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ANS Flashcards

1
Q

Peripheral nerves contain…

A

Both motor (somatic and autonomic) and sensory neurons

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2
Q

Somatic

A

More voluntary - both motor out ventral root

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3
Q

Autonomic

A

More involuntary - both motor out ventral root

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4
Q

Somatic vs. Autonomic - Tissues Innervation

A 
Somatic = skeletal muscle only and innervation is primarily under voluntary control
Autonomic = all other tissues except muscle fibers
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5
Q

Somatic vs. Autonomic - Myelination

A 
Somatic = motor neurons generally myelinated
Autonomic = Post ganglionic are generally not myelinated
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6
Q

Somatic vs. Autonomic - Neuronal Organization

A 
Somatic = all neuronal synapses occur within the CNS, cell bodies of somatic motor neurons are in the ventral horn
Autonomic = nerves may synapse outside the CNS, cell bodies of postganglionic autonomic neurons lie in ganglia or within tissues (entirely outside CNS)
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7
Q

Somatic vs. Autonomic - Synaptic Organization

A 
Somatic = highly organized with terminal synapse (NMJ)
Autonomic = forms extensive plexus with varicosities that are packed with NTs
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8
Q

Somatic vs. Autonomic - Response of Target Tissue to Lesion

A 
Somatic = paralysis - loss of ability to contract (results in atrophy)
Autonomic = some level of spontaneous activity independent of intact innervation
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9
Q

Primary differences btw Somatic and Autonomic

A
  1. Tissue Innervated
  2. Myelination
  3. Neuronal Organization
  4. Synaptic Organization
  5. Response of Target Tissue to Nerve Lesion
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10
Q

Sympathetic NS Reaction

A 
F/F
Pupils dilate
Piloerection
HR inc.
Blood shunted (splanchnic redistribution) to active muscles
GI function dec.
Stored fuel is catabolized/mobilized
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11
Q

Parasympathetic NS Reaction

A 
R/D
Vegetative Function - SLUDD
Salivation
Lacrimation
Urination
Digestion
Deification
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12
Q

Sympathetics originate from

A

Thoracic Region

T1-L2

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13
Q

Parasympathetics originate from

A 
Cranial nerves (3, 7, 9, 10) Vagus is largest responsible
Small sacral component S1-S4 = important for activity such as bladder control
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14
Q

Sympathetic vs. Parasympathetic and Pre/Post ganglions

A 
Sympathetic = Short pre, long post
Parasympathetic = long pre, short post 
Parasympathetic = very quick response
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15
Q

What receptors are stimulated with sympathetic nervous system

A

adrenergic - these are at the end point

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16
Q

Parasympathetic will have what receptors?

A

Muscarinic or cholinergic

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17
Q

Sympathetic Preganglionic

A

Ach

Binds to nicotinic receptors

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18
Q

Parasympathetic Preganglionic

A

Ach

Binds to nicotinic receptors

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19
Q

Sympathetic Postganglionic

A

Long and unmyelinated
NE
Binds to adrenergic receptors

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20
Q

Parasympathetic Postganglionic

A

Short
Ach
Binds to muscarinic receptors

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21
Q

4 options for how wired - where ganglion is

A
  1. Spinal Nerve (synapse on chain ganglion)
  2. Symp Nerve (synapse on chain ganglion)
  3. Collateral Gang (Passes thru chain ganglion)
  4. Direct (no postgang - passes thru chain ganglion)
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22
Q

4 options for how wired - where ganglion is - Spinal Nerve

A

Pre goes out ventral root and then joins up with a spinal nerve, goes through why ramus communicans, and then it will going to its ganglionic synapse (outside the CNS) to join up with a spinal nerve

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23
Q

4 options for how wired - where ganglion is - Symp Nerve

A

Pre to symp chain from ventral root

Postgang straight to heart

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24
Q

4 options for how wired - where ganglion is - Collateral Ganglion

A

Longer pre, passes thru symp chain, and then has ganglion that goes straight to viscera, cause dec in motility, and increase in constriction of sphincters

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25
4 options for how wired - where ganglion is - Direct - NO postganglion
Will pass through symp chain and go directly to the adrenal gland to release EP
26
Parasympathetic NS - Simple Overview
Preganglionic N (originate from cranial or sacral) --> Ach released and binds to nicotinic receptors --> stimulate post ganglionic --> release Ach that will bind to muscarinic receptors at target tissue
27
Curare
inhibits the nicotinic receptors | will cause paralysisof muscles and paralysis on ganglion level
28
Atropine
Will inhibit muscarinic receptors - parasympathetic tone on the heart
29
How is Ach produced?
Acetyl CoA + Choline = with help of ChAT (choline acetyltransferase)--> Ach
30
ACE
Acetylcholinesterase - breaks down Ach Target for many chemical weapons - inhibits ACE to allow for a buildup of Ach in the synapse - can use atropine to treat - symptoms would include SLUDD
31
7 types of Ach Receptors
2 are nicotinics (ligand gated) - Ach - ionotropic | 5 are muscarinics (G protein coupled) - metabotropic
32
Parasympathomimetics
Stimulate PNS Nicotine will do this Or Muscarine in muschrooms
33
Botulinum Toxin
Blocks at nerve terminal and inhibits release of Ach into synapse - it is a preganglionic blocker
34
EP in blood at rest? | Exercise?
10 ng/L | can inc 10 to 12 fold with exercise
35
Catecholamine Biosynthesis
LTyrosine --> LDopa --> Dopamine --> LNoradrenanline --> Adrenaline
36
Rate limiting enzyme in catchlamine biosynthesis
This is where you have control of how much catcholamines you are producing
37
What do all catcholamines originate as
L-Tyrosine
38
What does L-Tyrosine get hydroxide from
Tyrosine Hydroxylase | Rate Limiting Step
39
Where is this reaction occuring?
right there in the axon terminal
40
At adrenal medulla have a lot of...
PNMT so most of of what you are producing is epinephrine (adrenaline)
41
In vessels you have a lot of...
DBH so producing a lot of norepinephrine (noradrenaline)
42
Long term regulation of catcholamine biosynthesis
TH is formed in the cell body then transported to terminal
43
Short term regulation
Inc TH activity in nerve terminal with adrenergic stimulation
44
Feedback regulation
TH inhibited by nc intracellular NE
45
Cofactor
BH4 important to maintain TH in a reduced, active state
46
Postganglionic Adrenergic Receptor Locations - Alpha 1
Arterioles, Veins --> VC | Liver --> glycogenolysis
47
Postganglionic Adrenergic Receptor Locations - Alpha 2
Pancreas, Intestine - Inhibition
48
Postganglionic Adrenergic Receptor Locations - Beta 1
Heart --> Inc HR and contractility
49
Postganglionic Adrenergic Receptor Locations - Beta 2
Lungs = bronchodilation Liver = glycogenolysis Skeletal muscle = glycogenolysis, lipolysis
50
Alpha adrenergic Antagonist
Phentolamine | would block symp VC of blood vessels
51
Beta adrenergic Anatagonist
propanolol
52
What happens to NE release with amphetamines
increases
53
Not everything from motor traffic is just one NT, one nerve
Cotransmitters
54
Catecholamine Removal
MAO and COMT
55
MAO
reuptake and deamination by post ganglionic neurons Used as antidepressent drug - to inhibit MAO and keep more NE in synapse Hypertensive crisis - need to monitor BP
56
COMT
catabolism at tissues like the liver (primarily), kidneys and smooth muscle COMT inhibition is used in parkinsons to keep more dopamine around
57
U1
Takes NE back up into the axon terminal
58
U2
gets NE to the tissue
59
Pheochromocytoma
chromatin cell tumor that leads to excess secretion of catecholamines --> increased peripheral resistance and hypotension
60
Ways to test or see pheochromocytoma (symptoms)
Inc BP, headache, sweating, epigastric pain... Can also test by taking urine sample and looking for metabolites in urine Can image for tumor too
61
EPI vs. NE - CO
``` EPI = inc CO due to inc HR NE = small, transient inc in CO due to baroreceptor response - due to inc in SV and contractility ```
62
EPI and NE - VD/VC
``` EPI = VD of muscle and liver (Beta 2) NE = VC of vessels (alpha 1 and 2) ```
63
EPI and NE - BP
``` EPI = little impact on BP NE = elevated BP ```
64
EPI and NE - diastolic
``` EPI = dec cuz of dilation NE = inc due to constricting ```
65
EPI and NE - MAP
``` EPI = stays about the same NE = inc --> stimulate reflex --> vagal response --> dec HR ```
66
Which has bigger impact EPI or NE?
EPI - bigger impact with little stress on heart
67
Primary integration center for ANS
Hypothalamus
68
Any cervical lesion
Significant SNS dysfunction | Global BP dysregulation
69
Cervical Lesion T1-T4
Lung Dysfuntion | Airway hyper-reactivity
70
Cervical Lesion T6 and above
Affects SNS control of heart
71
Any lesion above sacrum
Lose parasympathetic innervation (pelvic N) to descending colon bladder and external genitalia - bowel/bladder control is #1 QOL issue in SCI
72
Autonomic Dysreflexia
Potential medical emergency in spinal cord injury Acute increase in BP 50-70% of individuals with SCI lesions at or above T6 experience these symptoms
73
Without trigger vs. with trigger
Without trigger, patients will typically have the hypotension due to loss of sympathetic outflow But with trigger (full bladder) will experience dysreflexia - the huge drop/change in BP
74
Beta 1
Inc HR, glycogenolysis, lipolysis, contractility
75
Beta 2
Brochodilation | Vasodilation
76
Alpha 1
Inc phosphodiesterase | Inc VC
77
Alpha 2
opposes actions of beta 1 and 2

FS Exam 5 (4 decks)

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