ANS2 Flashcards
Disease associated with Raynaud
scleroderma
Less common causes of Raynaud
Obstructive arterial disease–as might
occur with the thoracic outlet syndrome, vasospasm
because of drugs (ergot, cytotoxic agents, cocaine), previous
cold injury (frostbite), and circulating cryoglobulins
The presence of ____________, visible with an
ophthalmoscope, has been used as a bedside aid to reveal cases of connective tissue disease in pts with Raynaud
distorted and
proliferative capillaries in the nail bed
Pathophysio for Raynaud
arterial constriction or a decrease in the intraluminal
pressure
Drugs that cause vasoconstriction
ergots, sympathomimetics,
clonidine, and serotonin receptor agonists
condition in which the feet and lower extremities
become red and painful on exposure to warm temperatures
for prolonged periods
En;thromelalgia,
Extirpation of _________ relieves
the more severe cases of palmar sweating
T2 and T3 sympathetic ganglia
Tx for hyperhydrosis
Treatment with local injections of botulinum
toxin
T or F
sweating is affected in restricted spinal root
disease because there is much intersegmental mixing of
the preganglionic axons once they enter the sympathetic
chain and there are no preganglionic autonomic fibers in
the roots below L2.
F
where is the lesion?
The bladder is paralyzed for voluntary and
reflex activity and there is no awareness of the state of
fullness;
Complete Destruction of the Cord Below T12
What is this manuever?
lower abdominal compression and
abdominal straining
Crede maneuver, i.e.,
CMG findings of Complete Destruction of the Cord Below T12?
The cystometrogram
shows low pressure and no emptying contractions
causes of primary
sensory bladder paralysis.
fibers affected?
Diabetes and tabes dorsalis
Neuropathies affecting mainly the small
fibers are the ones usually implicated
Such lesions
result in a reflex neurogenic (spastic) bladder
Upper Spinal Cord Lesions, Above T12
_________________is the result
of vesicular p ressure exceeding the opening pressure
of the sphincter in an areflexic bladder
overflow incontinence
CMG of lesions above T12
The cystometrogram
shows uninhibited contractions of the detrusor muscle in
response to small volumes of fluid
Repeated overdistention
of the bladder wall often results in varying degrees of
decompensation of the _______ and permanent
___________, although the evidence for this mechanism
is uncertain
detrusor muscle
atonia or hypotonia
There is a supranuclear
type of hyperactivity of the detrusor that results in precipitant
voiding
Frontal Lobe Incontinence
pontine nucleus for
micturition
Barrington nucleus
In
the case of a flaccid paralysis of the bladder, ______
produces contraction of the detrusor by direct stimulation
of its muscarinic cholinergic receptors
bethanechol (Urecholine)
In spastic
paralysis, the detrusor can be relaxed by ______________ which acts as a muscarinic
antagonist, and by _____________________, which acts directly on the smooth muscle and
also has a muscarinic antagonist action.
propantheline (Pro-Banthine, 15 to 30 mg tid),
oxybutynin (Ditropan, 5 mg bid or tid)
More recently, alpha1 -sympathomimetic-blocking
drugs such as__________________ have
been used to relax the urinary sphincter and facilitate
voiding
terazosin, doxazosin, and tamsulosin