Innervation of Abdominal Viscera: Regulation of G-I Function and Pain Perception

Question 1

For sympathetic innervation with the T5-9 (or 10) spinal cor segment, what is the

1. ) Pre-ganglionic splanchnic nerve
2. ) Prevertebral ganglion

Answer 1

1. ) Greater splanchnic nerve

2. ) Celiac ganglion

Question 2

For sympthetic innervation with the T10-11 spinal cord segment what is the

1. ) Pre-ganglionic splanchnic nerve
2. ) Prevertebral ganglion

Answer 2

1. ) Lesser Splanchnic nerve

2. ) Superior mesenteric (or aorticorenal) ganglia

Question 3

For sympathetic innervation with the T12 spinal cord segment, what is the

1. ) Pre-ganglionic splanchnic nerve
2. ) Prevertebral ganglion

Answer 3

1. ) Least Splanchnic nerve

2. ) Aorticorenal (or cell bodies in renal plexus) ganglia

Question 4

For sympathetic innervation with the L1-2 spinal cord segment, what is the

1. ) Pre-ganglionic splanchnic nerve
2. ) Prevertebral ganglion

Answer 4

1. ) Lumbar Splanchnic nerve

2. ) Inferior mesenteric ganglia

Question 5

What is the destination of the sympathetic innervation from

1. ) T5-6
2. ) T7-9
3. ) T6-10

Answer 5

1. ) Abdominal esophagus
2. ) Liver and biliary tree
3. ) Stomach, spleen, pancreas, and proximal duodenum

Question 6

What is the destination of the sympathetic innervation from

1. ) T9-T10
2. ) T10
3. ) T10-T11

Answer 6

1. ) Distal duodenum, pancreas, jejunum, and ileum
2. ) Appendix
3. ) Proximal colon

Question 7

What is the destination of the sympathetic innervation from

1. ) T12
2. ) L1-2

Answer 7

1. ) Proximal colon

2. ) Distal colon

Question 8

Pain and pressure afferents follow

-sensitive to distension

Answer 8

Sympathetic pathways

Question 9

What is the function of sympathetic G-I innervation?

Answer 9

Decreases motility and secretion

Question 10

Site of synapse in intestinal wall for foregut and midgut

Answer 10

Myenteric and submucous plexuses

Question 11

Site of synapse in intestinal wall for hindgut

Answer 11

Enteric plexuses

Question 12

What is the function of parasympathetic G-I innervation?

Answer 12

Increases motility and secretion

Question 13

What are the two preganglionic nerves of parasympathetic G-I innervation?

Answer 13

1. ) Vagus nerve trunks

2. ) S2-4 ventral rami

Question 14

For the vagus nerve trunks, what is the autonomic plexus?

Answer 14

Celiac plexus and superior mesenteric plexus

Question 15

For the S2-4 ventral rami, what is the autonomic plexus?

Answer 15

Inferior hypogastric plexus

Question 16

What is the destination of innervation from the vagus nerve trunks?

Answer 16

Esophagus through proximal 2/3 of transverse colon

Question 17

Synapse within alimentary tract from esophagus through proximal 2/3 of transverse colon

Answer 17

Intrinsic (enteric) Ganglia

Question 18

What is the destination of innervation from the S2-4 ventral rami?

Answer 18

Distal 1/3 of transverse colon to rectum

Question 19

Synapse within alimentary tract from distal 1/3 of transverse colon to rectum

Answer 19

Intrinsic (enteric) Ganglia

Question 20

Reflex afferents follow

Answer 20

Parasympathetic pathways

Question 21

The system of neurons and their supporting cells that is found within the walls of the alimentary tract

Answer 21

Enteric Nervous System

Question 22

Neurons are within ganglia in

Answer 22

Intrinsic plexuses

Question 23

The main plexuses which contain neurons in ganglia are the

Answer 23

Myenteric (Auerbach’s) and Submucosal (Meissner’s)

Question 24

The myenteric (Auerbach’s) plexus is between the

Answer 24

Longituginal and circular muscles

Question 25

The submucosal (Meissner's) plexus is between the

Answer 25

Circular muscle and muscularis mucosae

Question 26

Synapse with cells in the same or other ganglia

Answer 26

Intrinsic neurons

Question 27

Intrinsic neurons project to effectors in the walls of the

Answer 27

Alimentary tract (e.g. muscle, mucosae)

Question 28

Outside the walls of the alimentary tract, intrinsic neurons connect with

Answer 28

Autonomic ganglia

Question 29

Intrinsic neurons send afferents to the

Answer 29

CNS

Question 30

Intrinsic neurons innervate

Answer 30

Mesenteric arteries and arterioles of the colon

Question 31

Governs the normal motility and secretory functions of the intestine

Answer 31

Enteric nervous system

Question 32

The enteric nervous systems actions are affected and modified by the

Answer 32

Extrinsic nerve supply

Question 33

Retains many functions after all central connections are severed

Answer 33

Enteric nervous system

Question 34

Sympathetic and parasympathetic denervation have a transient effect on

Answer 34

Gut motility

Question 35

Intrinsic plexuses contain complete reflex pathways consisting of

Answer 35

Enteric neurons, interneurons, and motor neurons

Question 36

Monitor intestinal wall tension and intestinal contents

Answer 36

Enteric neurons

Question 37

Form information links between enteric neurons

Answer 37

Interneurons

Question 38

Change the activity of the intestine

Answer 38

Motor neurons

Question 39

Involves transfer of impulses from intrinsic sensory neurons via the interneurons to cephalad directed excitatory motor neurons and caudally directed inhibitory motor neuron

Answer 39

Peristaltic reflex

Question 40

An unpleasant sensation associated with actual or potential tissue damage, and mediated by specific nerve fibers to the brain where its conscious appreciation may be modified by various factors

Answer 40

Pain (symptom/subjective)

Question 41

Sensitive or painful as a result of pressure or contact that is not sufficient to cause discomfort in normal tissues

Answer 41

Tenderness (sign/objective)

Question 42

Dull and poorly localized pain resulting from noxious stimulus to abdominal viscus

Answer 42

Abdominal pain

Question 43

Perceived in the midline because sensory afferents come from both sides of spinal cord

Answer 43

Abdominal pain

Question 44

What type of abdominal pain is seen in the 1. ) Foregut 2. ) Midgut 3. ) Hindgut

Answer 44

1. ) Epigastric 2. ) Unbilical 3. ) Suprapubic

Question 45

Corresponds roughly to dermatomes which are innervated by the same spinal cord level from which diseased organ receives its innervation

Answer 45

Site of abdominal pain

Question 46

Nerve impulses pass through the pre-vertebral splanchnic ganglia, reach the sympathetic chain in the splanchnic nerves, and enter the dorsal root via the

Answer 46

White ramus communicans

Question 47

Perceived as originating in areas supplied by the somatic nerves entering the spinal cord at the same segment as the sensory nerves from the organ producing the pain because of shared central pathways by afferent neurons from different sites

Answer 47

Referred pain

Question 48

usually fairly well localized

Answer 48

Referred pain

Question 49

Referred pain usually appears when the noxious visceral stimulus becomes

Answer 49

More intense

Question 50

Results from noxious stimulus to the parietal peritoneum -Aggrevated by movement or coughing

Answer 50

Parietal pain

Question 51

What is more intense, parietal pain or visceral pain?

Answer 51

Parietal

Question 52

In parietal pain, nerve impulses travel within

Answer 52

Somatic sensory nerves

Question 53

In parietal pain, nerve impulses travel within somatic sensory nerves and the fibers reach the spinal cord in the peripheral nerves corresponding to the

Answer 53

Cutaneous dermatomes from T6 to L1-3

Question 54

What is the following innervation for the biliary tree and gullbladder? 1. ) Parasympathetic via 2. ) Sympthetic and visceral sensory via 3. ) Somatic afferent fibers via

Answer 54

1. ) Vagus nerves 2. ) Greater splanchnic nerves 3. ) Phrenic nerve

Question 55

The physiological sphincter at the esophogastric junction is controlled by

Answer 55

Vagal innervation

Question 56

What is the parasympathetic innervation of the stomach?

Answer 56

anterior and posterior vagal trunks --> celiac plexus --> intrinsice (enteric) ganglia

Question 57

What does parasympathetic innervation to the stomach do?

Answer 57

Increases motility and acid secretion

Question 58

What is the sympathetic innervation of the stomach?

Answer 58

T6-9 --> Greater splanchnic --> celiac ganglia --> celiac plexus

Question 59

What is the parasympathetic and reflex afferent innervation to the appendix?

Answer 59

Vagus nerve

Question 60

What is the sympathetic and visceral sensory innervation of the appendix?

Answer 60

T10 spinal cord segment

Question 61

Responsible for regulating peristalsis

Answer 61

Myenteric (Auerbach's) Plexus

Question 62

For the parasympathetic system, what is the preganglionic cell body location?

Answer 62

Brainstem (vagus) and S2-S4 (pelvic splanchnic)

Question 63

For the parasympathetic system, what is the postganglionic cell body location?

Answer 63

Terminal ganglia

Question 64

For the sympathetic system, what is the preganglionic cell body location?

Answer 64

Lateral horn of T5-L2

Question 65

For the sympathetic system, what is the postganglionic cell body location?

Answer 65

Prevertebral ganglia

Question 66

Caused by mutation of the RET gene which causes failure of neural crest cell migration to enteric plexuses

Answer 66

Aganglionic megacolon (Hirschsprung's Disease)

Question 67

In Hirschsprung's the aganglionic (Myenteric Plexus) bowel segment becomes constricted and the proximal segment becomes

Answer 67

Dilated

Question 68

What is the path of sympathetic innervation to the G-I system starting from the lateral horn of T5-L2?

Answer 68

Lateral horn, through the ventral root, into the ventral ramus, through the white rami communicans into the paravertebral canal, and through the splanchnic nerve into the prevertebral ganglion (synapse) and onto the organ

Question 69

What is the embryonic region for 1. ) T5-T9 2. ) T10-T11 3. ) T12 4. ) L1-L2

Answer 69

1. ) Foregut 2. ) Midgut 3. ) Midgut 4. ) Hindgut

Question 70

In the foregut sympathetic innervation, preganglionic fibers in the greater splanchnic nerves synapse on postganglionic neurons in the

Answer 70

Celiac ganglia

Question 71

In the midgut sympathetic innervation, preganglionic fibers in the lesser thoracic splanchnic nerves sinapse on postganglionic neurons in the

Answer 71

Superior mesenteric ganglia

Question 72

In the hindgut sympathetic innervation, preganglionic fibers in the lumbar splanchnic nerves synapse on postganglionic fibers in the

Answer 72

Inferior mesenteric ganglia

Question 73

The post ganglionic fibers are then distributed to the organ wall/enteric plexus on the branches of the

Answer 73

Inferior mesenteric artery

Question 74

What is the embryonic region for the parasympathetic nerves with cell bodies located in 1. ) Brainstem 2. ) S2-S4

Answer 74

1. ) Foregut and midgut | 2. ) Hindgut

Question 75

In the foregut parasympathetic innervation, preganglionic fibers in anterior and posterior vagal trunks synapse on postganglionic neurons in

Answer 75

Enteric ganglia

Question 76

In the midgut parasympathetic innervation, preganglionic fibers in vagal trunks pass through superior mesenteric ganglia and synapse on cell bodies in the

Answer 76

Enteric plexus

Question 77

In the hindgut parasympathetic innervation, preganglionic fibers in pelvic splanchnic nerves (S2-S4) are distributed on -synapse on cell bodies in enteric plexus

Answer 77

Arteries within mesentery of rectum and colon

Question 78

In the foregut, postganglionic sympathetic and parasympathetic fibers are distributed by traveling on the

Answer 78

Celiac trunk

Question 79

In the midgut, sympathetic (postganglionic) and parasympathetic (preganglionic) fibers are distributed by traveling on the

Answer 79

Superior mesenteric artery