Sympathetic afferent fibers originate from a visceral organ, course in the thoracolumbar rami communicantes, have cell bodies located in dorsal root ganglia, and terminate in the gray matter of the spinal cord. Sympathetic afferent fibers from the heart transmit information about noxious stimuli associated with myocardial ischemia, i. e. angina pectoris. Previous reviews have described the characteristics of cardiovascular sympathetic afferent fibers (Bishop et al. 1983; Malliani 1982). This review summarizes that work and focuses on the neural mechanisms underlying the complexities of angina pectoris. In order to understand anginal pain, cells forming the classical pain pathway, the spinothalamic tract (STn, were chosen for study. These cells were chosen to address questions about anginal pain because they transmit nociceptive informa of pain. Antidromic tion to brain regions that are involved in the perception activation of STT cells provided a means of identifying cells involved with trans mission of nociceptive information in anesthetized animals. Other ascending pathways may also transmit nociceptive information, but many studies show that the STT plays an important role. Visceral pain is commonly referred to overlying somatic structures. The pain of angina pectoris can be sensed over a wide area of the thorax: in the retrosternal, precordial anterior thoracic, and anterior cervical regions of the chest; in the left or sometimes even the right shoulder, arm, wrist, or hand; or in the jaw and teeth (Harrison and Reeves 1968)."

Each Oklahoma Notes book presents the core information of one segment of the medical school curriculum. Written by some of the most effective medical educators in the U.S., and now thoroughly updated and revised, the Oklahoma Notes feature: Concise text presented in outline format for rapid review; contents oriented to promote success; self-assessment questions; and more tables and figures designed to facilitate self-assessment and review.

This review covers the major systems of human physiology. The review is not ex haustive; it assumes that the student has completed a course in human physiology and wishes to refresh their memory in preparing for an examination. The student is advised to refer to a competent textbook several times in this review. This book is a revised version of a review book used by our medical students for over ten years. Coverage of the various topics in physiology is comparable to the percentage of questions on those topics in recent National Board, Part I examinations. Review questions follow every few pages of text in order to monitor your under standing of the just preceding material. The multiple choice questions are mainly of the two conventional types; "single best answer" questions, for which you choose the single best answer, and "multiple correct answer" questions, for which you choose the one or more correct alternatives. The two multiple choice formats have been standardized throughout the book."