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1. The answer is C [III F 1 c, 3 c]. Coordination of movement (synergy) is the function of the cerebellum. Lesions of the cerebellum cause ataxia, lack of coordination, poor execution of movement, delay in initiation of movement, and inability to perform rapidly alternating movements. The premo-tor and motor cortices plan and execute movements. Lesions of the substantia nigra, a component of the basal ganglia, result in tremors, lead-pipe rigidity, and poor muscle tone (Parkinson's disease).

2. The answer is J [I C 1 a; Table 2-2]. Prazosin is a specific antagonist of cti receptors, which are present in vascular smooth muscle, but not in the heart. Inhibition of ctj receptors results in vasodilation of the cutaneous and splanchnic vascular beds, decreased total peripheral resistance, and decreased blood pressure.

3. The answer is B [I C 2 b; Table 2-3]. Erection is a parasympathetic muscarinic response. Dilation of the bronchioles, ejaculation, constriction of the gastrointestinal (GI) sphincters, and increased cardiac contractility are all sympathetic a or (3 responses.

4. The answer is A [II F 1 b; Table 2-4]. C fibers (slow pain) are the smallest nerve fibers and therefore have the slowest conduction velocity.

5. The answer is A [II C 2 c (2); Table 2-6]. Of the two types of photoreceptors, the rods are more sensitive to low-intensity light and therefore are more important than the cones for night vision. They adapt to darkness after the cones. Rods are not present in the fovea. The cones are primarily involved in color vision.

6. The answer is A [II D 4], Sound frequencies can be encoded by the organ of Corti because of differences in properties along the basilar membrane. The base of the basilar membrane is narrow and stiff, and hair cells on it are activated by high frequencies. The apex of the basilar membrane is wide and compliant, and hair cells on it are activated by low frequencies.

7. The answer is E [I A, B; Table 2-1; Figure 2-1], Sympathetic preganglionic neurons originate in spinal cord segments T!-L3. Thus, the designation is thoracolumbar. The sympathetic nervous system is further characterized by short preganglionic neurons that synapse in ganglia located in the paravertebral chain (not in the effector organs) and postganglionic neurons that release norepinephrine (not epinephrine). Common features of the sympathetic and parasympathetic nervous systems are preganglionic neurons that release acetylcholine (ACh) and postganglionic neurons that synapse in effector organs.

8. The answer is D [II G 1 b]. The chorda tympani [cranial nerve (CN) VII] is involved in taste; it innervates the anterior two-thirds of the tongue.

9. The answer is A [III E 2], Transection of the spinal cord causes "spinal shock" and loss of all reflexes below the level of the lesion. These reflexes, which are local circuits within the spinal cord, will return with time or become hypersensitive. Proprioception is permanently (rather than temporarily) lost because of the interruption of sensory nerve fibers. Fibers above the lesion are intact.

10. The answer is B [III B 3 a (1)]. Nuclear bag fibers are one type of intrafusal muscle fiber that make up muscle spindles. They detect dynamic changes in muscle length, give rise to group la afferent fibers, and are innervated by ^-motoneurons. The other type of intrafusal fiber, the nuclear chain fiber, detects static changes in muscle length.

11. The answer is B [II C 5 b (2)]. Complex cells respond to moving bars or edges with the correct orientation. Simple cells respond to stationary bars, and hypercomplex cells respond to lines, curves, and angles. Bipolar and ganglion cells are found in the retina, not in the visual cortex.

12. The answer is E [I C 1 d; Table 2-2], Asthma, a disease involving increased resistance of the upper airways, is treated by administering drugs that produce bronchiolar dilation (i.e., f}2 agonists). p2 Agonists include isoproterenol, albuterol, epinephrine and, to a lesser extent, norepinephrine. pz Antagonists, such as propranolol, are strictly contraindicated because they cause constriction of the bronchioles.

13. The answer is A [I C 1 a]. Adrenergic a! receptors produce physiologic actions by stimulating the formation of inositol 1,4,5-triphosphate (IP3) and causing a subsequent increase in intracellular [Ca2+], Both pi and p2 receptors act by stimulating adenylate cyclase and increasing the production of cyclic adenosine monophosphate (cAMP). a2 Receptors inhibit adenylate cyclase and decrease cAMP levels. Muscarinic and nicotinic receptors are cholinergic.

14. The answer is B [III E 3 a, b]. Decerebrate rigidity is caused by increased reflex muscle spindle activity. Stimulation of group la afferents would enhance, not diminish, this reflex activity. Cutting the dorsal roots would block the reflexes. Stimulation of a- and ^-motoneurons would stimulate muscles directly.

15. The answer is C [II B 4]. Representation on the motor homunculus is greatest for those structures that are involved in the most complicated movements—the fingers, hands, and face.

16. The answer is D [II E 1 a, 2 a, b]. The semicircular canals are involved in angular acceleration or rotation. Hair cells of the right semicircular canal are excited (depolarized) when there is rotation to the right. This rotation causes bending of the stereocilia toward the kinocilia, and this bending produces depolarization of the hair cell. Ascent in an elevator would activate the saccules, which detect linear acceleration.

17. The answer is D [II A 4 c]. Receptor potentials are graded potentials that may bring the membrane potential of the receptor cell either toward (depolarizing) or away from (hyperpolarizing) threshold. Receptor potentials are not action potentials, although action potentials (which are all-or-none) may result if the membrane potential reaches threshold.

18. The answer is A [II E 3]. The fast eye movement that occurs during a spin is nystagmus. It occurs in the same direction as the rotation. After the spin, post-rotatory nystagmus occurs in the opposite direction.

19. The answer is D [V B; Table 2-8]. Cerebrospinal fluid (CSF) is similar in composition to the interstitial fluid of the brain. Therefore, it is similar to an ultrafiltrate of plasma and has a very low protein concentration because large protein molecules cannot cross the blood-brain barrier. There are other differences in composition between CSF and blood that are created by transporters in the choroid plexus, but the low protein concentration of CSF is the most dramatic difference.

20. The answer is D [I C 1 c, d; Table 2-2], Among the autonomic drugs, only Pi and p2 adrenergic agonists act by stimulating adenylate cyclase. Norepinephrine is a (i, agonist. Atropine is a muscarinic cholinergic antagonist. Clonidine is an a2 adrenergic agonist. Curare is a nicotinic cholinergic antagonist. Phentolamine is an a! adrenergic antagonist. Phenylephrine is an a] adrenergic agonist. Propranolol is a Pi and p2 adrenergic antagonist.

21. The answer is B [II C 4]. Photoreception involves the following steps. Light converts 11-cis retinal to all-trans retinal, which is converted to such intermediates as metarhodopsin II. Metarhodopsin II activates a stimulatory G protein (transducin), which activates a phosphodiesterase. Phosphodiesterase breaks down cyclic guanosine monophosphate (cGMP), so intracellular cGMP levels decrease, causing closure of Na+ channels in the photoreceptor cell membrane and hyperpolar-ization. Hyperpolarization of the photoreceptor cell membrane inhibits the release of neurotransmitter. If the neurotransmitter is excitatory, then the bipolar cell will be hyperpolarized (inhibited). If the neurotransmitter is inhibitory, then the bipolar cell will be depolarized (excited).

22. The answer is C [VI C 1]. Pathogens release interleukin-1 (IL-1) from phagocytic cells. IL-1 then acts to increase the production of prostaglandins, ultimately raising the temperature set point in the anterior hypothalamus. The hypothalamus now "thinks" that the body temperature is too low (because the core temperature is lower than the new set-point temperature) and initiates mechanisms for generating heat—shivering, vasoconstriction, and shunting of blood away from the venous plexus near the skin surface.

23. The answer is A [II F 1 a, b]. Cranial nerve (CN) I innervates the olfactory epithelium. Its axons are C fibers. Fracture of the cribriform plate can tear the delicate olfactory nerves and thereby eliminate the sense of smell (anosmia); however, the ability to detect ammonia is left intact. Olfactory receptor cells are unique in that they are true neurons that are continuously replaced from undifferentiated stem cells.

24. The answer is B [I C 1 c]. Heart rate is increased by the stimulatory effect of norepinephrine on Pi receptors in the sinoatrial (SA) node. There are also sympathetic Pi receptors in the heart that regulate contractility.

25. The answer is E [I C 2 a; Figure 2-1]. Preganglionic parasympathetic fibers synapse on the chromaffin cells of the adrenal medulla at a nicotinic receptor, releasing epinephrine (and, to a lesser extent, norepinephrine) into the circulation.

26. The answer is E [I C 2 a]. Nicotinic receptors at the neuromuscular junction are not only the postsynaptic receptors for acetylcholine (ACh), but are also the ion channels for Na+ and K+; when they are opened by ACh, they depolarize the muscle end plate, producing the end plate potential.

27. The answer is E [I C 2 a]. Hexamethonium is a nicotinic blocker, but it acts only at ganglionic (not neuromuscular junction) nicotinic receptors. This pharmacologic distinction emphasizes that nicotinic receptors at these two locations, although similar, are not identical.

28. The answer is D [I C 2 b]. Atropine is a specific inhibitor of muscarinic receptors for acetylcholine (ACh). Atropine would be expected to block all effects of ACh that are mediated by muscarinic receptors. Therefore, atropine will decrease gastrointestinal (GI) motility, decrease bladder tone, dilate bronchiolar smooth muscle, and increase heart rate.

29. The answer is C [I C 1 d]. p2 Receptors on vascular smooth muscle produce vasodilation, a Receptors on vascular smooth muscle produce vasoconstriction. Because p2 receptors are more sensitive to epinephrine than are a receptors, low doses of epinephrine produce vasodilation, and high doses produce vasoconstriction.

30. The answer is A [II C 3 a]. Cutting the optic nerve from the left eye causes blindness in the left eye because the fibers have not yet crossed at the optic chiasm.

31. The answer is C [II C 3 c]. Fibers from the left temporal field and the right nasal field ascend together in the right optic tract.

32. The answer is B [II C 3 b]. Optic nerve fibers from both temporal receptor fields cross at the optic chiasm.

33. The answer is B [III H 1]. The premotor cortex (area 6) is responsible for generating a plan for movement before movement occurs. The supplementary motor cortex is responsible for the "mental rehearsal" of the movement.

34. The answer is E [III F 3 b]. Output of Purkinje cells from the cerebellar cortex to deep cerebellar nuclei is inhibitory. This output modulates movement and is responsible for the coordination that allows one to "catch a fly."

35. The answer is C [III C 3]. Flexor withdrawal is a polysynaptic reflex that is used when a person touches a hot stove or steps on a tack. On the ipsilateral side of the painful stimulus, there is flexion (withdrawal); on the contralateral side, there is extension to maintain balance.

36. The answer is A [III C 1], The stretch reflex is the monosynaptic response to stretching of a muscle. The reflex produces contraction and then shortening of the muscle that was originally stretched (homonymous muscle).

37. The answer is D [III B 1 b]. Group lb fibers are the afferent fibers from Golgi tendon organs that detect increases in muscle tension. The Golgi tendon reflex (inverse myotatic) compensates for the increased tension by causing relaxation of the homonymous muscle.

38. The answer is A [III B 2 a]. Extrafusal fibers constitute the bulk of muscle and are innervated by a-motoneurons.

39. The answer is C [III B 3 b]. Group la afferent fibers innervate intrafusal fibers of the muscle spindle. When the intrafusal fibers are stretched, the group la fibers fire and activate the stretch reflex, which causes the muscle to return to its resting length.

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Anxiety and Depression 101

Anxiety and Depression 101

Everything you ever wanted to know about. We have been discussing depression and anxiety and how different information that is out on the market only seems to target one particular cure for these two common conditions that seem to walk hand in hand.

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