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Year 1 Semester 2 > Autonomic Nervous System > Flashcards

Autonomic Nervous System Flashcards

1
Q

What is a ganglion?

A

A group of cell bodies outside the central nervous system

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2
Q

Where do pre-ganglionic fibres originate from?

A

The central nervous system

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3
Q

Where do post-ganglionic fibres originate from?

A

Autonomic ganglia

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4
Q

Describe the pre-ganglionic outflow of each system of the ANS

A

Sympathetic - Thoracolumbar (leaves spinal cord at thoracic and upper lumbar region)
Parasympathetic - Craniosacral (leaves from brain stem and sacro-spinal cord)

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5
Q

Where does the sympathetic nervous system synapse?

A

Paravertebral chain (close to spinal cord) or prevertebral ganglia (just in front of vertebra)

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6
Q

Where does the parasympathetic nervous system synapse?

A

In or near target organ

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7
Q

What is nicknamed the fight or flight system?

A

Sympathetic nervous system

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7
Q

What is nicknamed the fight or flight system?

A

Sympathetic nervous system

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8
Q

What is nicknamed the rest and digest system?

A

Parasympathetic nervous system

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9
Q

What is the parasympathetic effect on the heart?

A

Decreased heart rate

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10
Q

What is the sympathetic effect on the heart?

A

Increased heart rate

Increased force of contraction

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11
Q

What is the parasympathetic effect on the digestive tract?

A

Increased motility and secretion

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12
Q

What is the sympathetic effect on the digestive tract?

A

Decreased motility and secretion

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13
Q

What is the parasympathetic effect on the lungs?

A

Bronchoconstriction

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14
Q

What is the sympathetic effect on the lungs?

A

Bronchodilation

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15
Q

What is the parasympathetic effect on the urinary bladder?

A

Release of urine

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16
Q

What is the sympathetic effect on the urinary bladder?

A

Urinary retention

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17
Q

What is the parasympathetic effect on the pupil of the eye?

A

Constricts

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18
Q

What is the sympathetic effect on the pupil of the eye?

A

Dilates

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18
Q

What is the sympathetic effect on the pupil of the eye?

A

Dilates

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19
Q

What is the parasympathetic effect on the males sexual organs?

A

Erection

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20
Q

What is the parasympathetic effect on the males sexual organs?

A

Erection

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21
Q

What is the sympathetic effect on the male sexual organs?

A

Ejaculation

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22
Q

What is the parasympathetic effect on the blood vessels?

A

No effect (apart from those related to sexual organs)

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23
Q

What is the sympathetic effect on the blood vessels?

A

Constriction (apart from some skeletal muscle situations)

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24
Q

What is the parasympathetic effect on the salivary glands?

A

Increased secretion

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25
Q

What is the sympathetic effect on the salivary glands?

A

Increased secretion

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26
Q

What is the parasympathetic effect on the sweat glands?

A

No effect

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27
Q

What is the sympathetic effect on the sweat glands?

A

Increased secretion

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28
Q

What is the parasympathetic effect on the liver?

A

No effect

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29
Q

What is the sympathetic effect on the liver?

A

Glycogenolysis and gluconeogenesis

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30
Q

What is the parasympathetic effect on the pilomotor?

A

No effect

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31
Q

What is the sympathetic effect on the pilomotor?

A

Piloerection

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32
Q

What is mydriasis?

A

Dilation of the pupil (sympathetic)

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33
Q

What is miosis?

A

Constriction of the pupil (parasympathetic)

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34
Q

What is the purpose of the canal of Schlemm?

A

Drain excess fluid out of the eye

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35
Q

What effect would a sympathetic agonist have on the eye?

A

Mydriasis (dilation)

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36
Q

What effect would a parasympathetic antagonist have on the eye?

A

Mydriasis (dilation)

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37
Q

How does the ANS work when the bladder is filling?

A

Sympathetic control predominates

  • Relaxation of detrusor muscle
  • Contraction of internal sphincter muscles
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38
Q

How does the ANS work when the bladder is full?

A

Parasympathetic control predominates

  • Contraction of detrusor muscle
  • Relaxation of internal sphincter muscle
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39
Q

Describe sympathetic innervation of the adrenal gland

A
  • Preganglionic sympathetic fibres synapse on chromaffin cells
  • Chromaffin cells release adrenaline (roughly 80%) and noradrenaline (roughly 20%) into systemic circulation
  • Results in widespread tissue response
40
Q

Features of neurotransmitters of the ANS

A
  • All pre-ganglionic neurons in the parasympathetic and sympathetic systems release ACh - nicotinic receptors
  • All post ganglionic parasympathetic neurons release ACh - muscarinic receptors
  • Most postganglionic sympathetic neurons release noradrenaline - some release ACh (i.e sweat glands)
41
Q

What type of nicotinic receptors are found in muscle?

A

(alpha-1)2beta-1-delta-epsilon

42
Q

What type of nicotinic receptors are found in ganglia?

A

(alpha-3)2(beta-2)3

43
Q

What are predominate locations of nicotinic ACh receptors?

A
  • Neuromuscular junction
  • Sympathetic ganglia
  • Parasympathetic ganglia
  • Central nervous system
44
Q

What are predominate locations of muscarinic ACh receptors?

A
  • Parasympathetic target organs
  • Sweat glands (sympathetic)
  • Vascular smooth muscle
  • Central nervous system
45
Q

Can we differentiate muscarinic from nicotinic?

A
  • Nicotinic and muscarinic ACh receptors share some agonists, but can be differentiated by others
  • Drugs that affect the synthesis, storage, release and termination of ACh will affect both receptor types
  • Drugs that affect ACh at the Sk. NMJ may affect the ANS
46
Q

What is the muscarinic and nicotinic receptor specificity for acetylcholine?

A

Muscarinic - Very strong

Nicotinic - Very strong

47
Q

What is the muscarinic and nicotinic receptor specificity for nicotine?

A

Muscarinic - very little/none

Nicotinic - very strong

48
Q

What is the muscarinic and nicotinic receptor specificity for Muscarine?

A

Muscarinic - very strong

Nicotinic - very weak/none

49
Q

What is the muscarinic and nicotinic receptor specificity for bethanecol?

A

Muscarinic - very strong

Nicotinic - very weak/none

50
Q

What is the muscarinic and nicotinic receptor specificity for pilocarpine?

A

Muscarinic - Quite strong

Nicotinic - very weak/none

51
Q

What are the main locations of M1 (neural) muscarinic ACh receptors?

A
  • Autonomic ganglia

- Glands: gastric, salivary, lacrimal

52
Q

What are the main locations of M2 (cardiac) muscarinic ACh receptors?

A

Heart: atria

53
Q

What are the main locations of M3 (glandular/smooth muscle) muscarinic ACh receptors?

A
  • Exocrine glands: gastric, salivary
  • Smooth muscle: GI tract, eye, airways, bladder
  • Blood vessels: endothelium
54
Q

What is the cellular response of M1 receptors?

A

-Increase in IP3 and DAG

55
Q

What is the cellular response of M2 receptors?

A

Decrease in cAMP

56
Q

What is the cellular response of M3 receptors?

A

Increase in IP3 and DAG

57
Q

What is the functional response of M1 receptors?

A

Gastric secretion

58
Q

What is the functional response of M2 receptors?

A

Cardiac inhibition

59
Q

What are the functional responses of M3 receptors?

A
  • Gastric, salivary secretion
  • GI smooth muscle contraction
  • Ocular accommodation
  • Vasodilation
60
Q

Are all muscarinic receptors in the ANS?

A
  • No
  • M1,2,4 and 5 also found in CNS
  • M3 found on vascular endothelial and smooth muscle cells
60
Q

Are all muscarinic receptors in the ANS?

A
  • No
  • M1,2,4 and 5 also found in CNS
  • M3 found on vascular endothelial and smooth muscle cells
61
Q

What is pilocarpine?

A

Non-selective muscarinic agonist

62
Q

What are some clinical uses of pilocarpine?

A
  • Constriction of pupils (miosis)
  • Glaucoma (to decrease IOP)
  • Xerostomia (following head/neck radiotherapy)
63
Q

What is bethanechol?

A

Non-selective muscarinic agonist

64
Q

What are some clinical uses of bethanechol?

A

Bladder and gastrointestinal hypotonia

65
Q

What are some pharmacological properties of atropine?

A
  • Non-selective muscarinic antagonist
  • Well absorbed orally
  • CNS effects
66
Q

What are some pharmacological properties of glycopyrronium?

A
  • Similar to atropine

- Does not cross blood brain barrier

67
Q

What are some pharmacological properties of hyoscine hydrobromide?

A
  • Similar to atropine

- CNS effects

68
Q

What are some pharmacological properties of hyoscine butylbromide?

A
  • Similar to atropine but poorly absorbed

- Does not cross blood brain barrier

69
Q

What are some pharmacological properties of ipratropium?

A
  • Delivered via inhaler or nebuliser

- Does not cross blood brain barrier

70
Q

What are some pharmacological properties of tropicamide?

A

-Similar to atropine but shorter acting

71
Q

What are some clinical uses of atropine?

A
  • Adjunct for anaesthesia
  • Anticholinesterase poisoning
  • Bradycardia/cardiac arrest
72
Q

What are some clinical uses of glycopyrronium?

A

Similar to atropine

73
Q

What are some clinical uses of hyoscine hydrobromide?

A
  • Hypersalivation

- Motion sickness

74
Q

What are some clinical uses of hyoscine butylbromide?

A

Gastrointestinal spasms

75
Q

What are some clinical uses of ipratropium?

A

Maintenance treatment of COPD

76
Q

What are some clinical uses of tropicamide?

A

Opthalmic use (mydriasis)

77
Q

What facilitates release of noradrenaline?

A

Calcium ions

78
Q

How does noradrenaline carry out negative feedback?

A
  • alpha-2 adrenoreceptors on the presynaptic terminal
  • Noradrenaline binds to these receptors inhibiting adenylyl cyclase which regulates calcium flow across membrane
  • Results in a decrease in calcium influx and therefore a decrease in noradrenaline release
79
Q

Is noradrenaline degraded outside the neuron?

A
  • No, there is no equivalent to acetylcholinesterases for noradrenaline
  • ~75% recaptured by neurons
  • Using norepinephrine transporter (NET)
  • Repackaged by vesicular monoamine transporter (VMAT)
80
Q

What are drugs that affect noradrenergic neurons?

A

Drugs that affect catecholamine synthesis
-e.g. methyldopa

Drugs that affect catecholamine release

  • indirectly acting sympathomimetics e.g. amphetamines
  • by acting on alpha-2 adrenoreceptors e.g. clondine

Inhibitors of catecholamine uptake
-NET inhibitors e.g. cocaine, tricylic antidepressants

Inhibitors of catecholamine metabolic degradation
-monoamine oxidase inhibitors used in depression

81
Q

What are the three main catecholamines?

A
  • Dopamine
  • Noradrenaline
  • Adrenaline
82
Q

Define metabotropic receptors and give an example

A
  • G-protein coupled receptors

- e.g adrenergic receptors

83
Q

What are the two main groups of adrenoreceptors?

A
  • Alpha - alpha-1, alpha-2

- Beta - beta-1, beta-2, beta-3

84
Q

What are some features of alpha-1 adrenoreceptors?

A

Main ANS locations:

  • cardiovascular
  • GI tract
  • genitourinary

Cellular response:
-Increase IP3 and DAG

Functional ANS response:

  • Vasoconstriction
  • Smooth muscle contraction (GI sphincters and genitourinary)
85
Q

What are some features of alpha-2 adrenoreceptors?

A

Main ANS locations:
-Neuronal

Cellular response:
-decrease cAMP

Functional ANS response:
-decrease transmitter release

86
Q

What are some features of beta-1 adrenoreceptors?

A

Main ANS locations:

  • Heart
  • Kidneys

Cellular response:
-Increase cAMP

Functional ANS response:

  • Increase cardiac rate
  • Increase cardiac force
  • Renin release
87
Q

What are some features of beta-2 adrenoreceptors?

A

Main ANS locations:

  • Lungs
  • Smooth muscle
  • Skeletal muscle

Cellular response:
-Increase cAMP

Functional ANS response:

  • Bronchodilation
  • Relaxation of visceral smooth muscle
  • Vasodilation (sk. muscle)
  • Tremor
88
Q

What does phenylephrine do?

A
  • Constriction of airway blood vessels (alpha-1)

- Used to reduce nasal congestion

89
Q

What drugs can be used to cause bronchodilation via the beta-2 adrenoreceptors when treating asthma?

A
  • Salbutamol
  • Salmeterol
  • Terbutaline
90
Q

What is the main difference between salbuatmol and salmeterol?

A

Salbutamol is short-acting whereas salmeterol is long-acting

91
Q

What side effects can salbutamol and salmeterol cause?

A

Muscle tremor and cardiac arrhythmias

92
Q

How can salbutamol aid in premature labour?

A

Relaxation of uterine smooth muscle allowing delay in delivery

93
Q

What is the basic equation to determine mean arterial blood pressure?

A

Mean arterial blood pressure = cardiac output multiplied by total peripheral resistance

94
Q

How does the sympathetic nervous system increase cardiac output?

A
  • By increasing the heart rate
  • By increasing the volume pumped on each stroke
  • Both mediated by beta-1 receptors
95
Q

How does the sympathetic nervous system increase total peripheral resistance?

A
  • By constricting blood vessels (mainly small arteries/arterioles)
  • Mediated by alpha-1 receptors
96
Q

What is the purpose of dobutamine?

A
  • Increase heart rate and force (beta-1)

- Can be used to treat cardiogenic shock

97
Q

What drugs are used to treat hypertension and how do they work?

A
  • Prazosin - Vasodilation by blocking alpha-1 receptors
  • Propranolol - decrease heart rate and force by blocking beta-1 receptors, decrease renin release by kidneys (beta-1)
  • Atenolol - decrease heart rate by blocking beta-1 receptors, decrease renin release by kidneys (beta-1)
  • Clonidine - stimulation of pre-synaptic alpha-2 receptors to decrease NA release, also has central effect
98
Q

What drugs are used to treat cardiac dysrhythmias and how do they work?

A
  • Propanolol - decrease heart rate and force by blocking beta-1 receptors, decrease renin release by kidneys (beta-1)
  • Atenolol - decrease heart rate and force by blocking beta-1 receptors, decrease renin release by kidneys (beta-1)

Year 1 Semester 2 (26 decks)

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