Autonomic Nervous System 2

Question 1

What are the innervation of the parotid salivary gland?

Answer 1

Sympsthetic: viscous salivary secretion a1

Parasympathetic: watery salivary secretion M3

Question 2

What are the innervations of the sublingual and submandibular glands?

Answer 2

Sympathetic: viscous salivary secretion: a1

Parasympathetic: watery salivary secretion: M3

Question 3

What are the innervations of the lacrimal glands?

Answer 3

Sympathetic: not clear

Parasympathetic: secretion of tears M3

Question 4

What are the innervations of the sinoatrial node?

Answer 4

Heart rate

Sympathetic: B1-R
Parasympathetic: decreases M2

Question 5

What are the innervations of atrioventricular nerve?

Answer 5

Conduction velocity
Sympathetic: increases B1-R
Parasympathetic: decreases M2

Question 6

What is the innervation of ventricular muscle?

Answer 6

Symp: increases contractility B1-R

Question 7

What are the innervations of Bronchial smooth muscle?

Answer 7

Symp: bronchodilation B2-R
Parasympathetic: brinchoconstriction M3

Question 8

What are the innervations of bronchial glands ?

Answer 8

Symp: decrease secretion B2-R
Parasympathetic: increases secretion M3

Question 9

What are the innervations of smooth muscle in the walls of the GI tract?

Answer 9

Supymoathetic: relaxation a, B2

Parasympathetic: increased gut paralysis M3

Question 10

What are the innervations of the sphincters smooth muscle in the GI tracts?

Answer 10

Sympathetic: contraction a1

Parasympathetic: relaxation M

Question 11

What are the innervations of the glands of the GI tract?

Answer 11

Sympathetic: inhibition a1

Parasympathetic: stimulation M

Question 12

What are the innervations of the detrusor muscle?

Answer 12

Sympathetic: relaxation M3
Parasympathetic: contraction M3

Question 13

What are the innervations of the internal urethral sphincter?

Answer 13

Sympathetic: contraction a1

Parasympathetic: relaxation M

Question 14

What is the innervation of Juxtaglomerular cells?

Answer 14

Sympathetic: increased renin release B1

Question 15

What is the innervation of the chromaffin cell of the adrenal medulla?

Answer 15

Sympathetic: increased renin release Nicotinic neuronal receptors

Question 16

What are the symptoms of Horner syndrome ?

Answer 16

Ptosis (slight dropping of the eyelid)

Anhidrosis (absence of sweating)

Miosis (pupil construction )

Question 17

What are the causes of the Horner syndrome?

Answer 17

Sympathetic enervation of the face

1st neuron: pontine hemorrhage

2nd neuron: pancoast tumor (Stella the ganglion compression)

3rd neuron: carotid dissection

Question 18

Describe the baroreflex response

Answer 18

1. Afferent neuron-sensory input from the viscera:
   - drop in blood pressure

• reduced stretch of baroreceptors in the aortic arch
• Reduced frequency of afferent impulses to the medulla (brain stem)
  2. Reflex response- efferent reflex impulses via the autonomic nervous system
• inhibition of parasympathetic and activation of sympsthetic nervous system
• increased peripheral resistance and cardiac output
• Increased blood pressure

Question 19

What disorders affect the baroreflex response without the detectable nerve disease?

Answer 19

Vasovagal syncope or situational syncope 130 million people have had greater than or equal to 1

Takotsubo cardiomyopathy 10,000 new cases/year

Question 20

What disorders that affect the baroreflex function that heave a pathological substrate?

Answer 20

Metabolic disorders: diabetes mellitus 25 million people (20-30% of patients with type 1 or type 2 diabetes )

Neurodegenerative disorders:

• Parkinson’s disease 800,000 people
• Dementia with Lewy bodies 600,000 people
• Multiple system atrophy 15,000 people

Spinal cord injury (above T6)

Acute brain injury 150,000 people

Chemotherapy-induced and toxic autonomic neuropathies 50,000 people

Immune mediated and paraneoplastic autonomic disorders less than 5000 people-Guillian Barre syndrome

Question 21

What are the symptoms associated with efferent Barorefkex dysfunction for EFFERENT baroreflex failure?

Answer 21

• diabetes mellitus
• Parkinson’s disease
• dementia with Lewy bodies

Neurogenic orthostatic hypotension

Question 22

What are the symptoms associated with baroreflex dysfunction in the AFFERENT baroreflex failure?

Answer 22

Acquired:

• Damage to IX and X fibers due to radiotherapy to the neck, radical neck surgery, endarterectomy
• Giuliano barre syndrome

Headache, flushing, agitation, unstable blood pressure throughout the day

Question 23

What is orthostatic hypotension?

Answer 23

A sustained fall in blood pressure of atleast 20/10 mm Hg within 3 minutes after assumption of an upright posture

Question 24

What are the causes of orthostatic hypotension?

Answer 24

• Neurogenic orthostatic hypotension: dysfunction of the autonomic fibers of the baroreflex
• Other cases: medications, cardiac arrythmias, dehydration, anemia, hemorrhage

Question 25

What are the effectors and innervations of the skin?

Answer 25

Effectors- sweat glands and piloerector muscles both have no parasympathetic receptors Sweat glands -sympathetic fibers: secretion (cholinergic, muscuranic receptors) Piloerectors- sympsthetic fibers: contraction a1

Question 26

What are the effectors and innervations of blood vessels?

Answer 26

No parasympathetic fibers Skin (general)- sympathetic- constriction a1 Skeletal muscle- sympathetic - dilation B2 Viscera- sympathetic- constriction a1

Question 27

What are the effectors of the heart ?

Answer 27

- SA node - Atrioventriculaar node - Atria - Ventricle

Question 28

What is the innervation of the SA node?

Answer 28

Parasympathetic: decrease heart rate Sympathetic: increase heart rate B1> B2

Question 29

What are the innervations of the AV node?

Answer 29

Parasympathetic: decreased conduction velocity Sympathetic: increase conduction velocity B1> B2

Question 30

What are the innervations of the ATria node?

Answer 30

Parasympathetic: decreased Contractility Sympathetic: increased contractility B1>. B2

Question 31

What are the innervations of the ventricle?

Answer 31

Parasympathetic: little effect Sympathetic: increased contractility

Question 32

What are the effectors and innervations for metabolic functions?

Answer 32

Liver no parasympathetic, sympsthetic: glycogenolysis and gluconeogenesis a1, B2 Pancreas (insulin) : parasympathetic: increased secretion Sympathetic: decreased secretion a2 Adipose cells no parasympathetic, sympathetic: lipolysis B3 Kidney: no parasympathetic, sympathetic: renin release B1 Adrenal medulla: no parasympatheticm sympathetic: secretion of Catecholamines (cholinergic nicotinic)

Question 33

What are the effectors and innervations of the urinary. System ?

Answer 33

Ureter- parasympathetic: relaxation Sympathetic: contraction: a1 Detrusor parasympathetic: contraction sympathetic: relaxation B3, B2 Sphincter: parasympathetic: relaxation sympathetic: contraction: a1

Question 34

What are the effectors and innervations of the reproductive system?

Answer 34

Uterus: - variable from parasympathetic Sympsthetic: relaxation: B2 Genitalia: erection (ACh and NO) sympathetic: ejaculation/vaginal contract- alpha

Question 35

Contrast the types of autonomic nerve endings

Answer 35

Autoreceptors: parasympathetic- presynaptic inhibition of ACh release/ sympathetic: presynaptic inhibition of NE release a2 Heteroreceptors: parasympathetic: presynaptic inhibition of NE release/ sympathetic: presynaptic inhibition of ACh release a2