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Physio Test 2 > Bowman ANS > Flashcards

Bowman ANS Flashcards

1
Q

What composes peripheral nervous system (PNS)

A

Somatic nervous system

Autonomic nervous system

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2
Q

What is the somatic nervous system?

A

Motor and sensory pathways regulating voluntary motor control of skeletal muscle

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3
Q

What is the autonomic nervous system?

A

Motor and sensory pathways regulating body’s internal environment through involuntary control of organ systems (smooth muscle, cardiac muscle, and glands)

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4
Q

What makes up autonomic nervous system?

A
  • Sympathetic & parasympathetic nervous system<— not always physiologic antagonists
  • Enteric system
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5
Q

Where is autonomic nervous system located?

A

Both in CNS and PNS Coordinates and maintains steady state among the visceral (internal) orgnas

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6
Q

What are preganglionic neurons?

A

Cell body is located in CNS (myelinated B fibers)

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7
Q

What are postganglionic neurons?

A

Cell body in autonomic ganglia (unmyelinated C fibers)

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8
Q

What is an example of sympathetic and parasympathetic not being physiological antagonists?

A

Sympathetic maintains vascular tone but parasympathetic has very little roll in maintaining vascular tone

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9
Q

What autonomic centers activate the ANS?

A
  • Hypothalamus - thermoregulation, regulating visceral behaviors
  • Brain stem
    • medulla- vasomotor/vasodilator centers
    • pons- mecturition (urination)
  • Spinal cord

Regulate by sending out long efferent fibers

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10
Q

Where is sympathetic innervation?

A

Thoracolumbar: preganglionic neurone cell bodies are located in T1-L2/3 of spinal cord

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11
Q

Where are preganglionic neuron cell bodies located in spinal cord in sympathetic innervation?

A

Intermediolateral horn of grey matter

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12
Q

Where are post-gaglionic neuron cell bodies located for sympathetic innervation?

A

In ganglia

  • Paravertebral chains (either side of psinal column)
  • prevertebral ganglia (i.e.- celiac, superior, inferior, mesenteric ganglia in abdomen)
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13
Q

Relative size of preganglionic neurons to post ganglionic for SNS?

A

Short preganglionic neurons, long post ganglionic

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14
Q

What is baseline function of sympathetic nervous system?

A

Mobilized energy stores in times of need; “fight or flight” response.

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15
Q

Where do sympathetic nerve fibers leave the spinal cord? Where do they travel initially?

A
  • Nerve fibers leave spinal cord ventrally via the white rami
  • They then travel to 22 paravertebral ganglia (sympathetic chain ganglia)
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16
Q

Where can sympathetic nerves travel after the sympathetic chain ganglia?

A
  • Synpase with post-ganglionic neuron at same level OR
  • Move caudad or cephalad to synapse at another level
  • Pass through ganglia withouth synpasing to collateral ganglia surrounding the abdominal aorta (celiac, superior mesenteric, inferior mesenteric)
  • Some ganglia have inhibitory interneurons as well.
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17
Q

Do preganglionic sympathetic neurons in SNS need to synapse with post ganglionic at same level?

A

No, can move up and down sympathetic chain, so it can go a lot of different places outside of spinal cord

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18
Q

Of the preganglionic nerves that synapse inside sympathetic chain ganglia (aka paravertebral chain), where do the post-ganglionic fibers go? What do they affect?

A
  • Return to spinal nerves via gray ramus (like a highway interchange)
  • These postganglionic nerves go on to affect blood vessels, piloerector muscle and sweat glands.
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19
Q

Where do the pre-ganglionic nerves that do not synapse in the sympathetic chain ganglia go?

A

They go to a peripheral chain ganglion and synapse there with the post-ganglionic fiber.

  • The post-ganglionic fiber then exits to travel to various peripheral organs
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20
Q

What is T1 SNS fibers travel to?

A

Ascend into paravertebral sympathetic chain to head

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21
Q

Where do T2 fibers travel to?

A

Neck

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22
Q

Where do T3-T6 fibers travel to?

A

Chest

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23
Q

Where do T7-T11 fibers travel to?

A

Abdomen

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24
Q

Where do T12-L2 fibers travel to?

A

Legs

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25
Q

What is distribution of SNS fibers based on?

A

Embryonic development and NOT spinal segments

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26
Q

What is another name for parasympathetic innervation?

A

Craniosacral

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27
Q

Where does parasympathetic innervation arise from?

A
  • Cranial (medullary CN 3,7, 9, 10)
  • Sacral (spinal cord S2-S4 region)
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28
Q

Where are post-ganglionic neuron cell bodies in PSNS located?

A
  • Target organs
  • Discrete ganglia in head and neck (i.e. ciliary ganglia)
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29
Q

What are relative sizes of pre and post ganglion in PSNS

A
  • Long preganglionic neurons
  • Short post-ganglionic
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30
Q

What is the parasympathetic function?

A

Conserve and restore energy

“rest or repose response”

anabolic

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31
Q

Where are most of the PSNS fibers located?

A

75% of PSNS fibers are in vagus (X) nerve, passing to abdominal and thoracic areas

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32
Q

Where does Vagus nerve innervate in PSNS?

A
  • Heart
  • Lungs
  • Esophagus
  • Stomach
  • Small intestine
  • liver
  • gallbladder
  • pancreas
  • upper uterus
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33
Q

Where does cranial nerve III innervate for PSNS?

A
  • Edinger westphal nucleus: ciliary muscles of eye
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34
Q

Where does cranial nerve V innervate?

A
  • Submandibular gland
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35
Q

Where does cranial nerve VII innervate for PSNS?

A
  • Superior salivatory nucleus: lacrimal, nasal and submaxillary glands
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36
Q

Where does cranial nerve IX innervate PSNS?

A

Inferior salivatory nucleus: parotid gland

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37
Q

Where does S2-S3 innervate?

A

Distal colon, rectum, bladder, lower uterus, external genitalia

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38
Q

What is the ciliary ganglion?

A

Where preganglionic inpus from Edinger-Westphal nucleus synapse

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39
Q

What is pterygopalatine and submandibular ganglia?

A

Receive preganglionic input from superior salivatory nucleus

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40
Q

What is otic ganglion

A

Receive preganglionic input from inferior salivatory nucleus

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41
Q

PSNS is rest for organism but ______ for visceral functions such as digestion

A

excitatory

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42
Q

What is most important function of SNS?

A

Vasomotor tone (small degree happening at all times, not just in fight/flight mode)

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43
Q

Sympathetic is amplification response with ____ innervation

A

Diffuse

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44
Q

Sympathetic controls response to…

A
  • Postural changes
  • Exercise
  • Emergency massive response (fight or flight)
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45
Q

Parasympathetic Nervous system does ____ and ____ ____ resposnes

A

Discrete; narrowly targeted

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46
Q

Both parasympathetic and sympathetic nervous system exhibit baseline tone? T/F

A

True. HR- predominantly vagal predominance

Blood vessels- SNS tone

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47
Q

What receptor types and neurotransmitter in somatic efferent system?

A

Acetylcholine at nicotinic receptors

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48
Q

What is pre/post neurotransmitter and receptor for blood vessels?

A

Preganglionic neuron- Ach and nicotinic receptor

Postganglionic- Norepinephrine at andrenergic receptors

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49
Q

What are pre/post ganglionic neurotransmitters and receptor types at sympathetic system for sweat glands?

A
  • Preganglionic- ACh (nicotinic)
  • Postganglionic- ACh (muscarinic receptor)
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50
Q

What is neurotransmitter/receptor at adrenal medulla?

A
  • Preganglionic nerve synapses at adrenal medulla with ACh at a nicotinic receptor
    • Adrenal medulla produces 80% epinephrine, 20% norepinephrine released by adrenal gland
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51
Q

What is pre/post ganglionic fibers neurotransmitter at receptor for parasympathetic system?

A
  • Preganglionic ACh (Cholinergic- nicotinic receptor)
  • Post ganglionic ACh (Cholinergic- muscarinic receptor)

Always secretes Acetylcholine

52
Q

Sympathetic preganglionic fibers in general secrete what and act on what?

A

Neurotransmitter= Secrete ACh

Receptor= Cholinergic (nicotinic ntype)

53
Q

What are sympathetic postganglionic fibers neurotransmitter and receptor?

A

Neurotransmitter= Secrete Norepinephrine (EXCEPTION IS SWEAT GLANDS: they excrete ACh at muscarinic ( adrenal as well?))

Receptor: adrenergic

54
Q

What are the 3 majors anomalies to sympathetic innervation “rule”

A
  • Adrenal medulla (acts like a ganglia but it releases NE and EPI as HORMONES)
    • Norepi 20%
    • Epi 80%
  • Sweat glands
    • innervated anatomically by SNS
    • Post ganglionic nerve releases Ach onto muscarinic Ach
    • Thus “sympathetic cholingergic fibers”
  • Blood vessels smooth muscle
    • Have no direct innervation by PSNS (still has RECEPTORS for PSNS substances)
      • muscarinic Ach receptors present on blood vessels (activate NO with eventual vasodilation with circulating Ach)
55
Q

What are types of cholinergic receptors?

A
  • Nicotinic ACh receptors
    • Nm and Nn (nicotinic autonomic ganglia)
  • Muscarinic Ach
    • M1-5 (G-protein coupled)
56
Q

What are the adrenergic receptors?

A
  • Sympathetic side
  • Alpha 1,2
  • Beta (1, 2, 3)
57
Q

What is process of activation of G-protein coupled receptors? Which receptors do this?

A
  • Dopa, Beta, Alpha
  • NT binds to receptor and activates the G-protein
  • G-protein will activate or inhibit an intracellular enzyme (adenylate cyclae–> cAMP, phospholipase C) or will open or closee an ion channel
  • Uusally g-protein “cascade” will have eventual positive or negative ffect on amount of intracellular Ca= physiological effect
58
Q

What does specific effect of neurotransmitter depend on?

A
  • Type of receptor stimulated
  • Receptor density in given tissue
  • What the second messengers activate at a molecular level in the cell
59
Q

What will receptors do in response to plasma concentrations of neurotransmitters?

A

Up or down regulate

60
Q

What does Adenylate Cyclase do?

A
  • Activated cAMP= smooth muscle dilation
    • increase cAMP= vasodilation (also increased strength of cardiac contraction, increased HR)
    • Decreased cAMP= vasoconstriction
61
Q

What does PLC (phospholipase C) do?

A
  • Activates IP3 (inositol triphosphate) and DAG (diacylglycerol)
  • Results in increased PKC (Protein Kinase C) and increased free Ca
    • VASOCONSTRICTIon from Ca
62
Q

Gαq receptors IN GENERAL do what?

A
  1. PLC (phospholipase C) activated
  2. Increase IP3 (Inositol trisphosphate) and DAG
  3. PKC (protein kinase C) and increased free Ca stores

In general, causes more contraction and is EXCITATORY

63
Q

Gαi in general does what?

A

Inhibitory!

  • Inhibit adenylate cyclase
  • Decrease cAMP
  • Increase K conductance–> hyperpolarize cell
64
Q

What is general activity of Gαs receptors?

A
  • Activate adenylate cyclase
  • Increase cAMP
65
Q

What effect do M1 receptors have?

A
  • NT= ACh
  • G protein- Gαq
  • Signal- excitatory CNS. Modulatory at ganglia
  • 2nd messenger- PLC activated–> IP3 &DAG–> PKC and increased free Ca with decreased K conductance
  • Physiologic response (depends on tissue)- Increased CNS activity, modulation at ganglia
66
Q

What do M2 receptor types do?

A
  • Ach neurotransmitter
  • G-protein: Gαi
  • Signal: inhibitory cardiac
  • 2nd messenger: Inhibit adenylate cycale–> decrease cAMP–> Increase K conductance
  • Physiologic response (depends on tissue): Decreased cAMP slows HR and decreases contractility
67
Q

What do M3 receptors do?

A
  • AcH neurotransmitter
  • G protein- Gαq
  • Signal- excitatory smooth muscle and glands
  • 2nd messengers: PLC activated–> IP3 & DAG–> PKC and increased free Ca2+
  • Physiologic response: Smooth muscle contraction
68
Q

What do Nn receptors do? (nicotinic n type)

A
  • AcH neurotransmitter
  • Ligand gated ion channel
  • Signal: excitatory ganglia CNS
  • 2nd messenger: Increase Na and K permeability
  • Physiologic resposne: depolarization
69
Q

What do Nm receptors do?

A
  • Neurotransmitter- ACH
  • Ligand gated ion channel
  • Signal: excitatory NMJ
  • 2nd messenger: Increased Na and K permeability
  • Physiologic response: depolarization
70
Q

What do α1 receptors do?

A
  • Neurotransmitter: NE/EPI
  • G-protein: Gαq
  • Signal: excitatory blood vessels
  • 2nd messenger: PLC activated–> IP3 &DAG–> PKC and increased free Ca
  • Physiologic response: smooth muscle- vasoconstriction
71
Q

What do α2 receptors do?

A
  • Neurotransmitter: NE/EPI
  • Gprotein: Gαi
  • Signal: inhibitory blood vessels. Pre-synaptic CNS post-synpatic
  • 2nd messenger: Inhibit adenylate cyclase–> decrease cAMP–> Increase K conductance
  • Physiologic response:
    • Decreasesd cAMP increases smoother muscle contraction.
    • Increase K results in hyperpolarization
      • Can happen presynaptically and cause decrease in neurotransmitter release
      • Post synaptically it can decrease cAMP and cause smooth muscle contraction
    • Depends on where receptor is (pre/post synapse)!!!
72
Q

What do β1, 2, 3 do?

A
  • Neurotransmitter: NE/EPI
  • G-protein: Gαs
  • Signal: excitatory or inhibitory depends on cAMP actions!
  • 2nd messenger: Activate adenylate cyclase–> increase cAMP
  • Physiologic response:
    • Increased cAMP relaxes smoothe muscle
    • stimulates cardiac contractility
    • increases HR
73
Q

Whichmuscarinic receptors increase IP3?

A

M1, M3, M5

74
Q

Which muscarinic receptors inhibit adenylyl cyclase and reduce cAMP?

75
Q

Where are M1 receptors located?

A

CNS, stomach

76
Q

Where are M2 receptors located?

A

Widely expressed

  • Cardiac (decrease inotropy/chronotropy) modulating HR in SA node/AV node
  • Ganglia smooth muscle bladder, Gi, uterus- contract
77
Q

Where is M3 located?

A
  • Smooth muscle
  • Glandular tissues
  • Work with M2
78
Q

Where are M4 receptors?

A

CNS (ganglia)

79
Q

Where are M5 receptors?

A
  • Cerebral blood vessels
  • pupil
  • esophagus
  • parotid gland
80
Q

Where are Nm receptors?

A

Skeletal muscle at NMJ

81
Q

Where are Nn receptors?

A

Autonomic ganglia, adrenal medulla, CNS

82
Q

Adrenergic=

A

sympathetic

83
Q

Cholinergic=

A

parasympathetic (however not always….just in general)

84
Q

What is acetylcholine?

A
  • Synthesis
    • choline (active transport brings into cytoplasm)
    • acetyl coenzyme A (formed by mitochondria)
    • form acetylcholine under influence of enzyme choline acetyltransferase
  • Storage
    • stored in synaptic vesiclaes and released in response to action potential
85
Q

What is the metabolism of acetylcholine?

A
  • Brief effect <1ms, RAPID hydrolysis by acetylcholinesterase to choline and acetate
  • Choline transported back into nerve endings used for synthesis of new acetylcholine
86
Q

What is norepinephrine’s neurotransmitter selectivity?

A

α1= α2; β1>>>>>>>>>> β2 <- NO CLINICAL RESPONSE FOR NE

87
Q

What is epinephrine’s receptor selectivity?

A
  • α1=α2
  • β1=β2
88
Q

What receptor selectivity does dopamine exhibit?

A
  • D1=D2>> β>>α <- some activity, not all to same degree
89
Q

Why would it make sense that B2 receptors are present in many tissues but not innervated?

A

NE is released by post-ganglionic nerves in SNS BUT NE does not bind to B2 receptors. So therefore we would never have any response and rely instead on epi

90
Q

What is pathway for formation of adrenaline?

91
Q

How is norepinephrine formed?

A
  • In cytoplasm dopamine formed
  • Dopamine enters synaptic vesicle
  • in synaptic vesicle converted to norepinephrine
92
Q

How is norepinephrine stored and release?

A
  • Norepi stored in vesicle until action potential
  • With action potential, the norepi is released from postganglionic SNS nerve endings in ECF via exocytosis
93
Q

What is the termination of action of norepinephrine?

A
  • Reuptake back into postganglionic sympathetic nerve endings
    • # 1- 80% released NE can be resused
  • Dilution by diffusion from receptors
  • Metabolism by enzymes monoamine oxidase (MAO- cytoplasm) and catechol-o-methyltransferase (COMT- liver)
94
Q

How is epinephrine formed?

A
  • Synthesized in medulla of adrenal gland (chromaffin cells) in same enzymatic patheway that converts the amino acid tyrosin into NE and dopamine (epi is final step)
95
Q

How is epinephrine stored and released?

A
  • Released after stimulation of adrenal medulla by pre-ganglionic sympathetic neurons by Ach
96
Q

How is epinephrine’s action terminated?

A

COMT and MAO

97
Q

What is effect of α 2 presynaptic versus α2 postsynaptic?

A
  • Presynaptic will cause hyperpolarization<— feedback mechanism for neuron
  • Postsynaptic will cause decreased cAMP and vasoconstriction
98
Q

What is venillylmandelic acid (VMA)?

A

Metabolite released in urine from breakdown of NE and Epi. Can diagnose pheochromocytoma

99
Q

α1 at vascular smooth muscle (i.e. blood vessels, sphincters, bronchi) causes…

A

contraction

100
Q

α1 at iris (radial muscle) causes?

A

Contraction (DILATES pupils= mydriasis)

101
Q

α1 at pilomotor smooth muscle?

A

Erects hair

102
Q

α1 at prostate and uterus?

A

Contraction

103
Q

α1 in heart causes?

A

Increase force of contraction

B1 more important though

104
Q

α1 at pancreas?

A

Decreased insulin secretion (oppostie B2)

105
Q

α2 at platelets?

A

Aggregation

106
Q

α2 at adrenergic and cholinergic nerve terminals *presynpatic

A

Inhibits transmitter release

Decrease BP and HR

107
Q

α2 CNS actions?

A

Sedation and analgesia

via decreased SNS outflow from brainstem

108
Q

α2 at vascular smooth muscle?

A
  • Contraction (post-synaptic)
  • Dilation (presynaptic, CNS)
109
Q

α2 at GI tract?

A

Relaxation (presynaptic)

110
Q

B1 receptors at heart?

A

Increased force

Increased rate of contraction (SA and AV node)

111
Q

B1 receptors at kidneys?

A

Stimulation of renin release, increase angiotensin II, increase aldosterone, increase BP

112
Q

B2 receptors at respiratory, uterine, vascular, GI, detrusor of bladder (visceral smooth muscle)

A

Promotes smooth muscle relaxation

113
Q

B2 receptor mast cells

A

Decrease histamine release

why we give epi for anaphylaxis!!

114
Q

B2 skeletal muscle effect?

A
  • Potassium uptake
  • dilation vascular beds
  • tremor
  • increase speed contraction
    *
115
Q

B2 liver effect?

A

Glycogenolysis

Gluconeogenesis

116
Q

B2 effect at pancreas?

A

Increase insulin secretion (in order to get glucose into cell)

117
Q

B2 effect at adrenergic nerve terminals

A

increase release NE

118
Q

B1/3 effect on fat cells?

A

Activate lipolysis; themogenesis

119
Q

D1 effect at smooth muscle?

A

Post synaptic location: Dilates renal, mesenteric, coronary, cerebral blood vessels

120
Q

D2 effect at nerve endings?

A

Pre-synaptic- modulates transmitter rlease; nausea, vomiting

121
Q

Adrenal medulla is innervated by _______ fibers that bypass the paravertebral ganglia

A

preganglionic

122
Q

The fibers to adrenal medulla go directly from spinal cord to adrenal medulla (T/F)

123
Q

The cells of the adrenal medulla are anaglogous to _____

A

post-ganglionic neurons

124
Q

SNS stimulation of adrenal gland causes release of what catecholamines hormones?

A

Epinephrine 80%

Norepinephrine 20%

125
Q

Process of release of epinephrine by adrenal medulla?

A
  • Occurs after acetylcholine is released by preganglonic cholinergic fibers
  • Ach increases the permeability of Ca by acting on plasma membrane receptors of adrenal medulla cells
  • Calcium ions result in exocytosis of the hormones from adrenal medulla into systemic circulation
  • Results= similar to direct stimulation by SNS, however prolonged response 10-30 seconds (COMT)
126
Q

What is sympathetic activation process?

127
Q

Continuation of sympathetic activation?

Physio Test 2 (10 decks)

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