Podcast
Questions and Answers
Which reflex is NOT mentioned as being studied in relation to the trigeminal nerve?
Which reflex is NOT mentioned as being studied in relation to the trigeminal nerve?
- Trigeminal reflex
- Diving reflex
- Trigeminocardiac reflex
- Facial reflex (correct)
The heart is solely innervated by the sympathetic nervous system.
The heart is solely innervated by the sympathetic nervous system.
False (B)
What type of nervous reflexes are induced by the trigeminal nerve affecting cardiovascular function?
What type of nervous reflexes are induced by the trigeminal nerve affecting cardiovascular function?
Somato-autonomic nervous reflexes
The heart's function during trigeminal reflexes is regulated by an increased __________ response.
The heart's function during trigeminal reflexes is regulated by an increased __________ response.
Match the following reflexes with their characteristics:
Match the following reflexes with their characteristics:
What is the main role of the trigeminal nerve in cardiovascular responses?
What is the main role of the trigeminal nerve in cardiovascular responses?
The sympathetic activity during trigeminal reflexes can be increased, decreased, or remain unchanged.
The sympathetic activity during trigeminal reflexes can be increased, decreased, or remain unchanged.
The combination of increased parasympathetic and __________ activity regulates cardiac function during trigeminal reflexes.
The combination of increased parasympathetic and __________ activity regulates cardiac function during trigeminal reflexes.
What is the primary function of the diving response in humans?
What is the primary function of the diving response in humans?
The trigeminocardiac reflex can occur during surgery in the cerebellopontine angle.
The trigeminocardiac reflex can occur during surgery in the cerebellopontine angle.
What nerve is essential for initiating the nasopharyngeal response in rats?
What nerve is essential for initiating the nasopharyngeal response in rats?
The diving bradycardia mechanism is part of the __________ reflex.
The diving bradycardia mechanism is part of the __________ reflex.
Match the authors with their contributions related to trigeminocardiac reflexes:
Match the authors with their contributions related to trigeminocardiac reflexes:
What does the research by Hollandsworth et al. focus on?
What does the research by Hollandsworth et al. focus on?
Coronary vasospasm can occur during percutaneous trigeminal rhizotomy.
Coronary vasospasm can occur during percutaneous trigeminal rhizotomy.
What effect does intense vasoconstriction have during the diving reflex?
What effect does intense vasoconstriction have during the diving reflex?
The diving reflex is equally effective in humans as it is in natural diving animals.
The diving reflex is equally effective in humans as it is in natural diving animals.
What is the role of the ethmoidal nerve in the nasopharyngeal reflex?
What is the role of the ethmoidal nerve in the nasopharyngeal reflex?
The diving reflex is one of the most powerful ________ reflexes of the organism.
The diving reflex is one of the most powerful ________ reflexes of the organism.
Match the following components of the diving reflex with their effects:
Match the following components of the diving reflex with their effects:
What potential risks do patients undergoing surgical interventions in the trigeminal territory face?
What potential risks do patients undergoing surgical interventions in the trigeminal territory face?
The sympathetic response of the diving reflex in humans may significantly increase blood pressure.
The sympathetic response of the diving reflex in humans may significantly increase blood pressure.
What substances can activate the nasopharyngeal reflex?
What substances can activate the nasopharyngeal reflex?
The ________ reflex is activated by stimulating the nasal mucosa.
The ________ reflex is activated by stimulating the nasal mucosa.
In diving animals like seals, what is a primary effect of the diving reflex?
In diving animals like seals, what is a primary effect of the diving reflex?
What is the trigeminocardiac reflex associated with?
What is the trigeminocardiac reflex associated with?
The trigeminocardiac reflex was first described in the year 1988.
The trigeminocardiac reflex was first described in the year 1988.
What physiological response is produced by the stimulation of the trigeminal branches?
What physiological response is produced by the stimulation of the trigeminal branches?
In 1975, Kumada et al. observed a reflex that induced gastrointestinal symptoms including gastric __________.
In 1975, Kumada et al. observed a reflex that induced gastrointestinal symptoms including gastric __________.
Match the researchers with their contributions regarding trigeminal reflexes:
Match the researchers with their contributions regarding trigeminal reflexes:
What did Shelly and Church propose in relation to the trigeminal reflex?
What did Shelly and Church propose in relation to the trigeminal reflex?
The trigeminovagal reflex is characterized by a decrease in vagal tone.
The trigeminovagal reflex is characterized by a decrease in vagal tone.
What type of response occurs with low frequency stimulation in the trigeminal reflex?
What type of response occurs with low frequency stimulation in the trigeminal reflex?
The central occurrence of the trigeminovagal reflex was first published by __________ and colleagues.
The central occurrence of the trigeminovagal reflex was first published by __________ and colleagues.
Which of these symptoms is NOT associated with the trigeminal reflex?
Which of these symptoms is NOT associated with the trigeminal reflex?
What effect does the nasopharyngeal reflex have on sympathetic tone?
What effect does the nasopharyngeal reflex have on sympathetic tone?
The trigeminal reflex is known to decrease blood pressure in patients with cardiovascular diseases.
The trigeminal reflex is known to decrease blood pressure in patients with cardiovascular diseases.
What are two significant hemodynamic changes induced by trigeminal reflexes?
What are two significant hemodynamic changes induced by trigeminal reflexes?
The nasopharyngeal reflex is considered a powerful oxygen-preserving __________.
The nasopharyngeal reflex is considered a powerful oxygen-preserving __________.
Match the following complications with their related factors:
Match the following complications with their related factors:
What physiological process is primarily affected by the sympathetic/parasympathetic interaction during trigeminal reflexes?
What physiological process is primarily affected by the sympathetic/parasympathetic interaction during trigeminal reflexes?
The diving reflex and the nasopharyngeal reflex have no common characteristics.
The diving reflex and the nasopharyngeal reflex have no common characteristics.
How might cholinergic discharge affect coronary arteries in patients with atherosclerosis?
How might cholinergic discharge affect coronary arteries in patients with atherosclerosis?
The changes in vascular flow at the carotid level suggest blood flow redistribution to the __________.
The changes in vascular flow at the carotid level suggest blood flow redistribution to the __________.
What potential complication might arise as a consequence of the trigeminocardiac reflex during neurosurgeries?
What potential complication might arise as a consequence of the trigeminocardiac reflex during neurosurgeries?
Flashcards
Trigeminal reflexes
Trigeminal reflexes
Nervous system connections between the trigeminal nerve and the heart that rapidly change heart function.
Diving reflex
Diving reflex
A specific trigeminal reflex, primarily related to heart function during water immersion.
Trigeminocardiac reflex
Trigeminocardiac reflex
Another specific trigeminal reflex, connecting facial stimulation to changes in heart function.
Somato-autonomic nervous reflexes
Somato-autonomic nervous reflexes
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Cardiac function regulation
Cardiac function regulation
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Sympathetic nervous system
Sympathetic nervous system
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Parasympathetic nervous system
Parasympathetic nervous system
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Dually innervated heart
Dually innervated heart
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Nasopharyngeal Reflex
Nasopharyngeal Reflex
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Trigeminal-vagal Reflex
Trigeminal-vagal Reflex
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Ethmoidal Nerve
Ethmoidal Nerve
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Vasoconstriction
Vasoconstriction
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Species Differences in Diving Reflex
Species Differences in Diving Reflex
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Anesthesia Impact on Reflexes
Anesthesia Impact on Reflexes
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Sympathetic tone
Sympathetic tone
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Peripheral vascular resistance
Peripheral vascular resistance
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Carotid resistance
Carotid resistance
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Blood pressure changes
Blood pressure changes
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Cardiac complications
Cardiac complications
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Asystole
Asystole
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Ventricular fibrillation
Ventricular fibrillation
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Coronary spasm
Coronary spasm
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Diving Bradycardia
Diving Bradycardia
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Maxillary vs. Mandibular
Maxillary vs. Mandibular
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Trigeminocardiac Reflex Pathway
Trigeminocardiac Reflex Pathway
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Diving Reflex: Sympathetic Response
Diving Reflex: Sympathetic Response
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Subtenon Block
Subtenon Block
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Anesthetics' Effect on Reflexes
Anesthetics' Effect on Reflexes
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What is the effect of stimulating the trigeminal nerve?
What is the effect of stimulating the trigeminal nerve?
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What are the two stages of the respiratory response to trigeminal nerve stimulation?
What are the two stages of the respiratory response to trigeminal nerve stimulation?
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Aschner Phenomenon
Aschner Phenomenon
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What is the role of the sympathetic and parasympathetic nervous systems in the trigeminal reflexes?
What is the role of the sympathetic and parasympathetic nervous systems in the trigeminal reflexes?
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How do trigeminal reflexes affect cardiovascular regulation?
How do trigeminal reflexes affect cardiovascular regulation?
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What are the key differences between the trigeminal reflexes described in humans and animal models?
What are the key differences between the trigeminal reflexes described in humans and animal models?
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How can anesthesia impact trigeminal reflexes?
How can anesthesia impact trigeminal reflexes?
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Study Notes
Trigeminal Reflexes and Cardiovascular Function
- Trigeminal nerve and heart are strongly connected through somato-autonomic reflexes, inducing rapid cardiovascular changes.
- Diving and trigeminocardiac reflexes are the most studied trigeminal reflexes.
- The heart receives dual innervation (sympathetic and parasympathetic), influencing how cardiovascular function is regulated during trigeminal reflexes.
- These reflexes involve a combination of increased parasympathetic response and varying sympathetic activity.
- Hemodynamic changes (e.g., heart rate, blood pressure) result from these autonomic alterations.
- In oxygen-conserving reflexes (e.g., diving reflex), co-activation of sympathetic and parasympathetic systems reduces heart rate and maintains/increases blood pressure.
- Trigeminocardiac reflex often involves bradycardia and hypotension due to parasympathetic activation and sympathetic inhibition.
- Sudden cardiac innervation disturbances can cause arrhythmias or myocardial ischemia, especially during surgeries in the trigeminal territory.
Diving Reflex
- Oxygen deprivation (even brief) can be harmful, but many species (birds, mammals, humans) have adapted to withstand hypoxia/anoxia.
- Diving reflex is a key adaptation, triggering heart rate reduction (via vagal activation), increased blood pressure (via sympathetic response), and apnea.
- Apnea can be voluntary (breath-holding) or reflexive (cold receptor stimulation on face, eyes, and nasal cavity).
- Facial submersion rapidly triggers these responses.
Trigeminocardiac Reflex
- Clinically and experimentally proven brainstem reflex.
- Characterized by hypotension (20% drop in mean arterial blood pressure), bradycardia (<60 bpm) and response to trigeminal manipulation/disturbances.
- May lead to asystole in severe cases.
- Classified into central (ganglion to nucleus) and peripheral (peripheral divisions to ganglion) subtypes.
- Peripheral reflex can be further divided into ophthalmocardiac and maxillomandibulocardiac reflexes.
Other Reflexes
- Nasopharyngeal reflex: activated by irritating stimuli, water, or electrical stimulation.
- Oculocardiac reflex: triggered by physical stimulation of eyes or adnexa.
- Nasopharyngeal reflex involves increased parasympathetic tone (reduces heart rate and cardiac output) and increased sympathetic tone (greater peripheral vascular resistance), maintaining stable blood pressure.
- Trigeminal reflex responses vary based on stimulus type, intensity, frequency, duration, involved nerve fibers, and analgesic/anesthetic use.
Hemodynamic Changes During Trigeminal Reflexes
- Bradycardia and blood pressure modifications are prominent.
- Sudden changes can affect patients with cardiovascular issues.
- Potential for arrhythmias, asystole, and ventricular fibrillation during neuro-surgeries.
- Coronary spasm a potential factor in complications.
- Co-activation of sympathetic systems may reduce blood flow in damaged areas of the heart.
Conclusion
- Trigeminal nerve stimulation triggers hemodynamic changes through somato-autonomic reflexes (e.g., diving, trigeminocardiac)
- Hemodynamic changes are influenced by sympathetic/parasympathetic balance, stimulus factors, and other variables (e.g. anesthesia).
- These reflexes and resulting disturbances are clinically relevant, requiring proper management during surgeries in the trigeminal territory.
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