Sympathetics Flashcards
1
Q
Where are sympathetic cell bodies located?
A
lateral horn of T1-L2
2
Q
Where do the fibers of sympathetics exit?
A
exits in anterior rootlets, following the anterior primary ramus
3
Q
Where do the sympathetics end up after exiting the anterior primary ramus?
A
sympathetic trunk via white ramus communicans
4
Q
Most sympathetics will synapse on what and where?
A
postganglionic cells in ganglia of the sympathetic trunk
5
Q
Some preganglionic fibers pass through the sympathetic trunk to be carried in what nerves?
A
splanchnic nerves
6
Q
The splanchnic nerves synapse in what plexuses associated with the abdominopelvic viscera?
A
prevertebral plexuses
7
Q
Preganglionic fibers of the sympathetics release what?
A
acetylcholine
8
Q
Describe the sympathetic trunk
A
it is two paravertebral colummns of interconnected ganglia
carry ascending and descending fibers
extends from superior cervical ganglion inferior to ganglion impar
21 or 22 ganglia in each trunk
9
Q
How many of each trunk are there?
A
3 cervical
11 thoracic
4 lumbar
4 sacral
10
Q
Where is the sympathetic trunk located?
A
posterior to the carotid sheath in the cervical area and anterior to the necks of the ribs in the upper thoracic area
11
Q
When you go inferior, where are the sympathetic trunks located?
A
more medial, resting on the lateral aspect of the vertebral bodies in the lower thoracic in lumbars
12
Q
Where do the sympathetic trunks lie when it comes to the sacrum?
A
anterior aspect of sacrum, eventually joining at the level of the coccyx
13
Q
Where does the cervical sympathetic trunk lie?
A
between the carotid sheath and the longus colli and capitis muscles
14
Q
Are there white ramus communicans in the cervical sympathetic trunk and ganglia?
A
no
15
Q
Are there grey ramus communicans in the cervical sympathetic trunk?
A
yes, each cervical nerve has one
16
Q
How many cervical ganglia are there? What are their names?
A
3, superior, middle and inferior cervical ganglia
17
Q
Which cervical ganglion may fuse with the first thoracic ganglia? What is it called?
A
inferior cervical ganglion
stellate ganglion
18
Q
Which cervical sympathetic ganglia is the largest?
A
superior cervical ganglia
19
Q
What is the superior cervical sympathetic ganglia formed by?
A
the union of the upper 4 cervical ganglia
20
Q
Where is the superior cervical sympathetic ganglia located?
A
at the levle of C2 or 3, between the carotid sheath and the longus capitis muscle
21
Q
Postganglionic fibers of the superior cervical ganglia are distributed in what?
A
anterior, medial or lateral branches
22
Q
Lateral branches of superior cervical ganglia are what kind of ramus?
A
grey ramus communicans
23
Q
What do the lateral branches of the superior cervical ganglia communicate with?
A
anterior primary rami of C1-4 as well as CN IX, X, XIII
24
Q
Medial branches of the superior cervical ganglia go where?
A
larynx, pharynx, and heart
25
what are the branches of the medial branches of the supieror cervical ganglia called? What kind of information do they carry?
superior cardiac nerves
| efferent information only
26
Anterior branches of the supeiror cervical ganglia follow what arteries? What do they innervate
follow the common and external carotid arteries, innervate vessels that supply blood to structures inside and outside the skull
27
Which cervical ganglia is the smallest?
middle cervical sympathetic ganglia
28
Where is the middle cervical ganglia located?
C6
29
What does the middle cervical ganglia communicate with?
anteiror priamry rami of C5 and 6 via grey ramus communicans
30
What are the two branches of the middle cervical ganglia?
thyroid branches and cardiac branches
31
Where do the thyroid branches of the middle cervical ganglia go? What are the primarily?
they go to the thyroid and parathyroid glands
| primarily vasomotor
32
Where do the cardiac branches of the middle cervical ganglia make up? What do they contribute to?
make up the middle cardiac nerves
| contribute to the deep part of the cardiac plexus
33
Where does the inferior cervical ganglion lie?
at the level of C7 TVP and neck of first rib
34
What does the inferior cervical ganglion communicate with?
anterior primary rami of C7 and 8 (maybe T1) via grey ramus communicans
35
Cardiac branches of the inferior cervical ganglion travel to the heart as what?
inferior cardiac nerves
36
Branches from the inferior cervical ganlgion are sent to what artery?
subclavian artery
37
The branches of the inferior cervical ganglion surround what arteries?
subclavian, axillary and vertebral arteries
38
What makes the thoracic sympathetic nerves special?
they have a grey and white ramus communicans
39
Where are the ganglia located within the superior thorax?
anterior to the rib head
40
The lower part of the thoracic ganglia are located where?
on the lateral aspects of the vertebral bodies
41
Branches from the upper 5 thoracic ganglia travel medially and supply what?
structures in the thoracic cavity
42
What do the upper 5 thoracic ganglia carry?
postganglionic fibers and visceral afferents
43
How many splanchnic nerves ae associated with the lower 7 segments of the thoracic sympathetic trunk?
3, greater, lesser and least splanchnic nerves
44
What kind of fibers do the splanchnic nerves of the thoracic nerves carry?
Preganglionic fibers to plexuses in the abdominal and pelvic cavities as well as visceral afferent information
45
The greater splanchnic nerve is formed my what? Where does it terminate?
Thoracic ganglia 5-9
| Terminates in the celiac ganglion
46
The lesser splanchnic nerve is formed by fibers from what? Where does it terminate?
Thoracic ganglia 8 and 9, or 9 and 10
| Terminates in the celiac plexus
47
The least splanchnic nerve is formed by fibers from what? Where does it terminate?
Thoracic ganglia 12
| Trminates in renal plexus
48
Where are the lumbar sympathetic trunk ganglia located?
Retroperitoneal space on lateral aspects of lumbar vertebral bodies
49
How many lumbar ganglia are there typically?
4
50
Which lumbar ganglia have a white ramys communicans?
The first two or three
51
Which lumbar vertebra have grey ramus communicans?
All of them
52
Where do the lumbar splanchnic nerves carry preganglionic fibers to?
The plexus surrounding the abdominal aorta
53
Where do the sacral sympathetic ganglia lie?
On the anterior aspect of the sacrum, medial to the anterior sacral foramina
54
How many sacral ganglia are present?
4 or 5
55
What communicans are associated with the sacral nerves?
One for each sacral nerve and coccygeal nerve, so 6
56
Where do the two sacral sympathetic trunks travel?
Medially as they descend and meet to form the ganglion impar on the anterior surface of the coccyx
57
Where do preganglionic axons travel from to enter the sympathetic trunk?
T1 to L2, may ascend to higher or lower levels of the trunk
58
When fibers generally ascend and which generally descend? (sympathetic trunk)
T1-5 typically ascend
| T5-L2 typically descend
59
Axons that carry information that will be relayed to the head and neck are carried in which nerves?
T1-2, synapse in the superior cervical ganglion
60
Axons that influence the heart arise from which levels?
T1-4, most ascend to one of the 3 cervical ganglia, others pass directly to the heart
61
Axons that influence the lungs arise from what levels?
T2-4, synapse in the second, third and fourth thoracic ganglia
62
Axons that influence the upper extremities arise from what levels? What do they do after they enter the sympathetic trunk?
T3-7, they ascend to the middle and inferior cervical ganglia where they synapse
63
Axons that influence the abdominal viscera arise from what levels? Where will they synapse and by what nerves?
T5-12, pass the sympathetic trunk to be carried in the greater, lesser and least splanchnic nerves
64
Axons that influence the pelvic viscera arise from what levels? Where do they descend to?
T10-L2, descend to lower thoracic, lumbar and pelvic areas
65
Axons that influence the lower extremities arise from what levels? Where do they descend to?
T10-L2, descend in sympathetic trunk to synapse with L2-S4 sacral ganglia
66
Fibers are carried from the sympathetic trunk in which three ways?
nerves, blood vessels, direct branches
67
Virtually all nerves in the sympathetic trunk carry what fibers?
postganglionic sympathetic fibers
68
Within the field of distribution for "that nerve", these fibers will be...?
vasoconstrictors, sudomotor and motor to arrector pili
69
Direct branches to the viscera likely do what?
constrict blood vessels, dilate bronchial tree, stimulate glandular secretion, dilate pupils, inhibit digestive activities
70
What are the branches from the cervical sympathetic trunk that accompany nerves?
grey ramus communicans
71
What does the superior cervical ganglion send branches to?
inferior ganglion of glossopharyngeal nerve, vagus nerve and hypoglossal nerve
72
What branches specifically of the vagus nerve does the superior cervical ganglion send branches to?
recurrent laryngeal and auricular
73
What are the branches of the cervical sympathetic trunk that accompany blood vessels?
internal carotid nerve, branches accompanying inferior thyroid artery, branches that reach subclavian artery to reach upper extremity via axillary and brachial artery
74
Branches accompanying the inferior thyroid artery come from what ganglia?
middle cervical ganglia
75
Branches that reach the subclavian artery come from what ganglia?
inferior cervical or stellate ganglion
76
The internal carotid nerve is a branch from what cervical ganglia?
superior cervical ganglia
77
The internal carotid nerve enters the cranial cavity with what?
the internal carotid artery where it divides into medial and lateral branches
78
What does the lateral carotid nerve do?
forms the internal carotid plexus
79
Many branches of the internal carotid plexus will terminate where?
on blood vessels on the inside of the skull
80
When the lateral branches of the internal carotid nerve communicate with the trigeminal ganglion, what does that allow?
it allows postganglionic sympathetic fibers to reach any structure within the field of distribution of the trigeminal nerve
81
What does the abducens nerve supply?
blood vessels in the lateral rectus
82
Abducens nerve is a branch of what?
lateral internal carotid nerve
83
What nerve combines with the greater petrosal nerve to form the nerve of the pterygoid canal?
deep petrosal nerve
84
The deep petrosal nerve reaches what structures?
lacrimal, nasal, palatine and some pharyngeal glands
85
What are the 4 branches of the lateral internal carotid nerve?
communcation with trigeminal ganglion
abducens
deep petrosal nerve
caroticotympanic nerve
86
Caroticotympanic nerves combine with the tympanic branch of which cranial nerve to form which plexus?
glossopharyngeal nerve, form the tympanic plexus
87
What does the caroticotympanic nerve supply?
glands and bold vessels of the middle ear
88
The medial internal carotid nerve forms which plexus?
cavernous plexus
89
Where is the cavernous plexus located?
cavernous sinus along side the sella turcica
90
Fibers from the medial internal carotid nerve travel through what ganglion to reach what structure?
travel through the ciliary ganglion to reach the eyeball
91
What does the medial internal carotid nerve supply within the eye?
ciliaris, dilator pupillae, tarsus muscles
92
medial internal carotid nerve gives branches to the oculomotor nerve to reach blood vessels where?
blood vessels associated with the ciliaris, dilator pupillae and tarsus muscles
93
medial internal carotid nerve sends branches to the opthalmic division to supply what?
arrector pili, sweat glands, and blood vessels associated with the field of distribution of the opthalmic division
94
The pituitary gland receives fibers from what nerve?
medial internal carotid nerve
95
Branches accompanying what artery from the middle cervical ganglion supply the thyroid gland?
inferior thyroid artery
96
Branches from what ganglion reach the subclavian artery to reach what part of the body via axillary and brachial arteries?
inferior cervical/stellate ganglion, upper extremity
97
Branches from the cervical sympathetic trunk travel where?
directly to visceral structures
98
What branches come from the superior cervical ganglion?
laryngeopharyngeal branches
99
What nerves do the laryngopharyngeal nerve combine with to form the pharyngeal plexus?
glossopharyngeal and vagus
100
What does the pharyngeal plexus supply?
blood vessels and glands
101
Cardiac branches come from which cervical ganglia?
all of them
102
Which branches of the cervical sympathetic trunk accompany the vagus nerve to the sinoatrial node?
cardiac branches
103
Sympathetic stimulation of the cardiac branches does what?
increases heart rate and dilates the coronary arteries and afferents
104
What is associated with each thoracic sympathetic trunk?
grey ramus communicans
105
What do the grey ramus communicans from the thoracic sympathetic trunk supply?
arrector pili, sweat glands, blood vessels at the field of distribution of each thoracic nerve
106
Thoracic ganglia 1-5 send postganglionic fibers where?
thoracic aorta
107
Cardiac branches extend to the heart from which thoracic sympathetic ganglia?
T2-4
108
Pulmonary branches are emitted from what thoracic sympathetic ganglia?
T2-4
109
Pulmonary branches travel through what plexus to supply what structures?
pulmonary plexus to supply pleura, smooth muscle and blood vessels of the lungs and bronchial glands
110
Greater splanchnic nerve contains fibers from what thoracic sympathetic ganglia?
T5-9 or 10
111
What does the greater splanchnic nerve supply?
esophagus and thoracic aorta above the diaphragm
112
Fibers from the greater splanchnic nerve are transmitted to which plexuses via the celiac plexus?
gastric, hepatic, superior mesenteric plexuses
113
Lesser splanchnic nerves contain fibers from what thoracic sympathetic ganglia?
T9-10 or 11
114
What does the lesser splanchnic nerve supply?
abdominal viscera and suprarenal glands
115
Least splanchnic nerve contains fibers from what thoracic sympathetic ganglia?
lowest thoracic ganglia
116
What does the least splanchnic nerve supply?
kidneys via the renal plexus
117
What does the lumbar sympathetic trunks supply?
arrector pili, sweat glands and blood vessels within the distribution of that lumbar trunk
118
Vascular branches of the lumbar sympathetic trunk follow the lumbar arteries to where?
abdominal aorta all the way to median sacral artery and common iliac arteries
119
Lumbar splanchnic nerves supply what via what plexuses?
pelvic viscera via superior and inferior hypogastric and inferior mesenteric plexus1
120
The grey ramus communicans from the sacral sympathetic trunk supply what?
arrector pili, sweat glands and blood vessels in the field of distribution of that nerve
121
Vascular branches from the sacral sympathetic trunk supply what?
median sacral artery
122
Sacral splanchnic nerves supply what via what plexus?
pelvic viscera via inferior mesenteric plexus
123
Sacral splanchnic nerves supply what directly?
ureters and rectum
