The Visceral Nervous System

1. The Visceral Nervous System 山东大学医学院 解剖教研室 李振华

2. 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

3. Visceral motor nerves

5. Main differences between somatic motor and visceral motor n.

6. 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

7. 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

9. 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

10. 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

11. Three fates of preganglionic fibers 15 pairs white communicating branch Preganglionic fibers Sympathetic trunk (only spinal levels T1~L3 have white communicating branch)

12. 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

13. 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.

14. 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.

15. 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

16. Distribution of sympathetic nerve

17. 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

18. Cranial portion颅部 Ⅲ sphincter pupillae and ciliary muscles ciliary ganglion lacrimal gland Ⅶ pterygopalatine ganglion sublingual gland submandibular gland Ⅸ submandibular ganglion parotid gland Ⅹ otic ganglion heart, lungs, liver, spleen kidneys,alimentary tract asfar asleft colic flexure terminal ganglia

19. Cranial portion颅部 Ⅲ accessory oculomotor nucleus 〈○ sphincter pupillae and ciliary muscles ciliary ganglion pterygopalatine ganglion Ⅶ 〈○ lacrimal gland superior salivatory nucleus 〈○sublingual gland submandibular ganglion submandibular gland Ⅸ inferior salivator nucleus 〈○ parotid gland otic ganglion Ⅹ heart, lungs, liver, spleen, dorsal nucleus of vagus n. 〈○ kidneys,alimentary tract terminal ganglia asfar asleft colic flexure

20. 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

22. Main differences between sympathetic and parasympathetic

23. Main differences between sympathetic and parasympathetic

24. 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)

25. Visceral sensory nerves Nucleus of solitary tract Ⅶ，Ⅸ, Ⅹ Thalamus Cerebral cortex Enteroceptors Hypothalamus Posterior horn Effectors Sympathetic nerve Pelvic splanchnic nerve Somatic motor neurons visceral motor neuclei

26. Referred pain 牵涉痛

27. The Endocrine System 山东大学医学院 解剖教研室 李振华

28. The Endocrine System Composition • Endocrine glands: have no ducts, their secretions (hormone) release directly into bloodstream to its target organ • Endocrine tissue

29. 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

30. 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

31. 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

32. 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

33. Pineal body 松果体 • locates in posterosuperior to thalamus, attached by stalk to posterior part of roof of third ventricle

34. 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

35. Endocrine tissue • Pancreatic islet • Gonad • Ovary • Testis