Vanderah: Nolte's The Human Brain, 7th Edition

Test Bank
                         
Autonomic Nervous System

Multiple Choice

1.	Damage to the posterior and lateral zones of the hypothalamus would most likely result in which of the following?
	
A.	Increased heart rate
B.	Peripheral vasodilation
C.	Pupillary dilation
D.	Decreased gut peristalsis
E.	Closing of sphincters

ANS: B
Stimulation of the posterolateral zone of the hypothalamus typically results in behaviors associated with anxiety. These may include increased sympathetic visceromotor response as well as aggressive behavior and increased body temperature. Thus the most likely physiological process to occur if there is damage to this area would be peripheral vasodilation, as this is a parasympathetic-mediated phenomenon. 

2.	A 25-year-old woman suffered severe brain injury after her commuter train derailed. For weeks after the impact, she experienced episodes of agitation, dystonia, tachycardia, hypertension, and hyperthermia. Her caretakers note that the events are triggered by the doorbell, telephone, and alarm clocks. 

The symptoms experienced by this woman are mostly likely caused by which of the following?

A.	Increased parasympathetic activity
B.	Decreased parasympathetic activity
C.	Increased sympathetic activity
D.	Decreased sympathetic activity

ANS: C
Dysfunction of the balance between parasympathetic and sympathetic activity is common following traumatic brain injury. Increased activity in the sympathetic nervous system as a result of this dysfunction is referred to as dysautonomia or “sympathetic storming.”

3.	
During the exam of a 7-year-old girl her optometrist notices that her left eye does not constrict as the light from the ophthalmoscope is moved in front of her eye. 
	
A lesion in which of the following structures would most likely account for this observation?

A.	Facial motor nucleus
B.	Otic ganglion
C.	Cervical sympathetic trunk
D.	Ciliary ganglion
E.	Dorsal motor nucleus of X

ANS: D
The ciliary ganglion is a post-synaptic parasympathetic ganglion responsible for sending efferent fibers to the circular muscles of the pupil for constriction and the ciliary muscles of the lens for accommodation.

4.	Which of the following is the most rostral parasympathetic nucleus in the brainstem?

A.  Superior salivary
B.  Edinger-Westphal
C.  Abducens
D.  Otic
E.  Interior salivary

ANS: B
The Edinger-Westphal nucleus is located in the rostral midbrain, anterolateral to the cerebral aqueduct, at the level of the superior colliculus.

5.	A 47-year-old business executive is referred to a gastroenterologist after complaining of “burning pain” in the epigastric region. He indicates that the pain becomes more severe when he eats but is relieved after he drinks a glass of milk. Physical examination indicates that the abdomen is distended and tender in the umbilical region. 

An upper gastrointestinal endoscopic examination of this patient would most likely reveal which of the following?

A.	Duodenal ulcer
B.	Ulcerative colitis
C.	Esophageal varicosis
D.	Gastric ulcer
E.	Diverticulitis 

ANS: D
Gastric ulcers are a form of peptic ulcer that develop in the inside lining of the stomach. The pain associated with gastric ulcers usually worsens with eating. 

6.	Which of the following is responsible for stimulating gastric acid secretion?

A.	Glossopharyngeal nerve
B.	Vagus nerve
C.	Trigeminal nerve
D.	Great splanchnic nerve
E.	Anterior primary rami T5-T9

ANS: B
Parasympathetic fibers traveling with the vagus nerve and the hormone gastrin stimulate gastric acid secretion.

7.	A 62-year-old man with a history of hypertension complains to his urologist of a decreased ability to develop an erection. Parasympathetic fibers from which of the following nerves elicit erectile response?

A.	Pelvic splanchnic
B.	Greater splanchnic
C.	Lesser splanchnic
D.	Lumbar splanchnic

ANS: A
Erection is facilitated by innervation from the parasympathetic nervous system traveling with the pelvic splanchnic nerves.

8.	In which of the following spinal levels are the cell bodies of these fibers located?

A.	T4-T8
B.	S3-S5
C.	L5-S2
D.	S2-S4
E.	T9-12

ANS: D 
Primary cell bodies of the parasympathetic nervous system are present in the brainstem and sacral spinal cord levels S2-S4.

9.	General visceral afferent fibers from the abdominal viscera have their third-order cell bodies located in which of the following?

A.	Posterior root ganglion
B.	Spinal laminae III-V
C.	Mesencephalic nucleus
D.	Gracile nucleus
E.	Ventrolateral nucleus of the thalamus

ANS: E
Visceral afferents have their primary cell bodies in the dorsal root ganglion and synapse on second order neurons in the spinal cord. Before reaching the cerebral cortex they synapse in the ventrolateral nucleus of the thalamus.