Autonomics of Head, Neck, Bladder Flashcards
What NT and receptor are found on all preganglionic neurons?
ACh
nAChR
What NT does sympathetic innervation of sweat glands and vessels
ACh
Where are the ganglia of sympathetic neurons found?
Paravertebral
Where are the ganglia of parasympathetic neurons found?
Close to target organs
What portion of the brainstem is responsible for the baroreceptor reflex?
Rostral ventrolateral medulla
What structure do preganglionic sympathetic fibers use to enter the sympathetic chain?
White rami communicantes
How to postganglionic sympathetic fibers leave the sympathetic trunk?
Grey rami communicantes (on top of arteries, i.s. periarterial plexus)
Where in the brainstem do parasympathetic outputs originate?
Preganglionic neurons in the GVE column of brainstem
Travel with 3, 7, 9, 10 CN
What CN’s are associated with Edinger Westphal?
What is the fxn of this ganglia?
CN 2, 3
Accomodation
What CN’s are associated with the Superior Salivatory Nucleus?
What is the fxn of this ganglia?
CN 7
Salivary gland
What CN is associated with the Inferior Salivatory Nucleus?
Fxn of this nucleus?
CN 9
Innervation to parotid gland
What CN is associated with the Dorsal nucleus of vagus?
Fxn of this nucleus?
CN 10
Output to vsiceral organs
Pathway of pupillary light reflex?
Afferents: CN 2 Synapse at: Edinger-Westphal nucleus Efferents: CN 3 Synapse at: Ciliary ganglion Result: Accommodation; sphincter papillary constrictor M.
Where will preganglionic fibers of CN VII synapse before going to the lacrimal gland?
Sphenopalatine ganglion
Where will preganglionic fibers of CN VII synapse before going to the submandibular and sublingual glands?
Submandibular ganglion
Where will preganglionic fibers of CN IX synapse before going to the parotid gland?
Otic ganglion
Where will preganglionic fibers of CN X synapse before going to viscera?
Scattered ganglia along the neck
Where are the three lesions that can cause Horners?
- Central Lesion = Lateral brainstem/ Upper CSC
- Preganglionic Lesion = Sympathetic chain
* Pancoast tumor at apex of the lung - Postganglionic Lesion = Superior Cervical Ganglion
* Cavernous Sinus, Artery dissections
What sx of Horner’s will be seen in patients with a Central Lesion?
Anhidrosis
Pupil dilation in response to NOR release
What sx. of Horner’s will be seen in patients with a pre-ganglionic Lesion?
Anhidrosis
Pupil dilation in response to NOR release
(same as a central lesion)
What sx. of Horner’s will be seen in patients with a post-ganglionic Lesion?
Normal sweating
Exaggerated pupil dilation with direct alpha-agonists
What do carotid sinus vs. aortic arch respond to in the baroreceptor reflex?
Carotid sinus = Increase + Decrease arterial pressure
Aortic arch = Increased arterial pressure only
Result of an increase in blood pressure?
- Increase in stretch of baroreceptor reflex
- Nucleus Solitarius of Medulla
- Nucleus Ambiguous
- Inhibition of rostral ventrolateral medulla (less sympathetic information)
- Decrease in BP
Result of decrease in blood pressure?
- Decreased stretch of baroreceptor reflex
- Baroreceptor afferents decrease
- Less inhibition of Rostral ventrolateral medulla (more sympathetic information)
- Increase in BP
- More blood shunted to brain to prevent syncope
What two things must occur in order for micturition to occur?
- Excite the Sacral Parasympathetic
2. Inhibit the Onuf nucleus
What symptoms can occur with a neurogenic bladder?
Urinary Incontinence
Urgency
Retention
Uninhibited Bladder
Medial frontal cortex is inhibit pontine micturition center
Urgency + Incontinence
Spastic Bladder
Seen in *MS
Lesion between POMC and Sacral Spinal cord
(Detrusor and sphincter are uncoordinated)
Frequency + Incontinence
*Increased intravesical pressure)
Flaccid Bladder
No micturition reflex; lesion to conus medullaris
Overflow Incontinence + Retention
