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Anatomy Week 7 > ANS II > Flashcards

ANS II Flashcards

1
Q

The autonomic (or visceral) nervous system, is comprised of which functional components?

A

GVA and GVE

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2
Q

Where are GVA cell bodies located?

A

in sensory ganglia of spinal or cranial nerves. In spinal nerves, this sensory ganglia is the DRG associated with the dorsal root.

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3
Q

The GVE component of the ANS provides motor input to what structures?

A

glands, smooth muscle and cardiac muscle

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4
Q

preganglionic sympathetic fibers arise exclusively from which spinal cord segments?

A

T1-L2

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5
Q

The postganglionic cell bodies of the sympathetic system are found where?

A

either chain or collateral motor ganglia.

There are five regions that receive sympathetic innervation. These include visceral structures of the body wall (sweat glands, blood vessels, arrector pili smooth muscle), and viscera of the head, thorax and abdomen and pelvis.

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6
Q

Preganglionic parasympathetic cell bodies are located where?

A

in the nuclei of cranial nerves III, VII, IX and X in the brain stem and in the ventral horn gray matter of spinal cord segments S2‐S4

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7
Q

The postganglionic cell bodies of the parasympathetic system are located where?

A

in terminal motor ganglia located near the target

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8
Q

What three regions of the body receive parasympathetic innervation?

A

visceral structures of the head, thorax & amp; upper abdomen (foregut and midgut) and the lower abdomen (hindgut) & pelvis

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9
Q

T or F. there is NO parasympathetic distribution to the body wall.

A

T.

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10
Q

Where are chain ganglia of the sympathetic nervous system housed?

A

in the two sympathetic trunks that descend bilaterally from the cervical region through the thoracic and abdominal areas and terminate in the pelvic floor

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11
Q

T or F. Collateral (or prevertebral) ganglia are all located above the diaphragm in the abdominal and pelvic cavities

A

F. They are all below the diaphragm. These ganglia are either clustered along the named branches of the descending abdominal aorta or scattered in several autonomic plexuses on the pelvic floor

These ganglia are only used by those sympathetic GVE fibers that are destined to innervate visceral structures of the abdomen and pelvis.

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12
Q

T or F. All preganglionic sympathetic fibers arising from spinal cord levels T1‐L2 enter the sympathetic chain via the 14 white rami communicans

A

T. What they do once in the sympathetic chain depends upon the intended target.

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13
Q

Sympathetic fibers that pass through the chain ganglia without synapsing, exit in distinct fiber bundles called what?

A

splanchnic nerves

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14
Q

Preganglionic sympathetic fibers that pass through the sympathetic trunk as splanchnic fibers are destined to innervate what?

A

visceral structures of the abdomen and pelvis.

NOTE: Preganglionic sympathetic fibers that synapse within chain ganglia may follow one of two patterns. They may synapse in the chain ganglion at the level of entry, or they may ascend or descend within the chain to synapse in chain ganglia above or below the level of entry. Preganglionic sympathetic fibers taking one of these routes are destined to innervate the viscera of body wall, thorax or head.

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15
Q

postganglionic sympathetic fibers leaving the sympathetic chain exit through what structures?

A

gray rami communicans - if destined for the body wall

Otherwise the postganglionic nerve exits directly from the gangia

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16
Q

T or F. Gray rami communicans are found at all 31 spinal cord levels

A

T. As opposed to white rami communicans that are only found at levels T1-L2. Think why this would be so.

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17
Q

Parasympathetic preganglionic fibers destined for the head leave the brainstem through which nerve stems?

A

cranial nerves III, VII and IX. They synapse with postganglionic parasympathetic neurons in one of four terminal motor ganglia of the head.

These include ciliary, pterygopalatine, otic and submandibular ganglia

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18
Q

The vagus nerve (CN X) carries preganglionic parasympathetic fibers where?

A

thorax and upper abdomen (foregut & midgut). They synapse with postganglionic parasympathetic neurons in one of many terminal motor ganglia of the thorax and abdomen.

Terminal motor ganglia of the thorax and abdomen are usually located on or very near the wall of the target structure

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19
Q

Preganglionic parasympathetic fibers arising from sacral spinal cord segments S2‐S4 travel in discrete fiber bundles called what?

A

pelvic splanchnic nerves. They synapse with postganglionic parasympathetic neurons in one of many unnamed terminal motor ganglia of the abdomen and pelvis

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20
Q

What are the targets of the sacral portion of the parasympathetic system?

A

lower abdomen (hindgut) and pelvic viscera.

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21
Q

What are Autonomic (or visceral) nerve plexuses?

A

collections of autonomic nerve fibers that are formed in association with visceral structures and generally contain both visceral efferent (GVE; sympathetic and parasympathetic) and visceral afferent (GVA) components.

These plexuses also contain autonomic motor ganglia. The ganglia may be collateral (sympathetic), terminal (parasympathetic) or a combination of the two types depending upon the location of a particular plexus

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22
Q

What are the Autonomic (or visceral) nerve plexuses in the thorax?

A

the cardiac, esophageal and pulmonary plexuses

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23
Q

What is the autonomic nerve plexus in the abdomen called?

A

prevertebral (or aortic) plexus. This prevertebral plexus extends inferiorly along the lateral walls of the pelvis and may be subdivided into a number of smaller plexuses. It supplies input to and receives output from all abdominal and pelvic viscera.

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24
Q

T or F. The prevertebral (or aortic) plexus is located posterior to the descending abdominal aorta.

A

F. It is located anterior to it

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25
Q

GVE (both parasympathetic and sympathetic) innervation to the thorax arise from where?

A

Sympathetic- spinal nerve roots T1-T5

Parasympathetic- Vagus nerve (cranial nerve 10)

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26
Q

How do postganglionic sympathetic fibers reach the cardiac plexus from the sympathetic truck?

A

through the cervical cardiac nerves or via direct thoracic cardiac nerves

27
Q

Describe the route taken by preganglionic sympathetic fibers from spinal cord segments T1‐T5 to the cardiac autonomic plexus via cervical cardiac nerves

A

Preganglionic sympathetic fibers from spinal cord segments T1‐T5 enter the sympathetic chain via the white rami communicans. They then ascend in the chain to synapse in the superior, middle or inferior cervical chain ganglia. Postganglionic sympathetic fibers then exit the chain in distinct fiber bundles called cervical cardiac nerves (usually 3, superior, middle & inferior). These nerves join the cardiac plexus and are distributed to targets in the heart.

Note: these postganglionic fibers DO NOT use the gray rami communicans to exit the sympathetic chain.

28
Q

Describe the route taken by preganglionic sympathetic fibers from spinal cord segments T1‐T5 to the cardiac autonomic plexus via Direct thoracic cardiac nerves.

A

Preganglionic sympathetic fibers from spinal cord segments T1‐T5 enter the sympathetic chain via the white rami communicans. They synapse in thoracic chain ganglia at or near the level of entry. Postganglionic sympathetic fibers then exit the chain in distinct fiber bundles called direct thoracic cardiac nerves. These nerves also join the cardiac plexus and are distributed to targets in the heart. Note that these postganglionic fibers DO NOT use the gray rami communicans to exit the sympathetic chain.

29
Q

The parasympathetic system feeds into the cardiac plexus via what?

A

vagal cardiac nerves. These are direct branches from the vagus nerve (CN X) that convey preganglionic parasympathetic fibers.

They enter the cardiac plexus and synapse in terminal ganglia located either within the plexus or in the walls of the atria.

30
Q

What are the two sources of postsynaptic sympathetic feed into the cardiac plexus?

A

cervical cardiac nerves and the direct thoracic cardiac nerves.

NOTE: Preganglionic sympathetic fibers that are destined for the cardiac plexus arise from T1‐T5 spinal cord segments and enter the sympathetic chain via a white rami communicans but do not exit via grey rami communicans

31
Q

The structures of the lung and the visceral pleura are supplied by visceral afferents and efferents that are distributed through what structures?

What are the targets of these plexuses?

A

anterior and posterior pulmonary plexuses

Targets: bronchioles, muscous glands, blood vessels

Stimulation of the sympathetic system: 
Vasoconstriction
Dilates the bronchioles
Reduced secretion of bronchial mucous glands
glands

Stimulation of the parasympathetic system:
N/A
Constricts the bronchioles
Increased secretion of bronchial mucous

32
Q

Describe the route taken by preganglionic sympathetic fibers from the spinal cord to pulmonary plexuses.

A

Preganglionic sympathetic fibers reach the pulmonary plexus through branches from the sympathetic truck.

Preganglionic sympathetic fibers from spinal cord segments T1‐T4 enter the sympathetic chain via the white rami communicans. They synapse in thoracic chain ganglia at or near the level of entry. Postganglionic sympathetic fibers then exit the chain in distinct fiber bundles called sympathetic pulmonary branches. These nerves join the pulmonary plexus and are distributed to targets lungs or pleura.

33
Q

Describe the route taken by preganglionic parasympathetic fibers to pulmonary plexuses.

A

Preganglionic parasympathetic fibers reach the heart as parasympathetic pulmonary branches from the right and left vagus nerves. They enter the pulmonary plexus and synapse in terminal ganglia located either within the plexus or in the walls of the target organ.

Visceral afferents from the lungs and pleura are also a component of the pulmonary plexus. These fibers carry sensory information from pressure receptors in the wall of the bronchioles, stretch receptors and sensation related to the cough reflex.

34
Q

The esophageal plexus innervates what portion of the esophagus?

A

The lower portion of the esophagus.

35
Q

Describe the route taken by preganglionic parasympathetic fibers to pulmonary plexuses.

A

Preganglionic parasympathetic fibers that enter the esophageal plexus synapse in terminal ganglia in the esophageal wall. There is some mixing of fibers from the two vagus nerves as the plexus continues inferiorly on the esophagus toward the diaphragm. Just before reaching the diaphragm, the fibers of the plexus converge to form two trunks.

The anterior vagal trunk lies on the anterior surface of the esophagus and mainly contains fibers from the left vagus nerve. The posterior vagal trunk lies on the posterior surface of the esophagus and mainly contains fibers from the right vagus nerve. The vagal trunks continue through the diaphragm and into the abdomen.

36
Q

Describe the route taken by postganglionic sympathetic fibers to pulmonary plexuses.

A

Postganglionic sympathetic fibers reach the esophageal plexus through esophageal branches from the sympathetic truck. Preganglionic sympathetic fibers from spinal cord segments T6‐T10 enter the sympathetic chain via the white rami communicans. They synapse in thoracic chain ganglia at or near the level of entry. Postganglionic sympathetic fibers then exit the chain in distinct fiber bundles called esophageal branches. These nerves join the esophageal plexus and are distributed to visceral targets in the esophagus.

37
Q

T or F. Splanchnic nerves are autonomic nerves comprised of postganglionic GVE fibers

A

F. They are preganglionic GVE fibers

These may be either sympathetic or parasympathetic fibers depending upon which set of splanchnic nerves you are considering. They exclusively target visceral structures of the abdomen and pelvis.

38
Q

Sympathetic fibers that pass through the chain ganglia without synapsing, exit in distinct fiber bundles called what?

A

splanchnic nerves

39
Q

The splanchnic nerves from the sympathetic system travel to reach collateral ganglia in the abdomen and pelvis where the preganglionic fibers will synapse with the postganglionic sympathetic neurons. Preganglionic sympathetic fibers taking this route are destined to innervate visceral structures of the…?

A

abdomen and pelvis

40
Q

preganglionic parasympathetic fibers destined to innervate visceral structures in the hindgut and pelvis form what as they leave the spinal cord?

A

distinct fiber bundles called pelvic splanchnic nerves

41
Q

T or F. Thoracic, lumbar and sacral splanchnic nerves are comprised of preganglionic sympathetic fibers and Pelvic splanchnic nerves are comprised of preganglionic parasympathetic fibers.

A

T.

42
Q

Which three of the sympathetic splanchnic nerves arise from the thoracic spinal cord on the posterior abdominal wall?

A

the greater, lesser and least thoracic splanchnic nerves.

Note that they are medial to the sympathetic trunks. They descend inferiorly (below the diaphragm) to reach the abdominal cavity where they are responsible for sympathetic innervation to the foregut and midgut.

43
Q

Preganglionic cell bodies of sympathetic splanchnic nerves are located where?

A

in the intermediolateral cell column of spinal cord segments T5‐L2

Sympathetic splanchnic nerves synapse in one of several collateral (or prevertebral) ganglia in the prevertebral plexus associated with the abdominal aorta (see next slide). Postganglionic sympathetic fibers exit their respective autonomic ganglia to reach target structures in the abdomen and pelvis, traveling along the distal branches of the abdominal aorta (perivascular) to reach these targets

44
Q

Name the spinal cord roots and target of the Greater thoracic splanchnic nerve

A

(T5‐T9; to foregut)

45
Q

Name the spinal cord roots and target of the Lesser thoracic splanchnic nerve

A

(T10‐T11; to midgut)

46
Q

Name the spinal cord roots and target of the Least thoracic splanchnic nerve

A

(T12; to kidneys & gonads)

47
Q

Name the spinal cord roots and target of the Upper lumbar splanchnic nerves

A

(L1‐L2; to hindgut)

48
Q

Name the spinal cord roots and target of the Lower lumbar splanchnic nerves

A

(L1‐L2; to bladder, rectum & male genital tract; with some
additional supply via the sacral splanchnic nerves)

49
Q

Activation of the sympathetic system in abdomen/pelvis causes what?

A 
• Vasoconstriction
• Inhibition of peristalsis
• Increase tone of sphinchters
• Adrenalin secretion
• Release of glucose
• Ejaculation (note that there is also a somatic innervation via the pudendal nerve that plays a role in
ejaculation)
50
Q

Parasympathetic splanchnic nerves are comprised of preganglionic parasympathetic fibers arising from which spinal cord segments?

A

S2‐S4. Parasympathetic splanchnic nerves join one of several autonomic nerve plexuses in the abdomen or pelvis and synapse in terminal ganglia located in or near the wall of the target organ.

51
Q

Name the spinal cord roots and target of the Pelvic splanchnic nerves (parasympathetic)

A

(S2‐S4; to hindgut and pelvis/perineum including bladder, rectum &
erectile tissue of clitoris and penis)

52
Q

The preganglionic parasympathetic fibers to foregut, midgut, kidneys & gonads are from what nerve?

A

vagus nerve (anterior & posterior vagal trunks).

53
Q

Activation of the parasympathetic system in abdomen/pelvis causes what?

A
  • Increase peristalsis
  • Decrease tone of sphincters
  • Erection
54
Q

Name the autonomic plexuses of the abdomen and pelvis

A 
celiac plexus
superior mesenteric plexus
suprarenal and renal plexus
inferior mesenteric plexus
superior and inferior hypogastric plexuses
55
Q

Name the

1) preganglionic sympathetic fibers
2) Splanchnic Nerves Preganglionic parasympathetic fibers 3) ganglia
4) target

of the Celiac Plexus

A

Preganglionic sympathetic fibers: Greater & Lesser

Splanchnic Nerves Preganglionic parasympathetic fibers: Anterior & Posterior Vagal Trunks

Ganglia: Celiac

Targets: Foregut & Midgut

56
Q

Name the

1) preganglionic sympathetic fibers
2) Splanchnic Nerves Preganglionic parasympathetic fibers 3) ganglia
4) target

of the Superior Mesenteric Plexus

A

Preganglionic sympathetic fibers: Greater & Lesser

Splanchnic Nerves Preganglionic parasympathetic fibers: Anterior & Posterior Vagal Trunks

Ganglia: Superior Mesenteric

Targets: Foregut & Midgut

57
Q

Name the

1) preganglionic sympathetic fibers
2) Splanchnic Nerves Preganglionic parasympathetic fibers 3) ganglia
4) target

of the Suprarenal and Renal Plexus

A

Preganglionic sympathetic fibers: Least Splanchnic Nerve

Preganglionic parasympathetic fibers: Anterior & Posterior Vagal Trunks

Ganglia: Aorticorenal

Targets: Kidneys & Gonads

58
Q

Name the

1) preganglionic sympathetic fibers
2) Splanchnic Nerves Preganglionic parasympathetic fibers 3) ganglia
4) target

of the Inferior Mesenteric Plexus

A

Preganglionic sympathetic fibers: Upper Lumbar

Splanchnic Nerves Preganglionic parasympathetic fibers: Pelvic Splanchnics Nerves

Ganglia: Inferior Mesenteric

Targets: Hindgut

59
Q

Name the

1) preganglionic sympathetic fibers
2) Splanchnic Nerves Preganglionic parasympathetic fibers
3) ganglia
4) target

of the Superior & Inferior Hypogastric Plexus

A

Preganglionic sympathetic fibers: Lower Lumbar Splanchnic Nerves (with some additional contribution by sacral splanchnic nerves)

Preganglionic parasympathetic fibers: Pelvic Splanchnic Nerves

Ganglia: Superior & Inferior Hypogastric

Targets: Pelvis & Perineum

60
Q

Describe sympathetic innervation to the head

A

Preganglionic sympathetic fibers destined for the head arise from spinal cord segments T1‐T2. Pre‐ ganglionic cell bodies are located in the spinal cord gray matter (lateral horn) of these segments. The preganglionic axons exit the spinal cord via the T1 & T2 spinal nerves to reach the sympathetic trunk. These fibers then ascend in the sympathetic trunk to reach the superior cervical chain ganglia where they synapse with the postganglionic neurons. Postganglionic fibers exit the sympathetic chain and form the carotid peri‐arterial plexus which surrounds the internal and external carotid arteries and their branches to reach their targets in the head.

Note that most (>95%) of these fibers do not travel with cranial nerves.

Sympathetic targets in the head and neck include sweat glands, dilator pupillae muscle, vascular smooth muscle and the superior tarsal muscle.

61
Q

Describe parasympathetic innervation to the head

A

Three cranial nerves (III, VII, and IX) carry parasympathetic fibers destined for the head.

Pre‐ganglionic cell bodies are located in the brain motor nuclei associated with those CNs. The preganglionic sympathetic fibers synapse with the post‐ganglionic neurons in terminal motor ganglia of the head (ciliary, otic, submandibular & pterygopalatine)

Cranial Nerves Associated with Terminal Motor Ganglia of the Head:
CN III Ciliary Ganglion
CN VII Submandibular Ganglion
CN IX Pterygopalatine Ganglion Otic Ganglion

Postganglionic fibers “hitchhike” primarily on named branches of the three divisions of the trigeminal nerve (CN V) to reach their targets in the head.

Parasympathetic targets in the head and neck include constrictor pupillae and ciliary smooth muscles, submandibular, parotid and sublingual salivary glands, mucous glands of the nasal cavity and hard palate & the lacrimal glands.

62
Q

GVA Innervation of the Abdomen: Pain Pathways

A

follow the GVE fibers of the same splanchnic nerves (greater, lesser, and upper lumbar) back to the sympathetic trunk and spinal cord, passing through white rami, and to the dorsal root

63
Q

GVA Innervation of the Abdomen: Reflex Pathways

A

follow the parasympathetic pathways via the vagus (foregut and midgut) or pelvic splanchnic pathways (pelvis/perenium)

Anatomy Week 7 (7 decks)

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