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The Visceral Nervous System 山东大学医学院 解剖教研室 李振华 The Visceral Nervous System Composition Visceral motor nerves (autonomic nervous system) Sympathetic part 交感部 Parasympathetic part 副交感部 Visceral sensory nerves Visceral motor nerves Main differences between somatic motor and visceral motor n. Somatic Visceral Effectors Skeletal muscles Cardiac, smooth muscles and glands Kind of fibers One Two: sympathetic and parasympathetic From lower center to effect require Single neuron Two neurons: preganglionic neuron (fiber) and postganglionic neuron (fiber) Fibers Thick myelinated Distributive form Nerve trunk Nerve plexuses Control Voluntary Involuntary (unconsciousness ) (consciousness) Preganglionic: thin myelinated postganglionic: unmyelinated Sympathetic part 交感部 Lower center: located in lateral gray horn of spinal cord segments T1~L3 Sympathetic ganglia Paravertebral ganglia 椎旁节 Prevertebral ganglia 椎前节 Paravertebral ganglia 椎旁节 Arranged on either side of vertebral column Consist of 19~22 of oval-shaped ganglia Three cervical 10~12 thoracic 4 lumbar 2~3 sacral Ganglion impar奇神经节: unpaired on the anterior face of coccyx 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 Prevertebral ganglia 椎前节 Lie anterior to vertebral column and near the arteries for which they are named Celiac ganglion 腹腔神经节 Aorticorenal ganglion 主动脉肾节 Superior mesenteric ganglion 肠系膜上神经节 Inferior mesenteric ganglion肠系膜下神经节 Three fates of preganglionic fibers 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. The postganglionic fibers supplydescending and sigmoid colon, rectum, pelvic viscera and lower limbs. Three fates of postganglionic fibers Back to a spinal nerve along gray communicating branches ( 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 Preganglionic fibers Postganglionic fibers T1~T5 Head, neck, upper limb and thoracic viscera T5~T12 Abdominal viscera L1~L3 Pelvic viscera and lower limb Parasympathetic part 副交感部 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 ciliary ganglion Ⅶ lacrimal gland pterygopalatine ganglion Ⅸ submandibular ganglion sublingual gland submandibular gland parotid gland Ⅹ otic ganglion terminal ganglia heart, lungs, liver, spleen kidneys,alimentary tract as far as left colic flexure Cranial portion颅部 Ⅲ accessory oculomotor nucleus 〈○ sphincter pupillae and ciliary muscles ciliary ganglion Ⅶ pterygopalatine ganglion 〈○ lacrimal gland superior salivatory nucleus 〈○ submandibular ganglion sublingual gland submandibular gland Ⅸ 〈○ otic ganglion inferior salivator nucleus Ⅹ dorsal nucleus of vagus n. 〈○ terminal ganglia parotid gland 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 Main differences between sympathetic and parasympathetic Main differences between sympathetic and parasympathetic Sympathetic Parasympathetic Lower center Lateral gray horn of spinal cord segments T1~L3 Four pairs parasympathetic nuclei and sacral parasympathetic nucleus Ganglia Paravertebral, prevertebral Terminal 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) Visceral plexuses Cardiac plexuses Superficial , below aortic arch Deep, anterior to bifurcation on trachea Pulmonary plexus Celiac plexus Abdominal aortic plexus Hypogastric plexus Superior hypogastric plexus Inferior hypogastric plexus (pelvic plexus) Visceral sensory nerves Nucleus of solitary tract Ⅶ,Ⅸ, Ⅹ Thalamus Enteroceptors Posterior horn Cerebral cortex Hypothalamus Effectors Sympathetic nerve Pelvic splanchnic nerve Somatic motor neurons visceral motor neuclei Referred pain 牵涉痛 The Endocrine System 山东大学医学院 解剖教研室 李振华 The Endocrine System Composition Endocrine glands: have no ducts, their secretions (hormone) release directly into bloodstream to its target organ Endocrine tissue Thyroid gland 甲状腺 Shape and position H-shape Left and right lobes: lie on either side of inferior part of larynx and superior part of trachea, extend from middle of thyroid cartilage to level of sixth trachea cartilage Isthmus: overlies 2nd to 4th tracheal cartilage Pyramidal lobe: some times arises from isthmus Fibrous capsule: a sheath of pretracheal fascia which is attached to arch of cricoid and thyroid cartilages, hence, the thyroid gland moves with larynx during swallowing and oscillates during speaking Function: to produce thyroxin, regulating the rate of metabolism and growth of bony and nervous system Parathyroid gland 甲状旁腺 Yellowish-brown, ovoid bodies Position Two superior parathyroid glands: lie at junction of superior and middle third of posterior border of thyroid gland Two inferior parathyroid glands: lie near the inferior thyroid artery, close to the inferior poles of thyroid gland Function: regulate calcium and phosphate balance and is therefore essential for life Suprarenal gland Shape and position Right is pyramidal in shape, left one semilunar in shape, consisting of out cortex and inner medulla Located retroperitoneally, superomedial to superior poles of each kidney, enclose with the kidney by the renal fascia Function: secretes adrenaline, noradrenaline and several steroid hormones Hypophysis Shape and position Pea-sized organ, attached by infundibulum to hypothalamus, lies in hypophysial fossa Consists of two parts: Adenohypophysis Neurohypophysis Relationship Above-diaphragm sellae Anterosuperior-optic chiasma and optic nerve Laterally-cavernous sinus Below-sphenoid sinus Pineal body 松果体 locates in posterosuperior to thalamus, attached by stalk to posterior part of roof of third ventricle Thymus 胸腺 Position: Located in superior mediastinum Posterior to sternum and between the lungs Function: Secrets thymosin: to aid in maturation of T-cell Secrets thymopoietin Endocrine tissue Pancreatic islet Gonad Ovary Testis