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Apex > 2 ANS > Flashcards

2 ANS Flashcards

1
Q

Transduction pathway G protein coupled receptors

A

1st messenger, GPCR, effector, 2nd messenger, cellular response

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2
Q

Receptors that activate Gq, their effector and 2nd messenger

A

A1, M1/3/5, V1, H1. Phos C. IP3, CA, DAG

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3
Q

Receptors that activ Gi. Their effector and 2nd messenger

A

A2, M2/4, D2. Inhib Adenylate cyclase so ATP wont lead to camp

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4
Q

Receptors that activ Gs. Their effector and second messenger

A

B1/2, D1, V2, H2. Adenylate cyclase, ATP to CAMP

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5
Q

Myocardium SNS vs PNS receptor, what they effect

A

B1. M2. Contractility

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6
Q

Heart conduction SNS vs PNS, effects

A

B1- HR and conduc speed. M2- dec hr and cv

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7
Q

Arteries SNS receptor and action

A

A1>A2, NO pns. Vasoconstrict

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8
Q

Vein sns receptor and action

A

A2>a1, constrict, no pns

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9
Q

Myocardium sns receptor and action

A

B2 vasodilation

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10
Q

Renal and mesenteric sns receptor, action

A

DA, dilation

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11
Q

Bronchus: sns and pns receptors and actions

A

B2 dilation M3 constriction

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12
Q

Kidney: renal tubules sns receptor and renin release sns receptor, actions

A

Tubules: A2, diuresis/adh inhib. Renin: B1, inc renin release

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13
Q

Eye sphincter muscle: pns receptor and action

A

M, miosis

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14
Q

Eye radial muscle sns receptor and action

A

A1, mydriasis

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15
Q

Eye ciliary muscle sns vs pns and actions

A

SNS B2, relax for far vision.pns M, contract for near vision

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16
Q

GI: sphincter sns vs pns

A

A1 contract M relax

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17
Q

GI: motility and tone sns vs pns

A

SNS: a1-2, b1-2, decrease. PNS M inc

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18
Q

GI salivary glands sns vs pns

A

A2 decrease M increase

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19
Q

Gallbladder and duct sns vs pns

A

B2 relax, m contract

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20
Q

Pancreas beta cells sns receptors and actions

A

A2 dec insulin, B2 inc insulin release

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21
Q

Liver sns receptor and action

A

A1 and B2, inc BG

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22
Q

Uterus sns receptors and actions

A

A1 contract B2 relax

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23
Q

Bladder sns

A

A1 contract sphincter B2 relax detrusor

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24
Q

Bladder pns

A

M relax sphincter m contract detrusor

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25
Q

Sweat gland sns vs pns

A

A1 and M inc secretion

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26
Q

Locations of A2 receptor

A

Pre synaptic (NE releasing), postsynaptic (smooth muscle/organs), non synaptic (plt)

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27
Q

A2 actions in CNS

A

Dec sns in medulla, inc pns in vagus, sedation in locus, analgesia SC dorsal horn, antishivering

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28
Q

A2 actions in vessels, kidney, pancreas

A

Constriction, inhib ADH—> diuresis, dec insulin release

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29
Q

A2 Actions: plt, salivary glands, GI

A

Aggregation, dry mouth, dec motility

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30
Q

What metabolizes camp, result

A

PD3, turns off protein kinases and cell told not to do action anymore

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31
Q

What inhib of PD3 leads to

A

Inc cAMP and protein kinases maintained in on state

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32
Q

Inhib PD3 in heart leads to what

A

Inc ca and force of contraction, inc rate of relaxation (lusitropy)

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33
Q

Inhib pd3 in vascular muscle leads to

A

Inhib myosin, leads to vasodilation and dec SVR

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34
Q

Rate limiting step of tyrosine to dopa

A

Tyrosine hydroxylase

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35
Q

Steps from tyrosine to epi

A

Tyro - tyro hydroxylase - dopa - dopa decarboxylase - dopamine - dopa b hydroxylase - NE - PNM- epi

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36
Q

NT release from adrenal medulla

A

80% epi 20% NE

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37
Q

How NE inhib or augment release

A

Stim pre-synaptic A2 receptor inhibits, augment by stim pre synaptic B2 receptor

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38
Q

How NE metabolized

A

Kidneys and liver, only 5% excreted unchanged in kidneys

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39
Q

Nicotinic receptors are what, muscarinic receptors are what

A

Nicotinic- ion ch. muscarinic- G protein linked

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40
Q

Ach synthesis

A

Choline to blood from cytoplasm. Acetyl co a made in mitochondria. Choline and acetyl co a joined by choline acetyltransferase.

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41
Q

How mag effects ach release

A

Mag antagonizes calcium, can cause muscle weakness and synergizes NMB

42
Q

ACH metabolism

A

Acetyl cholinesterase hydrolizes ach, choline goes to nerve terminal by reuptake. Acetate diffuses away

43
Q

Control center of ans in body

A

Hypothalamus, brain stem, sc

44
Q

Preganglionic neuron fiber type, postganglionic type

A

Pre: myelinated B. Post: unmyelinated c

45
Q

SNS: origin, ganglia where, post to preganglionic ratio

A

T1-L3. Near SC. 30:1

46
Q

SNS: Pre vs post ganglionic fiber

A

Pre= short post= long

47
Q

PNS: origin, ganglia location, post to pre ganglionic ratio

A

S2-4 and CN 3/7/9/10. Near/in effector organ. 1-3:1.

48
Q

PNS pre vs post ganglionic fibers

A

Pre= long, post= short

49
Q

In sns where preganglionic fibers exit sc and enter the chain

A

Exit ventral roots and enter white communicating rami

50
Q

What stellate ganglion innervates

A

SNS to same upper extremity and pt of head and neck

51
Q

Consequence of blockade of stellate ganglion

A

Hornets syndrome: vasodilation, ptosis, anhidrosis, miosis

52
Q

Adrenal gland parts and their functions

A

Medulla sec catecholamines. Cortex sec glucocorticoids, mineralcorticoids, and androgens

53
Q

Preganglionic fibers release what onto adrenal medulla. There are no what here. What stim leads to

A

Ach. Postganglionic fibers. Chromaffin cells release epi and norepi

54
Q

Pheochromocytoma must do what

A

Alpha before beta block

55
Q

Alpha antagonists used in pheo

A

Non selec: phenoxybenzamine and phentolamine. Selec a1: doxazosin and prazosin

56
Q

Why its bad to beta before alpha block

A

Blocking B2 inc SVR b1 dec inotropy, can lead to CHF

57
Q

SNS stim causes hepatocytes to release what, in turn pancreas does what

A

K and glucose. Pancreas inc insulin output

58
Q

Things that shift k into the cell (hypokalemia)

A

Alkalosis, B2 agonists, theophylline, insulin

59
Q

Things that shift k out of cell and inc concentration in blood

A

Acidosis, cell lysis, sux

60
Q

Baroreceptor reflex: where sensors are for stretch, nerves there

A

Carotid sinus (nerve of hering - cn 9), transverse aortic arch (vagus). Both go to tractus solitarus in medulla

61
Q

Surgeries with baroreceptor reflex

A

Endarterectomy, mediastinoscopy

62
Q

What it means to preserve vs maintain BRR

A

Preserve= dec bp and inc hr. Impair= dec bp and hr

63
Q

Drugs that impair BRR

A

Va (iso least), propofol, BB

64
Q

Behold Jarisch reflex effects

A

Slows hr in hypovolemia: bradycardia, hypotension, CA vasodilation to allow filling

65
Q

Bainbridge reflex

A

Full heart sensed- leads to inc in HR

66
Q

Sensors: bezold, Bain

A

Bezold: LV. Bain: sa node, RV, pulm veins

67
Q

Afferrent, control, and efferent in bezold v bain

A

Both afferrent unmyelinated c vagus, control medulla, efferent vagal stim v inhib

68
Q

Tx of bezold reflex

A

IVF, tburg, inc hr

69
Q

Oculocardiac reflex limbs

A

Afferrent: CN V, efferent CN X

70
Q

Presentation of oculocardiac reflex, worsened by what

A

Low hr/bp, av block. Hypoxemia hypercarbia light anesthesia

71
Q

Cushing reflex: presentation, when it happens

A

Happens w IC htn. Htn, bradycardia, irreg resp,

72
Q

Celiac reflex

A

Traction on abd, mediated by vagus, causes bradycardia and hypotension

73
Q

Chemoreceptor reflex

A

Stim by hypoxia and hypercarbia. In min vent and sns tone

74
Q

Heart transplant: co dependent on what. Only reflex what is preserved

A

Preload. Bainbridge

75
Q

Glomus tumors: what they release and where

A

NE, serotonin, histamine, bradykinin on carotid artery, aorta, cn 9, middle ear

76
Q

Glomus tumor manifestations:

A

exag hypo or hypertension, flushing, bronchoconstriction

77
Q

Tx glomus tumor effects

A

Octreotide

78
Q

Mult sys atrophy: causes what, s/s

A

Degeneration of locus coeruleus, sc where sns lies, peripheral ans nerves. Ortho hypo, urinary retention, impotence, bowel issues

79
Q

How to treat autonomic dysfunc from mult sys atrophy

A

Volume, direct acting agents. Indirect acting not used bc exag response

80
Q

NE: receptors, dose

A

A1-2, B1. 0.02-0.4 mcg/kg/min. Low dose b1 selec, hi dose stim all

81
Q

Avoid NE when, tx for extravasation

A

Cardiogenic shock. Phentolamine 2.5-10 mg diluted

82
Q

Epi: low intermediate and hi dose fx

A

Low (<0.03) b1 and 2. Interned 0.03-0.15 a and b fx. High: >0.15 alpha mainly

83
Q

Dopamine: low intermediate and high doses and dx

A

Low 1-2 renal vasodil/inc rbf. Intermediate 2-10, cardiac stim. High 10-20 vasopressor fx, alpha

84
Q

Isuprel: receptor stim dose, fx

A

B1 and B2. 0.02-0.5 mcg/kg/min. Inc hr, dec scr.

85
Q

Isuprel: impairs what, poor choice when, good uses

A

Impairs CPP. Bad in septic shock. Cor pulm/heart trans

86
Q

Dobutamine fx and dose

A

0.5-15 mcg/kg/min, inc hr and co. B1 mainly, some B2

87
Q

Heart conditions where phenylephrine is useful

A

HOCM, tet of fallot

88
Q

Ephedrine: receptors, when it doesnt work

A

A1-2 b1-2. Sepsis and heart transplant or if mult doses given

89
Q

Vaso: made by what, released where, receptor stim

A

Made by hypothalamus, released by posterior pituitary. V1= constriction. V2= aquaporins in collecting ducts, water reabsorption

90
Q

OD of vaso van lead to what

A

Sz and hyponatremia

91
Q

B1 selective BB

A

MABE AB. Metop, aten, betax, esmolol, acet, biso

92
Q

Nonselective bb

A

Carved, labetolol, nadolol, pindolol, propranolol, timolol

93
Q

BB that depends on kidney elim

A

Atenolol

94
Q

Labetolol and carvedilol b:a ratio.

A

Labetolol: 7:1. Carvedilol: 10:1

95
Q

How to tx bb overdose

A

Glucagon, calcium, pde3 inhib, epi, isuprel

96
Q

What membrane stabilizing means, drugs that do this

A

Bb. Has local anesthetic like effects, reduces rate of rise of cardiac action potential. Propranolol and acebutolol

97
Q

How BB have intrinsic sympathomimetic fx, which ones

A

Partial agonists while blocking other agonists. Labetolol and pindolol

98
Q

Phenoxybenzamine: what it does/acts on, role

A

Non selec non compet alpha antagonist. Reflex tachy. Manage htn in pheo.

99
Q

Phentolamine: what it is, uses

A

Non selec, compet antagonist. Reflex tachy. Tx in pheo or autonomic hyperreflexia, or infiltration

100
Q

Prazosin: drug type, uses

A

A1 selec. No reflex tachy. Essential htn, bph

101
Q

Yohimbine: drug type, uses, od leads to

A

A2 antagonist. Tx ortho hypo. Od= tachycardia and htn

Apex (21 decks)

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