CHAPTER 14 - Book Review Questions Flashcards
The following statements concern the autonomic nervous system:
(a) An Argyll Robertson pupil indicates that the
accommodation reflex for near vision is normal
but that the light reflex is lost.
(b) White rami communicantes are limited to the
thoracic part of the sympathetic trunk.
(c) White rami communicantes contain postganglionic sympathetic fibers.
(d) The greater splanchnic nerves are formed of
nonmyelinated axons.
(e) The lesser splanchnic nerves arise from the
eighth and ninth ganglia of the thoracic part of
the sympathetic trunks.
A is correct.
- An Argyll Robertson pupil indicates that the accommodation reflex for near vision is normal but that the light reflex is lost. B. White rami communicantes are found in the thoracic and first and second lumbar parts of the sympathetic trunk. C. Gray rami communicantes contain postganglionic sympathetic fibers. D. The greater splanchnic nerves are formed of myelinated axons. E. The lesser splanchnic nerves arise from the 10th and 11th ganglia of the thoracic part of the sympathetic trunks.
The following general statements concern the autonomic nervous system (ANS):
(a) The hypothalamus has little control over the ANS.
(b) The cerebral cortex has no control over the ANS.
(c) A patient with Adie tonic pupil syndrome has an increased light reflex and a fast pupillary contraction to near vision and a fast dilatation in the dark.
(d) Pain arising in the gastrointestinal tract is referred to the midline.
(e) Visceral pain frequently is referred to skin areas that are innervated by different segments of the spinal cord as the painful viscus.
D is correct.
- Pain arising in the gastrointestinal tract is referred to the midline. A. The hypothalamus has great control over the ANS. B. The cerebral cortex can influence the ANS. C. A patient with Adie tonic pupil syndrome has a decreased or absent light reflex and a slow or delayed pupillary contraction to near vision and a slow or delayed dilatation in the dark. E. Visceral pain frequently is referred to skin areas that are innervated by the same segment of the spinal cord as the painful viscus.
The following statements concern Horner syndrome:
(a) The pupil is dilated.
(b) The upper eyelid is retracted.
(c) The patient has vasodilation of the facial skin
arterioles.
(d) The patient has excessive facial sweating.
(e) The patient has exophthalmos.
C is correct.
- In Horner syndrome, the patient has vasodilation of the facial skin arterioles. A. The pupil is constricted. B. Ptosis of the upper eyelid occurs. D. Facial sweating is absent. E. Enophthalmos occurs.
The sympathetic outflow:
(a) arises from nerve cells that are situated in the posterior gray column (horn) of the spinal cord.
(b) has preganglionic nerve fibers that leave the spinal cord in the posterior roots of the spinal nerves.
(c) is restricted to the T1-L2 segments of the spinal cord.
(d) receives descending fibers from supraspinal levels that pass down the spinal cord in the posterior white column.
(e) has many preganglionic nerve fibers that synapse in the posterior root ganglia of the spinal nerves.
C is correct.
- The sympathetic outflow is restricted to T1-L2 segments of the spinal cord (see Fig. 14-2).
Norepinephrine is secreted at the endings of the:
(a) preganglionic sympathetic fibers.
(b) preganglionic parasympathetic fibers.
(c) postganglionic parasympathetic fibers.
(d) postganglionlc sympathetic fibers.
(e) preganglionic fibers to the suprarenal medulla.
D is correct.
- Norepinephrine is secreted at the endings of most postganglionic sympathetic fibers.
The parasympathetic innervation controlling the parotid salivary gland arises from the:
(a) facial nerve.
(b) oculomotor nerve.
(c) vagus nerve.
(d) carotid plexus.
(e) glossopharyngeal nerve.
E is correct.
- The parasympathetic innervation controlling the parotid salivary gland is the glossopharyngeal nerve.
Which of the following statements best describes the parasympathetic part of the autonomic nervous system (ANS)?
(a) It is associated with the thoracolumbar part of
the spinal cord.
(b) Effects are local and discrete due to preganglionic neurons synapsing with few postganglionic
neurons.
(c) It has short preganglionic axons.
(d) It is active during an emotional crisis.
(e) Its activity mobilizes glucose from glycogen.
B is correct.
- The parasympathetic part of the ANS
produces effects that are local and discrete due to preganglionic neurons synapsing with few postganglionic neurons.
Anticholinesterase drugs act at synapses by:
(a) mimicking the action of acetylcholine at its
receptor sites.
(b) preventing the release of acetylcholine.
(c) increasing the secretion of acetylcholine.
(d) blocking the breakdown of acetylchollne.
(e) preventing the uptake of acetylcholine by the
nerve ending.
D is correct.
- Anticholinesterase drugs act at synapses by blocking the breakdown of acetylcholine.
Atropine has the following effect on the autonomic
nervous system:
(a) It is an anticholinesterase drug.
(b) It increases the activity of norepinephrine.
(c) It blocks the action of acetylcholine on effector
sites in the parasympathetic system.
(d) It blocks norepinephrine reuptake by presynaptic terminals in the sympathetic system.
(e) It blocks norepinephrine receptor sites.
C is correct.
- Atropine blocks the action of acetylcholine on the effector sites in the parasympathetic part of the autonomic system.
The parasympathetic outflow in the spinal cord occurs at levels:
(a) S1-S2
(b) S3-S5
(c) S1-S3
(d) S2-S4
(e) L1-L2
D is correct.
- The parasympathetic outflow in the spinal cord occurs at the level of S2-S4 (see Fig. 14-2).
The following statements concern autonomic innervation of the urinary bladder:
(a) The parasympathetic part brings about relaxation of the bladder wall muscle and contraction of the sphincter vesicae.
(b) The sympathetic part in the male causes relaxation of the sphincter vesicae and does not prevent reflux of semen into the bladder during ejaculation.
(c) The afferent fibers from the bladder reach the spinal cord at the first and second lumbar segments and the second, third, and fourth sacral segments.
(d) The sympathetic part causes contraction of the sphincter urethrae.
(e) The parasympathetic part innervates the blood vessels supplying the bladder wall.
C is correct.
- The afferent sensory fibers from the bladder reach the spinal cord at the first and second lumbar segments and the second, third, and
fourth sacral segments. A. The parasympathetic innervation of the bladder brings about contraction of the bladder wall muscle and relaxation of the sphincter vesicae. B. The sympathetic innervation of the bladder in the male causes contraction of the sphincter vesicae and prevents the reflux of semen into the bladder during ejaculation. D. The sphincter urethrae is not under the control of the autonomic nervous system; it is made to contract voluntarily by the internal pudendal nerve. E. The sympathetic nerves innervate the blood vessels supplying the bladder wall.
The following statements concern the autonomic innervation of the heart:
(a) The parasympathetic part causes dilation of
the coronary arteries.
(b) The postganglionic fibers do not terminate on
the sinoatrial and atrioventricular nodes.
(c) The sympathetic postganglionic fibers liberate
acetylcholine at their nerve endings.
(d) The sympathetic nerves cause cardiac acceleration and increased force of contraction of the heart.
(e) The neural control of dilatation of the coronary
arteries is more important than the chemical control exerted by the products of cardiac muscle metabolism.
D is correct.
- The sympathetic nerves supplying the heart cause cardiac acceleration and increased force of contraction of the cardiac muscle. A. The parasympathetic part of the autonomic system brings about constriction of the coronary arteries. B. The postganglionic autonomic nerves to the heart do terminate on the sinoatrial and atrioventricular nodes. C. The sympathetic postganglionic fibers supplying the heart liberate norepinephrine at their endings. E. The local metabolic needs of the cardiac muscle exert a greater control over the degree of dilation of the coronary arteries than the neural control of the arteries.
Match the numbered glands with the most appropriate lettered autonomic ganglion listed below. Each lettered option may be selected once, more than once, or not at all.
- Submandibular gland
- Lacrimal gland
- Nasal glands
- Parotid gland
- Sublingual gland
(a) Otic ganglion
(b) Submandibular ganglion
(c) Pterygopalatine ganglion
(d) Ciliary ganglion
(e) None of the above
B is correct. The submandibular salivary gland receives secretomotor parasympathetic nerves through the submandibular ganglion.
C is correct. The lacrimal gland receives secretomotor parasympathetic nerves through the pterygopalatine ganglion.
C is correct. The nasal glands receive secretomotor parasympathetic nerves through the pterygopalatine ganglion.
A is correct. The parotid salivary gland receives secretomotor parasympathetic nerves through the otic ganglion.
B is correct. The sublingual salivary gland receives secretomotor parasympathetic nerves through the submandibular salivary ganglion.
Match the numbered autonomic ganglia with the most appropriate lettered viscus or muscle listed below. Each lettered option may be selected once, more than once, or not at all.
- Superior cervical ganglion
- Ciliary ganglion
- Celiac ganglion
- Inferior mesenteric ganglion
- Superior mesenteric ganglion
(a) Levator palpebrae superioris (smooth muscle only)
(b) Vermiform appendix
(c) Constrictor pupillae
(d) Descending colon
(e) None of the above
A is correct. The levator palpebrae superioris (smooth muscle only) is innervated by sympathetic fibers from the superior cervical sympathetic ganglion.
C is correct. The constrictor pupillae is innervated by parasympathetic nerves from the ciliary ganglion.
E is correct. The celiac ganglion gives rise to nerves that supply the smooth muscle of the gut from the gastroesophageal junction down to the middle of the second part of the duodenum; it also supplies the liver, the pancreas, and the spleen.
D is correct. The descending colon receives sympathetic nerves from the inferior mesenteric ganglion.
B is correct. The vermiform appendix receives sympathetic nerves from the superior mesenteric
ganglion.
Match the numbered cranial nerves with the appropriate lettered nuclei listed below. Each lettered option may be selected once, more than once, or not at all.
- Facial nerve
- Oculomotor nerve
- Glossopharyngeal nerve
- Hypoglossal nerve
(a) Inferior salivatory nucleus
(b) Edinger-Westphal nucleus
(c) Lacrimatory nucleus
(d) None of the above
C is correct. Parasympathetic nerve fibers from the
lacrimatory nucleus travel in the facial nerve and
its branches to the pterygopalatine ganglion, synapse, and then pass to the lacrimal gland.
B is correct. Parasympathetic nerve fibers from the Edinger-Westphal nucleus travel in the oculomotor nerve to the ciliary ganglion, synapse, and then pass to the constrictor pupillae and the ciliary
muscle.
A is correct. Parasympathetic nerve fibers from
the inferior salivatory nucleus travel in the
glossopharyngeal nerve and its branches to the otic ganglion, synapse, and then pass to the parotid salivary gland.
D is correct. The hypoglossal nerve supplies the muscles of the tongue.
