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PNS Exam 4 > Sympathetics > Flashcards

Sympathetics Flashcards

1
Q

Where are sympathetic cell bodies located?

A

lateral horn of T1-L2

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2
Q

Where do the fibers of sympathetics exit?

A

exits in anterior rootlets, following the anterior primary ramus

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3
Q

Where do the sympathetics end up after exiting the anterior primary ramus?

A

sympathetic trunk via white ramus communicans

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4
Q

Most sympathetics will synapse on what and where?

A

postganglionic cells in ganglia of the sympathetic trunk

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5
Q

Some preganglionic fibers pass through the sympathetic trunk to be carried in what nerves?

A

splanchnic nerves

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6
Q

The splanchnic nerves synapse in what plexuses associated with the abdominopelvic viscera?

A

prevertebral plexuses

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7
Q

Preganglionic fibers of the sympathetics release what?

A

acetylcholine

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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

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9
Q

How many of each trunk are there?

A

3 cervical
11 thoracic
4 lumbar
4 sacral

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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

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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

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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

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13
Q

Where does the cervical sympathetic trunk lie?

A

between the carotid sheath and the longus colli and capitis muscles

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14
Q

Are there white ramus communicans in the cervical sympathetic trunk and ganglia?

A

no

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15
Q

Are there grey ramus communicans in the cervical sympathetic trunk?

A

yes, each cervical nerve has one

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16
Q

How many cervical ganglia are there? What are their names?

A

3, superior, middle and inferior cervical ganglia

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17
Q

Which cervical ganglion may fuse with the first thoracic ganglia? What is it called?

A

inferior cervical ganglion

stellate ganglion

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18
Q

Which cervical sympathetic ganglia is the largest?

A

superior cervical ganglia

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19
Q

What is the superior cervical sympathetic ganglia formed by?

A

the union of the upper 4 cervical ganglia

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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

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21
Q

Postganglionic fibers of the superior cervical ganglia are distributed in what?

A

anterior, medial or lateral branches

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22
Q

Lateral branches of superior cervical ganglia are what kind of ramus?

A

grey ramus communicans

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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

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24
Q

Medial branches of the superior cervical ganglia go where?

A

larynx, pharynx, and heart

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25
Q

what are the branches of the medial branches of the supieror cervical ganglia called? What kind of information do they carry?

A

superior cardiac nerves

efferent information only

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26
Q

Anterior branches of the supeiror cervical ganglia follow what arteries? What do they innervate

A

follow the common and external carotid arteries, innervate vessels that supply blood to structures inside and outside the skull

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27
Q

Which cervical ganglia is the smallest?

A

middle cervical sympathetic ganglia

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28
Q

Where is the middle cervical ganglia located?

A

C6

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29
Q

What does the middle cervical ganglia communicate with?

A

anteiror priamry rami of C5 and 6 via grey ramus communicans

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30
Q

What are the two branches of the middle cervical ganglia?

A

thyroid branches and cardiac branches

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31
Q

Where do the thyroid branches of the middle cervical ganglia go? What are the primarily?

A

they go to the thyroid and parathyroid glands

primarily vasomotor

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32
Q

Where do the cardiac branches of the middle cervical ganglia make up? What do they contribute to?

A

make up the middle cardiac nerves

contribute to the deep part of the cardiac plexus

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33
Q

Where does the inferior cervical ganglion lie?

A

at the level of C7 TVP and neck of first rib

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34
Q

What does the inferior cervical ganglion communicate with?

A

anterior primary rami of C7 and 8 (maybe T1) via grey ramus communicans

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35
Q

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

A

inferior cardiac nerves

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36
Q

Branches from the inferior cervical ganlgion are sent to what artery?

A

subclavian artery

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37
Q

The branches of the inferior cervical ganglion surround what arteries?

A

subclavian, axillary and vertebral arteries

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38
Q

What makes the thoracic sympathetic nerves special?

A

they have a grey and white ramus communicans

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39
Q

Where are the ganglia located within the superior thorax?

A

anterior to the rib head

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40
Q

The lower part of the thoracic ganglia are located where?

A

on the lateral aspects of the vertebral bodies

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41
Q

Branches from the upper 5 thoracic ganglia travel medially and supply what?

A

structures in the thoracic cavity

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42
Q

What do the upper 5 thoracic ganglia carry?

A

postganglionic fibers and visceral afferents

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43
Q

How many splanchnic nerves ae associated with the lower 7 segments of the thoracic sympathetic trunk?

A

3, greater, lesser and least splanchnic nerves

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44
Q

What kind of fibers do the splanchnic nerves of the thoracic nerves carry?

A

Preganglionic fibers to plexuses in the abdominal and pelvic cavities as well as visceral afferent information

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45
Q

The greater splanchnic nerve is formed my what? Where does it terminate?

A

Thoracic ganglia 5-9

Terminates in the celiac ganglion

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46
Q

The lesser splanchnic nerve is formed by fibers from what? Where does it terminate?

A

Thoracic ganglia 8 and 9, or 9 and 10

Terminates in the celiac plexus

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47
Q

The least splanchnic nerve is formed by fibers from what? Where does it terminate?

A

Thoracic ganglia 12

Trminates in renal plexus

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48
Q

Where are the lumbar sympathetic trunk ganglia located?

A

Retroperitoneal space on lateral aspects of lumbar vertebral bodies

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49
Q

How many lumbar ganglia are there typically?

A

4

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50
Q

Which lumbar ganglia have a white ramys communicans?

A

The first two or three

51
Q

Which lumbar vertebra have grey ramus communicans?

A

All of them

52
Q

Where do the lumbar splanchnic nerves carry preganglionic fibers to?

A

The plexus surrounding the abdominal aorta

53
Q

Where do the sacral sympathetic ganglia lie?

A

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

54
Q

How many sacral ganglia are present?

A

4 or 5

55
Q

What communicans are associated with the sacral nerves?

A

One for each sacral nerve and coccygeal nerve, so 6

56
Q

Where do the two sacral sympathetic trunks travel?

A

Medially as they descend and meet to form the ganglion impar on the anterior surface of the coccyx

57
Q

Where do preganglionic axons travel from to enter the sympathetic trunk?

A

T1 to L2, may ascend to higher or lower levels of the trunk

58
Q

When fibers generally ascend and which generally descend? (sympathetic trunk)

A

T1-5 typically ascend

T5-L2 typically descend

59
Q

Axons that carry information that will be relayed to the head and neck are carried in which nerves?

A

T1-2, synapse in the superior cervical ganglion

60
Q

Axons that influence the heart arise from which levels?

A

T1-4, most ascend to one of the 3 cervical ganglia, others pass directly to the heart

61
Q

Axons that influence the lungs arise from what levels?

A

T2-4, synapse in the second, third and fourth thoracic ganglia

62
Q

Axons that influence the upper extremities arise from what levels? What do they do after they enter the sympathetic trunk?

A

T3-7, they ascend to the middle and inferior cervical ganglia where they synapse

63
Q

Axons that influence the abdominal viscera arise from what levels? Where will they synapse and by what nerves?

A

T5-12, pass the sympathetic trunk to be carried in the greater, lesser and least splanchnic nerves

64
Q

Axons that influence the pelvic viscera arise from what levels? Where do they descend to?

A

T10-L2, descend to lower thoracic, lumbar and pelvic areas

65
Q

Axons that influence the lower extremities arise from what levels? Where do they descend to?

A

T10-L2, descend in sympathetic trunk to synapse with L2-S4 sacral ganglia

66
Q

Fibers are carried from the sympathetic trunk in which three ways?

A

nerves, blood vessels, direct branches

67
Q

Virtually all nerves in the sympathetic trunk carry what fibers?

A

postganglionic sympathetic fibers

68
Q

Within the field of distribution for “that nerve”, these fibers will be…?

A

vasoconstrictors, sudomotor and motor to arrector pili

69
Q

Direct branches to the viscera likely do what?

A

constrict blood vessels, dilate bronchial tree, stimulate glandular secretion, dilate pupils, inhibit digestive activities

70
Q

What are the branches from the cervical sympathetic trunk that accompany nerves?

A

grey ramus communicans

71
Q

What does the superior cervical ganglion send branches to?

A

inferior ganglion of glossopharyngeal nerve, vagus nerve and hypoglossal nerve

72
Q

What branches specifically of the vagus nerve does the superior cervical ganglion send branches to?

A

recurrent laryngeal and auricular

73
Q

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

A

internal carotid nerve, branches accompanying inferior thyroid artery, branches that reach subclavian artery to reach upper extremity via axillary and brachial artery

74
Q

Branches accompanying the inferior thyroid artery come from what ganglia?

A

middle cervical ganglia

75
Q

Branches that reach the subclavian artery come from what ganglia?

A

inferior cervical or stellate ganglion

76
Q

The internal carotid nerve is a branch from what cervical ganglia?

A

superior cervical ganglia

77
Q

The internal carotid nerve enters the cranial cavity with what?

A

the internal carotid artery where it divides into medial and lateral branches

78
Q

What does the lateral carotid nerve do?

A

forms the internal carotid plexus

79
Q

Many branches of the internal carotid plexus will terminate where?

A

on blood vessels on the inside of the skull

80
Q

When the lateral branches of the internal carotid nerve communicate with the trigeminal ganglion, what does that allow?

A

it allows postganglionic sympathetic fibers to reach any structure within the field of distribution of the trigeminal nerve

81
Q

What does the abducens nerve supply?

A

blood vessels in the lateral rectus

82
Q

Abducens nerve is a branch of what?

A

lateral internal carotid nerve

83
Q

What nerve combines with the greater petrosal nerve to form the nerve of the pterygoid canal?

A

deep petrosal nerve

84
Q

The deep petrosal nerve reaches what structures?

A

lacrimal, nasal, palatine and some pharyngeal glands

85
Q

What are the 4 branches of the lateral internal carotid nerve?

A

communcation with trigeminal ganglion
abducens
deep petrosal nerve
caroticotympanic nerve

86
Q

Caroticotympanic nerves combine with the tympanic branch of which cranial nerve to form which plexus?

A

glossopharyngeal nerve, form the tympanic plexus

87
Q

What does the caroticotympanic nerve supply?

A

glands and bold vessels of the middle ear

88
Q

The medial internal carotid nerve forms which plexus?

A

cavernous plexus

89
Q

Where is the cavernous plexus located?

A

cavernous sinus along side the sella turcica

90
Q

Fibers from the medial internal carotid nerve travel through what ganglion to reach what structure?

A

travel through the ciliary ganglion to reach the eyeball

91
Q

What does the medial internal carotid nerve supply within the eye?

A

ciliaris, dilator pupillae, tarsus muscles

92
Q

medial internal carotid nerve gives branches to the oculomotor nerve to reach blood vessels where?

A

blood vessels associated with the ciliaris, dilator pupillae and tarsus muscles

93
Q

medial internal carotid nerve sends branches to the opthalmic division to supply what?

A

arrector pili, sweat glands, and blood vessels associated with the field of distribution of the opthalmic division

94
Q

The pituitary gland receives fibers from what nerve?

A

medial internal carotid nerve

95
Q

Branches accompanying what artery from the middle cervical ganglion supply the thyroid gland?

A

inferior thyroid artery

96
Q

Branches from what ganglion reach the subclavian artery to reach what part of the body via axillary and brachial arteries?

A

inferior cervical/stellate ganglion, upper extremity

97
Q

Branches from the cervical sympathetic trunk travel where?

A

directly to visceral structures

98
Q

What branches come from the superior cervical ganglion?

A

laryngeopharyngeal branches

99
Q

What nerves do the laryngopharyngeal nerve combine with to form the pharyngeal plexus?

A

glossopharyngeal and vagus

100
Q

What does the pharyngeal plexus supply?

A

blood vessels and glands

101
Q

Cardiac branches come from which cervical ganglia?

A

all of them

102
Q

Which branches of the cervical sympathetic trunk accompany the vagus nerve to the sinoatrial node?

A

cardiac branches

103
Q

Sympathetic stimulation of the cardiac branches does what?

A

increases heart rate and dilates the coronary arteries and afferents

104
Q

What is associated with each thoracic sympathetic trunk?

A

grey ramus communicans

105
Q

What do the grey ramus communicans from the thoracic sympathetic trunk supply?

A

arrector pili, sweat glands, blood vessels at the field of distribution of each thoracic nerve

106
Q

Thoracic ganglia 1-5 send postganglionic fibers where?

A

thoracic aorta

107
Q

Cardiac branches extend to the heart from which thoracic sympathetic ganglia?

A

T2-4

108
Q

Pulmonary branches are emitted from what thoracic sympathetic ganglia?

A

T2-4

109
Q

Pulmonary branches travel through what plexus to supply what structures?

A

pulmonary plexus to supply pleura, smooth muscle and blood vessels of the lungs and bronchial glands

110
Q

Greater splanchnic nerve contains fibers from what thoracic sympathetic ganglia?

A

T5-9 or 10

111
Q

What does the greater splanchnic nerve supply?

A

esophagus and thoracic aorta above the diaphragm

112
Q

Fibers from the greater splanchnic nerve are transmitted to which plexuses via the celiac plexus?

A

gastric, hepatic, superior mesenteric plexuses

113
Q

Lesser splanchnic nerves contain fibers from what thoracic sympathetic ganglia?

A

T9-10 or 11

114
Q

What does the lesser splanchnic nerve supply?

A

abdominal viscera and suprarenal glands

115
Q

Least splanchnic nerve contains fibers from what thoracic sympathetic ganglia?

A

lowest thoracic ganglia

116
Q

What does the least splanchnic nerve supply?

A

kidneys via the renal plexus

117
Q

What does the lumbar sympathetic trunks supply?

A

arrector pili, sweat glands and blood vessels within the distribution of that lumbar trunk

118
Q

Vascular branches of the lumbar sympathetic trunk follow the lumbar arteries to where?

A

abdominal aorta all the way to median sacral artery and common iliac arteries

119
Q

Lumbar splanchnic nerves supply what via what plexuses?

A

pelvic viscera via superior and inferior hypogastric and inferior mesenteric plexus1

120
Q

The grey ramus communicans from the sacral sympathetic trunk supply what?

A

arrector pili, sweat glands and blood vessels in the field of distribution of that nerve

121
Q

Vascular branches from the sacral sympathetic trunk supply what?

A

median sacral artery

122
Q

Sacral splanchnic nerves supply what via what plexus?

A

pelvic viscera via inferior mesenteric plexus

123
Q

Sacral splanchnic nerves supply what directly?

A

ureters and rectum

PNS Exam 4 (3 decks)

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