Autonomics + Pain Flashcards by Iris Hart

Which division of the motor (efferent) nervous system has NO ganglia and is under single neuron control?

Somatic N.S. (voluntary)

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What part of the motor (efferent) nervous system has ganglia, and is under two neuron control?

ANS (involuntary)

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What two senses does the SNS have?

general + special senses

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What 2 senses does the ANS have?

general + visceral senses

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ANS sends motor output to __________ via _____________.

Cardiac muscle, smooth muscle, + glands

ACh + NE

(only pre-ganglionic = myelinated)

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The SNS sends motor output to ___________ via ________.

Skeletal muscle

ACh

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The ANS is broken into parasympathetics and sympathetics. What are the 4 crainal nerves that carry the parasympathetic crainial-sacral division?

3, 7, 9 ,10

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In the brain, the pre-ganglionic cell bodies of nerves 3, 7, and 9 synapse with what post-ganglionic cell bodies?

In the sacrum (nerve 10?)

Ciliary ganglion

Pterygopalatine ganglion

Submandibular ganglion

Otic ganglion

Wall of organ (pelvic splanchnic)

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What receptors are parasympathetic?

Nicotinic + muscarinic (ACh)

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The sympathetic division of T1-L2 (pre-ganglionic cell bodies) synapse with what?

Superior Cervical ganglion

Sympathetic chain ganglion

Prevertebral ganglion

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What receptors are sympathetic?

Alpha + beta receptors

ACh = pre

NE = post

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For sympathetics, at what level are the head, upper limb, and thoracic viscera?

T1-T6

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For the sympathetics, at what level are the abdominal body wall and viscera?

T7-T11

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In the sympathetics, at what level are the lower limb and pelvic viscera?

T12-L3

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Where are the cell bodies of the sympathetic presynaptic neurons found?

Intermediolateral (IML) cell column

Yhe lateral hord of spinal cord gray matter

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In the sympathetics, the paravertebral ganglia range from _____ to _________.

cervial —> sacrum

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As one of the options for a presynaptic fiber in the sympathetics, what can it pass through without having to synapse that will allow it to enter the sympathetic trunk?

paravertebral ganglion

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True or false, postsynaptic fibers of the sympathetic trunks exit at the level of the cell body laterally via gray rami communicans?

True

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What are the 3 functions of sympathetic neurons?

*fight or flight* what would happen?

Vasomotion –> constriction of blood vessels
Sudomotion –> sweat glands
Pilomotion –> muscles that give you goose bumps

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Where is the superior cervical ganglion located?

sympathetic

By the bifurcation of the aorta into internal and external coratid A.’s

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From the superior cervical ganglion, through the external carotid plexus, what do the sympathetics control?

Salivary gland (mucus)

Sweat gland

Blood vesseld

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From the superior cervical ganglion, to the internal carotid plexus, what does the sympathetics control?

Orbit:

diliate the pupil
Keeps the eye elevated (affected in horner syndrome)

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Coming off of the internal coratid artery, the deep petrosal nerve controls?

Blood vessels, nasal, + oral cavity

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If a person had a lesion at the superior cervical ganglion, what would be the outcome?

Horner Syndrome Symptoms: pupils constrict, ptosis (droopy eye), anhydrosis (no sweat), flushed

What goes to all 31 spinal nerves providing parietal stimulation of the sympathetics?

gray rami communicans

What supplies the periarterial plexuses of the parietal sympathetics?

Cephalic arterial rami (head)

What are the 4 prevertebal (preaortic) ganglia in the abdominal cavity?

1. Celiac ganglion 2. Superior mesenteric ganglion 3. Inferior mesenteric ganglion 4. Aortaco-renal ganglion

In the sympathetic abdominal viscera, they pass through \_\_\_\_\_vertebral and synapse at \_\_\_\_\_vertebral.

PARA PRE

Greater splanchnic nerves synapse w/ \_\_\_\_\_\_\_\_.

Celiac ganglia

Lesser + least splanchnic nerves synapse with \_\_\_\_\_\_\_\_.

Superior mesenteric ganglion

Aorticorenal ganglia synapses with \_\_\_\_\_\_\_\_.

All the splanchnics

Inferior mesenteric ganglion synapse with \_\_\_\_\_\_\_\_.

Lumbar splanchnics

Where do cardiopulmonary splanchnic nerves synapse at?

PARA vertebral ganglia

Where fo abdominopelvic splanchnic nerves synapse at?

PRE vertebral ganglia

Where do parasympathetics traveling in the vagus nerve stop?

splenic flexure

In the sympathetics, cell bodies are for PARA vertebral ganglia are found in all parts of the body EXCEPT

abdominopelvic viscera (organs)

Where do the abdominal viscera (organs) of the sympathetics synapse?

PRE vertebral ganglia pre = pretty organs

Why are suprarenal glands special?

Cause they do not synapse with anything! they are directly stimulated by pre-synaptic fibers as the gland actually functions are post-synaptic neurons. Come from NC cells

In the parasympathetics (w/ the enteric nervous system), which is longer the pre or post synaptic fiber?

Pre! because the post is directly on the gut!

Cranial nerve 3 goes to which ganglia?

Ciliary

Crainial nerve 9 goes to which ganglia?

otic

Crainal nerve 7 goes to which ganglia?

Pterygopalatine + submandibular

ciliary ganglia sends nerves to \_\_\_\_\_\_.

orbit (eyes)

Otic ganglia sends nerves to \_\_\_\_\_\_\_.

paratid salivary gland

Pterygopalatine ganglia sends nerves to \_\_\_\_\_\_\_.

Nasal + palate

Submandibular ganglia sends nerves to \_\_\_\_\_\_.

Oral region (submandibular + sublinguial salivary glands)

True or False: Parasympathetics only go to internal organs + glands (NEVER body wall + limbs)

True

Where do the cranial parasympathetic fibers stop innervating the abdominal organs, and the sacral fibers begin?

At the splenic flexure (between transverse and descending colon)

What are the 3 functions of the parasympathetic system crainial part?

1. Constriction of pupil 2. Accomodation (adjusting the eye) 3. Tears

What are 3 functions of the parasympathetic system overall?

1. Control vision 2. Stimulate GI tract 3. Eliminate waste

What type of nerves are composed of BOTH afferents and efferents?

Splanchnic nerves

Pain travels with the ________ from the stomach to the sigmoid colon.

sympathetics

What parts of the body produce pain via parasympathetics?

Above thoracic pain line (*vagus N.* ) --\> above esophagus And below the middle of the sigmoid colon (pelvic pain line) via the *pelvic splanchnics*

Pain is what type of transmitted via what type of fiber?

viscera afferents

Time: Acute abdominal pain Chronic abdominal pain

3 days 3 weeks

Describe visceral (organ) pain.

Diffuse + poorly localized

Describe somatic pain (body wall).

Well localized (can point to specific spot) In gallbladder + appi you can get somatic pain if the organ starts to irritate the peritoneum.

Where do foregut organs (stomach, duodenum, biliary tract) produce pain?

epigastric region

Where do midgut organs (small bowel, appendix, cecum) produce pain?

Periumbilical region

Where fo hindgut organs (most of colon, sigmoid, rectum) produce pain?

Suprapubic or hypogastric area

Visceral pain from the liver, stomach, pancreas, and proximal duodenum come from what level of the spinal cord?

T6-T9

The spleen has pain from what level of the spinal cord?

T6-8

The kidneys have pain from what level of the spinal cord?

T10 - L1

The small intestine has pain from what level of the spinal cord?

T8-T10

The ascending colon has pain from what level of the spinal cord?

T10

The transverse colon has pain from what level of the spinal cord?

T11

The descending colon has pain from what level of the spinal cord?

T12-L1

The sigmoid colon has pain from what level of the spinal cord?

S2-S4 (S4 = rectum)

MEMORIZE

Referred pain for irritation of the diaphragm via the liver/gallbladder/duodenum is where?

right shoulder pain

MEMORIZE

What type of pain does a patient have when it is retroperitoneal (kidney, aorta, pancreas)?

back pain

What is colicky pain?

Cramp-like When a hollow structure becomes obstructed (like a kidney stone, or bowel obstruction)

Perforated gastric ulcer

Gastric contents now spreading all over --\> foregut chronic visceral pain, sever pain spreading over abdomen

Acute cholecystitis

refers pain to right shouler, somatic pain in RUQ

What type of pain is adhesive small bowel obstruction?

History of previous abdominal surgery Midgut visceral colicky pain, no gas, distension

Passage of kidney stone pain

Sudden onset of very sever colicky pain from loin to groin, patient writhing in pain w/ no fever

Cancer of descending colon pain

hindgut visceral colicky pain, distended abdomen

Ruptured ectopic pregnancy pain

Sudden onset of sever pain in hypogastrium radiating to sacrum no fever localized peritonitis Do a rectal finger exam (DRE) - tender

Leaking aortic aneuryseum pain

history of male w/ atherosclerotic disease (hypertension) sever sudden back pain palapable impulse from aneurysm in epigastrium

Autonomics + Pain Flashcards

(82 cards)