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Nervous system Chapter 18 peripheral nervous system The Spinal Nerves The Cranial Nerves • • • • -1- The Autonomic Nervous System motor nerve visceral sensory nerve referred pain the innervation of some important organs The Autonomic Nervous System include central part periphery Distribute on internal organs, blood vessels, smooth muscle and glands。 Visceral motor nerve periphery sympathetic nerve parasympathetic nerve Visceral sensory nerve Visceral motor nerve is also called autonomic nervous system or vegetative nervous system. -2- The composition of autonomic nervous system can be summarized as following: periphery Visceral nervous system Spinal cord central part Brain stem diencephalons cerebrum -3- Visceral motor nerve periphery Sympathetic nerve Parasympathetic nerve Cranium part pars sacralis Visceral sensory nerve Spinal ganglion cerebral ganglion -4- Visceral motor nerve The differentiation between visceral motor nerve and somatic motor nerve: Visceral motor nerve Organs fiber ingredients the neuron number the different of fiber’s diameter the distributing type -5- Somatic motor nerve smooth muscle, cardiac muscle skeletal muscle and glands two ones: sympathetic or only one parasympathetic nerve two one thinner thicker the postganglionic fibre distribute as nerve plexuses nerve trunk -6- The visceral motor nerve can be divided into sympathetic nerve and parasympathetic nerve. sympathetic nerve The general view of sympathetic nerve sympathetic nerve lower centra:the T1~L3 intermediolateral nucleus paravertebral ganglia ( ganglia of sympathetic trunk) interganglionic branches cervical part 3-4 ones thoracic part 10-12 ones pars lumbalis 4 ones pars sacralis 2-3 ones the two sides of pars terminalis synthetize an odd knob -7- prevertebral ganglia middle cervical celiac ganglia ganglion superior mesenteric ganglion cervicothora inferior mesenteric ganglia cic ganglion sympathetic aorticorenal ganglia trunk pulmonary plexus thoracic ganglia superior mesenteric ganglion superior mesenteric ganglion Lumbar splanchnic nerves sacral ganglia -8- superior cervical ganglion cardiac plexus stomach celiac ganglia small intestine lumbar ganglion communicating branches white communicating branches gray communicating branches gray communica ting branch spinal ganglia anterior root white communicating branch -9- posterior root abdominal cavity ganglion ganglia of sympathetic trunk The 3 directions of preganglionic fibers of sympathetic nerve: intermediolateral nucleus—anterior root—trunk of spinal nerve—white communicating branches—sympathetic trunk ①End at the correspondent paravertebral ganglia,and change neuron. ②After trading upward or descending, terminates at the paravertebral ganglia. (T1~T6)The preganglionic fibers of intermediolateral nucleus go up to cervical part in the sympathetic trunk, and change neuron in the paravertebral ganglia of cervical part. (T6~T10)upgrading or descending in the sympathetic trunk, and change neuron in thoracic sympathetic ganglion. (T11~L3)descending in the sympathetic trunk and change neuron in the sympathetic ganglion of lumbosacral area. ③After going through paravertebral ganglia, neuron is changed in prevertebral ganglia. -10- The three directions of postganglionic fibre of sympathetic nerve ①The postganglionic fibre derived from sympathetic trunk return to spinal nerve via gray communicating branch, and distribute to pate, trunk and acral blood vessel, sweat glangds and arrector muscle.There are gray communicating branches between spinal nerves of 31 pairs and sympathetic trunk. The branches of spinal nerves usually contain postganglionic fibre of sympathetic nerve. ②To hold on to arteries and form correspondent nerve plexus on tunica adventitia of artery, and distribute to the dominant organs with artery . ③Distribute directly to dominant organs from sympathetic ganglia. -11- The distribution of sympathetic nerve cervical part: superior cervical ganglion middle cervical ganglion superior cervical ganglion cervicothorac middle cervical ganglion ic ganglion inferior cervical ganglion the 1st inferior cervical ganglion sympathetic trunk cervicothoracic ganglion thoracic ganglia cardiac plexus pulmonary plexus The distribution of postganglionic nerve fibers emerged from cervical part ganglia of sympathetic trunk: ①distribute on blood vessels, sweat glands and arrector muscles of head, neck and upper extremity. ②distribute directly to the adjacent arteries and form internal carotid plexus, external carotid plexus,subclavian plexus and vertebral plexus. ③the emergent pharyngeal branch composed of pharyngeal plexus with the pharyngeal branch of vagus nerve and cranial nerve. ④the 3 pairs of cervical ganglia of sympathetic trunk send out superior, middle and inferior cardiac nerve respectively and descend to thoracic cavity and add to cardiac plexus. -12- thoracic part: thoracic sympathetic nerve lie at the anterior aspect of capitulum costae thoracic ganglia 10~12 ones(the 11 ones is mostly common) branches: ①distribute on blood vessels, sweat glands and arrector muscle of thoracic and abdominal wall with 12 pairs of thoracic nerves via gray communicating branch. ②the 1st to 5th thoracic sympathetic ganglion→thoracic aortic plexus, esophageal plexus, pulmonary plexus and cardiac plexus and so on. ③the preganglionic fibre walking through the 6th to 9th thoracic ganglia constitute greater splanchnic nerve→celiac ganglia ④the preganglionic fibre walking through the 10th to 12th thoracic ganglia, constitute lesser splanchnic nerve→aorticorenal ganglia ⑤least splanchnic nerve -13- middle cervical ganglion cervicothoracic ganglion sympathetic trunk pulmonary plexus thoracic ganglia -14- superior cervical ganglion cardiac plexus stomach superior mesenteric ganglion celiac ganglia superior mesenteric ganglion lumbar ganglion splanchnic nerves sacral ganglia small intestine lumbar part 4 pairs of lumbar ganglion distribute branches thoracic ganglia There are 2 to 3 pairs of sacral ganglia and a coccygeal ganglion distribute branches: superior mesenteric ①distribute with sacral and ganglion coccygeal nerve via gray superior mesenteric communicating branches. ganglion ②some small branches add to pelvis plexus→pelvic cavity lumbar splanchnic nerves organs sacral ganglia stomach celiac ganglia small intestinal lumbar ganglion pelvic part ① Distribute to 5 pairs of lumbar nerve via gray commmunicating branches. ② The preganglionic fibre walking through lumbar ganglion — lumbar splanchnic nerves→superior and inferior mesenteric ganglion,postganglionic fibre→the digestive canal below left flexure of colon and pelvic cavity organs. -15- conclusions: 1、The preganglionic fibre derived from the 1st to 5th of thoracic part intermediolateral nucleus change neuron, then the postganglionic fibre arrange blood vessels, sweat glands and arrector muscle of head, neck, thoracic cavity organs and upper limb. 2、The preganglionic fibre derived from the 6th to 12th of thoracic part intermediolateral nucleus change neuron, then the postganglionic fibre arrange liver, spleen, kidney and the intestine canal above left colic flexure . 3、The preganglionic fibers derived from the 1st to 3rd of lumbar part intermediolateral nucleus change neuron, then the postganglionic fibre arrange the intestine canal and pelvic cavity organs below left colic flexure and the blood vessels, sweat glands and arrector muscle of lower limb. -16- parasympathetic nerve Lower center Cranial part: nucleus of oculomotor nerve superior salivatory nucleus inferior salivatory nucleus dorsal nucleus of vagus nerve Pars sacralis: the second to 4th sacral parasympathetic nucleus Parasympathetic ganglion • Head:ciliary ganglion、pterygopalatine ganglion、 • submandibular ganglion、auricular ganglion • The ganglia lie at cardiac plexus, pulmonary plexus, vesical plexus and uterovaginal plexus,and the ganglia lie at bronchus and the wall of digestive canal. The parasympathetic neuron belong to cholinergic neuron, and most of them contain VIP and CGRP and so on. -17- parasympathetic nerve of cranial part accessory nucleus of cranial nerve oculomotor nerve ciliary ganglion ciliary muscle contractor pupillae muscle submandibular gland、 cranial chorda tympani submandibular ganglion sublingual gland nerve Superior great superficial salivatory nucleus pterygopalatine ganglion lachrymal gland petrosal nerve cranial nerve inferior auricular ganglion salivatory nucleus -18- lesser petrosal nerve external salivary gland dorsal nucleus of vagus cranial nerve Paraganglion of organ intramural ganglion thoracic cavity organs abdominal cavity organs (the intestine canal above left colic flexure) -19- parasympathetic nerve of pars sacralis sacral pelvic splanchnic paraganglion of organs parasympathetic nerves nucleus intramural ganglion -20- intestine canal above Left colic flexure and pelvic cavity organs the difference between sympathetic nerve and parasympathetic nervous sympathetic nerve parasympathetic nerve Lower center thoracic part and pars lumbalis cranial part and pars sacralis the position of ganglion paravertebral ganglia prevertebral ganglia Near the walls of the innervated organs distribution range widespread limited scope effect -21- The comparison of effect: sympathetic nerve parasympathetic nerve heart heartbeat speeding、blood pressure rising the heartbeat slows, blood pressure decreases pupil scattering diminution bronchus the smooth muscle relax, and aperture become larger the smooth muscle contract, the aperture become smaller stomach intestine the wriggle steps down peristalsis reinforcement detrusor muscle loosening, sphincter muscle of urethra contracting detrusor muscle contracting, sphincter dilatation bladder (storing urine) -22- (urination) splanchnic plexus cardiac plexus pulmonary plexus -23- celiac plexus abdominal aortic plexus hypogastric plexus superior hypogastric plexus inferior hypogastric plexus (pelvic plexus) -24- visceral sensory nerve geniculate ganglion peripheral process ————cranial nerve •solitary central process inferior jugular ganglion —ossopharyngeal nerve →internal organ tract nucleus —vagus nerve inferior vagal ganglion •spinal cord (intermediomedia l nucleus) central process spinal peripheral process ———sympathetic nerve ganglia —parasympathetic nerve of pars sacralis →internal organ feature: 1. the pain threshold is higher. 2. dispersed visceralgia,the position isn’t exact. -25- referred pain When some internal organs had pathological changes, hyperaesthesis or sense of pain usually emerged on some region of body surface. This phenomenon is called referred pain. afferent fibers of skin (thoracic segments1~5) spinothalamic tract thoracic segments1~5 -26- dermatomic area substantia gelatinosa visceral afferent fiber(thoracic segments1~5) the innervation of some critical organ eyeball sensory nerve general sensation→nervi ciliaris longi→nasociliary nerve→ophthalmic nerve→trigeminal nerves→brain stem→nucleus sensorius nervi trigemini sympathetic nerve spinal cordT1~T2lateral horn (preganglionic fibre)→thoracic and cervical sympathetic trunk→superior cervical ganglion (exchange neuron) → (postganglionic fibre) internal carotid plexus→cavernous plexus→ciliary ganglion→dilator muscle of pupil and blood vessels parasympathetic nerve Midbraina ccessory nucleus of oculomotor nerve(E-W nucelus) (preganglionic fibre) →oculomotornerve courser→ciliary ganglion (exchange neuron)→postganglionic fibre) short ciliary nerve→pupil sphincter muscle and ciliary muscle •The excitation of sympathetic nerve of dominating eyeball will cause corectasis and vasoconstriction of iris. •The excitation of parasympathetic nerve will lead to constriction of pupil and the contraction of ciliary muscle. -27- Heart sensory nerve Algesthesia fiber(walk along sympathetic nerve, except superior cervical cardiac nerve)→spinal cordT1~T4,T 5 segment sensory fiber related to cardiac reflect(walk along vagus nerve) →enter into brain stem sympathetic nerve the lateral cord of spinal cord T1~T4,T 5 segment(preganglionic fiber) →the superior, middle and inferior ganglion of sympathetic trunk, and the upper part of thoracic ganglia (exchange neuron)→give out from ganglion(the superior, middle and inferior cervical cardiac nerve and thoracic cardiac branches)→the posterior aspect and inferior aspect of aortic arch(with the parasympathetic nerve come from vagus nerve)→cardiac plexus→heart parasympathetic nerve dorsal nucleus of vagus and ambiguous nucleus(preganglionic fibre)→walk along the rami cardiaci of vagus →cardiac ganglia(exchange neuron)→heart •The stimulation of sympathetic nerve dominating heart can induce tachycardia and the relaxation of coronary vessels. •The stimulation of vagus can induce bradycardia and the contraction of coronary vessels. -28-