Sympathetic Nervous System
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Questions and Answers

Which of the following nerves is not found in the posterior mediastinum?

  • Phrenic nerve (correct)
  • Left recurrent nerve
  • Vagus nerve
  • Splanchnic nerves

    • Which of the following structures is common to both the superior and middle mediastinum?

  • Trachea
  • Pericardium
  • Thymus
  • Esophagus (correct)

    • Which of the following nerves passes through the 5th to 9th thoracic sympathetic ganglia without making a synapse?

  • Least splanchnic nerve
  • Greater splanchnic nerve (correct)
  • Phrenic nerve
  • Lesser splanchnic nerve

    • Which of the following structures is not found in the anterior mediastinum?

    <p>Pericardium</p> Signup and view all the answers

    Which of the following nerves is a branch of the vagus nerve?

    <p>Left recurrent nerve</p> Signup and view all the answers

    At which level does the thoracic aorta change its name?

    <p>T12</p> Signup and view all the answers

    Which of the following structures does NOT receive blood from the thoracic aorta?

    <p>Liver</p> Signup and view all the answers

    Which vein receives the lower three posterior intercostal veins?

    <p>Hemiazygos vein</p> Signup and view all the answers

    Where do the sympathetic trunks unite?

    <p>At the ganglia impar</p> Signup and view all the answers

    What happens to venous blood if the IVC is blocked?

    <p>It drains into the SVC through the azygos vein and hemiazygos vein</p> Signup and view all the answers

    What is the common course of the right and left phrenic nerves in the middle mediastinum?

    <p>They descend in the fibrous pericardium anterior to the root of the lungs</p> Signup and view all the answers

    Which of the following nerves crosses the left side of the arch of aorta?

    <p>Left vagus nerve</p> Signup and view all the answers

    What is the origin of the brachiocephalic trunk?

    <p>At the level of the upper border of the right sternoclavicular joint</p> Signup and view all the answers

    Which of the following structures is NOT located in the superior mediastinum?

    <p>Pulmonary veins</p> Signup and view all the answers

    Which of the following nerves is crossed by the arch of the azygos vein?

    <p>Right vagus nerve</p> Signup and view all the answers

    Study Notes

    Splanchnic Nerves

    • Preganglionic fibers can either ascend in the trunk and make synapses at a high level or descend in the trunk and make synapses at the lumbar or sacral ganglia
    • The third way is when preganglionic fibers leave the trunk without making a synapse, these fibers are myelinated and seen as white, known as splanchnic nerves

    Splanchnic Nerves Classification

    • Greater splanchnic nerve: fibers pass through the 5th to 9th thoracic sympathetic ganglia without making a synapse
    • Lesser splanchnic nerve: T10-T11
    • Least splanchnic nerve: T12, forms the renal plexus

    Mediastinum

    • Central part of the thoracic cavity
    • Covered by mediastinal pleura
    • Contains thoracic viscera, nerves, and vessels

    Organization of Mediastinum

    • Divided into three parts: superior, middle, and posterior mediastinum

    Superior Mediastinum

    • Posterior to the manubrium and anterior to the first four thoracic vertebrae
    • Superior border: superior thoracic aperture
    • Inferior border: transverse thoracic plane (sternal angle and IV disc of T4 and T5)
    • Laterally: mediastinal pleura
    • Contents:
      • Thymus
      • Right and left brachiocephalic veins
      • Superior vena cava
      • Arch of aorta with its three large branches
      • Trachea
      • Esophagus
      • Phrenic nerves
      • Vagus nerves
      • Left recurrent laryngeal nerve
      • Thoracic duct

    Middle Mediastinum

    • Contents:
      • Pericardium
      • Heart
      • Roots of great vessels
      • Arch of azygos vein
      • Main bronchi

    Posterior Mediastinum

    • Contents:
      • Esophagus
      • Thoracic aorta
      • Azygos and hemiazygos veins
      • Thoracic duct
      • Vagus nerve
      • Sympathetic trunks
      • Splanchnic nerves

    Superior Vena Cava

    • Terminates at the lower margin of the right third costal cartilage
    • Receives: azygos vein, pericardial and mediastinal veins

    Arch of Aorta and its Branches

    • Aorta has three parts: arch, ascending, and descending
    • Ascending aorta emerges from the heart and forms the arch of aorta
    • From right to left: brachiocephalic trunk, left common carotid, and left subclavian

    Brachiocephalic Trunk

    • At the level of the upper border of the right sternoclavicular joint
    • Branches: right subclavian, right common carotid, and occasionally thyroid ima artery

    Vagus Nerve

    • Superior mediastinum posterior to the SC joint and brachiocephalic vein
    • Passes through the thorax, providing parasympathetic innervation to the thorax and visceral afferents from the organs

    Phrenic Nerve

    • Right phrenic nerve: enters the superior mediastinum posterior to the beginning of the right brachiocephalic vein
    • Left phrenic nerve: enters the superior mediastinum posterior to the beginning of the left brachiocephalic vein

    Thoracic Aorta

    • Lies posterior to the root of the left lung, pericardium, and esophagus
    • Changes its name at the T12 level

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    Description

    This quiz covers the sympathetic nervous system, including the pathways of preganglionic fibers and the role of splanchnic nerves.

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