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CJ: UoL Medicine Semester One (ESA1) > ICPP - Autonomic Nervous System > Flashcards

ICPP - Autonomic Nervous System Flashcards

1
Q

The autonomic nervous system and the somatic nervous system form part of what?

A

The peripheral nervous system

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2
Q

What does the autonomic nervous system split into?

A

Sympathetic and para-sympathetic

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3
Q

Where is the term “autonomic” derived from?

A

Greek ‘autos’ (self) and ‘nomos’ (law), meaning self-governing

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4
Q

Does the ANS control voluntary or involuntary functions?

A

Involuntary, eg heart rate, blood pressure, GI motility

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5
Q

Is the ANS efferent or afferent?

A

Entirely efferent, but regulated by afferent inputs

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6
Q

Briefly outline the roles of the sympathetic and parasympathetic nervous systems.

A

Sympathetic - responds to stressful situations, “fight or flight” response, increases heart rate/force of contraction/blood pressure

Parasympathetic - regulates basal activities, “rest and digest”

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7
Q

What are the five sections that the ANS is divided into? What do they control?

A

Medullary - eye, lacrimal + salivary glands

Cranial

Thoracic - Structures in head and neck, heart, lungs, adrenal medulla, liver, GI tract, bladder, genitalia

Lumbar - also controls bladder and genitalia

Sacral - Lower GI tract, bladder, genitalia

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8
Q

Which sections of the brain and spinal cord are under sympathetic control and which are under parasympathetic?

A

Sympathetic - thoracic and lumbar

Para-sympathetic - medullary, cranial and sacral

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9
Q

Where do parasympathetic nerves originate?

A

Lateral horn of the medulla

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10
Q

Describe the pre- and postganglionic fibres in the PNS.

A
  • long myelinated pre-ganglionic fibres

- short unmyelinated post-ganglionic fibres

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11
Q

Where are the ganglia located in the PNS?

A

Within innervated tissues

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12
Q

Where do sympathetic nerves originate?

A

In the lateral horn of the lumbar and thoracic spinal cord

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13
Q

Describe the pre- and post-ganglionic fibres of the SNS.

A
  • short myelinated preganglionic fibres

- long unmyelinated post-ganglionic fibres

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14
Q

Where are the ganglia located in the SNS?

A

In the paravertebral chain close to the spinal cord

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15
Q

What are the principal neurotransmitters in the ANS?

A

Acetylcholine (ACh) and noradrenaline (NA)

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16
Q

What sort of channels are nicotinic ACh receptors?

A

Ligand-gated ion channels

17
Q

What neurotransmitter do all pre-ganglionic neurones use?

A

ACh

18
Q

Which neurotransmitter do post ganglionic sympathetic and parasympathetic neurons use?

A

PNS - ACh

SNS - NA

19
Q

Which receptors does ACh act on?

A

Muscarinic ACh receptors (GCPRs) - m1, m2, m3, m4, m5 and nAChR

20
Q

Which receptors does NA interact with?

A

Alpha-adrenoceptors and beta-adrenoceptors (a1, a2, b1, b2, b3)

21
Q

Can some specialised sympathetic post-ganglionic neurons be cholinergic rather than noradrenergic?

A

Yes, eg sweat glands and hair follicles

22
Q

What are NANC transmitters?

A

Non-adrenergic, non-cholinergic transmitters. Examples include ATP, nitric oxide, serotonin and VIP

23
Q

Why are sympathetic post-ganglionic neurons in the adrenal glands different?

A

They form neurosecretory chromaffin cells, which can be considered as post-ganglionic sympathetic neurons. On sympathetic stimulation, they release adrenaline into the bloodstream.

24
Q

Give some consequences of parasympathetic release of ACh.

A
  • heart slows
  • bronchial contraction
  • increased intestinal mobility
  • increased sweat/salivary/lacrimal secretion
25
Q

Give some consequences of sympathetic release of noradrenaline.

A
  • tachycardia and positive inotropy
  • bronchiolar relaxation
  • increased salivary secretion
  • renin release from kidneys
26
Q

What is the umbrella term for distinct malfunctions of the ANS?

A

Dysautonomia

27
Q

Which parts of neurotransmission across a synapse can be targeted by drugs?

A
  • degradation of transmitter
  • interaction with post-synaptic receptors
  • inactivation of transmitter
  • re-uptake of transmitter
  • interaction with pre-synaptic receptors
28
Q

How is acetylcholine synthesised?

A

Acetylcholine CoA + choline -> acetylcholine + coenzyme A

This uses choline acetyltransferase (CAT)

29
Q

How is acetylcholine degraded?

A

Acetylcholine -> acetate + choline

This uses acetylcholinesterase (AChE)

30
Q

Why is it difficult to treat disorders with drugs that affect muscarinic receptors?

A

There are five mAChR subtypes, but few subtype-selective agonists/antagonists, meaning they have a large amount of side effects

31
Q

What side effects would a non-selective, muscarinic ACh receptor agonist be likely to cause?

A
  • decreased heart rate and cardiac output
  • increased bronchoconstriction and GI tract peristalsis
  • increased sweating and salivation
32
Q

What are the pathological effects indicative of massive discharge of the parasympathetic nervous system? (SLUDGE)

A 
Salivation
Lacrimation
Urination (relaxation of sphincter)
Defecation 
Gastrointestinal upset
Emesis
33
Q

When are the SLUDGE symptoms usually encountered?

A
  • drug overdose
  • ingestion of magic mushrooms
  • exposure to organophosphorus insecticides or nerve gases (theses covalently-modify AChE, so ACh levels are raised)

Treated with atropine, palidoxime or other anti-cholinergic agents

34
Q

Give some clinical uses of mACh receptor agonists/antagonists.

A
  • pilocarpine and bethanechol (agonists) treat glaucoma and stimulate bladder emptying respectively
  • ipratropium and tiotropium (antagonists) treat athsma and COPD
35
Q

What is a “varicosity” in a post-ganglionic sympathetic neuron?

A

A bulge in the axon which serves as a specialised site for Ca2+ dependent noradrenaline release

36
Q

How is noradrenaline synthesised?

A

Tyrosine -> DOPA -> dopamine (passes from cytosol to vesicle) -> noradrenaline

Within adrenal medulla, an enzyme converts noradrenaline to adrenaline

37
Q

Which ion is required for exocytosis release of NA?

A

Ca2+

38
Q

What is the difference between uptake 1 and uptake 2 in noradrenergic transmission?

A

Uptake 1 - NA actions terminated by re-uptake into pre-synaptic terminal by Na+ dependent, high affinity transporter
Uptake 2 - left over NA is taken in by lower affinity, non-neuronal mechanism

39
Q

What happens to NA once it’s taken into the pre-synaptic terminal?

A
  • some goes into vesicles where it’s stored for re-use

- remainder is susceptible to metabolism by monoamine oxidase (MAO) or COMT

CJ: UoL Medicine Semester One (ESA1) (55 decks)

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