Autonomics and Lymphatics

Question 1

memorize lympatic drainage

Answer 1

do it now!

Question 2

Thoracic duct? formation?

Answer 2

forms anterior to LV2 from a merging of left and right lumbar trunks
- enters thorax via the aorta hiatus at TV12

Question 3

fn. of symp efferents?

Answer 3

vasoconstriction, contraction of sphincter muscles, inhibition of glandular secretions

Question 4

fn. of PS efferents

Answer 4

vasodilation, increased peristalsis, relaxation of sphincter muscles

Question 5

Aortic plexuses

Answer 5

contain ANS fibers (PS and symp) on the surface of aorta

• plexuses contain:
  1. presynaptic PS (vagal) fibers
  2. Presynaptic Symp (Splanchnic) fibers
  3. Postsynaptic symp fibers
  4. Visceral affarent fibers

Question 6

celiac plexus

Answer 6

viscera of foregut

receives fibers primarily from greater splanchnic

Question 7

superior mesenteric plexus

Answer 7

viscera of midgut

receives fibers from greater, lesser and least splanchnic nn.

Question 8

aorticorenal plexus

Answer 8

kidneys, suprarenals, ureters

receives primarily from lesser/least splanchnic nn.

Question 9

inferior mesenteric plexus

Answer 9

viscera of hindgut

receives from lumbar splanchnic nn.

Question 10

intermesenteric plexus

Answer 10

courses along aorta between SMA and IMA

Question 11

superior hypogastric plexus

Answer 11

from IMA to bifurcation - gives rise to hypogastric nn

Question 12

Vagus n.

Answer 12

• provides PS innervation
• preganglionic cell bodies located in brain stem
• supplies to midgut and foregut
• CN X

Question 13

Pelvic Splanchnic nn.

Answer 13

S2,3,4

• PS innervation
• preganglionic cell bodies located in S2,3,4
• supply hindgut

Question 14

6 splanchnic nn?

Answer 14

4 symp in abdomen (greater, lesser least, lumbar)
2 PS (vagus, pelvic splanchnics)

Question 15

Sympathetic innervation to abdominal viscera?

Answer 15

• preganglionic cell bodies of T5-L2
• nerves enter symp. chain without synapsing
• distribute via 4 plexuses

Question 16

cord levels of symp. splanchnics?

Answer 16

greater: T5-9
Lesser: T10-11
Least: T12
Lumbar Splanchnic: T11-L2

Question 17

Greater splanchnic n.

Answer 17

• Symp preganglionic bodies at T5-9
• nerves synapse mostly in celiac ganglia
• innervation of foregut

Question 18

Lesser Splanchnic n.

Answer 18

• Symp preganglionic bodies at T10-11
• synapse mostly at superior mesenteric ganglia and some aorticorenal
  innervate midgut as well as kidney

Question 19

Least splanchnic n.

Answer 19

symp preganglionic bodies at T12

• synapse at SM ganglion and aorticorenal
• supply midgut and kidney

Question 20

Lumbar Splanchnics

Answer 20

symp preganglionic bodies at mostly L1,2

• synapse in inferior mesenteric ganglion
• provide for hindgut

Question 21

Foregut, midgut, hinddgut? PS inneration

Answer 21

foregut: vagus n.
Midgut: Vagus n.
Hindgut: Pelvic Splanchnic n.

Question 22

Foregut region?

Answer 22

Foregut: T5-9 symp, greater splanchnic, celiac ganglion, vagus n. PS

Question 23

Midgut region?

Answer 23

Vagus n PS
T8-12 Symp: via greater, lesser, leas
superior mesenteric ganglion

Question 24

Hindgut region?

Answer 24

Pelvic splanchnic n.
L1-2 Symp: via lumbar splanchnic
inferior mesenteric ganglion

Question 25

distension? vs. pain?

Answer 25

pain travels with sympathetic nn. back to thoracic/upper lumbar spinal cord - distension travels with PS nerves back to brainstem of sacral spinal cord

Question 26

Esophagus

Answer 26

Symp: T5-9 via greater splanchnic. celiac plexus. affarent acute pain felt substernally at T6 PS: vagus n.

Question 27

Stomach

Answer 27

Symp: T5-9 via greater splanchnic: celiac ganglia, acute pain felt T6-9 PS: vagus n.

Question 28

Small Intestine

Answer 28

Symp: T8-10 via greater and lesser splanchnic nn. celiac and superior mesenteric ganglia acute pain in T8-10 PS: via vagus nerve

Question 29

Cecum, Appendix, ascending colon, transverse colon

Answer 29

Symp: T10-12: lesser and least splanchnic: via superior mesenteric plexus - acute pain from appendix referred to region of umbilicus PS: via vagus n.

Question 30

Descending and sigmoid colon

Answer 30

Symp: L1-2: lumbar splanchnic nn. via inferior mesenteric plexus PS: pelvic splanchnic nn. from S2-4

Question 31

Rectum and canal superior to pectinate line

Answer 31

Symp: L1-2 via lumbar and sacral splanchnic nn. via inferior mesenteric plexus PS: pelvic splanchnic nn. from S2-4

Question 32

Anal canal inferior to pectinate line

Answer 32

innervatd by inferior rectal n. (somatic innervation)

Question 33

Spleen

Answer 33

Symp: T6-8 via greater splanchnic n. via celiac ganglia PS: vagus n.

Question 34

Pancreas

Answer 34

Pancreas is primraily hormonally controlled; however does receive autonomic fibers which distribute via celiac plexus and superior mesenteric plexus Pain referred to area above umbilical, and to mid back region, below scapula Symp: T6-9 via greater splanchnic: via celiac trunk and superior mesenteric a. PS: Vagus n.

Question 35

Pain due to problems with biliary release

Answer 35

RUQ and right shoulder

Question 36

Liver

Answer 36

Symp: T6-9 via greater splanchnic cell bodies in celiac ganglia PS: vagus

Question 37

Gallbladder and cystic duct

Answer 37

Symp: T5-9, greater splanchnic n. via celiac PS: vagus n.

Question 38

Kidney

Answer 38

Symp: T10-L1: via lesser, least, and lumbar splanchnic n. postganglionic cell bodies locate in aorticorenal and renal ganglia, via renal plexus PS: vagus

Question 39

suprarenal gland

Answer 39

Symp: T8-L1: via greater, lesser, least, lumbar Postganglionic bodies located in medulla of suprarenal gland Efferent: vasomotor; liberate NE/Epi PS: vagus n.