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MD3001 Cardiology > Nerves of the Thorax > Flashcards

Nerves of the Thorax Flashcards

1
Q

What controls the ANS?

A

hypothalamus

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2
Q

Describe the functionality of organs that have dual innervation

A
  • sympathetics and parasympathetics exert opposite effects

- but functionally complement each other

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3
Q

Examples of vessels supplied by only sympathetics

A
  • blood vessels
  • errector pili muscles
  • sweat glands
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4
Q

What is the role of the ANS?

A
  • maintains stable internal environment
  • regulates visceral activity (circulation/respiration/excretion/reproduction)
  • supplies smooth muscles
  • supplies cardiac muscle
  • supplies glands
  • regulates body temperature
  • fibres accompany general visceral afferent fibres
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5
Q

What is the structure of autonomic nerves?

A
  • reach end organ with 2 neurons
  • preganglionic neuron cell body is in grey matter of spinal cord
  • myelinated axon
  • postganglionic neuron is at an automatic ganglion
  • unmyelinated axon
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6
Q

What is the role of the parasympathetic system?

A
  • rest and digest to conserve energy
  • slows breathing and HR
  • reduces cardiac output and BP
  • opens sphincters
  • constricts pupils
  • secretomotor to glands (sweat/lacrimal)
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7
Q

What is the only parasympathetic source of abdominal organs?

A
  • vagus

- 10th cranial nerve

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8
Q

Describe the pathway of the vagus nerve from the skull

A
  • leaves cranial cavity through jugular foramen

- descends between IJV and internal then carotid artery in the carotid sheath

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9
Q

Describe where the right and left vagus enters the thoracic cavity

A
  • right vagus enters thoracic cavity between right subclavian and brachiocephalic vein
  • left vagus enters thoracic cavity posterior to left brachiocephalic vein between sublcavian and common carotid arteries
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10
Q

What are the branches of the left and right vagus nerves?

A
  • right vagus: recurrent largyngeal nerve that wraps around right subclavian artery
  • left vagus gives off recurrent laryngeal nerve that wraps around aortic arch forming the aortopulmonary window
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11
Q

What do the recurrent laryngeal nerves supply?

A
  • intrinsic laryngeal muscles (except cricothyroid)
  • middle and inferior pharyngeal constrictor muscles
  • sensory supply to the laryngeal cavity below the level of vocal folds
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12
Q

What is the role of the sympathetic system?

A
  • fight or flight (uses energy)
  • increases HR and strength of contraction
  • dilates coronary arteries (indirectly by local metabolic factors)
  • constricts peripheral arteries
  • relaxes bronchial smooth muscles
  • closes sphincters
  • controls body temperature (blood vessels/sweat glands)
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13
Q

Where are preganglionic sympathetic cell bodies found?

A

intermediolateral grey matter horn of T1-L2 spinal cord segments

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14
Q

Where are postganglionic sympathetic cell bodies found?

A

paravertebral sympathetic ganglia:

  • anterior to neck of ribs, lateral aspect of vertebral bodies
  • interconnected and covered with parietal pleura

prevertebral sympathetic ganglia:
- around the origins of branches of abdominal aorta

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15
Q

Describe the divisions of cervical parasympathetic ganglia to the vertebrae

A
  • superior cervical ganglia C1-4
  • middle cervical ganglia C5-6
  • inferior cervical ganglia C7-8
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16
Q

What is it called when T1 joins the inferior cervical ganglion?

A
  • stellate ganglion

- cervicothoracic ganglion

17
Q

Explain the pathway of the sympathetic system to supply the mid-body area

A

neuron can synapse in the sympathetic chain at its level, postganglionic axons pass in the GRC and joins T1-L2 spinal nerves to supply mid-body area

18
Q

Explain the pathway of the sympathetic system to supply the head, neck and upper limbs

A

neuron can travel up sympathetic chain to synapse in cervical ganglia, post ganglionic axons pass in GRC and joins cervical spinal nerves to supply head, neck and upper limbs

19
Q

Explain the pathway of the sympathetic system to supply the lower limbs

A

neuron can travel down sympathetic chain to synapse in lumbar/sacral ganglion, postganglionic axons pass in the GRC and join lumbar/sacral nerves to supply lower limbs

20
Q

Explain the pathway of the sympathetic system to supply abdominal viscera

A

preganglionic branches pass through the sympathetic trunk without synapsing, travels in splanchnic nerves to the abdomen to synapse in a prevertebral ganglion to supply abdominal viscera

21
Q

Different types of splanchnic nerves

A

Thoracic splanchnic nerves:

  • greater splanchnic nerve T5-9
  • lesser splanchnic nerve T10-11
  • least splanchnic nerve T12

Lumbar splanchnic nerves T1-L2
Pelvic splanchnic nerves

22
Q

Explain the pathway of sympathetic system to supply adrenal medulla

A

supplied directly, it is itself like a ganglion

23
Q

What are the divisions of the sympathetic system for the different segments of the body?

A
  • head T1-3
  • upper limb T4-6
  • thoracic and abdominal walls T1-12
  • lower limbs T12-L2
24
Q

What type of nerves are splanchnic nerves?

A

sympathetic

25
Q

What are visceral plexuses and where are they found?

A
  • a mixture of sympathetic and parasympathetic fibres

- found in the thorax

26
Q

Where is the cardiac plexus found?

A
  • anterior to bifurcation of trachea

- posterior to ascending aorta

27
Q

Where is the pulmonary plexus found?

A

anterior and mainly posterior to the root of the lungs

28
Q

Where is the oesophageal plexus found?

A

Around the oesophagus

29
Q

Describe the cardiac plexus

A
  • receives sympathetics from T1-5
  • synapses on T1-5 ganglia and inferior and middle cervical ganglia
  • visceral afferents travel alongside sympathetic nerves
  • referred pain from heart to T1/2 dermatomes, T3-5
  • parasympathetics from vagus
30
Q

Describe the pulmonary plexus

A
  • receives sympathetics from T2-4
  • synapses of T2-4 ganglia
  • parasympathetics from vagus
31
Q

What sensory supply is the phrenic nerve responsible for?

A
  • mediastinal parietal pleura
  • parietal pericardium
  • peritoneum and pleura related to central tendon
32
Q

What are intercostal nerves?

A

anterior rami of thoracic spinal nerves, mixed nerves

33
Q

Describe the intercostal nerves

A
  • motor branches to intercostal and abdominal wall muscles
  • viceromotor branches to vessels
  • lateral cutaneous branch
  • anterior cutaneous branch
34
Q

What is Pancoast’s tumour?

A
  • tumour at the apex of the lung
  • affects sympathetic trunk/stellate ganglion
  • compromises sympathetic supply to the head and neck on the same side
35
Q

Describe Horner’s syndrome

A
  • pstosis (drooping) of upper eyelid
  • pupillary constriction (miosis)
  • anhydrosis (lack of sweating)
  • flushing of the face

MD3001 Cardiology (56 decks)

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