11. Thoracic Neurology Flashcards
(44 cards)
what is the thoracic esophagus and where is it located
tube joining laryngopharynx to stomach
T1 & esophageal hiatus or diaphragm (travel thru post mediastinum)
what are the 4 constriction sites of the esophagus & why are they significant
- @ cricopharyngeus M - right below larynx (upper esophageal sphincter)
- @ aortic arch
- @ L. bronchus
- @ esophageal hiatus of diaphragm (lower esophageal sphincter)
-where food can get stuck if not small enough
what are the branches of the vagus N
recurrent laryngeal Ns
cardiac branches
pulmonary branches
esophageal branches
vagal trunks
how do R & L recurrent laryngeal Ns differ
R = off the neck, under subclavian A then back u
L = goes down and loops around aortic arch & ligamentum arteriosum & then back to larynx (prob at arch/ligamentum - hoarse voice)
where do the cardiac branches come off the vagus N
superior & middle @ neck
inferior @ thorax
where do anterior and posterior vagal trunks come from & where to they go
L vagus N –> ant
R vagus N –> post
==> both go to abd via esophageal hiatus
where does the phrenic N travel
what does it do
thru superior thoracic aperature and into space btn the mediastinal parietal pleura & fibrous pericardium
= sensory info from central diaphragm, mediastinal pleura & pericardium
what do the thoracic spinal Ns make
intercostal Ns
(=anterior rami of thoracic spinal Ns)
where do intercostal Ns travel
inf edge of superior rib in intercostal space
& btn internal and inner most intercostal Ms
what do the intercostal Ns innervate
skin
subcutaneous tissue
intercostal Ms
costal/diaphragmatic parietal pleura
which intercostal Ns are atypical & typical
atypical = 1-2 & 7-11
typical = 3-6
what are the branches of the typical intercostal Ns
- rami comunicates
- collateral branches
- lateral cutaneous branches
- anterior cutaneous branches
- muscular branches
what do rami communicates of the intercostal N do
connect intercostal N to ipsi thoracic sym trunk
where are the collateral branches of the intercostal Ns
sup edge of the inf rib in the intercostal space
-innervate intercostal Ms
what do the lateral & anterior cutaneous branches of the intercostal N supply
lateral: skin of thoracic wall
ant: ant skin of thoracic wall
both: T4-6 breast
what Ms are supplied by the muscular branches of the intercostal N
intercostal Ms
subcostal Ms
transverse thoracic Ms
why is the 1st intercostal N different
no cutaneous branches
majority of the superior part blends with the brachial plexus
what is the intercostobrachial N
2nd intercostal N cutaneous branch
-supplies skin & subcutaneous tissue of axilla
why are intercostal Ns 7-11 different
begin as intercostal N and travel anteriorly
but run out of rib to run along –> so become thoracoabdominal Ns
what does thoracolumbar mean
sym ANS (T1-L2)
describe the presynaptic fibers of the sym system
= short
cell bodies in lateral horns of T & upper L
travel in ant root –> ant ramus –> paravertebral ganglia at their own level
what are the options the presynaptic sym fibers can do after reaching the paravertebal ganglion
- synapse at same level –> go to heart/lungs
- ascend/descend –> then synpase
- exit w/o synapsing –> continue as abdominopelvic splanchnic Ns into corresponding prevertebral ganglia in abd
what are cardiopulmonary splanchnic Ns
=post synaptic fibers
cardio part (T1-5/6)
pul part (T1-2)
presyn - synapse in cervical/thoracic sym trunk –> postsyn (these fibers)
what type of fibers are abdominopelvic splanchnic Ns
presynaptic
