Autonomic Nervous System

Question 1

The sympathetic system runs in which vertebrae?

1 - T1 - L2
2 - T1 - S2
3 - C7 - L2
4 - C1 - S5

Answer 1

1 - T1 - L2

Question 2

What is a group of cell bodies called in the CNS and PNS?

Answer 2

• CNS = nucleus

- PNS = ganglion

Question 3

Where is the primary site for stimulation of the autonomic system begin in the brain?

1 - thalamus
2 - pons
3 - brain stem
4 - hypothalamus

Answer 3

4 - hypothalamus

• axons travel down spinal cord nucleus (CNS)
• synapse with pre-ganglionic neuron cell bodies in PNS

Question 4

Once the pre-ganglionic neuron leaves the spinal cord, what are the 2 places the pre-ganglionic neurons can go?

Answer 4

1 = enter sympathetic ganglion (lots of post ganglionic cell bodies)
2 = pass through the sympathetic ganglion (lots of post ganglionic cell bodies) and synapse with the post ganglionic cell bodies in the pre-vertebral ganglion

Question 5

Sympathetic ganglia can be divided into 2 separate groups, called the para-vertebral (meaning either side of the spine) and pre-vertebral (before the spine) ganglia. What are the para-vertebral ganglia?

Answer 5

• ganglia (groups of cell bodies) that run alongside spinal cord
• all interconnected forming a sympathetic chain
• pre-ganglionic neuron synapse at sympathetic chain with post-synaptic ganglion

Question 6

Sympathetic ganglia can be divided into 2 separate groups, called the para-vertebral and pre-vertebral ganglia. What are the pre-vertebral ganglia?

Answer 6

• located anteriorly to the spinal column (hence the pre)
• pre-ganglionic neurons pass through sympathetic chain without synapsing
• pre-ganglionic neuron synapses with ganglion at the pre-vertebral ganglia where they synapse with the post-ganglionic nerve

Question 7

There are 4 pre-vertebral ganglia that come from the sympathetic nervous system, label them on the image below using the labels here:

• aortico-renal ganglia
• superior mesenteric ganglia (near superior mesenteric artery)
• celiac ganglia (wall of aorta)
• inferior mesenteric ganglia (near inferior mesenteric artery)

Answer 7

1 = celiac ganglia (wall of aorta)
2 = superior mesenteric ganglia (near superior mesenteric artery)
3 = inferior mesenteric ganglia (near inferior mesenteric artery)
4 = aortico-renal ganglia

Question 8

What does di-synaptic mean?

Answer 8

• 2 neurons synapsing together in the ganglia

Question 9

There are 4 cranial nerves that contribute towards parasympathetic activity. Where do these originate from?

Answer 9

• brain stem

Question 10

There are 4 cranial nerves that contribute towards parasympathetic activity and originate in the hypothalamus. Some neurons from the hypothalamus are short and synapse with the pre-ganglionic neurons in the brain stem nuclei. There are 4 cranial nerves that have their nuclei in the brain stem and contribute towards parasympathetic activity, what are they?

Answer 10

• remember as 3, 7, 9 and 10
• CN III (3) oculomotor nerve
• CN VII (7) facial nerve
• CN IX (9) glossopharyngeal nerve
• CN X (10) vagus nerve

Question 11

Which sacral vertebrae have parasympathetic neurons?

1 - L4-L5
2 - L5-S4
3 - S2-S4
4 - S4-S5

Answer 11

3 - S2-S4

- innervates pelvic organs

Question 12

The parasympathetic system is often referred to as the craniosacral division, why?

Answer 12

• nerves originate from cranium and sacrum

Question 13

Does the parasympathetic (PS) or sympathetic (S) nervous system have long pre and post ganglionic neurons?

Answer 13

• PS = long pre and short post ganlionic neurons

- S = short pre and long post ganlionic neurons

Question 14

There are 3 divisions of the autonomic system, what are they?

Answer 14

1 - para-sympathetic
2 - sympathetic
3 - enteric (GIT)

Question 15

Although the sympathetic nervous system originate from T1 to L2, does that mean the sympathetic nervous system can innervate within the T1 to L2 vertebrae?

Answer 15

• no

- the sympathetic chain allows the sympathetic system to innervate anyway in the body

Question 16

The general autonomic circuitry has 2 axons, what are these called?

Answer 16

• pre-ganglionic neuron

- post-ganglionic neuron

Question 17

The general autonomic circuitry has 2 axons, called the pre-ganglionic and post-ganglionic neurons. What organ is the one exception to this rule?

1 - kidneys
2 - adrenal medulla
3 - adrenal cortex
4 - spleen

Answer 17

2 - adrenal medulla

- only has a pre ganglionic neuron

Question 18

The general autonomic circuitry has 2 axons, called the pre-ganglionic and post-ganglionic neurons. Are both pre and post ganglionic neurons myelinated?

Answer 18

• no
• pre = myelineated (white)
• post = unmyelineated (grey)

Question 19

What is the main receptor type and neurotransmitter that we have at the synapse between the pre and post ganglionic neuron in the nervous system?

1 - ionotropic nicotinic (Nn and Nm) and serotonin
2 - ionotropic nicotinic (Nn and Nm) and acetylcholine
3 - ionotropic nicotinic (Nn and Nm) and dopamine
4 - ionotropic nicotinic (Nn and Nm) and glutamate

Nn = nicotinic at neurons
Nm = nicotinic at muscles

Answer 19

2 - ionotropic nicotinic (Nn and Nm) and acetylcholine

- ionotropic ligand gated (fast response required)

Question 20

What is the main receptor type and neurotransmitter that we have at the synapse between the post ganglionic neuron and target tissue in the sympathetic nervous system?

1 - metabotropic receptors and neuroadrenalin
2 - metabotropic receptors and acetylcholine
3 - metabotropic receptors and dopamine
4 - metabotropic receptors and serotonin

Answer 20

1 - metabotropic receptors and neuroadrenalin

- metabotropic receptors include a1 and 2 and B1, 2 and 3

Question 21

The main receptor type and neurotransmitter that we have at the synapse between the post ganglionic neuron and target tissues are metabotropic receptors (a1 and 2 and B1, 2 and 3) and noradrenalin is main neurotransmitter. What is the one exception to this?

1 - sweat glands and acetylcholine
2 - adrenal medulla glands and acetylcholine
3 - kidney glands and acetylcholine
4 - pancreas glands and acetylcholine

Answer 21

1 - sweat glands and acetylcholine

Question 22

The exception in the pre-ganlgionic neurons is the adrenal medulla. What cells in the adrenal medulla act as a ganglion to synapse with the pre ganglionic neuron?

Answer 22

• chromaffin cells
• binds to acetylcholine
• causes release of adrenalin/noradrenalin

Question 23

In the parasympathetic system the pre ganglionic neurons are long and the post ganglionic neurons are short. What neurotransmitter binds at both the pre and post ganglion?

1 - neuroadrenalin
2 - acetylcholine
3 - dopamine
4 - serotonin

Answer 23

2 - acetylcholine

Question 24

In the parasympathetic system the pre ganglionic neurons are long and the post ganglionic neurons are short. What receptors are present on tissue where the post ganglion synapse in the para-sympathetic system?

1 - ionotropic
2 - metabotropic
3 - receptor tyrosine kinase
4- enzyme coupled receptors

Answer 24

2 - metabotropic

• M1, 3 and 5 are Gas
• M2 and 4 are Gai

Question 25

The para-vertebral ganglia are pre-ganglionic neurons that synapse with the post ganglionic neuron at the paravertebral ganglia, which is essentially the sympathetic chain. How do the pre-ganglionic fibres enter the sympathetic trunk from the spinal cord ventral horn (efferent = effector nerves)? 1 - spinal nerve 2 - white rami communicantes 3 - trunk 4 - dorsal horn

Answer 25

2 - white rami communicantes | - only occurs at the level of T1-L2 vertebrae

Question 26

What does a ramus mean in relation to nerves?

Answer 26

- latin for branch - roots from the dorsal or ventral roots form to make roots - the roots combine to form the spinal nerve - spinal nerve split again to form the white (pre-ganglionic) and grey rami (post-ganglionic)

Question 27

Once a pre-ganglionic neurons leaves the spinal cord via the ventral horn, if it is part of the para-vertebral ganglia, it will then enter a channel before enter a ganglia within the sympathetic chain. What is this channel called and what colour will it appear?

Answer 27

- called white ramus communicans | - white as pre-ganglionic neurons are myelinated

Question 28

Once a pre-ganglionic neurons leaves the spinal cord via the ventral horn, if it is part of the paravertebral ganglia, it will then enter a channel called the white ramus communicans, which is white because it is myelinated, before synapsing at the ganglia with the post-ganglionic neuron. The post-ganglionic neuron will then leave using a channel and travel towards its target tissue. What is this channel called and why?

Answer 28

- called grey ramus communicans | - grey as post-ganglionic neurons are un-myelinated

Question 29

The sympathetic chain is able to travel throughout the body, beyond the origins of the sympathetic trunk (T1-L2). In the cervical region of the sympathetic trunk there are 3 ganglia that supply the head, upper limbs and the heart, what are these called? 1 - top, middle and bottom cervical ganglion 2 - superior, middle and inferior cervical ganglion 3 - superior, lateral and inferior cervical ganglion

Answer 29

2 - superior, middle and inferior cervical ganglion

Question 30

The sympathetic chain is able to travel throughout the body, beyond the origins of the sympathetic trunk (T1-L2). In the cervical region of the sympathetic trunk there are 3 ganglia, superior cervical ganglion (largest), middle cervical ganglion (smallest) and inferior cervical ganglion. What are the 2 main roles these play in sympathetic innervation? 1 - innervate the spine 2 - innervate the face 3 - innervate upper limbs 4 - innervate the head

Answer 30

3 - innervate upper limbs | - piggyback down common carotid artery and innervate the heart

Question 31

The sympathetic chain is able to travel throughout the body, beyond the origins of the sympathetic trunk (T1-L2). In the cervical region of the sympathetic trunk there are 3 ganglia, superior cervical ganglion (largest), middle cervical ganglion (smallest) and inferior cervical ganglion. The superior cervical ganglion can then go onto to form 2 things, what are they called?

Answer 31

1 - internal carotid plexus (group of post-ganglionic nerves) 2 - external carotid plexus (group of post-ganglionic nerves)

Question 32

The sympathetic chain is able to travel throughout the body, beyond the origins of the sympathetic trunk (T1-L2). In the cervical region of the sympathetic trunk there are 3 ganglia, superior cervical ganglion (largest), middle cervical ganglion (smallest) and inferior cervical ganglion. The superior cervical ganglion can then go onto to form the internal and external carotid plexus (group of post-ganglionic nerves). What is the function of the internal carotid plexus? 1 - regulates the eyes (dilates, raises eye lid) 2 - regulate mucus production 3 - regulate hearing 4 - regulate blood supply of the face

Answer 32

1 - regulates the eyes (dilates, raises eye lid)

Question 33

The sympathetic chain is able to travel throughout the body, beyond the origins of the sympathetic trunk (T1-L2). In the cervical region of the sympathetic trunk there are 3 ganglia, superior cervical ganglion (largest), middle cervical ganglion (smallest) and inferior cervical ganglion. The superior cervical ganglion can then go onto to form the internal and external carotid plexus (group of post-ganglionic nerves). What is the function of the external carotid plexus? 1 - regulates the eyes (dilates, raises eye lid) 2 - regulate mucus production 3 - innervates submandibular and parotid glands 4 - regulate blood supply of the face

Answer 33

3 - innervates submandibular and parotid glands | - inhibits saliva production as not needed in fight or flight

Question 34

The sympathetic thoracic ganglia supply the heart, lungs and abdominal viscera. The grey rami communicans, which are the post ganglionic neurons leave the thoracic spinal cord and go on to form networks of intersecting sympathetic nerves, called plexi. What 2 plexi are formed here, thinking about 2 of the largest organs in the thoracic cavity?

Answer 34

1 - carotid plexus | 2 - pulmonary plexus

Question 35

The sympathetic lumbar ganglia supply the abdominal viscera (GIT) and lower limbs. The white rami communicans (myelinated) leave the spinal cord and synapse in the sympathetic ganglia chain, and instead of synapsing with the grey rami communicans, which are the post ganglionic neurons, they leave and synapse with what 2 pre-vertebral ganglia. What are these 2 pre-ganglionic ganglia that supply the lumbar region? 1 - superior and celiac mesenteric ganglia 2 - lumbar and inferior mesenteric ganglia 3 - brachial and inferior mesenteric ganglia 4 - superior and inferior mesenteric ganglia

Answer 35

4 - superior and inferior mesenteric ganglia

Question 36

The sympathetic sacral ganglia supplies the viscera and the lower limbs. The white rami communicans (myelinated) from T1 to L2 leave the spinal cord and synapse in the sympathetic ganglia chain with the grey rami communicans, which are the post ganglionic neurons in the sacral portion of the sympathetic chain. What are these nerves called and what plexus can these nerves form?

Answer 36

- sacral splanchnic nerves | - inferior hypogastric plexus

Question 37

The cranial nerves that are part of the para-sympathetic nervous system are cranial nerves III (3), VII (7), IX (9) and X (10). What is the normal pathway the pre and post ganglionic neurons of the cranial nerves take?

Answer 37

- pre ganglionic neuron = originates in the brain stem | - post ganglionic neuron = synapse with pre ganglionic neuron in a ganglia close to the target tissue

Question 38

In the para-sympathetic nervous system, are the pre-ganglionic neurons long or short ?

Answer 38

- long

Question 39

The sacral nerves of the parasympathetic nervous system are called what? 1 - pelvic splanchnic nerves 2 - splenic nerves 3 - iliopelvic nerves 4 - ceciliac nerve

Answer 39

1 - pelvic splanchnic nerves | - splanchnic = greek for inward organs

Question 40

Cranial nerve III (3) is called what, and where does it originate from?

Answer 40

- oculomotor nerve | - cell nuclei in midbrain of the brainstem, called the Edinger-Westphal nucleus

Question 41

Cranial nerve III (3) is the oculomotor nerve and originate from the nuclei in midbrain of the brainstem. What does this nerve innervate?

Answer 41

- occularis = eye (moves the eyeball) - all eye muscles except superior oblique CN IV (4) and lateral rectus (CN VI (6) - remember using SO4 and LR6

Question 42

Cranial nerve VII (7) is called what, and where does it originate from?

Answer 42

- facial nerve | - nuclei in pons of the brainstem

Question 43

Cranial nerve IX (9) is called what, and where does it originate from?

Answer 43

- glossopharyngeal nerve | - nuclei of medulla in brain stem

Question 44

Cranial nerve IX (9) is called the glossopharyngeal nerve and originates in the nuclei of pons in brain stem. What does this nerve innervate?

Answer 44

- glosso = greek for tongue and pharyngeal = pharynx | - innervates = posterior 1/3 of tongue, middle ear and stylopharyngeus muscle which is important for swallowing

Question 45

Cranial nerve VII (7) and IX (9) called the facial and glossopharyngeal nerve, respectively originate in the nuclei of pons in brain stem. These 2 nuclei are given names in relation to one another, what are they?

Answer 45

- superior salivatory nucleus | - inferior salivatory nucleus

Question 46

The nucleus ambiguous in the medulla of the brainstem provides the origin for which cranial nerve that is part of the para-sympathetic nervous system and also referred to as the wandering nerve?

Answer 46

- cranial nerve X (10) | - vagus nerve

Question 47

There are 4 cranial nerves that are part of the parasympathetic nervous system. The cranial nerves that leave the brainstem and synapse at pre-ganlionic before being carried via axons and synapse at specific ganglia in the head. Using the labels below, label the 4 ganglion in the image below using the below labels: - Pterygopalatine ganglion - Otic (greek for ear) ganglion - Submandibular ganglion - Ciliary ganglion

Answer 47

1 - Ciliary ganglion 2 - Pterygopalatine ganglion 3 - Otic ganglion 4 - Submandibular ganglion

Question 48

The pre-ganlionic axons will pass through cranial nerves and synapse at specific ganglia. What is the important ganglia of the glossopharyngeal nerve? 1 - otic ganglion 2 - ciliary ganglion 3 - foreman ganglion 4 - otitis ganglion

Answer 48

1 - otic (greek for ear) ganglion

Question 49

The pre-ganlionic axons will pass through cranial nerves and synapse at specific ganglia. What is the important ganglia of the oculomotor nerve? 1 - otic ganglion 2 - ciliary ganglion 3 - foreman ganglion 4 - otitis ganglion

Answer 49

2 - ciliary ganglion

Question 50

The pre-ganlionic axons will pass through cranial nerves and synapse at specific ganglia. The vagus nerve originates in the medulla oblongata and then must pass through which foraman to then innervate the heart, liungs and abdominal organs? 1 - optic canal 2 - foreman magnum 3 - foreman ovalum 4 - jugular foraman

Answer 50

4 - jugular foraman | - behind the carotid canal in the middle fossa

Question 51

The sacral nerves of the parasympathetic nervous system originate from S2-S4 vertebrae. The pre-ganglionic nerve fibres will exit the vertebrae of S2-S4 and travel to the pelvis organs using pelvic splanchnic nerves. These will then form which plexus that overlies the organs of the pelvis and gains its name which is the same as the lower mid region of the gastro examination?

Answer 51

- inferior hypogastric plexus

Question 52

The enteric nervous system is one of the main divisions of the autonomic nervous system and consists of a mesh-like system of neurons that governs the function of the gastrointestinal tract, ensuring control. 2 major plexus ensure this control, what are they? 1- splenic and submucosal plexi 2- splenic and hypogastric plexi 3- hypogastric and submucosal plexi 4- myenteric and submucosal plexi

Answer 52

4- myenteric and submucosal plexi - myenteric (auerbachs) plexus - submucosal (meissners) plexus

Question 53

The GIT is composed of layers, which are: 1 - mucosa (epithelium, lamina propria and muscularis mucosa) 2 - sub mucosa 3 - muscularis propria 4 - adventia Which layer can the Myenteric [Auerbach’s] plexus be located in?

Answer 53

3 - muscularis propria layer | - think myenteric has a similar sound to myo for muscle

Question 54

The GIT is composed of layers, which are: 1 - mucosa (epithelium, lamina propria and muscularis mucosa) 2 - sub mucosa 3 - muscularis propria 4 - adventia Which layer can the Submucosal [Meissner’s] plexus be located in?

Answer 54

2 - submucosal layer

Question 55

The Submucosal [Meissner’s] plexus can be located in the submucosal layer (2nd layer) of the GIT. What is the function of this plexus?

Answer 55

- controls glandular secretions | - controls blood flow

Question 56

The Myenteric (meaning muscle) [Auerbach’s] plexus can be located in the muscularis propria layer (3rd layer) of the GIT. What is the function of this plexus?

Answer 56

- controls peristalsis (motility/contraction)

Question 57

Cranial nerve X (10) the vagus nerve is known as the wandering nerve and is an important part of the parasympathetic nervous system. It has been shown to innervate lots of tissues, what are the main ones?

Answer 57

- lungs - heart - abdominal tissue

Question 58

What is the basis of the polyvagal theory and which cranial nerve is involved?

Answer 58

- CN X (10) - theory indicates that in addition to innervating tissue, there is an emotional connection with this nerve - BUT not lots of evidence supporting it

Question 59

In the sympathetic nervous system the neuron synapses with the ventral horn of the spinal cord. The efferent (effector) neurons (pre-ganglionic) then leave via what?

Answer 59

- ventral/anterior root

Question 60

In the sympathetic nervous system the neuron synapses with the ventral horn of the spinal cord the efferent neurons (pre-ganglionic) then leave via the ventral/anterior root and merge together with afferent nerves forming what?

Answer 60

- spinal nerve

Question 61

In the sympathetic nervous system the neuron synapses with the ventral horn of the spinal cord the efferent neurons (pre-ganglionic) then leave via the ventral/anterior root and merge together with afferent nerves forming spinal nerve. Once in the spinal nerve the pre-ganglionic neuron will then travel through what white structure?

Answer 61

- white rami communicantes - contains only pre-ganglionic neurons - pre-ganglionic neurons are myelinated so appear white, hence the name

Question 62

In the sympathetic nervous system the neuron synapses with the ventral horn of the spinal cord the efferent neurons (pre-ganglionic) then leave via the ventral/anterior root and merge together with afferent nerves forming spinal nerve. Once in the spinal nerve the pre-ganglionic neuron will then travel through what white structure, called the white rami communicantes, which contains only pre-ganglionic neurons. Here it can then travel to one of 2 places where groups of neuronal cell bodies can be found, what are they called?

Answer 62

- pre-vertebral ganglions | - para-vertebral ganglions (sympathetic chain)

Question 63

In the sympathetic nervous system the neuron synapses with the ventral horn of the spinal cord the efferent neurons (pre-ganglionic) then leave via the ventral/anterior root and merge together with afferent nerves forming spinal nerve. Once in the spinal nerve the pre-ganglionic neuron will then travel through what white structure, called the white rami communicantes, which contains only pre-ganglionic neurons. Here it can then travel to one of 2 places where groups of neuronal cell bodies can be found, called the pre-vertebral ganglions and para-vertebral ganglions (sympathetic chain). Those neurons that travel in the sympathetic chain (para-vertebal ganglion) will then enter a structure similar to the white rami communicantes. What is this structure called?

Answer 63

- grey rami communicantes - contains only post-ganglionic neurons - post-ganglionic neurons are un-myelinated so appear grey, hence the name