Final Exam: Unit VII-- Intro, Visceral Afferent, Parasympathetics, Autonomic Plexuses Flashcards

1
Q

T/F. It is more accurate to think of the sympathetic and parasympathetic systems working in concert with one another to maintain homeostasis and optimal functioning.

A

True

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2
Q

T/F. There are many more NT than just parasympathetics being cholinergic and sympathetics being adrenergic. And it is safe to assume there is more variability with postganglionic parasympathetics.

A

True

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3
Q

What is the visceral nervous system concerned with?

A

the internal env. of the body:

  • secretory glands (endocrine and exocrine)
  • organs of thoracic and abdominopelvic cavities
  • vasculature
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4
Q

Where are cell bodies located for visceral afferents?

A

posterior root ganglia(aka DRG) or relevant cranial nerve ganglion (in PNS)

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5
Q

What type of neurons are visceral afferents?

A

unipolar/ pseudounipolar neurons (“appear to have one axon come off body”)

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6
Q

How do the central processes (axons) of visceral afferent enter the cord?

A

through posterior root or specific cranial nerve

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7
Q

What do the peripheral processes (dendrites) of visceral afferents carry impulses from? Where are they carrying this info to? Via what?

A

from–> viscera
to–> cell bodies
via–> autonomic ganglia, plexus, or somatic nerves w/o synapse

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8
Q

T/F. We will use the terms visceral and autonomic interchangeably

A

True

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9
Q

Where are cell bodies located for Sympathetic afferents? What may they travel through?

A

cell bodies in spinal ganglia (aka DRG, or post. root ganglion) of T1-L2/L3

may travel through sympathetic trunk and to spinal ganglia by passing through white ramus communicans

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10
Q

Where are the cell bodies located for Parasympathetic afferents? how do they travel?

A

cell bodies in DRG of S2,3,4 or cranial ganglion of CN III, VII, IX, X

travel in spinal nerves or cranial nerves

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11
Q

What are the three sensitivities of receptors that visceral afferents are associated with?

A
  1. pressure
  2. chemical concs. (CO2 and O2)
  3. muscle stretching (esp. smooth ms in GI)
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12
Q

What cranial nerves and spinal nerves parasympathetic pre-ganglionic fibers carried in?

A

CNs III, VII, IX, X

sacral spinal nerves S2,3,4

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13
Q

Where to preganglionic parasympathetic neurons typically synapse? What do they release?

A

synapse on post-ganglionic neurons in peripheral ganglia

are “Cholinergic”–> release ACh

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14
Q

Postganglionic Parasympathetic fibers extend to effector organs to do what four things?

A

1, decrease cardiac output

  1. constrict the bronchial tree
  2. constrict the pupils
  3. stimulate peristalsis
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15
Q

In general, what will CN III, VII, and IX supply?

A

parasympathetic structures in the head (smooth muscle and glands)

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16
Q

In general, what will CN X supply?

A

cardiac, respiratory, and digestive structures in the neck, thorax, and abdomen

(“thoracic and abd. cavities”)

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17
Q

In general, what will S2, S3, S4 parasympathetic fibers supply?

A

distal parts of digestive system and urogenital systems

“pelvic cavity”

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18
Q

Where are the pre-ganglionic parasympathetic cell bodies located that are carried in the Oculomotor nerve? Where is that located?

A

Accessory oculomotor nucleus (aka Edinger-Westphal Nucleus); located in the periaqueductal gray

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19
Q

Describe the path of the preganglionic parasympathetic fibers traveling with CN III. Where do they synapse?

A

follow oculomotor nerve into orbit and synapse in ciliary ganglion

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20
Q

How are the postganglionic parasympathetic axons carried in CN III? What do they supply?

A

carried in short ciliary nerves–> enter eyeball and supply two muscles:

  1. Ciliary muscle
  2. Sphincter pupillae
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21
Q

What are the two muscles supplied by the parasympathetic fibers carried in the Oculomotor nerve and what are their actions?

A
  1. Ciliary muscle–> it contracts and it makes lens more convex to focus on closer objects
  2. Sphincter pupillae–> it contracts and decreases the size of the pupil (constricts pupil)
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22
Q

Where are the cell bodies of preganglionic parasympathetic fibers carried with CN VII located?

A

superior salivary nucleus

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23
Q

How do the preganglionic parasympathetic fibers exit the CNS that are carried with CN VII? What branches of the Facial nerve are they carried in?

A

in the intermediate nerve –> carried in two branches of the facial nerve:
1. Greater Petrosal Nerve
2. Chorda Tympani
(both come off w/in facial canal)

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24
Q

Where does the Greater Petrosal Nerve leave the facial nerve? What direction are these preganglionic parasym. fibers carried and what are they carried through?

A

leave at geniculate ganglion–> carried anteriorward –> through hiatus for the greater petrosal nerve

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25
Q

After the pregang. parasym. fibers carried in the Greater Petrosal Nerve travel through the hiatus for the greater petrosal nerve, how does it re-enter the temporal bone and then where does it travel?

A

re-enters temporal bone through the petrous part through the foramen lacerum–> travels in pterygoid canal–> then synapses in pterygopalatine ganglion

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26
Q

Where do the pregang. parasym. fibers carried in the Greater Petrosal Nerve synapse?

A

(branch of CN VII)

synapse in pterygopalatine ganglion

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27
Q

Where are the postganglionic parasympathetic fibers carried in the Greater Petrosal Nerve distributed in and to?

A

distributed in the lacrimal and other nerves to reach the lacrimal, nasal, palatine, and pharyngeal glands

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28
Q

What are the pregang. parasym. fibers carried through in the Chorda Tympani (branch of CN VII) and how do they leave the temporal bone?

A

carried through the tympanic cavity–> leaves temporal bone through the pterygotympanic fissure

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29
Q

What will the Chorda Tympani branch of CN VII carrying pregang. parasym. fibers combine with after it leaves the pterygotympanic fissure? What do the pregang. fibers then do?

A

combines with lingual nerve (branch of V3) —> then leave lingual nerve to reach the submandibular ganglion

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30
Q

Where do the pregang. parasym. fibers carried in the Chorda Tympani synapse? Where are the postgang. parasym. fibers then travel to?

A

in the submandibular ganglion–> postgang. parasym. then travel to submandibular and sublingual glands

submandibular gland–> fibers to glands in mucous membranes of oral cavity and lingual glands on anterior part of tongue

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31
Q

Where are the cell bodies of pregang. parasym. fibers carried in CN IX located? What branch of CN IX are they carried in? What ganglion do they eventually synapse on?

A

inferior salivary nucleus; carried in Tympanic Nerve (eventually turns into/renamed to Lesser Petrosal Nerve)–> synapse on otic ganglion

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32
Q

Where does the Tympanic nerve carrying pregang. parasym. fibers come off of CN IX? Where are these fibers carried through and therefore into?

A

come off of CN IX at the inferior ganglion–> carried through tympanic canaliculus –> into tympanic cavity

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33
Q

Once the Tympanic Nerve carrying pregang. parasym. fibers are in the tympanic cavity, what do they receive? What does this form? How do the pregang. parasym. travel?

A

receives postgang. symp. fibers from superior cervical ganglion–> and forms tympanic plexus

but the pregang. parasym. pass THROUGH the tympanic plexus and reform as Lesser Petrosal Nerve

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34
Q

Once the pregang. parasym. fibers are in the tympanic cavity (and have pregang. symp. joining them), what do they travel through and reform as? What do these reformed fibers travel through and synapse on?

A

pass THROUGH the tympanic plexus–> and reform as Lesser Petrosal Nerve–> then travels through lesser petrosal canal to otic ganglion

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35
Q

What structures are the postgang. parasym. traveling from the otic ganglion carried to? How do they get to these two structures? (pregang. parasym. were carried with CN IX)

A

parotid gland –> via Auricolutemporal Nerve (branch of V3)

posterior lingual gland –> via lingual branches of CN IX

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36
Q

What branch are other visceral afferents parasympathetic fibers carried in of the Glossopharyngeal nerve? From where?

A

carried in carotid branch–> from:

  • baroreceptors in carotid sinus
  • chemoreceptors in carotid body
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37
Q

Where are the cell bodies of preganglionic parasym. fibers carried in the Vagus nerve located?

A

in the posterior (dorsal) nucleus of the vagus

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38
Q

How do the pregang. parasym. fibers carried in CN X travel? What do they ultimately supply?

A
fibers descend in Vagus nerve; ultimately supply smooth muscle of:
- bronchial tree
- digestive tract
- gall bladder and bile ducts
- myocardium
and
- pancreas
- liver
- spleen
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39
Q

Where are the postganglionic parasym. cells located that are ass. with CN X? List the three places.

A

located in organs supplied or blood vessels that supply the organs

  1. myocardium
  2. Submucosal plexus (Meissner’s Plexus)
  3. Myenteric plexus (Auerbach’s Plexus)
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40
Q

How are the pregang. parasym. fibers ass. with the Vagus nerve carried to the heart? Where do they synapse?

A

in Superior and Inferior Cardiac Nerves –> synapse in cardiac plexus at base of heart and wall of heart

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41
Q

Where are the postgang. parasympathetic fibers ass. with CN X that synapses in the cardiac plexus carried to?

A
  1. sinoatrial node (SA node/pacemaker)
  2. atrioventricular node (AV node)
  3. atrioventricular bundle–> to reach subendocardial branches (Purkinje Fibers)
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42
Q

What effect with the parasympathetic impulses have on the myocardium? What about the coronary arteries?

A

inhibit myocardium

CONSTRICT the coronary arteries

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43
Q

How are the pregang. parasym. fibers ass. with CN X carried to the lungs? Where do they synapse?

A

in anterior and posterior bronchial branches –> synapse in pulmonary plexuses around bronchial tree

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44
Q

After synapsing in the pulmonary plexus, what will the postgang. parasym. fibers ass. with Vagus nerve reach? What effect will this have on these two structures?

A

bronchial musculature –> constrict bronchial tree

bronchial glands –> increase secretion

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45
Q

When considering asthmatics, what is occurring and what does an inhaler do for an individual with asthma?

A

asthma–> bronchial tree constricts and glandular secretion is increased
inhaler has meds–> that mimic sympathetic innervation (dilate bronchial tree and decrease secretion)

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46
Q

How are the pregang. parasym. fibers ass. with the Vagus nerve carried to the esophagus? Where do they synapse? What will the postgang. fibers supply?

A

in Recurrent Laryngeal Nerves and the Anterior and Posterior esophageal branches

–> synapse in wall of esophagus

postgang.–> supply smooth ms fibers of esophagus

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47
Q

What should we remember about the muscular arrangement of the esophagus?

A

upper 1/3 is skeletal muscle–> supplied by Recurrent Laryngeal Nerve
middle 1/3—> mix
Lower 1/3 –> all smooth ms

48
Q

How do pregang. parasym. fibers ass. with the Vagus Nerve reach the stomach? Where do they synapse?

A

via branches from both anterior (~4 branches) and posterior (~6 branches) vagal trunks

synapse in Submucosal (Meissner’s) and Myenteric (Auerbach’s) plexuses in wall of stomach

postganglionic fibers reach smooth ms via these plexuses

49
Q

What effect do parasympathetic stimulation have on the stomach?

A

contract smooth muscle and secretion of gastric juices

50
Q

How do the pregang. parasym. fibers ass. with Vagus Nerve reach the SI, Cecum, Vermiform appendix, and ascending and transverse colon?

A

via the posterior vagal trunk

51
Q

Through what plexus do pregang. parasym. fibers reach the duodenum? What do the remaining fibers go through to reach the other structures (cecum, appendix, ascending and transverse colon)?

A

through the celiac plexus

others–> through celiac plexus and continue through superior mesenteric plexus

52
Q

Where do the pregang. parasym. fibers ass. with Vagus Nerve reach the SI, Cecum, Vermiform appendix, and ascending and transverse colon synapse?

A

in the Submucosal (Meissner’s) and Myenteric (Auerbach’s) plexuses (same with the stomach)

postgang. parasym. reach smooth ms fibers via these plexuses

53
Q

What effect to parasympathetic stimulation have on the SI, Cecum, Vermiform appendix, and ascending and transverse colon?

A
  • contraction of smooth ms

- secretomotor for intestinal gland

54
Q

How do the pregang. parasym. fibers ass. with Vagus N. reach the gall bladder, pancreas, and biliary tree?

A

primarily through the hepatic branch of the right vagal trunk –> via the hepatic plexus (an extension of the celiac plexus)

55
Q

What other type of nerves does the vermiform appendix contain because postgang. parasym.? why is this important?

A

has visceral afferents (nociceptors–PAIN)

Right lower abd pain–> assume appendicitis until proven otherwise

56
Q

Where do the pregang. parasym. fibers going to the gall bladder, pancreas, and biliary tree synapse?

A

muscular walls of gall bladder and biliary tree
and
glandular tissue of pancreas

–> postgang. fibers reach smooth ms or glands of intended target

57
Q

What effect does parasympathetic stimulation have on the gall bladder and biliary vessels? What about the pancreas?

A

gall bladder and biliary vessels–> increases smooth ms activity (bile into duodenum)

secretomotor for pancreatic glands

58
Q

How do pregang. parasym. ass. with the Vagus nerve reach the spleen?

A

from posterior vagal trunk via splenic plexus (extension of celiac plexus)

59
Q

What three organs most have only visceral afferent parasympathetic fibers associated with them?

A
  1. Kidney
  2. Liver
  3. Suprarenal Glands
    (all ass. with Vagus)
60
Q

How do fibers ass. with the Vagus nerve reach the kidneys?

A

via the renal plexus form the posterior vagus

61
Q

The kidney mainly receives what type of fibers?

A

motor (efferent) fibers that are strictly sympathetic

therefore–> any fibers reaching kidney that are parasympathetic are likely visceral afferents

62
Q

Where are the cell bodies located for the visceral afferents (parasympathetics) ass. with the kidney, liver, and suprarenal glands located?

A

inferior ganglion of Vagus N. (nodose ganglion)

63
Q

How do the pregang. parasym. fibers ass. with the Vagus N. reach the liver?

A

primarily from the anterior vagal trunk (some from posterior vagal trunk)–> reach liver via hepatic plexus (extension of celiac plexus)

64
Q

What type fibers are the parasympathetic supply to the liver?

A

primarily visceral afferent (just like kidneys and suprarenal glands)

65
Q

How do the parasym. fibers ass. with the Vagus N. reach the suprarenal glands? Describe the parasympathetic innervation.

A

(similar to liver and kidneys)

supply is primarily visceral afferent–> carried in posterior vagal trunk

66
Q

Where do the sacral parasympathetic fibers arise from?

A

lateral horns of S2-S4 cord levels and leave cord via anterior rootlets

67
Q

How are the sacral parasympathetic fibers carried once the exit the spinal cord? What bone/where do they exit and what do they get carried in?

A

carried inferior in cauda equina—> exit anterior sacral foramina–> carried in Pelvic Splanchic Nerves

68
Q

What do the Pelvic Splanchnic Nerves travel to? In general, what are they distributed to?

A

the inferior hypogastric (pelvic) plexus–> distributed to pelvic organs

69
Q

T/F. There is a network of ganglia and nerves covering the rectum, internal genitalia, and base of the urinary bladder that include both parasympathetics and sympathetics.

A

True

70
Q

How do fibers from sacral parasympathetic nerves reach the distal part of the digestive tract?

A

through the inferior hypogastric plexus–> to the superior hypogastric and inferior mesenteric plexuses (subdivisions of inf. hypogastric plexus)

71
Q

How do sacral parasympathetic preganglionic fibers reach the distal colon? What plexuses are involved and what nerve are they carried in?

A

travel through the inf. hypogastric plexus–> reach the sup. hypogastric and inf. mesenteric plexuses–> via the “hypogastric nerve”

72
Q

What plexus do postganglionic parasympathetic fibers of sacral parasympathetic nerves reach the distal colon from?

A

from the inferior mesenteric plexus

73
Q

How do the pre and postgang. parasym. fibers from sacral parasyms. reach the rectum and anus?

A

pregang. fibers–> travel to inf. hypogastric plexus–> postgang. fibers reach target from there

74
Q

How do pre and postgang. parasym. fibers from sacral parasymps. reach the urinary bladder?

A

pregang. fibers–> travel to inf. hypogastric plexus

postgang. fibers–> reach target (primarily detrusor muscle) from inf. hyogastric plexus

75
Q

What effect will parasympathetic simulation have on the urinary bladder?

A

initiate emptying of the bladder

76
Q

We know somatic supply to the external urethral sphincter follows the same pathway as the sacral parasympathetics to the urinary bladder, what effect will they have on the sphincter when these neurons are inhibited?

A

the neurons are inhibited as the bladder empties

77
Q

How do pre and postgang. parasym. from the sacral parasym. pathways reach the prostate gland and seminal vesicle?

A

pregang. fibers–> reach prostatic plexus via inferior hypogastric plexus
postgang. fibers–> reach smooth ms of prostatic urtethra and seminal vesicle

78
Q

How do pre and postgang. parasym. from the sacral parasym. pathways reach the uterus?

A

pregang. fibers–> travel to inf. hypogastric plexus

postgang. fibers–> distributed throughout myometrium and uterus

79
Q

What effect will parasympathetic stimulation have on the uterus?

A

most likely inhibits the muscles of the uterus; but hormonal factors may play a larger role, esp. during pregnancy

80
Q

How do pre and postgang. parasym. from the sacral parasym. pathways reach the vagina?

A

pregang. fibers–> reach vaginal plexus via inf. hypogastric plexus and synapse

81
Q

What effect with parasympathetic stimulation have on the vagina?

A

vasodilation and increased glandular secretory activity at the target

82
Q

What nerve may the parasympathetic fibers reaching the inferior part of the vagina use to reach their target?

A

Pudendal nerve (S2,3,4 roots)

83
Q

How do pre and postgang. parasym. from the sacral parasym. pathways reach the penis or clitoris?

A

pregang. fibers–> travel to cavernous plexus via inf. hypogastric plexus

84
Q

What effect will parasympathetic stimulation have on the penis or clitoris?

A

vasodilation and filling of sinuses of erectile tissue

85
Q

What are the autonomic plexuses primarily concerned with supplying?

A

visceral structures in thoracic and abdominopelvic cavities

86
Q

What fiber types do the autonomic plexuses include?

A

Parasympathetic–> pre and postganglionic
Sympathetic–> pre and postganglionic
Afferents–> somatic and visceral

87
Q

How many plexuses do we have in the thoracic area?

A

Four:

  1. Esophageal plexus
  2. Thoracic Aortic Plexus
  3. Pulmonary Plexus
  4. Cardiac Plexus
88
Q

Where is the main contribution to the Esophageal Plexus from?

A

from vagus and recurrent laryngeal nerve–> that synapse on parasympathetic postganglionic cells in walls of esophagus

89
Q

Where is the sympathetic contribution to the Esophageal Plexus from?

A

Greater Splanchnic Nerves–> arising from T5-T9 or T10 ganglia

90
Q

Where are the three places the Thoracic Aortic Plexus receives contribution from? What purpose do they serve?

A
  1. Vagus Nerve (PSNS)—> sensory and visceral afferent
  2. Greater Splanchnic Nerve (SNS)–> sympathetic
  3. T1-T5 sympathetic ganglia (SNS)–> vascular
91
Q

What is the primary component of the Pulmonary Plexus?

A

parasympathetics–> arrive via anterior and posterior bronchial branches of Vagus nerve–> synapse on postgang. parasym. in wall of bronchial vessels

92
Q

What effect will parasympathetic stimulation have on the lungs via the Pulmonary Plexus?

A
  • bronchial constriction

- increase glandular activity

93
Q

Where are the postganglionic sympathetic fibers from that are contributing to the Pulmonary Plexus? What do they supply?

A

from T2-T4 ganglia–> supply pleura, bronchial glands, and musculature

94
Q

What does the cardiac plexus supply?

A

the myocardium and great vessels at base of heart and coronary arteries

95
Q

How does parasympathetic information arrive to the cardiac plexus?

A

via Superior and Inferior Cardiac nerves

Sup. cardiac nerve–directly off Vagus
(Inf. Cardiac nerve– off Recurrent laryngeal branch of Vagus)

96
Q

What effect does parasympathetic stimulation have on the heart and coronary arteries?

A

decreases HR and constricts coronary arteries

97
Q

How does Sympathetic information arrive to the cardiac plexus?

A
  • Superior cardiac nerve, middle cardiac nerve, inferior cardiac nerve (branches off Vagus)
  • T2-T4 sympathetic ganglia
98
Q

What effect does sympathetic stimulation have on the heart and coronary arteries?

A

increases HR and dilation of coronary arteries

99
Q

What is the main plexus of the Abdominopelvic plexuses?

A

Celiac Plexus (but can be subdivided)

100
Q

What is the largest preverterbal plexus?

A

Celiac plexus

101
Q

About at what vertebra level does the Celiac plexus begin?

A

L1

102
Q

What is the name of a dense gangliated plexus that forms a network around the abdominal aorta and its branches down to and including the common iliac and median sacral arteries?

A

Celiac Plexus

103
Q

The Celiac plexus forms a network around the abdominal aorta and its branches, down to what arteries?

A

down to and including the common iliac and median sacral arteries

104
Q

What are the three pairs of well-defined ganglia associated with the Celiac plexus? Where are they loacted?

A
  1. Celiac ganglia–> adjacent to celiac artery
  2. Superior Mesenteric ganglia–> ass. w/ sup. mesenteric artery
  3. Aorticorenal ganglia –> near renal arteries
105
Q

How are the secondary plexuses associated with the celiac plexus named?

A

named for the arteries associated with each one

106
Q

What are the secondary plexuses associated with the Celiac Plexus?

A
  1. Phrenic plexus; inf. phrenic artery
  2. Left gastric plexus
  3. Hepatic plexus
  4. Splenic plexus
  5. Sup. mesenteric plexus
  6. Suprarenal plexus; middle suprarenal artery
  7. Renal plexus
  8. Gonadal plexus
  9. Abdominal aorta plexus
  10. Inf. mesenteric plexus
  11. Sup. hypogastric plexus (includes 9. and 10.)
  12. Infer. hypogastric plexus
107
Q

What plexuses does the Superior Hypogastric plexus include?

A

Abdominal aorta plexus and inferior mesenteric plexus

108
Q

What plexus is the superior hypogastric plexus a part of and at what levels?

A

a part of the celiac plexus b/w L4 and S1 vertebral levels

109
Q

What is the second largest prevertebral plexus?

A

Inferior hypogastric plexus

110
Q

What four secondary plexuses is the Inferior hypogastric plexus associated with?

A
  1. Vesicle plexus
  2. Prostatic or uterine/vaginal plexuses
  3. Rectal plexus
  4. Cavernous plexus
111
Q

What plexus includes the celiac plexus below the internal iliac artery?

A

inferior hypogastric plexus

112
Q

What initiates defecation and micturition?

A

parasympathetic input

113
Q

What are visceral afferents sensitive to regarding deification and micturition?

A

to stretching of walls of bladder and rectum–> initiate a stretch reflex back to CNS

114
Q

How does the efferent response to stretching of bladder and rectum travel out? What muscle do they travel to?

A

out Pelvic Splanchnic Nerves to detrusor muscle and/or rectal musculature

external sphincter muscles are relaxed

115
Q

What effect does sympathetic stimulation have on the bladder and rectum?

A

opposite to parasympathetics

will contract external sphincter muscles