CHAPTER 18 Flashcards
1.Postganglionic sympathetic cholinergic fibers innervate the (A) sweat glands (B) lacrimal gland (C) ductus deferens (D) trigone of the urinary bladder (E) detrusor muscle
l-A. Postganglionic sympathetic cholinergic fibers innervate the eccrine (merocrine) sweat glands and some blood vessels; blood vessels, however, are predominantly innervated by post-
ganglionic sympathetic adrenergic fibers. Apocrine sweat glands of the axilla are innervated by adrenergic fibers; these glands secrete in response to mental stress.
2.Which of the following ganglia does not contain postganglionic parasympathetic neurons? (A) Otic (B) Celiac (C) Pterygopalatine (D) Submandibular (E) Ciliary
2-B. The celiac ganglion is a sympathetic prevertebral (collateral) ganglion that contains post-ganglionic neurons.
3.Destruction of the ciliary ganglion results in which of the following deficits? (A) Severe ptosis (B) Loss of corneal reflex (C) Loss of lacrimation (D) Loss of direct pupillary reflex (E) Miosis
3-D. Destruction of the ciliary ganglion interrupts postganglionic parasympathetic fibers, which innervate the sphincter muscle of the iris and the ciliary muscle; this results in loss of the direct pupillary reflex, mydriasis, and paralysis of accommodation. In addition, postganglionic sympa-thetic vasomotor fibers are interrupted, resulting in a hyperemic globe. Postganglionic sympa-
thetic pupillodilator fibers reach the iris via the nasociliary and long ciliary nerve. Severe ptosisresults from an oculomotor paralysis involving the fibers that innervate the levator palpebrae muscle. Mild ptosis results from a lesion of the oculosympathetic fibers, which innervate the smooth tarsal muscle (Horner syndrome).
4.Parasympathetic stimulation results in all of the following responses EXCEPT (A) contraction of the ductus deferens (B) secretion of the salivary glands (C) increased peristalsis (D) bronchial constriction (E) penile erection
4-A. Contraction of the smooth muscles of the ductus deferens and seminal vesicle (ejaculation) results from sympathetic stimulation.
5.All of the following statements concerning
gray communicating rami are correct EXCEPT
(A) they contain preganglionic sympathetic fibers
(B) they are found at all spinal cord levels
(C) they contain general visceral efferent (GVE) fibers
(D) they contain postganglionic sympathetic fibers
(E) they are gray because they contain no myelinated fibers
5-A. Gray communicating rami are associated with all spinal nerves; they contain only non-
myelinated postganglionic sympathetic fibers. All autonomic visceromotor fibers are GVE fibers
6.The viscera are insensitive to all of the fol- lowing stimuli EXCEPT (A) distention (B) cold (C) heat (D) cutting (E) touch
6-A. Visceral pain results from distention, strong contractions, mechanical stimulation of hy-peremic organs, and ischemia with release of kinins.
7.Sympathectomy of the superior cervical ganglion results in all of the following signs EXCEPT (A) vasodilation of the cutaneous vessels of the face (B) miosis (C) hemianhidrosis (D) exophthalmos (E) ptosis
7-D. Sympathectomy of the superior cervical ganglion interrupts sympathetic innervation to the head, resulting in Horner syndrome: mild ptosis (lid droop), miosis, facial hemianhidrosis, vasodilation, and an apparent enophthalmos due to ptosis.
8.Which of the following statements concern-ing preganglionic sympathetic fibers is FALSE?
(A) They arise from the intermediolateral cell column
(B) They project without synapse to the adrenal medulla
(C) Their terminals elaborate acetylcholine
(ACh)
(D) They are found in splanchnic nerves
(E) They synapse in the myenteric plexus
8-E. The myenteric plexus receives postganglionic sympathetic input from the prevertebral (collateral) ganglia. The adrenal medulla receives preganglionic sympathetic cholinergic fibers via the lesser splanchnic nerve.
9.All of the following statements concerning
the sacral division of the autonomic nervous
system (ANS) are correct EXCEPT
(A) it innervates the transverse colon
(B) it innervates the descending colon
(C) it innervates the detrusor muscle of the
urinary bladder
(D) it includes sacral segments S2, S3, and S4
(E) its postganglionic parasympathetic neu-
rons are found in, on, or near the walls of
the organs that they innervate
9-A. The sacral division (S2—S4) of the autonomic nervous system (ANS) innervates the lowerabdominal and pelvic viscera, including the colon distal to the left colic flexure, the urinary bladder (detrusor muscle), and the genital viscera. Postganglionic parasympathetic neurons are
found in or on the viscera that they innervate.
10.Sympathetic stimulation results in all of the following responses EXCEPT (A) dilation of the pupil (B) contraction of the bladder (C) dilation of the bronchial lumina (D) increased perspiration (E) ejaculation
10-B. Sympathetic stimulation results in dilation of the pupils (mydriasis), dilation of the lu-mina of the bronchi, increased perspiration (sudation), and constriction of the ductus deferens(resulting in ejaculation). Contraction of the detrusor muscle is a parasympathetic function.
11.All of the following statements concerning the vagal nerve are correct EXCEPT
(A) it supplies the transverse colon
(B) it supplies the esophagus
(C) it contains fibers from the carotid sinus
(D) it contains general visceral efferent (GVE) fibers from the nucleus ambiguus
(E) it contains fibers from the carotid body
11-C. The vagal nerve (CN X) contains preganglionic fibers from the nucleus ambiguus that terminate in the cardiac ganglia. It innervates the esophagus, thoracic viscera, and abdominal vis-
cera, excluding the descending colon, sigmoid colon, and rectum, which are innervated by the pelvic nerve (S2-S4). The carotid sinus (baroreceptor) is innervated by the glossopharyngeal nerve (CN IX; sinus nerve). The carotid body (chemoreceptor) is innervated by the glossopharyngeal and vagal nerves.
- All of the following statements concerning preganglionic parasympathetic fibers are correct EXCEPT
(A) they are found in the pelvic nerves
(B) they arise from the Edinger-Westphal nucleus
(C) they arise from the nuclei of CN III, VII,
IX, and X
(D) they traverse the white communicating
rami
(E) they project to the otic ganglion
12-D. Preganglionic parasympathetic fibers arise from the Edinger-Westphal nucleus of CN III, superior salivatory nucleus of CN VII, inferior salivatory nucleus of CN IX, and dorsal motor nucleus and nucleus ambiguus of CN X. Preganglionic parasympathetic fibers from sacral segments (S2-S4) traverse the pelvic nerves; they do not traverse the white communicating rami. The otic ganglion
receives preganglionic parasympathetic input from the inferior salivatory nucleus of CN IX.
13.Horner syndrome may result from all of
the following lesions EXCEPT
(A) carcinoma of the lung apex
(B) tumorous involvement of the cervical
lymph nodes
(C) hemisection of the cervical spinal cord
(D) thrombosis of the posterior inferior cere-
bellar artery
(E) destruction of the ciliary ganglion
13-E. Horner syndrome is caused by all lesions that interrupt sympathetic input to the eye. A lesion of the ciliary ganglion results in denervation of the sphincter pupillae muscle of the iris and the ciliary muscle. Postganglionic sympathetic fibers that innervate the dilator pupillae muscle and the smooth tarsal muscle do not traverse the ciliary ganglion.
The response options for items 14-18 are the same. You will be required to select one answer for each item in the set.
(A) Hirschsprung disease
(B) Horner syndrome
(C) Peptic ulcer disease
(D) Riley-Day syndrome
(E) Raynaud disease
Match each of the characteristics below with the condition it best describes.
14.Results from increased parasympathetic
stimulation
14-C. Peptic ulcer disease results from increased parasympathetic tone.
The response options for items 14-18 are the same. You will be required to select one answer for each item in the set.
(A) Hirschsprung disease
(B) Horner syndrome
(C) Peptic ulcer disease
(D) Riley-Day syndrome
(E) Raynaud disease
Match each of the characteristics below with the condition it best describes.
15.Is a painful vasospastic disorder affecting the digits
15-E. Raynaud disease is a benign symmetric disease characterized by painful vasospasms affecting the digits.
