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CPR Midterm > CPR Thoracic Neurology > Flashcards

CPR Thoracic Neurology Flashcards

(56 cards)

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1
Q

What is the role of the esophagus?

What is it composed of?

A

joins the laryngopharynx to the stomach

2 layer muscle tube (internal circular layer & external longitudinal layer)

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2
Q

Where is the esophagus located in the thorax?

A

between T1 & esophageal hiatus

travels thru posterior mediastinum

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3
Q

Name the constrictors of the esophagus

A

@ cricopharyngeus m (upper esophageal sphincter)

@ aortic arch

@ left bronchus

@ esophageal hiatus of thoracic diaphragm (lower esophageal sphincter)

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4
Q

Which CN is associated w/ thorax?

Where does it enter?

A

vagus N (R & L)

enters thru superior thoracic aperture

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5
Q

What are the branches of the vagus N in the thorax?

A

L recurrent laryngeal N

pulmonary branches

sup/middle/inferior cardiac branches

esophageal branches

anterior vagal trunk

posterior vagal trunk

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6
Q

Anterior v Posterior vagal trunks

A

anterior from L vagus N

posterior from R vagus N

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7
Q

What cervical spinal N is assoc w/ the thorax?

A

phrenic N (anterior rami of C3-5)

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8
Q

Where does the phrenic N travel?

A

thru superior thoracic aperature into space btwn mediastinal parietal pleura & fibrous pericardium

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9
Q

What does the phrenic N innervate?

A

thoracic diaphragm

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10
Q

What do the intercostal Ns innervate?

A

skin, subcutaneous tissue, muscles, and costal & diaphragmatic parietal pleura

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11
Q

What composes the intercostal Ns?

Where do they run?

A

anterior rami of thoracic spinal Ns

along inf edge of superior rib in the intercostal space btwn internal & innermost intercostal ms

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12
Q

What are the typical intercostal Ns?

A

3rd-6th intercostal Ns

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13
Q

Which intercostal Ns supply the breast?

A

lateral cutaneous branches & anterior cutaneous branches of T4-T6

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14
Q

What do the collateral branches of intercostal Ns 3-6 innervate?

Where do the collateral branches travel?

A

innervate intercostal ms

along sup edge of rib inf to intercostal space

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15
Q

What do the muscular branches of intercostal Ns 3-6 innervate?

A

intercostal ms
subcostal m
transversus thoracic m

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16
Q

What are the atypical intercostal Ns?

A

1st & 2nd, 7th-11th

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17
Q

What do the rami communicates of intercostal Ns 3-6 do?

A

connected intercostal N to ipsilateral sympathetic trunk

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18
Q

What makes the 1st intercostal N atypical?

A

no cutaneous branches & majority superior portion joins brachial plexus

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19
Q

What makes the 2nd intercostal N atypical?

A

majority travels in costal groove w/ small part joining w/ brachial plexus

lateral cutaneous branch supplies skin/tissue of axilla (intercostobrachial N)

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20
Q

Where does the intercostobrachial N originate?

A

2nd intercostal N

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21
Q

What makes the 7th-11th intercostal Ns atypical?

A

travel anteriorly & no longer exist btwn ribs

transition over abdomen to become thoracoadominal N

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22
Q

What are the general principles of the autonomic nervous system (ANS)?

A

sympathetic stimulation is catabolic (fight or flight)

parasympathetic stimulation is anabolic (normal function & energy conservation)

parasympathetic is only in head/neck & trunk viscera while sympathetic distributes to every vascular area of body

parasympathetic controls gland secretion (except sweat glands)

sympathetic can indirectly decrease non-sweat gland secretion via vasoconstriction

vasoconstriction is sympathetically stimulation (except of coronary As)

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23
Q

Where does sympathetic division of ANS arise from?

Study These Flashcards
A

presynaptic fibers have cell bodies in lateral horn of spinal cord from T1-L2

24
Q

Presynaptic fibers of sympathetic

Study These Flashcards
A

cells bodies in lateral horn of SC

always travel in anterior root

always travel into anterior ramus

quickly exit anterior ramus & enter paravertebral ganglia

25
What are the 3 synaptic options for sympathetic presynaptic fibers?
synapse @ paravertebral ganglion of same SC level ascend/descend to synapse @ paravertebral ganglion of different SC level exit paravertebral ganglion w/o synapsing & continue with abdominopelvic splanchnic nerve to a postsynaptic neuron in PREvertebral ganglion
26
Describe the paravertebral ganglia
contain postsynaptic cell bodies linked vertically to form sympathetic trunks 3 ganglia exist in cervical, lumbar & pelvic regions
27
Describe the prevertebral ganglia
contain postsynaptic cell bodies ganglia & corresponding plexuses surrounding the main unpaired branches of abdominal aorta
28
What are the 4 prevertebral ganglia?
celiac ganglion superior mesenteric ganglion aorticorenal ganglion inferior mesenteric ganglion
29
Describe the sympathetic presence in the thorax
thoracic sympathetic trunk cardiopulmonary splanchnic Ns abdominopelvic splanchnic Ns
30
What is the thoracic sympathetic trunk?
paravertebral sympathetic ganglia location of short presynaptic sympathetic fibers synapses w/ long postsynaptic cell bodies
31
Where are the presynaptic cell bodies of the cardiac splanchnic Ns? where do these Ns synapse & send info?
pre cell bodies are in lateral horn of SC @ T1-T5/6 synapse @ postsynaptic cell bodies in cervical & thoracic sympathetic trunks (sending fibers to superficial & deep cardiac plexuses)
32
Where are the presynaptic cell bodies of the pulmonary splanchnic Ns? where do they synapse & send info?
pre cell bodies in lateral horn of SC @ T2-3 synapse on postsynaptic cell bodies in thoracic sympathetic trunk (sending fibers to pulmonary plexus)
33
What are the 3 divisions of abdominopelvic splanchnic Ns?
Greater Splanchnic N Lesser Splanchnic N Least Splanchnic N
34
Greater Splanchnic N
T5-T9/10 send fibers to esophageal plexus & celiac ganglion in abdomen feeds into celiac plexus
35
Lesser Splanchnic N
T10 & T11 send fibers to celiac & superior mesenteric ganglion in abdomen feeds into superior mesenteric plexus
36
Least Splanchnic N
T12 sends fibers to aorticorenal ganglion in abdomen
37
What nerves make up the parasympathetic nervous system?
cranial components exit as CN III, VII, IX, X sacral components exit spinal levels as pelvic splanchnic Ns (S2-4)
38
Where are the nuclei of parasympathetic NS?
nuclei in brainstem & sacral spinal levels
39
Where are the postsynaptic nuclei of the parasympathetic NS?
4 cranial ganglia or in wall of target organ (intrinsic parasympathetic ganglia)
40
What are the 4 cranial ganglia receiving parasympathetic stimulation?
``` Ciliary ganglion (CN III) Pterygopalatine ganglion (CN VII) Submandibular Ganglion (CN VII) Otic Ganglion (CN IX) ```
41
Parasympathetic present in thorax
vagus N
42
What does the vagus N provide innervation to in the thorax?
presynaptic innervation of lungs, bronchi, pleurae, heart & pericardium
43
What forms the cardiac plexus?
superior, middle & inferior cardiac branches of vaus N (paraysympathetic) travel w/ cardiac splanchnic Ns (sympathetic)
44
What forms the pulmonary plexus?
pulmonary branches of vagus N (parasympathetic) traveling w/ pulmonary splanchnic Ns (sympathetic)
45
What forms the esophageal plexus?
parasympathetic from esophageal branches of vagus N (covers inf 2/3 of esophagus) sympathetic from greater splanchnic N & aortic plexus
46
What are the thoracic autonomic plexuses?
Pulmonary plexus Cardiac plexus Aortic plexus Esophageal plexus
47
What are the sympathetic functions of the pulmonary plexus?
dilate bronchi & bronchioles inhibits glands of bronchi & bronchioles constricts pulmonary vessels visceral sensory from lungs/bronchi/pleurae
48
What are the parasympathetic functions of the pulmonary plexus?
constrict bronchi & bronchioles increases gland secretion of bronchi & bronchioles dilator of pulmonary vessels sensory from bronchial mucosa (cough reflex) reflex of interalveolar CT pressure sensory from pulmonary A chemoreceptor from pumonary V
49
Where do the postsynaptic fibers of the cardiac plexus terminate?
near SA & AV nodes
50
What are the sympathetic functions of the cardiac plexus?
increase HR via innervation of nodal tissue increase force of heart contractions vasomotor to pericardium
51
What are the parasympathetic functions of the cardiac plexus?
decrease HR reduces force of heart contraction vasoconstrics coronary arteries
52
Where is the superficial cardiac plexus? Where is the deep cardiac plexus?
covers anterior surface of aorta anterior to bifurcation of trachea, posterior to aortic arch & superior to bifurcation of pulmonary trunk
53
What is the aortic plexus?
continuous superiorly w/ superficial cardiac plexus & continues inferiorly as arotic plexus in abdomen
54
Where does the aortic plexus feed?
intermesenteric plexus
55
What are the sympathetic functions of the esophageal plexus?
inhibit peristalsis | inhibits esophageal glands
56
What are the parasympathetic functions of the esophageal plexus?
stimulates peristalsis | stimulates esophageal glands

CPR Midterm (20 decks)

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