Anatomy of chest pain Flashcards Preview

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Flashcards in Anatomy of chest pain Deck (28)
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1
Q

What is meant by a visceral afferent?

A

sensory nerve from an organ

2
Q

What is a plexus?

A

Intertwining of nerves

3
Q

What is a ganglion?

A

Collection of nerve cell bodies outside th CNS

4
Q

Where are sympathetic ganglion located?

A

Along the sympathetic chain

5
Q

What are the two fibres used to get from CNS to organs?

A

presynaptic fibres and post synaptic fibres

6
Q

Where does presynaptic outflow occur in sympathetic signalling?

A

T1-L2/3

7
Q

How do sympathetic signals go from CNS to organs?

A
  • travel down spinal cord
  • exit spinal cors in one of the T1-L2/3 spinal nerves
  • then do one of 5 options
8
Q

What are the 5 options in sympathetic signalling from CNS to organs?

A
  • go into the ganglion of that level & synapse
  • travel superiorly in the sympathetic chain to another ganglion & synapse
  • travel inferiorly in the sympathetic chain to another ganglion & synapse
  • pass straight through the sympathetic chain ganglion without synapsing, as abdominopelvic splanchnic nerves ,to synapse in one of the prevertebral ganglia of the abdomen (e.g. celiac ganglion)
  • pass straight to the adrenal medulla without synapsing as an abdominopelvic splanchnic nerve (directly stimulating adrenaline release)
9
Q

What do Cardiopulmonary splanchnic nerves do?

A

send sympathetic signals to heart and lungs

10
Q

Where are Cardiopulmonary splanchnic nerves located?

A

behind the great vessels. They feed into the cardiac plexus

11
Q

What are the three fibres of the cardiac plexus?

A

parasympathetic, sympathetic and visceral afferent fibres

12
Q

Where are parasympathetic ganglia located?

A

isolated from chain

13
Q

Where is th parasympathetic ganglia for the heart located?

A

On the heart wall

14
Q

How do parasympathetic signals reach the organs?

A

cranial nerves 3,7,9,10 and sacral spinal nerves

15
Q

What accompany the sympathetic nerves to the heart?

A

cardiac visceral afferent accompany the sympathetic nerves which are carried together in the cardiopulmonary splanchnic nerves

16
Q

What are baroreceptors carried through?

A

The vagus nerve

17
Q

What pain characters are associated with somatic pain?

A

sharp, stabbing and well localised

18
Q

What pain characters are associated with visceral pain?

A

dull, aching, nauseating, poorly localised

19
Q

What does somatic refer to?

A

anything associated with body wall

20
Q

How does a painful prod to the chest become what we feel as pain?

A
  • action potential passing through anterior ramus
  • then pass through posterior root and rootlets
  • to get to spinal cord
  • pain pathway crosses in spinal cord to oposite side of brain where it then gets processed as consciousness
21
Q

What occurs at the precentral gyrus?

A

action potentials that originate here bring about contractions of skeletal muscles

22
Q

What occurs at the postcentral gyrus?

A

Action potentials that arrive here are brought into consciousness

23
Q

What does the sensory homunculus show?

A

Shows where APS arises

24
Q

Where can somatic central chest pain sources come from?

A

-shingles, muscle joint and bone, parietal pleura and fibrous pericardium

25
Q

Where does the vagus nerve sit?

A

on trachea and passes posterior to the route of the lung and then follows the oesophagus down

26
Q

Where do azygous veins drain into?

A

vena cava

27
Q

What nerve crosses the trachea?

A

right vagus nerve

28
Q

What nerve crosses the aorta?

A

left vagus nerve