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Cardiopulmonary I > Nerves in Thorax - Olinger > Flashcards

Nerves in Thorax - Olinger Flashcards

1
Q

Superior and inferior mediastinum are separated by

A

The sternal angle

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2
Q

The inferior mediastinum is divided into

A

Anterior
Middle
Posterior

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3
Q

Middle mediastinum

A

The heart

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4
Q

Esophagus

A

Joining the laryngopharynx to the stomach
Double layered
Muscular tube with an internal circular layer and external longitudinal layer
The upper 2/3 a combo of smooth and skeletal

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5
Q

Regions of the esophagus

A

Cervical part
Thoracic part
Abdominal part

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6
Q

Thoracic part of esophagus

A

Between T1 and the esophageal hiatus of the thoracic diaphragm
Travels through the posterior mediastinum

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7
Q

Constrictions of the esophagus

A

At the cricophayngeus m. - clinically referred to as the upper esophageal sphincter
At aortic arch
At the left bronchus
At the esophageal hiatus of the thoracic diaphragm - clinically referred to as the lower esophageal sphincter

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8
Q

Vagus N

A

Left recurrent laryngeal n.
Pulmonary and inferior cardiac branches —> in posterior mediastinum produces esophageal branches on esophagus
In abdomen become anterior and posterior vagal trunk

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9
Q

Left recurrent laryngeal n.

A

Loops under aortic arch and ligamentum arteriosum to return to the larynx

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10
Q

Phrenic N.

A

Anterior rami of C3-5
Space between mediastinal parietal pleura and fibrous pericardium
Innervate the thoracic diaphragm
Conveys sensory info from central diaphragmatic and mediastinal pleura and the pericardium

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11
Q

Intercostal N.

A

1-11th pair of anterior rami of the thoracic spinal nerves
Travel along the inferior edge of the superior rib in the intercostal space between internal and innermost intercostal m.
Innervates skin, subcutaneous tissue, musculature and costal and diaphragmatic parietal pleura

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12
Q

Typical Intercostal nerves

A 
3rd-6th
Rami communicantes
Collateral branches
Lateral cutaneous branches
Anterior cutaneous branches
Muscular branches
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13
Q

Rami communicates

A

Connect intercostal n. to ipsilateral sympathetic trunk

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14
Q

Collateral branches

A

Assist in innervating intercostal m., travels on the superior edge of the rib inferior to the intercostal space

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15
Q

Lateral cutaneous branches

A

Become anterior and posterior branches and suppy the skin of the thoracic wall

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16
Q

Which lateral cutaneous branches supply the breast?

A

T4-T6 - teat 4

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17
Q

Anterior cutaneous branches

A

Supply anterior aspect of the thoracic wall

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18
Q

Muscular branches

A

Supply intercostal m., subcostal m., and transversus thoracic thoracic m.

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19
Q

Atypical intercostal n.

A

1st and 2nd

7th - 11th

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20
Q

1st intercostal n.

A

No cutaneous branches and majority superior portion joins the brachial plexus

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21
Q

2nd intercostal n.

A

Majority travels in costal groove as a typical intercostal n. with a small part joining with the BP, the lateral cutaneous branch supplies the skin and subcutaneous tissue of the axilla and is called an intercostbrachial n.

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22
Q

7th-11th intercostal n.

A

Begin as intercostal n. but as they travel anteriorly cease to exist between ribs and transition over the abdomen to become thoracoadbominal n.

23
Q

Thoracoabdominal n.

A

What 7th-11th intercostal n become

24
Q

Sympathetic stimulation

A

Catabolic
fight or flight
ALL vascular areas of the body

25
Q

Parasympathetic stimulation

A

Anabolic
Normal function and energy conservation
Limited distribution - head, neck and trunk viscera

26
Q

Glandular secretion

A

Stimulated by the parasympathetic nervous system (except sweat glands)
The sympathetic nervous system can indirectly decrease non-sweat gland glandular secretion through vasoconstriction

27
Q

Symp division presynaptic fibers are

A

Short

28
Q

Sympathetic division presynaptic fibers

A

Cell bodies exist in the lateral horn of the spinal cord
Always travels in the ventral root
Always travel into the ventral ramus
Quickly exit ventral ramus and enters the paravertebral ganglia

29
Q

Sympathetic synaptic options

A
  1. Can enter paravertebral ganglion and synapse on postsynaptic neuron on SAME spinal level
  2. DIFFERENT level
  3. Can leave through an abdominopelvic splanchnic nerve on their way to a postsynaptic neuron in paravertebral ganglion
30
Q

Sympathetic presynaptic fibers

A

Long

Cell bodies exist in the paravertebral or pre vertebral ganglia

31
Q

Prevertebral ganglia

A

Ganglia and corresponding plexuses surrounding the main unpaired branches of the abdominal aorta

  • celiac
  • superior mesenteric
  • aorticorenal
  • inferior mesenteric
32
Q

Thoracic sympathetic trunk

A

Paravertebral sympathetic ganglia, location of presynaptic sympathetic nerve fibers synapsing onto long postsynaptic nerve cell bodies

33
Q

2 Cardiopulmonary splanchnic nerves

A

Cardiac splanchnic n.

Pulmonary splanchnic n.

34
Q

Cardiac splanchnic n

A

Presynaptic cell bodies in the lateral horn of the spinal cord at levels T1-5 or 6 synapse onto postysynaptic cell bodies in the cervical and thoracic sympathetic trunks which send fibers to the superficial and deep cardiac plexuses

35
Q

Abdominopelvic splanchnic nerves

A

Travel from the thoracic sympathetic trunk to corresponding pre vertebral ganglia in the abdomen
Greater splanchnic n.
Lesser splanchnic n.
Least splanchnic n.

36
Q

Greater splanchnic n.

A

T5-9 or 10

Sends fibers to the esophageal plexus and to the celiac ganglion in abdomen which then feeds into the celiac plexus

37
Q

Lesser splanchnic n.

A

T10 and T11

Sends fibers to celiac and sup mesenteric ganglion in abd which then feeds into the superior mesenteric plexus

38
Q

Least splanchnic n.

A

T12

Sends fibers to the aorticorenal ganglion in abdomen

39
Q

Parasympathetic nervous system

A

Presynaptic fibers - long

40
Q

Cranial component of parasympathetic exits as

A

Cranial nerves

  • oculomotor - III
  • facial - VII
  • glossopharyngeal - IX
  • vagus - X
41
Q

Sacral component of parasympathetic

A

exits spinal levels as pelvic splanchnic n.

42
Q

Postsynaptic fibers of parasympathetic

A

Usually short

With ganglia/postsynaptic neurons near or in the target get organ

43
Q

Parasympathetic presence in thorax

A

Vagus n.

44
Q

Vagus n.

A

Presynaptic parasympathetic innervation to the lungs, bronchi, pleurae, heart and pericardium

45
Q

Superior cardiac branch of vagus n.

A

Originates in the neck descends through the superior thoracic aperture and with the cardiac splanchnic n. forms the cardiac plexus

46
Q

Middle cardiac branch of vagus n.

A

Originates in the neck descends through the superior thoracic aperture and with the cardiac splanchnic n. forms the cardiac plexus

47
Q

Inferior cardiac branch of vagus n.

A

Originates in the thorax and with the cardiac splanchnic n. forms the cardiac plexus

48
Q

Pulmonary branches of vagus

A

Originates in the thorax and with the pulmonary splanchnic n. forms the pulmonary plexus

49
Q

Esophageal branches of vagus

A

After producing pulmonary branches the vagus nerve becomes indistinguishable from the esophageal plexus that covers the inferior 2/3 of the esophagus

50
Q

Pulmonary plexus

A

mixed sympathetic and parasympathetic
Symp input from pulmonary splanchnic n
Parasymp from pulmonary branches of the vagus n.
Innervates the lungs, bronchi and pleurae

51
Q

Superficial cardiac plexus

A

Anterior surface of aorta

52
Q

Aortic plexus

A

Mixed symp and parasymp

53
Q

Esophageal plexus

A

Mixed sump and parasymp

54
Q

Esophageal glands

A

Parasymp

Stimulates peristalsis and esophageal glands

Cardiopulmonary I (34 decks)

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