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Neuro 500 > Autonomic Nervous System > Flashcards

Autonomic Nervous System Flashcards

1
Q

Somatic Nervous System: motor and sensory receptors

A

Both from/to skeletal muscles

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2
Q

Autonomic Nervous System: sensory and motor

A

Sensory: from visceral organs

Motor: to smooth and cardiac muscles, glands

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3
Q

Enteric Nervous System: sensory and motor

A

Sensory: chemical changes and distension in GI tract

Motor: GI smooth muscles

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4
Q

Autonomic Tone

A

Balance between parasympathetic and sympathetic activity. As one increased, the other decreased.

Most organs innervated by both sympathetic and parasympathetic fibres, which release different NTs.

Regulated by hypothalamus

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5
Q

Organs that receive only sympathetic innervation

A 
sweat glands
kidneys
most blood vessels
arrector pili
spleen 
adrenal medulla
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6
Q

Why would the SNS dilate blood vessels to liver?

A

Energy from glycogenelysis

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7
Q

Focus of Sympathetic responses

A

Increase production of ATP, support vigorous physical activity, reduce expenditures to nonessential functions

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8
Q

Focus of Parasympathetic responses

A

Functions that replenish and restore energy

SLUDD: salivation, lacrimation, urination, defecation, digestion

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9
Q

Somatic nervous system: sensory input

A

Somatic and special senses.

Consciously perceived

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10
Q

Autonomic nervous system: sensory input

A

Interoceptors mostly.
Also from somatic and special senses.
Usually non-consciously perceived

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11
Q

Somatic nervous system: control of motor output

A

Voluntary control from cerebral cortex.
Contributions from basal ganglia (regulates initiation and termination of movement), cerebellum, brain stem and spinal cord.

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12
Q

Autonomic nervous system: control of motor output

A

Involuntary control from hypothalamus, limbic system, brain stem and spinal cord.
Limited control from cerebral cortex.

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13
Q

Somatic nervous system: NT and hormones

A

Acetylcholine (ACh)

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14
Q

Autonomic nervous system: NT and hormones

A

All preganglionic neurons, all parasympathetic postganglionic neurons, and sympathetic postganglionic neurons near sweat glands release ACh.

Most sympathetic postganglionic neurons release NE.

Chromaffin cells (adrenal medulla) release epinephrine and NE.

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15
Q

Somatic nervous system: motor neuron pathway

A

One neuron pathway.

Somatic motor neurons extending from CNS synapse directly with effector.

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16
Q

Autonomic nervous system: motor neuron pathway

A

Usually two-neuron pathway.
Preganglionic neurons extend from CNS to autonomic ganglion.
Synapse with Postganglionic neurons, which extend to visceral effector.

Alternatively: preganglionic neurons may synapse with chromaffin cells in adrenal medulla

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17
Q

Somatic nervous system: effectors and response

A

skeletal muscle (contraction)

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18
Q

Autonomic nervous system: effectors and responses

A 
Glands (increased or decreased secretion)
Smooth muscle (contraction or relaxation)
Cardiac muscle (increased or decreased rate or force of contraction)
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19
Q

Three parts of an autonomic pathway

A
  1. preganglionic neuron
  2. autonomic ganglia
  3. postganglionic neuron
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20
Q

Preganglionic neuron

A

First neuron in autonomic NS.
Relays signal from CNS to autonomic ganglia

Cell body is located in the CNS; axons exit CNS as part of a cranial or spinal nerve.
Axon: myelinated B fibre

Either synapses with a postganglionic fibre at an autonomic ganglion, or with a chromaffin cell in an adrenal medulla

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21
Q

Postganglionic neuron

A

Second neuron in the automic NS.
Relays signal from ganglion –> effector
Lies entirely within the PNS
Cell body and dendrites located within autonomic ganglion

Axon: unmyelinated type C fibre
Terminates in visceral effector.

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22
Q

Sympathetic Preganglion fibres

A

AKA thoracolumbar division

Cell bodies in lateral horns of gray matter in T spine and S1-2 or 3.

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23
Q

Parasympathetic Preganglion fibres

A

AKA craniosacral division

Cell bodies located in nuclei of CN III, VII, IX and X (occulomotor, facial, glossopharyngeal and vagus) in the brainstem, and in the lateral grey matter of S2-4.

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24
Q

Thoracolumbar outflow

A

The axons of the sympathetic preganglionic neurons

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25
Q

Craniosacral outflow

A

The axons of the parasympathetic preganglionic neurons

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26
Q

Postganglionic neuron

A

The second neuron in the ANS motor pathway
Peripheral nervous system
C fibre
Terminates in visceral effector

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27
Q

Autonomic ganglia

A

Where pre and post ganglionic neurons synapse

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28
Q

Two types of sympathetic autonomic ganglia

A
  1. sympathetic trunk/vertebral chain/paravertebral

2. prevertebral/collateral ganglia

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29
Q

Sympathetic trunk ganglia

A

AKA Vertebral Chain and Paravertebral Ganglia

Vertical row on either side of vertebral column, running from skull to coccyx

Mostly innervates organs above diaphragm

Short preganglionic and long postganglionic fibres

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30
Q

The named sympathetic trunk ganglia

A
  1. superior cervical
  2. middle cervical
  3. inferior cervical
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31
Q

Prevertebral ganglia

A

AKA collateral ganglia

Part of sympathetic system.

Anterior to vertebral column, close to large abdominal arteries
Generally innervate below the diaphragm

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32
Q

5 Major prevertebral ganglia

A
  1. celiac
  2. superior mesenteric
  3. inferior mesenteric
  4. aorticortical
  5. renal
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33
Q

Terminal ganglia

A

AKA intramural ganglia
The ganglia of the parasympathetic system

Close to or in the actual wall of visceral organs

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34
Q

Terminal ganglia in the head

A
  1. ciliary (CN III occulomotor)
  2. pterygopalatine (CN VII facial)
  3. submandibular (CN VII facial)
  4. otic (CN IX glossopharyngeal)
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35
Q

4 ways Sympathetic preganglionic neurons connect with postganglionic neurons

A
  1. synapse in sympathetic trunk ganglion
  2. ascend or descend to a different level, and then synapse in trunk ganglion
  3. pass through sympathetic trunk ganglion, and synapse in prevertebral ganglion
  4. pass through both sympathetic trunk and prevertebral ganglion and synapse with chromaffin cells in adrenal medulla
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36
Q

Divergence and sympathetic preganglionic fibres

A

Single preganglionic fibre may synapse with more than 20 postganglionic fibres

This divergence explains the speed and spread of sympathetic responses

37
Q

Parasympathetic preganglionic neurons

A

Synapse with 4 or 5 postganglionic neurons, in or near visceral effector, only affecting that one effector.

38
Q

Autonomic plexus

A

Tangled network of axons of both sympathetic and parasympathetic neurons, together with sympathetic ganglia and autonomic sensory neurons

Found in thorax, abdomen and pelvis.

39
Q

7 major autonomic plexuses

A 
Cardiac (thorax -- heart)
Pulmonary (thorax -- lungs)
Celiac/solar
Superior mesenteric (small and large intestine)
Inferior mesenteric (large intestine)
Hypogastric (pelvic viscera)
Renal (renal arteries and uterus)
40
Q

Solar/Celiac plexus

A

Largest autonomic plexus
In abdomen
Surrounds celiac trunk
Contains 2 large celiac ganglia

Stomach, spleen, pancreas, liver, gallbladder, kidneys, adrenal medulla, testes, ovaries

41
Q

Four ways Sympathetic Postganglionic neurons connect with visceral effectors

A
  1. spinal nerves
  2. cephalic periarterial nerves
  3. sympathetic nerves
  4. splanchnic nerves
42
Q

Spinal nerve postganglionic sympathetic pathways

A

White ramus + grey ramus [= Ramus communicantes]
Merges with anterior ramus of spinal nerve

Visceral effectors of neck, trunk and limbs

43
Q

Cephalic periarterial nerves

A

Sympathetic preganglionic nerves ascend to superior cervical ganglion (sympathetic trunk).
Then synapse with cephalic periarterial nerves which wrap around arteries that pass from neck to head (ie carotid)

Visceral effectors of skin of face and rest of head.

44
Q

Sympathetic Nerves

A

One way sympathetic postganglionic nerves connect with visceral effectors

Extend to visceral effectors in thoracic cavity, including heart and lungs.

How we get to abdominopelvic organs

45
Q

Sympathetic nerve to heart

A

Postganglionic sympathetic innervation of the heart

From superior, middle and inferior cervical ganglia, T1-4 –> cardiac plexus

46
Q

Sympathetic nerve to the lungs

A

Sympathetic trunk ganglia T2-4 –> pulmonary plexus

47
Q

Splanchic nerves

A

Nerves that synapse in prevertebral ganglia. Refers to pre- and post-ganglionic tracts.

T5-L4

48
Q

Four + Splanchic nerves

A 
Greater Splanchic
Lesser Splanchic
Least (lower) Splanchic 
Lumbar Splanchic 
(And Splanchic nerve to adrenal medulla)
49
Q

Greater Splanchic nerve

A

T5-9

Celiac ganglion

Blood vessels to stomach, liver, spleen, kidneys, small intestine

50
Q

Lesser Splanchic nerve

A

T10,11. Divides. Synapses at:

Aorticorenal ganglion –> kidneys, ureters

Superior mesenteric ganglion –> blood vessels of small intestine and proximal colon

51
Q

Least (lower) Splanchic nerve

A

T12 –> renal plexus –> kidney arterioles and ureter

Not always present.

52
Q

Lumbar Splanchic nerve

A

L1-4 –> inferior mesenteric ganglion (inferior mesenteric plexus) –> distal colon and rectum; blood vessels of distal colon, rectum, genitals

ONLY ONE THAT DOESNT PIERCE DIAPHRAGM

53
Q

Splanchic nerve to adrenal medulla

A

Preganglionic axons pass through sympathetic trunk, splanchic nerves, and celiac ganglion.

Extend to chromaffin cells in adrenal medulla.

Release 80% epinephrine, 20% norepinephrine, sprinkle of dopamine.

54
Q

Histological similarities between adrenal medulla and sympathetic ganglia.

A

Both derived from neural crest.

Adrenal medulla modified sympathetic ganglia.

Chromaffin cells stripped down sympathetic postganglionic neurons (no dendrites or axons).

55
Q

Horner’s Syndrome

A

Loss of sympathetic innervation to one side of the face

Congenital, injury (Klumpe’s or Erbs), disease.

Ptosis
Miosis
Anhidrosis
Possible enopthalmos

56
Q

Parasympthetic outflow: cell bodies

A

Cranial: brain stem

Sacral: lateral grey matter of S2-4

57
Q

Parasympathetic outflow: preganglionic fibres

A

Cranial: extend from brain stem along CN III, VII, IX and X

Sacral: extend from anterior roots of S2-4

58
Q

Cranial Parasympathetic Ganglia

A
  1. Ciliary (III). Ciliary (accommodation) and circular (constriction) muscles
  2. Pterygopalentine (VII). Lacrimal gland, nasal mucosa, palate, pharynx.
  3. Submandibular (VII) submandibular and sublingual glands
  4. Optic (IX). Parotid gland.
59
Q

How much of the total craniosacral outflow is carried by the vagus nerve,

A

80%

60
Q

Sacral Parasympthetic ganglia

A

Travel with spinal nerves, branch off to form pelvic splanchic nerves.

Synapse with parasympthetic neurons in terminal ganglia

Innervation smooth muscle and glands in walls of colon, ureters,

61
Q

Are all the Splanchic nerves sympathetic?

A

Nope. The sacral presympathetic axons form the Pelvic Splanchnic nerves

62
Q

Cholinergic neurons

A

Release ACh

All preganglionic neurons
All parasympthetic postganglionic neurons
Sympathetic postganglionic neurons that innervation sweat glands

63
Q

Which neurons aren’t cholinergic?

A

Most sympathetic postganglionic neurons (the ones that don’t innervate sweat glands)

64
Q

Two types of cholinergic receptors

A
  1. Nicotinic

2. Muscarinic

65
Q

Nicotinic receptors

A

ACh receptors found on:

  1. Sympathetic and parasympthetic postganglionic neurons
  2. Chromaffin cells
  3. Motor end plates at NMJ
66
Q

Muscarinic receptors

A

ACh receptors

All parasympathetic effectors.
Sweat glands.

67
Q

Acetylcholinesterase

A

Enzyme that quickly deactivates ACh.

The reason ACh effects are brief.

68
Q

Adrenergic neurons

A

Release NE

Most sympathetic postganglionic neurons (except those innervation sweat glands)

Effects last longer than ACh

69
Q

Adrenergic receptors

A

Bind to NE and epinephrine.

Alpha and beta receptors.

70
Q

What do chromaffin cells release?

A

NE and epinephrine (as hormones)

71
Q

How is NE terminated?

A

Reuptake or inactivated by monoamine oxidase (MAO) or catechol-O-methyltransferase (COMT)

72
Q

Agonist

A

A substance that binds to and activates a receptor.

Mimics effect of natural NT

73
Q

Antagonist

A

Binds to receptor and blocks it so natural NT or hormone is prevented from exerting its effect.

74
Q

Why are sympathetic responses more widespread and long-lasting than parasympathetic?

A
  1. Divergence. Sympathetic postganglionic axons diverge more, affect more tissues
  2. ACh-esterase deactivates ACh quickly. NE lingers.
  3. NE and epinephrine secreted as hormones in blood intensify and prolong the NT NE response.
75
Q

Charcot Marie Tooth Disease

A

AKA hereditary motor and sensory neuropathy/progressive muscular atrophy/peroneal muscular atrophy.

Progressive hereditary demyelination disorder. Dominant, recessive or X-linked

Affects primarily the fibularis nerve (muscles in foot and leg) then progresses to forearm and hands.

Distal limb wasting and weakness

76
Q

Symptoms of CMT disease

A 
Diminished DTR
Pes cavus
Hammer toes
Foot drop 
Decreased proprioception
Legs appear like inverted champagne bottles (distal wasting).
77
Q

CMT type 1

A

Most common variant. Autosomal dominant.

Duplication on Chromosome 17

78
Q

CMT Type 2

A

Abnormalities of Chromosomes 1,8,X

79
Q

Diabetic Neuropathy

A

Common complication of diabetes mellitus (especially Type 1)

Distal symmetric pattern. Glove and stocking.

Disturbances in peripheral microcirculation. Demyelination.

80
Q

Alcoholic neuropathy

A

Distal symmetric glove and stocking
Direct toxic effects from ethanol, and B12 (thiamine)

Decreased sensation, ankle reflexes, foot and wrist drop.

Insidious. Slow progression. Eventually affects all four limbs.

81
Q

Chronic renal failure – neuropathy

A

CNS and PNS dysfunction

Associated with increased uremia

82
Q

CNS effects of Chronic Renal Failure

A

uremia encephalopathy –> memory loss, inability to concentrate, perceptual errors and decreased alertness.

83
Q

PNS Effect of Chronic Failure

A

Demyelination and atrophy of sensory and motor neurons

Lower extremities more affected than upper.

Symmetric.

84
Q

Pernicious Anemia – neuropathy

A

B12 deficiency

Distal, symmetric pattern

Difficulty walking; loss of proprioception.

Increasing loss of motor function.

Headache, drowsiness, dizziness, fainting, slow thought processes, poor attention.

85
Q

Guiliain-Barre Syndrome

A

Immune mediated inflammatory response.

Most common cause of rapid motor and sensory problems.

Max weakness in 2-3 weeks; months to recover.

Rapidly ascending symmetric motor weakness and distal sensory impairment.

Flaccid paralysis, absence of DTRs
30% require mechanic ventilation

86
Q

Most common form of Guillain-Barre Syndrome

A

Acute inflammatory demyelinating polyradiculoneuropathy

87
Q

GBS: time of onset of peak impairment; and symptom cessation.

A

Acute: less than 4 weeks

Chronic: months

50%: progression stops within 2 weeks
90%. Progression stops within 4 weeks.

Recovery proximal to distal.

88
Q

Initial symptom of GBS

A

Paresthesia in toes, followed by distal weakness in legs.

Neuro 500 (3 decks)

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