Autonomics And Pain Flashcards by Zach Visinoni

What cranial nerves are part of the PSNS?

CN III, VII, IX, X

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PSNS is which part of the spinal cord?

Craniosacral (cranial ns and pelvic splanchnic ns)`

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What are the vertebral levels of the SNS?

T1-L2(3)

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Sympathetics come off of which part of the spinal cord itself? (Which horn)

Lateral horn and intermediolateral columns

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Parietal structures from the head, UE, and chest come from which levels?

T1-T6

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Sympathetics to the head, salivary gland and eyes come from which levels?

T1-T3(4) (eyes T1-T2)

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SNS to the heart, lungs and esophagus come from which levels?

T4-T6

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Parietal structures of the abdominal body wall are innervated by SNS at which levels?

T7-T11

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SNS to the stomach, liver, GB and spleen are at which levels?

T6-T9

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SNS to the SI are from which levels?

T7-T10

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SNS to the colon and appendix are at which levels?

T10-T11

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Parietal SNS to the LE are at which levels?

T11-L2(3)

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SNS to the kidney are at which levels?

T10-L1

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SNS too the suprarenal gland is at which levels?

T6-L2

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Path of presynaptic neurons from SC (4):

IML —> anterior motor root of spinal n —>white rami communicants —> paravertebral ganglion

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Sympathetic trunk includes (2):

Paravertebral ganglia and interganglionic connections

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4 options for presynaptic fibers entering the sympathetic chain

Ascend to higher level
Descend to lower level
Synapse at level of entry
Continue as abdominopelvic splanchnic n w/o synapsing

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What is the path for postsynaptic fibers that synapse at the sympathetic ganglia at level of cell body (parietal SNS)?

Exit paravertebral ganglia via the gray rami communicant and continue as a spinal n to body wall/limbs.

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Functions of parietal SNS (3)

Vasomotion
Sudomotion
Pilomotion

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What are the levels of SNS innervation of the UE?

Where does it synapse (2)?

C5-T1

Middle and inferior cervical ganglia.

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Superior cervical ganglia is near which structure(s)?

Bifurcation of carotid as.

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Middle cervical ganglia is near which structure?

Thyroid

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Stellate ganglia =

Inferior cervical and T1 ganglia

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Horner syndrome

Study These Flashcards

Disruption of nervous pathway near the superior cervical ganglia that results in pupillary constriction, ptosis, anhydrosis, flushing.

2 options for parietal innervation of the SNS

1. Gray rami communicants to all spinal ns. | 2. Cephlic arterial rami to periarterial plexuses of carotid as.

Prevertebral (preaortic) ganglia (4)

Celiac Superior mesenteric Inferior mesenteric Aorticorenal

Vertebral levels that form: Greater splanchnic n Lesser splanchnic n Least splanchnic n

Greater - T5-9 Lesser - T10-11 Least - T12

Visceral branches of sympathetic trunks (2) and where do they synapse?

Cardiopulmonary splanchnic ns. - paravertebral ganglia | Abdominovisceral splanchnic ns. - prevertebral ganglia

Innervation of the suprarenal glands

Travel all the way w/o synapsing until it reaches the cells of the adrenal gland. The cells of the adrenal gland act as the postsynaptic neurons.

4 PSNS ganglia in the head

Ciliary ganglia Otic Pterygopalatine Submandibular

Where does PSNS innervation transition from the vagus n to the pelvis splanchnic ns?

Splenic flexure

``` Overall what does the sympathetic system do to: Pupils Bronchioles HR Vessels Peristalsis Adrenal glands Erection ```

``` Overall what does the sympathetic system do to: Pupils - dilates Bronchioles - dilates HR - increase Vessels - vasoconstriction Peristalsis - inhibits Adrenal glands - actiivates Erection - ejaculation/remission of erection ```

``` Overall what does the parasympathetic system do to: Pupils Bronchioles HR Vessels Peristalsis Adrenal glands Erection ```

``` Overall what does the parasympathetic system do to: Pupils - constricts Bronchioles - constricts HR - decrease Vessels - dilates Peristalsis - activates Adrenal glands - inhibits Produces erection ```

Which system is most active controlling vision, GI tract and elimination?

PSNS

What 2 kinds of fibers exist in splanchnic ns?

Visceral afferents (sensory) and visceral efferents (autonomic)

What percentage of vagus fibers are afferent? | Splanchnic ns?

80% of vagus n fibers are afferent | 20% of splanchnic fibers are afferent

Pain travels with which part of the ANS? | What are the exceptions?

SNS, except for below the pelvic pain line (middle of sigmoid colon).

Where is the thoracic pain line and what are the vertebral levels?

Plane of sternal angle | T4-5

Duration of pain: Acute abdomen Chronic abdominal pain Subacute abdomen

Acute abdomen: <3 days Chronic abdominal: >3 wks Subacute abdomen: 3 days to 3 wks

Visceral pain

Diffuse and poorly localized. | Problems w/ internal organs or supportive tissues.

Somatic pain

Well localized. | Caused by injury to somatic tissues.

What is the cause for parietal pain?

Irritation of fibers that innervation the parietal peritoneum. It follows the Dermatomal pattern.

Vertebral levels for visceral pain of the liver and stomach

T6-T9

Vertebral levels for parietal pain of the pancreas

T6-T9

Vertebral levels for parietal pain of the small intestine

T8-T10

Vertebral levels for parietal pain of the kidneys

T10-L1

Vertebral levels for parietal pain of the spleen

T6-T8

``` Vertebral levels for parietal pain of the colon: Ascending colon Transverse colon Descending colon Sigmoid colon Rectum ```

``` Ascending: T10 Transverse: T11 Descending: T12-L1, distal descending L2 Sigmoid: S2 Rectum: S4 ```

Right hypochondriac pain could be (4)

Gallstones Cholangitis Hepatitis Liver abscess

Pain in the epigastric region could be (3)

Esophagitis Ulcers Pancreatitis

Pain in the umbilical region could be (4)

Appendicitis (early) Mesenteric amenities Meckel’s Lymphoma

Pain in the flank region could be (2)

Ureteric colic | Pyelonephritis

Pain in the right inguinal region could be (6)

``` Late appendicitis Crohn’s Cecum obstruction Ovarian cyst Ectopic pregnancy Hernias ```

Pain in the left inguinal region could be (5)

``` Diverticulitis Ulcerative colitis Constipation Ovarian cyst Hernia ```

Pain in the hypogastric/pubic region could be (4))

Testicular torsion Urinary retention Cystitis Placental abruption

Liver, GB, duodenum and diaphragm can refer pain:

To the right shoulders

Stomach can refer pain to:

Middle upper back

What kind of pain can retroperitoneal pain cause?

Back pain

Colicky pain

Cramp-like pain caused by obstruction of hollow muscular viscus (bowel obstruction, stones in ureter/GB). Usually presents in middle of abdomen.

Autonomics And Pain Flashcards

(59 cards)