Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

GI2 > Abdominopelvic Autonomics and Pain > Flashcards

Abdominopelvic Autonomics and Pain Flashcards

(83 cards)

Start Studying
1
Q

What is the nervous system broken down to?

A

Sensory (afferent), and Motor (efferent) nervous system

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Within the Somatic, what does it split to?

A

Somatic (touch, pain, temp, proprioception up to the brain to process)
super well localized

Visceral - doesn’t respond to pain and touch, but responds to ischemia and stretch.
diffuse pain, NOT localized

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What does the Motor (Efferent Nervous System) split into?

A

Somatic (Voluntary) motor system – Have to think about it

Visceral (Involuntary) Motor System – don’t have to think about it (This is the enteric nervous system!!)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What does the Visceral Motor Nervous System (Involuntary) supply?

what does it split into?

A

Smooth Muscle, cardiac muscle, glands

thoracolumbar (sympathetic) nervous system

Craniosacral (parasympathetic) – cranial brainstem or sacral region

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

SNS

Voluntary or Involuntary?

What type of neuron pathway?

ganglia?

Where does sensory input come from? motor output?

What excites it?

What kind of axons are they?

A

voluntary

single neuron pathway (the nerves in the femoral nerve for example, there’s one nerve that takes info from the spinal cord to the muscle)

no ganglia

general and sensory senses.. skeletal muscle

ACh

thick and myelinated - fast conducting

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

ANS

Voluntary or Involuntary?

What type of neuron pathway?

ganglia?

Where does sensory input come from? motor output?

What excites it?

What kind of axons are they?

A

Involuntary

2 neuron pathway (presynaptic and postsynaptic neuron)

ganglia are involved

sensory = general and visceral senses, motor = cardiac, smooth muscle, glands

Ach/NE can either excite or inhibit

Axons are thin, preganglionic are lightly myelinated… postganglionic are unmyelinated = slowly conducting

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are the parasympathetic nerves of the Cranial-Sacral division?

A

Cranial nerves 3,7,9,10

S2-S4 (pelvic splanchnic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Where do the parasympathetics of the Cranial nerves (3,7,9,10) synapse on?

Vagus + pelvic splanchnics?

A

Ciliary Ganglion
Pterygopalatine Ganglion
Submandibular Ganglion
Otic Ganglion

in the wall of the organ!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are the neurotransmitters for parasympathetics? where are these at?

receptors?

A

Acetycholine – for both the pre and post ganglionic fibers..

pre synaptic and post synaptic release Ach!

receptors are nicotinic and muscarinic.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Where are the sympathetic nerves of the thoracolumbar region?

A

T1-L2

synapse to superior cervical ganglion, sympathetic chain ganglion, or prevertebral ganglion (Celiac, Sup. Mesenteric, Inf. Mesenteric)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are the neurotransmitters for the sympathetic nerves?

A

Ach for the presynaptic cell

NE for the post-synaptic cell (alpha and beta receptors)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Explain the preganglionic sympathetics

A

you have the cell bodies for the presynaptic neurons located in the lateral horns of the spinal cord.

the cell bodies in the lateral horns are called the “intermediolateral cell columns”.. this is where you find the cell bodies.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Explain the head, upper limb, and chest, both parietal structures and visceral structures.

A

Parietal: Head, upper limb, chest @ T1-T6

Visceral structures (T1-T6)

Head, salivary glands = T1-T3/T4

Eye = T1/T2

Heart, Lungs, Esophagus = T4-T6

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Explain the abdominal body wall, both parietal structures and visceral structures:

A

Parietal: abdominal body wall T7-T11

Visceral structures (T6/T7-T11):

Stomach, Liver, GB, pancreas = T6-T9
Appendix, colon = T10-T11
Small Bowel: T7-T10
Kidney: T10-L1
Suprarenal gland = T6-L2
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Explain the lower limb wall, both parietal structures and visceral structures

A

Lower limb: T11-L2(3)

Visceral structures:

Rectum, bladder, uterus, T12-L2(3)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Explain the lower limb wall, both parietal structures and visceral structures

A

Lower limb: T11-L2(3)

Visceral structures:

Rectum, bladder, uterus, T12-L2(3)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Pathway of the sympathetic neurons (presynaptic)

A

ALL THE PRESYNAPTIC NERVES ARE THE SAME PROCESS BELOW (FROM T1-L2)

Presynaptic neurons leave the anterior/ventral root, go to where the nerve is a mixed spinal nerve, and continue on the anterior (ventral ramus) of a spinal nerve.

it’ll then enter the white ramus communicantes and go into the paravertebral ganglion.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What are the different types of paravertebral ganglion?

what connects the paravertebral ganglion from these two regions?

what do both of these together make?

A

3 cervical ganglion: superior, middle and inferior cervical ganglion.

Ganglion Impar

so you have ganglion going from cervical region all the way to coccyx region.

interganglionic connections.

sympathetic trunks!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Explain the process of what happens once we get into the paravertebral ganglion? (4 options)

A
  1. Ascend to a HIGHER LEVEL and synapse
  2. LOWER LEVEL and synapse
  3. SYNAPSE at the level of entry
  4. TRANSVERSE the trunk WITHOUT synapsing to become a abdominopelvic splanchnic nerve and synapse on prevertebral ganglion. (so passes the paravertebral ganglion)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

If we ascend and synapse, what is this good for for sympathetics??

what about descending?

A

getting sympathetics to the head

that’s how we get sympathetics to the reproductive organs.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Explain postsynaptic fibers of the sympathetics?

A

exit at the level of the cell body that they synapsed in!

the fibers that go to the parietal structures exit LATERALLY via gray rami communicates

if they’re destined to go to the back they’ll travel through the posterior ramus to go to the back to do sweat glands, blood vessels in the skin, and erector pile muscles that give you goosebumps…

OR

they can go through anterior ramus of the spinal nerves going to the rest of the body.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

why are white rami called white?

grey?

A

they have myelin, which is white!

unmyelinated look more grey!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

functions of the sympathetic neurons?

A

Vasomotion, Sudomotion, Pilomotion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

what happens to the sympathetic innervation of the lower limb?

A

INL to sympathetic chain via the white rami communicates and they’re going to take the descending option, where they synapse on the lower lumbar/sacral portions of sympathetic trunk.. then they jump onto the lumbosacral plexus or create periarterial plexus on the vessels.

from there they go and do vasomotor, sudomotion, pilomotion.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
What happens to the sympathetic innervation of the upper limb?
upper limb they go the sympathetic chain and go ascending to go to the cervical region... they synapse on the MIDDLE OR INFERIOR CERVICAL GANGLION... then the postganglionic fibers jump onto the nerves of the brachial plexus or make their own periarterial plexus to do the same functions... vasomotor, sudomotion, pilomotion
26
What are the different cervical ganglion? (where are they located?) what synapses here?
Superior cervical ganglion which is super close to the bifurcation of the common carotid (which becomes the internal carotid and external carotid) Middle cervical ganglion at the same level as the thyroid inferior cervical ganglion inferior can fuse with the paravertebral ganglion of T1 and become the "stellate ganglion" if the autonomic ganglion need to go to the head, this is where they go.
27
If there are sympathetic fibers that come up and synapse on the superior cervical ganglion, what happens?
it creates an external carotid plexus and an internal carotid plexus on these arteries.. the external carotid artery gives rise to the vasculature on the superficial face, so the sympathetics here innervate salivary glands (to make mucus), Sweat glands (sweat more), and blood vessels of the face (vasoconstriction)
28
when you're interviewing for medical school... what's happening from your superior cervical ganglion?
you're sweating more on your face.. your mouth is kind of dry, and you look kind of pale...
29
What happens to the internal carotid plexus? what about at the orbit?.. what keeps your eye open and what opens your eye?
sends fibers to vasoconstriction blood vessels and mucus glands in the nasal/oral cavity it dilates the pupil, and aids in keeping the eye elevated. CN3 opens your eye, sympathetics keep it open!
30
Horner syndrome? what happens? 4 symptoms?
lesion at the sympathetic trunk or the superior cervical ganglion.. you inhibit sympathetics going to the head. causes pupillary constriction (mitosis) Ptosis (droopy eyelid) Anhydrosis (no sweat) Flushing (red in the face)
31
What happens to the sympathetics that enter the cardiopulmonary splanchnics? (lungs, heart, blood vessles)
bronchodilator, vasoconstrictor, inhibits alveolar glands for the lungs increases heart rate, impulse conduction, force of contraction in the heart. blood vessels = relaxation of the smooth muscle via beta 2.
32
How does innervation of abdominal viscera work?
pass through paravertebral ganglion without synapsing, choosing to be a abdominopelvic splanchnic nerve... then synapse on prevertebral ganglion (celiac, superior mesenteric, inferior mesenteric, aorticorenal ganglion). from there they create a periarterial plexuses (celiac, inter mesenteric, superior hypogastric, etc) going to the abdominal organs
33
What are the abdominopelvic splanchnic nerves? how do they get through the diaphragm?
T5-T9, T10+T11, T12 piercing the diaphragm
34
Where does greater splanchnic synapse on? Superior mesenteric ganglion? aorticorenal? inferior mesenteric?
Celiac ganglia some lesser and least a little bit of everybody. most of the lumbar splanchnics.
35
the parasympathetics traveling with the vagus end where?
splenic flexure.
36
inferior mesenteric ganglion, descending to superior hypogastric plexus and coming down as hypogastric nerves are what?
this whole area are postganglionic or postsynaptic sympathetics.
37
Difference between cardiopulmonary splanchnic nerves and abdominopelvic splanchnic nerves?
CP --> synapse at paravertebral ganglia Abdominopelvic --> synapse at PREvertebral ganglia
38
Where are cell bodies found? where are these things found?
only in paravertebral ganglia or prevertebral ganglia paravertebral ganglia are found EVERYWHERE except the abdominopelvic viscera.
39
What happens with the suprarenal glands? what happens when there's a synapse on the medulla?
presynaptic fiber passes through the paravertebral ganglion, AND the prevertebral ganglion, and then it synapses in the medulla of the suprarenal gland... the cells of the suprarenal medulla actually function as the postsynaptic neurons NE is released into the blodosteram for a wide-spread response
40
Presynaptic neurons of the PNS are carried through what fibers?
Cranial nerves 3, 7, 9, 10 anterior roots of spinal nerves s2-s4
41
Sympathetics vs parasympathetics and the nerve fibers?
SNS - short presympathetic (myelinated), long post (unmyelinated) PNS - super long pre (myelinated), intrinsic ganglion found in the organ itself.
42
Of the outflow (cranial nerves or sacral), which one dominates?
Cranial
43
for parasympathetic postsynaptic neurons, what do the ganglia look like in the trunk?
widely scattered and irregularly spaced... located in the organ itself!! (this is the intrinsic or enteric ganglia)
44
Ciliary, otic, pterygopalatine, submandibular.. which cranial nerves are synapsing where?
3 on ciliary, 9 on otic, 7 on pterygopalatine and submandibular!
45
Where are ciliary ganglia found? what do we care about with the pterygopalatine ganglia?
behind the orbit. sends nerves into the nasal area and into the palate! otic ganglion goes to the parotid salivary gland! submandibular sends parasympathetics to sublingual and submandibular
46
what do parasympathetics do in the head?
Constriction of the pupil accommodation (helps adjust for near vision) Serous secretions from lacrimal glands (tears) watery serous secretion from salivary glands.
47
we see sympathetics going into the head, limbs, abdominals.. where do parasympathetics go? do parasympathetics go to the walls or limbs? do parasympathetics ever become components of the spinal nerves (or their peripheral branches)?
internal glands and glands of head and body cavities. no, except for the erectile tissue of the external genitalia. no, except for the initial parts of S2-S4
48
SNS on: ``` pupil bronchioles rate of contraction, force of contraction blood vessels on skin and GI peristalsis, sphincters suprarenal glands reproductive system? ```
dilates dilates increase vasoconstricts (get blood to the skeletal muscle) decrease, constricts stimulate release of adrenaline ejactulation and remission of erection.
49
PNS on: pupil bronchioles rate of contraction, force of contraction blood vessels on skin and GI peristalsis, sphincters bladder/rectum? reproductive system?
constrict constrict lower vasodilator increase, inhibits contraction of bladder/rectum genital erection
50
What is the PNS most active in controlling? what is it the primary stimulator of?
vision.. especially if you're trying to read (near vision) primary stimulator of the GI tract. Active in elimination
51
what are splanchnic nerves comprised of?
both visceral afferents and efferents! visceral afferents (sensory picking up from organs).. take it from the organ to the Brain to process it. then we have visceral motor (efferents) to our target gland.. (smooth muscle, glands) so both of these are in splanchnic!
52
What is most of the vagus? what about this same metric but for splanchnics?
80% of it is afferents, 20% of fibers in splanchnics are afferent
53
Homeostasis and different physiological receptors travel with what? pain travels with what? exceptions?
parasympathetics (vagus / pelvic splanchnics) Sympathetics, except below the pelvic pain line. (boundary is the middle of the sigmoid colon)
54
Where is the thoracic pain line located? above that where does pain travel with? where is the pelvic pain line? below that where does pain travel with? between these two lines?
sternal angle (T4-T5) pain travels with parasympathetics (vagus mostly) plane of lower extent of the peritoneum (top of the uterus, parts of the bladder OR AT THE MIDDLE OF THE SIGMOID COLON) travel with the parasympathetics. sympathetics
55
Pain: above sigmoid colon, travels with what? below?
sympathetics. parasympathetics.
56
What does Acute abdominal pain mean? chronic abdominal pain? subacute?
less than 3 days greater than 3 weeks in between
57
Visceral vs somatic pain? special case for somatic pain?
visceral = organs.. diffuse, poorly localized... often referred pain to somatic regions somatic = well localized. caused by injury to skin, muscles, bone, joint, connective tissue. you can get somatic pain if an organ irritates the parietal peritoneum! (gallbladder, appendix)
58
What is parietal pain? type of pain? what can this start out as?
irritation of the fibers that innervate the parietal peritoneum. this is localized can start as visceral pain and then gives way to parietal pain, causing tenderness and guarding.
59
Visceral pain can be localized to what? foregut organs in general are what spinal levels? where do they produce pain? jejunum and ileum, and the midgut organs? handgun organs?
an approximate spinal level T6-T9... epigastric region T8-T10... periumbilical region epigastric region
60
spleen, stomach, 1st and second part of the duodenum, pancreas? spleen?
T6-T9 T6-T8
61
Kidneys? 3rd part of the duodenum, jejunum, ileum? Cecum, ascending colon? transverse colon? descending colon? Sigmoid colon? Rectum?
T10-L1 T8-T10 T10, T10, T11, T12-L1 L2(3), S2/S4
62
What are you going to consider in the right hypochondriac region?
gallstones, cholangitis, hepatitis, liver abscess
63
What are you going to consider in the epigastric region?
foregut organs.. esophagitis, peptic ulcer, perforated ulcer, pancreatitis
64
What are you going to consider in the Left Hypochondriac region?
spleen abscess, acute splenomegaly, spleen rupture
65
What are you going to consider in the right or left flank?
ureteric colic | pyelonephritis
66
What are you going to consider in the umbilical?
appendicitis (early) mesenteric adenitis meckel's diverticulum lymphomas
67
What are you going to consider in the right inguinal region? left?
``` appendicitis late chron's disease cecum obstruction ovarian cyst ectopic pregnancy hernias ``` left same minus ectopic pregnancy and appendicitis
68
What are you going to consider in the hypogastric region?
testicular torsion, urinary retention, cystitis, placental abruption
69
Why would appendicitis start out epigastric pain and end up in right inguinal?
starting to irritate the parietal peritoneum, but its a midgut structure so it starts out in the umbilical region
70
Liver, gallbladder, and duodenum referred pain?
irritate the diaphragm, which is innervated by the phrenic nerve, which sends referred pain to right shoulder pain.
71
Duodenum, head of the pancreas, and stomach are in what regions of referred pain? what's different about the stomach?
epigastric can project pain to the back
72
Liver and gallbladder? appendix? kidneys and ureters?
right sided flank + back umbilical and then goes out to the right lower quadrant as it gets worse flank pains
73
what happens if a structure is retroperitoneal and referred pain?
pancreas, kidney, aorta severe back pain. aortic aneurism presents with back pain as an example
74
what is colicky pain what happens if its in the GI? urinary tract?
cramp-like pain intermittently usually caused by an obstruction of hollow muscular structures.. bowel obstruction, stone in ureter, or stone in neck of gall. in the foregut, midgut, or hindgut will go either to epigastric, umbilical, or hypogastric. loin to groin
75
Gastric Ulcer? affect what? when is it worse?
duodenum or stomach.. both are foregut visceral pain... duodenal = worse 2-5 hours after eating stomach ulcer = eating makes it worse
76
Perforated Gastric Ulcer?
posterior perforation goes into lesser sac.. anterior = greater sac. foregut chronic visceral pain. once this happens you have a sudden severe pain spreading all over abdomen. you'll get signs of general peritonitis
77
What is acute cholecystitis? what happens if it becomes inflamed? symptoms? what test do we do?
gallbladder so foregut visceral pain if it becomes inflamed we get somatic pain in right upper quadrant specifically under the 9th rib. if the gallbladder irritates the diaphragm --> referred pain to right shoulder N/V, Tenderness right upper quad, fever positive Murphys sign positive psoas sign
78
Acute appendicitis what happens when it gets inflamed? symptoms? what happens if it ruptures?
midgut structure = umbilical region as it becomes inflamed, we get somatic pain in right lower quadrant. n/v, fever, tenderness. peritonitis in right lower quadrant if it ruptures
79
adhesive small bowel obstruction? type of pain? vomiting? noises? symptoms?
adhesive shows signs of previous abdominal surgery midgut hollow structure so colicky cramp like pain... if higher in the ileum, vomiting more.. lower, might not no flatus or bowel action below the obstruction because you've defecated everything you could. dehydrated. distended, non tender increased bowel sounds that eventually become silent once filled up.
80
Passage of a kidney stone? symptoms
loin to groin pain severe colicky pain. severe back pain since retroperitoneal can't get comfortable, blood in the urine.. no fever.. soft abdomen.. tender renal angle.
81
Obstructing cancer of the descending colon? symptoms?
older patient unintentional weight loss hindgut visceral colicky pain no flatus/feces distended abdomen.. possible mass (dull percussion) increased bowel sounds until silent
82
Ruptured ectopic pregnancy?
missed last menstrual period sudden acute severe hypogastrium pain radiating to sacral area. no fever. peritonitis in s uprapubic area. tenderness in rectouterine pouch on DRE or vaginal examination.
83
Leaking aortic aneurysm
men more likely to get it.. history of atherosclerosis or cardiac disease. sudden onset of SEVERE BACK PAIN pale, shocked, hypotensive (losing blood) tender epigastrium (palpate the aorta in those region) impulse from aneurysm in epigastrium.

GI2 (20 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions