ANS, Respiration & Swallowing Disorders

Question 1

what are the difference betw parasympathetic & sympathetic nervous system?

Answer 1

• length of the preganglionic and postganglionic fibers
• position of the ganglia

Question 2

what does the pneumotaxic center modulate response to?

Answer 2

hypoxia
hypercapnia
lung inflation

Question 3

What is the main NT of the parasympathetic nervous system?

Answer 3

Acetylcholine

Question 4

What are the main NT of the sympathetic NS?

Answer 4

norepinephrine
epinephrine

Question 5

what are the 2 tests of autonomic function?

Answer 5

Orthostatic hypotension
Tilt table test

Question 6

what is the important abnormal response of BP in orthostatic hypotension?

Answer 6

if BP falls >30mmHg and >15mmHg diastolic

Question 7

what is the ormal response of HR in BP if there is NO orthostatic hypotension?

Answer 7

HR increases by 11-90bpm

Question 8

what is the time interval when checking for orthostatic hypotension?

Answer 8

1 and 3 minutes

Question 9

what is the indication of vagal syncope in orthostatic hypotension?

Answer 9

if there is failure of HR to rise in response to a drop in BP while standing

Question 10

what are the different clinical disorders of ANS?

Answer 10

Acute inflammatory demyelinating syndrome (Guillan-barre syndrome)

multiple system atrophy

diabetic polyneuropathy

autonomic failure in the elderly

horner syndrome

sympathetic storm in acute brain injury

Question 11

what disorder of ANS has numbness of the fingers and soles of the feet, dysautonomia, GI complaints & problems with micturition?

Answer 11

diabetic polyneuropathy

Question 12

what disorder of ANS has atrophy of the pontine and cerebellar areas with parkinsonism and dysautonomia symptoms?

Answer 12

multiple system atrophy

Question 13

for px who have autonomic failure in the elderly, what are the signs?

Answer 13

erratic BP
problems urinating
difficulty controlling their bowels

Question 14

what are the signs of Horner syndrome

Answer 14

Horner needs a MAP
Miosis, Anhidrosis, Pitosis

Ipsilateral to the lesion

Question 15

what are components of Cushing triad?

Answer 15

Increase in ICP

Triad: BRaH
Bradycardia
abnormal Respiration
Hypertension

“may CUSHING yung BRaH ko”

Question 16

what causes voluntary restraint of micturition?

Answer 16

cerebral
- paracentral motor region in the frontal lobe

Question 17

what condition causes urinary urgency and most common neurologic dis causing bladder dysfunction?

Answer 17

multiple sclerosis

Question 18

what could be causes of bladder dysfunction?

Answer 18

• complete destruction of SC at T
• above T
• stretch receptors interrupted

Question 19

where is the lesion in Ondine’s curse?

Answer 19

lower brainstem lesions

this condition is the absence of involuntary drive to breathe

Question 20

what are other common causes of respiration?

Answer 20

motor neuron disease = ALS

Myasthenia gravis

Question 21

what is the only thing required for reflex swallowing?

Answer 21

medullary function = retained in vegetative and locked-in states

Question 22

what does an intact gag reflex DOES NOT have?

Answer 22

= assure smooth coordination of swallowing
- obviate aspiration

Question 23

what is the failure of initiation of swallowing mean?

Answer 23

due to tongue weakness
- myasthenia gravis
- motor neuron disease

Question 24

what are the causes of no closure of the pharynx?

Answer 24

• myasthenia gravis
• CN X palsy
• pseudobulbar palsy

Question 25

what are the diff diseases prone to aspiration?

Answer 25

Parkinson disease
Myopathies
Medullary lesions = affecting NTS and cranial motor nuclei

Question 26

how long until after acute stroke can a px have dysphagia?

Answer 26

6 months

Question 27

what should be done in stroke px to check for progression of dysphagia?

Answer 27

bedside swallowing tests
- ask to drink glass of water