ANS practice extra

Describe how diabetic autonomic neuropathy affects the body's involuntary functions.

A. No impact on bodily functions.

B. Primarily affects voluntary muscle control.

C. Disrupts normal regulation of involuntary functions due to nerve damage.

D. Enhances temperature regulation.

C

What are clusters of nerve cell bodies in the autonomic nervous system called?

A. Preganglionic neurons.

B. Postganglionic neurons.

C. Somatic ganglia.

D. Autonomic ganglia.

D

What is gastroparesis?

A. Stomach inflammation.

B. Excess stomach acid.

C. Stomach does not empty properly.

D. Stomach empties too quickly.

C

What is the role of nicotinic receptors in the autonomic nervous system?

A. Facilitate communication between preganglionic and postganglionic neurons in both divisions.

B. Inhibit neurotransmitter release at neuromuscular junctions.

C. Found only in the CNS.

D. Responsible for the sympathetic fight-or-flight response.

A

What is the parasympathetic nervous system’s role in regulating heart rate and digestion?

A. Increases heart rate and inhibits digestion.

B. Decreases heart rate and promotes digestion.

C. No effect on either.

D. Increases heart rate and promotes digestion.

B

How does sympathetic activation affect the heart’s contraction strength?

A. Affects heart rate only.

B. Increases force of contraction.

C. Decreases force of contraction.

D. Has no effect.

B

Why is acetylcholinesterase important in neurotransmission?

A. Synthesizes acetylcholine.

B. Facilitates neurotransmitter release.

C. Prolongs acetylcholine’s presence in the synaptic cleft.

D. Terminates acetylcholine’s action to prevent continuous stimulation.

D

Dizziness and fainting upon standing may indicate which condition?

A. Chronic fatigue syndrome.

B. Diabetic neuropathy.

C. Orthostatic hypotension.

D. Multiple system atrophy.

C

How do preganglionic ANS neurons differ from postganglionic neurons?

A. Preganglionic neurons are shorter in both divisions.

B. Preganglionic neurons are lightly myelinated; postganglionic neurons are unmyelinated.

C. Preganglionic neurons secrete ACh; postganglionic neurons secrete either epinephrine or norepinephrine.

D. A and B.

E. All of the above.

B

Which muscles and glands are regulated by the autonomic nervous system?

A. Smooth and skeletal muscle only.

B. Skeletal muscle and connective tissue.

C. Cardiac muscle and glands only.

D. Cardiac muscle, smooth muscle, and glands.

D

Which condition is associated with autonomic dysfunction?

A. Corticobasal degeneration.

B. Progressive supranuclear palsy (PSP).

C. Multiple system atrophy.

D. Parkinson-plus syndromes.

E. Dementia with Lewy bodies.

C

Which ANS division is called the craniosacral division?

A. Parasympathetic.

B. Somatic.

C. Sympathetic.

D. Enteric.

A

What is the primary role of the cardiac plexus?

A. Manage respiratory rate.

B. Regulate heart rate and cardiac output.

C. Control skeletal muscle movement.

D. Facilitate digestion.

B

How does the cardiac plexus interact with the ANS divisions?

A. Solely regulates blood pressure.

B. Integrates signals from sympathetic and parasympathetic fibers to regulate heart function.

C. Receives only sympathetic signals.

D. Does not interact with the ANS.

B

What might MAO deficiency do to catecholamine levels?

A. No change.

B. Increase serotonin only.

C. Decrease catecholamines.

D. Increase catecholamines.

D

What do G-protein-coupled receptors (GPCRs) do in ANS neurotransmission?

A. Mediate slower responses by influencing ion channels and cellular responses.

B. Occur only in the somatic nervous system.

C. Provide rapid nerve impulse transmission.

D. Directly open ion channels for immediate effects.

A

What happens when ACh binds M2 muscarinic receptors in the heart?

A. Increases heart rate and contractility.

B. Causes vasodilation and increased blood flow.

C. Inhibits neurotransmitter release.

D. Hyperpolarizes pacemaker cells and slows spontaneous depolarization.

D

What is the significance of choline acetyltransferase (ChAT) in the ANS?

A. Breaks down ACh.

B. Regulates adrenal neurotransmitter release.

C. Synthesizes ACh, an important ANS neurotransmitter.

D. Synthesizes norepinephrine.

C

What is divergence in the ANS?

A. Multiple preganglionic neurons synapsing on one postganglionic neuron.

B. Interaction between sympathetic and parasympathetic divisions.

C. One preganglionic neuron synapsing on multiple postganglionic neurons.

D. Neurotransmitter release at a synapse.

C

Tillie feels nauseous and bloated and becomes full after eating a small amount. What does suspected gastroparesis mean?

A. Inflammation of the stomach and intestinal lining.

B. Electrolyte imbalance from fluid loss.

C. Persistent extreme vomiting.

D. Slowed gastric motility causing delayed emptying.

D

What are the three main products of catecholamine synthesis?

A. Dopamine, norepinephrine, and epinephrine.

B. Serotonin, dopamine, and norepinephrine.

C. Norepinephrine, serotonin, and epinephrine.

D. Epinephrine, ACh, and dopamine.

A

What effect can ACh have on GPCRs?

A. Blocks ion channels.

B. Inhibits GPCRs.

C. Activates GPCRs.

D. Decreases neurotransmitter release.

C

How does dysautonomia affect bodily functions?

A. Improves ANS efficiency.

B. Affects only respiration.

C. Affects only the somatic nervous system.

D. Disrupts ANS function, potentially affecting heart rate, blood pressure, and digestion.

D

In neurophysiology, divergence means:

A. Multiple presynaptic neurons communicate with one postsynaptic neuron.

B. One presynaptic neuron communicates with multiple postsynaptic neurons.

C. The depolarization threshold for an action potential.

D. Summation of graded potentials.

B

Why is divergence significant in the ANS?

A. Enables a widespread response by activating multiple postganglionic neurons from one preganglionic neuron.

B. Inhibits neurotransmitter release.

C. Limits the response to one organ.

D. Synchronizes the two ANS divisions.

A

How does sympathetic activation affect breathing?

A. No effect.

B. Constricts bronchi and decreases airflow.

C. Dilates bronchi and increases airflow.

D. Slows breathing and reduces oxygen intake.

C

Which condition is commonly associated with ANS dysfunction?

A. Alzheimer’s disease.

B. Asthma.

C. Orthostatic hypotension.

D. Parkinson’s disease.

C

What is divergence?

A. One preganglionic neuron acts on many postganglionic neurons.

B. Many preganglionic neurons synapse on one postganglionic neuron.

C. One sensory receptor is activated.

D. All senses synapse with the thalamus.

A

How does the fight-or-flight response prepare the body for action?

A. Increases heart rate, redirects blood to muscles, and releases adrenaline.

B. Slows bodily functions to conserve energy.

C. Enhances digestion and relaxation.

D. Focuses on long-term planning.

A

During stress, which neurotransmitter is predominantly released, and what does it do?

A. Dopamine, improves mood and reduces stress.

B. Epinephrine, relaxes blood vessels and lowers blood pressure.

C. ACh, slows heart rate and promotes digestion.

D. Norepinephrine, increases heart rate and blood flow to muscles.

D

Which medication targets β2 receptors to relieve an asthma attack, and how does it work?

A. Bronchodilator; activates β2 receptors to relax airway smooth muscle.

B. Antihistamine; blocks β2 receptors.

C. Sedative; depresses β2 activity.

D. Corticosteroid; inhibits β2 receptors.

A

What is the primary role of the parasympathetic division?

A. Sensory processing.

B. Maintenance activities and energy conservation.

C. Muscle contraction.

D. Fight-or-flight response.

B

What do α1 adrenergic receptors do?

A. Inhibit vasodilation and relax eye muscles.

B. Regulate digestion and promote sleep.

C. Mediate vasoconstriction and pupil dilation as part of sympathetic responses.

D. Affect skeletal muscle contraction.

C

During stress, which ANS division is activated, and what responses can it produce?

A. Sympathetic; both stimulatory and inhibitory responses.

B. Parasympathetic; inhibitory responses.

C. Parasympathetic; stimulatory responses.

D. Sympathetic; stimulatory responses only.

D

What can ACh binding at muscarinic receptors do?

A. Always inhibit the effector.

B. Produce excitation or inhibition depending on the tissue.

C. Always excite the effector.

D. Block reuptake of muscarine or release muscarine.

B

Where do fibers of the craniosacral ANS division originate?

A. Brainstem and sacral spinal cord.

B. Entire spinal cord.

C. Brainstem only.

D. Thoracic and lumbar spinal cord.

A

How does sympathetic activation prepare the body for rapid action?

A. Increases heart rate, dilates airways, and inhibits digestion.

B. Decreases heart rate and promotes digestion.

C. Has no significant effects.

D. Affects only digestion.

A

Dizziness upon standing may indicate which condition?

A. Multiple system atrophy.

B. Orthostatic hypotension.

C. Cerebral palsy.

D. Diabetic autonomic neuropathy.

B

What can ACh do through GPCRs?

A. Open Ca2+ channels and increase cytosolic Ca2+.

B. Inhibit neurotransmitter release.

C. Cause hyperpolarization.

D. Decrease membrane ion permeability.

A

What changes may occur during sympathetic activation in response to a sudden threat?

A. Increased saliva and relaxed muscles.

B. Increased heart rate and blood pressure.

C. Decreased breathing and blood sugar.

D. Decreased heart rate and increased digestion.

B

What changes may occur during sympathetic activation?

A. Decreased heart rate and increased digestion.

B. Lower blood sugar and constricted airways.

C. Increased heart rate and dilated airways.

D. Increased saliva and relaxed muscles.

C

What is the main function of the sympathetic nervous system during stress?

A. Mobilizes the body’s resources for immediate physical action.

B. Controls voluntary movement.

C. Regulates involuntary functions generally.

D. Promotes relaxation and energy conservation.

A

What activities are primarily promoted by the parasympathetic division?

A. Increased heart rate.

B. Fight-or-flight responses.

C. Heightened alertness.

D. Rest-and-digest activities.

D

In severe hypotension, which adrenergic receptor activation could help raise blood pressure?

A. β2 activation, causing vasodilation.

B. α2 activation, decreasing heart rate and pressure.

C. α1 activation, causing vasoconstriction.

D. β1 activation, increasing digestive enzyme secretion.

C

What is the primary effect of ACh on cardiac M2 receptors?

A. Increased heart rate and contractility.

B. Hyperpolarization and slowed spontaneous depolarization.

C. Vasodilation and increased blood flow.

D. Inhibition of neurotransmitter release.

B

What might autonomic denervation do to heart rate and blood pressure?

A. Decrease both due to lack of stimulation.

B. Cause irregular heart rate but stable pressure.

C. Cause no changes.

D. Increase them due to hypersensitivity.

D

Which neurotransmitter is primarily associated with the parasympathetic division?

A. ACh.

B. Epinephrine.

C. Norepinephrine.

D. Dopamine.

A

What are the two main enzymes that metabolize catecholamines?

A. AChE and dopamine β-hydroxylase.

B. LDH and phosphofructokinase.

C. COMT and MAO.

D. Serotonin transporter and glutamate decarboxylase.

C

What might excessive sympathetic stimulation do to kidney function and blood pressure?

A. Increase renin release, raising blood pressure.

B. Cause no change.

C. Decrease renin release and lower pressure.

D. Increase urine production and lower pressure.

A

What is norepinephrine’s role in the sympathetic nervous system?

A. Hormone acting only on digestion.

B. No significant role.

C. Inhibits sympathetic transmission and reduces heart rate.

D. Activates adrenergic receptors, causing effects such as increased heart rate and blood pressure.

D

Which pulmonary plexus component contributes to bronchoconstriction?

A. Parasympathetic CN IX.

B. Parasympathetic CN X (vagus).

C. Phrenic nerve.

D. Sympathetic T5–T12.

E. Sympathetic T1–T5.

B

Which effectors does the ANS influence?

A. No muscle tissue.

B. Skeletal muscle only.

C. Cardiac muscle, smooth muscle, and glands.

D. Voluntary muscles and sensory organs only.

C

How does the sympathetic division regulate cardiovascular function?

A. Raises blood pressure through vasoconstriction and changes in heart activity.

B. Has no effect on blood pressure.

C. Lowers pressure through vasodilation and slower heart rate.

D. Affects only breathing.

A

Which autonomic plexus contributes to bronchoconstriction?

A. Cardiac.

B. Medullary.

C. Pulmonary.

D. Abdominal.

E. Esophageal.

C

What type of receptors are muscarinic receptors?

A. Enzyme-linked.

B. G-protein-coupled.

C. Nuclear.

D. Ion-channel.

B

Which is NOT a typical way neurotransmitter effects are terminated?

A. Enzymatic degradation in the synaptic cleft.

B. Reuptake into the presynaptic neuron.

C. Diffusion away and uptake by glial cells.

D. Retrograde axonal transport to the cell body.

D

Why is vasomotor tone important?

A. Promotes vessel relaxation and lowers pressure.

B. Mainly regulates digestion.

C. Maintains some vessel constriction to help regulate blood pressure.

D. Has no impact on pressure.

C

How are adrenergic receptors classified, and why are they important?

A. Only in the sympathetic system and do not bind neurotransmitters.

B. Alpha and beta types mediate effects of norepinephrine and related catecholamines.

C. Alpha, beta, and gamma types.

D. Respond to ACh and are alpha and delta types.

B

What is the significance of convergence in the ANS?

A. Reduces signal-transmission efficiency.

B. Integrates signals from multiple sources to coordinate autonomic responses.

C. Ensures every organ receives input from only one preganglionic neuron.

D. Is mainly a somatic feature.

B

What happens if acetylcholinesterase is inhibited?

A. ACh cannot bind receptors.

B. ACh breakdown increases.

C. ACh acts longer at synapses.

D. Less ACh is available for release.

C

What state does the sympathetic nervous system primarily prepare the body for?

A. Rest and digest.

B. Fight or flight.

C. Homeostasis.

D. Sleep and recovery.

B

What is the main structural difference between ANS and somatic efferent pathways?

A. ANS uses multiple neurons; somatic uses a two-neuron chain.

B. Both use three neurons.

C. ANS uses a two-neuron chain; somatic uses one neuron.

D. Both use one neuron.

C

ACh is quickly terminated by hydrolysis by which enzyme?

A. ATP synthase.

B. Acetylcholinesterase.

C. Nucleotidase.

D. Coenzyme A.

B

Which is associated with ANS dysfunction?

A. Parkinson’s disease.

B. Alzheimer’s disease.

C. Multiple sclerosis.

D. Orthostatic hypotension.

D

Which activity is NOT associated with fight or flight?

A. Exercise.

B. Emergency.

C. Excitement.

D. Relaxation.

D

In the sympathetic ANS, norepinephrine generally acts to:

A. Increase heart rate and blood pressure.

B. Cause hypotension.

C. Dilate peripheral vessels.

D. Increase serotonin release in the brain.

A

What receptor type mediates many slow neurotransmitter responses in the ANS?

A. Ionotropic.

B. Muscarinic.

C. G-protein-coupled.

D. Nicotinic.

C

What is the primary function of the sympathetic division?

A. Regulate resting functions.

B. Control digestion and absorption.

C. Initiate fight-or-flight responses.

D. Control voluntary movement.

C

Which can be associated with diabetic autonomic neuropathy?

A. Enteropathy (constipation or diarrhea).

B. All of the above.

C. Orthostatic hypotension.

D. Gastroparesis.

B

How can denervation affect target-organ responsiveness?

A. No effect.

B. Makes organs completely unresponsive.

C. Decreases neurotransmitter production only.

D. Can cause target organs to become hypersensitive.

D

The ANS is involved in producing ______ reflexes that are ______.

A. Somatic, conscious.

B. Visceral, unconscious.

C. Somatic, unconscious.

D. Visceral, conscious.

B

Which statement distinguishes nicotinic from muscarinic receptors?

A. Nicotinic are in the CNS; muscarinic are in the PNS.

B. Nicotinic respond to ACh; muscarinic respond to norepinephrine.

C. Nicotinic are ligand-gated ion channels; muscarinic are GPCRs.

D. Nicotinic are excitatory; muscarinic are inhibitory.

C

What do sympathetic nerve impulses do to cardiac activity?

A. Decrease rate and force.

B. Increase rate and force.

C. Reduce lung blood flow and oxygenation.

D. Decrease cardiac output.

B

What is denervation hypersensitivity?

A. Exaggerated response of cardiac and smooth muscle after ANS nerves are severed.

B. Excess hormone production.

C. None of the above.

D. Loss of sensation in the limbs.

A

What condition can result from ANS denervation?

A. Decreased organ function.

B. Hypersensitivity in target organs.

C. Increased neurotransmitter release.

D. Enhanced somatic reflexes.

B

Alpha and beta receptors are ______ receptors and respond to ______.

A. Cholinergic; norepinephrine.

B. Cholinergic; ACh.

C. Adrenergic; ACh.

D. Adrenergic; norepinephrine.

D

What do presynaptic transporters do?

A. Reabsorb neurotransmitters into the neuron.

B. Release neurotransmitters into the cleft.

C. Break neurotransmitters down.

D. Convert neurotransmitters into hormones.

A

How does the pulmonary plexus contribute to respiratory function?

A. Regulates bronchoconstriction and bronchodilation to control airflow.

B. Has no significant role.

C. Only stimulates heart rate during exercise.

D. Controls digestion.

A

Dysfunction in pelvic splanchnic nerves may directly affect:

A. Respiratory rate.

B. Visceral innervation and bowel function.

C. Skin sensation.

D. Voluntary limb movement.

B

Which effect is associated with sympathetic activation?

A. Increased heart rate.

B. Decreased blood pressure.

C. Increased digestion.

D. Airway constriction.

A

Which changes are expected during sympathetic activation?

A. Increased blood flow to digestive organs.

B. Increased heart rate and vasoconstriction.

C. Slower breathing and vasodilation.

D. Decreased heart rate and increased digestion.

B

If a drug blocks ACh activation of GPCRs, what effect might occur?

A. Increased heart rate.

B. Enhanced neurotransmitter release.

C. Increased muscle contraction.

D. Decreased cytosolic Ca2+.

D

How does parasympathetic activation influence digestion?

A. No effect.

B. Promotes glandular secretion and intestinal motility.

C. Inhibits digestion by reducing digestive-organ blood flow.

D. Affects heart rate only.

B

What could happen if autonomic ganglionic transmission is blocked?

A. Enhanced sensory perception.

B. Disruption of autonomic functions such as heart rate and digestion.

C. Improved reflexes.

D. Increased voluntary muscle control.

B

In organs with dual sympathetic and parasympathetic innervation, the divisions usually produce:

A. Opposing effects.

B. Identical effects.

C. Inhibition of autonomic tone.

D. Additive effects that enhance each other.

A

Which sympathetic-related intervention may help stabilize hypotension?

A. Promote vasodilation.

B. Increase fluid intake without medication.

C. Promote vasoconstriction.

D. Encourage deep breathing.

C

What are clusters of neuron cell bodies where the two ANS neurons meet called?

A. Nerves.

B. Ganglia.

C. Axons.

D. Tracts.

B

Vasomotor tone of blood vessels is primarily a function of which division?

A. Parasympathetic.

B. Sympathetic.

B

Stress increases heart rate. Which division is responsible, and how does the cardiac plexus help?

A. Sympathetic; increases heart rate and cardiac output through the cardiac plexus.

B. Somatic; directly controls the heart.

C. Sympathetic; decreases heart rate.

D. Parasympathetic; decreases heart rate.

A

How do ACh effects vary by receptor subtype and target organ?

A. ACh is always inhibitory.

B. ACh affects only the heart.

C. All ACh receptors have the same effect.

D. Effects vary by subtype and organ, producing different responses.

D

How do β2 agonists help a patient breathe more easily?

A. Block GABA in the brain.

B. Activate β2 receptors, relaxing bronchial smooth muscle and causing bronchodilation.

C. Activate parasympathetic activity.

D. Activate lung dopamine receptors.

B

What is the primary role of pelvic splanchnic nerves?

A. Innervate pelvic viscera and portions of the distal large intestine.

B. Carry skin sensation.

C. Control voluntary limb movement.

D. Regulate fight-or-flight responses.

A

What sympathetic vasomotor response can counter a sudden drop in blood pressure?

A. Decrease heart rate.

B. Increase vasodilation.

C. Increase vasoconstriction.

D. Decrease sympathetic activity.

C

Why can ACh stimulate or inhibit the heart?

A. ACh has many forms.

B. Postsynaptic cells have different receptor subtypes.

C. Cellular metabolism changes over time.

D. Large doses stimulate, small doses inhibit.

B

What response does the sympathetic division primarily prepare the body for?

A. Rest and digest.

B. Relaxation.

C. Fight or flight.

D. Homeostasis.

C

What is the role of precursors in catecholamine synthesis?

A. They are not involved.

B. They are essential; pathway enzymes determine whether synthesis proceeds from dopamine to norepinephrine and epinephrine.

C. They affect only norepinephrine synthesis.

D. They are made from catecholamines.

B

What do COMT and MAO do?

A. Enhance catecholamine action; MAO inhibits it.

B. Synthesize and transport catecholamines.

C. Synthesize neurotransmitters in the brain.

D. Break down catecholamines and regulate their levels.

D

Which effect is caused by parasympathetic stimulation of the heart?

A. Increased AV-node conduction.

B. Decreased heart rate.

C. Increased heart rate.

D. Increased contraction force.

B

What is convergence in the ANS?

A. Several preganglionic neurons from different levels synapse on one postganglionic neuron.

B. One neuron signals multiple organs.

C. Interaction between sympathetic and parasympathetic divisions.

D. Neurotransmitter release.

A

What are the roles of norepinephrine and ACh in the ANS?

A. Both equally stimulate the sympathetic division.

B. ACh is involved in both divisions; norepinephrine only in parasympathetic.

C. Norepinephrine is mainly sympathetic; ACh is used in both divisions and is prominent in parasympathetic signaling.

D. Norepinephrine is only central; ACh is peripheral.

C