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Flashcards in CPR Thoracic Neurology Deck (56)
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What is the role of the esophagus?

What is it composed of?

joins the laryngopharynx to the stomach

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


Where is the esophagus located in the thorax?

between T1 & esophageal hiatus

travels thru posterior mediastinum


Name the constrictors of the esophagus

@ cricopharyngeus m (upper esophageal sphincter)

@ aortic arch

@ left bronchus

@ esophageal hiatus of thoracic diaphragm (lower esophageal sphincter)


Which CN is associated w/ thorax?

Where does it enter?

vagus N (R & L)

enters thru superior thoracic aperture


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

L recurrent laryngeal N

pulmonary branches

sup/middle/inferior cardiac branches

esophageal branches

anterior vagal trunk

posterior vagal trunk


Anterior v Posterior vagal trunks

anterior from L vagus N

posterior from R vagus N


What cervical spinal N is assoc w/ the thorax?

phrenic N (anterior rami of C3-5)


Where does the phrenic N travel?

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


What does the phrenic N innervate?

thoracic diaphragm


What do the intercostal Ns innervate?

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


What composes the intercostal Ns?

Where do they run?

anterior rami of thoracic spinal Ns

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


What are the typical intercostal Ns?

3rd-6th intercostal Ns


Which intercostal Ns supply the breast?

lateral cutaneous branches & anterior cutaneous branches of T4-T6


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

Where do the collateral branches travel?

innervate intercostal ms

along sup edge of rib inf to intercostal space


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

intercostal ms
subcostal m
transversus thoracic m


What are the atypical intercostal Ns?

1st & 2nd, 7th-11th


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

connected intercostal N to ipsilateral sympathetic trunk


What makes the 1st intercostal N atypical?

no cutaneous branches & majority superior portion joins brachial plexus


What makes the 2nd intercostal N atypical?

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

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


Where does the intercostobrachial N originate?

2nd intercostal N


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

travel anteriorly & no longer exist btwn ribs

transition over abdomen to become thoracoadominal N


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

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)


Where does sympathetic division of ANS arise from?

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


Presynaptic fibers of sympathetic

cells bodies in lateral horn of SC

always travel in anterior root

always travel into anterior ramus

quickly exit anterior ramus & enter paravertebral ganglia


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


Describe the paravertebral ganglia

contain postsynaptic cell bodies

linked vertically to form sympathetic trunks

3 ganglia exist in cervical, lumbar & pelvic regions


Describe the prevertebral ganglia

contain postsynaptic cell bodies

ganglia & corresponding plexuses surrounding the main unpaired branches of abdominal aorta


What are the 4 prevertebral ganglia?

celiac ganglion
superior mesenteric ganglion
aorticorenal ganglion
inferior mesenteric ganglion


Describe the sympathetic presence in the thorax

thoracic sympathetic trunk
cardiopulmonary splanchnic Ns
abdominopelvic splanchnic Ns


What is the thoracic sympathetic trunk?

paravertebral sympathetic ganglia

location of short presynaptic sympathetic fibers synapses w/ long postsynaptic cell bodies