GA: Autonomics

Question 1

What is the neurotransmitter for all preganglionic neurons?

Answer 1

Ach

Question 2

What is the neurotransmitter for all post-ganglionic neurons?

Answer 2

NE

(except, the sympathetic ganglion neurons that innervate sweat glands –> Ach via mAChR)

Question 3

Where are sympathetic fibers for the head + neck found?

Answer 3

Intermediolateral cell column

Question 4

The baroreceptor reflex is found where?

Answer 4

Rostral ventrolateral medulla

Question 5

Where do the sympatheitcs for the head synapse in?

Answer 5

Superior Cervical Ganglion

Question 6

What are the parasympathetic GVEfferent CN’s?

Answer 6

3,7,9,10

Question 7

Endinger Westphal nucleus = in between 2 + 3

Superior salvatory nucleus =

Inferior salivatory nucleus =

Dorsal nucleus of vagus =

Answer 7

3 –> ciliary ganglion

7 –> sphenopalatine + mandibular glands

9 –> otic ganglion –> parotid glands

10 –> synapse at various viscera

Question 8

Which CN (2/3) is afferent/efferent.

Answer 8

2 = afferent

3 = efferent (has to be active for light to pass and pupil to constrict)

Question 9

What happens if you have a lesion in CN 2 Left eye?

Answer 9

If you shine light in the opposite eye (R), both pupils will constrict.

(if you shine light in L eye they wont constrict)

Question 10

What happens if you have a lesion in CN 3 left eye?

Answer 10

Since 3 allows for the constriction, the opposite eye will work, but the ips. eye will not constrict

Question 11

A central lesion in Horner’s Syndrome (of sympathetics) means that it happened @ the:

Answer 11

LATERAL brainstem/upper cervical spinal cord

Question 12

Horner syndrome

preganglionic lesions damage:

postganglionic lesions damage:

Answer 12

pre = sympathetic chain

post = superior cervical ganglion/cavernous sinus –>internal carotid artery dissection

central = blue

green = pre

post = red

Question 13

What does the baroreceptor reflex prevent?

Answer 13

Orthostatic hypertension –> prevents fluctuations of arterial pressure, for example: where you feel faint if you try to stand up too fast

Question 14

Where are baroreceptors located + what CN’s are associated w/ them?

Answer 14

Mechanoreceptors in:

Carotid sinus = CN 9 (Inc. + dec. of BP)

Aortic arch = CN 10 (only looks at increases in BP)

Question 15

When we have an increase in BP, where do the baroreceptors send excitatory signals to?

Answer 15

The nucleus soliatrius of the medulla

Question 16

What is the pathway for the increase in BP baroreceptor reflex?

Answer 16

Baroreceptors notice increase in BP –> Nucleus solitarius of medulla –> Nucleus ambiguous

Question 17

What are the 2 roles of the nucleus ambiguous?

Answer 17

1. Bradycardia (slows down heart)
2. Inhibits the rostal ventrolateral medulla (sym.) to lower BP

Question 18

What happens when we have a decrease in BP (like in standing up/hemmorrhage)?

Answer 18

More blood gets shunted to the brain to prevent syncope (passing out)

Question 19

How do we evaluate supraventricular tachycardia?

Answer 19

With a carotid massage (which stretches the baroreceptors) to see if the BP goes down

Question 20

What happens in baroreflex afferent failure?

Answer 20

Flucuating hypertension

Question 21

What happens in baroreflex efferent failure?

Answer 21

Orthostatic hypotension (drop of BP, like you’re gonna pass out)

Question 22

Multiple sclerosis is associated with which mictruition reflex?

Answer 22

Spastic

Question 23

Which micturition defect has lost the control of the anal reflex?

Answer 23

Flaccid

Question 24

How do you describe spastic micturition disorder?

Answer 24

Bladder Volume = decreased

Intravesicular pressure = Increased

Retention = none early and then problems later on

Question 25

How would you describe flacid bladder?

Answer 25

Overflow Incontinence + Urinary Retention

No anal reflex

Question 26

Spastic + uninhibited bladder both have?

Answer 26

Urinary frequency + urinary incontinence,

but spastic has the decreased bladder volume to separate it

An uninhibited bladder has no retention

Question 27

What is the cause of uninhibited bladder?

Answer 27

A lesion that affects the inhibitory connections of the medial frontal cortex unable to inhibit the pontine mictruition center

Question 28

What are the 3 types of neurogenic bladder (disturbances in micturition reflex)?

Answer 28

1. Uninhibited
2. Spastic
3. Flaccid

Question 29

What 2 things must occur in the medial region of the pontine micturition center in order for peeing to occur?

Answer 29

1. Excitatory signals are sent to activate the sacral parasympathetic nucleus
2. Inhibitory signals are sent to inhibit the Onuf nucleus (sym.)

Question 30

Bladder lesion locations

Question 31

What is the primary center for voluntary control of micturition?

Answer 31

Medial frontal cortex –> it inhibits the pontine micturition center