Quiz 6: Sympathetics Flashcards
1
Q
Where are sympathetic preganglionic cell bodies located?
A
Lateral horn of cord levels T1-L2 or L3
2
Q
Where do the preganglionic sympathetic neurons exit the cord?
A
Anterior rootlets
3
Q
After exiting the anterior rootlets, what do the preganglionic sympathetic neurons follow?
A
Anterior primary ramus
4
Q
After exiting the anterior primary ramus, where do preganglionic sympathetics travel?
A
Enter the sympathetic trunk via white ramus communicans
5
Q
Most preganglionic sympathetics synapse on what?
A
Postganglionic cells in ganglia of the sympathetic trunk
6
Q
Some preganglionic sympathetic fibers will pass through the sympathetic trunk to be carried in _________ _______.
A
Splanchnic nerves
7
Q
Where do the splanchnic nerves synapse?
A
Prevertebral plexuses associated with abdominopelvic viscera.
8
Q
Preganglionic sympathetic fibers release what neurotransmitter?
A
ACH
9
Q
What does the sympathetic trunk consist of?
A
Two paravertebral columns of interconnected ganglia
10
Q
T/F: The sympathetic trunk carries ascending and descending fibers?
A
True
11
Q
The sympathetic trunk extends from what to what?
A
Superior cervical ganglion inferior to ganglion impar
12
Q
How many ganglia typically exist in each trunk?
A
21 or 22
13
Q
How many cervical ganglia exist in each trunk?
A
3
14
Q
How many thoracic ganglia exist in each trunk?
A
11
15
Q
How many lumbar ganglia exist in each trunk?
A
4
16
Q
How many sacral ganglia exist in each trunk?
A
4
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.
18
Q
In the cervical area, where is the sympathetic trunk located?
A
Posterior to carotid sheath
19
Q
In the upper thoracic area, where is the sympathetic trunk located?
A
Anterior to the necks of the ribs
20
Q
T/F: The sympathetic trunks become more laterally located inferiorly.
A
False, the sympathetic trunks become more medially located inferiorly.
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
22
Q
In the sacral area, where is the sympathetic trunk located?
A
Anterior aspect of the sacrum
23
Q
Where do the sympathetic trunks join?
A
At the level of the coccyx
24
Q
What three structures does the sympathetic trunk lie between in the cervical area?
A
Carotid sheath, longus colli and longus capitis muscles
25
How many white rami communicans exist in the cervical sympathetic trunk and ganglia?
0
26
How many gray rami communicans exist in the cervical sympathetic trunk and ganglia?
All (One for every cervical nerve)
27
What are the 3 cervical ganglia?
Superior, Middle and Inferior Cervical Ganglia
28
What is the largest cervical sympathetic ganglion?
Superior
29
The superior cervical ganglion is formed by the union of how many upper cervical ganglia?
Four
30
At what vertebral level is the superior cervical ganglion located?
C2-C3 (between carotid sheath and longus capitis m.)
31
Postganglionic fibers of the superior cervical ganglion may be distributed in what three branches?
Anterior, Medial or Lateral branches.
32
Lateral branches of the Superior Cervical Ganglion are the _______ rami communicans.
Gray
33
The lateral branches of the superior cervical ganglion communicate with what?
- Anterior primary rami of C1-C4
| - Cranial nerves (IX, X, XII)
34
Medial branches of the superior cervical ganglion travel where?
Larynx, pharynx and heart
35
What are the branches to the heart from the medial branches of the superior cervical ganglion called?
Superior Cardiac Nerves
36
What type of info do the superior cardiac nerves carry?
Efferent only
37
Anterior branches of the Superior Cervical Ganglion follow what structures and innervate what?
1. ) Follow: Common and External Carotid Arteries
| 2. ) Innervate: Vessels that supply blood to structures inside and outside the skull
38
What cervical ganglion is the smallest?
Middle Cervical Ganglion
39
At which vertebral level is the middle cervical ganglion located?
C6
40
The Middle Cervical Ganglion communicates with the anterior primary rami of ___ and ____ nerves via ______ rami communicans.
C5 and C6 nerves; Gray rami communicans
41
Thyroid branches of the middle cervical ganglion reach what?
Thyroid and Parathyroid glands
42
T/F: The thyroid branches of the middle cervical ganglion are primarily vasomotor.
True
43
Cardiac branches off of the middle cervical ganglion make up the ______ _______ nerves.
Middle Cardiac Nerves
44
The middle cardiac nerves contribute to what?
Deep part of the cardiac plexus
45
The inferior cervical ganglion lies at the level of what?
C7 transverse process and neck of the first rib
46
What does the inferior cervical ganglion communicate with?
Anterior primary rami of C7 and C8 (also T1 if fused to form stellate ganglion) nerves via gray rami communicans
47
Cardiac branches of the inferior cervical ganglion travel to the heart as what?
Inferior cardiac nerves
48
Branches from the inferior cervical ganglion are sent to the _________ artery and form plexuses around it and its branches.
Subclavian Artery
49
What are the main branches of the subclavian artery that the inferior cervical ganglion branches form plexuses around?
Axillary Artery and Vertebral Artery
50
Usually there are ___ thoracic ganglia, sometimes ___.
11, 12
51
T/F: All 12 thoracic nerves have a gray rami communicans and a white rami communicans.
True
52
In the superior thorax, thoracic ganglia are located anterior to what?
Rib heads
53
In the lower part of the thorax, thoracic ganglia are located on the lateral aspect of what?
Vertebral bodies
54
Branches from the upper five thoracic ganglia travel _______ and supply structures in the thoracic cavity.
Medially
55
What types of fibers are carried in the upper five thoracic ganglia branches?
Postganglionic fibers and visceral afferents
56
Three splanchnic nerves are associated with the lower ______(how many?) segments of the thoracic sympathetic trunk.
Seven
57
The three splanchnic nerves carry what type of info?
Preganglionic fibers & visceral afferent fibers
58
Where do the three splanchnic nerves carry preganglionic fibers?
Abdominal and pelvic cavities
59
The Greater Splanchnic Nerve is formed from the _____ through _____ ganglia.
5th through 9th
60
The Greater Splanchnic Nerve terminates in the ______ ganglion.
Celiac
61
The Lesser Splanchnic Nerve is formed by fibers from the _____ and _____ OR ______ and ______ ganglia.
9th and 10th
OR
10th and 11th
62
The Lesser Splanchnic Nerve ends in the _________ ganglion.
Aorticorenal
63
The least Splanchnic nerve is formed by fibers from the ____ ganglion and terminates in the ______ plexus.
12th, Renal Plexus
64
The lumbar sympathetic trunks lie in what?
Retroperitoneal Space, on the lateral aspects of the lumbar vertebral bodies
65
There are usually ___ lumbar ganglia.
4
66
The first two, and sometimes third, lumbar nerves have a _______________ that carries preganglionic axons into the sympathetic trunk.
White Ramus Communicans
67
T/F: Only the first three lumbar nerves have a gray ramus communicans.
False, all 5 have a gray ramus communicans.
68
Two to Four lumbar splanchnic nerves carry preganglionic axons to the plexus surrouding what?
Abdominal aorta
69
Where do the sacral sympathetic trunks lie?
On the anterior aspect of the sacrum, medial to the anterior sacral foramina
70
How many sacral ganglia are present?
four or five
71
T/F: Gray rami communicans are associated with each sacral nerve and the coccygeal nerve.
True
72
The two sympathetic trunks travel medially as they descend and meet to form the _______ ________ on the anterior surface of the coccyx.
Ganglion impar
73
Preganglionic axons travel from the ____ to ____ cord levels to enter the sympathetic trunk.
T1 to L2
74
T/F: the Preganglionic axons may ascend to higher levels of the trunk or descend to lower levels of the trunk.
True
75
Generally, fibers from the __ to __ levels of the cord will ascend and fibers from ___ to ___ levels will descend.
T1 - T5 ascend
| T5 - L2 descend
76
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 _____ _____ _____.
T1 and T2 nerves
| Superior Cervical Ganglion
77
Axons that influence the heart arise from ___ to ___ levels. Most will _______ to one of the three cervical ganglia. Some will pass directly to the _____.
T1-T4
ascend
heart
78
Axons carrying information that influences the lungs leaves the cord in the __-__ nerves.
T2-T4
79
Preganglionic fibers carrying information for the upper extremities are carried in the __-__ nerves.
T3-T7
80
After entering the sympathetic trunk, the upper extremity preganglionic fibers ascend to the ______ and ______ ganglia where they will synapse.
middle cervical & inferior cervical/stellate
81
Fibers that influence the abdominal viscera arise from the __-__ levels. They may synapse in _______ ganglia.
T5-T12, lower thoracic
82
The fibers that influence the abdominal viscera may also pass through the sympathetic trunk to be carried, primarily by what?
Greater, Lesser, and Least Splanchnic Nerves
83
Fibers that influence the pelvic viscera arise from the __-__ levels. They will descend to ganglia where?
T10-L2
| Lower thoracic, lumbar and pelvic areas
84
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?
T10-L2
| Second Lumbar through Fourth Sacral Ganglia
85
Fibers are carried in the sympathetic trunk in three ways:
1. ?
2. ?
3. ?
1. Nerves
2. Blood Vessels
3. Direct Branches (to visceral organs)
86
T/F: Virtually all nerves carry postganglionic sympathetic fibers.
True
87
Within the field of distribution for each nerve, postganglionic sympathetic fibers will carry what info?
1.
2.
3.
1. Vasoconstrictor
2. Sudomotor
3. Motor to the arrector pili
88
Direct branches to the viscera likely play what role in fight or flight?
1. Constrict blood vessels
2. Dilate bronchial tree
3. Stimulate glandular secretion
4. Dilate the pupils
5. Inhibit digestive activity
89
Superior cervical ganglion sends branches to what cranial nerves (branches)?
1. Glossopharyngeal N.
2. Vagus N.
a. recurrent laryngeal n.
b. auricular n.
3. Hypoglossal N.
90
What are the three branches from the cervical sympathetic trunk that accompany blood vessels?
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
T/F: The internal carotid nerve (branch from the superior cervical ganglion) enters the cranial cavity with the internal carotid artery
True
92
The internal carotid nerve divides into what?
Lateral and Medial branches
93
The lateral internal carotid nerve forms what?
Internal carotid plexus
94
T/F: Many branches of the lateral internal carotid nerve will terminate on blood vessels outside of the skull.
False, most will terminate on blood vessels inside of the skull.
95
Communication with the __________ __________ allows postganglionic sympathetic fibers to reach any structure within the field of distribution of the trigeminal nerve.
Trigeminal Ganglion
96
Abducens Nerve will supply blood vessels in the ______ ______.
Lateral Rectus (LR6)
97
Postganglionic fibers of the lateral internal carotid nerve form the ________ _______ nerve, which combines with the _______ ________ nerve to form the nerve of the pterygoid canal.
Deep Petrosal
| Greater Petrosal
98
The nerve of the pterygoid canal supplies what?
lacrimal, nasal, palatine, and some pharyngeal glands
99
_____________ nerves combine with the tympanic branch of the glossopharyngeal nerve to form the tympanic plexus.
Caroticotympanic nerves
100
Caroticotympanic nerves supply what?
Glands and blood vessels of the middle ear (Harvey Lillard?)
101
The medial internal carotid nerve forms the __________ plexus.
Cavernous plexus
102
The cavernous plexus is located within the cavernous sinus, alongside the _____ ________.
sella turcica
103
Fibers of the medial internal carotid nerve travel through the ________ _________ to reach the eyeball.
Ciliary Ganglion
104
What do the fibers of the medial internal carotid nerve that travel through the ciliary ganglion to the eyeball supply?
Ciliaris and dilator pupillae muscles as well as some tarsus muscles of the upper eyelid
105
Other branches of the medial internal carotid nerve travel to the _________ nerves to reach blood vessels associated with muscles supplied by the nerve.
Oculomotor
106
The _______ nerve supplies blood vessels in the superior oblique.
Trochlear Nerve (SO4)
107
Branches of the medial internal carotid nerve to the Opthalamic Division of the trigeminal nerve supply what?
Arrector pili, sweat glands, and blood vessels in the field of distribution of the opthalamic division.
108
The _______ gland also receives some fibers from the medial internal carotid nerve.
Pituitary
109
What are the branches from the cervical sympathetic trunk that travel directly to visceral structures?
1. ) Laryngeopharyngeal branches from superior cervical ganglion
2. ) Cardiac branches from each cervical ganglia
110
The laryngeopharyngeal nerve form the ________ plexus along with fibers from the ___________ & _______ nerves as well as the _________ plexus.
- Pharyngeal plexus
- Glossopharyngeal and Vagus Nerves
- Laryngeal plexus
111
Both pharyngeal and laryngeal plexuses supply what?
blood vessels and glands
112
Cardiac branches accompany branches of the _____ nerve through the cardiac plexus to the _______ ______.
- Vagus
| - Sinoatrial Node
113
Sympathetic stimulation will ________ heart rate and _______ coronary arteries.
Increase
| Dilate
114
A gray ramus communicans is associated with each thoracic nerve and will supply what in the field of distribution of each thoracic nerve?
- arrector pili
- sweat glands
- blood vessels
115
Ganglia __ - __ send postganglionic fibers to the thoracic aorta.
1-5
116
Branches from the thoracic sympathetic trunk that travel directly to visceral structures are?
1. Cardiac branches
| 2. Pulmonary branches
117
Thoracic Cardiac branches extend to the heart from the ___ - __ ganglia. They pass through the ________ plexus.
T2-T4, cardiac plexus
118
What is the function of the thoracic cardiac branches?
Increase HR
Dilate coronary arteries
Afferents as well
119
Pulmonary branches are emiited from the __-__ ganglia and travel through the __________ plexus.
T2-T4, pulmonary plexus
120
What do the pulmonary branches supply?
pleura, smooth muscle, and blood vessels of the lungs as well as the bronchial glands
121
T/F: pulmonary sympathetics cause bronchial constriction.
False, they cause bronchial dilation and pulmonary blood vessel constriction.
122
T/F: For asthmatics, inhalers mimic sympathetic stimulation.
True
123
The Greater Splanchnic Nerve contains fibers from the __-__ or __ ganglia.
T5-T9 or T10
124
Greater Splanchnic Nerve fibers supply what?
Esophagus and thoracic aorta above the diaphragm.
125
Fibers of the Greater Splanchnic Nerve are also transmitted through which plexuses via the celiac plexus to reach much of the abdominal viscera?
- gastric plexus
- hepatic plexus
- superior mesenteric plexus
126
The lesser splanchnic nerve contains fibers from __ or __-__ ganglia.
T9 or T10-T11
127
The lesser splanchnic nerve fibers reach some of the same abdominal structures that the greater splanchnic nerve supplies with the addition of the _________ _______.
Suprarenal glands
128
The least splanchnic nerve contains postganglionic fibers from the lowest thoracic ganglia. These fibers reach the _______ through the _______ plexus.
Kidneys, renal plexus
129
A gray ramus communicans is associated with each lumbar nerve and will supply what in the field of distribution of each lumbar nerve?
- arrector pili
- sweat glands
- blood vessels
130
__________ branches are given off the lumbar sympathetic trunk that follow the lumbar arteries back to the abdominal aorta.
Vascular branches
131
The vascular branches follow the abdominal aorta as far as the _______ _______ artery and the _______ ______ arteries.
median sacral artery
| common iliac arteries
132
Lumbar Splanchnic nerves supply pelvic viscera via what three plexuses?
1. ) Superior hypogastric
2. ) Inferior hypogastric
3. ) Inferior mesenteric
133
A gray ramus communicans is associated with each sacral nerve and will supply what in the field of distribution of each sacral nerve?
- arrector pili
- sweat glands
- blood vessels
134
Vascular branches are given off the sacral sympathetic trunk that follow the ________ _______ artery.
Median sacral artery
135
Sacral splanchnic nerves supply the pelvic viscera via the ______ _______ plexus.
Inferior mesenteric
136
Fibers supplying the _______ and the _______ pass directly to these structures via the sacral splanchnic nerves.
Ureters and rectum
