ANS & NGB Flashcards

(47 cards)

1
Q

at what vertebral levels are preganglionic sympathetic cell bodies to the head and neck

A

T1-T3

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2
Q

from what structure does sympathetic innervation for the baroreceptor reflex arise

A

rostral venterolateral medulla

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3
Q

what is the major distribution center for the sympathetics of the head

A

superior cervical ganglion

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4
Q

are nerve fibers in the grey rami communicantes pre- or postganglionic
are they sympathetic or parasympathetic

A

postganglionic

sympathetic

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5
Q

in what CNs do preganglionic parasympathetic axons travel

A

3, 7, 9, 10

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6
Q

what and where are the four autonomic ganglia in the head

A

edinger-westphal (midbrain)
superior salivatory nucleus (pons)
inferior salivatory nucleus (medulla)
dorsal nucleus of vagus (medulla)

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7
Q

what is the route of parasympathetic input to the eye

A

edinger-westphal => CN III => *ciliary ganglion => accomodation (ciliary m.) + miosis (pupillary sphincter m.)

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8
Q

what nerve do parasympathetics from the superior salivatory nucleus travel in

A

CN VII

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9
Q

what is the route of parasympathetic input to the lacrimal gland

A

superior salivatory nuc. => CN VII => spheno/pterygopalatine ganglion => lacrimal gland

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10
Q

what is the route of parasympathetics to the submandibular and sublingual salivary glands

A

superior salivatory nuc => CN VII => submandibular ganglion => submandibular and sublingual salivary glands

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11
Q

what is the route of parasympathetics to the parotid salivary gland

A

inferior salivatory ganglion => CN IX => otic ganglion => parotid

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12
Q

what type of tumor can cause horner’s syndrome

A

Pancoast tumor - at the apex of the lung

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13
Q

focal lesions in what areas can cause horner’s syndrome

A

lateral brainstem/upper c-spine

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14
Q

horner’s syndrome can be caused by a neoplasm in what two locations

A
  • apex of the lung

- cavernous sinus

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15
Q

what artery dissection can cause horner’s syndrone

A

internal carotid

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16
Q

in the case of a pancoast tumor, where is the sympathetic pathway being impinged?

A

at the sympathetic chain

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17
Q

in the case of a tumor of the cavernous sinus or internal carotid dissection, where is the sympathetic pathway being impinged?

A

superior cervical ganglion or post-ganglionic sympathetic fiber

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18
Q

if a pt has horner’s syndrome secondary to a neoplasm of the cavernous sinus, will they have facial anhidrosis

A

only above the eyebrow

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19
Q

where are mechanoreceptors responsible for the baroreceptor reflex located and what innervates them

A

carotid sinus, CN IX

aortic arch, CN X

20
Q

where is the signal sent from baroreceptors in the event of HTN

A

nucleus solitarius (in the medulla) => nucleus ambiguus

21
Q

what does the nucleus ambiguus do in response to activation by the nucleus solitarius

A
  • inhibits SA node via CN X => bradycardia

- inhibits isympathetic vasomotor activity in the rostral ventrolateral medulla => vasodilation

22
Q

what is the main consequence of lesion to an afferent baroreceptor structure

A

fluctuating HTN

23
Q

what is the main consequence of lesion to an efferent baroreceptor structure

A

orthostatic hypotension

24
Q

what are the sxs of orthostatic hypotension

A

light-headed
blurred vision
neck/shoulder pain after sitting upright
syncope

25
how would a lesion to the rostral venterolateral medulla affect BP
fluctuating HTN
26
through what structure do sympathetics to the bladder travel
sacral splanchnic/hypogastric n
27
what does sympathetic input to the bladder do
- relax detrusor m. | - contract internal urethral sphincter
28
through what structure do parasympathetics to the bladder travel
pelvic splanchnic n
29
what does parasympathetic input to the bladder do
- contract detrusor m | - relax internal urethral sphincter
30
what is the route of information from the bladder saying that it's full
PAG (midbrain) => pontine micturition center = > excitatory signal to sacral parasympathetic nucleus, inhibitory to onuf nucleus
31
what is the center for voluntary control of micturition
medial frontal cortex
32
how does the medial frontal cortex inhibit micturition
inhibits pontine micturition center
33
what are the three types of NGB
- uninhibited - spastic - flaccid
34
a lesion where causes uninhibited NGB
medial frontal cortex
35
what sxs are associated w/ uninhibited NGB
urinary urgency and incontinence
36
a lesion where causes spastic NGB
midline/bilateral of lower brainstem/T-spine above conus medullaris
37
what kind of NGB is caused by MS
spastic
38
what is spastic NGB
detrusor muscle and external urethral sphincter are dyssynergic => bladder hypertrophy
39
bladder wall hypertrophy in spastic NGB causes what symptom
low bladder capacity
40
what are the sxs of spastic NGB
urinary frequency | urinary incontinence
41
what conditions are associated with flaccid bladder
diabetes extruded disc neoplasm of the SC
42
in which type of NGB is bladder capacity INCREASED
flaccid
43
does a pt with flaccid NGB have a micturition reflex
no
44
what are the sxs of flaccid bladder
overflow incontinence | urinary retention
45
in which type of NGB is anal reflex affected?
flaccid
46
in which type of NGB is intravesical pressure normal
uninhibited
47
in which type of NGB would you expect in a pt with lesion to the cauda equina
flaccid