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Abdomen Autonomics

The autonomic nerve supply of the abdomen and pelvis

* What effect does the sympathetic system have on GI tract? Parasympathetic system? Inhibits peristalsis, constricts blood vessels, reduces glandular secretions, constricts sphincters; stimulates peristalsis, dilates blood vessels to tract, increases glandular secretions and relaxes sphincters
What part of the autonomic nervous system is the craniosacral division a part of? The parasympathetic
What part of the autonomic nervous system is the thoracolumbar division a part of? The sympathetic
* What effect does the sympathetic system have on liver? Parasympathetic system? Promotes breakdown of glycogen to glucose; promotes the production of glycogen
* What effect does the sympathetic system have on urinary bladder? Parasympathetic system? vasoconstriction of renal vessels (slow urine formation), relaxes detrusser muscle, contracts internal sphincter of the bladder; vasodilation of renal vessels, contract detrussor m., relax internal sphincter of bladder
* What effect does the sympathetic system have on genital system? Parasympathetic system? Causes ejaculation (males), orgasm (females); causes erection in penis and clitoris
* Which nerves supply the preganglionic sympathetic fibers to the abdominopelvic viscera? The thoracic, lumbar, and sacral splanchnic nerves
* From what vertebral levels do the preganglionic sympathetic fibers of the viscera originate from? From what structure in the spinal cord itself do they come from? ALL of them originate from levels T5-L2/L3; lateral gray horns
* Where do the preganglionic sympathetic fibers arising from the thoracic, lumbar, and sacral splanchnic nerves synapse? On the anterior aspect of the aorta prevertebral (collateral ganglia) and the hypogastric plexuses (where is this?)
* Name the major ganglia and where they are located They are named after the major branches of the abdominal aorta and receive the same names: celiac, superior mesenteric, aorticorenal, and inferior mesenteric ganglia
* Describe how the ganglia are connected; what is this structure called? The ganglia interconnect in front of the aorta in the aortic plexus (prevertebral plexus)
* What types of fibers does the aortic plexus contain? Pregang + postgangl. sympathetics, preganglionic parasympathetic, and visceral afferent
* What are the regional concentrations (e.g. subdivisions) of the aortic plexus called? How are they named? They are named after origins of the major arteries and proceed along major vessels: celiac, aorticorenal, superior mesenteric, and inferior mesenteric plexuses
* What structures do the celiac plexus supply? Postganglionic sympathatic fibers follow branches of celiac trunk to supply all of the derivatives of the FOREGUT: distal 1/3 esophagus, stomach, 1st and 2nd parts of duodenum, liver, gallbladder, pancreas, spleen
* What structures do the superior mesenteric plexus innervate? Midgut derivatives: 3rd and 4th parts of duodenum, jejunum, ileum, cecum, appendix, ascending colon, proximal 2/3 of transverse colon
* What structures do the aorticorenal plexus innervate? Follow renal arteries to supply kidneys and proximal uterer
* What structures do the inferior mesenteric plexus innervate? Hindgut derivatives: follow inferior mesenteric artery branches-->distal 1/3 of transverse colon, descending colon, sigmoid colon, rectum, and superior 1/2 of anal canal
* Where is the intermesenteric plexus located? (unsure what it supplies...) Part of the aortic plexus between the superior and inferior mesenteric plexus
Sympathetic fibers supplying the pelvis typically ____ follow the perivascular root. The organs are supplied by the ______ plexuses. do not; hypogastric
The superior hypogastric plexus is the continuation of the ____ plexus below the _____ plexus. It takes form over the inferior part of the ____ and the _____ ______. aortic, inferior mesenteric; aorta, aortic bifurcation
* What fibers form the superior hypogastric plexus (i.e. which kinds of fibers are carried?) Postganglionic sympathetics descending from the inferior mesenteric ganglion and preganglionic and some postganglionic sympathetic fibers from the lower lumber splanchnic nerves
The superior hypogastric plexus aggregates into two bundles called the ____ and ____ ______ nerves which descend into the pelvis. left and right hypogastric
Where does the inferior hypogastric plexus (pelvic plexus) form? What nerves are they the continuation of? Formed on each side of the pelvic viscera by continuation of the hypogastric nerves from the superior hypogastric plexus
Where are the right and left plexuses situated (of the inferior hypogastric plexus / pelvic plexus)? On the sides of the rectum, uterine cervix, and urinary bladder
The plexuses receive contributions from several ______ nerves, which consist primarily of ______ fibers that synapse with _______ neurons in the plexus Sacral splanchnic; preganglionic sympathetic fibers, postganglionic sympathetic neurons
* Name the two main sources of parasympathetic innervation in the abdomen and the pelvis Vagus nerve (CN X) and the pelvic splanchnic nerves (S2, S3, S4)
* Describe how the vagus nerve enters the abdominal cavity Vagal fibers enter on the surface of the esophagus as the anterior and posterior vagal trunks
* What structures receive direct branches from the vagal trunks? Stomach, liver, and gallbladder
* What plexuses in the abdomen receive branches from the vagal trunks? What structures do they innervate? What path do they generally take? Celiac, superior mesenteric, aorticorenal plexuses; preganglionic parasym. fibers follow respective blood vessels to organs of the foregut and midgut + kidneys and proximal urters (all organs in abdominal cavity as far as proximal 2/3 of transverse colon)
* Where do the preganglionic parasympathetic fibers that travel through the pelvic splanchnic nerves arise from in the spinal cord? S2, S3, S4
What structures do they supply? All of the hindgut derivatives (as well as all pelvic organs)
* What plexus do the pelvic splanchnic nerves join? What happens there? Join inferior hypogastric plexus; synapse with posganglionic parasympathetics neurons in plexus or int he walls of the organs innervated
* Describe the fate of the nerves destined to supply the hindgut derivatives int he abdomen (distal 1/3 of the colon, descending colon, sigmoid colon) Ascend the hypogastric nerves and plexuses, enter inferior mesenteric plexus, course along branches of inferior mesenteric; course upward on the posterior abdominal wall
_____ganglionic parasympathetic neurons serving the digestive tract are spread out into two interconnected plexuses within the layers of the ___________ wall. What are the often referred to as? Post; gastrointestinal; enteric nervous system
* Describe the components of the celiac, superior mesenteric, aorticorenal, intermesenteric, and inferior mesenteric plexuses Preganglionic sympathetics, sympathetic ganglia, postganglionic sympathetics, preganglionic parasympathetics, visceral sensory (afferent)
* Describe the components of the superior hypogastric plexus and hypogastric nerves Preganglionic sympathetics, sympathetic ganglia, postganglionic sympathetics, preganglionic parasympathetics, visceral sensory (afferent)
* Describe the components of the inferior hypogastric (pelvic) plexus Preganglionic sympathetics, sympathetic ganglia, postganglionic sympathetics, preganglionic parasympathetics, scattered postganglionic parasympathetic neurons, postganglionic parasympathetics, visceral sensory (afferent)
* Are somatic sensations always painful? Give examples of some somatic stimuli. They may or may not be, but they always reach conscious level and are well localized. Include: touch, temperature, pressure, stretch, cutting, etc.
Much _____ sensation never reaches conscious level because it is involved in ______ activities. Visceral, reflex
Visceral sensation reach the conscious level is generally categorized as _______ or _______. What are two examples of visceral sensations? painful, uncomfortable; hunger and nausea
Are visceral sensations poorly or well localized? What type of stimuli triggers visceral sensation? Poorly (compared to somatic sensations); ischemia, stretching, muscle cramping, chemical irritants; insensitive to cutting or temperature)
* Visceral pain fibers from most of the thoracic and all abdominal viscera travel centrally within the same bundles of nerves carrying _______ supply to those structures. Thus, if you know _____ outflow pathway, you know visceral inflow pathway. Sympathetic; sympathetic
What structure must pain fibers reach befoer reaching a spinal nerve? The sympathetic trunk
What rami do the visceral pain fibers travel through to pass from the sympathetic trunk to the spinal nerve? White communicating rami
Visceral pain fibers enter the dorsal roots of the spinal nerves from ____ to _____ (vertebral levels), though there are exceptions T1, L2
Visceral pain from most pelvic organs follow the _____ _____ nerves back to the ___-___ levels of the spinal cord except for what two structures? pelvic splanchnic nerves, S2-S4; Uterus (body and fundus) that follows sympathetic path back to T11-T12 and roof of the bladder that follows sympathetic path (T11-L2)
What nerve fibers do the visceral pain fibers for the lung tissue follow? Parasympathetic fibers of the vagus nerves
If you know the spinal cord supplying _______ nerve fibers to an organ, and also know the spinal cord levels receiving visceral pain fibers from the organ, you know part of body wall that will get referred somatic pain autonomic
Created by: karkis77



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