Autonomics

Question 1

Describe the components of the nervous system.

Answer 1

Central Nervous system
Peripheral Nervous system
Autonomic Nervous system (parasympathetic and sympathetic)

Question 2

Describe the differences in parasympathetic vs sympathetic.

Originate?

Answer 2

parasympathetic- (rest and digest) originate from brain and sacral cord. Brainstem cranial nerves III, VII, IX, X, S2 to S4 spinal segments

sympathetic (fight or flight) originate from thoracic cord. T1 to L2

Question 3

Describe parasympathetic vs sympathetic bodily functions.
(Sympathetics have dominance over parasym. effects)

eye
heart
lung
digestive tract
kidney
penis

Answer 3

parasympathetic - stimulates flow of saliva, slows heartbeat, constricts bronchi, stimulates peristalsis and secretion, stimulates release of bile, contracts bladder

sympathetic- dilates pupil, inhibits flow of saliva, accelerates heartbeat, dilates bronchi, inhibits peristalsis and secretion, conversion of glycogen to glucose, secretion of adrenaline and noradrenaline, inhibits bladder contraction, increases renin secretion, promotes ejaculation

“point and shoot”

Question 4

Describe the sympathetic division, preganglionic/postganglionic

Answer 4

Location of preganglionic neurons: T1-L2
preganglionic fibers are short and myelinated
postganglionic fibers and long and unmyelinated
“short arms, long fingers” SYMPATHETIC

preganglionic fibers may synapse with one or more neurons in the sympathetic trunk directly across from them
they can directly stimulate the release of epi and norepi from the adrenal medulla

responsible for vasomotor (sympathetic tone)

Question 5

Describe parasympathetic division.

Location of preganglionic neurons

Answer 5

location of preganglionic neurons - brain stem and S2, S3 and S4
preganglionic fibers travel through CN III, VII, IX, X and spinal nerves S2-S4 and synapse with peripheral ganglia located very near or directly on the effector organ… not on chain.

Long arms, short fingers… PARASYMPATHETIC
preganglionic fibers are long and myelinated
postganglionic fibers and short and unmyelinated

Question 6

Sympathetic and parasympathetic pre/post ganglionic release what?

Answer 6

sympathetic
from lateral horn of spinal cord, preganglionic (cholinergic) releases Ach. Postganglionic (adrenergic) releases NE

parasympathetic
preganglionic cholinergic releases Ach. Postganglionic Cholinergic rel. Ach…

Question 7

Ach is present at both pre and post ganglionic in parasympathetic or sympathetic?

Answer 7

Parasympathetic.

Question 8

Which are the parasympathetic autonomic nerves?

Answer 8

3, 7, 9, 10 (GVE)

Question 9

Key sympathetic stuff?

Answer 9

dilator pupillae, tarsal muscle of eyelid, sweating of face

Question 10

What syndrome is characterized by miosis, ptosis, and anhydrosis and describe the etiology.

Answer 10

anhidrosis- lack of sweating. due to loss of sympathetic stimulation of the sweat glands. redness/warm skin
redness is due to loss of sympathetic vasoconstriction of blood vessels which allows increased blood flow.

ptosis- drooping eyelid, caused by loss of sympathetic stimulation of the superior tarsal muscle, a small band of smooth muscle which helps levator palebrae superioris elevate the eyelid

miosis- right pupil smaller than left … dilator pupillae muscle is innervated by sympathetic fibers that enter the orbit via the nasociliary, long ciliary and sometimes short ciliary nerves. when this innervation is interrupted the pupillae constrictor muscle which is innervated by parasympathetic nerves has no antagonist to balance its action and it constricts the pupil

HORNER’S SYNDROME

Question 11

Ptosis 30 percent closure?

Ptosis full closure?

Answer 11

30 percent- results from loss of sympathetic stimulation

full- loss of oculomotor nerve (CNIII) to levator palpebrae superioris.

Question 12

What could cause Horner’s syndrome?

Answer 12

tumor of apex of lung which would put pressure on the inferior cervical sympathetic ganglion (Pancoast tumor)

Question 13

What can Pancoast’s tumor cause?

When should it be suspected in patients?

Answer 13

Horner’s syndrome bc the tumor of apex of lung can put pressure on inferior cervical sympathetic ganglion

should be suspected in patients suffering from shoulder and upper extremity pain who have a history of smoking

Question 14

Where is the superior cervical ganglion?

Answer 14

In the neck/sympathetic chain.

right next to Vagus, between carotid and internal jugular.

Question 15

What is IML?

What area has no IML? What are the implications of this?

Answer 15

Intermedial lateral cell column.
dorsal horn, lateral horn (presynaptic sympathetic nerve cell bodies), ventral horn
(sympathetic chain/sympathetic trunk)

no lateral horn (no IML) in cervical cord so sympathetic preganglionics travel up from the thoracic cord to synapse in the superior, middle, and inferior cervical chain ganglia

Question 16

Preganglionic neurons of the sympathetic division are located where?

Ganglionic neurons?

Postganglionic neurons?

Answer 16

T1-L2 in lateral horns of the gray matter of the spinal cord.

Preganglionic neurons send fibers out the ventral root. They leave the spinal nerves through the white rami (myelin) and enter the sympathetic trunk.

Ganglionic neurons are located within the sympathetic chain ganglia or in collateral ganglia outside of the sympathetic trunk.

Postganglionic fibers leave the sympathetic trunk through the gray rami and pass through the spinal nerve again before terminating on the effector organ.

Question 17

What is exception to preganglionic/sympathetic division?

Answer 17

Exceptions—splanchnics (greater, lesser, and least) are long SNS preganglionics that synapse on ganglia on or near the aorta and are near their target organs.

Question 18

Which cranial nerves have parasympathetic function and which ganglion do they use?

Answer 18

III, VII, IX, X

CPOS (ciliary, pterygopalatine, otic, submandibular)

Question 19

What do pelvic splanchnics do? Where do they come from? Are they para or sympathetic?

What do sacral splanchnics do? Are they para or sympathetic?

Answer 19

pelvic(parasympathetic) splanchnics (from nuclei in the sacral cord) help you pee, poop, and point.

sacral (sympathetic) splanchnics help you stop pee, stop poop, and shoot.

Question 20

Describe the Ciliary ganglion.
Location:
Parasympathetic fibers:
Chief distributions:

Answer 20

Location: lateral to optic nerve
Parasympathetic fibers: III (oculomotor nerve and its inferior division)
Chief distributions: ciliary muscle and sphincter pupillae (parasym.) dilator pupillae and tarsal muscles (sym.)

Question 21

Describe the Pterygopalatine ganglion.
Location:
Parasympathetic fibers:
Chief distributions:

Answer 21

Location: in pterygopalatine fossa
Parasympathetic fibers: facial nerve, greater petrosal nerve, and nerve of pterygoid canal
Chief distributions: lacrimal gland and glands in palate and nose

Question 22

Describe the Submandibular ganglion.
Location:
Parasympathetic fibers:
Chief distributions:

Answer 22

Location: on hyoglossus
Parasympathetic fibers: facial nerve, chorda tympani, and lingual nerve
Chief distributions: submandibular and sublingual glands

Question 23

Describe the Otic ganglion.
Location:
Parasympathetic fibers:
Chief distributions:

Answer 23

Location: below foramen ovale
Parasympathetic fibers: glossopharyngeal nerve, its tympanic branch, and lesser petrosal nerve
Chief distributions: partoid gland

Question 24

Which ganglion do III, VII, IX, X use?

Answer 24

III- ciliary
VII- pterygopalatine and submandibular
IX- otic
X- ganglia located in or near wall of heart and gut/ located near the target

Question 25

Which nerve is the “taxi” for parasympathetics of 7 and 9? Describe the “taxi” functions of 7 and 9.

Answer 25

7 hitches a ride on the lingual branch of 5 to get to the submandibular ganglion and drive the sublingual and submandibular glands. It also synapses in the pterygopalantine ganglion and uses branches of 5 (zygomatic- V2) to cause tearing of the lacrimal gland and dripping of the nasal mucosa.

9 uses the auriculotemporal branch of 5 to get to the otic ganglion and the parotid gland.

Question 26

Describe how one comes to “cry and snot”

Answer 26

preganglionics parasympathetics of 7 (greater petrosal nerve) run with the postganglionic sympathetics to become the nerve of the pterygoid canal (Vidian nerve).

Parasympathetics from 7 then synapse in the pterygopalantine ganglion and the postganglionics of 7 then take branches of 5 to the lacrimal and nasal glands to make you cry and snot. The sympathetics do not synapse in the pterygopalantine ganglion while travelling to the lacrimal gland to oppose its function.

Question 27

What do sympathetics do to the eye?

Answer 27

dilate the pupil , flatten the lens, and open the eyes wide (tarsal muscle of muller)

Question 28

Describe the GVE Function of VII.

Answer 28

The chorda tympani hitches a ride on the lingual branch of 5 to supply taste to the anterior 2/3 rds of the tongue and to drive the submandibular and sublingual glands.

greater petrosal nerve - pterygopalatine ganglion - lacrimal gland

chorda tympani - submandibular ganglion - submandibular, sublingual salivary glands

Question 29

Describe the GVE function of IX.

Answer 29

Glossopharyngeal nerve to lesser petrosal nerve to otic ganglion to auriculotemporal nerve (5) to parotid–GLOAP