The Autonomic Nerve Supply of the Abdomen & Pelvis Flashcards
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: ___
autonomic nervous
antagonistic
- thoracolumbar
- craniosacral
smooth muscle, glands, arteries
the sympathetic system is generally involved in the ___
the parasympathetic system is generally involved in the ___
mobilization of the body’s energy for quick response
conservation of energy
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
preganglionic, thoracic, lumbar, sacral, splanchnic
lumbar, sacral, splanchnic, postganglionic
___ of the preganglionic sympathetic fibers to the abdominopelvic viscera originate from preganglionic sympathetic neurons in the ___ ___ horns from levels ___ to ___
all, lateral gray, T5, L2/L3
the preganglionic sympathetic fibers in the ___, ___ & ___ ___ nerve synapse in ganglia on the anterior aspect of the aorta ___ (___ ganglia) & the ___ plexuses
thoracic, lumbar, sacral, splanchnic
prevertebral (collateral), hypogastric
these named ganglia are situated at the root of the major branches of the abdominal aorta & receive the same names (4)
celiac ganglion
superior mesenteric ganglion
aorticorenal ganglion
inferior mesenteric ganglion
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)
nerve plexus
aortic, prevertebral
the aortic plexus contains ___ sympathetic fibers, ___ parasympathetic fibers, & ___ ___ fibers
preganglionic & postganglionic
preganglionic
visceral afferent
regional concentrations of the aortic plexus around the origins of the ___, ___, ___, & ___ arteries from correspondingly named plexuses & proceed along the respective vessels
celiac
renal –> aorticorenal
superior mesenteric
inferior mesenteric
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 ___
- ___ & ___
- ___
- ___
postganglionic, foregut
- esophagus
- stomach
- duodenum
- liver & gallbladder
- pancreas
- spleen
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 ___ ___
postganglionic, midgut
- duodenum
- jejunum
- ileum
- cecum & appendix
- ascending colon
- transverse colon
distribution of the plexuses:
aorticorenal plexus:
___ fibers of the plexus follow the ___ arteries to supply the ___ & the proximal ___
postganglionic
renal
kidneys
ureter
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 ___ ___
postganglionic, hindgut
- transverse colon
- descending colon
- sigmoid colon
- rectum
- anal canal
distribution of the plexuses:
intermesenteric plexus:
the intermesenteric plexus is the part of the ___ plexus between the ___ & ___ plexuses
aortic
superior & inferior mesenteric
sympathetic supply to the pelvis:
fibers for the most part do not follow the ___ root
the organs are supplied by the ___ plexuses
perivascular
hypogastric
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 ___
aortic, inferior mesenteric
aorta, aortic bifurcation
- postganglionic, inferior mesenteric
- preganglionic, postganglionic, lumbar splanchnic
right & left hypogastric, pelvis
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
pelvic, pelvic, hypogastric, superior hypogastric
rectum, uterine cervix, urinary bladder
sacral splanchnic, preganglionic, postganglionic
parasympathetic supply to the abdomen & pelvis:
derived from two sources: ___
vagus nerve (CN X)
pelvic splanchnic nerves (S2, S3, S4)
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 ___
esophagus, vagal trunks
stomach, liver, gallbladder
celiac, superior mesenteric, aorticorenal
foregut, midgut, kidneys, proximal ureters
preganglionic parasympathetic, transverse colon
postganglionic parasympathetic, organs innervated
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
preganglionic parasympathetic
S2, S3, & S4
hindgut, plevic
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
pelvis, inferior hypogastric, postganglionic parasympathetic
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
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
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 ___
the part of the body wall that will experience referred somatic pain, if it arises
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
hindgut, abdomen
hypogastric, inferior mesenteric, inferior mesenteric
posterior abdominal
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
postganglionic parasympathetic, gastrointestinal tract
enteric
composition of the plexuses:
celiac, superior mesenteric, aorticorenal, intermesenteric, inferior mesenteric:
\_\_\_ \_\_\_ fibers \_\_\_ ganglia \_\_\_ \_\_\_ fibers \_\_\_ \_\_\_ fibers \_\_\_ \_\_\_ (\_\_\_) fibers
preganglionic sympathetic sympathetic postganglionic sympathetic preganglionic parasympathetic visceral sensory (afferent)
composition of the plexuses:
superior hypogastric & hypogastric nerves:
\_\_\_ \_\_\_ fibers \_\_\_ \_\_\_ \_\_\_ neurons \_\_\_ \_\_\_ fibers \_\_\_ \_\_\_ fibers \_\_\_ \_\_\_ (\_\_\_) fibers
preganglionic sympathetic scattered postganglionic sympathetic postganglionic sympathetic preganglionic parasympathetic visceral sensory (afferent)
composition of the plexuses: inferior hypogastric (pelvic) plexus:
\_\_\_ \_\_\_ fibers \_\_\_ \_\_\_ \_\_\_ neurons \_\_\_ \_\_\_ fibers \_\_\_ \_\_\_ fibers \_\_\_ \_\_\_ \_\_\_ neurons \_\_\_ \_\_\_ fibers \_\_\_ \_\_\_ (\_\_\_) fibers
preganglionic sympathetic scattered postganglionic sympathetic postganglionic sympathetic preganglionic parasympathetic scattered postganglionic parasympathetic postganglionic parasympathetic visceral sensory (afferent)
somatic sensations may or may not be ___
they always reach the ___ level
all somatic sensations are well ___
stimuli include: ___
painful
conscious
localized
touch, temperature, pressure, stretch, cutting, etc.
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 ___
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
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 ___
thoracic, abdominal, sympathetic
sympathetic
sympathetic trunk
sympathetic trunk, white communicating rami
dorsal roots, T1 - L2
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
pelvic splanchnic, S2 - S4
- uterus, sympathetic, T11 - T12
- bladder, sympathetic, T11 - L2
