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Testing the parasympathetic nervous system

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The integrity of the parasympathetic nervous system can be shown by:

  • the Valsalva manoeuvre: as the arterial blood pressure rises, the heart rate will fall inversely due to a baroreceptor reflex response.
  • pressure on carotid sinus or eyeball will produce reflex bradycardia; caution must be exercised as myocardial infarction can be precipitated.
  • drugs: antimuscarinics such as atropine, scopolamine and tropicamide will inhibit vagal activity with consequent manifestation of sympathetic effects e.g. pupillary dilation.

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