ANS & NGB Flashcards
at what vertebral levels are preganglionic sympathetic cell bodies to the head and neck
T1-T3
from what structure does sympathetic innervation for the baroreceptor reflex arise
rostral venterolateral medulla
what is the major distribution center for the sympathetics of the head
superior cervical ganglion
are nerve fibers in the grey rami communicantes pre- or postganglionic
are they sympathetic or parasympathetic
postganglionic
sympathetic
in what CNs do preganglionic parasympathetic axons travel
3, 7, 9, 10
what and where are the four autonomic ganglia in the head
edinger-westphal (midbrain)
superior salivatory nucleus (pons)
inferior salivatory nucleus (medulla)
dorsal nucleus of vagus (medulla)
what is the route of parasympathetic input to the eye
edinger-westphal => CN III => *ciliary ganglion => accomodation (ciliary m.) + miosis (pupillary sphincter m.)
what nerve do parasympathetics from the superior salivatory nucleus travel in
CN VII
what is the route of parasympathetic input to the lacrimal gland
superior salivatory nuc. => CN VII => spheno/pterygopalatine ganglion => lacrimal gland
what is the route of parasympathetics to the submandibular and sublingual salivary glands
superior salivatory nuc => CN VII => submandibular ganglion => submandibular and sublingual salivary glands
what is the route of parasympathetics to the parotid salivary gland
inferior salivatory ganglion => CN IX => otic ganglion => parotid
what type of tumor can cause horner’s syndrome
Pancoast tumor - at the apex of the lung
focal lesions in what areas can cause horner’s syndrome
lateral brainstem/upper c-spine
horner’s syndrome can be caused by a neoplasm in what two locations
- apex of the lung
- cavernous sinus
what artery dissection can cause horner’s syndrone
internal carotid
in the case of a pancoast tumor, where is the sympathetic pathway being impinged?
at the sympathetic chain
in the case of a tumor of the cavernous sinus or internal carotid dissection, where is the sympathetic pathway being impinged?
superior cervical ganglion or post-ganglionic sympathetic fiber
if a pt has horner’s syndrome secondary to a neoplasm of the cavernous sinus, will they have facial anhidrosis
only above the eyebrow
where are mechanoreceptors responsible for the baroreceptor reflex located and what innervates them
carotid sinus, CN IX
aortic arch, CN X
where is the signal sent from baroreceptors in the event of HTN
nucleus solitarius (in the medulla) => nucleus ambiguus
what does the nucleus ambiguus do in response to activation by the nucleus solitarius
- inhibits SA node via CN X => bradycardia
- inhibits isympathetic vasomotor activity in the rostral ventrolateral medulla => vasodilation
what is the main consequence of lesion to an afferent baroreceptor structure
fluctuating HTN
what is the main consequence of lesion to an efferent baroreceptor structure
orthostatic hypotension
what are the sxs of orthostatic hypotension
light-headed
blurred vision
neck/shoulder pain after sitting upright
syncope
how would a lesion to the rostral venterolateral medulla affect BP
fluctuating HTN
through what structure do sympathetics to the bladder travel
sacral splanchnic/hypogastric n
what does sympathetic input to the bladder do
- relax detrusor m.
- contract internal urethral sphincter
through what structure do parasympathetics to the bladder travel
pelvic splanchnic n
what does parasympathetic input to the bladder do
- contract detrusor m
- relax internal urethral sphincter
what is the route of information from the bladder saying that it’s full
PAG (midbrain) => pontine micturition center = > excitatory signal to sacral parasympathetic nucleus, inhibitory to onuf nucleus
what is the center for voluntary control of micturition
medial frontal cortex
how does the medial frontal cortex inhibit micturition
inhibits pontine micturition center
what are the three types of NGB
- uninhibited
- spastic
- flaccid
a lesion where causes uninhibited NGB
medial frontal cortex
what sxs are associated w/ uninhibited NGB
urinary urgency and incontinence
a lesion where causes spastic NGB
midline/bilateral of lower brainstem/T-spine above conus medullaris
what kind of NGB is caused by MS
spastic
what is spastic NGB
detrusor muscle and external urethral sphincter are dyssynergic => bladder hypertrophy
bladder wall hypertrophy in spastic NGB causes what symptom
low bladder capacity
what are the sxs of spastic NGB
urinary frequency
urinary incontinence
what conditions are associated with flaccid bladder
diabetes
extruded disc
neoplasm of the SC
in which type of NGB is bladder capacity INCREASED
flaccid
does a pt with flaccid NGB have a micturition reflex
no
what are the sxs of flaccid bladder
overflow incontinence
urinary retention
in which type of NGB is anal reflex affected?
flaccid
in which type of NGB is intravesical pressure normal
uninhibited
in which type of NGB would you expect in a pt with lesion to the cauda equina
flaccid
