Localization of ANS and Hypothalamic Disorders

Question 1

lesion of anterior hypothalamus

Answer 1

hyperthermia, insomnia, diabetes insipidus (hypernatremia), emaciation

Question 2

lesion of lateral hypothalamus

Answer 2

• “drinking center”

- adipsia (reduced intake of water), emaciation, apathy

Question 3

lesion of medial hypothalamus

Answer 3

hyperdipsia (intense thirst), diabetes insipidus (hypernatremia), SIADH (hyponatremia), obesity, rage, amnesia, ipsilateral Horner’s

Question 4

lesion of posterior hypothalamus

Answer 4

hypothermia, poikilothermia, hypersomnia, coma, narcolepsy, apathy, ipsilateral Horner’s

Question 5

function of medial hypothalamus

Answer 5

• regulates feeding behavior

- lesion causes obesity

Question 6

craniopharyngiomas frequently affect what region of hypothalamus?

Answer 6

medial hypothalamus

Question 7

craniopharyngioma: what is it, who is it found in primarily, symptoms?

Answer 7

• tumor within hypothalamus
• children
• bitemporal hemianopsia, endocrine disturbances (compression of pituitary stalk/gland) such as hot flashes and unexplained fevers

Question 8

Prader-Willi syndrome

Answer 8

• chromosomal deletion inherited through the father
• medial hypothalamus is affected
• hyperphagia with eventual obesity, narcolepsy, short stature

Question 9

descending hypothalamic fibers

Answer 9

sympathetic neurons that descend in the brainstem and is in close proximity to the spinothalamic tract for most of its course

Question 10

descending hypothalamic fibers synapse where and what are the steps that follow?

Answer 10

• synapse onto intermediolateral cell column (IML) in thoracic cord, which house preganglionic cells
• preganglionic neurons exits cord, enters sympathetic chain, and synapses onto superior cervical ganglion, inferior cervical ganglion, or celiac ganglion
• postganglionic neuron housed in these ganglia sends its axon to the target

Question 11

Klumpke’s palsy

Answer 11

• injury to lower trunk of brachial plexus
• disrupts ipsilateral sympathetic output
• ipsilateral Horner’s
• ipsilateral finger paralysis

Question 12

Pancoast syndrome

Answer 12

• tumor on apex of lung infiltrating superior cervical ganglion or lower brachial plexus
• disrupts ipsilateral sympathetic output
• ipsilateral Horner’s

Question 13

dissection of internal carotid artery (ICA)

Answer 13

• decreases sympathetic output

- can cause MCA stroke

Question 14

to maintain continence, inhibit _______ and activate ______

Answer 14

inhibit parasympathetic, activate sympathetic

Question 15

to void, inhibit _______ and activate ______

Answer 15

inhibit sympathetic, activate parasympathetic

Question 16

hyperactive “spastic” bladder

Answer 16

• lesion of sympathetics

- treat with anti-cholinergics

Question 17

hypoactive “flaccid” bladder

Answer 17

• incomplete emptying
• lesion of parasympathetics
• treat with anti-adrenergics or self-catheterization

Question 18

right ICA dissection symptoms

Answer 18

• R Horner’s
• L sided face and arm numbness to pin-prick, proprioception
• L hand apraxia (inability to execute learned movements)
• L side neglect