內臟神經(jīng)系統(tǒng)

Visceralnervoussystem包括中樞部→脊髓、腦干、間腦、大腦周圍部→內臟、心血管、平滑肌、腺體。內臟神經(jīng)系統(tǒng)周圍部內臟運動神經(jīng)內臟感覺神經(jīng)交感神經(jīng)副交感神經(jīng)內臟運動神經(jīng)又稱植物神經(jīng)系統(tǒng)。

vegetativenervoussystem一、內臟運動神經(jīng)

visceralmotornerve與軀體運動神經(jīng)的區(qū)別：內臟運動神經(jīng)軀體運動神經(jīng)支配器官纖維成分神經(jīng)元數(shù)目分布形式平滑肌、心肌、腺體（不受意志控制）兩種：交感神經(jīng)、副交感神經(jīng)低級中樞→植物神經(jīng)節(jié)→效應器兩個神經(jīng)元節(jié)后纖維以神經(jīng)叢形式分布骨骼?。ㄊ芤庵究刂疲┲挥幸环N低級中樞→效應器一個神經(jīng)元以神經(jīng)干形式分布節(jié)前神經(jīng)元、節(jié)前纖維preganglionicneuronpreganglionicfiber節(jié)后神經(jīng)元、節(jié)后纖維postganglionicneuronpostganglionicfiber脊神經(jīng)的組成和分布模式圖脊神經(jīng)節(jié)后根前根灰交通支白交通支交感干神經(jīng)節(jié)腹腔神經(jīng)節(jié)前根后根運動終板骨胳肌肌梭脊神經(jīng)節(jié)白交通支灰交通支神經(jīng)叢腹腔神經(jīng)節(jié)及腹腔叢主動脈腎神經(jīng)節(jié)腸系膜下神經(jīng)節(jié)腸系膜上神經(jīng)節(jié)骶交感干神經(jīng)節(jié)下腔靜脈腹主動脈骶叢內臟運動神經(jīng)分為交感神經(jīng)和副交感神經(jīng)兩部分。（一）交感神經(jīng)

sympatheticn.1、低級中樞：T1~L3中間外側核交感神經(jīng)和副交感神經(jīng)腹后壁的肌肉和神經(jīng)膈腰方肌髂肌腹股溝韌帶腰大肌股靜脈股神經(jīng)交感干股外側皮神經(jīng)肋下神經(jīng)髂腹下神經(jīng)髂腹股溝神經(jīng)股神經(jīng)閉孔節(jié)前纖維：中間外側核—前根—脊神經(jīng)干—白交通支—交感干交感神經(jīng)走行①終于相應椎旁神經(jīng)節(jié)，交換神經(jīng)元。②在交感干內上行或下行后，終于上方或下方的椎旁神經(jīng)節(jié)，交換神經(jīng)元。③穿過椎旁神經(jīng)節(jié)后終于椎前神經(jīng)節(jié)，交換神經(jīng)元。①發(fā)自椎旁神經(jīng)節(jié)的節(jié)后纖維，經(jīng)灰交通支返回脊神經(jīng)隨脊神經(jīng)分布于全身血管、汗腺、立毛肌。②攀附動脈走行，形成叢，隨動脈分布到所支配的器官。③直接分布于器官。節(jié)后纖維：3、交感神經(jīng)的分布1）來自T1~5節(jié)段中間外側核的節(jié)前纖維，更換神經(jīng)元后，其節(jié)后纖維支配頭、頸、胸腔器官和上肢血管、汗腺、豎毛肌。2）來自T5~10節(jié)段中間外側核的節(jié)前纖維，更換神經(jīng)元后，其節(jié)后纖維支配肝、脾、腎和結腸左曲以上的消化管。內臟大神經(jīng)greatersplanechnicn.-由穿過T5-T9胸交感干神經(jīng)節(jié)的節(jié)前纖維構成，終于腹腔神經(jīng)節(jié)。內臟小神經(jīng)lessersplanechnicn.-由穿過T10-T12胸交感干神經(jīng)節(jié)的節(jié)前纖維構成，終于主動脈腎節(jié)。3）來自L1~3節(jié)段中間外側核的節(jié)前纖維，更換神經(jīng)元后，其節(jié)后纖維支配結腸左曲以下的消化管、盆腔器官和下肢的血管、汗腺、豎毛肌。（二）副交感神經(jīng)

parasympatheticn.1、低級中樞

顱部：動眼神經(jīng)副核（位于中腦）上泌涎核（位于腦橋）下泌涎核（位于延髓）迷走神經(jīng)背核（位于延髓）骶部：S2~4骶副交感核一般內臟運動核動眼神經(jīng)副核（Ⅲ）→瞳孔括約肌、睫狀肌上泌涎核（Ⅶ）→下頜下腺、舌下腺、淚腺下泌涎核（Ⅸ）→腮腺迷走神經(jīng)背核（Ⅹ）→胃腸平滑肌和腺體交感神經(jīng)和副交感神經(jīng)2、副交感神經(jīng)節(jié)頭部：睫狀神經(jīng)節(jié)、下頜下神經(jīng)節(jié)、翼腭神經(jīng)節(jié)、耳神經(jīng)節(jié)位于心叢、肺叢、膀胱叢、子宮陰道叢內的神經(jīng)節(jié)支氣管和消化管壁內的神經(jīng)節(jié)等3、副交感神經(jīng)分布動眼神經(jīng)副核睫狀肌、瞳孔括約肌睫狀神經(jīng)節(jié)動眼神經(jīng)上泌涎核面神經(jīng)鼓索巖大神經(jīng)淚腺等下頜下腺、舌下腺翼腭神經(jīng)節(jié)下頜下神經(jīng)節(jié)下泌涎核耳神經(jīng)節(jié)腮腺舌咽神經(jīng)巖小神經(jīng)迷走神經(jīng)背核器官旁神經(jīng)節(jié)壁內神經(jīng)節(jié)迷走神經(jīng)胸腔臟器腹腔臟器（結腸左曲以上消化管）骶副交感核盆內臟神經(jīng)器官旁神經(jīng)節(jié)壁內神經(jīng)節(jié)結腸左曲以下消化管及盆腔器官眶及眶內容（外側面）動眼神經(jīng)眼神經(jīng)滑車神經(jīng)三叉神經(jīng)節(jié)翼腭神經(jīng)節(jié)睫狀神經(jīng)節(jié)眶下神經(jīng)睫狀短神經(jīng)下斜肌上直肌眶上神經(jīng)展神經(jīng)外直肌上頜神經(jīng)三叉神經(jīng)三叉神經(jīng)（外側面）眶上神經(jīng)滑車上神經(jīng)額神經(jīng)淚腺神經(jīng)鼻睫神經(jīng)睫狀神經(jīng)節(jié)眶下神經(jīng)翼腭神經(jīng)節(jié)眼神經(jīng)上頜神經(jīng)三叉神經(jīng)節(jié)三叉神經(jīng)下頜神經(jīng)面神經(jīng)鼓索下牙槽神經(jīng)舌下神經(jīng)舌神經(jīng)下頜下神經(jīng)節(jié)上牙槽神經(jīng)頦神經(jīng)三叉神經(jīng)（外側面）面神經(jīng)鼓索耳神經(jīng)節(jié)嗅球嗅神經(jīng)翼腭神經(jīng)節(jié)上頜神經(jīng)交感神經(jīng)副交感神經(jīng)低級中樞胸、腰部顱、骶部神經(jīng)節(jié)位置椎旁神經(jīng)節(jié)、器官節(jié)、椎前神經(jīng)節(jié)器官內節(jié)分布范圍廣泛范圍小作用（三）交感神經(jīng)與副交感神經(jīng)的比較作用比較：交感神經(jīng)心臟心跳減緩血壓下降瞳孔支氣管蠕動減慢蠕動增強膀胱逼尿肌松弛、尿道括約肌收縮（貯尿）逼尿肌收縮、尿道括約肌松弛（排尿）副交感神經(jīng)心跳加快血壓上升縮小散大平滑肌松弛平滑肌收縮口徑加大口徑縮窄胃腸二、內臟感覺神經(jīng)

visceralsensoryn.孤束核中樞突膝神經(jīng)節(jié)舌咽神經(jīng)下節(jié)迷走神經(jīng)下節(jié)周圍突面神經(jīng)舌咽神經(jīng)迷走神經(jīng)→內臟器官脊髓中樞突脊神經(jīng)節(jié)交感神經(jīng)副交感神經(jīng)內臟器官周圍突中間內側核特點：1、痛閾較高，疼痛性質模糊。2、彌散的內臟痛，定位不準確。三、牽涉