Localization of ANS & Hypothalamic Disorders

Question 1

anterior hypothalamus

Answer 1

“parasympathetic area” hyperthermia, insomnia, diabetes insipidus, emaciation

Question 2

lateral hypothalamus

Answer 2

“drinking center” adipsia, emaciation, apathy

Question 3

medial hypothalamus

Answer 3

hyperdipsia, diabetes insipidus, SIADH, obesity, rage, amnesia, ipsi Horners

Question 4

posterior

Answer 4

“sympathetic area” hypothermia, poikilothermia, hypersomnia, coma, narcolepsy, apathy, ipsi Horner

Question 5

suprachiasmatic nucleus (anterior)

Answer 5

circadian rhythm, lesion = insomnia

Question 6

anterior nucleus (anterior)

Answer 6

dissipates heat, lesion = hyperthermia (fever due to IL-1, PGE2)

Question 7

medial hypothalamus

Answer 7

regulates feeding behavior (stops overeating), lesion = overeating, obesity (prader-willi, craniopharyngioma)

Question 8

ANS, DHF

Answer 8

DHF from paraventricular nucleus, travel laterally in brainstem (STT alongside), synapse at T1/T2, enter paravertebral symp chain ganglia, travel to pupillary dilator m on interior carotid

Question 9

where does preganglionic sympathetic cell arise from?

Answer 9

interomediolateral cell column

Question 10

spinal cord lesion in thoracic cord causes?

Answer 10

spastic bladder

Question 11

pancoast tumor

Answer 11

tumor onto sympathetic chain, Klumpke’s

Question 12

cavernous sinus issues

Answer 12

CN III, IV, V1, V2, VI. thrombus. rupture of ICA. pituitary adenoma

Question 13

where could lesion causing horners be?

Answer 13

DHF, superior cervical ganglion, along carotid. pain could mean dissection.

Question 14

carotid dissection

Answer 14

expansion of artery stretches sympathetics

Question 15

eye with light shining on it dilates =?

Answer 15

afferent pupillary defect

Question 16

eye failure to constrict

Answer 16

efferent (CNII)

Question 17

sympathetics bladder control

Answer 17

detrussor relaxed, IUS contracted

Question 18

parasympathetics

Answer 18

detrussor contracts, IUS relaxed

Question 19

urinary continence

Answer 19

psp inhibited, symp stimulated

Question 20

urination

Answer 20

psp stimulated, symp inhibited

Question 21

incontinence due to hyperactive bladder or underactive sphincter

Answer 21

lesion of sympathetics. treat with anti-cholinergics

Question 22

incontinence due to overflow (hypoactive bladder, overactive bladder)

Answer 22

lesion of parasympathetics, treat with anti-adrenergics to relax sphincter, self-catheterization

Question 23

stx of hypothalamic tumor/craniopharyngioma

Answer 23

weight gain, can’t thermo-regulate, bitemporal hemianopia b/c pressing on optic chiasm