The Autonomic Nerve Supply of the Abdomen & Pelvis

Question 1

the visceral organs of the abdomen & pelvis are innervated by the ___ system

the system consists of two ___ divisions:

• sympathetic (___ division)
• parasympathetic (___ division)

the two systems innervate 3 things: ___

Answer 1

autonomic nervous

antagonistic

• thoracolumbar
• craniosacral

smooth muscle, glands, arteries

Question 2

the sympathetic system is generally involved in the ___

the parasympathetic system is generally involved in the ___

Answer 2

mobilization of the body’s energy for quick response

conservation of energy

Question 3

the abdominopelvic viscera are supplied w/ ___ sympathetic fibers by the ___, ___, & ___ ___ nerves

the lower ___ & ___ ___ nerves contain a variable number of ___ sympathetic fibers arising from lower levels of the sympathetic trunk

Answer 3

preganglionic, thoracic, lumbar, sacral, splanchnic

lumbar, sacral, splanchnic, postganglionic

Question 4

___ of the preganglionic sympathetic fibers to the abdominopelvic viscera originate from preganglionic sympathetic neurons in the ___ ___ horns from levels ___ to ___

Answer 4

all, lateral gray, T5, L2/L3

Question 5

the preganglionic sympathetic fibers in the ___, ___ & ___ ___ nerve synapse in ganglia on the anterior aspect of the aorta ___ (___ ganglia) & the ___ plexuses

Answer 5

thoracic, lumbar, sacral, splanchnic

prevertebral (collateral), hypogastric

Question 6

these named ganglia are situated at the root of the major branches of the abdominal aorta & receive the same names (4)

Answer 6

celiac ganglion
superior mesenteric ganglion
aorticorenal ganglion
inferior mesenteric ganglion

Question 7

the named ganglia are interconnected in front of the aorta by a delicate ___ ___

the entire network of ganglia & interconnecting nerve fibers is called the ___ plexus (___ plexus)

Answer 7

nerve plexus

aortic, prevertebral

Question 8

the aortic plexus contains ___ sympathetic fibers, ___ parasympathetic fibers, & ___ ___ fibers

Answer 8

preganglionic & postganglionic

preganglionic

visceral afferent

Question 9

regional concentrations of the aortic plexus around the origins of the ___, ___, ___, & ___ arteries from correspondingly named plexuses & proceed along the respective vessels

Answer 9

celiac
renal –> aorticorenal
superior mesenteric
inferior mesenteric

Question 10

distribution of the plexuses:
celiac plexus:

___ sympathetic fibers of the plexus follow the branches of the celiac trunk to supply all of the derivatives of the ___:

• distal 1/3 of the ___
• ___
• 1st & 2nd parts of ___
• ___ & ___
• ___
• ___

Answer 10

postganglionic, foregut

• esophagus
• stomach
• duodenum
• liver & gallbladder
• pancreas
• spleen

Question 11

distribution of the plexuses:
superior mesenteric plexus:

___ sympathetic fibers of the plexus follow branches of the superior mesenteric artery to supply all of the derivatives of the ___:

• 3rd & 4th parts of the ___
• ___
• ___
• ___ & ___
• ___ ___
• proximal 2/3 of ___ ___

Answer 11

postganglionic, midgut

• duodenum
• jejunum
• ileum
• cecum & appendix
• ascending colon
• transverse colon

Question 12

distribution of the plexuses:
aorticorenal plexus:

___ fibers of the plexus follow the ___ arteries to supply the ___ & the proximal ___

Answer 12

postganglionic
renal
kidneys
ureter

Question 13

distribution of the plexuses:
inferior mesenteric plexus:

___ fibers of the plexus follow branches of the inferior mesenteric artery to supply all of the derivatives of the ___:

• distal 1/3 of the ___
• ___ ___
• ___ ___
• ___
• superior 1/3 of the ___ ___

Answer 13

postganglionic, hindgut

• transverse colon
• descending colon
• sigmoid colon
• rectum
• anal canal

Question 14

distribution of the plexuses:
intermesenteric plexus:

the intermesenteric plexus is the part of the ___ plexus between the ___ & ___ plexuses

Answer 14

aortic

superior & inferior mesenteric

Question 15

sympathetic supply to the pelvis:

fibers for the most part do not follow the ___ root

the organs are supplied by the ___ plexuses

Answer 15

perivascular

hypogastric

Question 16

the superior hypogastric plexus is the continuation of the ___ plexus below the ___ plexus

it takes form over the inferior part of the ___ & the ___

the plexus is formed from:

• ___ sympathetic fibers descending from the ___ ganglion
• ___ & some ___ sympathetic fibers from the lower ___ nerves

the plexus aggregates into two bundles called the ___ & ___ nerves which descend into the ___

Answer 16

aortic, inferior mesenteric

aorta, aortic bifurcation

• postganglionic, inferior mesenteric
• preganglionic, postganglionic, lumbar splanchnic

right & left hypogastric, pelvis

Question 17

the inferior hypogastric plexus (___ plexus) is formed on each side of the ___ viscera by the continuation of the ___ nerves from the ___ plexus

the right & left plexuses are situated on the sides of the ___, ___, & ___

the plexuses receive contributions from several ___ nerves, which consist primarily of ___ sympathetic fibers that synapse w/ ___ sympathetic neurons in the plexus

Answer 17

pelvic, pelvic, hypogastric, superior hypogastric

rectum, uterine cervix, urinary bladder

sacral splanchnic, preganglionic, postganglionic

Question 18

parasympathetic supply to the abdomen & pelvis:

derived from two sources: ___

Answer 18

vagus nerve (CN X)

pelvic splanchnic nerves (S2, S3, S4)

Question 19

parasympathetic supply to the abdomen & pelvis:
the vagus nerve:

the vagal fibers enter the abdomen on the surface of the ___ as the anterior & posterior ___

these send direct branches to the ___, ___, & ___

these send branches to the ___, ___, & ___ plexuses

the preganglinoic parasympathetic fibers follow the respective blood vessels & supply all of the organs of the ___ & ___ as well as the ___ & ___

therefore, the vagus nerve supplies ___ ___ fibers to all of the organs in the abdominal cavity as far as the proximal 2/3 of the ___

___ ___ neurons (unlike their other-pathetic counterparts) do not lie in discreet ganglia but are scattered close to or in the walls of the ___

Answer 19

esophagus, vagal trunks

stomach, liver, gallbladder

celiac, superior mesenteric, aorticorenal

foregut, midgut, kidneys, proximal ureters

preganglionic parasympathetic, transverse colon

postganglionic parasympathetic, organs innervated

Question 20

the pelvic splanchnic nerves consist of ___ ___ fibers arising from spinal cord levels & spinal nerves ___

they supply all of the ___ derivatives as well as all ___ organs

Answer 20

preganglionic parasympathetic
S2, S3, & S4

hindgut, plevic

Question 21

pelvic splanchnic nerves destined to supply organs in the ___ join the ___ plexus & synapse w/ ___ ___ neurons in the plexus or in the walls of the organs innervated

Answer 21

pelvis, inferior hypogastric, postganglionic parasympathetic

Question 22

referred pain occurs when sensory information comes to the ___ from one location but is interpreted by the ___ as coming from another location innervated by the same ___ level

pain is most often referred from a region innervated by the ___ part of the nervous system to a region innervated (at the same ___ level) by the ___ part of the nervous system

the simplest hypothesis is that ___ ___ entering the posterior roots of spinal nerves may end on the same group of interneurons as ___ ___

what reaches consciousness in this case is not only the ___ pain but also ___ pain from the region of the body wall supplied by the same segments of the ___ which first received the ___ impulses

pain may also be referred from one ___ region to another

Answer 22

spinal cord, CNS, spinal cord

visceral, spinal cord, somatic

visceral afferents, somatic afferents

dull, poorly localized true visceral
sharp, well localized
spinal cord
visceral

somatic

Question 23

if you know the spinal cord levels supplying autonomic nerve fibers to an organ, & also the spinal cord levels receiving visceral pain fibers from that organ, then you will also know ___

Answer 23

the part of the body wall that will experience referred somatic pain, if it arises

Question 24

pelvic splanchnic nerves destined to supply the ___ derivatives in the ___ (distal 1/3 of the transverse colon, descending colon, & sigmoid colon) proceed upward by two roots:

they ascend in the ___ nerves & plexuses & then enter the ___ plexus coursing along the branches of the ___ artery

they course upward on the ___ ___ wall

Answer 24

hindgut, abdomen

hypogastric, inferior mesenteric, inferior mesenteric

posterior abdominal

Question 25

pelvic splanchnic nerves:

___ ___ neurons serving the digestive tract are spread out into two interconnected plexuses within the layers of the ___ ___

they are often described as components of the ___ nervous system

Answer 25

postganglionic parasympathetic, gastrointestinal tract

enteric

Question 26

composition of the plexuses:
celiac, superior mesenteric, aorticorenal, intermesenteric, inferior mesenteric:

\_\_\_ \_\_\_ fibers
\_\_\_ ganglia
\_\_\_ \_\_\_ fibers
\_\_\_ \_\_\_ fibers
\_\_\_ \_\_\_ (\_\_\_) fibers

Answer 26

preganglionic sympathetic
sympathetic
postganglionic sympathetic
preganglionic parasympathetic
visceral sensory (afferent)

Question 27

composition of the plexuses:
superior hypogastric & hypogastric nerves:

\_\_\_ \_\_\_ fibers
\_\_\_ \_\_\_ \_\_\_ neurons
\_\_\_ \_\_\_ fibers
\_\_\_ \_\_\_ fibers
\_\_\_ \_\_\_ (\_\_\_) fibers

Answer 27

preganglionic sympathetic
scattered postganglionic sympathetic
postganglionic sympathetic
preganglionic parasympathetic
visceral sensory (afferent)

Question 28

composition of the plexuses:
inferior hypogastric (pelvic) plexus:

\_\_\_ \_\_\_ fibers
\_\_\_ \_\_\_ \_\_\_ neurons
\_\_\_ \_\_\_ fibers
\_\_\_ \_\_\_ fibers
\_\_\_ \_\_\_ \_\_\_ neurons
\_\_\_ \_\_\_ fibers
\_\_\_ \_\_\_ (\_\_\_) fibers

Answer 28

preganglionic sympathetic
scattered postganglionic sympathetic
postganglionic sympathetic
preganglionic parasympathetic
scattered postganglionic parasympathetic
postganglionic parasympathetic
visceral sensory (afferent)

Question 29

somatic sensations may or may not be ___

they always reach the ___ level

all somatic sensations are well ___

stimuli include: ___

Answer 29

painful

conscious

localized

touch, temperature, pressure, stretch, cutting, etc.

Question 30

much visceral sensation never reaches ___ level b/c it is involved in ___ activities such as ___

visceral sensation reaching the ___ level is generally categorized as ___ or ___ (ex. ___)

all visceral sensations are poorly ___ by comparison w/ somatic sensations

stimuli include:

insensitive to ___ or ___

Answer 30

conscious
reflex
regulation of heart rates, blood pressure, vascular resistance, secretions, etc.

conscious
painful or uncomfortable
hunger, nausea

localized

ischemia, stretching (distention of an organ), muscle cramping, chemical irritants

cutting or temperature

Question 31

visceral pain fibers from most ___ & all ___ viscera travel centrally within the same bundles of nerves carrying ___ supply to those structures

therefore, if you know the ___ outflow pathway, you know the visceral inflow pathway

visceral pain fibers much reach the ___ before reaching a spinal nerve

visceral pain fibers travel from the ___ to a spinal nerve via the ___

visceral pain fibers enter the ___ of the spinal nerves from ___ to ___

Answer 31

thoracic, abdominal, sympathetic

sympathetic

sympathetic trunk

sympathetic trunk, white communicating rami

dorsal roots, T1 - L2

Question 32

visceral pain from most pelvic organs follows the ___ nerves pack to the ___ levels of the spinal cord

exceptions:

• the body and fundus of the ___ which follows the ___ pathway back to the ___ levels
• the roof of the ___ which follows the ___ pathway back to the ___ levels

Answer 32

pelvic splanchnic, S2 - S4

• uterus, sympathetic, T11 - T12
• bladder, sympathetic, T11 - L2