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19 Cards in this Set

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Somatic vs. visceral
Somatic:
- skin
- skeletal muscles
- tendons
- joint

(anything under your control)

Visceral structures:
- mucous membranes
- glands
- smooth muscle
- cardiac muscle

Visceral: anything not under your control
Spinal nerve components
- somatic motor fibers
- general sensory fibers
- visceral motor fibers
- visceral sensory fibers
Somatic Motor fiber
Go from ventral root to spinal nerve to muscle. Cell body in ventral horn.
General sensory fibers
Comes from dorsal horn, cell body in DRG, goes into spinal nerve and to tissue.

Transmits pain, temp, proprio, touch, pressure.
Visceral motor (sympathetic)
Preganglionic: goes from lateral horn out ventral root into spinal nerve. Goes into white commucantes rami into sympathetic trunk. Synapses with post ganglionic neuron.
Exits through gray communicantes rami, goes down ventral ramus.

Innvervates glands, smooth muscle, cardiac muscle.
Visceral sensory fibers
Cell body in DRG. Goes from mucous membranes, glands, smooth muscle, cardiac muscle. Enters dorsal horn of cord.

Carries pain and reflex info.
Autonomic Nervous System
Made of visceral motor fibers.

- A 2 neuron system (pre and post ganglionic)
- inenrvates smooth muscle, cardiac muscle, glands
- Divided into sympathetic (thoracolumbar) and parasympathetic (craniosacral).


Sympathetic can synapse at same level (thoraclumbar region/torso T1-L2), go above (cranial) or go below (sacral/coccygeal).
Others synapse IN sympathetic chain and enter splanchnic nerves. Can also synapse in ganglion post sympathetic chain then go on to viscera.
Sympathetic...
short preganglionic, long postganglionic (though some exceptions).

Makes sense since most sympathetic action is at thoracolumbar levels.
Parasympathetic...
...usually long preganglionic, short postganglionic.

Makes sense since located craniosacrally but work on thorax structures.
Visceral Sensory nerves of the heart
Sympathetic and parasympathetic.

Pain (sympathetic) goes from heart to DRG in thoracolumbar area.

Reflex goes parasympathetic. Cell body in DRG in cranial region.
Referred Pain
Visceral sensory and somatic sensory neurons converge in same DRG. This is ONLY true in thoracolumbar area.

Sometimes spinal cord can confuse somatic sensory with pain from the viscera (visceral sensory).

Somatic pain is sharp and at specific area. Visceral pain is diffuse, but can cover dermatomes corresponding to matching somatic sensory.

Heart problem would be confused with T1-T4.
Innervation of trachea/bronchi
Same as heart:
- sympathetic will have short preganglionic going to sympathetic trunk, and long postganglionic going to pulmonary plexus.

Parasympathetic will have vagus (X) nerve with long preganglionic too pulmonary plexus, short postganglionic to trachea/bronchi.
Innervation of foregut (T5-T9)
Exception: we have LONG preganglionic going to celia ganglion (as opposed to synapsing in trunk), and short postganglionic to foregut.

ALSO, exception in that parasympathetic synapses on wall of organ itself, not in celiac ganglion.

Nerve that does sympathetic action is the greater thoracic splanchnic nerve.

Nerve that does parasymp is vagus.
Celiac Ganglia Block
Used for cancers in abdominal region. These usually don't respond well to treatment. Can cause severe pain, and don't respond well to pain meds.

Inject contrast and drug under CT guidance.

Inject alcohol into celiac ganglion.
Innvervation of Midgut and Kidney (T10-T11)
Lesser thoracic splanchnic is sympathetic nerve. Once again synapse in ganglion (aorticorenal and sup. mes. ganglion).

Parasympathetic once again is vagus and synapses right at midgut.

Sup. mes. ganglion is right on sup. mes. artery.

Kidney also receives SOME sympathetic innvervation from LEAST thoracic splanchnic nerve (T12). Synapeses in renal plexus.
Innervation of hindgut
(parasymp S2-S4, symp L1-L2)
No longer vagus, parasympathetic comes from sacral regions. Pelvic splanchnic nerves do this. Synapses right at hindgut. P for pelvic and for parasympathetic!!

Lumbar splanchnic nerves provide sympathetic innervation, synapse at inferior mesenteric ganglion.
Hirschsprung's disease
Congenital aganglionic megacolon.

Birth defect, nerve in wall of intestine. These nerve cells are parasympathetically controlled to do peristalsis.

Trap stool, get inflammation, infection and constipation.

More common in guys.

Treat by surgical removal of part of colon.
Innervation of the suprarenal gland (T5-T8)
ON THE EXAM.

ONE NEURON SYSTEM.

Adrenal gland is cap of kidney.

Preganglionic goes from lateral horn in cord to cell in medulla, causes the release of epinephrine.

No parasympathetic innvervation.

It's a sympathetic on or off switch.
Rule of thumb for sympathetic synapse locations
If it innervates thorax, is synapses in sympathetic trunk.
If it innervates abdomen, it synapses at prevertebral ganglion close to viscera.