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?

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
Give some consequences of sympathetic release of noradrenaline.
- tachycardia and positive inotropy - bronchiolar relaxation - increased salivary secretion - renin release from kidneys
26
What is the umbrella term for distinct malfunctions of the ANS?
Dysautonomia
27
Which parts of neurotransmission across a synapse can be targeted by drugs?
- degradation of transmitter - interaction with post-synaptic receptors - inactivation of transmitter - re-uptake of transmitter - interaction with pre-synaptic receptors
28
How is acetylcholine synthesised?
Acetylcholine CoA + choline -> acetylcholine + coenzyme A This uses choline acetyltransferase (CAT)
29
How is acetylcholine degraded?
Acetylcholine -> acetate + choline This uses acetylcholinesterase (AChE)
30
Why is it difficult to treat disorders with drugs that affect muscarinic receptors?
There are five mAChR subtypes, but few subtype-selective agonists/antagonists, meaning they have a large amount of side effects
31
What side effects would a non-selective, muscarinic ACh receptor agonist be likely to cause?
- decreased heart rate and cardiac output - increased bronchoconstriction and GI tract peristalsis - increased sweating and salivation
32
What are the pathological effects indicative of massive discharge of the parasympathetic nervous system? (SLUDGE)
``` Salivation Lacrimation Urination (relaxation of sphincter) Defecation Gastrointestinal upset Emesis ```
33
When are the SLUDGE symptoms usually encountered?
- 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
Give some clinical uses of mACh receptor agonists/antagonists.
- pilocarpine and bethanechol (agonists) treat glaucoma and stimulate bladder emptying respectively - ipratropium and tiotropium (antagonists) treat athsma and COPD
35
What is a "varicosity" in a post-ganglionic sympathetic neuron?
A bulge in the axon which serves as a specialised site for Ca2+ dependent noradrenaline release
36
How is noradrenaline synthesised?
Tyrosine -> DOPA -> dopamine (passes from cytosol to vesicle) -> noradrenaline Within adrenal medulla, an enzyme converts noradrenaline to adrenaline
37
Which ion is required for exocytosis release of NA?
Ca2+
38
What is the difference between uptake 1 and uptake 2 in noradrenergic transmission?
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
What happens to NA once it's taken into the pre-synaptic terminal?
- some goes into vesicles where it's stored for re-use | - remainder is susceptible to metabolism by monoamine oxidase (MAO) or COMT