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Phys Exam 1 > Autonomic Nervous Sys > Flashcards

Autonomic Nervous Sys Flashcards

1
Q

Which autonomic division have short preganglionic fibers?

A

sympathetic

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2
Q

Which autonomic division have long preganglionic fibers?

A

parasympathetic

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3
Q

What is considered as a giant ganglion that does not have post-ganglionic fibers?

A

adrenal medulla

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4
Q

What does adrenal medulla release into bloodstream?

A

E, NE, dopamine and peptides

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5
Q

Cell bodies of sympathetic pre-ganglionic neurons are located where in throaco-lumbar spinal nerves?

A

intermediolateral cell column

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6
Q

Which rami do sympathetic fibers exit from spinal nerves?

A

ventral

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7
Q

What are the 3 modes of innervation of sympathetic division?

A

1) pre –> paravertebral ganglia or prevertebral ganglia –> post
2) pre –> specialized ganglia –> target organs
3) pre –> adrenal medulla

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8
Q

What are the specialized ganglia?

A

1) superior cervical
2) celiac
3) superior mesenteric
4) inferior mesenteric

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9
Q

What are the two outflows of parasympathetic division?

A

1) cranial

2) sacral

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10
Q

What cranial nerves do preganglionic fibers travel along?

A

1) oculomotor
2) facial
3) glossopharyngeal
4) vagus

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11
Q

What four organs do sacral outflow provide to?

A

1) bladder
2) descending large intestine
3) rectum
4) genitalia

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12
Q

What is a system of ganglia sandwiched between layers of the gut and connected by a dense meshwork of nerve fibers?

A

enteric nervous sys

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13
Q

Which plexus controls GI tract motility and is located in smooth muscle layer?

A

myenteric plexus

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14
Q

Which plexus controls secretions and ion and fluid transport?

A

submucosal plexus

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15
Q

What does dual innervation mean?

A

most organs receive both sympathetic and parasympathetic innervation and actions are controlled by both division

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16
Q

Which organs have sympathetic innervation only (5)?

A

1) hair follicles
2) thermoregulatory sweat glands
3) liver
4) adrenal glands
5) kidneys

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17
Q

Which organ has both divisions producing similar effects?

A

salivary glands

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18
Q

Which nerve fibers release Ach?

A

1) all somatic nerves
2) all preganglionic fibers in ANS
3) parasympathetic post-ganglionic

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19
Q

Which nerve fibers are adrenergic or dopaminergic?

A

sympathetic post-ganglionic

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20
Q

What type of receptors do sweat glands have?

A

muscarinic that responds to Ach and is regulated by sympathetic post-ganglionic fibers

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21
Q

What are the four steps to neurotransmission?

A

1) synthesis
2) storage
3) release
4) termination of action

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22
Q

What mediates the uptake of choline?

A

choline transporter (CHT)

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23
Q

What mediates the conjugation step in synthesis of Ach?

A 
choline acetyltransferase (ChAT)
acetyl-CoA + Choline --> Ach
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24
Q

What provides storage of Ach once it’s been synthesized?

A

vesicle-associated transporter (VAT)

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25
Q

What are the steps to release Ach from nerve terminal?

A

1) depolarization of nerve terminal
2) voltage-dependent Ca2+ entry
3) Ca2+ - calmodulin association with vesicle-associated membrane protein (VAMP) and synaptosome-associated proteins (SNAP)
4) vesicle fuses and Ach releases via exocytosis

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26
Q

What are the steps to termination of action in the neurotransmission of Ach?

A

1) rapid hydrolysis of Ach by AchE

2) choline is re-uptake

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27
Q

Which drug inhibits the synthesis step of Ach? What is its mechanism?

A

Hemicholiniums –> blocks uptake of choline by inhibiting choline transporter

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28
Q

What drug inhibits the storage of Ach? What is its mechanism?

A

Vesamicol –> inhibits vesicle-associated transporter

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29
Q

What drug inhibits the release of Ach? What is its mechanism?

A

Botulinum toxin –> blocks VAMP and SNAP

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30
Q

What drug inhibits the termination of action in the neurotransmission of Ach?

A

AchE inhibitors

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31
Q

Which steps of cholinergic neurotransmission the most important and if inhibited will have severe consequences?

A

synthesis and storage because Ach is needed all over the body, especially in NMJ and also all pre-ganglionic fibers of ANS require Ach

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32
Q

What are the two types of cholinergic receptors?

A

1) muscarinic

2) nicotinic

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33
Q

Which cholinergic receptor is a G-protein and which is a transmembrane ion channel?

A

muscarinic –> G-protein

nicotinic –> ion channel

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34
Q

What are the different subunits of ion channel and where does Ach bind?

A

5 subunits –> 2 alpha, beta, delta, gamma

Ach binds to both alpha subunits

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35
Q

Where are M3 receptors located in the eye?

A

1) sphincter muscle

2) ciliary muscle

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36
Q

What effects does the activation of M3 receptors have on the eye?

A

sphincter muscle –> pupil constriction

ciliary muscle –> decreases angle and increases drainage of aqueous humour

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37
Q

What type of receptors are most predominate in the heart?

A

M2

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38
Q

What type of G protein is M2?

A

inhibitory

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39
Q

What’s the effect on SA node with activation of M2?

A

decrease heart rate

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40
Q

What’s the effect on AV node with activation of M2?

A

decrease conduction velocity

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41
Q

What’s the effect on atrial muscle with activation of M2?

A

decrease atrial contraction

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42
Q

What’s the effect on ventricular muscle with activation of M2?

A

decrease ventricular contraction (weak effect)

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43
Q

What type of receptors are located in the lungs?

A

M3

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44
Q

What effect does activation of M3 receptors have on bronchi and bronchioles?

A

contraction –> bronchospasm

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45
Q

What effect does activation of M3 receptors have on bronchilar submucosal glands?

A

secretion –> narrow lumen

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46
Q

What type of manipulation to M3 can be done to alleviate symptoms of a patient with asthma?

A

M3 antagonists

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47
Q

What type of receptors are located in stomach? What effect does it have when activated?

A

M3 –> motility, cramps

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48
Q

What type of receptors are located in glands of GI tract? What effect does it have when activated?

A

M1 –> secretion

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49
Q

What type of receptors are located in intestine and what effect does it have when activated?

A

M3 –> contraction - diarrhea, involuntary defecation

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50
Q

What type of receptors are located in the bladder and what are the effects when activated?

A

M3 –> voiding, urinary incontinence

1) contracts detrusor m
2) peristaltic urethral contraction
3) inhibits external sphincter

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51
Q

What’s the significance of vascular smooth muscle innervation?

A

these muscles receive two sources of innervation:

1) perivascular nerves
2) endothelial cells

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52
Q

What effect do M3 receptors have on intact endothelium?

A

production of endothelium-derviced relaxing factor –> vasodilation

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53
Q

What effect do M3 receptors have on damaged endothelium?

A

None. Instead NT will act on M3 receptors on vascular smooth muscle cells

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54
Q

What effect do M3 receptors have on vascular smooth muscle?

A

vasoconstriction

55
Q

What type of receptors are in glands and sphincters?

A

M3

56
Q

What effects do M3R have on glands?

A

secretion –> sweat

salivation and lacrimation

57
Q

What effects do M3R have on sphincters?

A

mostly relaxation, except in lower esophageal sphincter —> contraction

58
Q

What type of G protein is M1?

A

Gq

59
Q

What type of G protein is M2?

A

Gi

60
Q

What type of G protein is M3?

A

Gq

61
Q

Describe the mechanism of Gq

A

phospholipase C –> PIP2 –> IP3 + DAG –> incr. Ca2+ + incr PKC

62
Q

Describe the mechanism of Gi

A

decr adenlyl cyclase –> decr cAMP –> decr PKA

63
Q

Where are nicotinic receptors located?

A

1) all autonomic ganglia
2) adrenal medulla
3) NMJ

64
Q

What is the rate-limiting step of catechnolamine synthesis?

A

tyrosine hydroxylase

Tyr –> DOPA

65
Q

What drug can inhibit tyrosine hydroxylase?

A

Metyrosine

66
Q

What is the final product in most sympathetic post ganglionic neurons?

A

NE

67
Q

What is the final product in adrenal medulla?

A

E

68
Q

What is the final product in dopaminergic neurons?

A

dopamine

69
Q

What is the alternative pathway in synthesis of NE?

A

Tyramine –> NE

70
Q

What effect does increased NE have on the body?

A

hypertension

71
Q

What protein facilitate transport of dopamine in neurons?

A

VMAT (vesicular monoamine transporter)

72
Q

What drug can inhibit the storage step in catecholamine synthesis?

A

Reserpine

73
Q

What other practical use does reserpine have besides inhibiting VMAT?

A

used to treat hypertension

74
Q

How is NE released from neurons?

A

similar to Ach release (exocytosis)

75
Q

What drug can inhibit the release step of catecholamine synthesis? What does it target?

A

Bretylium –> inhibits VAMP

76
Q

What are the different actions that can be taken in termination of action of catecholamine?

A

1) diffusion (synapse or circulation)
2) autoreceptor
3) re-uptake

77
Q

What are different ways to re-uptake NE?

A

1) re-uptake via NE transporter

2) metabolize by MAO (mitochondrial monoamine oxidase)

78
Q

What can happen when MAO is inhibited?

A

increase NE that can lead to hypertension

79
Q

What type of G protein does alpha-1 receptors have?

A

Gq

80
Q

What type of G protein does alpha-2 receptors have?

A

Gi

81
Q

What type of G protein does beta-1&2 receptors have?

A

Gs

82
Q

Which receptors have Gq?

A

alpha-1, M1, M3, H1, V1

83
Q

Which receptors have Gs?

A

beta-1&2, D1, H2, V2

84
Q

Which receptors have Gi?

A

M2, alpha-2, D2

85
Q

What autonomic receptor is found in radial muscle of the eye?

A

alpha-1

86
Q

What autonomic receptor is found in sphincter muscle of the eye?

A

M3

87
Q

What autonomic receptor is found in ciliary muscle of the eye?

A

M3 and beta-2

88
Q

What autonomic receptor is found in ciliary body epithelium?

A

beta-1 & 2

89
Q

Where are alpha-1 receptors located?

A

1) radial muscle
2) arterioles
3) veins
4) liver
5) male sex organ (vas deferens)
6) bladder trigone and internal sphincter

90
Q

What action does alpha-1 receptor have on radial muscle of the eye?

A

contraction –> dilate pupils

91
Q

What action does alpha-1 receptor have on arterioles?

A

contraction –> increase TPR

92
Q

What action does alpha-1 receptor have on veins?

A

contraction –> increase venous return

93
Q

What action does alpha-1 receptor have on liver?

A

increase glycogenolysis –> increase glucose

94
Q

What action does alpha-1 receptor have on male sex organ?

A

vas deferens –> ejaculation

95
Q

What action does alpha-1 receptor have on bladder trigone and internal sphincter?

A

contraction –> urinary retention

96
Q

Where are dopaminergic receptors found (3)?

A

vascular beds –> renal, mesenteric, coronary vasculature

97
Q

What is the action of dopaminergic receptors?

A

vasodilation

98
Q

What actions do dopaminergic receptors have on kidneys?

A

increases glomerular filtration rate, renal blood flow and Na+ excretion

99
Q

What autonomic receptor is responsible for increase production of aqueous humour by ciliary body epithelium?

A

beta-1 & 2

100
Q

Where are alpha-2 adrenoceptors found?

A

1) prejunctional nerve terminal
2) platelets
3) pancreas

101
Q

What action does alpha-2 have on prejunctional nerve terminal?

A

decrease terminal release and NE synthesis

102
Q

What action does alpha-2 have on platelets?

A

aggregation

103
Q

What action does alpha-2 have on pancreas?

A

decrease insulin secretion

104
Q

Where are beta-1 adrenoceptors found?

A

1) heart (opposite of M2)

2) kidney

105
Q

What action does beta-1 have on SA node?

A

increase heart rate

106
Q

What action does beta-1 have on AV node?

A

increase conduction velocity

107
Q

What action does beta-1 have on atrial and ventricular muscle?

A

1) incr force of contraction
2) incr conduction velocity
3) incr cardiac output
4) incr O2 consumption

108
Q

What action does beta-1 have on HIs-Purkinje?

A

increase automaticity and conduction velocity

109
Q

What action does beta-1 have on kidneys?

A

increase renin release (result in increase blood pressure)

110
Q

Where are beta-2 adrenoceptors found?

A

1) blood vessels
2) uterus
3) bronchioles
4) skeletal muscles
5) liver
6) pancreas

111
Q

What action does beta-2 have on blood vessels?

A

vasodilation (opposite of alpha-1)

112
Q

What action does beta-2 have on uterus?

A

relaxation

113
Q

What action does beta-2 have on bronchioles?

A

dilation (opposite of M3)

114
Q

What action does beta-2 have on skeletal muscles?

A

incr glycogenolysis

115
Q

What action does beta-2 have on liver?

A

incr glycogenolysis

116
Q

What action does beta-2 have on pancreas?

A

incr insulin secretion (opposite of alpha-2)

117
Q

Alpha-1 in the bladder is mainly located …

A

blood vessels

118
Q

Alpha-1 in the bladder has little effect on …

A

detrusor muscle

119
Q

Alpha-1 in the bladder is significant on ….

A

trigone/ internal sphincter –> urinary retention

120
Q

Presynaptic receptors whose ligands are the same as the NTs released by that nerve terminal

A

autoreceptors

121
Q

the transmitter affects the nerve terminals from which it is being released

A

homotropic interactions (autoinhibitory feedback)

122
Q

What type of autonomic receptor is located in sympathetic neuron and acting as an autoreceptor?

A

alpha-2

123
Q

What type of autonomic receptor is located in parasympathetic neuron and acting as an autoreceptor?

A

M2

124
Q

one NT affects the release of another via actions on heteroreceptors

A

heterotropic interactions

125
Q

In heterotropic interactions, what NT can affect sympathetic neurons and their release of NT?

A

Ach released by parasympathetic neurons can affect the release of NE by sympathetics

126
Q

In heterotropic interactions, what autonomic receptor is located on sympathetic neurons in order for Ach to act upon it?

A

M2

127
Q

In heterotropic interactions, what NT can affect parasympathetic neurons and their release of NT?

A

NE released by sympathetics can affect the release of Ach by parasympathetics

128
Q

In heterotropic interactions, what autonomic receptor is located on parasympathetic neurons in order for NE to act upon it?

A

alpha-2

129
Q

What is denervation supersensitivity?

A

when a nerve is cut, its downstream structure becomes supersensitive and responds to a much lower dose than before

130
Q

What are the mechanisms to denervation supersensitivity?

A

1) proliferation of receptors

2) loss of mechanisms for removal of transmitter such re-uptake

131
Q

What clinical significance is present for denervation supersensitivity?

A

1) caution when withdrawing patient off certain drugs such as beta blockers
2) can be used to detect autonomic failures

132
Q

Neurons release multiple transmitters that interact with specific receptors and produce effect both at the pre- and post- synaptic levels

A

cotransmission

133
Q

What are the two main functions of autonomic nervous system?

A

1) assist the body in maintaining homeostasis

2) accommodate coordinated body responses to external stimuli

Phys Exam 1 (8 decks)

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