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Neuro final > ANS & NGB > Flashcards

ANS & NGB Flashcards

1
Q

at what vertebral levels are preganglionic sympathetic cell bodies to the head and neck

A

T1-T3

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2
Q

from what structure does sympathetic innervation for the baroreceptor reflex arise

A

rostral venterolateral medulla

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3
Q

what is the major distribution center for the sympathetics of the head

A

superior cervical ganglion

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4
Q

are nerve fibers in the grey rami communicantes pre- or postganglionic
are they sympathetic or parasympathetic

A

postganglionic

sympathetic

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5
Q

in what CNs do preganglionic parasympathetic axons travel

A

3, 7, 9, 10

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6
Q

what and where are the four autonomic ganglia in the head

A

edinger-westphal (midbrain)
superior salivatory nucleus (pons)
inferior salivatory nucleus (medulla)
dorsal nucleus of vagus (medulla)

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7
Q

what is the route of parasympathetic input to the eye

A

edinger-westphal => CN III => *ciliary ganglion => accomodation (ciliary m.) + miosis (pupillary sphincter m.)

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8
Q

what nerve do parasympathetics from the superior salivatory nucleus travel in

A

CN VII

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9
Q

what is the route of parasympathetic input to the lacrimal gland

A

superior salivatory nuc. => CN VII => spheno/pterygopalatine ganglion => lacrimal gland

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10
Q

what is the route of parasympathetics to the submandibular and sublingual salivary glands

A

superior salivatory nuc => CN VII => submandibular ganglion => submandibular and sublingual salivary glands

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11
Q

what is the route of parasympathetics to the parotid salivary gland

A

inferior salivatory ganglion => CN IX => otic ganglion => parotid

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12
Q

what type of tumor can cause horner’s syndrome

A

Pancoast tumor - at the apex of the lung

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13
Q

focal lesions in what areas can cause horner’s syndrome

A

lateral brainstem/upper c-spine

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14
Q

horner’s syndrome can be caused by a neoplasm in what two locations

A
  • apex of the lung

- cavernous sinus

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15
Q

what artery dissection can cause horner’s syndrone

A

internal carotid

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16
Q

in the case of a pancoast tumor, where is the sympathetic pathway being impinged?

A

at the sympathetic chain

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17
Q

in the case of a tumor of the cavernous sinus or internal carotid dissection, where is the sympathetic pathway being impinged?

A

superior cervical ganglion or post-ganglionic sympathetic fiber

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18
Q

if a pt has horner’s syndrome secondary to a neoplasm of the cavernous sinus, will they have facial anhidrosis

A

only above the eyebrow

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19
Q

where are mechanoreceptors responsible for the baroreceptor reflex located and what innervates them

A

carotid sinus, CN IX

aortic arch, CN X

20
Q

where is the signal sent from baroreceptors in the event of HTN

A

nucleus solitarius (in the medulla) => nucleus ambiguus

21
Q

what does the nucleus ambiguus do in response to activation by the nucleus solitarius

A
  • inhibits SA node via CN X => bradycardia

- inhibits isympathetic vasomotor activity in the rostral ventrolateral medulla => vasodilation

22
Q

what is the main consequence of lesion to an afferent baroreceptor structure

A

fluctuating HTN

23
Q

what is the main consequence of lesion to an efferent baroreceptor structure

A

orthostatic hypotension

24
Q

what are the sxs of orthostatic hypotension

A

light-headed
blurred vision
neck/shoulder pain after sitting upright
syncope

25
Q

how would a lesion to the rostral venterolateral medulla affect BP

A

fluctuating HTN

26
Q

through what structure do sympathetics to the bladder travel

A

sacral splanchnic/hypogastric n

27
Q

what does sympathetic input to the bladder do

A
  • relax detrusor m.

- contract internal urethral sphincter

28
Q

through what structure do parasympathetics to the bladder travel

A

pelvic splanchnic n

29
Q

what does parasympathetic input to the bladder do

A
  • contract detrusor m

- relax internal urethral sphincter

30
Q

what is the route of information from the bladder saying that it’s full

A

PAG (midbrain) => pontine micturition center = > excitatory signal to sacral parasympathetic nucleus, inhibitory to onuf nucleus

31
Q

what is the center for voluntary control of micturition

A

medial frontal cortex

32
Q

how does the medial frontal cortex inhibit micturition

A

inhibits pontine micturition center

33
Q

what are the three types of NGB

A
  • uninhibited
  • spastic
  • flaccid
34
Q

a lesion where causes uninhibited NGB

A

medial frontal cortex

35
Q

what sxs are associated w/ uninhibited NGB

A

urinary urgency and incontinence

36
Q

a lesion where causes spastic NGB

A

midline/bilateral of lower brainstem/T-spine above conus medullaris

37
Q

what kind of NGB is caused by MS

A

spastic

38
Q

what is spastic NGB

A

detrusor muscle and external urethral sphincter are dyssynergic => bladder hypertrophy

39
Q

bladder wall hypertrophy in spastic NGB causes what symptom

A

low bladder capacity

40
Q

what are the sxs of spastic NGB

A

urinary frequency

urinary incontinence

41
Q

what conditions are associated with flaccid bladder

A

diabetes
extruded disc
neoplasm of the SC

42
Q

in which type of NGB is bladder capacity INCREASED

A

flaccid

43
Q

does a pt with flaccid NGB have a micturition reflex

A

no

44
Q

what are the sxs of flaccid bladder

A

overflow incontinence

urinary retention

45
Q

in which type of NGB is anal reflex affected?

A

flaccid

46
Q

in which type of NGB is intravesical pressure normal

A

uninhibited

47
Q

in which type of NGB would you expect in a pt with lesion to the cauda equina

A

flaccid

Neuro final (16 decks)

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