Chapter 3: Autonomic Nervous System

Question 1

A ________ originating in the ANS is transmitted to a ________ of secondary nerve cells for __________.

Answer 1

stimulus, ganglion, processing

p. 55

Question 2

The nerves of the ganglion relay the stimulus to their _____ ____, each of which terminates as a disc called a ______ that covers the receptors of a _______ cell or ________ ______ cell.

Answer 2

nerve ends
bouton
cardiac, arterial muscle
(p. 55)

Question 3

The terminal ends (boutons) of sympathetic nerves secrete ______________ which activates __________ receptors.

Answer 3

norepinephrine
adrenergic
(p. 56)

Question 4

In the heart, the sympathetic and parasympathetic nervous systems have opposite functions. Interestingly, the _______________ exercises some ______ _______ of the sympathetic.

Answer 4

parasympathetic
direct control
(p. 56)

Question 5

The terminal parasympathetic nerve ends (boutons) secrete the neurotransmitter _____________, which ___________ activates ___________ receptors.

Answer 5

acetylcholine, exclusively, cholinergic

p. 56

Question 6

The effects of Beta1 activation include:

1. ) ___________ the __ node to ____ faster
2. ) ________ __ node conduction and accelerating conduction through the atrial and ventricular __________
3. ) Increasing the _____ __ __________ ___________
4. ) Increasing the ____________ of ______ and __________ ____________ ____ and minimally affects ventricular ____.

Answer 6

stimulating, SA, pace

improving AV, myocardium

force of myocardial contraction

irritability, atrial, junctional automaticity foci, foci
(p. 57)

Question 7

Epinephrine is secreted into the blood by the _______ _______, and is an ____ ____ ______ stimulator of the heart’s B1 receptors.

Answer 7

adrenal glands, even more potent

p. 57

Question 8

There are ___ vagus nerves, ____ and _____. Each vagus nerve supplies the _____ and __ _____.

Answer 8

two, left and right
heart and g.i. tract
(p. 58)

Question 9

Parasympathetic nerves release ______________, which actives cardiac ___________ receptors (most of which are in the _____) to produce a cardiac __________ effect.

Answer 9

acetylcholine
cholinergic
atria
inhibitory
(p. 58)

Question 10

Converse to the heart, the gastrointestinal tract is __________ by its parasympathetic innervation.

Answer 10

stimulated

p. 58

Question 11

The cardiac inhibitory effects of acetylcholine are:

1. ) inhibition of the __ ____, decreasing the heart ____.
2. ) decrease in the speed of __________ ___________, and depression of the __ ____.
3. ) diminishing of the _____ of __________ ___________
4. ) depression of ____________ of ____________ ____, mainly those in the _____ and __ junction.

Answer 11

1. ) SA node, rate
2. ) myocardial conduction, AV node
3. ) force of myocardial contraction
4. ) irritability of automaticity foci, atria, AV

(p. 58)

Question 12

What is the body’s main parasympathetic pathway?

Therefore the phrase “parasympathetic stimulation of the heart” is synonymous with…

Answer 12

the vagus nerves

vagal stimulation, which is inhibitory
p. 58

Question 13

Excessive parasympathetic stimulation of the GI tract causes symptoms such as…

Answer 13

…severe vomiting, painful/crampy diarrhea

p. 58

Question 14

Sympathetic stimulation of arterial alpha1 receptors __________ ________ throughout the body.

Answer 14

constricts arteries 
(p. 59)

Question 15

The alpha1 receptors are more responsive to ______________ than to circulating ___________.

Answer 15

norepinephrine
epinephrine
(p. 59)

Question 16

Parasympathetic activation of arterial cholinergic receptors _______ the same arteries, reducing _____ ________.
Besides this direct cholinergic activity, there is also an ________ __________ parasympathetic effect on the ___________ _______ that send nerve fibers to the vessels.

Answer 16

dilates, blood pressure

indirect inhibitory, sympathetic ganglia
p. 59

Question 17

Severe pain or seeing one’s own blood can induce a ______ _______________ response. This sudden bradycardia and hypotension causes _______. This phenomenon is also known as
________ _______.

Answer 17

reflex parasympathetic, syncope
merciful syncope
(p. 60)

Question 18

GI stimulation (e. g., ___ ______), or _______ _____ _______ may be employed to produce a parasympathetic response.

Answer 18

gag reflex, carotid sinus massage

p. 61

Question 19

These vagal maneuvers can inhibit an _________ _____ (atrial or __ junction), and may be able to convert ___ to sinus rhythm.

Answer 19

irritable focus, AV
SVT
(p. 61)

Question 20

Vagal maneuvers can also be used as a diagnostic aid when assessing a patient with ___ __ block, or ______ _______, bc these maneuvers inhibit the AV node which _________ ______________.

Answer 20

2:1 AV block
atrial flutter
increases refractoriness
(p. 61)

Question 21

What is the sympathetic response to standing?

Answer 21

SA Node stimulation
increased rate of sinus pacing
compensatory vasoconstriction
(p. 62)

Question 22

What condition is caused by failure of the body’s compensatory mechanisms upon standing?

Answer 22

orthostatic hypotension
(p. 62)

Question 23

_____-___________ syncope, a ___________ parasympathetic response to prolonged standing, causes ____________ and slowing of the _____, resulting in a loss of _____________.

Answer 23

Neuro-cardiogenic, paradoxical, vasodilation
pulse
consciousness
(p. 63)

Question 24

Neuro-cardiogenic syncope can be explained another way: in some _______ patients, prolonged standing increases the rate of sinus pacing, but ________________ fails. The transient tachycardia coupled with poor cardiac volume stimulates left ventricular _______ receptors, (aka ________________).
This elicits an undesirable parasympathetic reflex that _____ __ ____ pacing, and reduces _____ ________, reducing blood flow to the _____.

Answer 24

elderly, vasoconstriction
stretch, mechanoreceptors
slows SA Node pacing, blood pressure, brain
(p. 63)

Question 25

Under controlled circumstances, what test confirms the diagnosis of neuro-cardiogenic syncope?

Answer 25

a Head Up Tilt (HUT) test

p. 63

Question 26

What are the 5 key areas of EKG interpretation?

Answer 26

Rate
Rhythm
Axis
Hypertrophy
Infarction
(p. 64)