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Y2S1 CARDIO. > Nerves of the thorax > Flashcards

Nerves of the thorax Flashcards

1
Q

AUTONOMIC NERVOUS SYSTEM

A

✓ Under the control of the hypothalamus

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2
Q

dual innervation of the ANS

A

Sympathetics and parasympathetics exert opposite effects in a particular organ/tissue but they functionally complement each other to keep the body functioning normally.

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3
Q

AUTONOMIC NERVOUS SYSTEM role

A

✓ Regulates the visceral activity (Circulation, respiration, digestion, excretion, reproduction)
• Supplies smooth muscles (walls of the blood vessels, bronchi, intestines)
• Supplies the cardiac muscle
• Supplies the glands
✓ Regulates body temperature
✓ Autonomic fibres “accompany” the general visceral afferent fibres

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4
Q

AUTONOMIC NERVES

A

✓Reach the end organ with two neurons
✓Cell body of the 1st neuron (preganglionic neuron) is at grey matter of the spinal cord or brain stem
− axon is myelinated

✓Cell body of the 2nd neuron (postganglionic neuron) is at an autonomic ganglion
− axon is unmyelinated

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5
Q

PARASYMPATHETIC SYSTEM

A

✓ Rest & digest or Rest & repose - conserves energy
✓ Slows breathing and heart rate, reducing cardiac output and BP ✓ Stimulates digestion (secretion of digestive enzymes)
✓ Opens sphincters
✓ Constricts pupils (accommodation for close focus)
✓ Secretomotor to glands (salivary, lacrimal)

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6
Q

VAGUS

A

✓ The parasympathetic innervation of the thoracic viscera is by the 10th cranial nerve, vagus
✓ Vagus leaves cranial cavity through jugular foramen, descends between internal jugular vein and internal (then common) carotid artery

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7
Q

right vagus

A

✓ Right vagus enters the thoracic cavity between the right subclavian artery and Brachiocephalic vein

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8
Q

left vagus

A

✓ Left vagus enters the thoracic cavity posterior to the left Brachiocephalic vein, between the subclavian and common carotid arteries

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9
Q

right recurrent laryngeal nerve

A

winds around right subclavian artery

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10
Q

left recurrent laryngeal nerve

A

winds around the aortic arch (aortopulmonary window), just posterolateral to the ligamentum arteriosum

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11
Q

✓ Recurrent laryngeal nerves supply

A

− Intrinsic laryngeal muscles (Except 1)
− Middle and inferior pharyngeal constrictor muscles
− sensory to the laryngeal cavity below the level of the vocal folds

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12
Q

SYMPATHETIC SYSTEM

A

✓ It prepares the body to “Fight or flight” situations → body uses energy
✓ Increases heart rate and strength of heart beat
✓ Dilates coronary arteries (indirectly, by local metabolic factors)
✓ Constricts peripheral arteries
✓ Relaxes bronchial smooth muscles (Increases respiratory efficiency)
✓ Closes sphincters
✓ Controls body temperature (blood vessels, sweat glands)

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13
Q

(THORACOLUMBAR OUTFLOW) ✓ Preganglionic cell bodies

A

lie in the intermediolateral horn of T1-L2 spinal cord segments

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14
Q

(THORACOLUMBAR OUTFLOW) ✓ Postganglionic cell bodies

A

lie either in paravertebral sympathetic ganglia
− Anterior to the neck of the ribs→lateral aspect of the vertebral bodies
− Covered by the parietal pleura
−Interconnected→sympathetic chain (sympathetic trunk)

OR

✓ Postganglionic cell bodies lie in prevertebral sympathetic ganglia
− around the origins of branches of abdominal aorta

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15
Q

✓ Number of paravertebral sympathetic ganglia

A

− Superior (C1-4), middle (C5-6) and inferior (C7-8) cervical ganglia
− Inferior cervical+T1→Stellate Ganglion (cervicothoracic ganglion) (C7-T1)

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16
Q

four routes for sympathetic synapse - Synapse at its level

A

• Postganglionic axons (unmyelinated, grey) pass in the GRC and join T1-L2 Spinal nerves

17
Q

four routes for sympathetic synapse - Travel up the chain to synapse in a cervical ganglion

A

• Postganglionic axons

pass in the GRC and join cervical spinal nerves

18
Q

four routes for sympathetic synapse - Travel down the chain to synapse in a lumbar/sacral ganglion

A

• Postganglionic axons

pass in the GRC and join lumbar/sacral spinal nerves

19
Q

four routes for sympathetic synapse - Preganglionic branches pass through the sympathetic trunk without synapsing

A
  • Travel in splanchnic nerves to the abdomen
  • Synapse in a prevertebral ganglion
  • Supply abdominal viscera
20
Q

✓ Thoracic splanchnic nerves

A
  • Greater splanchnic nerve: T5-9
  • Lesser splanchnic nerve: T10-11
  • Least splanchnic nerve: T12
21
Q

other types of splanchnic nerves (preganglionic autonomic(sympathetic) nerve )

A

✓ Lumbar splanchnic nerves

✓ Pelvic splanchnic nerves

22
Q

✓ Sympathetics of the head

A

from T1 - T3 segments

23
Q

✓ Sympathetics of the upper limb

A

from T4 - T6 segments

24
Q

✓ Sympathetics of the thoracic and abdominal walls

A

from T1 - T12 segments

25
Q

✓ Sympathetics of the lower limb

A

from T12 to L2 segments

26
Q

autonomic or visceral plexuses in the thorax, abdomen or pelvis

A

✓ Sympathetic and parasympathetic fibres mix

27
Q

• Cardiac plexus

A

Anterior to the bifurcation of the trachea and

posterior to the ascending aorta

28
Q

• Pulmonary plexus:

A

Anterior and (mainly) posterior to the roots of the lungs

29
Q

• Oesophageal plexus:

A

Around the oesophagus

30
Q

CARDIAC PLEXUS

A

✓ Sympathetics from T1-5 → T1-5 ganglia + inferior and middle cervical ganglia
− Visceral afferent fibres travel alongside the sympathetic nerves
− Referred pain from heart to T1 /T2 dermatomes (medial aspect of left arm) +T3-5
✓ Parasympathetics from vagus

31
Q

PULMONARY PLEXUS

A

✓ Sympathetics from T2-4 → T2-4 ganglia

✓ Parasympathetics from vagus

32
Q

PHRENIC NERVE

A

✓Sole motor supply to the diaphragm
✓Also supplies sensory fibres to ✓the mediastinal parietal
pleura
✓parietal pericardium
✓peritoneum and pleura related to the central tendon of the diaphragm

33
Q

INTERCOSTAL NERVES

A

✓ Anterior rami of the thoracic spinal nerves
✓ Mixed nerves
– Motor branches to intercostal and abdominal wall muscles
– Visceromotor branches to vessels
– Lateral cutaneous branch
– Anterior cutaneous branch

34
Q

PANCOAST’S TUMOUR

A

Tumour at the apex of the lung may affect the sympathetic trunk or stellate ganglion, compromising sympathetic supply to the head and neck on the same side

35
Q

Horner’s syndrome

A
  • Ptosis (drooping) of the upper eyelid • Pupillary constriction (miosis)
  • Anhydrosis (lack of sweating)
  • Flushing of the face

Y2S1 CARDIO. (47 decks)

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