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CVS > 5. Autonomic Control > Flashcards

5. Autonomic Control Flashcards

1
Q

What 3 things does the autonomic nervous system exert control over?

A

Smooth muscle
Exocrine secretion
Rate and force of contraction in the heart

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2
Q

What are the two divisions of the autonomic nervous system?

A

Parasympathetic

Sympathetic

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3
Q

What happens where parasympathetic and sympathetic divisions both innervates a tissue?

A

Have opposite effects

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4
Q

Where in the body are sympathetic alpha1 NA receptors found?

A

Pupil of the eye - dilation
Sweat glands - for localised secretion
Vasculature - for contraction/relaxation depending on what arteriole bed

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5
Q

Where in the body are beta1 sympathetic NA receptors found?

A

Heart - increase force and rate of contraction

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6
Q

Where in the body are beta2 sympathetic NA receptors found?

A

Airways of lungs - relaxation

Coronary and skeletal muscle vasculature - contraction/relaxation

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7
Q

Where in the body are PARASYMPATHETIC M3 ACh receptors found?

A

Pupil of the eye - contraction

Airways of the lungs - contraction

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8
Q

Where in the body are parasympathetic M2 ACh receptors found?

A

Heart - decrease rate

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9
Q

Where in the body are SYMPATHETIC M3 ACh receptors found?

A

Sweat glands - generalised secretion

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10
Q

What nerve supplies the parasympathetic input to the heart?

A

Preganglionic - Vagus nerve (10th X cranial)

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11
Q

Which nerve fibres supply the sympathetic input to the heart?

A

Postgangionic from the sympathetic trunk

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12
Q

Where is the synapse of the preganglionic parasympathetic fibres with the postganglionic fibres in the heart?

A

Epicardial surface or within walls of heart at SA and AV node

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13
Q

Where do the postganglionic fibres of the sympathetic input to the heat innervate?

A

SA node, AV node, myocardium

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14
Q

What is the name for the way in which the cells in the sinoatrial node steadily depolarise towards threshold?

A

Pacemaker potential

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15
Q

How does noradrenaline increase the force of contraction?

A

NA acting on beta1 receptors in myocardium, increase in cAMP, activates PKA. Leads to:
Phosphorylation of Ca2+ channels, so increased Ca2+ entry in plateau of AP.
Increased uptake of Ca2+ in SR.
Increased sensitivity of contractile machinery to Ca2+.

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16
Q

What type of innervation do most vessels receive? What do they release?

A

Sympathetic, so NA

17
Q

What does vasomotor tone allow for?

A

Vasodilation to occur

18
Q

What happens on increased sympathetic output to alpha1 adrenoceptor?

A

Vasculature - vasoconstriction

19
Q

What type of receptors does circulating adrenaline have a higher affinity for?

A

Beta2 adrenoceptors

20
Q

What affect does activating beta2 adrenoceptors have on vasculature?

A

Vasodilation (eg in heart etc so under stress want more blood to reach heart muscle)

21
Q

What molecular effects does activating beta2 adrenoceptors in vasculature have?

A

Increases cAMP, PKA, opens K+ channels, inhibits MLCK (myosin light-chain kinase which is only present in vascular smooth muscle), leading to relaxation of smooth muscle

22
Q

What molecular affects does activating alpha1 adrenoceptors have in vasculature?

A

Stimulates IP3 production

Increases Ca2+ conc in the cell from stores and via influx of extracellular Ca2+, resulting in smooth muscle contraction

23
Q

Give 2 examples of metabolises, and what effect does increases in local metabolites have?

A

Increased PCO2, H+

Strong vasodilator effect

24
Q

What are metabolites more important than in ensuring adequate perfusion of skeletal and coronary muscle?

A

Activation of beta2-receptors

25
Q

What is the baroreceptor reflex important for?

A

Maintaining BP over short term

26
Q

What can happen to baroreceptors with persistent increases in blood pressure?

A

They can reset to higher levels

27
Q

Where are nerve endings of the baroreceptors found?

A

Carotid sinus and aortic arch

28
Q

What are sympathomimetics?

A

Drugs which mimic the sympathetic nervous system

29
Q

Give 2 cardiovascular uses of sympathomimetics

A

Adrenaline - restore function in cardiac arrest or anaphylactic shock
Dobutamine - beta1 agonist given in cardiogenic shock (pump failure)

30
Q

When would you use an alpha-adrenoreceptor antagonist as an anti-hypertensive agent?

A

In resistant hypertension

31
Q

Give 2 examples of beta-adrenoreceptor antagonists and when they are used?

A

Propranolol - slows HR and reduced force of contraction. But non selective beta1/beta2 antagonist so also acts on bronchial smooth muscle causing bronchoconstriction.
Atenolol - selective beta1

32
Q

What are the two types of cholinergic drugs which can be used clinically? Give an example of each

A

Muscarinic agonists - eg pilocarpine for treatment of glaucoma
Muscarinic antagonists - eg atropine which increases HR, bronchial dilation and used to dilate pupils for examination of the eye

CVS (14 decks)

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