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The Autonomic Nervous System Overview
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The Autonomic Nervous System Overview

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Questions and Answers

Which of the following statements about the breakdown of acetylcholine is correct?

  • Acetylcholine is split into acetate and choline by acetylcholinesterase. (correct)
  • The primary breakdown product of acetylcholine is norepinephrine.
  • Choline is reused to synthesize more norepinephrine.
  • Acetylcholine is broken down by catechol-O-methyl transferase.

    • What mechanism is responsible for the rapid termination of norepinephrine activity in the synaptic cleft? (select all that apply)

  • Inhibition of neurotransmitter release
  • Active reuptake (50-80%) (correct)
  • Passive diffusion away from nerve endings (correct)
  • destruction by tissue enzymes (MAO and COMT) (correct)

    • Activation of beta receptors generally leads to which of the following physiological effects?

  • Increased intestinal peristalsis
  • Iris constriction and pilomotor contraction
  • Cardioacceleration and bronchodilation (correct)
  • Bladder wall contraction

    • Which of the following correctly describes the action of epinephrine on alpha and beta receptors?

    <p>Epinephrine interacts equally with both alpha and beta receptors.</p> Signup and view all the answers

    Which of the following accurately describes the primary function of cervical ganglia?

    <p>They provide sympathetic innervation to the head, neck, arms, and upper chest.</p> Signup and view all the answers

    What is the main characteristic of postganglionic nerve fibers in the autonomic nervous system?

    <p>They are unmyelinated and have a significantly slower conduction velocity.</p> Signup and view all the answers

    Which of the following statements correctly identifies an exception in autonomic nervous system innervation?

    <p>Sweat glands are innervated solely by sympathetic fibers that primarily secrete acetylcholine</p> Signup and view all the answers

    Which neurotransmitter is primarily associated with postganglionic sympathetic fibers?

    <p>Norepinephrine.</p> Signup and view all the answers

    Which medication is classified as a selective Beta-1 blocker?

    <p>Atenolol</p> Signup and view all the answers

    What term describes the indirect cholinergic stimulants that prevent the breakdown of acetylcholine?

    <p>Cholinesterase inhibitors</p> Signup and view all the answers

    Which of the following is NOT a symptom associated with excessive cholinergic stimulation?

    <p>Myocardial stimulation</p> Signup and view all the answers

    What type of fibers are responsible for the stimulation of most sweat glands?

    <p>Cholinergic fibers</p> Signup and view all the answers

    Which reflex involves stretch receptors in the walls of major arteries detecting pressure changes?

    <p>Baroreceptor reflex</p> Signup and view all the answers

    What is the main physiological outcome of autonomic dysreflexia when a noxious stimulus occurs below the level of the spinal injury?

    <p>Uncoordinated sympathetic response</p> Signup and view all the answers

    What physiological process does intrinsic compensation following a denervation injury primarily involve? (select 2)

    <p>Increased intrinsic tone in smooth muscle of vessels</p> Signup and view all the answers

    What could potentially increase the risk of a hypertensive episode in autonomic dysreflexia?

    <p>Noxious stimuli below the level of the spinal cord injury</p> Signup and view all the answers

    Which type of reflex involves the increase in salivation triggered by the smell of food?

    <p>Gastrointestinal reflex</p> Signup and view all the answers

    What characterizes the denervation supersensitivity that can follow a denervation injury?

    <p>Upregulation of receptors</p> Signup and view all the answers

    What primary role does the hypothalamus play in the Sympathetic Nervous System?

    <p>Long-term blood pressure control and stress reactions.</p> Signup and view all the answers

    Which cranial nerves are associated with the Parasympathetic Nervous System?

    <p>III, VII, IX, X</p> Signup and view all the answers

    What does the term 'sympathetic tone' refer to?

    <p>Baseline constriction of blood vessels maintained by the SNS.</p> Signup and view all the answers

    How does the Adrenal Medulla contribute to the sympathetic response?

    <p>It releases epinephrine and norepinephrine into the bloodstream.</p> Signup and view all the answers

    Which of the following statements regarding preganglionic and postganglionic neurons is correct?

    <p>Preganglionic neurons for the SNS originate between T1 and L2 segments of the spinal cord.</p> Signup and view all the answers

    What describes the effect of dual sympathetic stimulation from both the sympathetic system and adrenal medulla?

    <p>It provides a safety mechanism for stimulating target organs.</p> Signup and view all the answers

    What role does the medulla oblongata play in the autonomic nervous system?

    <p>Regulates momentary adjustments in blood pressure and breathing.</p> Signup and view all the answers

    What syndrome is commonly associated with a stellate ganglion block?

    <p>Horner syndrome</p> Signup and view all the answers

    What are the symptoms of Horner's syndrome? (Select all that apply)

    <p>Ipsilateral ptosis</p> Signup and view all the answers

    Autonomic innervation to the adrenal glands is from _____

    <p>preganglionic sympathetic fibers from T5-T9.</p> Signup and view all the answers

    What is the symptom triad of pheochromocytoma?

    <p>Headache, diaphoresis, tachycardia</p> Signup and view all the answers

    What enzyme synthesizes choline and acetyl CoA to form acetylcholine?

    <p>Choline acetyltransferase</p> Signup and view all the answers

    Nicotinic receptors play a role in which of the following? (select 2)

    <p>Receptor at synapse between preganglionic and postganglionic fibers in the ANS</p> Signup and view all the answers

    Match the appropriate fibers

    <p>SNS preganglionic fiber = short b fiber PNS preganglionic fiber = long b fiber SNS post ganglionic fiber = long c fiber PNS postganglionic fiber = short c fiber</p> Signup and view all the answers

    What type of receptors are found at the postganglionic cholinergic effector organs in the autonomic nervous system?

    <p>Muscarinic acetylcholine receptors (mAChRs)</p> Signup and view all the answers

    Where do splanchnic nerves synapse?

    <p>Outside of the sympathetic chain to prevertebral ganglia near abdominal organs</p> Signup and view all the answers

    What is the rate limiting step in norepinephrine and epinephrine synthesis?

    <p>Conversion of tyrosine to DOPA via tyrosine hydroxylase</p> Signup and view all the answers

    Catecholamines are synthesized from each other via enzymes Dopamine -> Norepi -> Epi

    <p>True</p> Signup and view all the answers

    Where does 80% of norepinephrine convert to epinephrine?

    <p>Adrenal medulla</p> Signup and view all the answers

    Where is the preganglionic nerve of the sympathetic nervous system located?

    <p>Intermediolateral horn of the spinal cord</p> Signup and view all the answers

    What is the only nerve fiber that transmits to the adrenal medulla?

    <p>Sympathetic preganglionic fibers</p> Signup and view all the answers

    What is the purpose of the baseline secretion of catecholamines from the adrenal medulla?

    <p>Provides redundancy if direct sympathetic innervation is halted</p> Signup and view all the answers

    What is the basal secretion level of epinephrine in a healthy adult?

    <p>0.2 mcg/kg/min</p> Signup and view all the answers

    What is the basal secretion level of norepinephrine in a healthy adult?

    <p>0.05 mcg/kg/min</p> Signup and view all the answers

    What is the exception to cholinergic sympathetic innervation to sweat glands?

    <p>Adrenergic fibers to palms and soles</p> Signup and view all the answers

    All adrenergic antagonists produce reversible (competitive) blockade EXCEPT ____.

    <p>Phenoxybenzamine</p> Signup and view all the answers

    Cholinergic crisis = SLUDGE and the Killer BBBs Salivation, lacrimation, urination, diaphoresis, GI, emesis Bradycardia, bronchospasm, bronchorrhea

    <p>True</p> Signup and view all the answers

    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.

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