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Questions and Answers
Which of the following statements about the breakdown of acetylcholine is correct?
Which of the following statements about the breakdown of acetylcholine is correct?
What mechanism is responsible for the rapid termination of norepinephrine activity in the synaptic cleft? (select all that apply)
What mechanism is responsible for the rapid termination of norepinephrine activity in the synaptic cleft? (select all that apply)
Activation of beta receptors generally leads to which of the following physiological effects?
Activation of beta receptors generally leads to which of the following physiological effects?
Which of the following correctly describes the action of epinephrine on alpha and beta receptors?
Which of the following correctly describes the action of epinephrine on alpha and beta receptors?
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Which of the following accurately describes the primary function of cervical ganglia?
Which of the following accurately describes the primary function of cervical ganglia?
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What is the main characteristic of postganglionic nerve fibers in the autonomic nervous system?
What is the main characteristic of postganglionic nerve fibers in the autonomic nervous system?
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Which of the following statements correctly identifies an exception in autonomic nervous system innervation?
Which of the following statements correctly identifies an exception in autonomic nervous system innervation?
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Which neurotransmitter is primarily associated with postganglionic sympathetic fibers?
Which neurotransmitter is primarily associated with postganglionic sympathetic fibers?
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Which medication is classified as a selective Beta-1 blocker?
Which medication is classified as a selective Beta-1 blocker?
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What term describes the indirect cholinergic stimulants that prevent the breakdown of acetylcholine?
What term describes the indirect cholinergic stimulants that prevent the breakdown of acetylcholine?
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Which of the following is NOT a symptom associated with excessive cholinergic stimulation?
Which of the following is NOT a symptom associated with excessive cholinergic stimulation?
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What type of fibers are responsible for the stimulation of most sweat glands?
What type of fibers are responsible for the stimulation of most sweat glands?
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Which reflex involves stretch receptors in the walls of major arteries detecting pressure changes?
Which reflex involves stretch receptors in the walls of major arteries detecting pressure changes?
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What is the main physiological outcome of autonomic dysreflexia when a noxious stimulus occurs below the level of the spinal injury?
What is the main physiological outcome of autonomic dysreflexia when a noxious stimulus occurs below the level of the spinal injury?
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What physiological process does intrinsic compensation following a denervation injury primarily involve? (select 2)
What physiological process does intrinsic compensation following a denervation injury primarily involve? (select 2)
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What could potentially increase the risk of a hypertensive episode in autonomic dysreflexia?
What could potentially increase the risk of a hypertensive episode in autonomic dysreflexia?
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Which type of reflex involves the increase in salivation triggered by the smell of food?
Which type of reflex involves the increase in salivation triggered by the smell of food?
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What characterizes the denervation supersensitivity that can follow a denervation injury?
What characterizes the denervation supersensitivity that can follow a denervation injury?
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What primary role does the hypothalamus play in the Sympathetic Nervous System?
What primary role does the hypothalamus play in the Sympathetic Nervous System?
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Which cranial nerves are associated with the Parasympathetic Nervous System?
Which cranial nerves are associated with the Parasympathetic Nervous System?
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What does the term 'sympathetic tone' refer to?
What does the term 'sympathetic tone' refer to?
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How does the Adrenal Medulla contribute to the sympathetic response?
How does the Adrenal Medulla contribute to the sympathetic response?
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Which of the following statements regarding preganglionic and postganglionic neurons is correct?
Which of the following statements regarding preganglionic and postganglionic neurons is correct?
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What describes the effect of dual sympathetic stimulation from both the sympathetic system and adrenal medulla?
What describes the effect of dual sympathetic stimulation from both the sympathetic system and adrenal medulla?
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What role does the medulla oblongata play in the autonomic nervous system?
What role does the medulla oblongata play in the autonomic nervous system?
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What syndrome is commonly associated with a stellate ganglion block?
What syndrome is commonly associated with a stellate ganglion block?
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What are the symptoms of Horner's syndrome? (Select all that apply)
What are the symptoms of Horner's syndrome? (Select all that apply)
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Autonomic innervation to the adrenal glands is from _____
Autonomic innervation to the adrenal glands is from _____
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What is the symptom triad of pheochromocytoma?
What is the symptom triad of pheochromocytoma?
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What enzyme synthesizes choline and acetyl CoA to form acetylcholine?
What enzyme synthesizes choline and acetyl CoA to form acetylcholine?
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Nicotinic receptors play a role in which of the following? (select all that apply)
Nicotinic receptors play a role in which of the following? (select all that apply)
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Match the appropriate fibers
Match the appropriate fibers
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What type of receptors are found at the postganglionic cholinergic effector organs in the autonomic nervous system?
What type of receptors are found at the postganglionic cholinergic effector organs in the autonomic nervous system?
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Where do splanchnic nerves synapse?
Where do splanchnic nerves synapse?
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What is the rate limiting step in norepinephrine and epinephrine synthesis?
What is the rate limiting step in norepinephrine and epinephrine synthesis?
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Catecholamines are synthesized from each other via enzymes
Dopamine -> Norepi -> Epi
Catecholamines are synthesized from each other via enzymes Dopamine -> Norepi -> Epi
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Where does 80% of norepinephrine convert to epinephrine?
Where does 80% of norepinephrine convert to epinephrine?
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Where is the preganglionic nerve of the sympathetic nervous system located?
Where is the preganglionic nerve of the sympathetic nervous system located?
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What is the only nerve fiber that transmits to the adrenal medulla?
What is the only nerve fiber that transmits to the adrenal medulla?
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What is the purpose of the baseline secretion of catecholamines from the adrenal medulla?
What is the purpose of the baseline secretion of catecholamines from the adrenal medulla?
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What is the basal secretion level of epinephrine in a healthy adult?
What is the basal secretion level of epinephrine in a healthy adult?
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What is the basal secretion level of norepinephrine in a healthy adult?
What is the basal secretion level of norepinephrine in a healthy adult?
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What is the exception to cholinergic sympathetic innervation to sweat glands?
What is the exception to cholinergic sympathetic innervation to sweat glands?
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All adrenergic antagonists produce reversible (competitive) blockade EXCEPT ____.
All adrenergic antagonists produce reversible (competitive) blockade EXCEPT ____.
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Cholinergic crisis = SLUDGE and the Killer BBBs
Salivation, lacrimation, urination, diaphoresis, GI, emesis
Bradycardia, bronchospasm, bronchorrhea
Cholinergic crisis = SLUDGE and the Killer BBBs Salivation, lacrimation, urination, diaphoresis, GI, emesis Bradycardia, bronchospasm, bronchorrhea
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Study Notes
Cervical Ganglia
- Provide sympathetic innervation to the head, neck, arms, and upper chest.
- Divided into superior, medial, and inferior cervical ganglia.
- Inferior cervical ganglion often fuses with the 1st thoracic ganglion to form the Stellate Ganglion (Cervicothoracic ganglion).
- Stellate ganglion blocks treat various conditions, such as chronic pain syndromes and PTSD.
- Horner’s Syndrome is characterized by ptosis, miosis, and anhidrosis.
Sympathetic and Parasympathetic Nervous Systems (SNS and PSNS)
- SNS and PSNS serve as the motor components of the autonomic nervous system (ANS).
- Most organs receive innervation from both SNS and PSNS, with sweat glands receiving only SNS fibers.
- Employ a two-neuron system (preganglionic and postganglionic neurons) to transmit signals from the CNS to effector organs.
Neurotransmitters and Receptors
- Acetylcholine (ACh), norepinephrine (NE), and epinephrine (Epi) are key neurotransmitters.
- Preganglionic fibers are myelinated and release acetylcholine; postganglionic fibers are unmyelinated.
- Almost all preganglionic fibers in both SNS and PSNS are cholinergic.
- Most sympathetic postganglionic fibers are adrenergic, secreting norepinephrine.
- ACh activates muscarinic receptors (effector cells) and nicotinic receptors (autonomic ganglia).
Autonomic Reflexes
- Baroreceptor Reflex detects stretch in arteries and regulates blood pressure via sympathetic inhibition and parasympathetic stimulation.
- Gastrointestinal reflexes enhance salivation and digestive secretion upon smelling food.
- Sexual reflexes are regulated by the PSNS (erection) and SNS (ejaculation).
Denervation Injury and Dysregulation
- Intrinsic compensation mechanisms can restore normal activity in response to denervation.
- Increased sensitivity to circulating catecholamines occurs post-injury.
- Autonomic dysreflexia is a potentially life-threatening condition following spinal cord injury, causing uncoordinated sympathetic responses.
Pharmacology of the Autonomic Nervous System
- Sympathomimetics mimic catecholamines and increase SNS activity.
- Cholinomimetics enhance PSNS activity by directly or indirectly activating cholinergic receptors.
- Adrenergic antagonists block catecholamine actions and are used for conditions like hypertension and migraines.
- Anticholinergics decrease PSNS activity, while anticholinesterases increase it.
Cholinergic Crisis
- Characterized by excessive muscarinic stimulation with symptoms encompassed in the acronym "DUMBELS":
- Diaphoresis/Diarrhea
- Urination
- Miosis
- Bradycardia/Bronchospasm/Bronchorrhea
- Emesis
- Lacrimation
- Salivation
- The “Killer Bs” refers to symptoms of muscarinic toxicity, indicating life-threatening situations.
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Description
Explore the intricacies of the Autonomic Nervous System, focusing on cervical ganglia and their role in sympathetic innervation for the head, neck, arms, and upper chest. Understand the formation of the Stellate Ganglion and its application in chronic pain treatment.
