Unit VII: Sympathetics Flashcards

1
Q

General course of pre-ganglionic sympathetic neurons Pg 267

A

Lateral horn T1-L2 or L3 -> anterior rootlets -> anterior primary ramus -> enter sympathetic trunk via white ramus communicans -> some synapse on post-ganglionic cells in the trunk, some pass through in splanchnic nerves to synapse in prevertebral plexuses

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2
Q

Sympathetic are classical _____ (cholinergic or adrenergic) Pg 267

A

Adrenergic

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3
Q

Sympathetic fibers release what? Pg 267

A

Acetylcholine

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4
Q

Where does the sympathetic trunk extend from? Pg 267

A

Superior cervical ganglion inferior to ganglion impar

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5
Q

How many ganglion in each sympathetic trunk? Pg 267

A

21 or 22 (2-3 cervical, 11 thoracic, 4 lumbar, and 4 sacral)

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6
Q

Location of the sympathetic trunk Pg 267

A

Posterior to the carotid sheath in the cervical area, anterior to the necks of the ribs in the upper thoracic area, more medial resting on the lateral aspects of the vertebral bodies in the lower thoracic and lumbar areas, anterior aspect of the sacrum, and joining at the ganglion impar at the coccyx

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7
Q

Where does the cervical sympathetic trunk and ganglion lie? pg 267

A

Between the carotid sheath and the longus colli and longus capitis muscles

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8
Q

Does the cervical sympathetic trunk and ganglion have white rami communicans? Pg 267

A

NO

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9
Q

Does the cervical sympathetic trunk and ganglion have gray rami communicans? Pg 267

A

Yes, one to each cervical nerve

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10
Q

How many cervical ganglion are there and what are their names? Pg 268

A

3; superior, middle, and inferior cervical ganglion

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11
Q

The inferior cervical ganglion may fuse with the first thoracic ganglion to form what ganglion? Pg 268

A

Stellate

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12
Q

Which cervical ganglion is the largest? Pg 268

A

Superior

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13
Q

What forms the superior cervical ganglion? Pg 268

A

Union of upper four cervical ganglion

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14
Q

Where is the superior cervical ganglion located? Pg 268

A

C2-C3, between carotid sheath and longus capitis muscle

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15
Q

How are post-ganglion fibers distributed from the superior cervical ganglion? Pg 268

A

Anterior, medial, and lateral branches

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16
Q

What do the lateral branches from the superior cervical ganglion communicate with? Pg 268

A

Anterior primary rami of C1-4 as well as come cranial nerves (IX, X, XII)

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17
Q

Which branch off the superior cervical ganglion is the gray ramus communicans? Pg 268

A

Lateral

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18
Q

Where do the medial branches off the superior cervical ganglion travel? Pg 268

A

Larynx, pharynx and the heart

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19
Q

What are branches to the heart from the medial branches off the superior cervical ganglion called? Pg 268

A

Superior cardiac nerves

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20
Q

What kind of information is carried in superior cardiac nerves? Pg 268

A

Efferent information only

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21
Q

Where do the anterior branches off the superior cervical ganglion travel? Pg 268

A

Follow the common and external carotid arteries, innervating blood vessels that supply structures inside and outside the skull

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22
Q

Which cervical ganglion is the smallest? Pg 268

A

Middle

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23
Q

Where is the middle cervical ganglion located? Pg 268

A

C6

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24
Q

Middle cervical ganglion communicates with anterior primary rami of C5 and C6 nerves via what? Pg 268

A

Gray rami communicans

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25
Q

Which branch of the middle cervical ganglion reaches the thyroid and parathyroid glands? Pg 268

A

Thyroid branches

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26
Q

Cardiac branches from the middles cervical ganglion travel to the heart as what nerves? Pg 268

A

Middle cardiac nerves

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27
Q

What % of the time does the inferior cervical ganglion fuse with the first thoracic ganglion? Pg 270

A

80%

28
Q

Where is the inferior cervical ganglion located? Pg 270

A

Level of C7 transverse and neck of first rib

29
Q

Inferior cervical ganglion communicates with anterior primary rami of C7 and C8 nerves via what? Pg 270

A

Gray rami communicans

30
Q

Cardiac branches from the inferior cervical ganglion travel to the heart as what nerves? Pg 270

A

Inferior cardiac nerves

31
Q

Where do the branches from the inferior cervical ganglion travel? Pg 270

A

Subclavian artery and form plexuses around it and its branches ie. axillary and vertebral arteries

32
Q

How many thoracic ganglion are there? Pg 270

A

11-12

33
Q

Do all thoracic nerves have white rami communicans, gray rami communicans, or both? Pg 270

A

Both

34
Q

Where are thoracic ganglion located in the superior thorax? Pg 270

A

Anterior to the rib heads

35
Q

Were are thoracic ganglion located in the inferior thorax? Pg 270

A

Lateral aspects of the vertebral bodies

36
Q

What do branches from the upper 5 thoracic ganglion supply? Pg 270

A

Structures in the thoracic cavity

37
Q

What kind of information is carried in branches from the upper 5 thoracic ganglion? Pg 270

A

Post-ganglionic sympathetic fibers and visceral afferents

38
Q

How many splanchnic nerves are associated with the lower 7 segments of the thoracic sympathetic trunk? Pg 270

A

3

39
Q

What are the names of the 3 splanchnic nerves associated with the lower 7 segments of the thoracic sympathetic trunk Pg 270

A

1) greater splanchnic
2) lesser splanchnic
3) least splanchnic

40
Q

Path of the greater splanchnic nerve Pg 270

A

Formed from the 5th-9th ganglion, terminates in the celiac ganglion

41
Q

Path of the lesser splanchnic nerve Pg 270

A

Formed from 9th and 10th or 10th and 11th ganglion, terminates in the aorticorenal ganglion

42
Q

Path of the least splanchnic nerve Pg 270

A

Formed from the 12th ganglion, terminates in the renal plexus

43
Q

Where is the lumbar sympathetic trunk located? Pg 271

A

Retroperitoneal space, on the lateral aspects of the lumbar vertebral bodies

44
Q

How many lumbar ganglion are there? Pg 271

A

4

45
Q

Which lumbar nerves have white rami communicans? Pg 271

A

The first 2 sometimes the 3rd

46
Q

Which lumbar nerves have gray rami communicans? Pg 271

A

ALL

47
Q

How many splanchnic nerves are associated with the lumbar sympathetic trunk? Pg 271

A

2-4

48
Q

Splanchnic nerves associated with the lumbar sympathetic trunk carry what kind of information where? Pg 271

A

Pre-ganglionic sympathetic to the plexus surrounding the abdominal aorta

49
Q

Where is the sacral sympathetic trunk located? Pg 271

A

Anterior aspects of the sacrum, medial to the anterior sacral foramina

50
Q

How many sacral ganglion are there? Pg 271

A

4-5

51
Q

Which sacral nerves have white rami communicans? Pg 271

A

NONE

52
Q

Which lumbar nerves have gray rami communicans? Pg 271

A

All

53
Q

Where do the sympathetic trunks converge? Pg 271

A

Anterior surface of the coccyx (ganglion impar)

54
Q

Preganglionic axons travel from __-__ cord levels to enter the sympathetic trunk Pg 271

A

T1-L2(L3)

55
Q

Preganglionic axons that influence the head and neck are carried in what nerves and synapse where? Pg 271

A

T1-T2 nerves, superior cervical ganglion

56
Q

Preganglionic axons that influence the heart are carried in what nerves and synapse where? Pg 271

A

T1-T4 nerves, one of the three cervical ganglion

57
Q

Preganglionic axons that influence the lungs are carried in what nerves and synapse where? Pg 272

A

T2-T4 nerves, 2nd, 3rd, and 4th thoracic ganglia

58
Q

Preganglionic axons that influence the upper extremities are carried in what nerves and synapse where? Pg 272

A

T3-T7, middle cervical and inferior cervical/stellate ganglia

59
Q

Preganglionic axons that influence the abdominal viscera are carried in what nerves and synapse where? Pg 272

A

T5-T12, lower thoracic ganglion (may also pass through to be carried by the greater, lesser, least splenic nerves)

60
Q

Preganglionic axons that influence the pelvic viscera are carried in what nerves and synapse where? Pg 272

A

T10-L2, lower thoracic, lumbar, and pelvic ganglia

61
Q

Preganglionic axons that influence the lower extremities are carried in what nerves and synapse where? Pg 272

A

T10-L2, 2nd-4th sacral ganglion

62
Q

Fibers are carried from the sympathetic trunk in what 3 ways? Pg 272

A

1) nerves
2) blood vessels
3) direct branches

63
Q

What do fibers of the greater splanchnic nerve supply? Pg 275

A

The esophagus and thoracic aorta above the diaphragm, fibers also transmitted through the celiac plexus to much of the abdominal viscera

64
Q

What do fibers of the lesser splanchnic nerve supply? Pg 275

A

The same abdominal structures as the greater splanchnic nerve with the addition of suprarenal glands

65
Q

What do fibers of the least splanchnic nerve supply? Pg 275

A

Kidneys through the renal plexus