Phys 61 Flashcards

___ cranial nerve fibers go to the parotid gland.
A. CN VII
B. CN IX
C. CN X
D. CN V

Sacral parasympathetic fibers are carried mainly in the:
A. Sympathetic chain nerves
B. Lumbar splanchnic nerves
C. Pelvic nerves
D. White rami communicantes

Parasympathetic postganglionic neurons are located in the:
A. Sympathetic chain ganglia
B. Dorsal root ganglia
C. Paravertebral ganglia
D. Wall of the organ

Most ANS synapses use which transmitters?
A. Acetylcholine or norepinephrine
B. Dopamine or serotonin
C. Glutamate or glycine
D. GABA or glutamine

Fibers that secrete acetylcholine are called:
A. Adrenergic fibers
B. Cholinergic fibers
C. Dopaminergic fibers
D. Serotonergic fibers

Fibers that secrete norepinephrine are called:
A. Cholinergic fibers
B. Dopaminergic fibers
C. Adrenergic fibers
D. Purinergic fibers

All preganglionic autonomic neurons are:
A. Cholinergic
B. Adrenergic
C. Dopaminergic
D. Serotonergic

Most postganglionic sympathetic neurons are:
A. Cholinergic
B. GABAergic
C. Glutamatergic
D. Adrenergic

A key sympathetic exception using acetylcholine is innervation of:
A. Adrenal medulla
B. Sweat glands
C. Renal cortex
D. Salivary acini

Neurotransmitter vesicles are synthesized and stored mainly in:
A. Nucleus of cell body
B. Dendritic spines
C. Axonal varicosities
D. Myelin sheath layers

Reactants for acetylcholine formation are:
A. Acetyl-CoA and choline
B. Tyrosine and choline
C. Choline and dopamine
D. Acetyl-CoA and tyrosine

The enzyme that forms acetylcholine is:
A. Dopamine β-hydroxylase
B. Monoamine oxidase
C. Catechol-O-methyl transferase
D. Choline acetyltransferase

Norepinephrine synthesis begins with which amino acid?
A. Tyrosine
B. Tryptophan
C. Glycine
D. Glutamate

Tyrosine → DOPA occurs by:
A. Methylation
B. Hydroxylation
C. Decarboxylation
D. Deamination

DOPA → dopamine occurs by:
A. Hydroxylation
B. Methylation
C. Decarboxylation
D. Conjugation

In adrenergic terminals, dopamine is transported into:
A. Cell nucleus
B. Synaptic cleft
C. Mitochondria
D. Vesicles

Dopamine → norepinephrine occurs by:
A. Methylation
B. Hydroxylation
C. Decarboxylation
D. Oxidation

Norepinephrine → epinephrine occurs by:
A. Methylation
B. Hydroxylation
C. Decarboxylation
D. Deamination

Norepinephrine is methylated to epinephrine mainly in the:
A. Sympathetic chain ganglia
B. Dorsal root ganglia
C. Adrenal medulla
D. Organ effector wall

The major removal mechanism for released norepinephrine is:
A. COMT in the liver
B. MAO in mitochondria
C. Diffusion into capillaries
D. Reuptake into nerve endings

Reuptake accounts for removal of approximately:
A. 10–20%
B. 50–80%
C. 80–95%
D. 95–99%

Most remaining norepinephrine is removed by:
A. Diffusion into fluids and blood
B. Reuptake into vesicles
C. Breakdown by COMT only
D. Breakdown by MAO only

Small amounts of norepinephrine are destroyed mainly by:
A. Acetylcholinesterase and COMT
B. ChAT and MAO
C. MAO and COMT
D. Tyrosine hydroxylase and MAO

Norepinephrine at a tissue site remains active for:
A. Several minutes
B. One hour
C. One day
D. A few seconds

Catechol-O-methyl transferase action occurs mainly in the:
A. Brain stem
B. Liver
C. Cardiac myocytes
D. Adrenal cortex

Acetylcholine activates mainly which receptor types?
A. Muscarinic and nicotinic
B. Alpha and beta
C. NMDA and AMPA
D. GABA-A and GABA-B

Muscarinic receptors are best described as:
A. Ligand-gated chloride channels
B. Voltage-gated sodium channels
C. G-protein–coupled receptors
D. Intracellular nuclear receptors

Nicotinic receptors in autonomic ganglia are:
A. G-protein–coupled receptors
B. Tyrosine kinase receptors
C. Nuclear transcription factors
D. Ligand-gated ion channels

Postganglionic cholinergic fibers stimulate effector cells mainly via:
A. Muscarinic receptors
B. Alpha receptors
C. Beta receptors
D. Nicotinic receptors

A drug that blocks autonomic ganglionic transmission targets:
A. Muscarinic receptors
B. Nicotinic receptors
C. Alpha receptors
D. Beta receptors

Two major classes of adrenergic receptors are:
A. Nicotinic and muscarinic
B. M1 and M2
C. N1 and N2
D. Alpha and beta

Two major types of alpha receptors are:
A. Alpha3 and alpha4
B. Alpha1 and alpha2
C. Alpha2 and alpha3
D. Alpha1 and alpha5

Beta receptors are divided into:
A. Beta1, beta2, beta3
B. Beta2, beta4, beta5
C. Beta1, beta3, beta5
D. Beta1, beta2, beta4

Norepinephrine excites mostly:
A. Muscarinic receptors
B. Alpha receptors
C. Nicotinic receptors
D. Beta3 receptors

Cocaine prolongs norepinephrine signaling primarily by inhibiting:
A. MAO enzymatic breakdown
B. COMT liver metabolism
C. Vesicular methylation
D. Reuptake into nerve endings

A patient given atropine develops tachycardia and dry mouth. The blocked receptor is:
A. Alpha1 receptor
B. Nicotinic receptor
C. Muscarinic receptor
D. Beta1 receptor

Epinephrine excites alpha and beta receptors:
A. Alpha more than beta
B. Beta more than alpha
C. Equally
D. Only beta receptors

A synthetic agent with strong β action and minimal α action is:
A. Isoproterenol
B. Phenylephrine
C. Methoxamine
D. Norepinephrine

Autonomic control of pupil diameter is best described as:
A. Both systems constrict
B. Both systems dilate
C. Parasympathetic dilates pupil
D. Sympathetic dilates, parasympathetic constricts

Lens accommodation during near vision depends mainly on:
A. Sympathetic radial ligaments
B. Parasympathetic ciliary contraction
C. Somatic extraocular muscles
D. Enteric neural reflexes

Primary control of small and large intestinal glands is:
A. Sympathetic stimulation
B. Parasympathetic stimulation
C. Local enteric mechanisms
D. Adrenal medullary hormones

Axillary apocrine glands secrete primarily in response to:
A. Parasympathetic activation
B. Enteric nervous system
C. Somatic motor neurons
D. Sympathetic stimulation

The intrinsic neural network of the GI tract is the:
A. Sympathetic chain
B. Intramural enteric plexus
C. Dorsal root ganglia
D. Corticospinal tract

Sympathetic stimulation of the heart increases:
A. Rate and force
B. Rate only
C. Force only
D. Stroke volume only

The typical sympathetic effect on systemic blood vessels is:
A. Dilation
B. No net effect
C. Constriction
D. Cyclic vasomotion

Arterial pressure is determined primarily by:
A. Heart rate and preload
B. Cardiac output and resistance
C. Blood viscosity
D. Venous compliance

Compared with norepinephrine, epinephrine produces:
A. Stronger alpha vasoconstriction
B. Reduced cardiac stimulation
C. Minimal metabolic effects
D. Greater beta, cardiac, metabolic effects

Dual sympathetic action via nerves and adrenal hormones provides a:
A. Safety factor
B. Feedback inhibition
C. Parasympathetic dominance
D. Sensory amplification

A key difference between autonomic and skeletal systems is that ANS:
A. Requires tetanic firing
B. Needs cortical initiation
C. Activates at low frequency
D. Lacks synaptic delay

Intrinsic smooth muscle tone persists after denervation due to:
A. Spontaneous action potentials
B. Smooth muscle contractile force
C. Residual neurotransmitter stores
D. Endocrine oscillations

Baroreceptors are best described as:
A. Chemoreceptors sensing hypoxia
B. Stretch receptors in ventricles
C. Pain receptors in arteries
D. Pressure sensors in carotid, aorta

Near-simultaneous discharge of most sympathetic pathways is called:
A. Mass discharge
B. Reciprocal inhibition
C. Local reflex activation
D. Segmental facilitation

Brain stem autonomic centers primarily regulate:
A. Temperature and thirst
B. Endocrine secretion
C. Arterial pressure, heart, respiration
D. Voluntary motor control

Intravenous acetylcholine fails to mimic parasympathetic activation because it is degraded by:
A. MAO in liver
B. Plasma cholinesterase
C. COMT in plasma
D. Tyrosine hydroxylase

A patient given pilocarpine develops miosis and salivation. This drug is best classified as:
A. Adrenergic agonist
B. Ganglionic blocker
C. Alpha antagonist
D. Parasympathomimetic drug

Post-op ileus is treated by inhibiting acetylcholinesterase. Which drug?
A. Neostigmine
B. Scopolamine
C. Propranolol
D. Phenylephrine

Atropine causes tachycardia and mydriasis mainly by blocking:
A. Alpha receptors
B. Beta receptors
C. Cholinergic effector receptors
D. Ganglionic nicotinic receptors

Which drug directly stimulates autonomic postganglionic neurons?
A. Reserpine
B. Nicotine
C. Phenoxybenzamine
D. Guanethidine

A drug that blocks preganglionic → postganglionic transmission is:
A. Hexamethonium
B. Methacholine
C. Atropine
D. Albuterol

Celiac, superior mesenteric, and aorticorenal ganglia are:
A. Paravertebral ganglia
B. Intramural ganglia
C. Dorsal root ganglia
D. Prevertebral ganglia

Preganglionic sympathetic outflow arises from spinal segments:
A. C1–C4
B. L3–S1
C. T1–L2
D. S2–S4

Sympathetic preganglionic neuron cell bodies are located in the:
A. Anterior horn
B. Dorsal root ganglion
C. Posterior horn
D. Intermediolateral horn

Preganglionic fibers reach prevertebral ganglia primarily via:
A. Splanchnic nerves
B. Gray rami
C. Pelvic nerves
D. Dorsal roots

Sympathetic fibers in skeletal nerves to sweat glands are:
A. Aα fibers
B. Aδ fibers
C. Type C fibers
D. Ia afferents

Sympathetic fibers from T7–T11 primarily terminate in the:
A. Head
B. Abdomen
C. Neck
D. Thorax

Chromaffin cells of the adrenal medulla receive:
A. Preganglionic sympathetic fibers
B. Postganglionic sympathetic fibers
C. Preganglionic parasympathetic fibers
D. Somatic motor fibers

Parasympathetic outflow exits the CNS via:
A. T1–L2 only
B. C1–C8 only
C. L3–S1 only
D. CN III VII IX X, S2–S4

Vagus supplies most parasympathetic fibers, except to the:
A. Stomach
B. Small intestine
C. Distal colon and rectum
D. Liver and gallbladder

Parasympathetic innervation to the parotid gland travels via:
A. CN VII → submandibular ganglion
B. CN IX → otic ganglion
C. CN III → ciliary ganglion
D. CN X → intramural ganglia

Pelvic splanchnic (S2–S4) fibers primarily support:
A. Foregut secretion
B. Pupil dilation
C. Sweat gland activation
D. Erection and bladder emptying

Compared with sympathetic pathways, parasympathetic pathways have:
A. Short pre, short post
B. Long pre, short post
C. Short pre, long post
D. Long pre, long post

ACh is hydrolyzed into acetate and choline. ACh resynthesis from acetyl-CoA uses:
A. Choline acetyltransferase
B. Monoamine oxidase
C. Catechol-O-methyltransferase
D. Dopamine β-hydroxylase

Catecholamine destruction in peripheral tissues occurs mainly via:
A. Catechol-O-methyl transferase
B. Monoamine oxidase
C. Dopamine β-hydroxylase
D. Phenylalanine hydroxylase

Which catecholamine excites alpha and beta receptors equally?
A. Dopamine
B. Methoxamine
C. Epinephrine
D. Phenylephrine

Which catecholamine excites alpha more than beta?
A. Norepinephrine
B. Epinephrine
C. Dopamine
D. Isoproterenol

Sudden fear causes mydriasis primarily via:
A. Iris circular muscle contraction
B. Ciliary muscle contraction
C. Iris radial muscle contraction
D. Pupillary sphincter relaxation

A decongestant causes acute urinary retention by:
A. Detrusor muscle contraction
B. Bladder sphincter contraction
C. Detrusor muscle relaxation
D. Increased bladder wall secretion

Goosebumps during cold exposure are mediated by:
A. Bronchial smooth relaxation
B. GI sphincter relaxation
C. Presynaptic transmitter inhibition
D. Pilomotor muscle contraction

A drug that decreases NE release acts primarily at:
A. Presynaptic alpha2 receptors
B. Postsynaptic beta2 receptors
C. Postsynaptic alpha1 receptors
D. Autonomic nicotinic receptors

Catecholamine-driven tachycardia and lipolysis are mediated by:
A. Beta2 receptors
B. Beta1 receptors
C. Alpha1 receptors
D. Alpha2 receptors

Epinephrine causes bronchodilation and glycogenolysis mainly via:
A. Alpha1 receptors
B. Beta1 receptors
C. Beta2 receptors
D. Alpha2 receptors

A β2 agonist can delay preterm labor by:
A. Increasing uterine contraction
B. Tightening uterine sphincters
C. Increasing oxytocin release
D. Uterine smooth muscle relaxation

Brown fat heat production is mediated primarily by:
A. Beta3 receptors
B. Alpha1 receptors
C. Beta1 receptors
D. Alpha2 receptors

Near-vision accommodation occurs when:
A. Sympathetic dilator contracts
B. Sympathetic chain discharges
C. Parasympathetic ciliary contracts
D. Alpha1 receptors are blocked

Acute stress reduces bowel sounds by:
A. Increases peristalsis, relaxes sphincters
B. Inhibits peristalsis, tightens sphincters
C. Increases secretion, relaxes sphincters
D. Inhibits secretion, relaxes sphincters

After sympathectomy, targets still respond because of:
A. Circulating adrenal catecholamines
B. Cortical motor overflow
C. Spinal reflex activation
D. Local acetylcholine production

Intravenous epinephrine raises arterial pressure mainly by:
A. Decreasing cardiac output
B. Increasing peripheral resistance
C. Decreasing heart rate
D. Increased cardiac output

Which has a stronger metabolic effect?
A. Norepinephrine
B. Epinephrine
C. Dopamine
D. Methoxamine

After stellate ganglionectomy, a small NE dose causes exaggerated effects due to:
A. Decreased receptor density
B. Reduced second messenger activity
C. Upregulated receptors on effector cells
D. Increased neurotransmitter destruction

A patient given phenylephrine develops constipation. This reflects α1 action causing:
A. GI relaxation, sphincter contraction
B. GI contraction, sphincter relaxation
C. Increased peristalsis strongly
D. Increased watery secretion

Cold, pale fingers after adrenergic surge most directly reflect α1-mediated:
A. Bronchodilation
B. Lipolysis
C. Vasoconstriction
D. Neurotransmitter inhibition

Clonidine reduces sympathetic outflow mainly by activating:
A. Beta2 receptors
B. Alpha2 receptors
C. Beta1 receptors
D. Alpha1 receptors

A catecholamine increasing HR and contractility most strongly activates:
A. Alpha2 receptors
B. Beta3 receptors
C. Beta2 receptors
D. Beta1 receptors

Low-dose epinephrine can lower diastolic pressure mainly via:
A. Beta2 vasodilation
B. Alpha1 vasoconstriction
C. Alpha2 transmitter inhibition
D. Beta1 increased stroke volume

A β2 agonist may worsen urinary retention by causing:
A. Bladder sphincter contraction
B. Increased detrusor contraction
C. Bladder smooth muscle relaxation
D. Increased bladder secretions

Post-meal heat production attributed to β2 activation is best termed:
A. Lipolysis
B. Calorigenesis
C. Vasoconstriction
D. Neurotransmitter inhibition

Thermogenesis via adrenergic stimulation is most associated with:
A. Beta3 receptors
B. Beta1 receptors
C. Alpha1 receptors
D. Alpha2 receptors

After eating, increased peristalsis + relaxed sphincters best reflects:
A. Sympathetic stimulation
B. Alpha1 receptor activation
C. Adrenal medullary surge
D. Parasympathetic stimulation

The dominant adrenergic receptor subtype in myocardium is:
A. Alpha1
B. Alpha2
C. Beta2
D. Beta1

Norepinephrine raises arterial pressure primarily by increasing:
A. Cardiac output strongly
B. Venous capacitance
C. Peripheral resistance
D. Pulmonary compliance

Denervation supersensitivity occurs mainly due to:
A. Upregulation of effector receptors
B. Increased acetylcholinesterase activity
C. Reduced catecholamine secretion
D. Increased neurotransmitter diffusion

Stretching carotid/aortic baroreceptors causes what immediate autonomic change?
A. Increased sympathetic to heart
B. Decreased sympathetic to heart/vessels
C. Decreased vagal to heart
D. Increased vagal to vessels

“Mass discharge” refers to:
A. Local reflex in one organ
B. Isolated adrenal release only
C. Only spinal sympathetic outflow
D. Near-total SNS discharge simultaneously

Mass discharge is commonly triggered when the hypothalamus is activated by:
A. Fright or severe pain
B. Mild hunger and fatigue
C. Slow deep breathing
D. Bright light exposure

The widespread body reaction from mass discharge is best termed:
A. Rest-and-digest response
B. Vagal rebound reflex
C. Alarm/stress response
D. Postganglionic fatigue

Methoxamine, phenylephrine, isoproterenol, and albuterol are:
A. Sympathomimetic drugs
B. Parasympatholytic drugs
C. Ganglion-blocking drugs
D. Cholinesterase inhibitors

Phenylephrine primarily acts on:
A. Muscarinic receptors
B. Nicotinic receptors
C. Beta receptors
D. Alpha receptors

Isoproterenol primarily stimulates:
A. Alpha1 receptors mainly
B. Beta1 and beta2 receptors
C. Muscarinic receptors only
D. Alpha2 receptors mainly

Albuterol primarily stimulates:
A. Alpha1 receptors only
B. Beta1 receptors only
C. Beta2 receptors only
D. Alpha2 receptors only

Ephedrine, tyramine, and amphetamine are:
A. Direct alpha agonists
B. Direct beta agonists
C. Cholinesterase inhibitors
D. Indirect sympathomimetic drugs

Guanethidine lowers sympathetic effects by blocking release of:
A. Acetylcholine
B. Norepinephrine
C. Dopamine
D. Epinephrine

Phenoxybenzamine and phentolamine are best described as:
A. Beta receptor agonists
B. Muscarinic receptor agonists
C. Alpha receptor blockers
D. Nicotinic receptor blockers

Yohimbine selectively blocks:
A. Alpha2 receptors
B. Beta1 receptors
C. Beta2 receptors
D. Alpha1 receptors

Atenolol, nebivolol, and metoprolol mainly block:
A. Alpha1 receptors
B. Alpha2 receptors
C. Beta2 receptors
D. Beta1 receptors

Propranolol blocks:
A. Alpha1 and alpha2 receptors
B. Beta2 receptors only
C. Beta1 and beta2 receptors
D. Muscarinic receptors only

A drug blocking both SNS and PNS ganglionic transmission is:
A. Atropine
B. Hexamethonium
C. Neostigmine
D. Albuterol

Pilocarpine and methacholine are best classified as:
A. Parasympathomimetic drugs
B. Indirect sympathomimetics
C. Ganglion-blocking drugs
D. Alpha receptor blockers

Neostigmine, pyridostigmine, and ambenonium act mainly via:
A. Alpha receptor blockade
B. Beta receptor blockade
C. Acetylcholinesterase inhibition
D. Norepinephrine release blockade

Atropine, homatropine, and scopolamine are:
A. Sympathomimetic agents
B. Parasympathomimetic agents
C. Ganglion stimulants
D. Antimuscarinic drugs

Nicotine produces widespread autonomic effects by stimulating:
A. Ganglionic nicotinic receptors
B. Effector muscarinic receptors
C. Effector alpha1 receptors
D. Adrenal COMT enzymes

Tetraethyl ammonium, hexamethonium, and pentolinium are:
A. Beta receptor blockers
B. Ganglion-blocking drugs
C. Alpha receptor agonists
D. Muscarinic receptor agonists

White rami communicantes are present at:
A. All spinal levels
B. T1–L2 only
C. S2–S4 only
D. C1–C8 only

Gray rami communicantes are present at:
A. T1–L2 only
B. T7–T11 only
C. C1–C8 only
D. All spinal levels

Postganglionic sympathetics re-enter spinal nerves via:
A. Gray rami communicantes
B. White rami communicantes
C. Pelvic nerves
D. Dorsal roots

Parasympathetic fibers to parotid synapse in:
A. Ciliary ganglion
B. Otic ganglion
C. Submandibular ganglion
D. Pterygopalatine ganglion

Parasympathetic fibers to pupillary sphincter use:
A. CN III → ciliary ganglion
B. CN VII → otic ganglion
C. CN IX → ciliary ganglion
D. CN X → intramural ganglia

A preganglionic fiber entering the chain may:
A. Ascend/descend then synapse
B. Enter dorsal root ganglion
C. Synapse in dorsal horn
D. Join vagus nerve directly

Preganglionics reaching celiac ganglion travel via:
A. Gray rami communicantes
B. White rami communicantes
C. Pelvic nerves
D. Splanchnic nerves

Sympathetic outflow from T1 usually targets:
A. Abdomen
B. Head
C. Legs
D. Pelvis

Sympathetic outflow from T3–T6 usually targets:
A. Head
B. Neck
C. Thorax
D. Legs

Sympathetic outflow from T12–L2 usually targets:
A. Thorax
B. Abdomen
C. Neck
D. Legs

Sympathetic outflow from T7–T11 usually targets:
A. Abdomen
B. Head
C. Thorax
D. Legs

Ganglionic cholinergic receptors are mainly:
A. Alpha1 receptors
B. Beta1 receptors
C. Nicotinic ion channels
D. Muscarinic GPCRs

Most parasympathetic effector receptors are:
A. Nicotinic ion channels
B. Muscarinic GPCRs
C. Alpha1 receptors
D. Beta2 receptors

White rami communicantes carry mainly:
A. Postganglionic sympathetic fibers
B. Postganglionic parasympathetic fibers
C. Preganglionic sympathetic fibers
D. Somatic motor fibers

ACh is broken down into:
A. DOPA and acetate
B. Choline and acetate ion
C. Tyrosine and choline
D. Dopamine and acetate

Basal sympathetic tone most maintains:
A. Lens convexity
B. Vascular resistance
C. Watery salivary flow
D. Pupillary constriction

A selective β2 agonist used clinically is:
A. Methoxamine
B. Albuterol
C. Atenolol
D. Yohimbine