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FS Exam 5 > ANS > Flashcards

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
Q

4 options for how wired - where ganglion is - Direct - NO postganglion

A

Will pass through symp chain and go directly to the adrenal gland to release EP

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26
Q

Parasympathetic NS - Simple Overview

A

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

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27
Q

Curare

A

inhibits the nicotinic receptors

will cause paralysisof muscles and paralysis on ganglion level

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28
Q

Atropine

A

Will inhibit muscarinic receptors - parasympathetic tone on the heart

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29
Q

How is Ach produced?

A

Acetyl CoA + Choline = with help of ChAT (choline acetyltransferase)–> Ach

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30
Q

ACE

A

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

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31
Q

7 types of Ach Receptors

A

2 are nicotinics (ligand gated) - Ach - ionotropic

5 are muscarinics (G protein coupled) - metabotropic

32
Q

Parasympathomimetics

A

Stimulate PNS
Nicotine will do this
Or Muscarine in muschrooms

33
Q

Botulinum Toxin

A

Blocks at nerve terminal and inhibits release of Ach into synapse - it is a preganglionic blocker

34
Q

EP in blood at rest?

Exercise?

A

10 ng/L

can inc 10 to 12 fold with exercise

35
Q

Catecholamine Biosynthesis

A

LTyrosine –> LDopa –> Dopamine –> LNoradrenanline –> Adrenaline

36
Q

Rate limiting enzyme in catchlamine biosynthesis

A

This is where you have control of how much catcholamines you are producing

37
Q

What do all catcholamines originate as

A

L-Tyrosine

38
Q

What does L-Tyrosine get hydroxide from

A

Tyrosine Hydroxylase

Rate Limiting Step

39
Q

Where is this reaction occuring?

A

right there in the axon terminal

40
Q

At adrenal medulla have a lot of…

A

PNMT so most of of what you are producing is epinephrine (adrenaline)

41
Q

In vessels you have a lot of…

A

DBH so producing a lot of norepinephrine (noradrenaline)

42
Q

Long term regulation of catcholamine biosynthesis

A

TH is formed in the cell body then transported to terminal

43
Q

Short term regulation

A

Inc TH activity in nerve terminal with adrenergic stimulation

44
Q

Feedback regulation

A

TH inhibited by nc intracellular NE

45
Q

Cofactor

A

BH4 important to maintain TH in a reduced, active state

46
Q

Postganglionic Adrenergic Receptor Locations - Alpha 1

A

Arterioles, Veins –> VC

Liver –> glycogenolysis

47
Q

Postganglionic Adrenergic Receptor Locations - Alpha 2

A

Pancreas, Intestine - Inhibition

48
Q

Postganglionic Adrenergic Receptor Locations - Beta 1

A

Heart –> Inc HR and contractility

49
Q

Postganglionic Adrenergic Receptor Locations - Beta 2

A

Lungs = bronchodilation
Liver = glycogenolysis
Skeletal muscle = glycogenolysis, lipolysis

50
Q

Alpha adrenergic Antagonist

A

Phentolamine

would block symp VC of blood vessels

51
Q

Beta adrenergic Anatagonist

A

propanolol

52
Q

What happens to NE release with amphetamines

53
Q

Not everything from motor traffic is just one NT, one nerve

A

Cotransmitters

54
Q

Catecholamine Removal

A

MAO and COMT

55
Q

MAO

A

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
Q

COMT

A

catabolism at tissues like the liver (primarily), kidneys and smooth muscle
COMT inhibition is used in parkinsons to keep more dopamine around

57
Q

U1

A

Takes NE back up into the axon terminal

58
Q

U2

A

gets NE to the tissue

59
Q

Pheochromocytoma

A

chromatin cell tumor that leads to excess secretion of catecholamines –> increased peripheral resistance and hypotension

60
Q

Ways to test or see pheochromocytoma (symptoms)

A

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
Q

EPI vs. NE - CO

A 
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
Q

EPI and NE - VD/VC

A 
EPI = VD of muscle and liver (Beta 2)
NE = VC of vessels (alpha 1 and 2)
63
Q

EPI and NE - BP

A 
EPI = little impact on BP
NE = elevated BP
64
Q

EPI and NE - diastolic

A 
EPI = dec cuz of dilation 
NE = inc due to constricting
65
Q

EPI and NE - MAP

A 
EPI = stays about the same
NE = inc --> stimulate reflex --> vagal response --> dec HR
66
Q

Which has bigger impact EPI or NE?

A

EPI - bigger impact with little stress on heart

67
Q

Primary integration center for ANS

A

Hypothalamus

68
Q

Any cervical lesion

A

Significant SNS dysfunction

Global BP dysregulation

69
Q

Cervical Lesion T1-T4

A

Lung Dysfuntion

Airway hyper-reactivity

70
Q

Cervical Lesion T6 and above

A

Affects SNS control of heart

71
Q

Any lesion above sacrum

A

Lose parasympathetic innervation (pelvic N) to descending colon bladder and external genitalia - bowel/bladder control is #1 QOL issue in SCI

72
Q

Autonomic Dysreflexia

A

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
Q

Without trigger vs. with trigger

A

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
Q

Beta 1

A

Inc HR, glycogenolysis, lipolysis, contractility

75
Q

Beta 2

A

Brochodilation

Vasodilation

76
Q

Alpha 1

A

Inc phosphodiesterase

Inc VC

77
Q

Alpha 2

A

opposes actions of beta 1 and 2

FS Exam 5 (4 decks)

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