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MIDTERM > ANS midterm > Flashcards

ANS midterm Flashcards

1
Q

What are three membrane bound receptors?

A

Ion Channel

G protein

Enzyme linked

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2
Q

Example of an Ion Channel?

A

Voltage gated

Ions travel along concentration gradient

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3
Q

Example of a G protein linked coupled receptor?

A

M2 in the SA node

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4
Q

Example of an enzyme linked receptor?

A

Insulin in skeletal muscle
*linked to tyrosine kinase

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5
Q

Examples of intracellular receptors?

A

Steroids in the cytoplasm

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6
Q

Order of G protein coupled receptors?

A
  1. First messenger
  2. G protein receptor
    3.Effector
  3. Second messenger
    5.Cellular response
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7
Q

Examples of effectors?

A

Adenylate cyclase
Phospholipase C

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8
Q

Examples of Second messengers?

A

cAMP
cGMP
IP3
DAG
Ca

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9
Q

Sweat glands are which G coupled receptor?

A

Alpha 1

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10
Q

Bladder sphincter is which G coupled receptor?

A

Alpha 1

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11
Q

Bladder detrusor is which G coupled receptor?

A

Beta 2

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12
Q

Where are alpha 2 non synaptic receptors located?

A

Platelets

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13
Q

How does alpha 2 affect insulin release?

A

Decreases

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14
Q

How does alpha 2 affect renal tubules ?

A

Inhibits ADH - Diuresis

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15
Q

How does alpha 2 affect GI tract?

A

Decreased motility

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16
Q

What are the five steps of norepi release?

A

Tyrosine
Dopa
Dopamine
Norepi
Epi

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17
Q

Which percent of Norpi is reuptaken into the synaptic cleft?

A

80%

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18
Q

What are the three ways Norepi is removed?

A
  1. Reuptake into presynaptic nerve
  2. Reuptake by other tissues
    3.Diffuses away
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19
Q

What metabolizes norepi and epi?

A

COMT and MAOI

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20
Q

What is the final metabolite of norepi and epi?

A

VMA - vanillylmandelic acid

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21
Q

what does high levels of VMA indicate?

A

Pheochromocytoma

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22
Q

What is the primary transmitter in the PNS?

A

norepi

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23
Q

What is the primary transmitter in the SNS?

A

acetylcholine

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24
Q

What type of receptors are nicotinic?

A

Ion channels

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25
Q

What type of receptors are muscarinic?

A

G linked protein

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26
Q

How is Ach synthesized?

A

Choline + Acetyl CoA with the help of acetyltransferase

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27
Q

What is a antagonist of Ca at the presynaptic terminal?

A

Mag

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28
Q

What does the preganglionic neuron always release? What type of fiber?

A

Always Ach

Myelinated B fiber

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29
Q

What does the postganglionic neuron release in the SNS? What type of fiber?

A

Norepi

C fiber

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30
Q

What does the postganglionic neuron release in the PNS? What type of fiber?

A

Ach

C fiber

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31
Q

Where does the SNS originate from?

A

T1-L3

32
Q

Where are ganglia located in the SNS?

A

Near the spinal cord

33
Q

Length of pre and post ganglion in the SNS

A

Short Pre
Long Post

34
Q

Where does the PNS originate from?

A

Craniosacral

CN 3,5,9,10

S2-S4

35
Q

Length of pre and post ganglion in the PNS

A

Short Pre

Long Post

36
Q

Organ response to PNS and SNS?

A

SNS 30:1 (mass response)

PNS 1:1 (precise control)

37
Q

What is the sympathetic ganglia?

A

Efferent limb- where the pre and post ganglion synapse

38
Q

What are the three paths a preganglionic fiber can take?

A

Synapse on the same level

Ascend or descend

Bypass entirely and move to a different collateral ganglion

39
Q

***Know the Stellate Ganglion. What is it?

A

Provides sympathetic innervation to the ipsilateral upper extremity and neck

40
Q

When might the stellate ganglion be blocked? (what nerve block)

A

Brachial Plexus

41
Q

Signs of Horners syndrome?

A

Very Horny PAM

-Vasodilation
-Horner
-Ptosis
-Anhidrosis
-Miosis

42
Q

Which part of the adrenal gland secretes catecholamines?

A

Medulla

43
Q

Are there post ganglionic fibers in the Adrenal gland?

A

NO - just pre

44
Q

How much epi and norepi is secreted by the Adrenal Gland?

A

Epi - 80%
Norepi - 20%

Epi - .2mcg/kg/min
Norepi- .05mcg/kg/min

45
Q

**What us critical to remember when managing pheochromocytoma?

A

MUST ALPHA BLOCK FIRST

46
Q

What happens after the tumor is removed from the adrenal gland?

A

-Hypotension and hypoglycemia because the tumor isn’t secreting it

47
Q

What does the hepatocyte release when the SNS is activated?

A

-Glucose and Potassium

-Insulin is also released in response to the glucose

48
Q

What happens to the potassium levels once it is released?

A
  1. Initial increase
  2. Decreases due to the K/Na Pump and shifts it back into the cells
49
Q

What shifts K out of the cell?

A

Succ

ACIDOSIS

Hyperosmolarity

Cell lysis

50
Q

What shifts K into the cell?

A

Insulin or Epi
Beta 2
Alkalosis
Theophylline

51
Q

Where are stretch receptors located?

A

Aortic Arch and carotid sinus

52
Q

Afferent pathway of the aortic arch?

A

Vagus

53
Q

Afferent pathway of the carotid bodies?

A

Carotid sinus
Glossopharyngeal

(nerves of herring)

54
Q

How does a mediastinoscopy affect the baroreceptor reflex?

A

Scope presses on the aortic arch causing bradycardia

55
Q

What keeps the baroreceptor reflex intact?

A

Thiopental
Nitro + Nipride
Ketamine?

56
Q

What is the Bezold-Jarisch reflex?

A

Empty heart - Slow the heart down

Venous return low

57
Q

How to treat the Bezold Jarisch reflex?

A

Fluids
Trendelenburg
Elevate legs

Atropine
Epi
Ephedrine

58
Q

What is the Bainbridge reflex?

A

Increased Preload - increases HR

No treatment

59
Q

When is ANP released?

A

increased volume

Leads to diuresis

60
Q

What is the oculocardiac reflex? (Five and Dime)

A

Traction on extraocular muscles
-Pressure on eye
-Retrobulbar blook

61
Q

What are the pathways for the oculocardic reflex?

A

Afferent - 5 (trigeminal)

Efferent - 10 (Vagus)

62
Q

What happens when the 5 and dime reflec occurs? Treatment?

A

M2 - Bradycardia, hypotension, AV block, junctional

Treatment-
Remove stimulus
1000%
Anticholinergic

63
Q

What is Cushing’s reflex?

A

(Crushing)

Intracranial HTN

HTN, bradycardia, irregular respirations

64
Q

What is celiac reflex?

A

Traction on mesentery or other abdominal organs -
Bradycardia and hypotension

65
Q

What drugs can be used in a heart transplant?

A

Isoproterenol
Glucagon
Epi

66
Q

What does stimulation of V1 cause?

A

Vasoconstriction

67
Q

What does stimulation of V2 cause?

A

Water reabsorption

68
Q

Beta 1 selective drugs?

A

Beginning of the alphabet + metoprolol

69
Q

Beta non selective drugs?

A

End of alphabet + carvedilol

70
Q

Which beta blocker is metabolized by RBS Esterases?

A

Esmolol???

71
Q

How is a beta blocker overdose treated?

A

Glucagon
Isoproterenol
PDEIII
Epi
Cardiac pacing

72
Q

Which beta blockers have membrane stabilizing properties?

A

Propranolol + acebutolol

73
Q

Which beta blockers have intrinsic sympathomimetic activity?

A

Labetalol and Pindolol

74
Q

Primary drug for treating pheochromocytoma?

A

phenoxybenzamine - nonselective alpha blocker

75
Q

Primary drug for medication infiltration ?

A

phentolamine

76
Q

Which beta blocker is excreted by the kidneys?

A

Atenolol

MIDTERM (6 decks)

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