Ch. 13 & 14 from slides

Question 1

divisions of the nervous system

Answer 1

1. CNS - brain and spinal cord
2. PNS
   - somatic system (voluntary) - controls skeletal muscles
   - autonomic nervous system - slight control/minimal or none - regulates glands, blood vessels, internal organs

Question 2

autonomic nervous system divisions

Answer 2

1. parasympathetic - rest and digest - conserves energy, maintains quiet state
2. sympathetic - fight or flight - mobilizes body for action, energy output

Question 3

Autonomic Nervous System Functions

Answer 3

1. Regulate the heart
2. Regulate the secretory glands (salivary, gastric, sweat, and bronchial)
3. Regulate the smooth muscles (bronchi, blood vessels, urogenital system, and gastrointestinal tract)

Question 4

sympathetic nervous system - regulating functions

Answer 4

“fight-or-flight” 
Increasing heart rate and blood pressure
Shunting blood away from the skin and viscera
Dilating the bronchi
Dilating the pupils
Mobilizing stored energy

Question 5

Parasympathetic Nervous System- regulating functions

Answer 5

“Rest and Digest”
Slowing the heart rate
Increasing the gastric secretions
Emptying the bladder
Emptying the bowel
Focusing the eye for near vision
Constricting the pupil
Contracting the bronchial smooth muscle

Question 6

SNS and PNS Control

Answer 6

-Dual innervation – opposing action (HR)
-Dual innervation –complementary action (erection and ejaculation)
-Single innervation: Blood vessels (only acted upon by the SNS)
-PNS and CNS balance each other – one of the other is primary at any given time, you don’t have both being on at the same time, if resting PNS, if fight SNS
Exception w/ reproduction – ejeculation/erection need both

Question 7

Autonomic Nervous System – sites of drug actions

Answer 7

Two general sites of action
Synapses: Preganglionic/postganglionic
Junction: Postganglionic neurons/effector organs

Question 8

Acetylcholine

Answer 8

Employed at most junctions of the peripheral nervous system

Question 9

Norepinephrine

Answer 9

Released by most postganglionic neurons

Question 10

Epinephrine

Answer 10

Released by the adrenal medulla

Question 11

CHOLENERGIC RECEPTORS RESPOND TO

Answer 11

ACETYLCHOLENE

Question 12

ADRENERGIC RESPOND TO

Answer 12

EPINEPHRINE AND NOREPINEPHRINE

Question 13

Subtypes of cholinergic receptors

Answer 13

NicotinicN (neuronal)
NicotinicM (muscle)
Muscarinic

Question 14

Subtypes of adrenergic receptors

Answer 14

Alpha1
Alpha2
Beta1
Beta2
Dopamine (responds only to dopamine)

Question 15

Functions of cholinergic receptor subtypes

Answer 15

Activation of nicotinicN (neuronal) receptors
Activation of nicotinicM (muscle) receptors
Activation of muscarinic receptors

Question 16

Cholinergic Receptor Subtypes - Muscarinic (PNS response)

Answer 16

Eye – Accommodation (near vision), miosis - construction
Heart – ↓ rate
Lungs – bronchoconstriction
Bladder – contraction, relaxation of sphincter (urination)
GI – ↑ salivation, secretions, motility (defecation)

Question 17

Adrenergic Receptor Subtypes - Alpha 1

Answer 17

Eye – Mydriasis (pupils large and dilated)
Arterioles – constriction (skin, viscera, mucus membranes) - basil constriction
Veins – constriction - venus constriction
Bladder – relaxation, sphincter constriction

Question 18

Adrenergic Receptor Subtypes - Alpha 2

Answer 18

Minimal pharm implication - affects BP via brain

Question 19

Adrenergic Receptor Subtypes - Beta 1

Answer 19

Heart - sympaathitic
increased Heart rate
increased Force of contraction
increased Atrioventricular (AV) node conductivity

Kidney
increased Renin release - causes water reabsorption to improve BP

Question 20

Adrenergic Receptor Subtypes - Beta 2

Answer 20

Sympathetic - basil dilation
Bronchi - dilation
Uterus - relaxation 
Arterioles - vasodilation
Heart
Lung
Skeletal muscle
Liver – glycogenolysis – need glucose
Muscle –increased contractility – need muscles to be ready

Question 21

Adrenergic Receptor Subtypes - Dopamine

Answer 21

Dilates renal blood vessels

Improved renal perfusion

Question 22

Receptor Specificity of the Adrenergic Neurotransmitters - epinephrine

Answer 22

all alpha and beta receptors

Question 23

Receptor Specificity of the Adrenergic Neurotransmitters - Norepinephrine

Answer 23

alpha1, alpha2, and beta1

Question 24

Receptor Specificity of the Adrenergic Neurotransmitters - Dopamine

Answer 24

alpha1, beta1, and dopamine receptors – at low doses improves renal profusion

Question 25

The nurse administers a medication to a patient that stimulates the function of the parasympathetic nervous system. The nurse should assess the patient for which intended effect?

Answer 25

Reduced esophageal motility – no
Improved bladder emptying - yes
Dilation of the pupils – no will constrict
Decreased gastric secretions – no increased gastric secretions

Question 26

The nurse administers a medication to a patient that stimulates the sympathetic nervous system. The nurse should assess the patient for which intended effect?

Answer 26

Increased heart rate – yes
Blood pressure reduction – no – BP will increase
Bronchial constriction – no – dilation
Decreased blood glucose level – increase by liver

Question 27

A nurse administers a medication that activates dopamine receptors. The nurse should assess the patient for which intended effect?

Answer 27

Rationale: Activation of dopamine receptors dilates blood vessels in the kidney, thereby resulting in improved renal perfusion.
Dopamine stimulates: alpha 1, beta 1, and dopamine receptors
Piloerection – erection of hair of the skin

Question 28

A patient is prescribed a drug that causes the selective stimulation of beta2 receptors. The nurse should assess the patient for what?

Answer 28

Hypoglycemia - no
Improved breathing – dilates lungs
Tachycardia – if does is normal – no, high dose then yes because looses selectivity
Decreased pain