Chapter 4

Question 1

What is the Autonomic Nervous system divided into?

Answer 1

Parasympathetic

Sympathetic

Question 2

Afferent

Answer 2

Sensory

Question 3

Efferent

Answer 3

Motor

Question 4

What cranial nerves are associated with the PANS?

Answer 4

III Oculomotor Nerve
VII Facial nerve
IX Glossopharyngeal Nerve
X Vagus nerve
Sacral (S2-S4) segments of spinal cord

Question 5

Thoracic (T1) to lumbar (L2)

Adrenal medulla

Answer 5

SANS

Question 6

What are some of the muscles that the PANS affect

Answer 6

Smooth mucles
Cardiac muscles
Glands

Question 7

What are some of the muscles that the SANS affect?

Answer 7

Heart
Blood vessels
Skeletal muscles

Question 8

What is Cholinergic also called?

Answer 8

Parasympathomimetic agents

Question 9

These mimic the PANS

Answer 9

Cholinergic (Parasympathomimetic)

Question 10

Direct acting (cholinergic)

Answer 10

Acts like acetylcholine at receptor sites

Question 11

Indirect acting (cholinergic)

Answer 11

Causes increase in amount of acetylcholine indirectly

Inhibits AChE —> Breaks down ACh

Question 12

Cardiovascular effects from cholinergic direct effects

Answer 12

A decrease in cardiac output is associated with these agents, bradycardia, and decrease in BP

Question 13

GI effects (cholinergic)

Answer 13

Excite smooth muscles of the GI tract (Diarrhea)

Question 14

Adverse reactions of cholinergic agents

Answer 14

S= Salivation
L= Lacrimation
U= Urination
D= Defecation

Question 15

Contraindications of cholinergic agents

Answer 15

Bronchial asthma
Hyperthyrodism
GI or urinary tract obstruction
Severe cardiac disease
Peptic ulcer

Question 16

How is xerostomia treated?

Answer 16

With pilocarpine (Salagen) 
5 mg tablet tid

Question 17

What is Anticholinergic also called?

Answer 17

Parasympatholytic agents

Question 18

What does anticholinergic agents do ?

Answer 18

• They are cholinergic blocking agents
• Prevents ACh action at postganglionic parasympathetic nerve endings
• Block ACh action on smooth muscle, glandular tissue, and the heart

Question 19

Antimuscarnic agents

Answer 19

anticholinergic agents

Question 20

What happens if you increase drug penetration in CNS

Answer 20

You increase the chance of CNS side effects

Question 21

Anticholinergic effects on exocrine glands

Answer 21

Reduce the flow and volume of secretions

Question 22

Anticholinergic effects on smooth muscles

Answer 22

• Relax smooth muscle in respiratory tract
• Relax smooth muscle in GI tract
• Spasmolytic agents

Question 23

Anticholinergic effects on the eye

Answer 23

Mydriasis (dialation)

Cycloplegia (paralized cillary muscles)

Question 24

Anticholinergic effects on the cardiovascular

Answer 24

• Large doses produce vagal blockade > tachycardia

* Small doses, bradycardia predominates

Question 25

Anticholinergic adverse reactions

Answer 25

``` Xerostomia Blurred vision Photophobia Tachycardia Fever Urinary and gastrointestinal stasis Hyperpyrexia Signs of CNS excitation ```

Question 26

Contraindications of anticholinergic agents

Answer 26

``` Glaucoma Prostatic hypertrophy Intestinal obstruction Urinary obstruction or retention Cardiovascular disease ```

Question 27

Uses of anticholinergic agents

Answer 27

``` Postoperative medication Treatment of GI disorders Ophthalmologic examination Reduction of Parkinson like movements Motion sickness ```

Question 28

What are some considerations a Dental Hygenist must make when having a patient on anticholinergic agents?

Answer 28

Xerostomia Tachycardia Sedation

Question 29

Neurotransmitters

Answer 29

Communication between nerves or between nerves and effector tissue takes plase by the release of a chemical neurotransmitters across synaptic cleft

Question 30

Between preganglionic and postganglionic nerves

Answer 30

ACh Cholinergic Nicotinic

Question 31

Between postganglionic nerves and the effector tissues

Answer 31

PANS: ACh, cholinergic, muscarnic SANS: NE, adrenergic

Question 32

In the autonomic nervous system, the preganglionic neuron originates in the __________ and passes out to form the ganglia at the __________ with the postganglionic neuron. The postganglionic neuron originates in the __________ and innervates the __________.

Answer 32

central nervous system, ganglia, synapse, effector organ

Question 33

A drug that has the suffix __________ has the same action as an agonist.

Answer 33

-mimetic

Question 34

What is the principal neurotransmitter of the PANS?

Answer 34

Acetylcholine

Question 35

The action of the released acetylcholine is terminated by hydrolysis by what enzyme

Answer 35

Acetylcholinesterase

Question 36

The two components of the ANS, the sympathetic autonomic nervous system (SANS) and the parasympathetic autonomic nervous system (PANS) together control regulation of which bodily functions?

Answer 36

Regulation of blood pressure and heart rate and smooth muscles of the gut and bronchi

Question 37

A single preganglionic fiber often synapses with what?

Answer 37

numerous postganglionic neurons to produce a diffuse effect

Question 38

When the sympathetic autonomic nervous system is stimulated, the __________ releases epinephrine and norepinephrine, acting as a large sympathetic ganglion.

Answer 38

Adrenal Medulla

Question 39

What is the preganglionic neurotransmitter of the parasympathetic nervous system?

Answer 39

Acetylcholine

Question 40

What are the primary postsynaptic neurotransmitters for the sympathetic nervous system?

Answer 40

Norepinephrine/epinephrine

Question 41

Which naturally occurring cholinergic agents is given to stimulate saliva flow?

Answer 41

Pilocarpine