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Auntonomic Nervous System in the Thorax & Abdomen
Cole lecture 2/24 - 2 hrs
63
Anatomy
Undergraduate 4
02/23/2011

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Term
somatic innervation
Definition
this type of innervation concerns the body wall, ex: skeletal muscle and skin
Term
visceral innervation
Definition
this type of innervation concerns the internal organs ex: innervation of the heart
Term
2
Definition
how many neurons connect the CNS to target tissue with visceral motor innervation(sympathetic/parasympathetic)?
Term
smooth muscle, cardiac muscle, and glands
Definition
what are the target tissues of visceral innervation?
Term
sympathetic and parasympathetic
Definition
what are the 2 components of visceral innervation?
Term
sympathetic
Definition
increases in ____ innervation are associated with energy expenditure and increased metabolic rate
Term
+ increased HR, strength of contraction and stroke volume
+ dilation of coronary arteries => + blood flow to heart
+ dilation of respiratory passages
- constriction of pulmonary arteries
+ increased blood flow to skeletal musc.
- decrease blood to/secretion of digestive organs/glands
+ retention of urine/feces (think constipation here, contract bladder/anal sphincter)
+ increase in sweating
+ important for sexual function
Definition
list the effects of increased sympathetic innervation
Term
sweating - cole said it is like an on/off switch with sympathetic on or off
Definition
what recieves only sympathetic innervation (has no parasympathetic counterpart)?
Term
- decreased HR, contraction strength, stroke volume
- constriction of coronary arteries => -decreased blood flow to heart
-constriction of resp. passages
+ dilation of pulmonary arteries
- decreased blood to skeletal musc.
+ increase blood to/secretion of digestive organs/glands
+ increased elimination of urine/feces (relax bladder/anal sphincter)
+ important in sexual function
Definition
list the effects of increased parasympathetic innervation
Term
symp: T1-L2 (thoracolumbar) lateral gray horn
para: brain or S2-S4 (craniosacral) lateral gray horn
Definition
where are sympathetic preganglionic cell bodies found? para?
Term
paravertebral -sympathetic trunk, about half way between target and CNS (supposedly with longer post ganglionic neuron)
Definition
where are the ganglia for sympathetics located?
Term
embedded in the organ
Definition
where are the ganglia for parasympathetics located?
Term
sympathetic (para doesn't always - cranial nerves)
Definition
always uses a spinal nerve for innervation
Term
cell body between T1-L2 lateral gray horn -> ventral root (motor) -> spinal nerve proper -> ventral rami -> white ramus communicans -> paravertebral ganglia(thoracic) -> [pre-vertebral ganglia(abdomen)] synapse! -> target tissue (hops out the side of the ganglia)
Definition
describe the path of sympathetic inervation to the thoracic region
Term
thoracic splanchnic/ cardiopulmonary splanchnic nerve
Definition
what is the name of the post ganglioninc neuron in sympathetic thorax innervation (above the diaphragm)?
Term
abdominal splanchnic n. (abdominopelvic splanchnic n.)
Definition
what is the name of the PRE-Ganglionic neuron in abdominal sympathetic innervation (below the diaphragm)
Term
a post ganglionic sympathetic plexus
Definition
what is a prevertebral ganglia?
Term
sympathetic THORACIC visceral motor (and the body wall sympathetics)
Definition
which neuron synapses in the paravertebral ganglia?
Term
sympathetic ABDOMINAL visceral motor
Definition
what neuron synapses in pre-vertebral ganglia?
Term
no, abdominal sympathetics are in the prevertebral ganglia so the preganglionic neuron passes through, but does not synapse in the paravertebral ganglia
Definition
do all sympathetics synapse in paravertebral ganglia?
Term
above T5 = post ganglionic sympathetics
below T5 = preganglionic sympathetics
Definition
nerves coming out of sympathetic chain (paravertebral) ganglia anteriorly above t5 are what? below T5?
Term
sympathetic innervation (post ganglionic neurons) of the body wall in T1-L2 ONLY, no visceral motor!!!!
Definition
what goes through gray rami communicans?
Term
greater splanchnic nerce
Definition
name of the biggest abdominal splanchnic nerve
Term
lumbar and sacral ganglia
Definition
which ganglia do the sympathetics to the pelvis go through?
Term
preganglionic parasympathetic
Definition
the vagus nerve is pre/post ganglionic para/sympathetic
Term
common carotid artery
Definition
what vessel does the vagus nerve follow in the neck?
Term
right at the target organ (the synapse is microscopic)
Definition
where does the vagus nerve synapse?
Term
thoracic and abdominal organs until 2/3 of the way through the transverse colon (pancreas, liver, spleen)
Definition
what does the vagus nerve innervate?
Term
last part of colon, rectum, pelvic organs
Definition
what is innervated by the S2-S4 part of parasympathetics?
Term
small lateral horn of S2-S4 ->
ventral root (motor) ->
spinal nerve proper ->
ventral rami(epaxial) ->
no rami communicans!, comes out its own side branch to synapse right before the organ
Definition
how does the spinal portion of parasympathetics travel?
Term
preganglionic parasympathetic
Definition
what kind of neuron is the pelvic splanchnic nerve? (not abdominopelvic)
Term
brain -> target tissue, may branch near one tissue before going to the next
Definition
describe the path of the vagus nerve
Term
it may have some fibers, but it will not synapse or mix with sympathetics
Definition
does the vagus nerve pass through the sympathetic plexi?
Term
pre-ganglionic neuron
Definition
in the lower abdomen, what kind of neuron is the parasympathetic neuron you see? (pre/post ganglionic)
Term
pain, visceral afferents
Definition
what are the 2 types of visceral sensations?
Term
ischemia (no O2)
cramping (prolonged smooth muscle contraction)
distention (stretching)
Definition
what are the stimuli of visceral pain?
Term
dull, diffuse, poorly localized
Definition
descriptors of visceral pain
Term
no
Definition
do visceral organs feel cutting or burning or freezing?
Term
it can cause bloating and stimulate the visceral stretch receptor => pain
Definition
why does bad gas cause pain?
Term
follow sympathetic pathways backwards to the spinal nerve proper, then dorsal root (just like somatic sensory)
Definition
where do visceral PAIN axons in the thorax and abdomen travel?
Term
dorsal root ganglia
Definition
where are all visceral pain neuron cell bodies?
Term
they follow parasympathetic pathways (pelvic splanchnic n,) backwards to spinal nerve proper then go through dorsal root like somatic sensory
Definition
where do the visceral pain axons for the pelvis travel?
Term
-sympathetic/parasympathetic balance
-consciously nausea and hunger (NOT PAIN)
Definition
what do the visceral afferents (other than pain sense?)
Term
thorax/abs- follow vagus nerve
pelvic- pelvic splanchnic n. just like visceral pain
Definition
what is the path of visceral afferents other than pain for the thorax/abdomen? the pelvis?
Term
somatic sensory synapse
visceral pain synapse
visceral afferent synapse
Definition
what is found in the dorsal root ganglia of the abdomen?
Term
somatic sensory synapse
visceral pain synapse
(no visceral afferent other than pain, they follow the vagus n.)
Definition
what is found in the dorsal root ganglia of the thorax?
Term
visceral pain cell synapse
visceral afferent synapse
no somatic sympathetics - (they only come out of T1-L2)
Definition
what is found in the dorsal root ganglia of the pelvis? (below L2)
Term
no, just sensory-autonomics are motor
Definition
do dorsal root ganglia contain autonomics?
Term
it can be "referred" to the dermatome at the same spinal level, even though there is no real stimulus causing somatic pain (could be a mixing in the spinal cord at the dorsal horn)
Definition
when visceral pain is felt, somatic pain can be felt elsewhere, where?
Term
shoulder and arm (and between shoulder blades at base of neck)
Definition
where is pain from an MI felt?
Term
brain takes in visceral pain, but thinks everything in that spinal cord is hurting
Definition
how does referred pain work?
Term
right side of the neck and right upper quardant
Definition
where is liver and gall bladder pain referred to?
Term
left side of the neck
Definition
where is lung and diaphragm pain referred to?
Term
below the xiphoid process and mid upper back (between lower parts of scapula)
Definition
where is stomach pain referred to?
Term
left upper quardant of abdomen, and above the waist on the left side of the back
Definition
where is pancreas pain referred to?
Term
either side of the unbillicus
Definition
where is ovary pain referred to?
Term
right lower quadrant
Definition
where is appendix pain referred to?
Term
above the pubic symphysis, around the anal opening, and posteriorly between the legs in the upper thigh
Definition
where is bladder pain referred to?
Term
groin (area where people who don't shave have hair hanging out their bikini)
Definition
where is ureter pain referred to?
Term
HUGE AREA everything that would be covered by ass-less chaps that only go down the thigh half way
Definition
where is kidney pain referred to?
Term
area just superior to the umbillicus
Definition
where is small intestine pain referred to?
Term
lung/diaphragm
heart
gall bladder/liver
stomach
pancreas
kidney
urinary bladder
Definition
which organs refer pain to both anterior and posterior areas of the body?
Term
looks about halfway between umbillicus and groin
Definition
where is colon pain referred to?
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