12- CIS CPR Autonomics Flashcards
The Sympathetic nervous system is responsible for producing the fight-or-flight response. Anatomically, it is distinguished by activation of the Presynaptic neurons via __________ nuclei receiving input from brainstem regulatory regions.
Hypothalamic
For the Sympathetics, the NT released from the Presynaptic neuron is…
ACh
For the Sympathetics, what type of receptor is found on the Postsynaptic dendrites/cell body?
Nicotinic Cholinergic Receptors
For Sympathetics, the Postsynaptic axon leaves the Sympathetic chain and travels to the target organ. The NT __________ is released from the Postsynaptic axon.
Norepinephrine
For Sympathetics, the cells of the target organ express what type of receptors?
Alpha-Adrenergic or Beta-Adrenergic Receptors
For Sympathetics, the Presynaptic axons that did NOT synapse with the Sympathetic chain are a special case. They passed through the chain ganglia without synapsing and went to the ________ ________ where they snapped on the _________ cells. The Presynaptic axons released the NT __________ that bound to these cells.
Adrenal Medulla
Chromaffin
ACh
For Sympathetics, the ACh released from Presynaptic axons synapsing with Chromaffin cells bound to what type of receptors on the cells?
Nicotinic Cholinergic Receptors
For Sympathetics, when ACh binds to the Chromaffin cells (via Nicotinic Cholinergic Receptors) there is an influx of ________ into the Chromaffin cells. This produces the release of ________ into the blood.
Sodium
Epinephrine
Alpha- and Beta-Adrenergic Receptors are (IONOTROPIC/METABOTROPIC).
Metabotropic
***Remember, Ionotropic and Metabotropic are both ligand-gated but Ionotropic will change shape and allow ions to pass through a channel when a ligand binds. Metabotropic activates a GPCR when a ligand binds.
Alpha-Adrenergic Receptors have two subtypes, which are…
Alpha1-Adrenergic – Activation on smooth muscle is almost always associated with contraction of the smooth muscle
Alpha2-Adrenergic – On vascular smooth muscle is associated with relaxation/dilation
Beta-Adrenergic Receptors have two important subtypes we talked about, which are…
Beta1-Adrenergic – Found on cardiac myocytes
Beta2-Adrenergic – On smooth muscle and causes relaxation
The Parasympathetic division is often considered to be responsible for “rest and digest”. Once again, brain activation arises largely from the _________, in response to inputs from other parts of the brain including the medulla.
Hypothalamus
For Parasympathetics, the Presynaptic fibers release the NT _________, which binds to _______ _______ receptors on the Postsynaptic dendrites/cell body (which is on or near the target organ).
ACh
Nicotinic Cholinergic
For Parasympathetics, the Postsynaptic fibers release the NT __________ and it binds to _________ _________ receptors on the target organ.
ACh
Muscarinic Cholinergic
Muscarinic receptors have five subtypes, and all are (IONOTROPIC/METABOTROPIC).
Metabotropic
Describe the subtypes of the Muscarinic Receptors.
M1, M3, and M5 = Associated with IP3/DAG production and release of intracellular Calcium stores
M2 and M4 = Associated with Gi proteins and lead to a reduction in cAMP
T/F. The SA Node is strongly innervated by both Sympathetics and Parasympathetics.
True
What provides Parasympathetic innervation to the SA Node?
Vagus N.
What type of Parasympathetic receptors lie on the specialized conducting tissue of the SA Node?
Muscarinic Receptor
What are the actions and effects of the Parasympathetics for the SA Node?
Action = Decreases rate of depolarization of the pacemaker potential
Effect = Slows heart rate
What provides Sympathetic innervation to the SA Node?
Arises from T1-T5 levels of the spinal cord
What type of Sympathetic receptors lie on the target organ, in this case the SA Node?
Beta1-Adrenergic Receptor
What are the actions and effects of the Sympathetics for the SA Node?
Action = Increase the rate of depolarization of the pacemaker potential
Effect = Increases heart rate
What provides Parasympathetic innervation to the AV Node and Ventricular conducting pathways (Bundle of His and Purkinje Fibers)?
Vagus N.
What type of Parasympathetic receptors lie on the target organ, which is the AV Node and Ventricular conducting pathways (Bundle of His and Purkinje Fibers) in this case?
Muscarinic Cholinergic
What are the actions and effects of the Parasympathetics for the AV Node and Ventricular conducting pathways (Bundle of His and Purkinje Fibers)?
Actions =
- Decrease slope of pacemaker potential
- Decrease depolarization rate during Phase 0 of the slow action potential
Effects =
- Decrease conduction velocity through AV Node and ventricles
- If AV Node is pacemaker for the heart (not normal), it decreases Ventricular rate
What provides Sympathetic innervation to the AV Node and Ventricular conducting pathways (Bundle of His and Purkinje Fibers)?
T1-T5 spinal nerves
What type of Sympathetic receptors lie on the target organ, which is the AV Node and Ventricular conducting pathways (Bundle of His and Purkinje Fibers) in this case?
Beta1-Adrenergic
What are the actions and effects of the Sympathetics for the AV Node and Ventricular conducting pathways (Bundle of His and Purkinje Fibers)?
Actions =
– Increase rate of depolarization during phase 0 and the pacemaker potential
Effects =
- Increase conduction velocity through AV Node
- Increase ventricular rate if AV Node is serving as pacemaker (not normal)
What provides Parasympathetic innervation to the Atrial and Ventricular myocytes?
Atrial = Vagus N. Ventricular = Debated
What type of Parasympathetic receptors lie on the target organ, in this case the Atrial and Ventricular myocytes?
Muscarinic
What are the Parasympathetic actions and effects in the Atrial and Ventricular myocytes?
Actions = Decrease Calcium entry into myocyte
Effects =
- Decrease in Atrial contractility
- Possible decrease in Ventricular contractility
What provides Sympathetic innervation to the Atrial and Ventricular myocytes?
T1-T5 spinal nerves
What type of Sympathetic receptors lie on the target organ, in this case the Atrial and Ventricular myocytes?
Beta1-Adrenergic
***Beta2-Adrenergic is listed in some sources, but it’s mostly Beta1
What are the Sympathetic actions and effects in the Atrial and Ventricular myocytes?
Actions = Increased Calcium conductance into myocytes
Effects = Increase myocyte contractility (meaning the Cardiac muscle pumps stronger)
What provides the Parasympathetic innervation for the Coronary As.?
Vagus N.
What type of Parasympathetic receptors are on the Coronary As.?
Muscarinic Cholinergic
What are the Parasympathetic actions and effects in the Coronary As.?
Actions = Smooth muscle relaxation
Effects = Vasodilation and an increase in Coronary blood flow
***Can be overridden by decreased production of metabolites and constriction (because Vagus N. causes decrease in metabolic activity)
What provides the Sympathetic innervation for the Coronary As.?
T1-T5 spinal nerves
What type of Sympathetic receptors are on the Coronary As.?
Alpha1-Adrenergic
What are the Sympathetic actions and effects in the Coronary As.?
Actions = Smooth muscle contraction
Effects = Vasoconstriction and a decrease in Coronary blood flow
***Can be overridden by the increased production of metabolites by the myocardium (due to Sympathetics) and lead to vasodilation
The innervation of the Cutaneous vasculature is strongly controlled by the ANS, mainly the (SYMPATHETICS/PARASYMPATHETICS), and arises from multiple sources.
Sympathetics
What type of Sympathetic receptors are on the Cutaneous vasculature?
Alpha1-Adrenergic
What are the Sympathetic actions and effects in the Cutaneous vasculature?
Actions = Contraction of vascular smooth muscle
Effects = Vasoconstriction
Sympathetic innervation for sweat glands is a special case. They use Muscarinic receptors and their actions and effects are…
Actions = Relaxation of vascular smooth muscle
Effects = Vasodilation and increase in primary sweat production
The major autonomic influence of the vasculature supplying the skeletal muscle is (SYMPATHETIC/PARASYMPATHETIC), and has multiple sources of innervation.
Sympathetic
What type of Sympathetic receptors are there for the vasculature of skeletal muscle?
Alpha1-Adrenergic
Beta2-Adrenergic
What are the Sympathetic actions and effects of the vasculature of the skeletal muscle based on their receptors?
Actions =
Alpha1-Adrenergic - Contraction of vascular smooth muscle
Beta2-Adrenergic - Relaxation of vascular smooth muscle
Effects =
Alpha1-Adrenergic - Vasoconstriction of arterioles supplying a muscle
Beta2-Adrenergic - Vasodilation of blood supply to muscle
Vasculature of skeletal muscle also has some Parasympathetic innervation, and its sources are variable. Its receptors are Muscarinic Cholinergic and the actions and effects are…
Actions = Relaxation of vascular smooth muscle
Effects = Vasodilation of vasculature supplying the muscle
***This is the same as the Beta2-Adrenergic receptors of the Sympathetics!
Innervation of the Splanchnic vessels is (SYMPATHETIC/PARASYMPATHETIC) only.
Sympathetic
What is the source of the Sympathetic innervation for the Splanchnic vessels?
T5-L2 spinal nerves
***Can synapse in the Celiac, Superior Mesenteric, and Inferior Mesenteric Ganglion (Prevertebral) – This is Abdominopelvic Splanchnic Ns.
What type of Sympathetic receptors are used for innervation of Splanchnic vessels?
Alpha1-Adrenergic
What are the Sympathetic actions and effects of the Splanchnic vessels?
Action = Contraction of vascular smooth muscle
Effects = Vasoconstriction of Splanchnic blood vessels
***Vasodilation is produced when the sympathetic activity is decreased!
The primary source of autonomic innervation for the veins is (SYMPATHETIC/PARASYMPATHETIC).
Sympathetic
What Sympathetic receptors are used for the veins?
Alpha1-Adrenergic
Alpha2-Adrenergic
Beta2-Adrenergic
What are the Sympathetic actions and effects for the veins based on the receptors?
Actions =
Alpha1 - Contraction of venous smooth muscle
Alpha2 - Relaxation of venous smooth muscle
Beta2 - Relaxation of venous smooth muscle
Effects =
Alpha1 - Contraction of veins, increasing return of blood back to heart
Alpha2 and Beta2 - Dilation of veins, slowing return of blood back to heart
The blood flow to the lungs is divided into two parts, which are…
Bronchial Circulation
Alveolar (Pulmonary) Circulation
For the Bronchial Circulation, this provides ________ and removes ________ to the airways that are too thick to get oxygen from the air in the lungs.
Oxygen
Metabolites
Bronchial Circulation follows all the same rules as the Systemic Circulation, which means the oxygenated blood is sent to the Bronchial Circulation from the _______ _______. The arteries contain high _______ and low _______ _______.
Left Ventricle
Oxygen
Carbon Dioxide
For Bronchial Circulation, one thing that makes it different from Systemic Circulation is that this blood returns to the heart via the ________ ________.
Pulmonary Veins
For Alveolar (Pulmonary) Circulation, this is blood that is being sent to the lungs for _______ ______ and arises from the Right Ventricle and travels to the lungs via the Pulmonary Artery. This blood is low in ________ and high in ________ ________.
Gas Exchange
Oxygen
Carbon Dioxide
For Alveolar (Pulmonary) Circulation, the blood is transported to the ________ and get oxygen, then returned back to the heart via the Pulmonary Vein.
Alveoli
What give the Parasympathetic innervation to the Pulmonary Vasculature?
Vagus N. (fibers arise in Nucleus Ambiguus)
What Parasympathetic receptors are used on the Pulmonary Vasculature?
Muscarinic Cholinergic
What is the point of highest Parasympathetic innervation for the Pulmonary Vasculature?
At the extrapulmonary arteries (Pulmonary A. and the Pulmonary Trunk and hilar vessels)
***Parasympathetic innervation decreases as you move closer to the Alveoli. There is overall more Sympathetic at all locations.
What are the Parasympathetic actions and effects for the Pulmonary vasculature?
Actions =
Directly – Production of NO and release from endothelial cells
Indirectly – Via NO, relaxation of vascular smooth muscle
Effects =
– Vasodilation
What gives the Sympathetic innervation to the Pulmonary Vasculature?
First five Thoracic ganglia (including Stellate)
What are the locations of Sympathetic innervation of the Pulmonary Vasculature?
Most extensive in Pulmonary A. and hilar vessels, and decreases as it goes to smaller vessels. Acinar vessels not innervated.
***Similar to Parasympathetic
What Sympathetic receptors are used for the Pulmonary Vasculature?
Primary = Alpha1-Adrenergic
Also present is Beta1-Adrenergic and Beta2-Adrenergic
What are the Sympathetic actions and effects for the Pulmonary Vasculature based on their receptors?
Actions =
Alpha1 – Contraction of vascular smooth muscle
Beta1 and Beta2 – Relaxation of vascular smooth muscle
Effects =
Alpha1 – Vasoconstriction of large pulmonary vessels
Beta1 and Beta2 – Vasodilation of large pulmonary vessels
Sympathetic innervation of the Pulmonary vasculature can be reflexively activated by __________ that detect distension of the Pulmonary A. or the large airways. Can also be activated by exposure to cold air or _______ (such as occurs at altitude).
Mechanoreceptors
Hypoxia
Note that the Alveolar and Acinar Arterioles are not well innervated by the ANS and therefore are more likely to be controlled by local influences, like how much _______ and _______ _______ are in the Alveoli.
Oxygen
Carbon Dioxide
For the innervation of smooth muscle and glands of the airways, it is divided into the _______ airways and _______ airways.
Upper
Lower
The smooth muscle and glands of the Upper airways are mainly confined to the ________ ________.
Nasal Mucosa
What provides Parasympathetic innervation to the Upper airways (smooth muscle and glands)?
Parasympathetic branches of the Trigeminal N. and the Sphenopalatine Ganglion
What Parasympathetic receptors are used for the Upper airways (smooth muscle and glands)?
Muscarinic Cholinergic
What are the Parasympathetic actions and effects for the Upper airways (smooth muscle and glands)?
Actions = Vasodilation and increase secretion
Effects = Increased mucus secretion
What provides the Sympathetic innervation to the Upper airways (smooth muscle and glands)?
Superior Cervical Ganglia via the Facial N.
What Sympathetic receptors are used for the Upper airways (smooth muscle and glands)?
Alpha1-Adrenergic
What are the Sympathetic actions and effects for the Upper airways (smooth muscle and glands)?
Actions =
- No direct influence on glands
- Smooth muscle contraction
Effects =
– Vasoconstriction and reduction in mucous secretion
The Lower airways have intrinsic and extrinsic innervation. The Trachea and large airways are innervated by an _________ nerve plexus that develops embryologically from the gut. The Sympathetic and Parasympathetic innervation is considered _________.
Intrinsic
Extrinsic
What provides the Parasympathetic innervation for the Lower airways?
Vagus N.
What Parasympathetic receptors are used for the Lower airways?
Muscarinic Cholinergic
What are the Parasympathetic actions and effects for the Lower airways?
Actions =
- Contraction of Bronchial smooth muscle
- Increased synthesis of mucus
Effects =
- Bronchoconstriction
- Increased mucus secretion
What provides the Sympathetic innervation for the Lower airways?
T1-T5 spinal nerves
What Sympathetic receptors are used for the Lower airways?
Bronchial – Beta2-Adrenergic
What are the Sympathetic actions and effects for the Lower airways?
Actions =
– Relax Bronchial smooth muscle
Effects =
- Bronchodilation
- Increase in Bronchial secretions, but minor
Although both the vasculature of the lungs and the heart are innervated by autonomic nerves, the major control in each organ is based on availability or need for _______. The kidneys are slightly different, its vasculature is heavily innervated by the _________ nerves and blood flow to the kidney is primarily dictated by the ANS.
Oxygen
Sympathetic
The Sympathetic innervation of the kidneys also influences the secretion of the enzyme ________ to provide long-term control of blood pressure.
Renin
The major job of the kidney is to…
Remove metabolic waste products from the blood
In order to do its job, the kidney receives about ______ of the blood pumped by the heart every minute.
20%
This is the functional unit of the kidney, there are millions.
Nephron
What are the parts of the Nephron?
Bowman’s Capsule/Space
Proximal Convoluted Tubule
Loop of Henle
Distal Convoluted Tubule and Collecting Duct
This part of the Nephron provides the initial filtration to provide the raw materials to make urine out of.
Bowman’s Capsule/Space
This part of the Nephron is used for “bulk operations”. It moves everything that was filtered in Bowman’s Space (that we need) back to the blood via the process of reabsorption. It moves things that didn’t get filtered and needs to get out into the urine via the process of secretion.
Proximal Convoluted Tubule
This part of the Nephron is preparing to concentrate the urine (if needed). Its main job is to concentrate the interstitium and creates the gradient that can be used to reabsorb water as needed.
Loop of Henle
This part of the Nephron is used for fine tuning and uses hormones to control (in particular) water and sodium.
Distal Convoluted Tubule and Collecting Duct
This is what supplies blood to the kidney.
Renal A.
T/F. Each part of the Nephron has a specific vascular “piece” associated with it and required to do the job.
True
What are the vascular components of Bowman’s Capsule/Space?
Afferent Arteriole – heavily Sympathetic
Glomerular Capillaries
Efferent Arteriole – heavily Sympathetic
This vascular component of Bowman’s Capsule/Space controls the blood flow into the Glomerular Capillaries. If they are constricted, less blood goes into the capillaries, and if they’re dilated, more blood goes into the capillaries.
Afferent Arterioles
***Mostly Sympathetic
This vascular component of Bowman’s Capsule/Space delivers blood/plasma so the plasma can be filtered.
Glomerular Capillaries
Bowman’s Capsule + Glomerular Capillaries = __________.
Glomerulus
This vascular component of Bowman’s Capsule/Space controls the blood flow OUT of the Glomerular Capillaries. If they are constricted, less plasma is filtered into Bowman’s Space. If they are dilated, more plasma is filtered into Bowman’s Space.
Efferent Arterioles
***Mostly Sympathetic
What is the vascular component of the Proximal Convoluted Tubule?
Peritubular Capillaries
The Efferent Arterioles (from Bowman’s Capsule) break down into the Peritubular Capillaries (in Proximal Convoluted Tubule). Altogether, the Afferent Arterioles, Glomerular Capillaries, Efferent Arterioles, and Peritubular Capillaries make up the…
Renal Portal System
What is the job of the Peritubular Capillaries (in Proximal Convoluted Tubule)?
– Secrete substances into the Proximal Convoluted Tubule to be excreted in the urine
– Reabsorb substances that were filtered but that we need (like glucose, etc.)
What is the blood supply to the Loop of Henle?
Set of capillaries known as the Vasa Recta
***These are not from the Efferent Arteriole
What is the role of the Vasa Recta?
– Secrete Na, Cl, and K
– Reabsorbs water to keep the interstitium concentrated
What is the blood supply to the Distal Convoluted Tubule/Collecting Duct?
Peritubular Capillaries
***Also the supply to the Proximal Convoluted Tubule!
What is the purpose of the Peritubular Capillaries in the Distal Convoluted Tubule/Collecting Duct?
Reabsorb the Na and water as dictated by need
The Peritubular Capillaries in the Distal Convoluted Tubule/Collecting Duct are hormonally controlled by what?
Antidiuretic Hormone (ADH, also known as Vasopressin) Aldosterone
In addition to controlling the composition of the blood, the kidneys also control the blood ________.
Volume
If blood volume/pressure decreases, a part of the Glomerulus known as the _________ _________ secretes a protein called Renin. This is innervated by the Sympathetic nervous system.
Juxtaglomerular Apparatus
What are the Sympathetic receptors involved with vasculature of the kidney?
Alpha-Adrenergic
What are the Sympathetic actions and effects on the vasculature of the kidney?
Actions = Contraction of vascular smooth muscle
Effect = Vasoconstriction of the -- -- Renal A. and all arteries of the kidney -- Afferent Arteriole -- Efferent Arteriole
End Result = Decrease in blood flow into the kidney and decreased urine production. Preserves BP to the rest of the body (heart, lungs, brain in particular).
There are Sympathetic effects on the Juxtaglomerular Apparatus, which are specifically in the _________ cells of the Afferent Arteriole.
Granule
What are the Sympathetic receptors involved with the Juxtaglomerular Apparatus?
Beta1-Adrenergic
What is the effect of Sympathetics on the Juxtaglomerular Apparatus?
– Increased release of the enzyme Renin
Which leads to:
- Increased production of Angiotensin
- Increased production of Angiotensin II
- Angiotensin causes increased release of Aldosterone
- Aldosterone causes increased reabsorption of Na
- Aldosterone also causes release of ADH (reabsorbs water)
End result = Increase in blood volume/pressure
