ANS A&P Flashcards

1
Q

The peripheral nervous system consists of how many spinal nerve pairs?

A

31 pairs of spinal nerves

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2
Q

Another name for the ANS is the:

A

Visceral nervous system

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3
Q

What are the three divisions of the ANS?

A

Sympathetic
Parasympathetic
Enteric

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4
Q

Alpha 2 receptors are found in three locations:

A

Presynaptic
Postsynaptic
Plateletes

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5
Q

Why does precedex cause a biphasic response?

A

Stimulation of A2 receptors in the vasculature causes hypertension
CNS depression (which kicks in later) leads to reduced sympathetic output

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6
Q

A2 receptor stimulation on platelets causes:

A

increased aggregation

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7
Q

Which enzyme metabolizes cAMP?

A

PDE3

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8
Q

PDE-3 inhibitors are also called:

A

inodilators

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9
Q

What effect does cAMP have in the myocardium?

A
  1. Increased intracellular calcium causes increased contractility
  2. Accelerates the return of calcium to the sarcoplasmic reticulum, which accelerates relaxation (lusitropy)
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10
Q

What effect does cAMP have in the vasculature?

A

Inhibits myosin light chain kinase:

Vasodilation
Decreased SVR

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11
Q

What is the primary mechanism of NE removal from the synaptic cleft?

A

Reuptake

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12
Q

All sympathetic preganglionic nerves are __________ fibers

A

myelinated B fibers

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13
Q

Preganglionic sympathetic fibers exit the spinal cord via the _________

A

ventral rami

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14
Q

Once they exit the spinal cord, sympathetic fibers enter the sympathetic chain via the _________

A

White ramus (white because it’s myelinated)

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15
Q

Once inside the sympathetic chain, preganglionic nerve fibers can take three paths:

A
  1. Synapse at the same level they enter the chain
  2. Synapse at a different level than where they enter the chain
  3. Exit the chain without synapsing at all
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16
Q

All preganglionic B fibers release _______

A

Ach! They are all cholinergic!

17
Q

Why is autonomic innervation of the adrenal medulla unique?

A

It is innervated only by preganglionic nerve fibers. There’s no synapse until it gets to the chromaffin cells

18
Q

Name two nonselective alpha antagonists

A

Phenoxybenzamine
(non-competitive)

Phentolymine

19
Q

Name two alpha 1 selective antagonists

A

Doxazosin
Prazosin

20
Q

What antagonists should be given to someone with pheochromocytoma

A

A before B always!

21
Q

Which drugs should be avoided in the patient with pheochromocytoma?

A
  1. SNS activating drugs (des, ketamine, pancuronium)
  2. Ephedrine (nothing to recruit)
  3. Histamine releasing agents (SAM, morphine)
22
Q

What effect does SNS stimulation have on K levels?

A

Serum K will decrease, because epinephrine is stimulating B2 receptors

23
Q

How long does it take baroreceptors to reset and adapt to a change in BP?

24
Q

What drugs impair the baroreceptor reflex?

A
  1. Volatile anesthetics
  2. NE
  3. Propofol
  4. Beta Blockers
  5. Ca channel blockers
  6. ACE inhibitors
  7. PDE Inhibitors
25
Activation of the Bezold-Jarisch reflex manifests as:
Bradycardia Hypotension Coronary Artery vasodilation
26
What is the Bainbridge Reflex?
Tachycardia in response to increased volume return
27
Cushing's Triad consists of:
Increased ICP Bradycardia Hypertension
28
All postganglionic nerve fibers are _______ fibers
C
29
What is the post-to-pre ganglion ratio in the PNS?
Roughly 1:1
30
What is the post-to-pre ganglion ration in the SNS?
Roughly 30:1
31
Compare SNS and PNS postganglionic fibers
SNS are long PNS are short
32
Where are SNS ganglia located?
Near the spinal cord
33
Where are PNS ganglia located?
Near the effected organ
34
What vertebral level does the SNS arise from?
Thoracolumbar (T1-L3)
35
What vertebral level does the PNS arise from?
Craniosacral: CN 3,7,9,10 S2-S4