Autonomic Nerve exam questions

Question 1

what symptoms are most likely to be associated with horner’s syndrome?

Answer 1

-miosis
-anhidrosis (lack of sweating)
-ptosis

Question 2

the ciliary ganglion __? (3) (explain)

Answer 2

• contains afferent sensory fibers from the cornea
• is a common site of damage in Adie’s tonic pupil
• is located within the muscle cone between the lateral rectus and the optic nerve
  -contains sympathetic fibers that innervate the choroidal vasculature

Question 3

a male presents with mild ptosis and anisocoria. he has a headache and neck pain, pupil testing shows constricted right pupil and anisocoria greater in dim lighting. Which of the following statements about this patient are correct (select 3)? explain why

Answer 3

-He requires urgent neurological referral
-His signs and symptoms might be explained by a dissection of the internal carotid artery affecting the carotid sympathetic plexus
- He has signs consistent with a right Horner’s syndrome

Question 4

The pupillary near reflex (near triad) is comprised of?

Answer 4

convergence
accommodation
pupillary constriction

Question 5

A patient is experiencing symptoms of dry mouth and altered taste sensation. Which nerve is most likely to be involved? (why)

Answer 5

chorda tympani nerve

Question 6

The nerve of the pterygoid canal (vidian nerve) is formed by?

Answer 6

is formed by the junction of the deep petrosal and greater petrosal nerve

Question 7

The cell bodies of the pre-ganglionic parasympathetic neurons that innervate the lacrimal gland are located in the?

Answer 7

superior salivatory nucleus

Question 8

A post-ganglionic Horner’s syndrome could arise from a lesion in the?

Answer 8

cavernous sinus

Question 9

Which of the following conditions is MOST LIKELY to cause a relative afferent pupillary defect? why

Answer 9

optic neuritis or central retinal artery occlusion

Question 10

Adie’s tonic pupil is a condition that?

Answer 10

a condition that affects the parasympathetic innervation of the pupil

Question 11

The postganglionic parasympathetic fibers to the lacrimal gland pass through all of the following nerves, EXCEPT for the?

Answer 11

nasocilliary nerve

Question 12

correct this false statement: Parasympathetic fibers en route to the iris and ciliary body form a plexus surrounding the internal carotid artery in the cavernous sinus.

Answer 12

should read: Sympathetic fibers en route to the iris…. etc

Question 13

correct this false statement: the cell bodies of the pre-ganglionic parasympathetic neurons that innervate the iris are located in the spinal cord in the ciliospinal center of Budge-Waller

Answer 13

should read: sympathetic neurons etc

Question 14

correct this false statement: an acquired Horner’s syndrome is usually associated with iris hypopigmentation
on the affected side.

Answer 14

should read a congenital Horner’s syndrome…. etc

Question 14

correct this false statement: the intrinsically photosensitive retinal ganglion cells carry the efferent component of the pupillary light reflex.

Answer 14

should read: the intrinsically photosensitive retinal ganglion cells carry the afferent component

Question 15

Sympathetic fibers reach the iris dilator muscle via?

Answer 15

the long ciliary nerves.

Question 16

correct this false statement: Parasympathetic nerves originating in the Edinger-Westphal nucleus project to the contralateral ciliary ganglion.

Answer 16

should read: Neurons from the EW nucleus project to the ipsilateral side

Question 17

correct this false statement: Neurons in the pretectal olivary nucleus project ipslaterally to the Edinger-Westphal nucleus.

Answer 17

ipsilateral is wrong should say bilateral

Question 18

Tumors near the apex of the lung could give rise to?

Answer 18

Horner’s syndrome

Question 19

Which symptoms are MOST LIKELY to be associated with a Horner’s syndrome caused
by damage to the postganglionic sympathetic fibers at the level of the neck? (select 2) why?

Answer 19

-ptosis
-miosis

Question 20

Which neural structure is NOT involved in the pupillary near reflex?

Answer 20

pretectal olivary nucleus