Autonomic Dysfunctions

Question 1

Between what levels of the spinal cord does the sympathetic chain exist?

Answer 1

T1-L2

Question 2

Ejaculation is controlled by which division of the autonomic NS?

Answer 2

Sympathetic

Question 3

Where does the autonomic NS originate within the spinal cord?

Answer 3

Lateral horn

Question 4

What is neurogenic bladder?

Answer 4

This occurs when there is damage to the LMN at S2-S4 that prevents urination. The bladder fills and cannot be released. This is a medical emergency.

Question 5

What nerve is responsible for sympathetic control fo the bladder?

Answer 5

Hypogastric nerve (T10-L2)

Question 6

What nerve is responsible for voluntary control of the bladder via the external urethral sphincter?

Answer 6

Pudendal Nerve (S2-S4)

Question 7

What nerve is responsible for sympathetic input to the GI tract?

Answer 7

Inferior hypogastric plexus (T10-L2)

Question 8

Between what sacral levels do parasympathetic fibers exit?

Answer 8

S2-S4

Question 9

The pudendal nerve (S2-S4) plays what role in defecation?

Answer 9

Voluntary control of defecation via contraction of the external anal sphincter and levator ani

Question 10

What occurs following sympathetic stimulation of the bladder?

Answer 10

Relaxation of the detrusor muscle, contraction of the internal urethral sphincter (urinary incontinence)

Question 11

What symptoms are associated with cauda equina syndrome?

Answer 11

Incontinence, sexual dysfunction, saddle anesthesia

Question 12

What CNs have parasympathetic function?

Answer 12

CN 3, 7, 9, 10

Question 13

This disorder is characterized by a lack of sympathetic input to organs.

Answer 13

Horner’s Syndrome

Question 14

At what spinal levels is the ejaculatory center located?

Answer 14

T12-L2

Question 15

True/False. Patients with damage of somatic nerves to the GI tract will not be able to defecate.

Answer 15

False. This patients are still able to defecate as parasympathetic input is intact, but will have difficulty as the levator ani and abdominal muscles cannot be contracted to increase abdominal pressure and support defecation

Question 16

What is the function of the pudendal nerve (S2-S4) in sexual function?

Answer 16

Voluntary control of erectile muscles and assist with initiation of ejaculation

Question 17

True/False. Erections and sexual intercourse are possible, even with damage to the spinal damage.

Answer 17

True, so long as the parasympathetics remain intact. This is referred to the reflexogenic erection and is initiated by afferent signals without cortical involvement

Question 18

True/False. Damage to the UMN of S2-S4 will cause neurogenic bladder.

Answer 18

False. This will cause incontinence as the urination sensory reflex remains intact.

Question 19

Where is the micturition center located?

Answer 19

Pons

Question 20

What nerves play a role in supporting an erection?

Answer 20

Parasympathetics - Inferior hypogastric plexus (S2-S4)

Question 21

What symptoms are associated with Horner’s Syndrome?

Answer 21

Ptosis, miosis (pupil constriction), redness, ipsilateral anhidrosis (no sweating), ipsilateral iris color change

Question 22

What muscles are stimulated by parasympathetic input to the bladder?

Answer 22

The detrusor muscle is contracted and the internal urethral sphincter relaxed to induce urination