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ICPP > ICPP 8 > Flashcards

ICPP 8 Flashcards

1
Q

What regions of the spinal cord do sympathetic axons emerge from?

A

Thoracic and lumbar

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2
Q

Where do sympathetic pre-ganglionic neurones synapse with post-ganglionic neurones?

A

Paravertebral column

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3
Q

What region do parasympathetic nerves emerge from?

A

Medullary and Sacral region

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4
Q

Where do parasympathetic pre-ganglion neurones synapse onto post -ganglion ?

A

Close to or within target tissue, short post-ganglionic fibres

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5
Q

What is the neurotransmitter for all pre-ganglionic fibres?

A

ACh

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6
Q

Give examples of NANC transmitters.

A

NO, ATP, 5-HT

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7
Q

What is unique about post-ganglionic neurons in the adrenal glands?

A

They differentiate to form neurosecretory chromaffin cells which release adrenaline into the blood stream.

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8
Q

What receptors do parasympathetic post-ganglionic fibres synapse to?

A

muscarinic ACh receptors in target tissue

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9
Q

What enzyme is involved in acetylcholine synthesis?

A

Choline acetyltransferase

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10
Q

What is acetylcholine made from?

A

Acetyl CoA and choline

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11
Q

What is ACh degraded into?

A

Choline and acetate

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12
Q

What is pilocarpine?

A

muscarinic ACh receptor agonist

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13
Q

What acronym describes side effects of excessive parasympathetic discharge.

A

SLUDGE

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14
Q

What is atropine?

A

Anti-cholinergic agent

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15
Q

Outline the steps of Noradrenaline synthesis.

A

Tyrosine -> Dopa -> Dopamine -> Noradrenaline

Adrenal medulla further enzyme which converts to adrenaline

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16
Q

What are the 2 uptake mechanisms for NA?

A

Uptake 1 = Na+ dependent transporter uptake into pre-synaptic terminal
Uptake 2 = lower affinity, non-neuronal mechanism

17
Q

What 2 enzymes are involves in NA metabolism?

A

MAO - monoaminoxidase

COMPT - catechol-o-methyltransferase (COMT)

18
Q

What is thyrotixicosis?

A

High levels of thyroid hormone in the bloodstream

19
Q

What are the functions of the 2 thyroid hormones?

A

T3 - active hormone, increases basal metabolic rate

T4- relatively inactive, reduces levels of T3

20
Q

What are symptoms of thyrotoxicosis?

A 
weight loss 
Increased appetite
increased bowel movement
Rapid and irregular heart rate
Goitre
Tremor
21
Q

How is thyrotoxicosis related to the autonomic nervous system?

A

Thyroid hormones up-regulate the number of adrenoceptors in the body.

More beta receptors in the heart results in tachycardia and may cause hypertension

22
Q

What ANS drug would be used to treat thyrotoxicosis?

A

Non-selective B-adenoceptor antagonists

E.g propanolol

23
Q

What other treatment is used for thyrotoxicosis?

A

Iodide - blocks release of thyroid hormones

Thiomides - inhibit hormone synthesis

24
Q

What are the clinical abnormalities in asthma?

A

Chronic airway inflammation
Episodes of bronchoconstriction
Hypersecretion of mucus which narrows airways

25
Q

What is the major autonomic innervation of the airways?

A

Parasympathetic

But also beta-2-adrenoceptors in airway smooth muscle

26
Q

What asthma drugs are used as ‘relievers’?

A

Bronchodilators

Beta-2 agonists - salbutamol and salmeterol

27
Q

What anti-asthma drugs are used as preventers?

A

Glucocorticosteroids

28
Q

What 2 systems regulate blood pressure?

A

Sympathetic NS

RAAS

29
Q

What is the clinical criteria for hypertension?

A

140/90 mmHg

30
Q

What target sites for drug action can you define to control hypertension?

A

heart
smooth muscle - arteriole contraction
Kidney - renin release
CNS - determines bp set point

31
Q

What are the main unwanted side effects of using alpha-adrenoceptor antagonists to treat hypertension?

A

Postural hypotension
Impotence
Diarrhoea (increased Gi motility)

32
Q

What 3 ways do beta adrenoceptor antagonists appear to exert anti-hypertensive action?

A
  • reduced inotropy
  • reduced chronotropy
  • reduced renin release
33
Q

What are unwanted side effects of b-adrenoceptor antagonists?

A
  • bronchoconstriction in asthmatics
  • cardiac failure in patients with heart disease
  • bradycardia
  • fatigue
  • hypoglycaemia
  • impotence
34
Q

What effect does parasympathetic ACh release have on the heart?

A

M2 receptors

Bradycardia

35
Q

What effect does parasympathetic ACh release have on smooth muscle?

A

M3 -bronchial contraction

Increased GI motility

36
Q

What effect does parasympathetic ACh release have on glands?

A

Increased saliva and sweat secretion via M1 / M3

37
Q

What effect does sympathetic NS have on the heart?

A

Increased inotropy and chronotropy via B1 receptor.

38
Q

What effect does sympathetic NS have on smooth muscle?

A

Alpha 1 causes arteriole constriction

Beta 2 cause bronchiole, uterine and intestinal relaxation

39
Q

What effect does sympathetic NS have on the kidney?

A

Increased renin release

ICPP (7 decks)

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