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Anaesthetic FRCA Primary - eLFH Physiology > eLFH - Nervous System Physiology > Flashcards

eLFH - Nervous System Physiology Flashcards

1
Q

Nernst equation

A
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2
Q

Nernst equation use

A

Calculate electrical potential across a cell membrane

Removing constants from equation shows that resting membrane potential depends on ration of intracellular to extracellular ions

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3
Q

Resting membrane potential charge

A

Always negative
Refers to intracellular charge

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4
Q

How is resting membrane potential maintained

A

Sodium/Potassium ATPase - 3 Na+ out and 2 K+ in

Membrane freely permeable to K+ so K+ moves out of cell

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5
Q

Synaptic transmission at the motor endplate / neuromuscular junction

A

1) Nerve impulse propagated along pre-synaptic membrane

2) Calcium influx through voltage gated Ca2+ channels

3) Migration of ACh vesicles to pre-synaptic membrane via activation of SNARE proteins by Ca2+

4) Release of ACh into synaptic cleft + binds receptors on post synaptic membrane

5) ACh also stimulates receptors on pre-synaptic membrane - mobilises more ACh

6) Post-synaptic receptor activation allows Na+ ions into post-synaptic cell via its sodium channel - alters membrane potential

7) ACh unbinds from receptors - broken down by Acetylcholinesterase

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6
Q

SNARE proteins description

A

Proteins on vesicular membranes and on the pre-synaptic membranes

Control the docking and exocytosis of ACh vesicles

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7
Q

SNARE protein examples on vesicle membranes

A

Synaptobrevin

Synaptotagmin

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8
Q

SNARE protein examples on presynaptic membrane

A

Syntaxin

SNAP 25

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9
Q

Substance which inactivates SNARE proteins

A

Botulinum toxin

Therefore prevents ACh release and causes flaccid paralysis

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10
Q

How does Ca2+ also mobilise vesicles in reserve pool within presynaptic cell

A

Ca2+ triggers phosphorylation of Synapsin molecules holding vesicles in reserve pool

This releases the vesicles into the available pool

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11
Q

How is action potential at neuromuscular junction propagated to rest of the muscle fibre

A

Action potential spreads down t-tubular system and results in Excitation-Contraction coupling

See flashcard in Cardiovascular physiology

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12
Q

Distance of synaptic cleft

A

~ 20 nm

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13
Q

Number of vesicles containing ACh released following action potential

A

~ 125 vesicles released into synaptic cleft

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14
Q

Number of ACh molecules within each vesicle released by pre-synaptic cell

A

10,000 - 12,000 molecules of ACh

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15
Q

Acetylcholine chemical structure

A
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16
Q

Acetylcholine synthesis, release and breakdown cycle

A

CoA forms Acetyl-CoA (acetyl-coenzyme A)

Acetyl group binds with Choline which is reabsorbed after ACh breakdown - forms ACh and CoA

ACh released

ACh broken down by acetylcholinesterase to form Choline + Acetate

Choline reabsorbed into pre-synaptic cell to re-form ACh with Acetyl-CoA

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17
Q

Adult nicotinic ACh receptor structure and binding sites

A

2 alpha subunits
Beta subunit
Delta subunit
Epsilon subunit

ACh binding sites on alpha subunits

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18
Q

Foetal nicotinic ACh receptor structure

A

Same as adult except Epsilon subunit replaced with Gamma subunit

I.e.
2 alpha subunits
Beta subunit
Delta subunit
Gamma subunit

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19
Q

Breakdown of ACh by acetylcholinesterase process

A

Anionic binding site and Esteric binding site

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20
Q

Where is acetylcholinesterase in synaptic cleft bound

A

Bound to Basal lamina of connective tissue within cleft

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21
Q

Action potential in nerve fibre propagation

A

By voltage gated ion flux down concentration gradients

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22
Q

Action potential in nerve fibre phases

A

Phase 0 - Resting state

Phase 1 - Depolarising

Phase 2 - Repolarising

Phase 3 - Refractory period

Back to phase 0

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23
Q

Phase 0 of neuronal action potential

A

Resting membrane potential maintained by Na/K ATPase

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24
Q

Phase 1 of neuronal action potential

A

Depolarisation
Sodium influx into cell once threshold potential reached

Rise in membrane potential

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25
Q

Phase 2 of neuronal action potential

A

Repolarisation
Potassium moves out of cell

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26
Q

Phase 3 of neuronal action potential

A

Refractory period
Undershoots membrane potential
Sodium gates cannot open - time required to re-establish Na/K gradients

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27
Q

Resting membrane potential value in nerve cells

A
  • 70 mV
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28
Q

Peak positive membrane potential reached during action potential

A

+ 35 mV

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29
Q

Nerve fibre classification overview

A

Usually classify according to fibre type

Also a I - IV classification of sensory fibres but don’t worry about those

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30
Q

Nerve fibre types

A

A alpha
A beta
A gamma
A delta
B
C dorsal root
C sympathetic

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31
Q

A alpha nerve fibres - Modality served

A

Proprioception
Motor

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32
Q

A alpha nerve fibres - Diameter

A

12 - 20 micrometres for Motor and type Ia proprioception A alpha fibres

12 - 30 micrometres for type Ib proprioception A alpha fibres

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33
Q

A alpha nerve fibres - Conduction speed

A

70 - 120 m/s

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34
Q

A alpha nerve fibres - Myelination

A

Yes

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35
Q

A beta nerve fibres - Modality served

A

Touch
Pressure
Proprioception

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36
Q

A beta nerve fibre - Diameter

A

5 - 12 micrometres

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37
Q

A beta nerve fibre - Conduction speed

A

30 - 70 m/s

38
Q

A beta nerve fibre - Myelination

A

Yes

39
Q

A gamma nerve fibre - Modality served

A

Motor (muscle spindle)

40
Q

A gamma nerve fibre - Diameter

A

3 - 6 micrometres

41
Q

A gamma nerve fibre - Conduction speed

A

15 - 30 m/s

42
Q

A gamma nerve fibre - Myelination

A

Yes

43
Q

A delta nerve fibre - Modality served

A

Pain
Temperature
Touch

44
Q

A delta nerve fibre - Diameter

A

2 - 5 micrometres

45
Q

A delta nerve fibre - Conduction speed

A

12 - 30 m/s

46
Q

A delta nerve fibre - Myelination

A

Yes

47
Q

B nerve fibre - Modality served

A

Preganglionic autonomic fibres

48
Q

B nerve fibres - Diameter

A

< 3 micrometres

49
Q

B nerve fibres - Conduction speed

A

3 - 14 m/s

50
Q

B nerve fibres - Myelination

A

Some

51
Q

C dorsal root nerve fibres - Modality served

A

Pain
Temperature
Touch

52
Q

C dorsal root nerve fibres - Diameter

A

0.4 - 1.2 micrometres

53
Q

C dorsal root nerve fibres - Conduction speed

A

0.5 - 2 m/s

54
Q

C dorsal root nerve fibres - Myelination

A

No

55
Q

C sympathetic nerve fibres - Modality served

A

Postganglionic autonomic fibres

56
Q

C sympathetic nerve fibres - Diameter

A

0.3 - 13 micrometres

57
Q

C sympathetic nerve fibres - Conduction speed

A

0.7 - 2.3 m/s

58
Q

C sympathetic nerve fibres - Myelination

A

No

59
Q

Pain pathway - sensation transmission

A

Peripheral stimulation of nerve ending by painful stimulus

Pre-synaptic cell bodies located in ipsilateral dorsal root ganglion in spinal cord

Impulses transmitted via secondary neurones in contralateral spinothalamic tract to thalamus

Impulses transmitted from thalamus to somatosensory cortex

Some descending inhibitory pathways originating in hypothalamus and periaqueductal grey matter

60
Q

Spinal cord tracts and which are ascending sensory vs descending motor

A
61
Q

Ipsilateral spinal cord tracts

A

Dorsal columns - cuneate and gracile fasciculus

62
Q

Contralateral spinal cord tracts

A

Lateral + Anterior spinothalamic tracts
Spinocerebellar tracts

63
Q

Modalities of dorsal columns

A

Touch
Vibration
Proprioception

64
Q

Modalities of spinocerebellar tracts

A

Proprioception

65
Q

Modalities of lateral spinothalamic tract

A

Pain
Temperature

66
Q

Modalities of anterior spinothalamic tract

A

Light touch
Pressure

67
Q

Role of lateral corticospinal tract

A

Contralateral motor innervation

68
Q

Role of anterior corticospinal tract

A

Ipsilateral motor innervation
Predominantly to trunk

69
Q

Role of extrapyramidal tracts

A

From brainstem nuclei to lower neurones
Primarily for posture + muscle tone

70
Q

Spinal shock

A

Flaccid paralysis with loss of limb reflexes
Occurs immediately after cord transection

71
Q

When does hyper-reflexia occur post spinal cord injury

A

2 - 6 weeks after injury

72
Q

Brown-Sequard syndrome effects

A

Ipsilateral:
- Paralysis
- Loss of proprioception
- Loss of vibration

Contralateral:
- Loss of pain
- Loss of temperature

73
Q

Monosynaptic reflex arc phases

A

Stimulation of receptor (muscle spindle) when stretched

Signal carried by type Ia afferent fibres

Neuron enters dorsal root of spinal cord

Ia neuron synapses directly with A alpha motor neurons

Signal to neuromuscular junction and muscle activation

74
Q

Is knee reflex monosynaptic or polysynaptic reflex

A

Technically polysynaptic as Ia fibres also synapse with inhibitory interneurons to cause relaxation of hamstring muscles as well as contraction of quadriceps

75
Q

Types of muscle fibre

A

Extrafusal - normal muscle

Intrafusal - contain muscle spindle

76
Q

Innervation of extrafusal muscle fibres

A

A alpha motor fibres

77
Q

Innervation of muscle spindles

A

A gamma fibres

78
Q

Function of Golgi tendon organs

A

Protect the muscle
Produce inhibitory impulse following overstretch of the muscle

79
Q

Location of Golgi tendon organs and their innervation

A

In tendons

Type Ib fibres

80
Q

Sympathetic nervous system outflow

A

T1 to L2
Synapses in sympathetic chain
Adrenal medulla is supplied by pre-ganglionic fibres

81
Q

Parasympathetic nervous system outflow

A

Cranial nerves 2, 7, 9, 10
Sacral nerves S2 to S4

75% outflow is via Vagus nerve

82
Q

Location of parasympathetic ganglia

A

In the effector organs themselves

Therefore all parasympathetic nerves are pre-ganglionic

83
Q

Role of vagus nerve and parasympathetic supply to respiratory system

A

Bronchoconstriction

84
Q

Role of vagus nerve and parasympathetic supply to cardiovascular system

A

Bradycardia
Vasodilation

85
Q

Role of vagus nerve and parasympathetic supply to GI system

A

Stimulates stomach and intestine motility
Stimulates gastric and pancreatic secretion

86
Q

Autonomic nerve fibres that use Acetylcholine as neurotransmitter

A

All pre-ganglionic fibres - therefore:
- All parasympathetic fibres use ACh as neurotransmitter
- Sympathetic innervation to adrenal glands use ACh

Also post-ganglionic sympathetic innervation of sweat glands and piloerector muscles use ACh (exception to the rest of post-ganglionic sympathetic fibres)

87
Q

Autonomic nerve fibres that use Noradrenaline as neurotransmitter

A

Post-ganglionic (therefore sympathetic) fibres

EXCEPT postganglionic sympathetic innervation of sweat glands, piloerector muscles and renal vessels

88
Q

Autonomic nerve fibres that use Dopamine as neurotransmitter

A

Post-ganglionic sympathetic innervation of renal vessels

89
Q

Glands which receive only Parasympathetic fibre innervation (not under dual control)

A

Lacrimal glands

90
Q

Glands which receive only Sympathetic fibre innervation (not under dual control)

A

Piloerector muscles
Adipose tissue
Juxtaglomerular apparatus

Anaesthetic FRCA Primary - eLFH Physiology (13 decks)

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