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BS - Cardiovascular System > Nerves of the Thorax > Flashcards

Nerves of the Thorax Flashcards

1
Q

What is the main branch of the vagus nerve?

A

The recurrent laryngeal nerve

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2
Q

Where are the phrenic nerves positioned?

A

They travel down either side of the pericardium

They are anterior to the root of the lung

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3
Q

What is the main division of the nervous system?

A
  1. central (brain and spinal cord)

2. peripheral

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4
Q

How is the peripheral nervous system divided?

A
  1. somatic

2. autonomic

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5
Q

What does the somatic nervous system control?

A

It is voluntary control

It controls external actions of skin and muscles

It has a sensory and a motor component

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6
Q

What does the autonomic nervous system control?

A

It is involuntary control

It controls the internal activities of organs and glands

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7
Q

How is the autonomic system divided?

A
  1. sympathetic (arousing)

2. parasympathetic (calming)

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8
Q

What type of inputs are interpreted by the CNS?

A

Both sensory and motor inputs

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9
Q

What is the peripheral nervous system involved with?

A

Getting information from the peripheries and viscera to the central processing unit (CNS)

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10
Q

What types of fibres are found in both the sympathetic and parasympathetic nervous systems?

A

They both contain both sensory and motor fibres

Sensory fibres lead back to the CNS, and motor fibres lead to the viscera

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11
Q

What is meant by afferent and efferent fibres?

A

Sensory fibres are afferent fibres

Motor fibres are efferent fibres

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12
Q

What type of input does the vagus nerve provide to the heart?

A

Parasympathetic input

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13
Q

What type of fibres are within the vagus nerve?

A

Parasympathetic and somatic fibres

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14
Q

Why does the vagus nerve contain somatic fibres?

A

It gives off a branch - the recurrent laryngeal nerve

The larynx is under somatic control

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15
Q

How is the spinal cord divided into segments?

What is significant about each segment (vertebral level)?

A

Spinal cord is divided into 31 segments

Each segment (vertebral level) gives rise to a pair of spinal nerves

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16
Q

What types of nerves are spinal nerves predominantly?

What are the thoracic spinal nerves?

A

They are predominantly somatic nerves

The thoracic spinal nerves are the intercostal nerves

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17
Q

How is the spinal cord divided according to the regions supplied by the spinal nerves?

A
  1. 8 pairs of cervical spinal nerves
  2. 12 pairs of thoracic spinal nerves
  3. 5 pairs of lumbar spinal nerves
  4. 5 pairs of sacral spinal nerves
  5. 1 pair of coccygeal spinal nerves
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18
Q

What is the central part of the spinal cord comprised of?

A

Grey matter which contains cell bodies

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19
Q

What is the external part of the spinal cord comprised of?

A

White matter which contains the axons of neurones

It is white due to the presence of the myelin sheath

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20
Q

Where will sensory (afferent) information arrive to the spinal cord?

How does it enter into the spinal cord?

A

It arrives at the dorsal aspect of the spinal cord

Dorsal rootlets carry sensory information back from the relevant area and enter into the spinal cord

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21
Q

Where will motor (efferent) information leave the spinal cord and how does it do so?

A

It leaves the spinal cord at the ventral aspect to supply the relevant area

Information leaves via ventral rootlets

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22
Q

How are the motor and sensory rootlets related?

A

The motor rootlets and sensory rootlets will join together to form a spinal nerve

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23
Q

why is a spinal nerve described as a ‘mixed nerve’?

A

It contains both sensory and motor information in the same sheath

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24
Q

Where are the cell bodies of sensory nerves found?

A

In the dorsal root ganglion

This is just outside of the CNS

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25
Q

What will the spinal nerves branch to form?

A

An anterior (ventral) and a posterior (dorsal) ramus

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26
Q

What structures are supplied by the anterior and the posterior rami?

A

Anterior (ventral) ramus supplies the body wall and front of the body

Posterior (dorsal) ramus supplies back musculature and skin

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27
Q

Why is the autonomic nervous system described as a 2-neurone pathway?

A

There is a preganglionic neurone in the CNS

This synapses on to a postganglionic neurone in the PNS that leads to the target tissue/organ

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28
Q

Where is the preganglionic neurone’s cell body found?

A

In the brain stem or spinal cord (CNS)

This gives rise to a preganglionic axon

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29
Q

Where will the preganglionic axon synapse onto the postganglionic cell body?

A

The postganglionic cell body is in an autonomic ganglion

This is located outside of the CNS, in the PNS

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30
Q

What is significant about the length of the fibres in the parasympathetic system?

A

Very long preganglionic fibres

Short postganglionic fibres

31
Q

What is significant about the length of the fibres in the sympathetic system?

Why?

A

Short preganglionic fibres

Long postganglionic fibres

The preganglionic fibre only has to travel a short distance to the sympathetic chain before it synapses

32
Q

Where does the vagus nerve originate?

A

Medulla of the brainstem

33
Q

How close will the vagus nerve get to the organ before it synapses?

Why?

A

It gets very close to the organ before it synapses

There is a long preganglionic fibre and short postganglionic fibre

34
Q

What is the origin of the parasympathetic system?

What does this mean?

A

It has a cranio-sacral origin

The cranial outflow is the vagus nerve

There is some contribution from the sacral region (S2-S4)

35
Q

Where are the only regions that the parasympathetic nervous system originates from?

A

Medulla of brainstem

Sacral region of spinal cord

36
Q

What do the autonomic ganglia form?

What do these contain?

A

The autonomic ganglia form plexi

There are both pre- and post-ganglionic fibres within a plexus

37
Q

Where are the only regions where sympathetic preganglionic fibres will leave the spinal cord?

A

Sympathetic fibres only leave the spinal cord in segmental spinal nerves T1 - L2

38
Q

What happens after the sympathetic fibre leaves the spinal cord in segmental spinal nerves?

A

They run to the sympathetic chains, where they synapse

From the sympathetic chain, they are distributed to the body

39
Q

Why is the sympathetic chain longer than the input it is getting from the nervous system?

A

Fibres can enter the chain and travel up or down

40
Q

How does motor information leave the spinal cord?

A

It leaves the spinal cord and joins onto the spinal nerve

41
Q

Why can the motor information not remain in the spinal nerve?

A

It needs to travel to the viscera

The spinal nerve is travelling to the body wall

42
Q

what happens to the motor information once it has entered a spinal nerve?

A

It jumps off the spinal nerve and enters the sympathetic chain

It does this by travelling through a white ramus communicans

43
Q

What is a white ramus communicans?

A

It is a fibre that is white as it contains a myelin sheath

It is a ramus as it is a branch

44
Q

What happens after the motor information has entered the sympathetic chain?

A

It synapses in the sympathetic chain and then the postganglionic fibre leads to the organ requiring sympathetic input

45
Q

How will the sympathetic motor preganglionic fibre synapse onto the postganglionic fibre?

A

Through the sympathetic ganglia

This is a collection of cell bodies that is outside of the CNS

46
Q

How does the sympathetic chain act as an ‘elevator’?

A

Once the efferent information has entered the sympathetic chain via the white ramus communicans, it can synapse and move either up or down the sympathetic chain

47
Q

What happens after the efferent nerve has synapsed at the sympathetic ganglion?

A

It jumps back onto the spinal nerve to travel to the effector organs

It does this via a grey ramus communicans

48
Q

What is the nerve that returns to the spinal nerve from the sympathetic chain?

A

Grey ramus communicans

It is grey as the nerves have no myelin sheaths

49
Q

What is a plexus formed from?

A

Fibres from the sympathetic and parasympathetic nervous systems forming a braid-like structure

50
Q

where will a plexus form?

A

It will form around an organ

Small fibres then go on to supply the relevant organ

51
Q

Where must parasympathetic information pass before it reaches the target organ?

A

Parasympathetic input has information coming from the vagus nerve, and passing towards relevant structures

The nerves must pass through the relevant plexus before they reach the structure

52
Q

What plexus is found just behind the right atrium?

What fibres are found within it?

A

Cardiac plexus

Fibres from the vagus nerve synapse here

There are also postganglionic fibres from the sympathetic chains

53
Q

What is the difference in fibres from the sympathetic and parasympathetic nervous systems found within a plexus?

A

The plexus contains:

  1. preganglionic fibres from the parasympathetic NS (vagus)
  2. postganglionic fibres from the sympathetic NS (sympathetic chain)
54
Q

What is the origin of the intercostal nerves?

A

Thoracic segments T1-T11

Subcostal nerve comes from T12

55
Q

What are the components of the intercostal nerves?

A
  1. autonomic - sympathetic
  2. somatic - motor
  3. somatic - sensory
56
Q

What structures do the intercostal nerves supply?

A
  1. intercostal muscles
  2. costal and cervical pleura
  3. skin adjacent to the intercostal space
57
Q

Where does the vagus nerve originate?

A

Medulla of brainstem

58
Q

What are the components of the vagus nerve?

A
  1. autonomic - parasympathetic
  2. somatic - motor
  3. somatic - sensory
59
Q

What does the vagus nerve supply?

A

Parasympathetic output to the thoracic viscera

60
Q

Where does the phrenic nerve originate?

A

Cervical segments C3 - C5

61
Q

What are the components of the phrenic nerve?

A
  1. somatic - motor

2. somatic - sensory

62
Q

what does the phrenic nerve supply?

A
  1. diaphragm
  2. diaphragmatic and mediastinal pleura
  3. pericardium
63
Q

Where does the recurrent laryngeal nerve originate?

A

It is a branch of the vagus nerve

64
Q

What are the components of the recurrent laryngeal nerve?

A
  1. somatic - motor

2. somatic - sensory

65
Q

What does the recurrent laryngeal nerve supply?

A
  1. muscles of the larynx

2. intrinsic sensory from membranes below vocal folds

66
Q

what type of information is carried in the sensory fibres of the parasympathetic nervous system?

A

Sensory information relating to the state of the viscera

This is involved in homeostasis or the organs

67
Q

Which pathway is used by pain fibres and noxious stimuli?

A

Sympathetic pathway

68
Q

How do spinal nerves usually receive sensory information?

A

They receive sensory information from the body wall and carry it to the spinal cord

This comes from particular regions (spinal levels)

69
Q

Where does information from the heart return to?

A

Spinal level T1 - T4

70
Q

what happens to spinal nerves if there is a noxious stimulus (e.g. in heart attack)?

A

There is an increased amount of sensory impulses travelling along the spinal nerves to the CNS

71
Q

How does referred pain result from noxious stimuli?

A

The CNS is not used to receiving a large quantity of information from an organ at a particular spinal level

This leads to pain at this spinal level

72
Q

Why does referred pain occur in a heart attack?

Where does it occur?

A

Due to noxious stimuli, the CNS is receiving a large amount of information from T1 - T4

It assumes that, as it does not usually receive much information from the heart, the increased amount of impulses are coming from the body wall

73
Q

What is a dermatome?

A

An area of skin supplied by a particular segmental spinal nerve

74
Q

Why does referred pain occur?

A

The CNS interprets sensory information from the relevant spinal level

It gets ‘confused’ and thinks the increased impulses are coming from the body wall rather than the relevant organ

BS - Cardiovascular System (20 decks)

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