2 ANS Flashcards
1
Q
Transduction pathway G protein coupled receptors
A
1st messenger, GPCR, effector, 2nd messenger, cellular response
2
Q
Receptors that activate Gq, their effector and 2nd messenger
A
A1, M1/3/5, V1, H1. Phos C. IP3, CA, DAG
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
4
Q
Receptors that activ Gs. Their effector and second messenger
A
B1/2, D1, V2, H2. Adenylate cyclase, ATP to CAMP
5
Q
Myocardium SNS vs PNS receptor, what they effect
A
B1. M2. Contractility
6
Q
Heart conduction SNS vs PNS, effects
A
B1- HR and conduc speed. M2- dec hr and cv
7
Q
Arteries SNS receptor and action
A
A1>A2, NO pns. Vasoconstrict
8
Q
Vein sns receptor and action
A
A2>a1, constrict, no pns
9
Q
Myocardium sns receptor and action
A
B2 vasodilation
10
Q
Renal and mesenteric sns receptor, action
A
DA, dilation
11
Q
Bronchus: sns and pns receptors and actions
A
B2 dilation M3 constriction
12
Q
Kidney: renal tubules sns receptor and renin release sns receptor, actions
A
Tubules: A2, diuresis/adh inhib. Renin: B1, inc renin release
13
Q
Eye sphincter muscle: pns receptor and action
A
M, miosis
14
Q
Eye radial muscle sns receptor and action
A
A1, mydriasis
15
Q
Eye ciliary muscle sns vs pns and actions
A
SNS B2, relax for far vision.pns M, contract for near vision
16
Q
GI: sphincter sns vs pns
A
A1 contract M relax
17
Q
GI: motility and tone sns vs pns
A
SNS: a1-2, b1-2, decrease. PNS M inc
18
Q
GI salivary glands sns vs pns
A
A2 decrease M increase
19
Q
Gallbladder and duct sns vs pns
A
B2 relax, m contract
20
Q
Pancreas beta cells sns receptors and actions
A
A2 dec insulin, B2 inc insulin release
21
Q
Liver sns receptor and action
A
A1 and B2, inc BG
22
Q
Uterus sns receptors and actions
A
A1 contract B2 relax
23
Q
Bladder sns
A
A1 contract sphincter B2 relax detrusor
24
Q
Bladder pns
A
M relax sphincter m contract detrusor
25
Sweat gland sns vs pns
A1 and M inc secretion
26
Locations of A2 receptor
Pre synaptic (NE releasing), postsynaptic (smooth muscle/organs), non synaptic (plt)
27
A2 actions in CNS
Dec sns in medulla, inc pns in vagus, sedation in locus, analgesia SC dorsal horn, antishivering
28
A2 actions in vessels, kidney, pancreas
Constriction, inhib ADH—> diuresis, dec insulin release
29
A2 Actions: plt, salivary glands, GI
Aggregation, dry mouth, dec motility
30
What metabolizes camp, result
PD3, turns off protein kinases and cell told not to do action anymore
31
What inhib of PD3 leads to
Inc cAMP and protein kinases maintained in on state
32
Inhib PD3 in heart leads to what
Inc ca and force of contraction, inc rate of relaxation (lusitropy)
33
Inhib pd3 in vascular muscle leads to
Inhib myosin, leads to vasodilation and dec SVR
34
Rate limiting step of tyrosine to dopa
Tyrosine hydroxylase
35
Steps from tyrosine to epi
Tyro - tyro hydroxylase - dopa - dopa decarboxylase - dopamine - dopa b hydroxylase - NE - PNM- epi
36
NT release from adrenal medulla
80% epi 20% NE
37
How NE inhib or augment release
Stim pre-synaptic A2 receptor inhibits, augment by stim pre synaptic B2 receptor
38
How NE metabolized
Kidneys and liver, only 5% excreted unchanged in kidneys
39
Nicotinic receptors are what, muscarinic receptors are what
Nicotinic- ion ch. muscarinic- G protein linked
40
Ach synthesis
Choline to blood from cytoplasm. Acetyl co a made in mitochondria. Choline and acetyl co a joined by choline acetyltransferase.
41
How mag effects ach release
Mag antagonizes calcium, can cause muscle weakness and synergizes NMB
42
ACH metabolism
Acetyl cholinesterase hydrolizes ach, choline goes to nerve terminal by reuptake. Acetate diffuses away
43
Control center of ans in body
Hypothalamus, brain stem, sc
44
Preganglionic neuron fiber type, postganglionic type
Pre: myelinated B. Post: unmyelinated c
45
SNS: origin, ganglia where, post to preganglionic ratio
T1-L3. Near SC. 30:1
46
SNS: Pre vs post ganglionic fiber
Pre= short post= long
47
PNS: origin, ganglia location, post to pre ganglionic ratio
S2-4 and CN 3/7/9/10. Near/in effector organ. 1-3:1.
48
PNS pre vs post ganglionic fibers
Pre= long, post= short
49
In sns where preganglionic fibers exit sc and enter the chain
Exit ventral roots and enter white communicating rami
50
What stellate ganglion innervates
SNS to same upper extremity and pt of head and neck
51
Consequence of blockade of stellate ganglion
Hornets syndrome: vasodilation, ptosis, anhidrosis, miosis
52
Adrenal gland parts and their functions
Medulla sec catecholamines. Cortex sec glucocorticoids, mineralcorticoids, and androgens
53
Preganglionic fibers release what onto adrenal medulla. There are no what here. What stim leads to
Ach. Postganglionic fibers. Chromaffin cells release epi and norepi
54
Pheochromocytoma must do what
Alpha before beta block
55
Alpha antagonists used in pheo
Non selec: phenoxybenzamine and phentolamine. Selec a1: doxazosin and prazosin
56
Why its bad to beta before alpha block
Blocking B2 inc SVR b1 dec inotropy, can lead to CHF
57
SNS stim causes hepatocytes to release what, in turn pancreas does what
K and glucose. Pancreas inc insulin output
58
Things that shift k into the cell (hypokalemia)
Alkalosis, B2 agonists, theophylline, insulin
59
Things that shift k out of cell and inc concentration in blood
Acidosis, cell lysis, sux
60
Baroreceptor reflex: where sensors are for stretch, nerves there
Carotid sinus (nerve of hering - cn 9), transverse aortic arch (vagus). Both go to tractus solitarus in medulla
61
Surgeries with baroreceptor reflex
Endarterectomy, mediastinoscopy
62
What it means to preserve vs maintain BRR
Preserve= dec bp and inc hr. Impair= dec bp and hr
63
Drugs that impair BRR
Va (iso least), propofol, BB
64
Behold Jarisch reflex effects
Slows hr in hypovolemia: bradycardia, hypotension, CA vasodilation to allow filling
65
Bainbridge reflex
Full heart sensed- leads to inc in HR
66
Sensors: bezold, Bain
Bezold: LV. Bain: sa node, RV, pulm veins
67
Afferrent, control, and efferent in bezold v bain
Both afferrent unmyelinated c vagus, control medulla, efferent vagal stim v inhib
68
Tx of bezold reflex
IVF, tburg, inc hr
69
Oculocardiac reflex limbs
Afferrent: CN V, efferent CN X
70
Presentation of oculocardiac reflex, worsened by what
Low hr/bp, av block. Hypoxemia hypercarbia light anesthesia
71
Cushing reflex: presentation, when it happens
Happens w IC htn. Htn, bradycardia, irreg resp,
72
Celiac reflex
Traction on abd, mediated by vagus, causes bradycardia and hypotension
73
Chemoreceptor reflex
Stim by hypoxia and hypercarbia. In min vent and sns tone
74
Heart transplant: co dependent on what. Only reflex what is preserved
Preload. Bainbridge
75
Glomus tumors: what they release and where
NE, serotonin, histamine, bradykinin on carotid artery, aorta, cn 9, middle ear
76
Glomus tumor manifestations:
exag hypo or hypertension, flushing, bronchoconstriction
77
Tx glomus tumor effects
Octreotide
78
Mult sys atrophy: causes what, s/s
Degeneration of locus coeruleus, sc where sns lies, peripheral ans nerves. Ortho hypo, urinary retention, impotence, bowel issues
79
How to treat autonomic dysfunc from mult sys atrophy
Volume, direct acting agents. Indirect acting not used bc exag response
80
NE: receptors, dose
A1-2, B1. 0.02-0.4 mcg/kg/min. Low dose b1 selec, hi dose stim all
81
Avoid NE when, tx for extravasation
Cardiogenic shock. Phentolamine 2.5-10 mg diluted
82
Epi: low intermediate and hi dose fx
Low (<0.03) b1 and 2. Interned 0.03-0.15 a and b fx. High: >0.15 alpha mainly
83
Dopamine: low intermediate and high doses and dx
Low 1-2 renal vasodil/inc rbf. Intermediate 2-10, cardiac stim. High 10-20 vasopressor fx, alpha
84
Isuprel: receptor stim dose, fx
B1 and B2. 0.02-0.5 mcg/kg/min. Inc hr, dec scr.
85
Isuprel: impairs what, poor choice when, good uses
Impairs CPP. Bad in septic shock. Cor pulm/heart trans
86
Dobutamine fx and dose
0.5-15 mcg/kg/min, inc hr and co. B1 mainly, some B2
87
Heart conditions where phenylephrine is useful
HOCM, tet of fallot
88
Ephedrine: receptors, when it doesnt work
A1-2 b1-2. Sepsis and heart transplant or if mult doses given
89
Vaso: made by what, released where, receptor stim
Made by hypothalamus, released by posterior pituitary. V1= constriction. V2= aquaporins in collecting ducts, water reabsorption
90
OD of vaso van lead to what
Sz and hyponatremia
91
B1 selective BB
MABE AB. Metop, aten, betax, esmolol, acet, biso
92
Nonselective bb
Carved, labetolol, nadolol, pindolol, propranolol, timolol
93
BB that depends on kidney elim
Atenolol
94
Labetolol and carvedilol b:a ratio.
Labetolol: 7:1. Carvedilol: 10:1
95
How to tx bb overdose
Glucagon, calcium, pde3 inhib, epi, isuprel
96
What membrane stabilizing means, drugs that do this
Bb. Has local anesthetic like effects, reduces rate of rise of cardiac action potential. Propranolol and acebutolol
97
How BB have intrinsic sympathomimetic fx, which ones
Partial agonists while blocking other agonists. Labetolol and pindolol
98
Phenoxybenzamine: what it does/acts on, role
Non selec non compet alpha antagonist. Reflex tachy. Manage htn in pheo.
99
Phentolamine: what it is, uses
Non selec, compet antagonist. Reflex tachy. Tx in pheo or autonomic hyperreflexia, or infiltration
100
Prazosin: drug type, uses
A1 selec. No reflex tachy. Essential htn, bph
101
Yohimbine: drug type, uses, od leads to
A2 antagonist. Tx ortho hypo. Od= tachycardia and htn
