Autonomic Nervous System

Question 1

Differentiate Dorsal and Ventral roots of spinal nerves.

Answer 1

Dorsal Root: Afferent fibers with neural bodies in ganglion

Ventral Root: Efferent motor fibers stemming from motor neuron cell bodies in spinal cord

Question 2

What type of neuron is the first order sensory neuron? What are the branches?

Answer 2

Pseudo unipolar

Peripheral branch coming from sensory

Central branch going to CNS

Question 3

Which tract convert information about pain and temperature?

Answer 3

Spinothalamic

Question 4

Differentiate Paravertebral and prevertebral ganglia

Answer 4

1. Paravertebral: Around the Vertebral column on both sides (sympathetic chain)
2. Prevertebal: In front of the vertebral column (celiac, superior mesenteric)

Question 5

What are major anatomical differences in neuron pathway for sympathetic and parasympathetic pathways?

Answer 5

• Parasympathetic: Postganglionic is short; Preganglionic is long
• Sympathetic: - Preganglionic is short; Postganglionic is long

Question 6

Where do intramural ganglion lie?

Answer 6

Within the wall of the organ

Question 7

What are chromaffin cells?

Answer 7

transformed postsynaptic sympathetic neurons in the adrenal gland that contribute to generalized sympathetic activation by adrenaline release into the circulation

Question 8

What are the physiological changes in flight/flight?

Answer 8

1. INC BP, HCV, Contraction force, and HR
2. INC depth/rate resp
3. Shift of blood f/ organs to muscle
4. Increased lipolysis/glycogenolysis
5. Inhibition of GI motility/secretion
6. Widening of eyelids
7. Mydriasis
8. Sweating and piloerection

Question 9

What is an example of parasympathetic and sympathetic cooperation?

Answer 9

Diving in cold water

• DEC HR
• Skin vascocontriction

Question 10

What are the receptors and NTs for the parasympathetic pathway?

Answer 10

Ach —> Nic (Ach) —> Muscarinic target

Question 11

What are the receptors and NTs for the sympathetic pathway?

Answer 11

Ach —> Nic; NA —> Adrenergic target

Question 12

What type of receptor is a Nicotinic receptor?

Answer 12

Ligand gated Na channel

Question 13

What type of receptor is the muscarinic receptor

Answer 13

7 pass transmembrane Ach GPCR

Question 14

Which nerves modulate central sympathetic tone (baroreflex)?

Answer 14

Afferent visceral fibers of glossopharyngeal CN IX and Vagus CN X Nerve

Question 15

How does Adrenal medulla and sweat gland sympathetic activation differ from other pathways?

Answer 15

• Activated via Ach

- No ganglia

Question 16

What type of receptor is on the cells of the adrenal medulla and sweat glands?

Answer 16

Nicotinic

Question 17

Differentiate binding affinity EP/E to their receptors

Answer 17

• NE preferentially binds alpha, while Ep binds Beta receptors

Question 18

Differentiate alpha-1 and alpha-2 receptor action.

Answer 18

Alpha-1: Postsynaptic, excitatory

Alpha-2: presynaptic, inhibitory

Question 19

Differentiate action of beta 1/2 receptors

Answer 19

Beta-1: Postsynaptic excitatory

Beta-2: Postsynaptic inhibitory

Question 20

What are the main side affects of activation of alpha 1 receptors?

Answer 20

• Vasoconstriction
• INC BP/peripheral resistance
• Lid retraction

Question 21

What are the main side effects of alpha 2 receptors?

Answer 21

• Inhibits NE release
• DEC BP/Vessel tone
• DEC intraocular pressure

Question 22

What are the main symptoms of activation of Beta 1 receptors?

Answer 22

Tachycardia

INC myocardial contractibility/metabolism

INC renin

Question 23

What are the main symptoms from Beta 2 receptor activation?

Answer 23

Bronchodilation

Relaxed Uterine Muscle

Increased intraocular pressure

Question 24

How does propanalol affect angina pectoris?

Answer 24

Propanalol decreases metabolic demand of cardiomyocytes abundant hero’s to balance deficiency in circulatory O2 supply

Question 25

What is the action of clonidine?

Answer 25

Alpha-2 agonist

Question 26

Which type of sympathetic receptors dominate the heart?

Answer 26

Beta 1

Question 27

Which type of sympathetic receptors predominate skin/splanchnic and result in contraction?

Answer 27

Alpha 1

Question 28

What type of sympathetic receptors predominate skeletal muscle, and what are the symptoms?

Answer 28

Beta2 - Dilation Alpha 1 - Contrictions

Question 29

What type of sympathetic receptors predominate bronchioles?

Answer 29

Beta2 - Dilation

Question 30

What type of sympathetic receptors predominate in the GI?

Answer 30

Smooth Muscle - Relaxatin; Beta2 Sphincter - Contraction; Alpha 1 Saliva secretion - Beta1

Question 31

What type of sympathetic receptors predominate the bladder?

Answer 31

Relaxation - Beta2 Internal sphincter contraction - Alpha1

Question 32

What type of sympathetic receptors predominate male genitalia?

Answer 32

Alpha - ejaculation

Question 33

What type of sympathetic receptors predominate Uterene muscle?

Answer 33

Beta2 - relaxation

Question 34

What type of sympathetic receptors predominate the Iris?

Answer 34

Alpha 1 - Mydriasis

Question 35

What type of sympathetic receptors predominate the ciliary muscles?

Answer 35

Beta - dilation

Question 36

What type of sympathetic receptors predominate pilomotor mucles?

Answer 36

alpha - Contriction

Question 37

What type of sympathetic receptors predominate Liver, adipose, and kidney?

Answer 37

Liver - Alpha and Beta; Increases secretions Adipose - Beta; Lipolysis Kidney - Increased filtration; Beta 1

Question 38

What are the main parasympathetic CN?

Answer 38

CNIII, VII, IX, and X

Question 39

Differentiate control of eyelid elevation vs winking.

Answer 39

Eyelid elevation - CN III Winking - Orbicularis oculi: CN VII

Question 40

Describe pathology of Facial palsy Of CN VII. What type of receptor is inactive?

Answer 40

- Damage to CN VII - Cannot close eyelids - Dry eyes - Bell’s phenomenon - Nicotinic receptors affected

Question 41

Describe the affects of organophophorous poisoning and treatment

Answer 41

- Cholinergic Crisis ``` Salivation Lacrimation Urination Defecation/Diaphorisis Gastric Secretion Emesis ``` Treated with Atropine

Question 42

What is anisocoria?

Answer 42

Pupillary inequality

Question 43

What is the mechanism of action of cocaine?

Answer 43

Blocks NE reuptake

Question 44

What are the two chemical mechanisms for pupil dilation?

Answer 44

Activation of adrenergic receptors Blockage of muscarinic receptors

Question 45

What is meiosis/myosis?

Answer 45

Pupil constriction via parasympathetic influence

Question 46

Describe the pathology of Horner’s Syndrome

Answer 46

1. Anhydrosis 2. Myosis 3. Partial Ptosis 4. Enophthalmos - Interruption of the sympathetic pathway - Pancoast tumor

Question 47

What is the main upper eyelid retractor? What innervates it?

Answer 47

Levator Palpebrae superioris Somatic of CN III

Question 48

What is the action of: Botox Black widow venom Ampthetamine

Answer 48

Botox - Anticholinergic Venom - Cholinergic Amphetamine - adrenergic

Question 49

What is the pathology of Sjogren’s syndrome?

Answer 49

- Chronic inflammatory autoimmune - Deficiency of exocrine glands in mouth/eye - Cholinergic drugs may treat - Anticholunergic drugs will not (Atropine)

Question 50

Describe pathology of pheochromocytoma.

Answer 50

- Rare tumor of adrenal gland - Increases production of NE/EP by chromaffin cells - Chest pain. Hypertension, Headache, Racing heart, and diaphoresis *NE levels do not decrease after clonidine

Question 51

Describe pathology of autonomic dysreflexia.

Answer 51

- Spinal cord injury T6 to above - Lower sympathetic tone - hypotension due to dilation of splanchnic vessels - headaches f/ sever hypertension due to aberrant sympathetic activation - Profuse sweating and orthostatic hypotension

Question 52

What are the types of diabetic neuropathy and associated symptoms?

Answer 52

1. Sensory somatic nerves - Parasthesia and pain in extremities 2. Motor somatic nerve - CN II palsy 3. Visceral somatic - “silent MI” Fromm atherosclerosis. 4. Efferent autonomic fibers - Symp/Para with wide range of symptoms like tachycardia, hypertension, hyper hydros is, constiptation, xerophtalmos

Question 53

Describe pathology of Reflex sympathetic dystrophy.

Answer 53

- Chronic progressive disorder - Pain, swelling, discoloration, and sudomotor disturbances - Affects sympathetic nerves that innervates cutaneous vasculature and sweat glands