Lecture 2.5 - Autonomic nervous system

Question 1

What role does the paravertebral ganglia play in Sympathetic Pathway?

Answer 1

Paraverterbal ganglion are:

• site of synapse for:
• • sympathetic innervation to skin
• • sympathetic innervation from T1-T5 to the thoracic organs
• connected to form the sympathetic chain/trunk

Question 2

What role does the prevertebral ganglia play in Sympathetic Pathway?

Answer 2

Prevertebral ganglion are:

• site of synapse for sympathetic innervation to abdominal and pelvic organs:
• • celiac ganglion: synapse form T5-T9 (greater splanchnic nerve) to Foregut, liver, pancreas
• • superior mesenteric ganglion: synapse from T9-T12 (lesser splanchnic nerve) to Midgut, kidneys
• • inferior mesenteric ganglion: synapse from T12-L2 (least splanchnic and lumbar splanchnic nerves) to Hindgut, pelvic organs

Question 3

What are the organs and blood supply of the skin?

Answer 3

Organs: sweat glands, sebaceous glands, arrector muscles

Blood supply: cutaneous vessels

Question 4

Where are the sympathetic/parasympathetic pre-synaptic and synapse neurons for the skin?

Answer 4

Sympathetic pre-synapse: T1-L2 spinal cord levels
Sympathetic synapse: paravertebral ganglia within sympathetic trunk
Parasympathetic pre-synapse/synapse: none

Question 5

Which dermatome is referred for pain in skin?

Answer 5

at corresponding dermatome level

Question 6

What are the organs and blood supply of the thorax?

Answer 6

Organs: heart and lungs

Blood supply: branches off of aorta

Question 7

Where are the sympathetic/parasympathetic pre-synaptic and synapse neurons for the thorax?

Answer 7

Sympathetic pre-synapse: T1-T5 spinal cord levels
Sympathetic synapse: paravertebral ganglia within
sympathetic trunk
Parasympathetic pre-synapse: Vagus n. (CN X)
Parasympathetic synapse: On the target organ

Question 8

Which dermatome is referred for pain in thorax?

Answer 8

T1-T5 dermatomes

Question 9

What are the organs and blood supply of the foregut?

Answer 9

Organs: liver, pancreas, spleen, stomach, duodenum

Blood supply: branches of celiac trunk

Question 10

Where are the sympathetic/parasympathetic pre-synaptic and synapse neurons for the foregut?

Answer 10

Sympathetic pre-synapse: T5-T9 spinal cord levels
Sympathetic synapse: prevertebral ganglia around celiac trunk
Parasympathetic pre-synapse: Vagus n. (CN X)
Parasympathetic synapse: On the target organ

Question 11

Which dermatome is referred for pain in skin foregut?

Answer 11

T5-T9 dermatomes

Question 12

What are the organs and blood supply of the midgut?

Answer 12

Organs: jejunum, ileum, cecum, ascending colon, transverse colon, kidneys
Blood Supply: branches of superior mesenteric artery

Question 13

Where are the sympathetic/parasympathetic pre-synaptic and synapse neurons for the midgut?

Answer 13

Sympathetic pre-synapse: T9-T12 spinal cord levels
Sympathetic synapse: prevertebral ganglia around superior mesenteric artery
Parasympathetic pre-synapse: Vagus n. (CN X)
Parasympathetic synapse: On the target organ

Question 14

Which dermatome is referred for pain in midgut?

Answer 14

T9-T12 dermatomes

Question 15

What are the organs and blood supply of the hindgut?

Answer 15

Organs: descending colon, rectum, ovary, testis

Blood Supply: branches of inferior mesenteric artery

Question 16

Where are the sympathetic/parasympathetic pre-synaptic and synapse neurons for the hindgut?

Answer 16

Sympathetic pre-synapse: T12-L2 spinal cord levels
Sympathetic synapse: prevertebral ganglia around inferior mesenteric artery
Parasympathetic pre-synapse: S2-S4 spinal cord levels
Parasympathetic synapse: On the target organ

Question 17

Which dermatome is referred for pain in hindgut?

Answer 17

T12-L2 dermatomes

Question 18

What are the organs and blood supply of the pelvis touching the peritoneum (above pelvic pain line)?

Answer 18

Organs: fundus of bladder, fundus of uterus

Blood Supply: branches of internal iliac arteries

Question 19

Where are the sympathetic/parasympathetic pre-synaptic and synapse neurons for the pelvis touching the peritoneum (above pelvic pain line)?

Answer 19

Sympathetic pre-synapse: L1-L2 spinal cord levels
Sympathetic synapse: prevertebral ganglia around common and internal iliac arteries
Parasympathetic pre-synapse: S2-S4 spinal cord levels
Parasympathetic synapse: On the target organ

Question 20

Which dermatome is referred for pain in the pelvis touching the peritoneum (above pelvic pain line)?

Answer 20

L1-L2 dermatomes

Question 21

What are the organs and blood supply of the pelvis below peritoneum (below pelvic pain line)?

Answer 21

Organs: anal canal, base of bladder, prostate, cervix of uterus
Blood Supply: branches of internal iliac arteries

Question 22

Where are the sympathetic/parasympathetic pre-synaptic and synapse neurons for the pelvis below peritoneum (below pelvic pain line)?

Answer 22

Sympathetic pre-synapse: L1-L2 spinal cord levels
Sympathetic synapse: prevertebral ganglia around common and internal iliac arteries
Parasympathetic pre-synapse: S2-S4 spinal cord levels
Parasympathetic synapse: On the target organ

Question 23

Which dermatome is referred for pain in the pelvis below peritoneum (below pelvic pain line)?

Answer 23

S2-S4 dermatomes

Question 24

What are the organs and blood supply of the perineum?

Answer 24

Organs: erectile tissue (corpus cavernosus, corpus
spongiosus)
Blood Supply: branches of internal iliac arteries

Question 25

Where are the sympathetic/parasympathetic pre-synaptic and synapse neurons for the perineum?

Answer 25

Sympathetic pre-synapse: L1-L2 spinal cord levels
Sympathetic synapse: prevertebral ganglia around common and internal iliac arteries
Parasympathetic pre-synapse: S2-S4 spinal cord levels
Parasympathetic synapse: On the target organ

Question 26

Which dermatome is referred for pain in the perineum?

Answer 26

S2-S4 dermatomes