Ask any OMS 3 or 4 and they will tell you that if you have a good understanding of viscerosomatic reflexes you can get a lot of easy points on the COMLEX. While the concept seems easy enough, students are rarely taught an easy method of remembering these things. The following is not exhaustive, but it represents pretty much all a student will need to know to answer most of the viscerosomatic questions on COMLEX.
First don’t try to remember every single organ’s specific autonomic innervation. Focus your efforts on memorizing the following 9 groups:
T1-T4 (Head and Neck)
T1-T5 (Heart)
T2-T7 (Lungs)
T5-9 (Organs of Celiac Ganglion)
T10-T11 (Organs of Superior Mesenteric Ganglion)
T12-L2 (Organs of Inferior Mesenteric Ganglion)
Sympathetic Mavericks (see table)
Vagus Nerve (Parasympathetic)
Pelvic Splanchnic (S2-S4)
Try to remember that when it comes to viscerosomatics, testers will not try to confuse you. Remember that the COMLEX is a multiple-choice test and only one of the answers will be from the previous groups. For instance, if a question indicates that a patient has cirrhosis of the liver, and asks you at what spinal segment a somatic dysfunction is likely found, only one choice will include a segment from the celiac ganglion (T5-9). They understand the discrepancy that exists between sources regarding the specific innervations, and therefore try to make sure that there are no contradictions within the given choices.
The second tip I can give you regarding viscerosomatics is for visual learners like myself. Almost all of the sympathetic innervations from the abdominal organs can be associated with 3 specific ganglions. I have included images mapping out the regions the celiac ganglion, the superior mesenteric ganglion, and the inferior mesenteric ganglion. If you remember these regions you can easily associate the spleen with the celiac ganglion (T5-T9), the kidneys with the superior mesenteric ganglion (T10-T11), and the prostate with the inferior mesenteric ganglion (T12-L2). The same can be done for the parasympathetic innervations by mapping out the regions innervated by the vagus and pelvic splanchnic nerves.
If you can remember the previous 9 groupings of autonomics, then you can save yourself some headache on the OMM portion of the COMLEX. To test your knowledge here is a board style question on viscerosomatics. Good Luck!
Viscerosomatics for COMLEX
By: Dan Lynch - WCUCOM