Phrenic, Vagus, Sympathetic Trunks and Ganglia

Question 1

which cranial nerve is the vagus nerve?

Answer 1

10

Question 2

what sort of nerve fibres are carried by the vagus nerve?

Answer 2

parasympathetic fibres to thoracic and abdominal viscera

Question 3

where does the vagus nerve originate from?

Answer 3

medulla oblongata in the brain stem

Question 4

which blood vessel does the vagus nerve follow out of the skull?

Answer 4

the internal jugular vein

Question 5

which structure in the neck does the vagus nerve pass into?

Answer 5

carotid sheath

in-between internal jugular vein and internal common carotid artery

Question 6

how does the vagus nerve enter the thoracic inlet?

Answer 6

lies in between the venous and arterial planes
posterior to brachiocephalic vein
medial to phrenic nerves

Question 7

at what vertebral level does the vagus nerve leave the thorax? With what structure?

Answer 7

• T10

- oesophagus

Question 8

how does the vagus nerve pass the root/hilum of the lung?

Answer 8

posteriorly

Question 9

how does the R vagus relate to the trachea?

Answer 9

lies lateral

Question 10

how does the R vagus relate to the arch of the azygous vein?

Answer 10

medial to the arch

Question 11

what vessels form plexus at the oesophagus?

Answer 11

L and R vagus nerves

Question 12

which nerve passes on the left side of the aortic arch?

Answer 12

L vagus

Question 13

which arteries is the L vagus related to?

Answer 13

L common carotid, L subclavian

Question 14

the recurrent laryngeal nerves are branches of which nerves?

Answer 14

vagus nerves

Question 15

what autonomic plexuses do both the vagus nerves give preganglionic branches to ?

Answer 15

pulmonary
cardiac
oesophageal

Question 16

what are the sensory and motor innervations of the recurrent laryngeal nerves?

Answer 16

motor to laryngeal muscles

sensory to mucosa below the vocal folds

Question 17

which nerve curves superiorly under the Right subclavian artery?

Answer 17

right recurrent laryngeal

Question 18

what vessel does the left recurrent laryngeal nerve pass under?

Answer 18

arch of the aorta

Question 19

which nerve passes posterior to the ligamentum arteriosum?

Answer 19

L recurrent laryngeal

Question 20

what structures does the L RCLN pass between to reach the larynx?

Answer 20

trachea and oesophagus in a groove

Question 21

which arteries do the RCLNs relate to?

Answer 21

inferior thyroid arteries

Question 22

what surgery hurts the RCLNs and the inferior thyroid arteries at risk? what is the outcome if damaged?

Answer 22

• thyroid surgery

- hoarse voice if damaged

Question 23

a tumour where causes hoarseness of voice?

Answer 23

in left lung

enlarged lymph nodes due to tumour compresses the L RCLN

Question 24

what are the functional units of the nervous system?

Answer 24

neurones specialised for rapid communication

Question 25

what is the sympathetic neurotransmitter?

Answer 25

noradrenaline

Question 26

what is the parasympathetic neurotransmitter?

Answer 26

acetylcholine

Question 27

what are the functions of the sympathetic system on cardiovascular system?

Answer 27

``` increases BP increases heart rate+contraction strength dilates coronary vessels increases respiratory efficiency constricts peripheral circulation inhibits sphincters controls body temperature ```

Question 28

where do preganglionic bodies of the sympathetic system lie?

Answer 28

lateral grey matter of thoracic spinal cord

Question 29

which vertebral levels do primary neurones of preganglionic cell bodies of the sympathetic nervous system arise from?

Answer 29

T1 to L2

Question 30

how is sympathetic outflow described?

Answer 30

thoracolumbar

Question 31

what lies in sympathetic ganglion?

Answer 31

postganglionic cell bodies

Question 32

in what 2 ways are postganglionic cell bodies of sympathetic system distributed?

Answer 32

- hitch hike along somatic nerves/ and or arteries and are distributed widely all over the body - supply adjacent viscera through autonomic plexuses

Question 33

what forms the sympathetic trunks?

Answer 33

2 trunks formed of 2 chains of cell bodies of postganglionic neurones lie alongside all the vertebral bodies atlas to coccyx

Question 34

what are the lengths of sympathetic pre and post ganglionic neurones?

Answer 34

short pre | long post

Question 35

how do sympathetic preganglionic neurones reach the sympathetic trunk?

Answer 35

white rami communicates they either: synapse immediately in adjacent ganglion or travel up or down in trunk to be distributed above and below T1 and L2

Question 36

what is the name of the structure where the sympathetic ganglion fuse?

Answer 36

ganglion impart opposite coccyx

Question 37

what cervical ganglia are there?

Answer 37

superior, middle and inferior

Question 38

what is the stellate ganglion? where is it?

Answer 38

fusion of middle and inferior cervical ganglia | lies on neck of rib 1

Question 39

what pre ganglionic neurones pass straight through trunk to reach abdominal viscera and adrenal gland?

Answer 39

greater: T5-9, coeliac lesser: T10, 11, superior mesenteric least splanchnic nerves: T12, inferior mesenteric

Question 40

what are the three things primary neurones can do when they reach body wall and limbs?

Answer 40

- synapse immediately and secondary neurones pass in GRC to spinal nerve - travel up trunk synapse with cervical ganglion above T1, 2y neurones pass in GRC to cervical spinal nerves - travel down trunk and synapse in a ganglion below L2, 2y neurones pass in GRC to lumbar and sacral spinal nerves

Question 41

what levels does head receive sympathetic innervation from?

Answer 41

T1-T3

Question 42

what level of sympathetic nerves supplies upper limb?

Answer 42

T4-T6

Question 43

what level are the abdominal and thoracic walls sympathetic neurones derived from?

Answer 43

T1-12

Question 44

what is the level of sympathetic innervation to lower limb?

Answer 44

T12- L2

Question 45

where are parasympathetic nerves distributed to?

Answer 45

head neck viscera

Question 46

what preganglioinc cell bodies lie in the CNS?

Answer 46

parasympathetic

Question 47

where do pregnaglionic cell bodies of parasympathetic system lie?

Answer 47

``` cranial= 3,7,9 and 10 sacral= 2,3 ,4 ```

Question 48

how is parasympathetic outflow described?

Answer 48

craniosacral

Question 49

Where do postganglionic parasympathetic cell bodies lie?

Answer 49

special ganglia of the head and neck close to viscera they supply contribute to anatomical plexuses

Question 50

what are the effects of the parasympathetic system?

Answer 50

``` slows breathing and heart rate reduces CO and BP opens sphincters meiosis-constriction of pupils secretomotor to glands ```

Question 51

heart and lungs are supplied by neurones arising between which vertebral levels?

Answer 51

T1-5

Question 52

what do cardiac branches (2y sympathetic neurones)supply?

Answer 52

SA node coronary vessels T1 fibres included

Question 53

where do primary neurones travel to and synapse to provide cardiac branches?

Answer 53

ascend trunk and synapse in T1 and inferior and middle cervical ganglia (stellate)

Question 54

where do cardiac branches (2y sympathetic neurones) emerge from?

Answer 54

cervical part of sympathetic trunk | pass down to the cardiac plexus at the tracheal bifurcation

Question 55

pulmonary sympathetic fibres emerge from which level?

Answer 55

T2-4 | bronchial dilation and bronchial vessels

Question 56

what level do oesophageal sympathetic fibres emerge form?

Answer 56

T4-6

Question 57

neurones originating from T7-9 supply what?

Answer 57

stomach

Question 58

where is a Pancots tumour located?

Answer 58

apex of lung

Question 59

what causes Horners syndrome?

Answer 59

Pancots tumour

Question 60

what does pants tumour affect?

Answer 60

sympathetic trunk | stellate ganglion on neck of 1st rib

Question 61

what is the neurological effect of pants tumour?

Answer 61

compromises sympathetic supply to head and neck on the same side as tumour

Question 62

what are the signs and symptoms of horners syndrome?

Answer 62

Ptosis- upper eyelid dropping mitosis= pupillary constriction anhydrosis= lack of sweating flushing of face