Posted by lae2 on August 24, 2009 at 15:53:25:
Questions for the Superior and Posterior Mediastinum, and the Autonomic Nervous System
These questions were not submitted by the lecturer.
True/False
1. The parasympathetic division of the autonomic nervous system generally has postganglionic cell bodies in intrinsic ganglia at the target organ.
2. Intermediolateral cell columns are identified from spinal levels T1-12 and and S1-3.
3. Dorsal and ventral rami belong the the autonomic nervous system whereas gray and white rami belong to the somatic nervous system.
4. The sympathetic trunk extends the entire length of the vertebral column.
5. Nerve fibers derived from gray rami typically travel within the sympathetic trunk.
6. Fibers derived from white rami travel anterior, medial, and inferior from the sympathetic trunk within the splanchnic nerves.
7. The esophageal plexus receives postganglionic fibers derived from the vagus nerve.
8. The greater, lesser, and least splanchnic nerves leave the thorax by passing through the esophageal plexus.
9. The thorax receives parasympathetic fibers nearly entirely, if not entirely, from the vagus nerve.
10. The cardiac nerves carry sympathetic nerves from the cervical region into the supericial and deep cardiac plexuses.
11. Intermediolateral cell colums host preganganglionic sympathetic cell bodies at thoracic spinal levels and parasympathetic postganglionic cell bodies at sacral spinal levels.
12. The vertebral projection of the xiphoid process is to T10 and the spinal nerve that provides sensory innervation to skin overlying the xiphoid is T10.
13. The superficial cardiac plexus is applied to the lateral margin of the aorta near the ligamentum arteriosum and the deep cardiac plexus is located on the anterior surface of the bifurcation of the trachea.
14. The cardiac plexuses receive both sympathetic and parasympathetic postganglionic fibers.
15. For the most part, the parasympathetic nervous system mediates homeostatic processes.
16. The sympathetic nervous system directly strengthens muscle contractions during stressful events.
17. Dilation of deep vasculature and contraction of peripheral vasculature is mediated by the parasympathetic nervous system.
18. Sensory fibers that follow pathways hosting sympathetic fibers tend to mediate high threshold (pain) sensation and sensory fibers that follow parasympathetic pathways tend to mediate low threshold (homeostatic) sensation.
19. Arising from the posterior margin of sympathetic trunk ganglia are splanchnic nerves and from the anterior margin are gray and white rami.
20. Spinal nerves convey autonomic, somatic, and viscerosensory fibers.
21. Visceral sensation, relative to somatic sensation, is dull, aching, and poorly localized.
22. Crosstalk between the viscerosensory and somatosensory systems is thought to occur in the dorsal root ganglia and, thus, explains referred pain.
23. Viscerosensation from the heart projects to spinal level T2 along cardiac nerves and the intercostobrachial cutaneous nerve is derived from spinal nerve T2.
24. The fibrous coat of the pericardium of innervated by the somatic nervous system whereas the epicardium is innervated by the viscerosensory system.
25. The diaphragm muscle is innervated by parasympathetic postganglionic fibers conveyed by the phrenic nerve.
26. Posterior intercostal spaces 2-4 on the right drain into the superior intercostal vein, a tributary of the arch of the azygos vein.
27. Posterior intercostal spaces on the left generally drain into the accessory hemiazygos vein.
28. The 9th anterior intercostal space drains into the internal thoracic vein.
29. Branches from musculophrenic artery anastomoses with the 10th posterior intercostal artery.
30. Posterior intercostal spaces 1-2 are derived from the costocervical trunk on the left and the brachiocephalic artery on the right.
31. The inferior and superior vena cava are shunted by veins that fun along the vertebral column.
32. The right recurrent laryngeal nerve ascends on the medial surface of the aortic arch.
33. The left recurrent laryngeal nerve passes the posterior margin of the ligamentum venosum.
34. The thoracic duct passes through both the posterior and superior mediastinum.
35. The thoracic duct drains into the subclavian vein on the left and into the brachiocephalic vein on the right.
36. The lymphatic drainage of the upper lateral quadrant of the right breast drains into the right lymphatic duct.
Definition and Short Answer
1. What is the difference between a spinal level and a vertebral level?
2. Splanchnic nerve
Essay
1. What is the anatomy of the sympathetic trunk that explains why white rami are limited to T1-12 and S1-3 whereas the gray rami exist at all spinal levels.
2. Cardiac embarrassment may provoke pain along the medial aspect of the left upper limb. Explain.
3. Discuss the course of the left vagus nerve though the thorax. Include key relations at several locations (e.g. mediastinal regions).
4. Explain the mechanism leading to pain of the left shoulder and medial arm during cardiac embarrassment.
5. What structures lie immediately to the left of the arch of the azygos vein?
6. Follow the course of the esophagus in the thoracic cavity. Identify 4 areas of constrictions of the esophagus in the thorax.
7. Discuss the pattern of blood flow when there is coarctation of the aorta.
8. What fascial layers compromised by a breast cancer that directly invades into the lung.