Major sensory and motor pathways within the central nervous system in relation to nervous connections of the pelvic organs Flashcards
T/F: ‘nerve sparing’ surgical procedure preserveS the normal functions of pelvic organs
T
6 treatment options for chronic pelvic pain which include:
- sympathectomy
- nerve blocks
- neurolysis
- presacral neurectomy
- laparoscopic uterine nerve ablation (LUNA)
- pelvic neuromodulation
Sensory impulses ascend through the spinal cord to the brain via –
the sensory pathways
Motor impulses from the brain and spinal cord descend to the pelvic viscera via
Motor pathways
The pelvic sympathetic system derives from what column and region of the spinal cord
Intermediolateral grey column of the thoracolumbar region of the spinal cord
The presynaptic sympathetic fibres synapse in two ways:
Paravertebral sympathetic trunks
Prevertebral autonomic plexuses
Post-synaptic fibres from the sympathetic trunk run with –, – and –
somatic nerves, vessels or enter autonomic plexuses
The lumbar and sacral part of the sympathetic trunks are responsible for the innervation of
the pelvic and lower limb structures
Series of nerve plexuses and ganglia located anterior to the vertebra are known as
Prevertebral autonomic plexuses
The prevertebral autonomic plexuses include –, – and –
- Inferior hypogastric plexus (IHP)
- Hypogastric nerve (HN)
- Superior hypogastric plexus (SHP)
The prevertebral autonomic plexuses receive sympathetic fibres in 2 ways – and –
presynaptic fibres from the sympathetic trunks
post synaptic fibres from the trunks
T/F: The sympathetic nervous system relaxes the internal urethral sphincter
F. Constricts
T/F: The sympathetic nervous system constricts the internal anal sphincter
T
The sympathetic system mediates proprioception and pain from the upper pelvis via – and – to the sympathetic trunk
Hypogastric nerve and superior hypogastric plexus
Parasympathetic supply of the pelvis comes from – and –
Primarily from the pelvic splanchnic nerves (PSN), but with some contribution from the Vagus nerve
the sacral component of the parasympathetic system is constituted by –
Pelvic splanchnic nerves
PSN fibers arise from
the sacral spinal nerves S2–S4
Fibres from the pelvic splanchnic nerves pass to the —- plexus without synapsing
inferior hypogastric plexus
T/F: Fibres from the pelvic splanchnic nerves pass to the inferior hypogastric plexus (IHP) without synapsing
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T/F: Fibres from the pelvic splanchnic nerves pass to the inferior hypogastric plexus without synapsing and pass from there to synapse at ganglia close to the target organs
T
T/F: The bladder muscles contract under the influence of the parasympathetic system
T
T/F: The sympathetic system has some proerectile function
T
T/F: contraction of smooth muscle of the rectum is mediated by the parasympathetic system
T
T/F: The sensation of the bladder and rectum is carried by the sympathetic system
F. Parasympathetic
Pain impulses from the vagina, cervix and bladder is carried by which arm of the autonomic nervous system
Parasympathetic
The parasympathetic system carries pain impulses from the –, – and –
Vagina, cervix and bladder
Where is the pelvic pain line for the genitourinary viscera
corresponds to the inferior limit of the peritoneum
Where is the pelvic pain line for the large intestine
middle of the sigmoid colon
Which arm of the autonomic system conducts pain impulses from abdominopelvic viscera above the pelvic pain line
Sympathetic
Which arm of the autonomic system conducts pain impulses from abdominopelvic viscera below the pelvic pain line
Parasympathetic
The somatic nerve system of the pelvis is supplied by the – plexus
Lumbosacral plexus
The chief nerve from the lumbosacral plexus is
the pudendal nerve (S2-S4)
The chief nerve from the lumbosacral plexus is
the pudendal nerve (S2-S4)
T/F: All somatic nerves are accompanied by postsynaptic parasympathetic fibers
F. All somatic nerves are accompanied by postsynaptic sympathetic fibers to supply the smooth muscles of the blood vessels, sweat glands, apocrine glands, arrector pili muscle of hair follicle of the skin, and also the bone marrow
T/F: During sexual activity the somatic system stimulates the pelvic floor muscles (ischiocavernosus, bulbospongiosus, superficial and deep transverse perineal muscles, external anal sphincter, and the pelvic diaphragm) to maintain rigidity
T
T/F: Rhythmic contractions of the bulbospongiosus cause semen to release into the spongy urethra causing ejaculation
T
T/F: Sensory or ascending pathways
T
T/F: Only the afferent impulses that reach the cerebral cortex are consciously perceived
T
T/F: Afferent impulses ending in the cerebellum or in the brainstem are consciously perceived
F.
Afferent impulses ending in the cerebellum or in the brainstem influence the activities of cerebellum and brainstem respectively