M. Textbook of Anatomy and Physiology. St. Louis: CV Mosby, 1978.) blood vessels of visceral structures, blood vessels, sweat glands, and arrector muscles of hairs eye (iris) cephalic arterial ramus carotid periarterial plexus cardiopulmonary splanchnic nerves heart larynx trachea bronchi lungs diaphragm stomach pancreas spleen liver gallbladder bladder penis (clitoris) gonad inferior mesenteric ganglion superior mesenteric ganglion aorticorenal ganglion celiac ganglion abdominopelvic splanchnic nerves large intestine small intestine kidney suprarenal (adrenal) gland rectum internal anal sphincter presynaptic postsynaptic sympathetic fibers lacrimal gland nasal, palatine, and pharyngeal glands eye (iris, ciliary mm.) sacral parasympathetic outflow (via pelvic splanchnic nerves) parotid gland sublingual and submandibular glands heart larynx trachea bronchi lungs liver gallbladder left colic (splenic) flexure dividing sacral para-sympathetic supply from cranial supply large intestine small intestine rectum innervation via sacral outflow innervation via cranial outflow ciliary ganglion bladder penis (clitoris) stomach pancreas pterygopalatine ganglion otic ganglion submandibular ganglion cranial parasympathetic outflow (via 4 cranial nerves) III VII IX X S2 S3 S4
FIGURE 12.25 • Schematic diagram showing the general arrangement of sympathetic and parasympathetic neurons of the ANS. The sympathetic outflow is shown on the right; the parasympathetic, on the left. The sympathetic (thoracolumbar) outflow leaves the CNS from the thoracic and upper lumbar segments (T1–L2 or L3) of the spinal cord. These presynaptic fibers communicate with postsynaptic neurons in two locations, the paravertebral and prevertebral ganglia. Paravertebral ganglia are linked together and form two sympathetic trunks (yellow columns on each side of the spinal cord). Prevertebral ganglia are associated with the main branches of the abdominal aorta (yellow circles). Note the distribution of postsynaptic sympathetic nerve fibers to the viscera. The parasympathetic (craniosacral) outflow leaves the CNS from the gray matter of the brain stem within cranial nerves III, VII, IX, and X and the gray matter of sacral segments (S2–S4) of the spinal cord and is distributed to the viscera. The presynaptic fibers traveling with cranial nerves III, VII, and IX communicate with postsynaptic neurons in various ganglia located in the head and neck region (yellow circles). The presynaptic fibers traveling with cranial nerve X and with pelvic splanchnic nerves have their synapses with postsynaptic neurons in the wall of visceral organs (terminal ganglia). The viscera thus contain both sympathetic and parasympathetic innervation. Note that a two-neuron chain carries impulses to all viscera except the adrenal medulla. (Modified from Moore KL, Dalley AF. Clinically Oriented Anatomy. Baltimore: Lippincott Williams & Wilkins, 1999:48–50.) the intestine will continue peristaltic movements even by the same pathologic changes that can occur in neuafter the vagus nerve or pelvic splanchnic nerves are rons of the brain. Lewy bodies associated with Parkin severed. son’s disease (see Folder 12.1) as well as amyloid plaques