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CPR Exam 1 > Thoracic Neurology > Flashcards

Thoracic Neurology Flashcards

1
Q

What are the regions of the esophagus?

A 
Cervical part 
Thoracic part (between T1 and esophageal hiatus of the thoracic diaphragm travels through the posterior mediastinum) 
Abdominal part
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2
Q

Where can constrictions of the esophagus occur?

A

At the cricopharyngeus M (clinically referred to as the upper esophageal sphincter)
At the aortic arch
At the left bronchus
At the esophageal hiatus of the thoracic diaphragm (clinically referred to as the LES)

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3
Q

Describe the vagus N

A

Enters the thorax through superior thoracic aperture
Produces the left recurrent laryngeal N, the pulmonary and inferior cardiac branches on the esophagus
Immediately proximal to entering the abdomen the vagus nerves become an anterior and posterior vagal trunk on the anterior and posterior surface of the esophagus

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4
Q

What are the branches of the vagus N?

A

Left recurrent laryngeal N, pulmonary branches, inferior cardiac branch, anterior and posterior vagal trunk

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5
Q

Describe the left recurrent laryngeal N

A

Loops under aortic arch and ligamentum arteriosum to the larynx

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6
Q

Describe the anterior vagal trunk

A

Derived primarily from the left vagus N
Anterior to the esophagus
Enters the abdomen through the esophageal hiatus

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7
Q

Describe the posterior vagal trunk

A

Derived primarily from the right vagus N
Posterior to the esophagus
Enters the abdomen through the esophageal hiatus

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8
Q

Describe the phrenic nerve

A

Anterior rami of C3-5

Travels through the superior thoracic aperture into the space b/w mediastinal parietal pleura and fibrous pericardium

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9
Q

What does the phrenic N innervate?

A

The thoracic diaphragm

Conveys sensory information from central diaphragmatic and mediastinal pleura and the pericardium

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10
Q

Describe the intercostal N

A

1-11th pair of anterior rami of thoracic spinal nerves

Travel along the inferior edge of the superior rib in the intercostal space b/w internal and innermost intercostal M

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11
Q

What do the intercostal N innervate?

A

Skin, subcutaneous tissue, musculature and costal diaphragmatic parietal pleura

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12
Q

What are the typical intercostal Ns?

A

3rd-6th

Rami communicans, collateral branches, lateral branches, anterior cutaneous and muscular branches

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13
Q

What do the rami communicantes of the typical intercostal Ns connect?

A

Intercostal N to ipsilateral sympathetic trunk

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14
Q

What is the function of collateral branches of typical intercostal Ns?

A

Assist in innervating intercostal M

Travels on the superior edge of the rib inferior to the intercostal space

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15
Q

Describe the lateral cutaneous branch of the typical intercostal Ns

A

Become anterior and posterior branches and supply the skin of the thoracic wall
T4-6 supply the breast

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16
Q

What do the anterior cutaneous branches (of typical intercostal) supply?

A

Anterior aspect of the thoracic wall

T4-6 supply the breast

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17
Q

What do the muscular branches of the typical intercostal Ns supply?

A

Intercostal Ms, Subcostal M and transversus thoracis M

18
Q

Describe the 1st atypical intercostal N

A

No cutaneous branches and majority superior portion joins the brachial plexus

19
Q

Describe the 2nd atypical intercostal Ns

A

Majority travels in the costal groove as a typical intercostal N with a small part joining the brachial plexus
The lateral cutaneous branch supplies the skin and subcutaneous tissue of the axilla and is called the intercostobrachial N

20
Q

Describe 7th-11th atypical intercostal Ns

A

Begin as intercostal N but as they travel anteriorly cease to exist between ribs and transition over the abdomen to become thoracoabdominal Ns

21
Q

Describe the distribution of the PNS

A

Limited to the head, neck and trunk viscera, never in the body wall or extremities whereas the SNS distributes to all vascular areas of the body

22
Q

What is glandular secretion stimulated by?

A

The PNS (except sweat glands)

23
Q

What can indirectly decrease non-sweat gland glandular secretion through vasoconstriction?

A

SNS

24
Q

What stimulates vasoconstriction?

A

Sympathetics

25
Q

Review

A

Sympathetic synapse options

26
Q

Describe the thoracic sympathetic trunk

A

Paravertebral sympathetic ganglia

Location of presynaptic sympathetic nerve fibers synapsing onto long postsynaptic nerve cell bodies

27
Q

What do the cardiopulmonary splanchnic nerves innervate?

A

The heart and lungs via cardiac splanchnic and pulmonary splanchnic nerves

28
Q

Describe the abdominopelvic splanchnic nerves

A

Travel from the thoracic sympathetic trunk to corresponding prevertebral ganglia in the abdomen
Greater, lesser and least splanchnic N

29
Q

Describe the greater splanchnic N

A

T5-9 or 10

Sends fibers to the esophageal plexus and to the celiac ganglion in the abdomen which then feeds into the celiac plexus

30
Q

Describe the lesser splanchnic nerve

A

T10-11
Sends fibers to the celiac an superior mesenteric ganglion in the abdomen which then feeds into the superior mesenteric plexus

31
Q

Describe the least splanchnic nerve

A

T12

Sends fibers to the aorticorenal ganglion in the abdomen

32
Q

Review

A

PNS synapse

33
Q

Describe the superior cardiac branch of the vagus N

A

Originates in the neck and descends through the superior thoracic aperture and with the cardiac splanchnic Ns forms the cardiac plexus

34
Q

Describe the middle cardiac branch of the vagus N

A

Originates in the neck and descends through the superior thoracic aperture and with the cardiac splanchnic Ns forms the cardiac plexus

35
Q

Describe the inferior cardiac branch of the vagus N

A

Originates in the thorax and with the cardiac splanchnic Ns forms the cardiac plexus

36
Q

After producing pulmonary branches the vagus N becomes indistinguishable from what?

A

The esophageal plexus that covers the inferior 2/3 of the esophagus

37
Q

What are the thoracic autonomic plexuses?

A

Pulmonary plexus, cardiac plexus, aortic plexus, esophageal plexus

38
Q

Describe the pulmonary plexus

A

Mixed sympathetic and parasympathetic
Sympathetics from pulmonary splanchnic Ns (post)
Parasympathetics from pulmonary branches of vagus N (pre)

39
Q

Describe the cardiac plexus

A

Mixed
Superficial and deep both going to the heart
Sympathetics from cardiac splanchnic N
Parasympathetic contribution from superior, middle and inferior cardiac branches of vagus N

40
Q

Describe the aortic plexus

A

Mixed
Sympathetic contribution: continuous with the superficial cardiac plexus
Parasympathetic contribution: continuous with the superficial cardiac plexus
Travels down aorta

41
Q

Describe the esophageal plexus

A

Mixed
Sympathetic from greater splanchnic N
Parasympathetic from esophageal branches of the vagus N

42
Q

What does the pulmonary plexus innervate?

A

Lungs, bronchi and pleura

CPR Exam 1 (14 decks)

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