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Chapter 14 The Autonomic Nervous System

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Chapter 14 The Autonomic Nervous System matching exam, fill in the blank exam, true / false exam, short answer exam, clinical questions

updated 4 years ago by SuperNerdo

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College: First year, College: Second year, College: Third year, College: Fourth year

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Using Figure 14.1, match the following:

1) Myelin sheath.

2) Cell body of ANS preganglionic neuron.

3) Cell body of ANS postganglionic neuron.

4) Nonmyelinated neuron.

Using Figure 14.1, match the following:

1) Answer: E

2) Answer: A

3) Answer: C

4) Answer: C


Match the following:

5) Short preganglionic, long
postganglionic fibers.

6) Collateral ganglia.

7) Active after you have eaten a

8) Decreases heart rate.

9) Causes erection of the penis.

10) Stimulates ciliary muscles of
the eye.

11) Increases blood pressure.

A) Sympathetic
B) Parasympathetic

5) A
6) A
7) B
8) B
9) B
10) B
11) A


Match the following:

12) Preganglionic sympathetic.

13) Preganglionic

14) Postganglionic sympathetic to
sweat glands.

15) Postganglionic

16) Most postganglionic

A) Acetylcholine (ACh)
B) Norepinephrine (NE)

12) A
13) A
14) A
15) A
16) B


True/False Questions

1) Since the ANS is a visceral motor system, afferent pathways are of no importance and actually
are rarely found.

Answer: FALSE


2) The rami communicantes are associated only with the sympathetic division of the ANS.

Answer: TRUE


3) The gray rami communicantes consist of myelinated postganglionic fibers.

Answer: FALSE


4) Splanchnic nerves are mixed motor and sensory nerves.

Answer: FALSE


5) The autonomic nervous system may cause activation or inhibition, depending on the division
that is active and the target that is affected.

Answer: TRUE


6) The celiac ganglion is primarily associated with the sympathetic division.

Answer: TRUE


7) The sympathetic chain is composed of collateral ganglia.

Answer: TRUE


8) Thermoregulatory responses to increased heat are mediated by the sympathetic nervous

Answer: TRUE


9) Most disorders of the autonomic nervous system reflect abnormalities of smooth muscle

Answer: TRUE


10) Alpha-adrenergic effects are usually stimulatory and mediatory.

Answer: TRUE


11) The adrenal medulla is considered a ʺmisplacedʺ sympathetic ganglion by some.

Answer: TRUE


12) Acetylcholine is the substance released by the axonal endings of the somatic efferent fibers and
by the parasympathetic nerve fiber endings.

Answer: TRUE


13) Most body organs are innervated by only the sympathetic division of the nervous system.

Answer: FALSE


14) Through direct neural stimulation, the sympathetic division promotes many metabolic effects via hormone release.

Answer: TRUE


15) Cranial nerves VII, IX, and X contain postganglionic fibers of the parasympathetic nervous

Answer: FALSE


16) In contrast to the parasympathetic division, the sympathetic division has numerous
postganglionic neurons in the gray matter of the spinal cord.

Answer: FALSE


17) Norepinephrine-releasing fibers are called cholinergic fibers.

Answer: FALSE


18) The parasympathetic division is a branch of the somatic nervous system.

Answer: FALSE


19) The craniosacral division is another name for the parasympathetic division.

Answer: TRUE


20) The chain ganglion, like the dorsal root ganglion, contains soma from sensory neurons.

Answer: FALSE


21) Most blood vessels are innervated by the sympathetic division alone.

Answer: TRUE


22) The blood vessels of the skin are one of the few areas of the body where the vessels are
innervated by both the sympathetic and parasympathetic divisions.

Answer: FALSE


23) Events recorded in a lie detector examination are controlled by the sympathetic division.

Answer: TRUE


24) All splanchnic nerves are sympathetic.

Answer: FALSE


25) Splanchnic nerves pass through the abdominal aortic plexus.

Answer: TRUE


26) The structures that specifically exhibit vasomotor tone are mostly under sympathetic control.

Answer: TRUE


27) Since many of the same cardiac cells are innervated by both parasympathetic and sympathetic
fibers, the influence of the two divisions on the heart is synergistic.

Answer: FALSE


28) β-adrenergic receptors are the only receptors found on the heart.

Answer: FALSE


29) Autonomic reflex centers occur in the spinal cord, medulla, and midbrain.

Answer: TRUE


Fill-in-the-Blank/Short Answer Questions

1) The sympathetic division is often casually referred to as the ________ system.

Answer: fight-or-flight


2) Two major classes of adrenergic receptors, ________ and ________ are found in the ANS.

alpha; beta


3) The ________ division causes erection of the penis and clitoris.

Answer: parasympathetic


4) Sweat glands are innervated by the ________ fibers alone.

Answer: sympathetic


5) The ________ division alone stimulates the lens of the eye.

Answer: parasympathetic


6) The two cholinergic receptor types are ________ and ________.

Answer: nicotinic; muscarinic


7) The ________ receptor type is used by the heart, and when activated increases heart rate.

Answer: β1


8) The only sympathetic preganglionic neuron to go directly to an organ is one branch of the
________ splanchnic nerve.

Answer: greater


9) Pain from the diaphragm will be referred to the anterior cutaneous area of the ________.

Answer: neck


10) The parasympathetic division uses only ________ as a neurotransmitter in the ganglionic

Answer: acetylcholine


11) What effect does aging have on the ANS?

Answer: In old age, ANS efficiency decreases. Constipation (due to GI motility decline), dry eyes, and frequent eye infections can occur. Fainting may occur due to slow responding
vasomotor centers. Most of these problems can be controlled by lifestyle changes or artificial aids.


12) What studies have suggested that the ANS can also be subject to voluntary controls?

Answer: Experimentation involving meditation and biofeedback have indicated that this is
possible. Meditating yogis have indicated major physiological states, while biofeedback
training suggests that we can alter certain processes such as heart rate, blood pressure,
and muscle tone.


13) How is hypertension (high blood pressure) related to the ANS?

Answer: The ANS is involved with nearly every process that goes on within the body. Since it
controls smooth muscle activity, the heart, and blood vessel constriction, it is not surprising that hypertension and ANS activity are related. Overproduction of adrenergic responses for extended periods keeps vessels constricted and heart rate and force of contraction high. This can lead to hypertension that is often stress-related and can be treated with adrenergic blocking agents.


14) Carla was startled by an extremely loud bang that sounded like a gunshot. Her heartbeat
accelerated rapidly. When she found that the noise was only a car backfiring, she felt greatly
relieved but her heart kept beating heavily for over half an hour. Why did this happen?

Answer: The effects of sympathetic activators are long lasting, since norepinephrine is inactivated slowly. Also, the adrenal medulla releases this neurotransmitter, which adds to the long-lasting effects of adrenergic stimulation.


15) Mark eats a very big meal in the evening. After the meal his wife would like him to help clean up, but Mark explains that he is ʺtoo tiredʺ and promptly goes to sleep. What seems to be his

Answer: After a meal, parasympathetic influences dominate, which increase digestive functions while decreasing cardiac and respiratory activity. This causes the individual to feel


16) Richard has been under great stress and has complained of migraine headaches for weeks. He
tried all kinds of drugs, with little effect. When he was at the end of his rope, a friend suggested yoga and meditation. Having nothing to lose, he tried them and after several months, felt like a new person. How could these practices help him?

Answer: The practitioner of meditation and biofeedback techniques seems to enter a
physiological state of concentration that can reduce sympathetic-induced hypertension. By concentrating on relaxing thoughts, the practitioner can slow heart and respiratory
rates. The effects are more widespread than can be explained by parasympathetic influences; the control could be consciously induced.


17) Describe four paths a preganglionic sympathetic fiber may take to reach its synapse point with the postganglionic neuron.

Answer: It can synapse with a ganglionic neuron in the paravertebral ganglion; ascend or descend within the chain to synapse in another ganglion; or pass through the sympathetic chain and synapse in a collateral ganglion. The fourth path is a single event in which one branch of the greater splanchnic nerve innervates the adrenal medulla, stimulating it to release the hormone norepinephrine.


18) Discuss a way in which the opposing ANS systems cooperate with each other.

18) Discuss a way in which the opposing ANS systems cooperate with each other.


19) How are the sympathetic and parasympathetic divisions anatomically different?

1. They have unique origin sites.

2. They have different lengths of pre- and postganglionic axons.

3. Their ganglia are located in different areas.


20) In what ways are the autonomic nervous system and the somatic nervous system different?


1. The autonomic is a two-neuron system; the somatic uses one.

2. The autonomic uses smaller neuron fibers (type B or C); the somatic generally uses
the type A fibers.

3. The autonomic is mostly involuntary and automatic; the somatic is voluntary.

4. The autonomic uses several neurotransmitters and many receptor types; the
somatic uses only one.

5. The autonomic is a slow system; the somatic is a fast system.

6. The autonomic has opposing forces to regulate the body; the somatic does not.


1) Ms. Johnson, a whiplash victim, has been suffering spinal shock but is looking forward to
complete recovery. One night on evening rounds, her nurse discovered her in a fetal position,
her body drenched with sweat. She was incontinent of feces and urine and her blood pressure
was dangerously high (over 200 mm Hg). After a while she was stabilized. How could these
events happen and what is this response called?

Answer: The mass reflex reaction is a life-threatening condition involving both somatic and autonomic nerves in most quadriplegics and victims of spinal shock. The symptoms can
precipitate a stroke.


2) Mrs. Oberhaus needs surgery to correct a severe case of Raynaudʹs disease, affecting one of her
hands. What surgical procedure will be performed? After the surgery, will she be more likely
to suffer from anhidrosis (lack of sweating) or hyperhidrosis (profuse sweating) in the affected

Answer: Mrs. Oberhausʹ doctor will perform a sympathectomy. Cutting the sympathetic fibers
will result in dilation of the affected blood vessels. Since sweating is stimulated by
sympathetic nerves, after they are cut, the affected hand will suffer from anhidrosis.


3) An elderly patient in a nursing home has recurrent episodes of fainting when he stands. An
alert nurse notes that this occurs only when his room is fairly warm; on cold mornings, he has
no difficulty. What is the cause of the fainting, and how does it relate to the autonomic
nervous system and to room temperature?

Answer: The fainting episodes are a result of orthostatic hypotension, due to slowed responding
of aging sympathetic vasoconstrictor centers. The condition is exaggerated when blood supply to the skin is increased (as when the room is warm) since the shunting of blood to the skin reduces blood flow to other body parts.


4) Describe outcome criteria that can be used to evaluate whether a patient is effectively coping
with a stressful problem.

Answer: Signs of mobilization of the sympathetic nervous system are: pounding heart, rapid deep breathing, cold and sweaty skin, and dilated pupils. Therefore, outcome criteria to evaluate a patientʹs ability to cope would be: regular heart beat, even and unlabored breathing, warm and dry skin, and constricted or normal pupils.


5) Sensory nerve endings that are located in the carotid bodies are rich in vagal fibers. How
would external stimulation of the carotid artery, such as carotid message, affect the heart rate?

Answer: External stimulation of the carotid artery would slow the heart down because of the
stimulation of the vagus nerve.


6) Propranolol hydrochloride (Inderal) is a beta-adrenergic blocker often used as an antianginal, antiarrhythmic, and antihypertensive drug. Before giving Inderal to a patient, the nurse
should assess what?

Answer: Inderal blocks beta-adrenergic receptors in the heart, thereby decreasing the influence
of the sympathetic nervous system on these tissues. The nurse should assess the heart
rate for bradycardia and the blood pressure for hypertension.


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