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Gross > Gross Exam 3 > Flashcards

Gross Exam 3 Flashcards

1
Q

what movements @ vertebral column

A

flexion, extension, lateral bending/flexion, rotation

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2
Q

what are the primary curvatures

A

thoracic and sacral

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3
Q

what are the secondary curvatures

A

cervical and lumbar

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4
Q

extrinsic ms in vertebral column are what rami

A

ventral rami

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5
Q

extrinsic ms in vertebral column (3) superficial layer and intermediate layer

A

superficial: trapezius and latissimus dorsi
intermediate: serratus posterior

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6
Q

function of extrinsic ms in vertebral column

A

mostly extension if bilateral

lateral flexion/rotation if unilateral

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7
Q

intrinsic ms in vertebral column- what rami

A

dorsal rami

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8
Q

what does the anterior longitudinal ligament do on the spinal cord

A

limits extension

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9
Q

what does the posterior longitudinal ligament do (spinal cord)

A

prevents hyperflexion

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10
Q

what is the nucleus pulposus

A

gel like structure at center. strong and flexible. 80% water/ little collagen

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11
Q

what is the annulus fibrosus

A

ring shaped disc of fibrous CT that surrounds NP

Outer ring. Tough!

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12
Q

what is a herniated disc

A

NP is displaced from intervertebral space

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13
Q

intercostal space ms (3)

A

external intercostal ms
internal intercostal ms
transverse thoracis ms

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14
Q

intercostal layers (3)

A

external intercostal muscle (and membrane)
internal intercostal nerve
innermost intercostal muscle (NO membrane)

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15
Q

where does the VAN bundle lie

A

on the innermost intercostal ms. when we cant see the VAN anymore –> innermost intercostal ms

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16
Q

what is in the 3rd layer of the thorax

A

transversus thoracis ms
internal thoracic a
subcostal ms

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17
Q

what does the internal thoracic a turn into

A

straight down : superior epigastric a

branched : musculophrenic a

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18
Q

what drains each space (intercostal)

A

intercostal veins

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19
Q

what arteries lie in each each space (intercostal)

A

ant. intercostal a
post. intercostal a

ant and post anatamosis

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20
Q

ant. intercostal a.

upper spaces vs lower spaces

A

upper spaces off internal thoracic a (branch of subclavian)
lower spaces off musculophrenic a

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21
Q

post. intercostal a comes off what

upper 2 ICS from what?

A

descending aorta (super high pressure!)

upper 2 ICS from supreme intercostal a from costococervical trunk off subclavian a. rest come off descending aorta

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22
Q

nerves in ICS

A

ventral rami T1-T12 = intercostal N
T12 = subcostal N

each space gets own nerve!

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23
Q

thoracic cavity compartments (2)

A
  1. pulmonary cavities: 2 individual compartments containing lungs and pleurae
  2. mediastinum: 1 central compartment containing all other thoracic structures
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24
Q

what is the pulmonary cavities

A

2 individual compartments containing lungs and pleurae

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25
Q

what is the mediastinum

A

1 central compartment containing all other thoracic structures. separates pulmonary cavities from each other

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26
Q

what is pleura

A

serous membrane that produces fluid

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27
Q

parietal pleura

A

lines inner surface of each pulmonary cavity

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28
Q

visceral pleura

A

completely invests lungs (makes them shiny) directly ON lung

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29
Q

pleural cavity

A

space b/w pleura layers

pleurae are continous with each other

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30
Q

whats the purpose of serous fluid

A

lubricates pleural linings and provides surface tension

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31
Q

what are the 4 subdivisions of the parietal pleura

A
  1. cervical
  2. costal
  3. diaphragmatic
  4. mediastinal
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32
Q

where is the cervical parietal pleura

A

root of lung

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33
Q

where is the costal parietal pleura

A

lines internal surface of ribs and intercostal spaces

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34
Q

where is the diaphragmatic parietal pleura

A

covers sup. surface if the diaphragm on either side of the mediastinum

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35
Q

where is the mediastinal parietal pleura

A

covers both sides of mediastinum

reflects laterally at root of the lung and becomes continuous with visceral pleura

pulmonary ligament: double layer of mediastinal pleura that extends inferiorly from root of lung

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36
Q

parietal pleura innervation

A

costal and peripheral diaphragmatic pleurae: intercostal N

mediastinal and central diaphragmatic pleurae: phrenic N

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37
Q

visceral pleura innervation

A

visceral afferent (run w/ sympathetics)

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38
Q

where is the costodiaphragmatic recess

A

in potential space inferior in each pleural cavity –> accommodates lung during DEEP inspiration

this is where lung COULD go during super deep inspiration

clinically: low point where fluid/blood would accumulate

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39
Q

where is the costalmediastinal recesses

A

found ant. in each pleural cavity –> larger on L due to heart and cardiac notch

formed by costal and mediastinal parietal pleurae

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40
Q

what is pneumothorax

open vs closed

A

air into pleural cavity

open: penetrating injury to the parietal pleura (stab)
closed: air leakage from damage to respiratory system itself

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41
Q

what is hemothorax

A

accumulation of blood in the pleural cavity

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42
Q

what is hydrothroax

A

accumulation of fluid in pleural cavity (from serous membrane)

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43
Q

location and function of hilum

A

L: depression on medial surface of lung
F: entrance and exit for root structures

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44
Q

location and function of root

A

L: w/i hilum
F: contains bronchi, pulmonary a and v, bronchial a and v, ant and post. pulmonary plexuses, lymphatics. Pulmonary ligament extends inferiorly from root

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45
Q

lung anatomy:

apex:

A

extends above 1st rib

adjacent to trachea and esophagus, L common carotid and L subclavian a

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46
Q

lung anatomy:

base

A

sits on diaphragm

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47
Q

lung anatomy:

costal surface

A

large surface
adjacent ro costal pleura

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48
Q

lung anatomy:

mediastinal surface

A

concave medial surface

where pulm. root and ligament are located

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49
Q

lung anatomy:

diaphragmatic surface

A

deeper on R to accommodate liver

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50
Q

RIGHT LUNG:
lobes and fissues

A

Lobes: 3. superior, middle and inferior

Fissues: 2. oblique and horizontal

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51
Q

RIGHT LUNG:

impressions

A

SVC and arch of azygos v.

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52
Q

which lung is larger

A

right but shorter and wider. liver is pushing it up

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53
Q

where is pulm a on right lung

A

anterior to bronchus (carries low O2)

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54
Q

where is pulm v. on R lung

A

most ant. and inferiorly located structures

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55
Q

where is bronchus on R lung

A

primary/lobar post. in location

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56
Q

LEFT LUNG:

lobes and fissues

A

Lobes: 2. sup and inferior

fissues: 1. oblique

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57
Q

LEFT LUNG:

impressions

A

cardiac arch and thoracic aorta

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58
Q

where is the cardiac notch

A

in ant. margin of superior lobe

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59
Q

where is the lingula on L lung

A

on sup lobe below cardiac notch

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60
Q

where is pulm a on L lung

A

sup. to bronchus in hilum

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61
Q

where is pulm v. on L lung

A

most ant. in location

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62
Q

LEFT LUNG: where is bronchus

A

primary/lobar most post in locaton

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63
Q

what does RALS stand for

A

R pulmonary a is Anterior to bronchus

L pulmonary a is Superior to bronchus

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64
Q

where does the tracheobronchial tree begin

A

inferior boarder of cricoid cartilage

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65
Q

tracheobronchial tree:

cartilage rings

A

16-20 c shaped rings

Just on trachea!

incomplete post.

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66
Q

tracheobronchial tree location

A

pass from trachea to root of lung

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67
Q

tracheobronchial tree:

what is the carina

A

internal ridge demarcating tracheal bifurcation –> R/L primary bronchus.

at level of sternal angle and sensitive to cough (good!)

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68
Q

R primary main bronchus features

A

wider/shorter.more vertical

direct continuation of trachea

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69
Q

R primary main bronchus lobar branches:

A

3 secondary bronchi at root

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70
Q

R primary main bronchus segmental branches

A

tertiary bronchi to bronchopulmonary segments

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71
Q

where do aspirated bodies most likely end up

A

R primary main bronchus

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72
Q

L primary main bronchus features

A

narrower/longer/more horizontal

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73
Q

L primary main bronchus lobar branches

A

2 secondary

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74
Q

L primary main bronchus segmental branches

A

tertiary bronchi to brochopulmonary segments

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75
Q

brochopulmonary segments features

A

largest subdivision of a lobe (8-10 per lung)

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76
Q

brochopulmonary segments shape

A

pyramidal in shape

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77
Q

brochopulmonary segments contents

A

tertiary bronchus
tertiary pulmonary a
autonomic n

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78
Q

pulmonary circulation:

pulm a. L:

A

starts @ pulmonary trunk. carries low O2 blood to lungs

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79
Q

pulmonary circulation:

pulm v L on heart

A

starts at 2 from each lung
R and L : sup/inferior on heart
L: carries high O2 blood to L atrium

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80
Q

pulmonary circulation:

bronchial a L:

A

starts at thoracic aorta

supply lung substance itself!

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81
Q

pericaridum

A

surrounds heart and proximal parts of great vessels

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82
Q

pericardium F

A

protects and stabilizes heart and secretes serous fluid to create friction-free movement of the heart

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83
Q

types of pericardium

A

parietal -> fibrous and serous
visceral

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84
Q

pareital fibrous pericaridum

A

outermost layer -> tough!
continuous with central tendon of diaphragm and tunica adventitia of IVC
continuous sup. w/ tunica adventitia of great vessels -> ascending aorta, pulm. trunk, SVC, pulm v.

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85
Q

serous parietal pericardium

L and F

A

L: mesothelial lining on inner surface of fibrous parietal layer
F: secretes serous fluid

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86
Q

visceral pericardium

A

directly on heart -> fatty layer
serous in nature
continuous w/ serous layer of parietal pericardium @ root of great vessels

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87
Q

pericardial cavity L and F

A

L: potential space b/w parietal and visceral layers of serous pericardium.
F: facilitates frictionless movement of heart (contains serous fluid)

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88
Q

pericardial sinuses L

A

inside pericardial cavity

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89
Q

L of oblique pericardial sinus

A

recess on post. surface of heart, inferior to pulm v

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90
Q

L of transverse pericardial sinus

A

passage post. to ascending aorta and pulmonary trunk, ant. to SVC

used to access great vessels for heart bypass

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91
Q

pericardial neurovascular structures L

A

plane b/w fibrous pericardium and mediastinal pleura

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92
Q

pericardial neurovascular structures relationship to root of lung:

A

pass ant. to root of lung

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93
Q

pericardial neurovascular structures a and n

A

a: pericardiacophrenic a: internal thoracic a runs w/ phrenic n

n: phrenic n -> origin = VPR C3-C5. innervates thoracic diaphragm

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94
Q

SVC L

A

sits to the R of the aorta. in vertical line with IVC as they enter R atrium.

furthest R and post

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95
Q

SVC is union of what

A

R and L brachiocephalic veins

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96
Q

SVC drains

A

ALL structures sup. to thoracic diaphragm EXCEPT heart and lungs

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97
Q

SVC empties into

A

R atrium

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98
Q

IVC L

A

sits to the R of the aorta. hard to see

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99
Q

IVC is the union of what

A

R and L common iliac Veins

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100
Q

IVC drains

A

lower limbs, abs, abdominal viscera

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101
Q

IVC empties into

A

R atrium

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102
Q

origin of ascending aorta

A

L ventricle - extends to beginning of aortic arch

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103
Q

branches of ascending aorta

A

R/L coronary a

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104
Q

pulmonary trunk origin

A

R ventricle

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105
Q

pulmonary trunk L

A

ant and to the L of the ascending aorta

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106
Q

pulmonary trunk branches

A

R/L pulmonary a

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107
Q

pulmonary trunk ligament

A

ligamentum arteriosum

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108
Q

ligamentum arteriosum is

A

circulatory modifcation b/w pulm. trunk and aorta.

landmark: L recurrent laryngeal n. loops around aortic arch

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109
Q

pulmonary veins origin and termination

A

origin: lungs
terminates: drain into L atrium

4 of them!

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110
Q

what does the cardiac skeleton do

A

keeps valves open and from being overly distended

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111
Q

what is the cardiac skeleton

A

4 fibrous connect tissue rings. surrounds 4 heart valves

separates atrial and ventricular ms

112
Q

what is the attachment point for cusps

A

cardiac skeleton

113
Q

what allows the valves to contract independently and forms an electrical insulator

A

cardiac skeleton

114
Q

what forms the sternocostal surface of the heart

A

R ventricle. has oracles

115
Q

what forms the diaphragmatic surface of the heart

A

formed by L ventricle. small part by R ventricle

116
Q

what forms the R pulm. surface of the heart

A

R atrium

117
Q

what forms the L pulm. surface of the heart

A

L ventricle. creates cardiac impression of L lung -cardiac notch

118
Q

where is the base of the heart

A

primarily formed by L atrium. where SVC and IVC and pulm v enter heart

119
Q

where is the apex of heart

A

L ventricle. 9-10 cm L of midline @ 5th intercostal space

120
Q

ant. interventricular groove on heart L and contains

A

L: b/w R and L ventricles on sternocostal surface

contains: ant. interventricular a and great cardiac v

121
Q

atrioventricular groove L and contents

A

L: junction b/w atria and ventricles
contents: R and L coronary a and coronary sinus

122
Q

post. interventricular groove L and contents

A

L: furrow b/w R and L ventricles on diaphragmatic surface
contents: post. interventricular a and middle cardiac v

123
Q

where do you find trabeculae carneae

A

lining R and L ventricle

124
Q

where do you find conus arteriosus

A

funnel-shaped smooth area leading to pulm trunk in right ventricle

125
Q

where do you find septomarginal trabecula (moderator band)

A

r ventricle. interventricular septum to ant. papillary ms. contains R bundle branch. gets papillary ms contracting before ventricular contraction

126
Q

what are the names of the 3 cusps on the puml semilunar valve

A

lunule, nodule, sinus

127
Q

where can you find the fossa ovalis (adult)

A

R atrium

128
Q

what is the interventricular septum

A

strong oblique partition b/w ventricles

129
Q

what is the interventricular septum muscular part

A

forms majority of the septum. has same thickness as L ventricle

130
Q

what is the interventricular septum membranous part

A

thin. sits superiorly and post. to muscular part. common site of ventricular septal defects

131
Q

what kind of control are the coronary a under

A

autonomic control. no anatamosis!

132
Q

when do coronary a fill?

A

during diastole

133
Q

what does the R coronary a supply

A

R atrium and vent. post. L ventricle, part of the IV septum, SA and AV nodes

134
Q

where is the R coronary a

A

post. to pulm. trunk in atrioventricular groove

135
Q

branches of R coronary a

A

SA nodal a, R marginal a, post interventrivular a

136
Q

what does the L coronary a supply

A

LA and most of LV, interventricuvlar septum and AV bundle

137
Q

is the L coronary a long or short

A

Long!

138
Q

location of L coronary a

A

lies b/w L auricle and pulm. trunk

139
Q

branches of L coronary a

A

circumflex a: L marginal a

ant. interventricular a : L ant. desecnding (widowmaker)

post. interventricular a

140
Q

what is known as the widowmaker

A

L ant. descending artery = anterior Interventricular artery

141
Q

what does the conorary sinus get

A

gets majority of venous drainage from heart. in atrioventricular groove. drains into RA

142
Q

ant. cardiac v drains into

A

RA. crosses over R coronary a

143
Q

great cardiac V runs with

A

ant. interventricular a

144
Q

middle cardiac v runs with

A

post. interventricular a

145
Q

small cardiac v runs with

A

R marginal a

146
Q

in a fetus, where is the site of O2 and nutrient exchange

A

placenta

147
Q

what does the umbilival v carry

A

O2 RICH blood to IVC via ductus venosus -> bypasses liver. IVC takes O2 rich blood to RA

148
Q

what is the foramen ovale

A

opening b/w RA and LA. blood shunted from Ra to La. blood then goes to LV

FETUS

149
Q

what is the ductus arterisus

A

connects pulm trunk to arch of aorta and bypasses lungs

FETUS

150
Q

which side of heart is systemic

A

Left. O2 RICH

151
Q

which side of heart is pulmonary

A

R. O2 POOR

152
Q

where to auscultate the tricuspid valve

A

5th intercostal space just left of stenum

153
Q

where to auscultate the bicuspid vavle

A

5th intercostal space 9-10cm left of midline

154
Q

where to auscultate the pulmonary semilunar valve

A

in 2nd intercostal space adjacent to L sternum

155
Q

where to auscultate the aortic semilunar valve

A

in 2nd intercostal space to R of sternum

156
Q

what is valvular stenosis

A

failure of valve to open fully. heart murmur

157
Q

what is valvular insufficiency

A

regurgitation. valves cant fully close

158
Q

where is the SA node located

A

junction of SVC and sulcus terminalis

159
Q

where is the AV node located

A

on interatrial wall near coronary sinus opening

160
Q

where is AV bundle

A

passes through cardiac skeleton
electrical link b/w contraction in A and V

161
Q

where are the L and R bundle branches

A

in the muscular interventricular septum.

162
Q

what is the cardiac plexus

A

contains SNS and PSNS and visceral afferent.

regulates rate and strength of contraction

NOT required to initiate beat

163
Q

boarders of mediastinum divisions

A

superior thoracic aperture and thoracic diaphragm inferiorly

164
Q

divisions of mediastinum

A

superior: above transverse plane b/w sternal angle and T4 T5 IVD

inferior: below transverse plane b/w sternal angle and T4 T5 IVC (divided into 3 more parts)

165
Q

contents of sup. medistinum

A

mediastinal lymph nodes, thymus, brachiocephalic v, SVC, arch of aorta, vagus, phrenic, recurrent laryngeal n, trachal, esophagus, thoracic duct

166
Q

thymus L and F

A

L: immediately post. to manubrium and anterosuperior to pericardium

F: primary lymphoid organ -> site of T-lymphocyte development. undegoes involution (Gets fatter) after puberty

167
Q

what forms the brachiocephalic veins

A

union of internal jugular and subclavian veins

168
Q

which brachiocephalic vein is longer

A

the L is 2x as long

169
Q

what the brachiocephalic veins drain and where does it end

A

drains blood from head neck and VE.

ends to form SVC

170
Q

what is the azygos vein

A

SVC receives azygos just superior to entry into pericardial sac. arch of azygos passes sup. to root of R lung

171
Q

where is the terminal part of the SVC

A

middle mediastinum

172
Q

branches of aortic arch

A

brachiocephalic trunk (R common carotid and R subclavian a)
L common carotid a
L subclavian a
continuation to become descending thoracic aorta

173
Q

where does the aortic arch begin and end

A

starts at sternal angle anteriorly and ends at sternal angle posteriorly

174
Q

where does trachea begin

A

at inferior boarder of cricoid cartilage

sits ant. to esophagus and to the R of midline

175
Q

trachealis ms

A

smooth ms that spans the gap post. abuts esophagus

176
Q

is the trachea found in the post. mediastinum?

A

NO! terminates at sternal angle (T4-T5)

177
Q

esophagus is

A

fibromuscular tube from pharynx ->stomach

178
Q

where does the esophagus enter

A

sup. mediastinum b/w trachea and vertebrae
and enters post. mediastinum inferior to aortic arch

thoracic duct lies to the L side in the superior mediastinum

179
Q

R vagus nerve L:

A

ant. to R subclavian a -> gives rise to R recurrent laryngeal n. passes thru sup. mediastinum to the R of the trachae

180
Q

L vagus nerve L:

A

b/w L common carotid a and L subclavian a. passes anterolaterally over aortic arch

L recurrent laryngeal n: loops around aortic arch, behind ligamentum artieriosum

181
Q

L vagus n plexus

A

anterior esophageal plexus

182
Q

R vagus n plexus

A

post. esophageal plexus

183
Q

origin of phrenic n

A

VPR (ventral primary ramus) C3-5

“C3, 4, 5 keep the diaphragm alive”

184
Q

phrenic n does what

A

supplies motor and sensory to thoracic diaphragm

185
Q

anterior division of inferior mediastinum

A

lower part of thymic remnant. internal thoracic vessels, parasternal lymph nodes. adipose tissue

186
Q

middle division of inferior mediastinum

A

heart, pericardium, root of great vessels, phrenic n, pericardiacophrenic a/v on fibrous pericardium

187
Q

post division of inferior mediastinum

A

contains descending thoracic aorta, esophagus and esophagus plexus, thoracic duct, lymph nodes, azygos system of veins, thoracic sympathetic trunk and splanchnic n

188
Q

post division of inferior mediastinum is located where

A

post to pericardium. b/w pulm cavities

189
Q

location of descending thoracic aorta

A

descends thru thorax on L side of T5-12. displaces esophagus to R

190
Q

aortic hiatus is a name change from what

A

descending thoracic aorta

Once you hit diaphragm!

191
Q

esophagus L

A

b/w trachea and T1-4 vertebrae in sup. mediastinum

post to pericardium adjacent to T5-10 in post mediastinum

192
Q

blood supply to esophagus

A

esophageal a from descending thoracic aorta

193
Q

esophageal hiatus

A

T10. opening for esophagus to pass thru to go to stomach

194
Q

esophageal plexus

A

formed by L and R vagal n

195
Q

what is the ant. vagal trunk

A

neurons from L vagus n emerging from ant esophgeal plexus. on ant surface of esophagus

“LA”

196
Q

what is the post. vagal trunk

A

neurons from R vagus n. emerging from post esophageal plexus. on post. surface of esophagus

197
Q

what is the thoracic duct

A

lymphatic system
small thin walled, oftened beaded due to many valves

drains lymph from entire body excpet under right quadrant and inferior lobe of L lung

198
Q

location of thoracic duct

A

post : esophagus
ant: to thoracic vertebrae
b/w: thoracic aorta and azygos v

199
Q

what is cisterna chyle

A

origin of thoracic duct in abdomen @ L1. enters thorax via aortic hiatus

200
Q

what does the thoracic duct drain into

A

L venous angle -> junction of L subclavian and L internal jugular v

201
Q

do azygos veins have valves?

A

NO!

202
Q

hat do azygos veins drain

A

back, thoracoabdominal walls and mediastinal viscera

203
Q

where is the azygos vein

A

in post. mediastinum on R side

204
Q

where is arch of azygos v

A

sup. to root of R lung

205
Q

where is the hemi-azygos vein

A

in post. mediastinum on L side inferiorly

usually crosses over around T9 to drain into azygos v

receives blood from lower left side

206
Q

where is the accessory hemi-azygos v

A

in post. mediastinum on L side superiorly

usually crosses over around T8 to drain into azygos vein

receives blood from upper L side

provides alternate venous return: connects w/ lumbar v and IVC

207
Q

what is the thoracic sympathetic trunk

A

series of paravertebral ganglia -> linked by interganglionic rami

208
Q

where are thoracic sympathetic trunk

A

parallel vertebral column bilaterally. continuous w/ cervical and lumbar symp. trunks

209
Q

thoracic splanchnic n

A

arises from sympathetic trunk ganglia

preganglionic sump fibers

supply viscera inferior to the thoracic diaphragm

210
Q

thoracic splanchnic n -> preganglionc symp fibers (3)

A
  1. greater thoracic splanchnic n (T5-9)
  2. lesser thoracic splanchnic n (T10-11)
  3. least thoracic splanchnic n (T12)
211
Q

thoracic diaphragm attachments

A

xiphoid process, lower 6 ribs and costal cartilages, post. body wall via arcuate ligament

212
Q

Location of L crus bodies

A

L1-2

213
Q

R crus bodies of

A

L1-2/3

214
Q

blood supply of thoracic diaphragm

A

musculophrenic a and superior phrenic a and inferior phrenic a

215
Q

post abdominal wall attachments of thoracic diaphragm

A

median arcuate ligament
medial arcuate ligament
lateral arcuate ligament

216
Q

apertures in thoracic diaphragm

A

caval hiatus: most ant. through central tendon. IVC @ T8
esophageal hiatus: created by R crus of diaphragm. esophagus @ T10. vagal trunks as well
aortic hiatus: most post. surrounded by R/L cruca. thoracic aorta @T12. thoracic duct and azygos v

“I 8 10 Eggs At 12”

217
Q

autonomic nervous system is also called

A

general visceral effect (motor!) (GVE)

218
Q

what does the GVE do

A

motor innervation of viscera and regulation and maintenance of homeostasis

219
Q

3 groups cell bodies can exist in and their locations

A
  1. nuclei -> CNS
  2. ganglia -> PNS
  3. intramural ganglia or cluster -> in the walls of viscera
220
Q

where is cell body #1

A

in CNS. Preganglionic
ALWAYS myelinated

221
Q

where is cell body #2

A

in PNS ganglia. Post ganglionic
NEVER myelinated.
travels to target

222
Q

is each organ innervated with SNS and PSNS

A

YES! -> dual innervation

PSNS and SNS are usually antagonistic

223
Q

what is unique about PSNS

A

can act on each organ separately. Just urinary or just respiratory can act separate

224
Q

what is unique about SNS

A

discharges as a WHOLE system. gets the whole body going.

225
Q

is the SNS needed to live?

A

NO! not ideal but can live

226
Q

what does SNS and PSNS do to coronary vessels

A

PSNS: constricts
SNS: dilates

227
Q

pre-gang PSNS NT and R

A

NT: ACh
R: nicotinic (cholinergic)

228
Q

pre-gang SNS NT and R

A

NT: ACh
R: nicotinic (cholinegric)

229
Q

post-gang PSNS NT and R

A

NT: ACh
R: muscarinic (cholinegric)

230
Q

SOME post-gang SNS NT and R

sweat glands and arrector pili ms

A

NT: ACh
R: muscarinic (cholinegric)

231
Q

MOST post-gang SNS NT and R

A

NT: norepi
R: adrenergic

232
Q

what is the main controller of ANS

A

hypothalamus

233
Q

SNS is found in the

A

thoracolumbar

234
Q

SNS: where is cell body #1 found?

A

in the intermediolateral nucleus (IML) of T1-L2

235
Q

what is the IML

A

Intermediolateral nucleus. group of cell bodies in the lateral horn of the spinal cord

236
Q

paravertebral ganglia are part of what

A

the sympathetic chain (seen in lab, next to the vertebral column)

237
Q

paravertebral and prevertebral are PSNS or SNS

A

SNS

238
Q

where do prevertebral ganglia sit

A

in front of the vertebral bodies

239
Q

what nerve innerates viscera

A

splanchnic nerves

240
Q

what nerve innervates viscera

A

splanchnic nerves

241
Q

splanchnic nerves pass through what and synpase where

A

pass through the PARAvertebral ganglia and synpase in the PREvertebral ganglia

242
Q

what are rami communicantes

A

connecting branches b/w the spinal nerve and sympathetic chain

243
Q

what are white rami

A

lateral, pregang -> myelinated

244
Q

what are grey rami

A

medial, postgang -> unmyelinated

Rejoining the spinal nerve

SNS

245
Q

what are the 3 pathways pregang axons from the IML travel through the white rami into the sympathetic chain and they can:

A
  1. synapse RIGHT AWAY
  2. Ascend OR descend to another vertebral level ganglia to synapse
  3. Exit without synapsing at all (splanchnic) still pregang and myelinated
246
Q

where do splanchnic nerves leave and synapse

A

pre-gang fibers leave the sympathetic chain and synapse in the abdominal prevertebral ganglia

247
Q

PSNS Cranial portion:
Edinger-Westphal - where are cell bodies 1 and 2 found

A

1: cranial nerve III
2: ciliary

248
Q

PSNS Cranial portion:
Superior Salivatory - where are cell bodies 1 and 2 found

A

1: cranial nerve VII
2: pterygopalatine and submandibular

249
Q

PSNS Cranial portion:
Inferior Salivatory - where are cell bodies 1 and 2 found

A

1: cranial nerve IX
2: otic

250
Q

PSNS Cranial portion:
Dorsal Nucleus of Vagus - where are cell bodies 1 and 2 found

A

1: cranial nerve X
2: mostly intramural ganglia (cluster)

251
Q

PSNS Sacral portion:
where are cell bodies 1 and 2 found

A

1: in IML of S2-S4
2: mostly in intramural ganglia (cluster)

252
Q

what are the 3 plexi in the thorax

A

cardiac plexus
pulmonary plexus
esophageal plexus

dont care about esophageal and cardiac and pulm are the same just different locations

253
Q

Location of cardiac plexus

A

superior mediastinum -> 2 regions

  1. superficial cardiac plexus : concavity of the aortic arch
  2. Deep cardiac plexus : b/w the aortic arch and trachea. Sits in front of bifurcation of trachea
254
Q

location of superficial cardiac plexus

A

concavity of the aortic arch

255
Q

location of deep cardiac plexus

A

b/w the aortic arch and trachea

256
Q

cardiac plexus consists of

A

PREgang PSNS fibers from CN X

POSTgang SNS fibers from cardiac nerves (cardiopulmonary splanchnics)

257
Q

sympathetic contribution to the cardiac plexus:

cell body #1 begins ____

A

in the IML of T1-T6

axons leave through the ventral root of the same segment, enter the sympathetic chain via white rami to synapse with cell body #2

258
Q

sympathetic contribution to the cardiac plexus:

cell body #2 4 possible locations:

A
  1. superior cervical ganglia
  2. middle cervical ganglia
  3. inferior cervical ganglia
  4. T1-T4 thoracic sympathetic ganglia
259
Q

sympathetic contribution to the cardiac plexus:

the axon of cell body #2 is called a

A

cardiac nerve -> name based on the ganglia it came from

260
Q

sympathetic contribution to the cardiac plexus:

cell body #2 -> cardiac nerves (4)

A
  1. superior sympathetic cardiac nerve
  2. middle sympathetic cardiac nerve
  3. inferior sympathetic cardiac nerve
  4. T1-T4 cardiac nerves
261
Q

Parasympathetic contribution to the cardiac plexus:

supplied by which 2 nerves

A

Vagus nerve and recurrent laryngeal nerve

(vagus nerve usually means intramural ganglia)

262
Q

Parasympathetic contribution to the cardiac plexus:

where are cell bodies 1 and 2 located

A

1: dorsal nucleus of vagus (pregang)
2: located in wall of viscera (postgang)

263
Q

is the ANS necessary for life?

A

NO!

264
Q

heart transplant main idea

A

easier to run a marathon than a 5k -> can regenerate autonomic fibers and can still respond to humoral factors (catecholamines)

265
Q

what do the SA and AV nodes do?

A

conduction system of the heart. Intrinsic system controlled by specialize myocardial cells

266
Q

can SNS innervate SA and AV nodes?

A

Yes

267
Q

Pulmonary Plexus consists of 2 groups:

A

Anterior pulmonary plexus (ant. root of lung)
Posterior pulmonary plexus (post. root of lung)

268
Q

where is the pulmonary plexus continues with the cardiac plexus?

A

at the tracheal bifurcation and continues on to communicate with the esophageal plexus on the aorta and the anterior surface of the esophagus. It enters the abdomen through the esophageal hiatus

269
Q

Pulmonary plexus PSNS:

is supplied by what nerve

A

CN X = VAGUS NERVE (same as cardiac plexus)

270
Q

Pulmonary plexus PSNS:

Preganglionic to ________
Postganglionic to _________

A

Pre : parasympathetic ganglia

Post : to target organ

271
Q

Pulmonary plexus SNS:

supplied by what nerve

A

Cardiopulmonary splanchnics (same as cardiac plexus)

272
Q

Pulmonary plexus SNS:

pregang from _____ to _______
postgang out to _______

A

pregang from spinal cord to sympathetic chain

postgang out to the target organ

273
Q

PSNS effects on
broncho
mucous secretion
vaso

A

bronchoCONSTRICTION
INCREASED mucous secretion
vasoDILATION

274
Q

SNS effects on
broncho
mucous secretion
vaso

A

bronchoDILATION
DECREASED mucous secretion
vasoCONSTRICTION

275
Q

4 HEAD AND NECK GANGLIA OF THE PSNS

A
  1. ciliary (III)
  2. Pterygopalatine (VII)
  3. submandibular (VII)
  4. otic (IX)
276
Q

how do splanchnic nerves exit?

A

WITHOUT synpases

Gross (4 decks)

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