Autonomic Nervous System Flashcards

1
Q

Why is it important to study the autonomic nervous system?

A

It’s very important in homeostasis (there’s a tightly controlled internal environment), drug actions (some classes of drugs work on the ANS) and drug side effects (over 200 drugs that don’t work primarily at this site have side effects due to activation of the ANS

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2
Q

What are the two main systems that control body functions?

A

The endocrine system (hormones, e.g., insulin, are released into the blood)
The nervous system (electrical transmission with chemical “links”, i.e., neurotransmitters)

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3
Q

Explain how the peripheral nervous system is organized/divided?

A

The PNS has motor nerves and sensory nerves (efferent and afferent, respectively). There are two kinds of two kinds of PNS motor nerves: somatic and autonomic. Within the autonomic nervous system, there is sympathetic nerves, enteric nerves and parasympathetic nerves

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4
Q

How do sensory nerves work?

A

They are also known as the “afferent” division (flows to the CNS)
Information from the periphery (sensory) goes to the spinal cord and/or to the central nervous system

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5
Q

How do motor nerves work?

A

They are also know as the “efferent” division (flows to the CNS)
Information from the CNS or spinal cord goes to the periphery. This results in some peripheral change (motor), such as altered muscle activity, somatic (skeletal muscles), autonomic (smooth muscles, i.e., gut, bronchiolar; cardiac muscle i.e., atria ventricles)

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6
Q

What makes the somatic nervous system different form the autonomic nervous system?

A

Largely not automatic
Consciously controlled functions
Movement - locomotion, respiration, posture
Involves electrical and chemical transmission

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7
Q

What makes the autonomic nervous system different from the somatic nervous system?

A

“Automatic” and involuntary (you process information and the ANS response accordingly)
It controls organs and glands
It involves electrical and chemical transmission
Control of the internal environment/milieu (Heart, blood vessels, salivation, digestion, muscle tone (intestinal, urinary, bronchioles), accommodation of the eye (near/far vision, etc.)
There are two main divisions: sympathetic nervous system (SNS) and the parasympathetic nervous system (PNS)

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8
Q

What do the SNS and the PNS have in common?

A

Both are efferent (motor) systems (visceromotor)
Both involve regulation of the “internal” environment generally outside of our conscious control: “autonomous”
Both involve 2 neutrons that synapse in a peripheral ganglion
They innervate glands, smooth muscle, cardiac muscle

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9
Q

What is unique about the basic function of SNS?

A

It is widespread of local
It’s “ergotropic”, meaning leading to energy expenditure
It’s involved in the fight or flight response
It causes cardiac stimulation, increases blood sugar, causes cutaneous vasoconstriction
The preganglionic axons are short and the postganglionic axons are long (when the SNS fires, it affect pretty much all the organs)

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10
Q

What is unique about the basic function of the PNS?

A

It’s “trophotropic”, meaning leading to growth

It is energy conserving; slows the heart rate, stimulates digestion
The preganglionic axons are long and the postganglionic axons are short (allows the PNS to control organs separately)

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11
Q

Where are the preganglionic cell bodies of the PNS and SNS found? Why is this important?

A

The sympathetic preganglionic cell bodies are in the thoracolumbar segments of the spinal cord.
The parasympathetic preganglionic cell bodies are in the brain (CN III, VII, IX, X) and the sacral sacrel segments of the spinal cord.
This is important because it has implications for spinal cord injury (e.g., spinal cord injury in the lower thoracic region could result in a loss of SNS function in the digestive system but not PNS, leading to an overactive digestive system)

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12
Q

What neurotransmitters do the preganglionics of the SNS and the PNS release?

A

All preganglionics release acetylcholine (ACh) and are excitatory

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13
Q

What neurotransmitters do postganglionics of the SNS and the PNS release?

A

Sympathetic postganglionics release norepinephrine and they are excitatory or inhibitory
Parasympathetic postganglionics release ACh and are excitatory or inhibitory
Excitation or inhibition is a receptor-dependent and receptor-mediated response

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14
Q

What are the target tissues of the SNS?

A
Organs of the head, neck, trunk and external genitalia
Adrenal medulla
Sweat glands in the skin
Arrector muscles of hair
ALL vascular smooth muscle

The SNS is distributed to essentially all tissues (because of vascular smooth muscle)

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15
Q

What are the target tissues of the PNS?

A

Organs of the head, neck, trunk and external genitalia

The PNS never reaches the limbs or body wall (except for external genitalia)

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16
Q

What are the functional differences between the SNS and the PNS?

A

Sympathetic: fight or flight (catabolic; expend energy)
Parasympathetic: feed and bread or rest and digest (homeostasis)

17
Q

Within the sympathetic nervous system, what are the most common ganglionic neurons? What are the other kinds?

A

Sympathetic chain ganglia (paired) are the most common

There is also Collateral ganglia (unpaired) and adrenal medullae (paired).

18
Q

Describe the epinephrine synthesis pathway (catecholamine biochemistry)

A

L-tyrosine is hydroxylated by tyrosine hydrolase to give DOPA
Dopamine decarboxylase transforms DOPA into dopamine
Dopamine beta-hydroxylase transforms dopamine into norepinephrine
Phenylethanolamine N-methyl transferase transforms norepinephrine into epinephrine

19
Q

What are the different adrenergic receptors?

A

Alpha 1
Alpha 2 (not found on all SNS targets)
Beta

20
Q

What do alpha 1 receptors do?

A

Activates protein kinase C (PLC)
Increases calcium
Causes smooth muscle contraction (vasoconstriction, sphincter, mydriasis)

21
Q

What do alpha 2 receptors do?

A

Inhibits adenylate cyclase
Increases potassium, causing hyper polarization
Inhibits norepinephrine release
Inhibits insulin release
Found on presynaptic neurons and pancreatic beta cells

22
Q

What do beta receptors do?

A

Activates adenylate cyclase
Increases protein kinase A activity
Found on the heart and lungs, and is important for energy regulation
Increases heart rate, contractility, bronchodilation, vasodilation, gluconeogenesis, lipolysis

23
Q

What are the 6 sites to alter activity of a neurotransmitter (potential sites for drug action)?

A

Synthesis of norepinephrine
Uptake of norepinephrine into storage vesicles
Release of neurotransmitter (e.g., calcium channel blockers)
Binding to the receptor
Removal of norepinephrine
Metabolism

24
Q

Why is the vagus nerve important?

A

The vagus nerve is a major preganglionic parasympathetic supply to the thorax and abdomen
Problems with the vagus nerve can cause major problems (it innervates the heart and lungs and keeps things at a normal background level)

25
Q

What type of receptors do preganglionic neurons of the SNS activate?

A

The ACh activates nicotinic cholinergic receptors

26
Q

What type of receptors do preganglionic neurons of the PNS activate?

A

The ACh activates nicotinic and muscarinic cholinergic receptors

27
Q

What are the different kinds of muscarinic receptors? What do they do?

A

M1, M3 and M5: activate PLC, increasing calcium, which activates PKC, causing excitation (gastric release, smooth muscle, bladder, etc.)
M2 and M4: inhibits adenylate cyclase, activates potassium channels, inhibits PKA (cardiac muscle, smooth muscle)

28
Q

There are a variety of interactions between the SNS and the PNS. What are they?

A

Opposite effects at the same time (NE on beta receptors increases the heart rate via the SA node and ACh on muscarinic receptors decrease the heart rate via the SA node)
Opposite effects at different sites (NE via alpha receptors dilates the pupil (mydriasis) and ACh via muscarinic receptors retracts the pupil (miosis)
Sympathetic nerve act on parasympathetic nerve endings (NE via alpha receptors decreases ACh release in intestinal walls)
Complementary (male genital organ: PNS causes and erection and the SNS causes ejaculation)
Some organs receive only one system (ciliary muscles of the eye: PNS; arterioles of most organs: SNS)

29
Q

Clinically, how can receptors be a help or a problem (using bronchiole smooth muscle as an example)?

A

How would you clinically increase air flow in the bronchioles? Stimulates beta2-adrenergic receptors (salbutamol), block muscarinic receptors (ipatropium)
How would you clinically decrease air flow in the bronchioles? Block beta-adrenergic receptors (propanolol), stimulate muscarinic receptors

30
Q

How do you inhibit micturition?

A

Increase SNS activity (increase beta2 and/or alpha adrenergic receptor activity)
Decrease PNS activity (decrease muscarinic activity)

31
Q

How is blood pressure controlled?

A

Resting blood pressure is maintained within narrow limits by feedback loops. It is determined by cardiac output and total peripheral resistance (BP = CO x TPR). The ANS is very important here. The baroreceptor reflex provides feedback for BP control

32
Q

How does the baroreceptor respond to an increase in blood pressure?

A

Decrease in sympathetic nerve activity and an increase in parasympathetic nerve activiyt

33
Q

How does the baroreceptor respond to a decrease in blood pressure?

A

Increase in sympathetic nerve activity and a decrease in parasympathetic nerve activity

34
Q

Describe the baroreceptor reflex

A

A drop in blood pressure signals the carotid sinus/aortic arch and causes a decrease in firing of afferents. This goes to to the cardiovascular centre of the brain, which causes an increase in sympathetic nerve activity and a decrease in parasympathetic nerve activity. This causes an increase in heart rate, in contractile force and arteriolar constriction. Blood pressure returns to normal.

35
Q

What can mess up the baroreceptor reflex?

A

Heart failure
Hypovolemia
Hemorrhage
Postural changse

36
Q

The OTC cold medication, neocitran, contains antihistamine and sympathomimetic. What does the antihistamine do?

A

Blocks histamine receptors
Histamine has nothing to do with the common cold.
The benefit is due to additional blocking effects at “non-histamine receptors”
“Atronpinic” like - blocks muscarinic receptors, which dries mucous membranes and also causes sedation and anti nausea

37
Q

The OTC cold medication, neocitran, contains antihistamine and sympathomimetic. What does the sympathomimetic do?

A

Increases sympathetic receptor activity
“Mimic” neurotransmitter of the SNS
Constricts blood vessels in the nasal mucosa (beneficial) and decreases exudate (runny nose)

38
Q

What are the common side effects of neocitran due to the antihistamine?

A

“Atropinic” - a decrease in parasympathetic receptor activity
Side effect of antihistamine: sedation and drying
The bladder is relaxed with a constricted sphincter
The gut has a relaxed wall, the sphincters are constricted and there’s a decrease in secretion

39
Q

What are the common side effects of neocitran due to the sympathomimetic?

A

Increases sympathetic receptor activity
The bladder is relaxed with a constricted sphincter
The gut has a relaxed wall, the sphincters are constricted and there’s a decrease in secretion
The heart has an increased heart rate and contractility and the arterioles are constricted