ganglion

34
Q

What characterizes the lesser splanchnic N?

A

T10-11 –> fibers to celiac and superior mesenteric ganglion –> superior mesenteric plexus

35
Q

What characterizes the least splanchnic N?

A

T12 –> aorticorenal ganglion

36
Q

What cranial Ns and spinal levels make up the parasympathetic NS?

A

CN 3, 7, 9, and 10

S2-4

37
Q

What are the pre and post-synaptic neurons like in the parasympathetic NS?

A 
pre = long
post = short
38
Q

Where are the postsynaptic parasympathetic cell bodies located?

A

in the walls of target organs

39
Q

What makes up the pulmonary plexus?

Is it sympathetic or parasympathetic?

A

mixed
sympathethic from pulmonary splanchnic Ns
parasympathetic from pulmonary branches of vagus N
innervates Lungs, bronchi, and pleurae

40
Q

What makes up the cardiac plexus?

Is it sympathetic or parasympathetic?

A 
mixed
sympathetic = cardiac splanchnic Ns
parasympathetic: superior, middle, and inferior cardiac branches of vagus N
fibers near sinuatrial and AV nodes
superficial and deep
41
Q

What makes up the aortic plexus?

Is it sympathetic or parasympathetic?

A

mixed
continuous superiorly w/ superficial cardiac plexus
continues inferiorly as aortic plexus in abdomen

42
Q

Where is the superficial cardiac plexus located?

A

covers anterior surface of heart

43
Q

Where is the deep cardiac plexus located?

A

anterior to bifurcation of the trachea, posterior to aortic arch, superior to bifurcation of pulmonary trunk

44
Q

What makes up the esophageal plexus?

Is it sympathetic or parasympathetic?

A

mixed

sympathetic: greater splanchnic N and aortic plexus
parasympathetic: esophageal branches of Vagus N

CP-1 (32 decks)

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