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Autonomics of the Thorax (Lecture 51), - - Coggle Diagram

- - - - striated voluntary muscle
      - in body wall
      - Sensory
        
        AP from origin cell
        
        up peripheral process of axon (Dorsal OR Ventral RAMUS)
        
        into cell body (outside CNS in sensory ganglia)
        
        up central process of axon (Dorsal Root)
        
        synapse in CNS (Dorsal Horn)
      - Motor
        
        AP from cell body inside CNS (Ventral Horn)
        
        down the axon (Dorsal OR Ventral Root and Ramus)
        
        synapse inside target cell
    - - Cardiac muscle, smooth muscle, glands
      - structures of body cavities
      - Sensory
        
        AP from origin cell
        
        up peripheral process of axon
        
        into cell body (outside CNS in sensory ganglia)
        
        up central process of axon
        
        Synapse in CNS
        
        Does not always reach conciousness
        
        When perceived it is always dull, uncomfortable, and poorly localized
        
        TRUE visceral sensation is misinterpreted by CNS as somatic sensation (REFERRED PAIN)
        
        Because dorsal horn has alternating layers of somatic and viscero-somatic cell bodies (there are NO PURELY VISCERAL CELL BODIES)
        
        Ex) Pain around umbillicus (T10 dermatome) could be appendicitis, Left arm or chest pain (T1-T5 dermatomes) could be a heart attack IN MEN (this is where heart visceral sensory nerves synapse!)
        
        :warning: Women experience heart attack pain as neck, jaw, upper back, chest, lower chest, or upper abdomen pain, can also have indigestion, fainting, extreme fatigue
        
        Can arise from ischemia, distension, cramping, or inflammation
        
        NOT from touch, temp, or cutting
        
        Usually follows pathway of sympathetic outflow to organ (except pelvic organs)
      - Motor (Autonomics)
        
        AP from cell body in CNS
        
        down the preganglionic axon
        
        SYNAPSE in cell body (outside the CNS in autonomic ganglia)
        
        down the postganglionic axon
        
        SYNAPSE on target cell
        
        Sympathetic
        
        thoracolumbar
        
        Energy expenditure (fight or flight)
        
        supplies structures in the body wall AND body cavity
        
        preganglionic bodies(lateral horn T1-L2)
        
        In thoracic this is T1-T5/6
        
        Preganglionic axons are thru white rami communicans to the sympathetic chain
        
        postganglionic bodies (paravertebral ganglia and subdiaphragmatic ganglia)
        
        in thoracics this is C1-T5/6
        
        Postganglionic axons are cervical or thoracic sympathetic organ nerves (cardiac, esophageal)
        
        Sympathetic Chain/Trunk
        
        Preganglionic cell bodies are confined to T1 -L2 levels BUT need to innervate structures outside this area
        
        Thus, preganglionic axons ascend and descend and synapse in higher or lower paravertebral ganglion
        
        Parasympathetic
        
        craniosacral
        
        energy intake (rest and digest)
        
        Preganglionic cells bodies are brainstem or S3/4 (or S2/5)
        
        Preganglionic axons (LONG) travel with the vagus nerve (CN X)
        
        Preganglionic parasympathetic axons from the vagus nerve join postganglionic sympathetic axons to form plexuses that supply each thoracic organ (cardiac plexus, esophageal plexus, etc)
        
        Postganglionic cell bodies are in four dissectible ganglia in the head or near/in target organ wall
        
        axons NEVER enter body wall