VSR and Autonomics Flashcards
What vertebral levels are the sympathetic outflow for the head and neck
T1 - T4
What vertebral levels are the sympathetic outflow for the heart
T1 - T5
What vertebral levels are the sympathetic outflow for the lungs and upper extremities
T2 - T7
What vertebral levels are the sympathetic outflow for the esophagus, stomach, duodenum, pancreas, liver, gallbladder, and spleen
T5 - T9
What vertebral levels are the sympathetic outflow for the adrenals, kidneys, upper ureters, ovaries/testes, jejunum to mid-transverse, colon, and appendix
T10 - T11
What vertebral levels are the sympathetic outflow for the distal transverse colon, anus, lower ureters, bladder, uterus and cervix/prostate, and lower extremities
T12 - L2
What vertebral level is the major VSR levels for the heart
T3
What vertebral level is the major VSR levels for the lungs
T2 Left (asthma reflex)
What vertebral levels are the major VSR levels for the esophagus
T3 - T6
What vertebral levels are the major VSR levels for the stomach
T5 Left
What vertebral level is the major VSR levels for the liver
T9 Right
What vertebral levels are the major VSR levels for the gallbladder
T10 Right
What vertebral levels are the major VSR levels for the kidneys
T10 - L1
What vertebral levels are the major VSR levels for the lower ureters
T12 - L1
What vertebral levels are the major VSR levels for the bladder
T11 - L2
What vertebral levels are the major VSR levels for the ureters and cervix/prostate
T11 - L2 (cervix/penis)
What vertebral levels are the major VSR levels for the lower extremities
T10 - T12
What are the main splanchnic nerves for T5 - T9
Greater splanchnic
What are the main splanchnic nerves for T10 - T11
Lesser splanchnic
What are the main splanchnic nerves for T12 - L2
Least splanchnic (T12)
Lumbar splanchnic (L1 - L2)
What are the main ganglion for T1 - T4
Superior, medial, and inferior cervical/stellate (sympathetic chain)
What are the main ganglion for T1 - T5
Superior, medial, and inferior cervical/stellate (sympathetic chain)
What are the main ganglion for T5 - T9
Celiac (prevertebral ganglia)
What are the main ganglion for T10 - T11
Superior mesenteric (prevertebral ganglia)
What are the main ganglion for T12 - L2
Inferior mesenteric (prevertebral ganglia)
(Some lesser splanchnic synapse onto IMG as well)
What cranial nerves are the parasympathetic outflow for the eye (pupil constriction)
CN III (oculomotor)
What cranial nerves are the parasympathetic outflow for the lacrimal and mucus glands of the nasal cavity
CN VII (Facial)
What cranial nerves are the parasympathetic outflow for the parotid glands
CN IX (glossopharyngeal)
What cranial nerves are the parasympathetic outflow for above the diaphragm and the “upper RUG”
CN X (vagus)
What nerves are the parasympathetic outflow for the “lower RUG”
S2 - S4
What is the main parasympathetic ganglion for CN III (oculomotor)
Ciliary
What is the main parasympathetic ganglion for CN VII (facial)
Pterygopalatine/sphenopalatine
Submandibular
What is the main parasympathetic ganglion for CN IX (glossopharyngeal)
Otic
What is the main parasympathetic ganglion for CN X (vagus)
Intramural ganglion of the innervated organ
What is the main parasympathetic ganglion for S2 - S4
Intramural ganglion of the innervated organ
What is the “upper RUG”
Reproductive (testes/ovaries)
Urinary (proximal ureter)
GI (everything to the proximal colon)
What is the “lower RUG”
Reproductive (erection of penis/ovaries)
Urinary (distal ureter and voiding)
GI (distal colon to anus)
What is the somatic nerve cell system
One long axon with acetylcholine to muscle
What is the PNS nerve cell system
Long preganglionic axon with acetylcholine to short postganglionic axon with acetylcholine to organs
What is the SNS nerve cell system
Short preganglionic axon with acetylcholine to long postganglionic axon with norepinephrine to organs
What is the SNS sweat gland nerve cell system
Short preganglionic axon with acetylcholine to long postganglionic axon with acetylcholine to sweat glands
What is the SNS adrenal gland nerve cell system
Long axon with acetylcholine to adrenal glands to produce epinephrine
Pathway of the SNS
T vertebra
White rami
Sympathetic chain ganglion
Splanchnic nerves
Plexuses
Ganglion
Effector organs
What are the cervical ganglion
Superior cervical (C2 - C3)
Middle cervical (C6)
Inferior/stellate (if fused with thoracic) (C7 - 1st rib)
Function of superior cervical ganglion
Dilate iris, lacrimal glands, salivary glands, erector pili muscles
Innervates heart (superior cardiac nerve)
Function of middle cervical ganglion
Innervates thyroid, esophagus, trachea, lower neck, arm, posterior cranial arteries
Innervates heart (middle cardiac nerve to cardiac plexus)
Function of inferior cervical ganglion
Innervates heart, lower neck, arm, radial artery, posterior cranial arteries
3 Borders of the GI SNS
T5 - T9 ligament of Treitz (jejunum) (celiac ganglia)
T10 (Treitz) - T11 (splenic flexure) (superior mesenteric)
T12 (splenic flexure)- L2 (rectum/ genitourinary, and pelvis) (inferior mesenteric)
Pathway of PNS
Craniosacral Vertebrae (vagus or S2 - S4)
Vagus or pelvic splanchnic nerves
Plexus
Organ ganglion
Effector organ
What splanchnics exit S2 - S4
Sacral (SNS)
Pelvic (PNS)
Reflexes related to spinal fascilitation
Somatosomatic
Viscerosomatic and Chapman points
Viscerovisceral
Somatovisceral
Example of somatosomatic reflex
Hot stove
Example of viscerosomatic reflex
Heart pain deferred to arm
When might you use dorsal inhibition
To balance autonomics
To affect VSRs or visceral pathology
When might you use rib raising
To balance the autonomics
To affect VSRs or visceral pathology, i.e., an asthma attack
When might you use ventral inhibitory release
To affect digestion, absorption, elimination
When might you use sacral inhibition
To affect predominately the PNS sacral division
To affect pelvic organs
When might you use sacral rocking
To affect predominately the PNS sacral division
To affect pelvic organs
