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<3 > CPR Autonomics > Flashcards

CPR Autonomics Flashcards

1
Q

What is the pathway for Sympathetic stimulation (generally)?

A 
Pre 
—> ACh
—> Nic. Chol. R. On post ganglionic
—> NE 
—> Alpha/beta Adrenergic Rs. On organs

(Pre - short, post - long)

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2
Q

What is the pathway for Parasympathetic stimulation (generally)?

A 
Pre 
—> ach 
—> Nic. Chol. Rs. On post ganglionic 
—> ACh
—> Musc. Chol. Rs. On organs

(Pre - long, post - short)

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3
Q

How are pre-ganglionic neurons of the Sympathetic NS activated?

A

Via hypothalamic nuclei receiving input from brainstem regulatory regions

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4
Q

How do pre=ganglionic fibers of the Sympathetic system leave the CNS?

A

From thoracic and lumbar regions of SC

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5
Q

Where do we find the synapse b/w most preganglionic axons and Postganglionic cells of the sympathetic system?

A

In sympathetic chain ganglia relaeasing ACh

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6
Q

Are all alpha and beta adrenergic receptors metabotropic?

A

Yes

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7
Q

What is the activation of ALpha 1 receptors assoc. w/?

A

Action on SM is almost always assoc. w/

Contraction of SM

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8
Q

What is the activation of alpha 2 rs. On vascular Sm assoc. w/?

A

Relaxation/dilation

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9
Q

Where are beta 1 receptors found?

A

On cardiac myocytes

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10
Q

Where are beta 2 receptors found?

What will they cause?

A

On smooth muscle

Cause relaxation

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11
Q

Where do pre-ganglionic axons that did not synapse in symapthetic chain go to?

A

To adrenal medulla to synapse on chromaffin cells of adrenal medulla

-ach —> Nic. CHol. Rs. —> release of epi

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12
Q

Where do preganglionic fibers of the Parasympathetic NS leave the CNS at ?

A

At cranial and sacral levels

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13
Q

Where is parasympathetic ganglia located?

A

On or Near target organs

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14
Q

What is M1, 3, and 5 receptors associated w/?

A

W/ IP3/DAG production and release of intracellular calcium stores

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15
Q

What is M2 and M4 associated w/?

A

Assoc. w/ Gi proteins and lead to

REDUCTION in cAMP

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16
Q

What is the PNS innervation of the
SA node?

Action and effect?

A

Cn 10 —> Musc. Rs. On SA

Decreases rate of depolarization
—> slows HR

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17
Q

What is the SNS innervation of the
SA node?

Action and effect?

A

From T1-T5 —> Beta 1 adrenergic

Increases rate of depolarization
—> increases HR

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18
Q

What is the PNS innervation to

AV node & ventricular conducting pathways (bundle of his, purkinje fibers)?

A

CN 10 —> Musc. Chol. Rs.

-decreases depolarization rate during phase 0 of slow AP
—> decreases conduction velocity thru AV node and ventricles

(could decrease ventricular rate if AV node is acting as heart pacemaker)

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19
Q

What is the SNS innervation to

AV node & ventricular conducting pathways (bundle of his, purkinje fibers)?

A

From T1-T5 —> Beta-1 Rs.

-increases rate of depolarization during phase 0
—> increases conduction velocity thru AV node

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20
Q

What is the PNS innervation of the Atrial and Ventricular myocytes?

A

Atrial myocytes: CN 10 —> Musc. Rs.
(Ventriuclar myocytes- debated)

-decreases Ca entry into myocyte
—> Decreases atrial contractility

(Could decrease ventricular contractility)

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21
Q

What is the SNS innervation of the Atrial and Ventricular myocytes?

A

From T1-T5 —> Beta 1 (beta-2 maybe)

Increases Ca conductance
—> increases myocyte contractility
Cardiac muscle pumps stronger

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22
Q

what is the major control over innervation of cerebral vasculature?

What ANS innervation will it have

A

Major control = local

-nueonral activity produces metabolites that vasodilates local blood vessels in proportion to metabolic need

ONLY HAS SNS !!!

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23
Q

What is the SNS innervation of the Cerebral Vasculature ?

Action and effect?

A

R.: alpha 1 rs

Contracts vascular smooth muscle
—> vasoconstriction of cerebral vasculature

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24
Q

When will SNS innervation to Cerebral Vasculature occur?

A

Does not occur under normal circumstances

  • will only happen when SYSTEMIC BP BECOMES TOO HIGH and might damage the cerebral capillaries
  • constructs small starters to decrease blood flow thru caps and protect them
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25
Q

What is the major control of blood flow to heart thru Coronary As.?

A

Based on local factors associated w/ metabolic need, rather than ANS

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26
Q

What is the PNS innervation of Coronary Blood vessels?

Action and effects?

A

CN 10 —> Musc. Chol. R.s

SM relaxation —> vasodilates and increases coronary blood flow

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27
Q

What is the overal effect of Vagal stimulation on the heart?

A

Decrease in metabolic activity

-thus, an increase in coronary blood flow may be overridden by decreased production of metabolites and constriction (local control factors)

28
Q

What is the SNS innervation of the Coronary As.?

Action and effect?

A

T1-T5 —> alpha 1

SM contraction —> vasoconstriction and decrease in coronary blood flow

(Short lived though bc this will increase metabolic need and local factors will lead to a vasodilation that overcomes the sympathetic effect)

29
Q

What is the SNS innervation of cutaneous vasculature?

Action and effect?

A

From multiple sources —> alpha-1

Contraction of vascular SM —> Vasoconstriction

30
Q

How are sweat glands innervated by sympathetics?

Action and effect?

A

Sympathetic Muscarinic

relaxation of vascular SM
—> vasodilation and increase in primary sweat production

31
Q

What is the SNS innervation of the Vasculature supplying S.M.?

Actions and effects?

A

Sympathetic - major influence

mult. Sources—> alpha & beta 2

Alpha1 = contracts vasc. Sm —> vasoconstriction of arteries supplying a m.

Beta 2 = relaxes vasc. Sm —> vasodilation of blood supply to a M.

32
Q

What is the PNS innervation of Vasculature supplying Skel. M.?

A

—> Musc. Chol. Rs.

Relaxes vasc. Sm —> vasodilates vasc. Supplying Sk.M.

33
Q

How does PNS innervation affect NO?

A

May increase nitric oxide release from vascular endothelium

—> produces vasodilation

34
Q

What is the ANS innervation to Splanchnic vessels?

A

Sympathetic only

35
Q

What is the SNS innervation of Splanchnic vessels?

Action and effect?

A

T5-L2 —> celiac/superior Mesenteric/inferior Mesenteric ganglion —> alpha-1

Contracts Vasc. SM —> Vasoconstriciton of splanchnic blood cells

36
Q

How do you achieve vasodilation of splanchnic blood cells?

A

Occurs when sympathetic activity is decreased

And local controls are allowed to exert their influence
(I.e. presence of food in GI —> activates intrinsic nerve plexus of the intestine)

37
Q

What is the SNS of veins?

Action and effect?

A

Symp = primary source
—> ALpha 1, alpha 2 and beta 2

Alpha 1: contracts venous SM —> increases return of blood to heart

Alpha 2 and Beta 2: relaxes venous SM —> dilation of veins, slows return of blood to heart

38
Q

What will the ANS innervate re: lungs?

A

Innervates SM and mucus glands of the airways

39
Q

How is blood flow tot he lungs divided?

A

Into 2 parts

  1. Bronchial circulation
  2. Alveolar (pulmonary) circulation
40
Q

What is bronchial circulation?

A

Provides o2, removes metabolites to airways that are too thick to get oxygen from air in lungs

Arteries = high oxygen, low CO2

41
Q

What is Alveolar Circulation?

A

Blood is being sent to lungs for gas exchange

42
Q

What controls blood flow to alveoli?

A

Dictated primarily by local conditions in the alveoli, specifically CO2 and O2 levels

43
Q

What is the PNS innervation of Pulmonary Vasculature?

Action and effect?

A

Nucleus ambiguus —> CN 10 —> Muscarinic chol.

(W/ highest amt. of innervation at extra-pulmonary as. And lowest closest to alveoli)

Directly: produces No and releases it from endothelial cells
Indirectly: via No, relaxes vasc. SM
—> vasodilation

44
Q

What is the caveat for vasodilation pulmonary vasculature?

A

SM must already be contracted

Implies that this is not necessarily important under normal resting conditions

45
Q

What is the SNS innervation to the Pulmonary vasculature?

A

First 5 thoracic ganglia —> alpha 1 and beta 1 and 2

(Will not innervate acinar vessels)

Alpha 1: contracts vasc. SM —> vasoconstriction large pulmonary vessels
Beta 1 and 2 —> vasodilation of large pulm. Vessels

46
Q

Why is SNS innervation of Pulmonary vasculature important?

A

Helps maintain Basal Tone in PUlm. A.

Will be activated by mechanoreceptors that detect distension of pulmonary a. Or large airways (or by exposure to cold air or hypoxia-high altitude)

47
Q

What is the PNS innervation of Upper airways (nasal mucosa) ?

Action and effect?

A

Trigeminal N. —> sphenopalatine ganglion —> Musc. Chol.

Vasodilation and increased secretion —> Increased mucus secretion

48
Q

What is the SNS innervation for Upper Airways(nasal mucosa)?

A

Superior cervical ganglia via CN 7 —> Alpha-1

Has no direct influence on glands

Contracts SM —> vasoconstricts and reduces mucus secretion

49
Q

What is the PNS innervatio of the Lower airways (trachea and large airways) ?

Action and effect?

A

Cn 10 —> Musc. Chol.

Contracts bronchial SM and increases synthesis of mucus
—> bronchoconstriction and increased mucus secretion

50
Q

What is the SNS innervation of Lower Airways (trachea and large airways)?

A

T1-T5 —> Beta 2

Relaxes bronchial SM
—> Bronchodilator

51
Q

What is kidney vasculature primarily dictated by?

A

By ANS

52
Q

What is the major function of the kidney?

A

Remove metabolic waste products from the blood

53
Q

How much blood does the kidney receive per minute?

A

~2% of blodo pumped by heart / min.

54
Q

What is the nephron?

A

Function unit of kidney

55
Q

What are the parts of a Nephron?

A
  1. Bowman’s capsule/space
  2. Proximal convoluted tubule
  3. Loop of Henle
  4. Distal convoluted tubule and collecting duct
56
Q

What is the purpose of Bowman’s capsule/space?

A

Initial filtration to provide raw material to make urine out of

57
Q

What is the role of the Proximal convoluted tubule?

A

Move everything that was filtered into Bowman’s space back to blood via process of reabsorption
&
Move things that need to go into urine via process of secretion

58
Q

What is the purpose of the Loop of Henle?

A

Prepares to concentrate urine

Concentrates interstitium and creates gradient that can be used to reabsorb water

59
Q

What is the role of the Distal convoluted tubule and collecting duct?

A

Uses hormones to control water and sodium

Fine tunes concentrate

60
Q

What is the role of the Renal artery?

A

Supplies blood to the kidney

61
Q

What vascular components of the kidney are heavily innervated by the SNS?

A

Afferent and efferent artierole

62
Q

What is the role of the afferent arteriole?

A

Controls blood flow INTO the glomerular capillaries

63
Q

What is the role of the Efferent arterioles?

A

Controls blood flow OUT of glomerular capillaries

64
Q

What else does the SNS innervate in the Kidneys? Why?

A

Will innervate the Juxtaglomerular apparatus to secrete renin

-when BV/BP decreases

65
Q

What is the SNS innervation on REnal vasculature?

A

Via alpha-adrenergic fibers

Contracts Vasc. SM —> vasoconstricts Renal A. , afferent arteirole, and efferent arteriole

Results in decreased blood flow to kidney, decreased urine production, and preserved BP to rest of the body

66
Q

What is the SNS innervation of the Juxtaglomerular Apparatus?

A

—> granule cells of afferent arterioles —> beta -1 Rs.

-increases release of Renin

67
Q

What will increased release of Renin lead to?

A

Leads to

-increased production of angiotensin
—> increases release of aldosterone
—> increased reabsorption of Na and release of ADH
—> ADH will reabsorb water
—> increased production of angiotensin II

==increased blood volume

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