Autonomic nervous system anatomy

Autonomic nervous system anatomy US Medical PG Question 1: A 68-year-old man comes to the physician because of double vision and unilateral right eye pain that began this morning. His vision improves when he covers either eye. He has hypertension, mild cognitive impairment, and type 2 diabetes mellitus. The patient has smoked two packs of cigarettes daily for 40 years. His current medications include lisinopril, donepezil, metformin, and insulin with meals. His temperature is 37°C (98.6°F), pulse is 85/minute, respirations are 12/minute, and blood pressure is 132/75 mm Hg. His right eye is abducted and depressed with slight intorsion. He can only minimally adduct the right eye. Visual acuity is 20/20 in both eyes. Extraocular movements of the left eye are normal. An MRI of the head shows no abnormalities. His fingerstick blood glucose concentration is 325 mg/dL. Further evaluation is most likely to show which of the following?

• A. Ptosis (Correct Answer)
• B. Dilated and fixed pupil
• C. Bitemporal hemianopsia
• D. Miosis and anhidrosis
• E. Positive swinging-flashlight test

Autonomic nervous system anatomy Explanation: ***Ptosis*** - The patient's presentation of an **abducted and depressed right eye with minimal adduction** is highly suggestive of an **ischemic (diabetic) third nerve palsy**. - Ischemic third nerve palsies characteristically **spare the pupillary fibers** (pupil remains normal in size and reactive) but affect the **somatomotor fibers** that innervate the extraocular muscles and the **levator palpebrae superioris**, leading to **ptosis**. - The key clinical feature distinguishing ischemic from compressive CN III palsy is **pupil-sparing**, which is present in this case. *Dilated and fixed pupil* - A dilated and fixed pupil would indicate **compression of the oculomotor nerve**, often by an aneurysm (e.g., posterior communicating artery aneurysm). - Compressive lesions affect the superficial **pupillomotor fibers** first, while ischemic third nerve palsies, as seen in patients with **diabetes**, typically affect the inner somatomotor fibers while **sparing the pupil**. *Bitemporal hemianopsia* - This visual field defect is characteristic of **optic chiasm compression**, commonly caused by a **pituitary adenoma**. - This patient's symptoms are localized to a single eye and involve extraocular muscle dysfunction, not visual field loss. *Miosis and anhidrosis* - **Miosis** (constricted pupil) and **anhidrosis** (decreased sweating) on one side of the face, accompanied by **ptosis**, are classic signs of **Horner syndrome**. - Horner syndrome results from a lesion in the **sympathetic pathway**, which is inconsistent with the extraocular muscle deficits observed in this patient. *Positive swinging-flashlight test* - A positive swinging-flashlight test (Marcus Gunn pupil) indicates an **afferent pupillary defect**, often seen in conditions affecting the **optic nerve** (e.g., optic neuritis, severe retinal disease). - This patient's symptoms point to a **cranial nerve III palsy**, which affects efferent ocular movements and typically does not cause an afferent pupillary defect.

Autonomic nervous system anatomy US Medical PG Question 2: A 65-year-old male with a history of CHF presents to the emergency room with shortness of breath, lower leg edema, and fatigue. He is diagnosed with acute decompensated congestive heart failure, was admitted to the CCU, and treated with a medication that targets beta-1 adrenergic receptors preferentially over beta-2 adrenergic receptors. The prescribing physician explained that this medication would only be used temporarily as its efficacy decreases within 2-3 days due to receptor downregulation. Which of the following was prescribed?

• A. Epinephrine
• B. Norepinephrine
• C. Milrinone
• D. Isoproterenol
• E. Dobutamine (Correct Answer)

Autonomic nervous system anatomy Explanation: ***Dobutamine*** - **Dobutamine** is a beta-1 adrenergic agonist preferentially acting on beta-1 receptors in the heart, increasing contractility and heart rate during acute decompensated heart failure. - Its efficacy reduces over time due to **receptor downregulation**, making it effective for only short-term use, typically less than 72 hours. *Epinephrine* - **Epinephrine** is a non-selective adrenergic agonist acting on both alpha and beta receptors, causing vasoconstriction and bronchodilation in addition to cardiac stimulation. - It is typically used in emergency situations like **cardiac arrest** and **anaphylaxis**, not primarily for acute CHF exacerbation in this manner. *Norepinephrine* - **Norepinephrine** primarily acts on alpha-1 adrenergic receptors, causing significant vasoconstriction, and has some beta-1 agonistic effects. - It is mainly used as a **vasopressor** in septic shock or severe hypotension to increase systemic vascular resistance, rather than directly improving cardiac output in decompensated CHF. *Milrinone* - **Milrinone** is a phosphodiesterase-3 inhibitor, increasing intracellular cAMP levels and leading to positive inotropy and vasodilation. - While used in acute heart failure, its mechanism is distinct from adrenergic agonists, and its efficacy is not limited by a rapid receptor downregulation mechanism as described. *Isoproterenol* - **Isoproterenol** is a non-selective beta-adrenergic agonist, stimulating both beta-1 and beta-2 receptors, leading to increased heart rate and contractility, as well as bronchodilation and vasodilation. - Due to its strong chronotropic effects and potential for severe arrhythmias and hypotension, it is rarely used in CHF and is primarily reserved for conditions like **bradycardia** or **torsades de pointes**.

Autonomic nervous system anatomy US Medical PG Question 3: A 72-year-old woman is brought in to the emergency department after her husband noticed that she appeared to be choking on her dinner. He performed a Heimlich maneuver but was concerned that she may have aspirated something. The patient reports a lack of pain and temperature on the right half of her face, as well as the same lack of sensation on the left side of her body. She also states that she has been feeling "unsteady" on her feet. On physical exam you note a slight ptosis on the right side. She is sent for an emergent head CT. Where is the most likely location of the neurological lesion?

• A. Pons
• B. Internal capsule
• C. Cervical spinal cord
• D. Medulla (Correct Answer)
• E. Midbrain

Autonomic nervous system anatomy Explanation: ***Medulla*** - This presentation describes **Wallenberg syndrome** (lateral medullary syndrome), characterized by **ipsilateral facial sensory loss**, **contralateral body sensory loss**, and **ataxia** due to involvement of the spinothalamic tracts, trigeminal nucleus, and cerebellar pathways. - **Dysphagia** (choking) and **Horner's syndrome** (ptosis, miosis, anhidrosis) are also classic signs, specifically the ptosis seen here, pointing to an infarct in the **lateral medulla**. *Pons* - Lesions in the pons typically present with varying degrees of **cranial nerve deficits** (e.g., trigeminal, abducens, facial) and **motor or sensory deficits** affecting both sides of the body due to the decussation of tracts. - The specific combination of **crossed sensory loss** and other symptoms seen here is not characteristic of isolated pontine lesions. *Internal capsule* - A lesion in the internal capsule would primarily cause **contralateral motor weakness (hemiparesis)** and **sensory loss** affecting both the face and body on the same side, without the ipsilateral facial involvement. - It would not explain the **ataxia** or specific cranial nerve signs like ptosis. *Cervical spinal cord* - Spinal cord lesions result in **sensory and motor deficits below the level of the lesion**, affecting both sides of the body symmetrically, or ipsilaterally depending on the tract involved. - They do not cause **facial sensory disturbances**, **dysphagia**, or **ataxia** in the manner described. *Midbrain* - Midbrain lesions typically involve the **oculomotor nerve** (CN III), causing eye movement abnormalities, and can result in **contralateral hemiparesis**. - They do not produce the **crossed sensory deficits** (ipsilateral face, contralateral body) or **ataxia** characteristic of this case.

Autonomic nervous system anatomy US Medical PG Question 4: A 29-year-old man presents to his primary care provider complaining of not being able to get enough rest at night. He goes to bed early enough and has otherwise good sleep hygiene but feels drained the next day. He feels he is unable to perform optimally at work, but he is still a valued employee and able to complete his share of the work. About a month ago his wife of 5 years asked for a divorce and quickly moved out. He has cut out coffee after 12 pm and stopped drinking alcohol. He also exercises 3 days per week. Today, his blood pressure is 120/80 mm Hg, heart rate is 95/min, respiratory rate is 25/min, and temperature is 37.0°C (98.6°F ). On physical exam, his heart has a regular rate and rhythm and his lungs are clear to auscultation bilaterally. A CMP, CBC, and thyroid test are negative. Which of the following statements best describes this patient’s condition?

• A. Symptoms are usually self-limited and may persist for 2 years
• B. Symptoms typically resolve within 6 months after the stressor ends (Correct Answer)
• C. Symptoms develop within 3 months of the stressor
• D. Symptoms may be persistent if the stressor is chronic
• E. Symptoms represent a maladaptive response to an identifiable stressor

Autonomic nervous system anatomy Explanation: ***Symptoms typically resolve within 6 months after the stressor ends*** - This statement accurately describes the **temporal criterion for adjustment disorder** according to DSM-5. Once the stressor or its consequences have terminated, symptoms should resolve within 6 months. - This patient experienced a clear stressor (divorce and wife moving out ~1 month ago) and developed symptoms in response. The diagnosis of adjustment disorder requires that these symptoms resolve within 6 months of the stressor's termination. - His symptoms (poor sleep, feeling drained, suboptimal performance) represent a significant but not incapacitating response, consistent with adjustment disorder. Normal labs rule out medical causes. - This temporal criterion distinguishes adjustment disorder from more chronic conditions and helps guide prognosis and treatment planning. *Symptoms are usually self-limited and may persist for 2 years* - Adjustment disorder symptoms should resolve within **6 months**, not 2 years, after the stressor or its consequences have ended. - If symptoms persist beyond 6 months, this suggests either ongoing stressor consequences, a persistent subtype (for chronic stressors), or an alternative diagnosis should be considered. *Symptoms develop within 3 months of the stressor* - While this is a **correct diagnostic criterion** (symptoms must develop within 3 months of stressor onset), it only addresses timing of onset, not the complete picture. - The question asks for the statement that "best describes" the condition, and the resolution timeline is more distinctive and prognostically important than onset timing alone. *Symptoms may be persistent if the stressor is chronic* - This describes the **persistent specifier** in DSM-5, which applies when the stressor or its consequences are ongoing (chronic stressor or enduring consequences). - However, in this case, the stressor appears to be acute (wife moved out), not chronic, making this less applicable to the specific clinical scenario presented. *Symptoms represent a maladaptive response to an identifiable stressor* - This is a **core defining feature** of adjustment disorder - the development of emotional/behavioral symptoms in response to an identifiable stressor with marked distress or impairment. - While accurate, this is a general characteristic shared across the definition and doesn't capture the specific **temporal criteria** (resolution within 6 months) that is most distinctive for adjustment disorder diagnosis and prognosis.

Autonomic nervous system anatomy US Medical PG Question 5: A 21-year-old man was involved in a motor vehicle accident and died. At autopsy, the patient demonstrated abnormally increased mobility at the neck. A section of cervical spinal cord at C6 was removed and processed into slides. Which of the following gross anatomic features is most likely true of this spinal cord level?

• A. Cuneate and gracilis fasciculi are present (Correct Answer)
• B. Least amount of white matter
• C. Prominent lateral horns
• D. Absence of gray matter enlargement
• E. Involvement with parasympathetic nervous system

Autonomic nervous system anatomy Explanation: **Cuneate and gracilis fasciculi are present** - At the **C6 level** of the spinal cord, both the **fasciculus gracilis** (carrying information from the lower body) and the **fasciculus cuneatus** (carrying information from the upper body) are present in the dorsal column. - The fasciculus cuneatus typically appears at **T6 and above**, making it visible at C6. *Least amount of white matter* - The cervical spinal cord, particularly at C6, contains a **significant amount of white matter** because it carries all ascending and descending tracts to and from the brain, including those for the upper and lower limbs. - The **sacral segments** typically have the least amount of white matter due to fewer tracts remaining. *Prominent lateral horns* - **Lateral horns** are characteristic of the **thoracic and upper lumbar (T1-L2/L3)** spinal cord segments, where they house preganglionic sympathetic neurons. - They are generally **absent or poorly developed** in the cervical spinal cord. *Absence of gray matter enlargement* - The **cervical enlargement** of the spinal cord, particularly pronounced from C4 to T1, contains an increased amount of gray matter to accommodate the innervation of the **upper limbs**. - Therefore, the C6 level would show **significant gray matter enlargement**. *Involvement with parasympathetic nervous system* - The **parasympathetic nervous system** exits the spinal cord at the **sacral levels (S2-S4)** and as cranial nerves, not primarily from the cervical spinal cord through distinct horns. - The cervical spinal cord is primarily associated with **somatic motor and sensory pathways** for the neck, shoulders, and upper limbs, and receives some sympathetic input, but is not where parasympathetic outflow predominantly originates.

Autonomic nervous system anatomy US Medical PG Question 6: Which neurotransmitter is primarily responsible for parasympathetic effects on heart rate?

• A. Norepinephrine
• B. Dopamine
• C. Acetylcholine (Correct Answer)
• D. Epinephrine

Autonomic nervous system anatomy Explanation: ***Acetylcholine*** - **Acetylcholine** is the primary neurotransmitter released by postganglionic parasympathetic neurons. - It acts on **muscarinic receptors** (M2 receptors) in the heart to decrease heart rate. *Norepinephrine* - **Norepinephrine** is primarily associated with the **sympathetic nervous system**, increasing heart rate and contractility. - It acts on **beta-1 adrenergic receptors** in the heart. *Dopamine* - **Dopamine** is a precursor to norepinephrine and epinephrine, and primarily functions as a neurotransmitter in the **central nervous system** and in regulating renal blood flow. - While it can have cardiac effects, it is not the primary neurotransmitter for parasympathetic actions on heart rate. *Epinephrine* - **Epinephrine** (adrenaline) is a hormone released by the adrenal medulla and a neurotransmitter in the sympathetic nervous system, causing an **increase in heart rate** and contractility. - It works through **beta-1 adrenergic receptors**, antagonistic to parasympathetic effects.

Autonomic nervous system anatomy US Medical PG Question 7: A 49-year-old male presents with a primary complaint of several recent episodes of severe headache, sudden anxiety, and a "racing heart". The patient originally attributed these symptoms to stress at work; however, these episodes are becoming more frequent and severe. Laboratory evaluation during such an episode reveals elevated plasma free metanephrines. Which of the following additional findings in this patient is most likely?

• A. Anhidrosis
• B. Diarrhea
• C. Episodic hypertension (Correct Answer)
• D. Hypoglycemia
• E. Decreased 24 hour urine vanillylmandelic acid (VMA) levels

Autonomic nervous system anatomy Explanation: ***Episodic hypertension*** - The patient's symptoms of severe headache, sudden anxiety, a "racing heart," and **elevated plasma free metanephrines** are classic presentations of a **pheochromocytoma**, a tumor that produces catecholamines. These catecholamines cause **paroxysmal (episodic) hypertension**. - **Hypertensive episodes** are a hallmark symptom of pheochromocytoma, often triggered by stress, exercise, or changes in body position. *Anhidrosis* - **Anhidrosis** (lack of sweating) is not a typical manifestation of pheochromocytoma; rather, patients often experience **diaphoresis (excessive sweating)** due to overstimulation of adrenergic receptors. - Anhidrosis can be a feature of certain neuropathies or autonomic dysfunction, but it does not align with the hyperadrenergic state described. *Diarrhea* - While pheochromocytoma can cause gastrointestinal symptoms due to altered autonomic tone, **diarrhea** is uncommon; **constipation** is more frequently reported because of catecholamine effects on gut motility. - Diarrhea is more commonly associated with conditions like carcinoid syndrome or irritable bowel syndrome. *Hypoglycemia* - **Hypoglycemia** is generally not associated with pheochromocytoma; the excess catecholamines typically promote **glycogenolysis and gluconeogenesis**, leading to **hyperglycemia**. - Hypoglycemia could be caused by an insulinoma or certain endocrine deficiencies. *Decreased 24 hour urine vanillylmandelic acid (VMA) levels* - **Elevated plasma free metanephrines** indicate excessive catecholamine production, which would lead to **elevated 24-hour urine VMA** (a catecholamine metabolite), not decreased levels. - Decreased VMA levels would suggest conditions with reduced catecholamine production, which contradicts the clinical picture of hyperadrenergic symptoms.

Autonomic nervous system anatomy US Medical PG Question 8: An 87-year-old male presents to his neurologist for a follow-up visit. He is being followed for an inoperable tumor near his skull. He reports that he recently noticed that food has started to lose its taste. He also notes increasing difficulty with swallowing. He has a history of myocardial infarction, diabetes mellitus, hyperlipidemia, hypertension, and presbycusis. He takes aspirin, metoprolol, metformin, glyburide, atorvastatin, lisinopril, and hydrochlorothiazide. On examination, the patient is a frail-appearing male sitting in a wheelchair. He is oriented to person, place, and time. Gag reflex is absent on the right side. A taste evaluation is performed which demonstrates a decreased ability to detect sour and bitter substances on the right posterior tongue. The nerve responsible for this patient’s loss of taste sensation also has which of the following functions?

• A. Somatic sensory innervation to the roof of the pharynx
• B. Parasympathetic innervation to the trachea
• C. Somatic sensory innervation to the lower lip
• D. Parasympathetic innervation to the parotid gland (Correct Answer)
• E. Parasympathetic innervation to the submandibular gland

Autonomic nervous system anatomy Explanation: ***Parasympathetic innervation to the parotid gland*** - The patient's symptoms, including loss of taste on the **right posterior tongue**, difficulty swallowing, and an absent gag reflex, point to an issue with the **glossopharyngeal nerve (CN IX)**. - The glossopharyngeal nerve provides **parasympathetic innervation to the parotid gland** via the otic ganglion, stimulating saliva production. *Somatic sensory innervation to the roof of the pharynx* - The glossopharyngeal nerve (CN IX) does provide somatic sensory innervation to the pharynx, but specifically the **posterior 1/3 of the tongue**, tonsils, and part of the pharynx, not primarily the roof. - While related to the pharynx, this option is not the most precise or unique function associated with the primary nerve implicated here. *Parasympathetic innervation to the trachea* - **Parasympathetic innervation to the trachea** is primarily mediated by the **vagus nerve (CN X)**, which innervates the smooth muscle and glands of the trachea and bronchi. - The glossopharyngeal nerve (CN IX) does not have a direct role in tracheal innervation. *Somatic sensory innervation to the lower lip* - **Somatic sensory innervation to the lower lip** is primarily provided by the **mental nerve**, a branch of the **trigeminal nerve (CN V)**. - The glossopharyngeal nerve (CN IX) is not involved in sensory innervation of the lower lip. *Parasympathetic innervation to the submandibular gland* - **Parasympathetic innervation to the submandibular and sublingual glands** is provided by the **facial nerve (CN VII)** via the submandibular ganglion. - This function is distinct from the glossopharyngeal nerve's role in innervating the parotid gland.

Autonomic nervous system anatomy US Medical PG Question 9: A 28-year-old male presents to his primary care physician with complaints of intermittent abdominal pain and alternating bouts of constipation and diarrhea. His medical chart is not significant for any past medical problems or prior surgeries. He is not prescribed any current medications. Which of the following questions would be the most useful next question in eliciting further history from this patient?

• A. "Does the diarrhea typically precede the constipation, or vice-versa?"
• B. "Is the diarrhea foul-smelling?"
• C. "Please rate your abdominal pain on a scale of 1-10, with 10 being the worst pain of your life"
• D. "Are the symptoms worse in the morning or at night?"
• E. "Can you tell me more about the symptoms you have been experiencing?" (Correct Answer)

Autonomic nervous system anatomy Explanation: ***Can you tell me more about the symptoms you have been experiencing?*** - This **open-ended question** encourages the patient to provide a **comprehensive narrative** of their symptoms, including details about onset, frequency, duration, alleviating/aggravating factors, and associated symptoms, which is crucial for diagnosis. - In a patient presenting with vague, intermittent symptoms like alternating constipation and diarrhea, allowing them to elaborate freely can reveal important clues that might not be captured by more targeted questions. *Does the diarrhea typically precede the constipation, or vice-versa?* - While knowing the sequence of symptoms can be helpful in understanding the **pattern of bowel dysfunction**, it is a very specific question that might overlook other important aspects of the patient's experience. - It prematurely narrows the focus without first obtaining a broad understanding of the patient's overall symptomatic picture. *Is the diarrhea foul-smelling?* - Foul-smelling diarrhea can indicate **malabsorption** or **bacterial overgrowth**, which are important to consider in some gastrointestinal conditions. - However, this is a **specific symptom inquiry** that should follow a more general exploration of the patient's symptoms, as it may not be relevant if other crucial details are missed. *Please rate your abdominal pain on a scale of 1-10, with 10 being the worst pain of your life* - Quantifying pain intensity is useful for assessing the **severity of discomfort** and monitoring changes over time. - However, for a patient with intermittent rather than acute, severe pain, understanding the **character, location, and triggers** of the pain is often more diagnostically valuable than just a numerical rating initially. *Are the symptoms worse in the morning or at night?* - Diurnal variation can be relevant in certain conditions, such as inflammatory bowel diseases where nocturnal symptoms might be more concerning, or functional disorders whose symptoms might be stress-related. - This is another **specific question** that should come after gathering a more complete initial picture of the patient's symptoms to ensure no key information is overlooked.

Autonomic nervous system anatomy US Medical PG Question 10: A 29-year-old man presents to the emergency room with facial weakness. He first noticed that he was having trouble smiling normally while at dinner with friends the night before. He also noticed that his food had less taste than usual during the dinner. He woke up on the day of presentation with a complete inability to move the right side of his face. He recently returned from an extended camping trip in the Appalachian Mountains, but he did not find any tick bites following the camping trip. His past medical history is notable for Achilles tendonitis and carpal tunnel syndrome. He works as a computer programmer. He smokes marijuana occasionally but does not smoke cigarettes. His temperature is 98.6°F (37°C), blood pressure is 120/75 mmHg, pulse is 80/min, and respirations are 18/min. On exam, he is well-appearing in no acute distress. There is loss of facial wrinkles along the forehead, eyelids, and nasolabial folds. He is unable to completely close his right eye, raise his eyebrows, or smile with the right side of his mouth. Sensation is intact to light touch along the forehead, maxilla, and mandible bilaterally. Where is the most likely source of this patient’s lesion?

• A. Superior orbital fissure
• B. Petrotympanic fissure
• C. Inferior orbital fissure
• D. Dorsal frontal lobe
• E. Stylomastoid foramen (Correct Answer)

Autonomic nervous system anatomy Explanation: ***Stylomastoid foramen*** - The patient presents with classic signs of **Bell's palsy**, characterized by unilateral **facial weakness affecting both the upper and lower face**, including loss of forehead wrinkles, inability to close the eye, and loss of nasolabial folds. - The **stylomastoid foramen** is the exit point of the **facial nerve (CN VII)** from the skull, and inflammation or compression at this site is the most common cause of idiopathic facial nerve paralysis (Bell's palsy). *Superior orbital fissure* - Lesions in the **superior orbital fissure** would primarily affect cranial nerves **III, IV, V1, and VI**, leading to symptoms like ophthalmoplegia, ptosis, and sensory loss in the V1 distribution of the face, not a facial nerve palsy. - While it is a bony canal, it is not the primary exit for the facial nerve. *Petrotympanic fissure* - The **petrotympanic fissure** transmits the **chorda tympani nerve**, which carries taste sensation from the anterior two-thirds of the tongue and parasympathetic fibers to the submandibular and sublingual glands. - A lesion here would cause **loss of taste** and potentially dry mouth, but would not typically explain the extensive motor deficits of the entire ipsilateral face as seen in this patient, which indicates a more proximal or complete facial nerve involvement. *Inferior orbital fissure* - The **inferior orbital fissure** transmits the **maxillary nerve (V2)**, the zygomatic nerve, and branches of the inferior ophthalmic vein, affecting sensation to the mid-face. - Damage here would result in **sensory deficits in the V2 distribution** and potentially orbital symptoms, not motor weakness of the facial muscles. *Dorsal frontal lobe* - A lesion in the **dorsal frontal lobe**, specifically involving the **motor cortex**, would cause contralateral facial weakness. However, it would typically spare the forehead and eyelid muscles due to bilateral cortical innervation of the upper facial muscles. - The patient's presentation of **forehead and entire facial weakness** is characteristic of a **lower motor neuron lesion** of the facial nerve, not a central (upper motor neuron) lesion.

Autonomic nervous system anatomy Flashcard 1 of 9

Question: The _____ nucleus sends parasympathetic fibers to the heart, lungs, and upper GI tract

Answer: dorsal motor

Autonomic nervous system anatomy Flashcard 2 of 9

Question: Lesions to CN III (oculomotor) result in a "_____" pupil (size)

Answer: blown/dilated

Autonomic nervous system anatomy Flashcard 3 of 9

Question: Which nerves (2) carry parasympathetics to the GI tract? _____

Answer: Vagus, Pelvic splanchnic

Autonomic nervous system anatomy Flashcard 4 of 9

Question: Pelvic splanchnic nerves and CNs III, VII, IX and X are part of the _____ nervous system

Answer: parasympathetic

Autonomic nervous system anatomy Flashcard 5 of 9

Question: Which sympathetics (2) innervate the regions of the foregut and midgut? _____

Answer: Greater and lesser splanchnics (T5 - T12)

Autonomic nervous system anatomy Flashcard 6 of 9

Question: Which sacral nerves carry parasympathetics? _____

Answer: S2 - S4

Autonomic nervous system anatomy Flashcard 7 of 9

Question: Which parasympathetics innervate the regions of the foregut and midgut? _____

Answer: Vagus nerve

Autonomic nervous system anatomy Flashcard 8 of 9

Question: Does the adrenal medulla have postganglionic sympathetic fibers?_____

Answer: No

Autonomic nervous system anatomy Flashcard 9 of 9

Question: celiac ganglion

Answer: neural crest