Quiz 6: Sympathetics Flashcards

1
Q

Where are sympathetic preganglionic cell bodies located?

A

Lateral horn of cord levels T1-L2 or L3

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2
Q

Where do the preganglionic sympathetic neurons exit the cord?

A

Anterior rootlets

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3
Q

After exiting the anterior rootlets, what do the preganglionic sympathetic neurons follow?

A

Anterior primary ramus

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4
Q

After exiting the anterior primary ramus, where do preganglionic sympathetics travel?

A

Enter the sympathetic trunk via white ramus communicans

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5
Q

Most preganglionic sympathetics synapse on what?

A

Postganglionic cells in ganglia of the sympathetic trunk

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6
Q

Some preganglionic sympathetic fibers will pass through the sympathetic trunk to be carried in _________ _______.

A

Splanchnic nerves

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7
Q

Where do the splanchnic nerves synapse?

A

Prevertebral plexuses associated with abdominopelvic viscera.

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8
Q

Preganglionic sympathetic fibers release what neurotransmitter?

A

ACH

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9
Q

What does the sympathetic trunk consist of?

A

Two paravertebral columns of interconnected ganglia

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10
Q

T/F: The sympathetic trunk carries ascending and descending fibers?

A

True

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11
Q

The sympathetic trunk extends from what to what?

A

Superior cervical ganglion inferior to ganglion impar

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12
Q

How many ganglia typically exist in each trunk?

A

21 or 22

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13
Q

How many cervical ganglia exist in each trunk?

A

3

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14
Q

How many thoracic ganglia exist in each trunk?

A

11

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15
Q

How many lumbar ganglia exist in each trunk?

A

4

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16
Q

How many sacral ganglia exist in each trunk?

A

4

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17
Q

What exists when the inferior cervical and superior thoracic ganglion combine?

A

Stellate ganglion, and therefore 21 ganglia in sympathetic trunk instead of 22.

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18
Q

In the cervical area, where is the sympathetic trunk located?

A

Posterior to carotid sheath

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19
Q

In the upper thoracic area, where is the sympathetic trunk located?

A

Anterior to the necks of the ribs

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20
Q

T/F: The sympathetic trunks become more laterally located inferiorly.

A

False, the sympathetic trunks become more medially located inferiorly.

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21
Q

Where is the sympathetic trunk located in the lower thoracic and lumbar regions?

A

Resting on the lateral aspect of the vertebral bodies

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22
Q

In the sacral area, where is the sympathetic trunk located?

A

Anterior aspect of the sacrum

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23
Q

Where do the sympathetic trunks join?

A

At the level of the coccyx

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24
Q

What three structures does the sympathetic trunk lie between in the cervical area?

A

Carotid sheath, longus colli and longus capitis muscles

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25
Q

How many white rami communicans exist in the cervical sympathetic trunk and ganglia?

A

0

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26
Q

How many gray rami communicans exist in the cervical sympathetic trunk and ganglia?

A

All (One for every cervical nerve)

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27
Q

What are the 3 cervical ganglia?

A

Superior, Middle and Inferior Cervical Ganglia

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28
Q

What is the largest cervical sympathetic ganglion?

A

Superior

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29
Q

The superior cervical ganglion is formed by the union of how many upper cervical ganglia?

A

Four

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30
Q

At what vertebral level is the superior cervical ganglion located?

A

C2-C3 (between carotid sheath and longus capitis m.)

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31
Q

Postganglionic fibers of the superior cervical ganglion may be distributed in what three branches?

A

Anterior, Medial or Lateral branches.

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32
Q

Lateral branches of the Superior Cervical Ganglion are the _______ rami communicans.

A

Gray

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33
Q

The lateral branches of the superior cervical ganglion communicate with what?

A
  • Anterior primary rami of C1-C4

- Cranial nerves (IX, X, XII)

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34
Q

Medial branches of the superior cervical ganglion travel where?

A

Larynx, pharynx and heart

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35
Q

What are the branches to the heart from the medial branches of the superior cervical ganglion called?

A

Superior Cardiac Nerves

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36
Q

What type of info do the superior cardiac nerves carry?

A

Efferent only

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37
Q

Anterior branches of the Superior Cervical Ganglion follow what structures and innervate what?

A
  1. ) Follow: Common and External Carotid Arteries

2. ) Innervate: Vessels that supply blood to structures inside and outside the skull

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38
Q

What cervical ganglion is the smallest?

A

Middle Cervical Ganglion

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39
Q

At which vertebral level is the middle cervical ganglion located?

A

C6

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40
Q

The Middle Cervical Ganglion communicates with the anterior primary rami of ___ and ____ nerves via ______ rami communicans.

A

C5 and C6 nerves; Gray rami communicans

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41
Q

Thyroid branches of the middle cervical ganglion reach what?

A

Thyroid and Parathyroid glands

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42
Q

T/F: The thyroid branches of the middle cervical ganglion are primarily vasomotor.

A

True

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43
Q

Cardiac branches off of the middle cervical ganglion make up the ______ _______ nerves.

A

Middle Cardiac Nerves

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44
Q

The middle cardiac nerves contribute to what?

A

Deep part of the cardiac plexus

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45
Q

The inferior cervical ganglion lies at the level of what?

A

C7 transverse process and neck of the first rib

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46
Q

What does the inferior cervical ganglion communicate with?

A

Anterior primary rami of C7 and C8 (also T1 if fused to form stellate ganglion) nerves via gray rami communicans

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47
Q

Cardiac branches of the inferior cervical ganglion travel to the heart as what?

A

Inferior cardiac nerves

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48
Q

Branches from the inferior cervical ganglion are sent to the _________ artery and form plexuses around it and its branches.

A

Subclavian Artery

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49
Q

What are the main branches of the subclavian artery that the inferior cervical ganglion branches form plexuses around?

A

Axillary Artery and Vertebral Artery

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50
Q

Usually there are ___ thoracic ganglia, sometimes ___.

A

11, 12

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51
Q

T/F: All 12 thoracic nerves have a gray rami communicans and a white rami communicans.

A

True

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52
Q

In the superior thorax, thoracic ganglia are located anterior to what?

A

Rib heads

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53
Q

In the lower part of the thorax, thoracic ganglia are located on the lateral aspect of what?

A

Vertebral bodies

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54
Q

Branches from the upper five thoracic ganglia travel _______ and supply structures in the thoracic cavity.

A

Medially

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55
Q

What types of fibers are carried in the upper five thoracic ganglia branches?

A

Postganglionic fibers and visceral afferents

56
Q

Three splanchnic nerves are associated with the lower ______(how many?) segments of the thoracic sympathetic trunk.

A

Seven

57
Q

The three splanchnic nerves carry what type of info?

A

Preganglionic fibers & visceral afferent fibers

58
Q

Where do the three splanchnic nerves carry preganglionic fibers?

A

Abdominal and pelvic cavities

59
Q

The Greater Splanchnic Nerve is formed from the _____ through _____ ganglia.

A

5th through 9th

60
Q

The Greater Splanchnic Nerve terminates in the ______ ganglion.

A

Celiac

61
Q

The Lesser Splanchnic Nerve is formed by fibers from the _____ and _____ OR ______ and ______ ganglia.

A

9th and 10th
OR
10th and 11th

62
Q

The Lesser Splanchnic Nerve ends in the _________ ganglion.

A

Aorticorenal

63
Q

The least Splanchnic nerve is formed by fibers from the ____ ganglion and terminates in the ______ plexus.

A

12th, Renal Plexus

64
Q

The lumbar sympathetic trunks lie in what?

A

Retroperitoneal Space, on the lateral aspects of the lumbar vertebral bodies

65
Q

There are usually ___ lumbar ganglia.

A

4

66
Q

The first two, and sometimes third, lumbar nerves have a _______________ that carries preganglionic axons into the sympathetic trunk.

A

White Ramus Communicans

67
Q

T/F: Only the first three lumbar nerves have a gray ramus communicans.

A

False, all 5 have a gray ramus communicans.

68
Q

Two to Four lumbar splanchnic nerves carry preganglionic axons to the plexus surrouding what?

A

Abdominal aorta

69
Q

Where do the sacral sympathetic trunks lie?

A

On the anterior aspect of the sacrum, medial to the anterior sacral foramina

70
Q

How many sacral ganglia are present?

A

four or five

71
Q

T/F: Gray rami communicans are associated with each sacral nerve and the coccygeal nerve.

A

True

72
Q

The two sympathetic trunks travel medially as they descend and meet to form the _______ ________ on the anterior surface of the coccyx.

A

Ganglion impar

73
Q

Preganglionic axons travel from the ____ to ____ cord levels to enter the sympathetic trunk.

A

T1 to L2

74
Q

T/F: the Preganglionic axons may ascend to higher levels of the trunk or descend to lower levels of the trunk.

A

True

75
Q

Generally, fibers from the __ to __ levels of the cord will ascend and fibers from ___ to ___ levels will descend.

A

T1 - T5 ascend

T5 - L2 descend

76
Q

Axons that carry information that will be relayed to the head and neck are carried in the ____ and ____ nerves. They ascend to and synapse in the _____ _____ _____.

A

T1 and T2 nerves

Superior Cervical Ganglion

77
Q

Axons that influence the heart arise from ___ to ___ levels. Most will _______ to one of the three cervical ganglia. Some will pass directly to the _____.

A

T1-T4
ascend
heart

78
Q

Axons carrying information that influences the lungs leaves the cord in the __-__ nerves.

A

T2-T4

79
Q

Preganglionic fibers carrying information for the upper extremities are carried in the __-__ nerves.

A

T3-T7

80
Q

After entering the sympathetic trunk, the upper extremity preganglionic fibers ascend to the ______ and ______ ganglia where they will synapse.

A

middle cervical & inferior cervical/stellate

81
Q

Fibers that influence the abdominal viscera arise from the __-__ levels. They may synapse in _______ ganglia.

A

T5-T12, lower thoracic

82
Q

The fibers that influence the abdominal viscera may also pass through the sympathetic trunk to be carried, primarily by what?

A

Greater, Lesser, and Least Splanchnic Nerves

83
Q

Fibers that influence the pelvic viscera arise from the __-__ levels. They will descend to ganglia where?

A

T10-L2

Lower thoracic, lumbar and pelvic areas

84
Q

Preganglionic fibers carrying info. for the lower extremities are carried in the __-__ nerves. These fibers will descend in the sympathetic trunk to synapse with which ganglia?

A

T10-L2

Second Lumbar through Fourth Sacral Ganglia

85
Q

Fibers are carried in the sympathetic trunk in three ways:

  1. ?
  2. ?
  3. ?
A
  1. Nerves
  2. Blood Vessels
  3. Direct Branches (to visceral organs)
86
Q

T/F: Virtually all nerves carry postganglionic sympathetic fibers.

A

True

87
Q

Within the field of distribution for each nerve, postganglionic sympathetic fibers will carry what info?
1.
2.
3.

A
  1. Vasoconstrictor
  2. Sudomotor
  3. Motor to the arrector pili
88
Q

Direct branches to the viscera likely play what role in fight or flight?

A
  1. Constrict blood vessels
  2. Dilate bronchial tree
  3. Stimulate glandular secretion
  4. Dilate the pupils
  5. Inhibit digestive activity
89
Q

Superior cervical ganglion sends branches to what cranial nerves (branches)?

A
  1. Glossopharyngeal N.
  2. Vagus N.
    a. recurrent laryngeal n.
    b. auricular n.
  3. Hypoglossal N.
90
Q

What are the three branches from the cervical sympathetic trunk that accompany blood vessels?

A
  1. Internal Carotid Nerve: Branch from superior cervical ganglion travels with the Internal Carotid Nerve
  2. Branches accompanying the inferior thyroid artery from middle cervical ganglion.
  3. Branches from the inferior cervical/stellate ganglion reach the subclavian artery to reach the upper extremity via the axillary and brachial arteries.
91
Q

T/F: The internal carotid nerve (branch from the superior cervical ganglion) enters the cranial cavity with the internal carotid artery

A

True

92
Q

The internal carotid nerve divides into what?

A

Lateral and Medial branches

93
Q

The lateral internal carotid nerve forms what?

A

Internal carotid plexus

94
Q

T/F: Many branches of the lateral internal carotid nerve will terminate on blood vessels outside of the skull.

A

False, most will terminate on blood vessels inside of the skull.

95
Q

Communication with the __________ __________ allows postganglionic sympathetic fibers to reach any structure within the field of distribution of the trigeminal nerve.

A

Trigeminal Ganglion

96
Q

Abducens Nerve will supply blood vessels in the ______ ______.

A

Lateral Rectus (LR6)

97
Q

Postganglionic fibers of the lateral internal carotid nerve form the ________ _______ nerve, which combines with the _______ ________ nerve to form the nerve of the pterygoid canal.

A

Deep Petrosal

Greater Petrosal

98
Q

The nerve of the pterygoid canal supplies what?

A

lacrimal, nasal, palatine, and some pharyngeal glands

99
Q

_____________ nerves combine with the tympanic branch of the glossopharyngeal nerve to form the tympanic plexus.

A

Caroticotympanic nerves

100
Q

Caroticotympanic nerves supply what?

A

Glands and blood vessels of the middle ear (Harvey Lillard?)

101
Q

The medial internal carotid nerve forms the __________ plexus.

A

Cavernous plexus

102
Q

The cavernous plexus is located within the cavernous sinus, alongside the _____ ________.

A

sella turcica

103
Q

Fibers of the medial internal carotid nerve travel through the ________ _________ to reach the eyeball.

A

Ciliary Ganglion

104
Q

What do the fibers of the medial internal carotid nerve that travel through the ciliary ganglion to the eyeball supply?

A

Ciliaris and dilator pupillae muscles as well as some tarsus muscles of the upper eyelid

105
Q

Other branches of the medial internal carotid nerve travel to the _________ nerves to reach blood vessels associated with muscles supplied by the nerve.

A

Oculomotor

106
Q

The _______ nerve supplies blood vessels in the superior oblique.

A

Trochlear Nerve (SO4)

107
Q

Branches of the medial internal carotid nerve to the Opthalamic Division of the trigeminal nerve supply what?

A

Arrector pili, sweat glands, and blood vessels in the field of distribution of the opthalamic division.

108
Q

The _______ gland also receives some fibers from the medial internal carotid nerve.

A

Pituitary

109
Q

What are the branches from the cervical sympathetic trunk that travel directly to visceral structures?

A
  1. ) Laryngeopharyngeal branches from superior cervical ganglion
  2. ) Cardiac branches from each cervical ganglia
110
Q

The laryngeopharyngeal nerve form the ________ plexus along with fibers from the ___________ & _______ nerves as well as the _________ plexus.

A
  • Pharyngeal plexus
  • Glossopharyngeal and Vagus Nerves
  • Laryngeal plexus
111
Q

Both pharyngeal and laryngeal plexuses supply what?

A

blood vessels and glands

112
Q

Cardiac branches accompany branches of the _____ nerve through the cardiac plexus to the _______ ______.

A
  • Vagus

- Sinoatrial Node

113
Q

Sympathetic stimulation will ________ heart rate and _______ coronary arteries.

A

Increase

Dilate

114
Q

A gray ramus communicans is associated with each thoracic nerve and will supply what in the field of distribution of each thoracic nerve?

A
  • arrector pili
  • sweat glands
  • blood vessels
115
Q

Ganglia __ - __ send postganglionic fibers to the thoracic aorta.

A

1-5

116
Q

Branches from the thoracic sympathetic trunk that travel directly to visceral structures are?

A
  1. Cardiac branches

2. Pulmonary branches

117
Q

Thoracic Cardiac branches extend to the heart from the ___ - __ ganglia. They pass through the ________ plexus.

A

T2-T4, cardiac plexus

118
Q

What is the function of the thoracic cardiac branches?

A

Increase HR
Dilate coronary arteries
Afferents as well

119
Q

Pulmonary branches are emiited from the __-__ ganglia and travel through the __________ plexus.

A

T2-T4, pulmonary plexus

120
Q

What do the pulmonary branches supply?

A

pleura, smooth muscle, and blood vessels of the lungs as well as the bronchial glands

121
Q

T/F: pulmonary sympathetics cause bronchial constriction.

A

False, they cause bronchial dilation and pulmonary blood vessel constriction.

122
Q

T/F: For asthmatics, inhalers mimic sympathetic stimulation.

A

True

123
Q

The Greater Splanchnic Nerve contains fibers from the __-__ or __ ganglia.

A

T5-T9 or T10

124
Q

Greater Splanchnic Nerve fibers supply what?

A

Esophagus and thoracic aorta above the diaphragm.

125
Q

Fibers of the Greater Splanchnic Nerve are also transmitted through which plexuses via the celiac plexus to reach much of the abdominal viscera?

A
  • gastric plexus
  • hepatic plexus
  • superior mesenteric plexus
126
Q

The lesser splanchnic nerve contains fibers from __ or __-__ ganglia.

A

T9 or T10-T11

127
Q

The lesser splanchnic nerve fibers reach some of the same abdominal structures that the greater splanchnic nerve supplies with the addition of the _________ _______.

A

Suprarenal glands

128
Q

The least splanchnic nerve contains postganglionic fibers from the lowest thoracic ganglia. These fibers reach the _______ through the _______ plexus.

A

Kidneys, renal plexus

129
Q

A gray ramus communicans is associated with each lumbar nerve and will supply what in the field of distribution of each lumbar nerve?

A
  • arrector pili
  • sweat glands
  • blood vessels
130
Q

__________ branches are given off the lumbar sympathetic trunk that follow the lumbar arteries back to the abdominal aorta.

A

Vascular branches

131
Q

The vascular branches follow the abdominal aorta as far as the _______ _______ artery and the _______ ______ arteries.

A

median sacral artery

common iliac arteries

132
Q

Lumbar Splanchnic nerves supply pelvic viscera via what three plexuses?

A
  1. ) Superior hypogastric
  2. ) Inferior hypogastric
  3. ) Inferior mesenteric
133
Q

A gray ramus communicans is associated with each sacral nerve and will supply what in the field of distribution of each sacral nerve?

A
  • arrector pili
  • sweat glands
  • blood vessels
134
Q

Vascular branches are given off the sacral sympathetic trunk that follow the ________ _______ artery.

A

Median sacral artery

135
Q

Sacral splanchnic nerves supply the pelvic viscera via the ______ _______ plexus.

A

Inferior mesenteric

136
Q

Fibers supplying the _______ and the _______ pass directly to these structures via the sacral splanchnic nerves.

A

Ureters and rectum