Section 3 Visceral Nervous System ( 内脏神经系统 )

2. Section 3 Visceral Nervous System (内脏神经系统) A. Division 1. Visceral efferent (motor) nerves (内脏传出神经) [The Autonomic Nervous System(自主神经系统)] → smooth m., cardiac m. and gland. 2. Visceral afferent (sensory) nerves (内脏传入神经) ← sensory of viscera.

3. B. The Difference Between Somatic Motor Nerve and Visceral Motor Nerve . somatic(躯体) motor nerve visceral (内脏) motor nerveeffectors (效应器) skeletal muscle smooth m. cardiac m. & glandnerve fiber one kinds: two kind(神经纤维) sympathetic. parasympathetic . n. to effector directly (直接) indirectly(间接): ( (至效应器) pre & postganglionic fiber . lower nervous general somatic motor nuclei general visceral motor nuclei centers special visceral motor nuclei intermediolateral nucleus (低级中枢) nuclei of ant horn sacral parasympathetic nucleus form of distribution nerve trunk (神经干) nerve plexus (神经丛) around (分布方式) viscera or blood vessel ... nerve fiber‘s axon myelinated (有髓) thin or unmyelinated (薄或无) . controlling (管理) voluntarily by consciousness involuntary and unconscious─────────────────────────────────────────

4. C. The Sympathetic Nervous System (交感神经系) 1. Introduction 1) lower centers (低级中枢): intermediolateral nuclei (lateral) (中间外侧核) of T1-L3 2) paravertebral ganglia of sympathetic trunk (交感干椎旁节) interganglionic branches (节间支) 3) prevertebral ganglia (椎前神经节)

5. C. The Sympathetic Nervous System (交感神经系) 4) communicating branchs (交通支): a. white communicating branch (白交通支): myelinated, spinal n. → sympathetic ganglion b. grey communicating branch (灰交通支): unmyelinated, spinal n. ← sympathetic ganglion

6. C. The Sympathetic Nervous System (交感神经系) 2. Distributions 1) The cervical portion of the sympathetic trunk (颈部交感神经干) a. composition i. superior cervical ganglion (颈上神经节) ii. middle cervical gangion (颈中神经节) iii. inferior cervical ganglion (颈下神经节) iv. cervicothoracic ganglion (stellate ganglion) (颈胸神经节) [Horner's syndrome 霍纳氏征]

7. C. The Sympathetic Nervous System (交感神经系) b. Innervations i. communicating branch (交通支) → the blood vessels, sweat glands and arrectores pilorum of upper limb. ii. arterial branch (动脉支) → arterial plexuses → the iris dilator pupillae.

8. C. The Sympathetic Nervous System (交感神经系) iii. visceral branch (内脏支) sup. cervical cardiac n. (颈上心神经) cardiac plexus → the heart mid. cervical cardiac n. (颈 中心神经) cardiac plexus → the heart inf. cervical cardiac n. (颈下心神经)cardiac plexus → the heart laryngopharyngeal branchs (喉咽支) → 咽喉

9. C. The Sympathetic Nervous System (交感神经系) 2) The thoracic portion of the sympathetic trunk (胸部交感神经干) a. composition thoracic ganglia (胸交感神经节) (11-12 pairs) b. Innervations i. communicating branch (交通支) → blood vessels, sweat glands and arrectores pilorum of thoracic and abdominal walls.

10. C. The Sympathetic Nervous System (交感神经系) ii. arterial plexuses (动脉丛) → thoracic aorta, esophagus and lungs. iii. visceral branch (内脏支) - greater splanchnic n. (内脏大神经) (T5-T9) → celiac ganglia (腹腔神经节) - lesser splanchnic n.(内脏小神经) (T9-T10) → aortorenal ganglia (主动脉肾节)→the upper abdominal organs and the alimentary tract as far as left colonic flexure (上腹部脏器-结肠左曲 前消化道)

11. C. The Sympathetic Nervous System (交感神经系) 3) The lumbar portion of the sympathetic trunk (腰部交感神经干) a. composition lumbar ganglia (腰交感神经节) (L1-L4,L5) b. Innervation i. communicating branch (交通支) → the blood vessels, sweat glands and arrectores pilorum of the lower limb.

12. C. The Sympathetic Nervous System (交感神经系) ii. arterial plexuses → abdominal aorta., celiac, superior & inferior mesenteric plexuses. iii. visceral branch → superior hypogastric plexus (上腹下丛) and pelvic plexus (盆丛) (inferior hypogastric plexus 下腹下丛) → the lower abdominal and pelvic organs [lumbar sympathectomy 腰交感神经切除术]

13. C. The Sympathetic Nervous System (交感神经系) 4) The pelvic portion of the sympathetic trunk (盆部交感干) a. compositioni.sacral ganglia (骶交感神经节)(2-3 pairs) ii. ganglion impar (奇神经节) (Co1)

14. C. The Sympathetic Nervous System (交感神经系) b. Innervations i. communicating branch (交通支) → the blood vessels, sweat glands and arrectores pilorum of the perineum and lower limb. ii. arterial plexuses (动脉丛) → internal iliac a. iii. visceral branch (内脏支) → inferior hypogastric plexus (下腹下丛) (pelvic plexus盆丛) → pelvic organs.

15. D. The Parasympathetic Nervous System (副交感神经系) 1. Introduction 1) lower centre (低级中枢): a. cranial portion (颅部):general visceral motor nuc. b. sacral portion (骶部):S2-S4 2) paraorganic or intraorganic ganglion (器官旁或器官内神经节) 3) pelvic splanchnic nerve (盆内脏神经)

16. D. The Parasympathetic Nervous System (副交感神经系) 2. Distributions (分布) 1 paraoculo- motor nucleus (动眼神经副核) [platycoria 瞳孔散大] ciliary m. (睫状肌) sphincter pupillae (瞳孔括约肌) ciliary ganglion (睫状神经节) short ciliary n. (睫短N)

17. D. The Parasympathetic Nervous System (副交感神经系) 2 Superior salivatory nucleus (上泌涎核) Lingual n. (舌神经) submandibular ganglion (下颌下神经节) VII chorda tympanic (鼓索) ptergopalatine ganglion (翼腭神经节) lacrimal gland (泪腺) glands of nasal & palatine(鼻额腺) submandibular gland (下颌下腺) sublingual gland(舌下腺)

18. D. The Parasympathetic Nervous System (副交感神经系) 3 inferior salivary neu. (下泌涎核) otic ganglion (耳神经节) parotid gland (腮腺) IX 4 intraorganic ganglia (器官内神经节) dorsal neu. of vagus n. (迷走背核) thorac& pelvic viscera (胸腹部内脏) X 5 intraorganic ganglia (器官内神经节) alimentary tract (降结肠下 消化道) Sacral parasympath.neu. (骶副交感核) (S2-4) pelvic splanchnic n.(盆内脏神经)

19. E. The Visceral Sensory Nerve 1 Visceral sensation (内脏感觉) nucleus of solitary tract (孤束核) visceral center (内脏 感觉中枢) IX, X 2 Visceral sensation (内脏感觉) sympath.n. (交感神经) post. Horn (后角核)

20. 2. The Referred Pain(牵涉性痛) Items (项目) somatic nerve (躯体神经) visceral nerve (内脏神经) nerve fibers (神经纤维) much, thick(多厚) less, thin(少薄) afferent way (传入方式) concentrate(集中) disperse(分散) pain threshold ( 痛阈 ) low(低) sensitive to pain (对痛觉敏感) high(高) insensitive to pain(cutting, crushing, burning) and tensioncontraction of smooth muscle and certain pathological condition (牵掣敏感) localizing the pain area (痛区) very clear (很清楚) not clear (不清楚)

21. 2. The Referred Pain(牵涉性痛) Definition: The pain is felt in a surface area far from the stimulated organ. In general, the area to which the pain is referred and the visceral organ involved are served by nerve fibers from the same segment of the spinal cord (内脏与皮肤至脊髓同节段). [angina pectoris 心绞痛] T1 -T4 Thoracic skin and heart.

22. 2. The Referred Pain(牵涉性痛)