Question 1

In the parasympathetic branch of the nervous system,what name is given to the neurotransmitter that conducts nerve transmission at the ganglionic site?

Accepted Answer

Cholinesterase is the name given to the enzyme that inactivates acetylcholine.Acetylcholine conducts nerve transmission at ganglionic sites and at parasympathetic effector sites found at the end of postganglionic fibers.Epinephrine is a neurotransmitter similar to norepinephrine and is capable of stimulating sympathetic neuroeffector sites.Norepinephrine is generally the neurotransmitter found at sympathetic end sites (with the exception of sweat glands and the adrenal medulla,where acetylcholine is found).

Question 2

A patient is experiencing changes in heart rate and pupillary response to light.What division of the nervous system is responsible for these changes?

Accepted Answer

The autonomic nervous system is the involuntary,unconscious control mechanism of the body,sometimes said to control vegetative or visceral functions.The autonomic nervous system regulates heart rate,pupillary dilation and contraction,glandular secretion such as salivation,and smooth muscle in blood vessels and the airway.

Question 3

Epinephrine stimulates which of the following receptor sites?

Accepted Answer

Epinephrine stimulates α and βsites equally.

Question 4

A parasympathetic effect is generally the same as which of the following?

Accepted Answer

An antimuscarinic effect may also be referred to as a parasympatholytic effect.Muscarine stimulates acetylcholine receptors at the parasympathetic terminal sites.A parasympatholytic effect would also be known as an antimuscarinic effect and an anticholinergic effect.

Question 5

After administering a sympathomimetic drug to your patient,in what areas would you expect to see an upward trend?
1)Heart rate
2)Blood pressure
3)Blood glucose

Accepted Answer

The sympathetic branch reacts as a general alarm ("fight or flight")system.As the organism prepares for maximal physical exertion,heart rate and blood pressure increase,blood flow shifts from the periphery to muscles and the heart,blood glucose increases,and bronchi dilate.

Question 6

How is the neurotransmitter acetylcholine inactivated at the parasympathetic terminal receptor site?

Accepted Answer

The enzymes COMT and MAO inactivate catecholamines such as epinephrine.The reuptake process terminates norepinephrine and sympathetic transmission.Cholinesterase inactivates the neurotransmitter acetylcholine at the parasympathetic terminal receptor site.

Question 7

As a practitioner,you would expect which parts of the physical examination to be affected by a dose of atropine or other parasympatholytic agent?

Accepted Answer

Atropine decreases the tone and mobility of the gastrointestinal tract and causes pupillary dilation (mydriasis),which could lead an unknowing practitioner to suspect head injury,brain infarct,or some other type of detrimental process.Atropine increases the heart rate by blocking vagal innervation and may cause a patient to present with drug-induced tachycardia.

Question 8

Following administration of a dose of atropine to your patient,which of the following effects are not likely to occur?

Accepted Answer

As a parasympatholytic agent,atropine blocks salivary secretion and causes dry mouth.Atropine also blocks the parasympathetically maintained basal tone of bronchial smooth muscle and would produce an expected relaxation of bronchial smooth muscle.Atropine has a parasympatholytic effect on the mucous glands,decreasing mucus production,and blocks vagal innervation of the heart to produce an increased heart rate.

Question 9

Which of the following drugs are sympathomimetic agents?
1)Salmeterol
2)Dopamine
3)Labetalol
4)Propranolol

Accepted Answer

Both salmeterol and dopamine stimulate the sympathetic nervous system.Labetalol and propranolol are sympatholytic agents.

Question 10

What is the adrenergic effect on bronchial smooth muscle?

Accepted Answer

The effect of sympathetic (adrenergic)stimulation of the bronchi is relaxation and dilation of airway diameter.

Question 11

Your patient has bradycardia.Which type of drug do you recommend?

Accepted Answer

A sympatholytic drug would work to block the "fight or flight" response and prevent an increase in heart rate.A sympathomimetic drug would induce a "fight or flight" response and cause an increase in heart rate.A parasympathomimetic response would involve slowing the rate of sinoatrial (SA)node conduction and decreasing atrioventricular (AV)node conduction.

Question 12

A direct-acting cholinergic agent often used in bronchial challenge tests to assess the degree of airway activity is

Accepted Answer

Edrophonium is used in the Tensilon test to determine whether muscle weakness is caused by overdosing with an indirect-acting cholinergic agent or undertreatment with insufficient drug.The methacholine challenge is a lung function test used to help diagnose reactive airways.Neostigmine is used to increase muscle strength in patients with myasthenia gravis.Phospholine is an organophosphate used in insecticides (a cholinesterase reactivator)that may have lethal effects via initial stimulation and then blockade of cholinergic receptors.

Question 13

The somatic portion of the nervous system controls which of the following?

Accepted Answer

Heart muscle is under autonomic control.Glandular secretion and smooth airway muscle are controlled by the autonomic nervous system.Skeletal muscle (used for such motor actions as lifting,walking,and breathing)is under conscious control by the somatic portion of the nervous system.

Question 14

Your patient is accidentally given a large dose of a parasympathomimetic drug.What side effects of parasympathetic overstimulation do you expect to see?
1)Salivation
2)Lacrimation
3)Urination
4)Defecation

Accepted Answer

Overstimulation of the parasympathetic branch would render the body incapable of violent action and would result in what is termed the SLUD syndrome: salivation,lacrimation,urination,and defecation.

Question 15

You are treating an asthmatic who also happens to be taking propranolol (a $\beta$blocker)for a history of cardiac arrhythmias.What type of effect would you expect albuterol to have on this patient?

Accepted Answer

As a $\beta$ blocker,propranolol would prevent albuterol (a$\beta$agonist)from inducing the desired effect of bronchodilation.Propranolol and albuterol are not synergistic drugs and actually compete for the same receptor sites.

Question 16

You are treating a patient for bronchospasm.Albuterol (an adrenergic bronchodilator)is the only aerosolized agent being administered at this time.What other type of aerosolized drug might you recommend?

Accepted Answer

Two classes of drugs modify smooth airway muscle tone: adrenergic bronchodilators and anticholinergic bronchodilators.A sympatholytic drug would act to negate the effects of an adrenergic bronchodilator such as albuterol.

Question 17

The peripheral nervous system consists of which of the following?
1)Spinal cord
2)Autonomic nervous system
3)Brain
4)Somatic portion

Accepted Answer

The peripheral nervous system consists of sensory (afferent)neurons;somatic (motor)neurons;and the autonomic nervous system,which can be divided into parasympathetic and sympathetic branches.

Question 18

The stimulation of which receptor sites produces bronchial smooth muscle relaxation?

Accepted Answer

Stimulation of β₁ receptors increases the force and rate of cardiac contraction.Stimulation of β₂ receptors relaxes bronchial smooth muscle as well as the vascular beds of skeletal muscle.Stimulation of F1F1F1S1F1F1F10 receptors results in the vasoconstriction of peripheral blood vessels.

Question 19

Which type of impulse travels from the brain to the neuroeffector sites?

Accepted Answer

Afferent nerves carry impulses from the periphery to the cord.Somatic reflex arcs travel from the periphery and back.Ganglionic is a term used to describe agents that are anticholinergic in nature.Efferent impulses travel from the brain and spinal cord out to the various neuroeffector sites.

Question 20

You administer an inhaled bronchodilator that is known to have adrenergic side effects.What cardiovascular clinical effect should you watch for in your patient?

Accepted Answer

The adrenergic effect on the heart is excitatory,leading to an increase in heart rate.The muscles of respiration are under somatic control.

Quiz 5: Central and Peripheral Nervous Systems

In the parasympathetic branch of the nervous system,what name is given to the neurotransmitter that conducts nerve transmission at the ganglionic site?

A patient is experiencing changes in heart rate and pupillary response to light.What division of the nervous system is responsible for these changes?

Epinephrine stimulates which of the following receptor sites?

A parasympathetic effect is generally the same as which of the following?

After administering a sympathomimetic drug to your patient,in what areas would you expect to see an upward trend? 1) Heart rate 2) Blood pressure 3) Blood glucose

How is the neurotransmitter acetylcholine inactivated at the parasympathetic terminal receptor site?

As a practitioner,you would expect which parts of the physical examination to be affected by a dose of atropine or other parasympatholytic agent?

Following administration of a dose of atropine to your patient,which of the following effects are not likely to occur?

Which of the following drugs are sympathomimetic agents? 1) Salmeterol 2) Dopamine 3) Labetalol 4) Propranolol

What is the adrenergic effect on bronchial smooth muscle?

Your patient has bradycardia.Which type of drug do you recommend?

A direct-acting cholinergic agent often used in bronchial challenge tests to assess the degree of airway activity is

The somatic portion of the nervous system controls which of the following?

Your patient is accidentally given a large dose of a parasympathomimetic drug.What side effects of parasympathetic overstimulation do you expect to see? 1) Salivation 2) Lacrimation 3) Urination 4) Defecation

You are treating an asthmatic who also happens to be taking propranolol (a $\beta$ blocker) for a history of cardiac arrhythmias.What type of effect would you expect albuterol to have on this patient?

You are treating a patient for bronchospasm.Albuterol (an adrenergic bronchodilator) is the only aerosolized agent being administered at this time.What other type of aerosolized drug might you recommend?

The peripheral nervous system consists of which of the following? 1) Spinal cord 2) Autonomic nervous system 3) Brain 4) Somatic portion

The stimulation of which receptor sites produces bronchial smooth muscle relaxation?

Which type of impulse travels from the brain to the neuroeffector sites?

You administer an inhaled bronchodilator that is known to have adrenergic side effects.What cardiovascular clinical effect should you watch for in your patient?

Quiz 5: Central and Peripheral Nervous Systems

In the parasympathetic branch of the nervous system,what name is given to the neurotransmitter that conducts nerve transmission at the ganglionic site?

A patient is experiencing changes in heart rate and pupillary response to light.What division of the nervous system is responsible for these changes?

Epinephrine stimulates which of the following receptor sites?

A parasympathetic effect is generally the same as which of the following?

After administering a sympathomimetic drug to your patient,in what areas would you expect to see an upward trend? 1) Heart rate 2) Blood pressure 3) Blood glucose

How is the neurotransmitter acetylcholine inactivated at the parasympathetic terminal receptor site?

As a practitioner,you would expect which parts of the physical examination to be affected by a dose of atropine or other parasympatholytic agent?

Following administration of a dose of atropine to your patient,which of the following effects are not likely to occur?

Which of the following drugs are sympathomimetic agents? 1) Salmeterol 2) Dopamine 3) Labetalol 4) Propranolol

What is the adrenergic effect on bronchial smooth muscle?

Your patient has bradycardia.Which type of drug do you recommend?

A direct-acting cholinergic agent often used in bronchial challenge tests to assess the degree of airway activity is

The somatic portion of the nervous system controls which of the following?

Your patient is accidentally given a large dose of a parasympathomimetic drug.What side effects of parasympathetic overstimulation do you expect to see? 1) Salivation 2) Lacrimation 3) Urination 4) Defecation

You are treating an asthmatic who also happens to be taking propranolol (a β\betaβ blocker) for a history of cardiac arrhythmias.What type of effect would you expect albuterol to have on this patient?

You are treating a patient for bronchospasm.Albuterol (an adrenergic bronchodilator) is the only aerosolized agent being administered at this time.What other type of aerosolized drug might you recommend?

The peripheral nervous system consists of which of the following? 1) Spinal cord 2) Autonomic nervous system 3) Brain 4) Somatic portion

The stimulation of which receptor sites produces bronchial smooth muscle relaxation?

Which type of impulse travels from the brain to the neuroeffector sites?

You administer an inhaled bronchodilator that is known to have adrenergic side effects.What cardiovascular clinical effect should you watch for in your patient?

You are treating an asthmatic who also happens to be taking propranolol (a $\beta$ blocker) for a history of cardiac arrhythmias.What type of effect would you expect albuterol to have on this patient?