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GI Midterm > Lumbar Plexus > Flashcards

Lumbar Plexus Flashcards

1
Q

What forms the lumbar plexus (rami and spinal nerves)

A

Formed by ventral rami of spinal nerves L1-L4, in some cases L5 too. T12 contributes in about 50% of people.

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2
Q

What spinal level is subcostal nerve arise from?

A

T12.

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3
Q

How does the subcostal nerve arise after it leaves the intervertebral foramina?

A

It emerges lateral to psoas major, deep to the lateral arcuate ligament, just beneath the 12th rib.

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4
Q

The subcostal nerve traverses quadratus lumboram and then peirces what structures and then runs between what?

A

After traversing quadratus lumborum, it pierces the transversus abdomininis and runs bewteen it and the internal oblique muscle.

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5
Q

What muscles does the subcostal nerve provide motor innervation to?

A

All the abdominal muscles (rectus abdominis, pyramialis, transversus abdominis, internal oblique, and external oblique.

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6
Q

The subcostal nerve provide sensory innervation to what regions.

A

Anterior and lateral abdominal wall, and upper gluteal area.

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7
Q

What spinal level does iliohypogastric nerve arise from?

A

L1. with contribution from T12 in 50% of people.

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8
Q

how does the iliohypogastric nerve emerge?

A

Same as subcostal.
From lateral side of psoas, traverses quadratus lumborum and pierces transversus abdominis and runs between it and internal oblique then few cm later pieces the internal oblique inferomedially to the ASIS and runs between external and internal oblique.

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9
Q

What muscles/regions does the iliohypogastric nerve supply?

A

Anterolateral abdominal muscles (transversus abdominis, intenal oblique, external oblieuq)
Skin of suprapubic region and skin of upper gluteal region

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10
Q

What nerve carries the afferent and efferent fibers for the abdominal reflex?

A

Iliohypogastric nerve

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11
Q

What spinal level does ilioinguinal nerve arise from?

A

L1

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12
Q

how does the ilioinguinal nerve emerge?

A

Same as iliohypogastric but slightly inferior. sometimes it even anastomoses with iliohypogastric

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13
Q

What nerve pierces the internal oblique near the deep inguinal ring and it’s terminal branch accompanies the spermaticcord/round ligament as it runs within the canal. it exits the canal and then runs on the anterior surface of the spermatic cord or round ligament.

A

ilioinguinal n.

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14
Q

What muscles does the ilioinguinal provide motor innervation to/

A

transversus abdominis and internal oblique

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15
Q

The ilioinguinal n provides sensory innervation to what regions?

A
  1. root of the penis and the anterior scrotum in males
  2. skin of mon pubis and labia majora in females
  3. skin of the medial and upper thigh in males, and constitites the afferent limb of the cremasteric reflex.
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16
Q

What spinal level does Genitofemoral n arise from?

A

L1 and L2

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17
Q

How doe the genfem n. emerge?

A

from anterior surface of psoas major near LV3 and LV4 level.

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18
Q

which branch of the genfem enters the inguinal canal at the deep inguinal ring, runs through the ring, exits at the superficial ring.

A

Genital branch.

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19
Q

What nerve promotes motor innervation to the cremaster muscle.

A

Genital branch of GemFem.

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20
Q

What nerve constitites the efferent limb of the cremaster reflex in men?

A

Genital branch of genfem.

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21
Q

What nerve provides sensory to the anterior scrotum or upper part of the labia majora?

A

gen branch of genfem.

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22
Q

Which nerve passes under he inguinal ligament on the surface of external iliac artery to enter the femoral sheath?

A

Femoral branch of femoral branch.

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23
Q

What nerve pierces the femoral sheath and deep fascia of the thigh to innerve the skin of the thigh?

A

femoral branch of genfem.

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24
Q

What spinal level does lateral femoral cutaneous nerve arise from?

A

L2 and L3

25
Q

What nerve provides sensory to the skin of the anterolateral and posterolateral thigh?

A

Lateral femoral cutaneous.

26
Q

What spinal level does the femoral nerve arise?

A

L2, L3 and L4 (posterior division)

27
Q

what nerve provides motor to iliacus, anterior thigh muscles

A

Femoral nerve

28
Q

What nerve provides the sensory and motor innerve for the knee jerk reflex?

A

femoral n.

29
Q

What spinal level does the obturator nerve arise?

A

L2, L3, L4 (anterior division)

30
Q

What nerve crosses the scaroiliac joint and passes lateral to the internal iliac vessels and provides motor to the medial thigh musles.

A

obturator

31
Q

What nerve provides sensory innervation to the hip joint, skin of the medial thigh?

A

obturator.

32
Q

The preganglionic sympathetic fibers for the autonomic abdominal plexues, originate from what spinal cord level?

A

T5-L2

33
Q

True or False, the pregnalion sympathic fibers of the abdominal plexus courses through but do not synapse in the sympathetic chain.

A

True

34
Q

where do the preganglionic sympathetic fibers of the abdomen synapse?

A

On the prevertbral ganglia located near the aorta.

35
Q

What are the prevertebral ganglia of the sympathetic division associated with and thus named for?

A

It’s associated with the major arteries. For example: the celiac ganglion is associated with the celiac plexus which courses along the celiac artery.

36
Q

Where do the preganglionic fibers of the parasymapthetic division originate from for the foregut and midgut?

A

Cranial nerve 10. (CNX)

37
Q

What organs does the vagus nerve provide parasympathetic innervation to?

A

All the GI tract and associated organs until the distal 1/3 of the transverse colon.

38
Q

What provides parasympathetics to the lower abdomen and pelvis?

A

Pelvic splanchnics (S2, S3 and S4)

39
Q

The anterior vagal trunk provides preganglionic fibers to what organs?

A

stomach, liver, gall bladder, duodenum, and pancreas.

40
Q

what organs does the posterior vagal trunk provide parasympathetic innervation to?

A

stomach and intestines

41
Q

What controls swallowing reflex (sympathetic or parasympathetic

A

parasympathetic axons control swallowing reflex.

42
Q

what structures do the hypogastric plexus mainly innervate?

A

The pelvic viscera = autonomic control of urinary and reproductive function.

43
Q

where are the sympathetic preganglionic neuron cell bodies housed?

A

In the lateral horn of the T1-L2 regions of the spinal cord.

44
Q

what do the paravertebral ganglia aka sympathetic trunk house?

A

they house sympathetic ganglionic neuron cell bodies.

45
Q

what connects the spinal nerves to each sympathetic trunk?

A

rami communicantes.

46
Q

What do white rami carry?

A

preganglionic sympathetic axons from the T1-L2 spinal nerves to the sympathetic trunk.

47
Q

are preganglionic axons myelinated or not myelinated?

A

Myelinated.

48
Q

what do gray rami carry?

A

They carry postganglionic sympathetic axons from the sympathetic trunk to the spinal nerve.

49
Q

are axons of gray rami myelinated or unmyelinated?

A

unmyelinated.

50
Q

Which spinal nerves do gray rami connect to?

A

They connect to all spinal nerves, including the cervical, sacral and occygeal spinal nerves.

51
Q

For a sympathetic nerve pathway, describe the spinal nerve pathway starting at spinal column to target.

A

Start at lateral horn, come out through the ventral ramus through the spinal nerve proper, then through the white ramus to a ganglion. it can synapse at that ganglion at that level or it can come in and dsecend or ascend to go to a different ganglion by using the gray rami and going back to the spinal nerve.

52
Q

Describe the pathway for splanchnic nerve pathway.

A

Start at lateral horn, go through the ventral ramus, go through the white ramus and then does not synapase in the trunk, but continuous to travel as a myelinated fiber in a thoracic splanchnic nerve to a prevertrebral ganglion.

53
Q

What are splanchnic nerves composed of?

A

preganglionic sympathetic axons.

54
Q

describe the adrenal medulla pathway.

A

Comes out of the spinal cord, through the ventral root, and then through the thoracic splanchnic nerve and goes straight to adrenal medulla. It does nto synapse at a ganglion. This is why its a really fast pathway.

55
Q

What spinal level do visceral pain of gallbladder come from?

A

T6, RIGHT

56
Q

What spinal level do visceral pain of stomach come from?

A

T5-T9 Left

57
Q

What spinal level do visceral pain of cecum and appendix come from?

A

T10-T12 right

58
Q

Match the spinal cord segments with the organs listed:

  1. Liver
  2. Stomach
  3. Pancreas
  4. Spleen
  5. Small intestine
  6. Cecum, ascending colon, appendix
  7. Transverse colon
  8. Descending colon
  9. sigmoid colon
  10. Rectum
  11. Kidney
  12. Adrenal glands
A
  1. Liver = T6-T9
  2. Stomach = T6-T9
  3. Pancreas = T6-T9
  4. Spleen = T6-T8
  5. small intestine = T 8-T12
  6. cecum, ascending colon and appendix = T8
  7. Transverse colon = T10
  8. Descneding colon = T12-L2
  9. Sigmoid colon = S2
  10. rectum = S4
  11. kidney = T10 - L1
  12. Adrenal glands = T6-L1

GI Midterm (11 decks)

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