Sympathetics Flashcards
Cardiac branches (direct visceral structures-thoracic) extend to the heart from T2-T4 and have 3 affects?
Increase heart rate
Dilate coronary arteries
Afferent
The parasympathetics of the pulmonary plexus arrive there via the _____ and _______ ________ branches of the ______ nerve
Anterior and posterior bronchial branches of the vagus nerve
The medial internal carotid nerve forms the cavernous plexus which has fibers that travel through the _____ _____ to reach the _______ and supply the ____ and _____ ____ muscles as well as some tarsus muscles of the upper eyelid
Ciliary ganglion
Eyeball
Ciliaris and dilator pupillae
The medial internal carotid nerve forms the cavernous plexus which has branches to the ______ division of the _____ nerve to supply arrector pilli, sweat glands, and blood vessels in the field of distribution.
Opthalamic division of the trigeminal nerve
What forms the lesser splanchnic nerve?
Fibers from 9th/10th or 10th/11th ganglia
T5-T12 give rise to axons that supply what?
Abdominal viscera
Branches from the sacral sympathetic trunk that accompany nerves
Gray ramus communicans ( each sacral and coccygeal nerve)
-supply arrector pilli, sweat glands, blood vessels
What does the inferior cervical ganglion communicate with?
Anterior primary rami of C7 and C8 (T1 if stellate) via gray rami communicans
Where are branches from the inferior cervical ganglion sent?
Subclavian artery and form plexuses around it and its branches (axillary/vertebral)
Sympathetic trunk carries _____ and _____ fibers
Ascending and descending
Sympathetic trunk extends from _____ _____ _____ inferior to the ganglion impar
Superior cervical ganglion
The efferent response to the stretch reflex sends signals to detrusor muscle or rectal musculature and causes what?
Relaxation of external sphincter muscles
What type of fibers does the greater splanchnic nerve supply the thoracic aortic plexus with?
Sympathetic
What does the cardiac plexus supply?
Myocardium
Great vessels at base of heart
Coronary arteries
All nerves carry postganglionic sympathetic fibers that have what 3 fields of distribution?
Vasoconstriction
Sudomotor
Motor to arrector pilli
What fibers are sensitive to and initiate the stretch reflex during defecation and micturation?
Visceral afferent sensitive to stretching of walls of bladder and rectum
What does the thoracic aortic plexus consist of?
Vagus N (sensory and visceral afferent)
greater splanchnic N (sympathetic)
T1-T5 sympathetic ganglia (vascular)
The cervical sympathetic trunk lies between the ____ ____ and what two muscles?
Carotid sheath
Longs collision and capitis muscles
Postganglionic branches from the superior cervical ganglia are distributed in what branches?
Anterior, medial or lateral
What two plexuses does the superior hypogastric plexus include?
Abdominal aortic and inferior mesenteric
Vascular branches of the lumbar sympathetic trunk that accompany blood vessels are given off and follow _____ _____ back to the abdominal aorta and then follow it down as low as the ____ ____ ____ and the _____ _____ _____
Lumbar arteries
Medial sacral artery and common iliac arteries
Where does the lumbar sympathetic trunk lie?
Retroperitoneal space on the lateral aspect of lumbar vertebrae
What plexus is located between L4-S1
Superior hypogastric
There are usually _____ ganglia in each trunk. ____ cervical, _____ thoracic, ______ lumbar, and ____ sacral ganglia
21 or 22 3 cervical 11 thoracic 4 lumbar 4 sacral
The lesser splanchnic nerves contain fibers from T9/T10 T10/T11 and reach some of the same abdominal structures as the greater splanchnic but also supply what?
Suprarenal glands
How many splanchnic nerves are associated with the what segments of the thoracic sympathetic trunk?
3
Lower 7 segments
Branches from the lumbar sympathetic trunks that travel directly to visceral structures?
Lumbar splanchnic nerves
The medial internal carotid nerve forms the cavernous plexus has branches to the ______ nerves to reach blood vessels associated with?
Oculomotor
Muscles supplied by the nerve
Where does the lesser splanchnic nerve terminate?
Aorticorenal ganglion
Branches from the lumbar sympathetic trunk that accompany nerves
Grey ramus communicans
What type of fibers are carried in the splanchnic nerves associated with the lower 7 thoracic segments?
Preganglionic and visceral afferent
The lateral internal carotid artery forms what plexus?
Internal carotid plexus
Branches from the thoracic sympathetic trunk that accompany nerves?
Gray ramus communicans (each nerve)
What is the main contribution to the esophageal plexus? Where do they synapse?
From vagus and recurrent laryngeal nerve that synapse on postganglionic cells in wall of esophagus
Clinical implication of lateral internal carotid nerve forming the internal carotid plexus.
Communication with the trigeminal ganglion allows postganglionic sympathetic fibers to reach where?
Any structure within the field of distribution of the trigeminal nerve
What it’s he second largest prevertebral plexus?
Inferior hypogastric plexus
Where is the superior hypogastric plexus located?
Between L4-S1
What type of information does the white ramus communicans carry to the sympathetic trunk from lumbar nerves 1 & 2, sometimes 3?
Preganglionic
If there are ____ ganglia in the sympathetic trunk it is because the lower _____ and upper _____ fused to form a ________ ganglion
21
Cervical and thoracic
Stellate
2-4 lumbar splanchnic nerves carry preganglionic axons to where?
The plexus surrounding the abdominal aorta
What are the names of the four thoracic plexuses?
Esophageal
Thoracic Aortic
Pulmonary
Cardiac
T1/T2 fibers carry information that is relayed to where?
Head and neck
What’s the smallest cervical ganglion and where is it located?
Middle cervical ganglion
C6
Sympathetic fibers from ___ - ____ ganglia supply the pulmonary plexus and supply what 3 things?
T2-T4
Pleura, bronchial glands and musculature
Can you name the 12 secondary plexuses associated with the celiac plexus?
Phrenic plexus Left gastric Hepatic Splenic Superior mesenteric Suprarenal Renal Gonadal Abdominal aorta Interior mesenteric Superior hypogastric Inferior hypogastric
Branches from the cervical sympathetic trunk that accompany blood vessels
Internal carotid nerve (lateral/medial internal carotid N)
Branches accompanying the inferior thyroid artery
Subclavian A. To reach upper extremities via axillary/brachial A.
The medial internal carotid nerve forms what?
Cavernous plexus
What are the contributions to the esophageal plexus?
Vagus N.
Recurrent laryngeal N
Greater splanchnic NS (from T5-T9/10)
What does the middle cervical ganglion communicate with?
Anterior primary rami of c5/c6 via gray rami communicans
What are the two branches from the cervical sympathetic trunk that travel directly to visceral structures?
Laryngeopharyngeal
Cardiac
Where does the greater splanchnic nerve terminate?
Celiac ganglion
What plexus includes the celiac plexus below the internal iliac A?
Inferior hypogastric plexus
The anterior branch of the superior cervical ganglion are what? What do they communicate with?
Gray rami communicans
Communicate with anterior primary rami of c1-c4 and CN 9, 10, 12
Where are the cell bodies of the sympathetic located?
Lateral horn of T1-L2 or L3
The medial internal carotid nerve forms the cavernous plexus which has influence on the _____ nerve to supply blood vessels in the superior oblique
Trochlear
The least splanchnic nerve fibers reach the ______ through the ______ plexus
Kidneys
Renal
What are dedication and micturation intimated by?
Parasympathetic input
The abdominal aortic and inferior mesenteric plexus are part of what larger secondary celiac plexus?
Superior hypogastric
The sympathetic trunk is ____ _______ columns of ______ ganglia
2 paravertebral
Interconnected
The lateral internal carotid nerve forms the internal carotid plexus which many of its branches terminate on blood vessels within the skull. The internal carotid plexus has 4 other clinical implications. What are they?
- communication with trigeminal ganglion
- abducens nerve
- postganglionic fibers form deep petrosal nerve + greater pet. N = N. Of pterygoid canal
- caroticotympanic nerve + tympanic branch of CN9 = tympanic plexus
Axons that carry information that influence the lungs arise from ___-____ and synapse where?
T2-T4
2nd-4th thoracic ganglia
Many times what ganglion fuses with the first thoracic ganglion to form the stellate ganglion? (%)?
Inferior cervical ganglion
80%
The anterior and posterior bronchial branches of the pulmonary plexus (preganglionic fibers) synapse with postganglionic fibers in the wall of the _____ _____ and result in what?
Bronchial vessels
Parasympathetic stimulation results in bronchial constriction and vasodilation (increases glandular secretion)
Axons that carry information that will be relayed to the head and neck are carried in the ___ and ____ nerves and synapse where?
T1/T2
Superior cervical ganglion
Greater splanchnic nerves contain fibers from T5-T9/T10 and supply what two structures? (Direct to visceral structures-thoracic)
Esophagus and thoracic aorta above diaphragm
Some preganglionic fibers pass through the sympathetic trunk to be carried in ____ ______ to synapse in _____ _______ associated with ______ _____
Splanchnic nerves
Prevertebral plexuses
Abdominopelvic viscera
What is the primary component of the pulmonary plexus?
Parasympathetic
What plexuses are primarily concerned with supply of visceral structures in the thoracic and abdominopelvic cavities?
Autonomic
What makes up the least splanchnic nerve?
Fibers from the 12th ganglion
The internal carotid nerve is a branch of the _____ ____ ____, enters the cranial cavity with the _____ _____ artery and splits into the _____ and ____ branches
Superior cervical ganglion
Internal cartotid artery
Medial and lateral
Do lumbar nerves have a gray ramus communicans?
Yes
What secondary plexus are the vesicle, prostatic or uterine/vaginal, rectal and cavernous plexuses associated with?
Inferior hypogastric plexus
What thoracic plexus has contributions from superior and inferior cardiac N from vagus N, and superior, middle and inferior cardiac N via t2-t4 sympathetic ganglia?
Cardiac plexus
What four secondary plexuses is the inferior hypogastric plexus (already a secondary plexus to the celiac plexus) associated with?
Vescile
Prostatic or uterine/vaginal
Rectal
Cavernous
T2-T4 give rise to axons that influence what?
Lungs
sympathetic trunk rests on the _____ aspect of the _____ ______ in the lower thoracic and lumbar areas
Lateral
Vertebral bodies
What lumbar nerves have white ramus communicans?
1 & 2, sometimes 3
where does the inferior cervical ganglion lie?
C7 TVP
Neck of 1st rib
Generally fibers from t1-t5 ______ while t5-L2 ______?
Ascend
Descend
The lumbar splanchnic nerves that branch from the lumbar sympathetic trunk and travel directly to visceral structures supply _____ ____ via _____ and _______ _____ and _____ ______ plexuses
Pelvic viscera
Superior and inferior hypogastric and inferior mesenteric plexus
What thoracic plexus has contributions from Vagus N, recurrent laryngeal N and greater splanchnic N (t5-t9/10)
Esophagus
Preganglionic sympathetic fibers release?
Ach
What plexuses does the inferior hypogastric plexus include?
Celiac plexus below internal iliac artery
Clinical implication of lateral internal carotid nerve forming the internal carotid plexus.
-abducens nerve to supply blood vessels within?
Lateral rectus
Does the thoracic sympathetic trunk have white ramus communicans?
Yes
Most sympathetics will synapse on ______ _______ in ganglia of the sympathetic trunk
Postganglionic cells
Medial branch of superior cervical ganglion travel where and carry what information?
Larynx, pharynx, heart (superior cardiac nerves)
Efferent information
The sympathetic trunk lie on the ______ aspect of the sacrum eventually joining at the level of the coccyx to form the ____ ______
Anterior
Ganglion impar
Pulmonary branches (direct to visceral structures-thoracic) are emitted from ___-___ ganglia and travel through the _____ plexus to supply what?
T2-T4
Pulmonary plexus
Pleura, smooth muscle, blood vessels of lungs and bronchial glands
Bronchial dilation effect
Where does the least splanchnic nerve terminate?
Renal plexus
What are the contributions to the pulmonary plexus?
Parasympathetic from anterior and posterior bronchial branches of vagus
Sympathetic from t2-t4 ganglia
What plexus is a dense gangliated plexus that forms networks around the abdominal aorta and its branches down to C. Iliac and medial sacral arteries
Celiac plexus
What type of fibers does the t1-t5 sympathetic ganglia supply the thoracic aortic plexus with?
Vascular
What type of fibers does the vagus nerve supply within the thoracic aortic plexus?
Sensory and visceral afferent
Branches from the cervical sympathetic trunk that accompany nerves
A gray ramus communicans (each spinal nerve)
Superior cervical ganglion (branches to CN 9, 10, 12)
What branches come off the middle cervical ganglion?
Thyroid and cardiac branches
Fibers carrying information for the upper extremities are carried in the ___-____ nerves and synapse where?
T3-T7
Middle cervical/inferior/stellate
What type of fibers are the branches of the upper five thoracic ganglia?
Postganglionic fibers
Visceral afferent
What 3 parts of the celiac plexus are associated with well defined ganglia?
Celiac ganglia- next to celiac A
Superior mesenteric ganglia-“ A
Aorticorenal ganglia- near renal A
Sympathetics exit the cord via what?
Anterior rootlets
Where is the superior cervical ganglia located?
C2/c3 between carotid sheath and longus capitis
Where do branches from the upper five thoracic ganglia travel and what do they supply?
Medially to supply structures on thoracic cavity
Fibers from the greater splanchnic nerve are also transmitted to ___, ____ _____ _____ plexus via the celiac plexus to much of the abdominal viscera
Gastric, hepatic, superior mesenteric
What forms the superior cervical ganglion?
Upper four cervical ganglia
What is the largest paravertebral plexus?
Celiac plexus
Axons that influence heart arise from ___- ____ and ascend to synapse where?
T1-T4
One of the cervical ganglia
What plexus has it’s main contribution come from vagus and recurrent laryngeal that synapse on postganglionic cell in esophagus wall?
Esophageal plexus
Where do the thoracic ganglia 1-5 send postganglionic fibers to?
Thoracic aorta
What thoracic plexus has contributions from anterior and posterior bronchial branches of the vagus and t2-t4 sympathetic ganglia?
Pulmonary plexus
After stretch reflex is initiated an _____ response travels out _____ ________nerves to ______ muscle or _______ musculature
Efferent travels out of pelvic splanchnic nerves to detrusor muscle or rectal musculature
Clinical implication of lateral internal carotid nerve forming the internal carotid plexus.
-___________ nerves combine with the _______ branch of the glossopharyngeal nerve to form the _____ plexus and supply?
Caroticotympanic + tympanic = tympanic plexus
Supply glands and bold vessels of middle ear
Information for the lower extremities are carried in ___-___ and synapse where?
T10-L2
2nd-4th sacral ganglia
After the sympathetics exit the cord in the cord in the anterior rootlets they follow the _____ _____ ______ and enter the sympathetic trunk via what?
Anterior primary ramus
White ramus communicans
What 3 ways are fibers carries from the sympathetic trunk?
Nerves
Blood vessels
Direct branches
How do the parasympathetics arrive at the pulmonary plexus?
Via the anterior and posterior bronchial branches of the vagus nerve
T1-T4 give rise to axons that influence what?
Heart
What do the sacral splanchnic nerves supply? Via what?
Direct to ureters and rectum
Pelvic viscera via inferior mesenteric plexus
Fibers influence pelvic viscera arise from ___-___ and synapse where?
T10-L2
Lower thoracic, lumbar, pelvic areas
What is the largest of the cervical sympathetic ganglia?
Superior
What thoracic plexus has sympathetic fibers from t2-t4 that supply the pleura, bronchial glands and musculature?
Pulmonary plexus
Fibers that influence abdominal viscera arise from ___-____ and synapse where?
T5-T-12
Lower thoracic ganglia
Pass through sympathetic trunk to be carried by greater/lesser/least splanchnic nerves
Where does the sympathetic contribution of the esophageal plexus arise from?
Greater splanchnic nerves from T5-T9 or T10 ganglia
The laryngeopharyngeal branches (directly to visceral structures-cervical) are from the _____ _____ ____. They form the _______ plexus along with fibers from the ______ and _____ nerves and the ______ plexus.
Superior cervical ganglion
Pharyngeal plexus
Glossopharyngeal and vagus nerves and laryngeal plexus = pharyngeal
What level does the celiac plexus start at?
L1
What thoracic plexus arise from contributions from vagus N, greater splanchnic N, and t1-t5 sympathetic ganglia?
Thoracic aortic
Does the thoracic sympathetic trunk have gray ramus communicans?
Yes
The thyroid branches of the middle cervical ganglion reach what and have what type of fibers?
Thyroid and parathyroid glands
Vasomotor
What does the inferior cervical ganglion communicate with?
Anterior primary rami of c7/c8 (t1 if fused)
Anterior branches of the superior cervical ganglion follow what and supply what?
Common and external carotid arteries
Innervate BV that supply structures in/out skull
What does sympathetic input do in regards to muscles controlling defecation and micturation?
Constricts external sphincter muscles
What are the contributions to the thoracic aortic plexus?
Vagus N
Greater splanchnic N
T1-t5 sympathetic ganglia
Branches from the lumbar sympathetic trunk that accompany blood vessels?
Vascular branches
What are the fiber types within the autonomic plexuses?
Parasympathetic (pre/post)
Sympathetic (pre/post)
Afferent (somatic/visceral)
What is the main abdominopelvic plexus?
Celiac plexus
Secondary plexuses associated with the celiac plexus are named for what?
The arteries that are associated with each one
Branches from the sacral sympathetic trunk that accompany blood vessels
Vascular branches (follow medial sacral artery)
What are the contributions to the cardiac plexus?
Parasympathetic from superior and inferior cardiac N of the vagus N
Sympathetic from superior, middle and inferior cardiac N from t2-t4 sympathetic ganglia
Branches from the thoracic sympathetic trunk that accompany blood vessels?
-ganglia 1-5
The cardiac branches of the middle cervical ganglion make up what and contribute to what?
Middle cardiac nerves
Deep part of cardiac plexus
What 5 things do direct branches to the viscera likely do?
Constrict BV Dilate bronchial tree Stimulate glandular secretion Dilate pupils Inhibit digestive activity
What ganglia form the greater splanchnic nerve
5th-9th ganglia
Does the cervical sympathetic trunk have white rami communicans?
No
How does parasympathetic stimulation within the pulmonary plexus affect glandular secretion?
Increases
sympathetic trunk is located ____ to the carotid sheath and _______ to the necks of the ribs in the upper thoracic
Posterior
Anterior
Branches from the sacral sympathetic trunks that travel directly to visceral structures?
Sacral splanchnic nerves
Cardiac branches (direct to visceral structures- cervical) come from ____ _____ ______ and accompany branches of the _______ through the ______ plexus to the ______ ______
Each cervical ganglia
Vagus
Cardiac
Sinoatrial node
T10-L2 give rise to axons that supply what?
Pelvic viscera and lower extremities
Clinical implication of lateral internal carotid nerve forming the internal carotid plexus.
-postganglionic fibers from the ____ ____ nerve which combines with the ______ _____ neve to form the Nerve of the pterygoid canal. These fibers reach what glands?
Deep petrosal N + greater petrosal N
Lacrimal, nasal, palatine, and some pharyngeal glands
Branches from the thoracic sympathetic trunk that travel directly to visceral structures?
Cardiac branches
Pulmonary branches
