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Peripheral Nervous System The Visceral Nerve 内脏神经 Ling Shucai Introduction • Place of the PNS in the structural organization of the nervous system • Comparision of the somatic and autonomic nervous system. Place of the PNS in the structural organization of the nervous system CNS PNS Sensory division Sympathetic division Parasympathetic division Motor division Autonomic nervous system Somatic nervous system Comparision of the somatic and autonomic nervous system 躯体运动神经与内脏运动神经之比较 Main differences between somatic motor and visceral motor n. 躯体运动神经与内脏运动神经之区别 Effectors Somatic Visceral Skeletal muscles Cardiac, smooth muscles and glands From lower center Single neuron to effect require Two neurons: preganglionic neuron (fiber) and postganglionic neuron (fiber) Kind of fibers One Two: sympathetic and parasympathetic Fibers Thick myelinated Distributive form Nerve trunk Nerve plexuses Control Voluntary (consciousness) Involuntary (unconsciousness ) Preganglionic: thin myelinated Postganglionic: unmyelinated The visceral nervous system ¾Compositions: 1. Visceral sensory nerve 2. Visceral motor nerve (ANS , Autonomic Nervous System) Sympathetic nerves 交感神经 Parasympathetic nerves 副交感神经 3. Centers of visceral nerves Main differences between sympathetic and parasympathetic 交感与副交感神经之区别 Sympathetic 交感神经 Parasympathetic 副交感神经 Lower center Lateral gray horn of spinal cord segments T1~L3 Four pairs parasympathetic nuclei and sacral parasympathetic nucleus Ganglia Paravertebral, 椎旁节 prevertebral 椎前节 Terminal 终节 Preganglionic f. Shorter Longer Postganglionic f. Longer Shorter Pre: Postganglionic 1: many more 1: a few Distributions Throughout the body Limited primarily to head and viscera of thorax, abdomen, and pelvis Different action Prepares for emergency situation (fight or flight) Conserve and restore body energy (rest and relaxation) Sympathetic Nerve System 交感神经系统 Lower center: in lateral horn of T1~ L3 (or C8~L3 ) segments of spinal cord (intermediolateral nucleus) Peripheral part: sympathetic trunks 交感干 sympathetic ganglia 交感神经节 sympathetic plexuses 交感神经丛 sympathetic nerves 交感神经 communicating branches 节间支 • Lower center: 低级中枢 located in lateral gray horn of spinal cord segments T1~L3 Peripheral part:周围部 1. sympathetic trunks ¾ paravertebral ganglia ¾ Interganglionic branches 2. sympathetic ganglia ¾ paravertebral ganglia ¾ prevertebral ganglia 3. sympathetic plexuses 4. sympathetic nerves 5. communicating branches ¾ gray ramus ¾ white ramus Sympathetic trunk 交感干 • Formed by paravertebral ganglia and interganglionic branches • Lie on either side of vertebral column from base of skull to coccyx • The trunks of two side unite in front of the coccyx at a small swelling, the ganglion impar (奇节) Sympathetic trunks Paravertebral ganglia 交感神经节 • Arranged on either side of vertebral column • Consist of 19~22 of oval-shaped ganglia – cervical ganglion 3 – thoracic ganglion 10~12 – lumbar ganglion 4~5 – sacral ganglion 2~3 – coccygeal ganglion 1 Cervical ganglion Thoracic ganglion 1 Prevertebral ganglia 椎前节 2 Lie anterior to vertebral column and near the arteries for which they are named 1. Celiac ganglion 腹腔神经节 2. Aorticorenal ganglion 主动脉肾节 3. Superior mesenteric ganglion 肠系膜上神经节 4. Inferior mesenteric ganglion 肠系膜下神经节 3 Three fates of preganglionic fibers 节前纤维的三种去向 Preganglionic fibers 15 pairs white communicating branch (only spinal levels T1~L3 have white communicating branch) Sympathetic trunk Three fates of preganglionic fibers • Relay in corresponding ganglion • Ascend or descend in sympathetic trunk and relay in higher or lower ganglia • Pass without synapse to a prevertebral ganglion for relay • Greater splanchnic nerve 内脏大神经 formed by preganglionic fibers from T5~T9 ganglia, and relay in celiac ganglion. • Lesser splanchnic nerve 内脏小神经 formed by preganglionic fibers from T10~T12 ganglia, and relay in aorticorenal ganglion. • The postganglionic fibers supply the liver, spleen, kidney and alimentary tract as far as the left colic flexure. • Lumbar splanchnic nerve 腰内脏神经 – Formed by preganglionic fibers from L1~L4 ganglia, and relay in prevertebral ganglia (Inferior mesenteric ganglion 肠系膜下节). – The postganglionic fibers supply descending and sigmoid colon, rectum, pelvic viscera and lower limbs. Three fates of postganglionic fibers 节后纤维的三种去向 • Back to a spinal nerve along gray communicating branches 灰交通支 ( 31 pairs ) to terminate in blood vessels, arrectores pilorum and sweat glands of head, neck, trunk and limbs • The fibers from their networks around blood vessels passing to visceral end organs • Terminate directly in certain organs Distribution of sympathetic nerve 交感神经的分布 Preganglionic fibers Postganglionic fibers 节前纤维 节后纤维 T1~T5 Head, neck, upper limb and thoracic viscera T5~T12 Abdominal viscera L1~L3 Pelvic viscera and lower limb Parasympathetic Nerve System 副交感神经系统 Parasympathetic nerve 副交感神经 • Lower center: located in four pairs parasympathetic nuclei in brain stem and in sacral parasympathetic nucleus of spinal cord segments S2~S4 • Parasympathetic ganglia: terminal ganglia are near or within the wall of a visceral organ – Para-organ ganglia 器官旁节: • Ciliary ganglion 睫状神经节 • Pterygopalatine ganglion 翼腭神经节 • Submandibular ganglion 下颌下神经节 • Otic ganglion 耳神经节 – Intramural ganglia 壁内节 Cranial portion 颅部 Ⅲ sphincter pupillae and ciliary muscles 瞳孔括约肌和睫状肌 ciliary ganglion 睫状神经节 Ⅶ Ⅸ Ⅹ pterygopalatine ganglion 蝶腭神经节 submandibular ganglion 下颌下神经节 otic ganglion 耳神经节 terminal ganglia 终节 lacrimal gland 泪腺 sublingual gland submandibular gland 舌下腺和下颌下腺 parotid gland 腮腺 heart, lungs, liver, spleen kidneys,alimentary tract as far as left colic flexure Sacral portion 骶部 • Preganglionic fibers from sacral parasympathetic nucleus leave spinal cord with anterior roots of the spinal nerves S2~S4, • Then leave sacral nerves and form pelvic splanchnic nerve and travel by way of pelvic plexus to terminal ganglia in pelvic cavity • Postganglionic fibers terminate in descending and sigmoid colon, rectum and pelvic viscera Visceral sensory nerves 内脏感觉神经 Nucleus of solitary tract孤束核 Ⅶ,Ⅸ, Ⅹ Thalamus丘脑 Cerebral cortex 大脑皮质 Enteroceptors Posterior horn 后角 Sympathetic nerve Pelvic splanchnic nerve 交感和副交感神经 Hypothalamus 下丘脑 Effectors Somatic motor neurons visceral motor neuclei Referred pain 牵涉痛 Referred pain Heart Lungs and diaphragm Liver Gallbladder Gallbladder Heart Appendix Liver Stomach Pancreas Small intestine Ovaries Colon Kidneys Urinary bladder Ureters 思考题 1. 内脏运动神经与躯体运动神经在形态结构上有何不同? 2. 交感神经和副交感神经在形态结构上有何区别? 3. 解释:节前神经元、节后神经元、节前纤维、节后纤维 4. 指出下列神经的性质:内脏大神经、内脏小神经、腰内脏神经、盆内 脏神经 5. 指出下列神经节的性质:睫状神经节、翼腭神经节、下颌下神经节、 耳神经节、三叉神经节、腹腔神经节、肠系膜上神经节、肠系膜下神 经节、主动脉肾节、脊神经节 Central Nervous System The Spinal Cord 脊 髓 The Spinal Cord 1. External features 外形 2. Internal structure 内部结构 3. Functions 功能 1. External features: ¾ 位置(Location): foramen magnum → lower border of first lumbar vertebra ¾ 8条沟(fissure or sulci): ¾ 2个膨大(Enlargements): 颈膨大 cervical enlargement: C4-T1 腰骶膨大 lumbar enlargement: L2-S3 ¾ 脊髓圆锥 Conus medullaris: ¾ 终丝 Filum terminale: ¾ 31个节段(Segment): External longitudinal fissure and sulci posterior lateral sulcus anterior lateral sulcus posterior median sulcus anterior median fissure Filum terminale Cauda equina Spinal segment 脊髓节段 It's a part of spinal cord, which is connected with the rootlets of a pair of spinal nerve. 31 segments cervical segments thoracic segments lumbar segments sacral segments coccygeal segments 8 12 5 5 1 Corresponding relationship between spinal segments and vertebrae spinal segments C1-C4 C5 ~ C8, T l~ T4 vertebrae bodies C1-C4 C4 ~ T3 T5 ~ T8 T3 ~ T6 T9-T12 T6-T9 L1-L5 T10-T12 S l~S5,Co1 LI 2. Internal structure • Gray matter and central canal 灰质和中央管 • White matters 白质 Gray matter central canal posterior horn ¾ Parts 分部: ¾ Main nuclei 主要核团: Intermediate zone Lateral horn 外侧角 (only extends from lateral horn Tl to L3 segments.) gray commissure 灰质联合 (anterior and posterior ) anterior horn Gray matter gray commissure anterior horn 前角: medial group lateral group intermediate zone 中间带: the nucleus posteromarginalis the substantia gelatinosa the nucleus proprius intermediolateral nucleus中间外侧核 intermediomedial nucleus中间内侧核 the dorsal nucleus posterior horn 后角: nucleus posteromarginalis 边缘核 substantial gelatinosa 胶状质 nucleus proprius 固有核 dorsal nucleus 背核 (thoracic nucleus 胸核) (thoracic nucleus) intermediolateral nucleus Intermediomedial nucleus: lateral group medial group The nuclei and the laminas (板层) the nucleus posteromarginalis the substantia gelatinosa the nucleus proprius the dorsal nucleus (thoracic nucleus) intermediolateral nucleus Intermediomedial nucleus: lateral group medial group White matter: ¾ 3 parts: anterior, lateral and posterior funiculus posterior median sulcus posterior funiculus posterior lateral sulcus funiculus proprius lateral funiculus anterior white commissure anterior median fissure anterior lateral sulcus anterior funiculus ¾ Main tracts (or fasciculi): Ascending tracts 上行纤维束: • fasciculus gracilis(薄束): come from sacral, lumbar and lower six thoracic nerves, terminate upon nucleus gracilis • fascicules cuneatus(楔束): come from cervical and upper six thoracic nerves, terminate upon nucleus cuneatus. *conducts the fine tactile and kinesthetic sense of the ipsilateral trunk and limbs. fascicules cuneatus fascicules gracilis thalamus • Spinothalamic tracts(脊髓丘脑束) anterior spinothalamic tracts lateral spinothalamic tracts --- arises from opposite nucleus proprius --- terminate on thalamus --- conduct pain, thermal and rough tactile sense of opposite trunk and limbs anterior spinothalamic tracts lateral spinothalamic tracts nucleus proprius ¾ Descending tracts 下行纤维束 lateral corticospinal tract: --- arises from opposite cerebral cortex --- descends through lateral funiculus of spinal cord --- terminate on ipsilateral anterior horn (lateral group) --- controls the contraction of skeletal muscles of ipsilateral limbs anterior corticospinal tract: --- controls the movement of bilateral muscles of trunk lateral corticospinal tract anterior corticospinal tract Decussatio Pyramidum 锥体交叉 Other descending tracts: they are related to regulate muscles Fascicules gracilis fascicules cuneatus lateral corticospinal tract Rubrospinal tract anterior spinothalamic tracts Reticulospinal tract anterior spinothalamic tracts vestibulospinal tract tectospinal tract anterior corticospinal tract 3. Functions: ¾ To convey afferent impulses, which come from somatic and visceral receptors to the brain, and conduct efferent impulses from brain to effectors. ¾ Related to reflexes 思考题 • 哪些沟或裂?有哪些膨大?位于何处? • 马尾位于何处?由哪些结构组成? • 何为脊髓节段?第6胸椎外伤可能会损伤到哪个节段的脊髓? • 脊髓的前角、后角和侧角各含有什么神经元,有什么功能? • 脊髓白质内有哪些重要的纤维束?试述其位置、起源以及纤维性质。 • 试述脊髓各代表断面有何特征?试绘图表示脊髓横断面的各结构。