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NBME 23 Answers

nbme23/Block 1/Question#49 (reveal difficulty score)
Electrical stimulation of the stellate ...
Heart rate🔍,📺
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 +7 
submitted by seagull(1688),
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So, -T/2T615/ rea eth sayimecptht vllee rof het ea.thr hTe ealttlse ogilanng era evicrlca mhcitaytsep aligngon. isTh stuoiqne meses mroe rconeirct (ro a uheg )lape ot .me uBt ehy, I ownk epople wlli ia.srgdee

dentist  you're right! heart rate is the only option under sympathetic control. +  
drzed  The cervical ganglion is a fusion of the last few cervical levels and the first thoracic level, so it is plausible. +  



 +6 
submitted by kentuckyfan(44),
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oNecit that )A ,ooocortBnschninrcti )B lGrladanu icr,osneet D) sirls,esaPti E) taliiasonVod fo skni ear lal ndreu tisyptcapharema ncor.lto

The yoln thtsmayepci lotcnro is hetar ,reta hhcwi woldu aecn.reis

drzed  Vasodilation of the skin is under sympathetic control as well -- beta-2 receptors when stimulated cause vasodilation (via increase of cAMP in vascular smooth muscle). The key is recognizing that stimulation of a GANGLION of the pns will lead to release of NOREPINEPHRINE, which preferentially stimulates alpha-1 receptors. Those receptors will cause vasoconstriction. If the question asked what happens when you stimulate the adrenal medulla, the answer would be (potentially) vasodilation. This is because the adrenal medulla releases EPINEPHRINE which preferentially stimulates beta-1/2 receptors. +8  
jesusisking  @drzed Awesome explanation except I think sympathetic response induces vasoconstriction in the skin though vasodilation in the muscles! +1  
usmile1  @jesusisking yes you are correct! α1: vasoconstriction in skin and intestine ; β2: vasodilation in skeletal muscle (transmitter: only epinephrine!) +  

Stellate ganglion is the result of fusion of inf cervical symp ganglion and T1 symp ganglion heart is supplied by T1-T4 so it will lead to increase HR

+3/- mhmdreyad(3),


 +2 
submitted by real_rawgary(2),
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ehT yaw I uceedxdl iialvtsnaodo wsa ihs:t the siaytmhtecp cotrpree that tdaisle is ,β2 cwihh si ton edlatusmti yb reiiroenn.pnphe So to ltmatuesi hte rcoetpre, het eallstet nalgnogi loduw vhea dah ot ifsrt smttiuela eth ndlaare dmulela to slaeeer pieehpinner tlaslet(e oot high ot ettsamiul eht am.uldl)e

krewfoo99  But isint beta 1 (heart rate) also stimulated by Epinephrine? +  



 +1 
submitted by realmedicmd(2),
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I noicytlerrc oshec lvoidaoinsta. udoFn tou ttha t’is ayulcalt osnrascitvnctioo la(nodivistao si ppe)yisactatmar:h

ounocAimt enerv srefib rea losa iaurlcylc deloinvv ni the netruglioa fo slruaavc fseefct ni teh si.nk yptteaShicm nreev sirfbe eelsrae eohperrpneniin aonrd/ PNY ot enteianvr ieos,lretar uoiarstoevner manes,toasso dna osvenu snudisois wchhi trelsus ni ooin,onartsctiscv resewha rphcsytpmtieaaa neervs dmeetai tanoaositaldiv hgthruo niaoactvti fo uevson eodssusnii yb eth eeresal fo hAC dna idV/tIeppeP sehtidiin t.ieeinhmno

/s6/t0lyf0.eyog/d0y052/.ou.hsrprtogi1hp0:1i5vl//.2l0s1hp2o




 +0 
submitted by consistentwrongdoer3(20),
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I toughht ahtt teh rmipayr apsyhtmicte rivnenatnio to the reath aws guohthr T.41-T Why wduol attoilsiumn fo tish igaoglnn otn etfacf nsik leesssv ni the eppur ml?ib

methylased  Stellate ganglion --> sympathetics for sweat to skin in UE + head. Apparently also to increase HR (some cardiologists ablate stellate ganglion for tachy that cant be controlled by beta blockers). +  
tea-cats-biscuits  The stellate ganglion is a sympathetic ganglion, so it wouldn’t increase vasodilation in the skin of the upper extremity. Also in most people, the inferior cervical ganglion is fused with the first thoracic ganglion (T1), forming the stellate ganglion. +36  
sympathetikey  Got this wrong too. I think upper extremity skin vasodilation (which I picked) is probably more due to local metabolites. +  



 +0 
submitted by criovoly(15),
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the teatelsl ognnliga si trpa of the tytsiehmcap unresvo smsety hftlgi ro tigfh. seearcnI arhte reat si teh stmo oovis.bu