Lecture 37 Flashcards

1
Q

The ANS innervates what tissues?

A
  1. smooth muscle tissue
  2. heart
  3. glands
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2
Q

How does the ANS effect blood vessels?

A

blood pressure and body temp.

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3
Q

How does the ANS impact the GI?

A

digestion

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4
Q

How does the ANS impact the bladder?

A

micturition (urination)

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5
Q

How does the ANS impact the bronchial tree?

A

bronchial dilation or constriction

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6
Q

how does the ANS impact the eye?

A

pupillary dilation or constriction

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7
Q

How does the ANS impact the heart?

A

heart rate and heart contractility

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8
Q

How does the ANS impact the endocrine glands such as the pancreas and ardrenal glands?

A

metabolism

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9
Q

how does the ANS impact the exocrine glands such as the sweat glands, salivary glands, and lacrimal glands?

A

lacrimination
sweating
salivation

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10
Q

What does the vagus nerve innervate?

A

Parasympathetic fibers Innervation of the thoracic and

abdominal viscera

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11
Q

What is a vagomoty?

A

a surgical operation in which one or more branches of

the vagus nerve are cut, typically to reduce the rate of gastric secretion (e.g. in treating peptic ulcers)

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12
Q

What are the characteristics of the cholinergic fibers and adrenergic fibers of the sympathetic NS?

A

The adrenergic fibers are much longer than the cholinergic fibers.

short cholinergic preganglionic fiber
long adrenergic postganglionic fiber

adrenergic fiber innervates the effector tissue

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13
Q

What are the characteristics of the cholinergic fibers and adrenergic fibers of the parasympathetic NS?

A

long cholinergic preganglionic fiber

short cholinergic postganglionic fiber

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14
Q

What is the primary neurotransmitter of the postganglionic neurons in the sympathetic?

A

norepinephrine

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15
Q

What is the primary neurotransmitter of the postganglionic neurons in the parasympathetic?

A

acetylcholine

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16
Q

What kind of fiber innervates the adrenal medulla?

A

Directly innervated by preganglionic sympathetic fibers.

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17
Q

What fibers innervate sweat glands?

A

Innervated by cholinergic sympathetic postganglionic neurons

Receptors on the sweat glands are cholinergic muscarinic: M3

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18
Q

What fibers innervate the renal vasculature smooth muscle?

A

Innervated by dopaminergic sympathetic postganglionic neurons

Receptors on the renal vasculature are dopaminergic: D1

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19
Q

What are chromaffin cells and where are they found?

A

Chromaffin cells releases catecholamines
into the CIRCULATION: 80% Epinephrine(E),
20% Norepinephrine(NE)

they are found in the adrenal gland

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20
Q

What fibers synapse with chromaffin cells?

A

Preganglionic sympathetic axons

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21
Q

What is pheochcromocytoma?

A

It is the most common tumor found in the adrenal medulla in adults

derived from chromaffin cells

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22
Q

What are the symptoms of pheochcromocytoma?

A
  1. elevated blood pressure
  2. headache
  3. excessive sweating
  4. tachycardia
  5. pallor
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23
Q

How to determine pheochcromocytoma? (lab)

A

elevated catecholamines and their metabolites (metanephrine)

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24
Q

how to treat pheochcromocytoma?

A

surgery (Phenoxybenzamine + Beta-blocker during preop)

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25
Q

Explain the synthesis of acetylcholine?

A
  1. Acetyl CoA synthesized in mitochondria.
  2. Choline transported into the neuron terminal by
    a sodium-dependent carrier (CHT1).
  3. ACh is synthesized in the cytoplasm from acetyl-CoA and choline, a reaction catalysed by choline acetyltransferase (ChAT).
4. ACh transported into vesicles by a the vesicular
ACh transporter (VAChT).
  1. ACh released occurs when an action potential reaches the terminal and triggers calcium influx
    through voltage-gated calcium channels
26
Q

What is the rate-limiting step of ACh synthesis?

A

the uptake of choline

27
Q

Explain cholinergic transmission of acetylcholine?

A
  1. ACh binds to cholinergic receptors: nicotinic
    or muscarinic in the postsynaptic membrane
  2. ACh binds to presynaptic M2 Ach receptors,
    which inhibit Ach release
  3. Acetylcholinesterase (AChE) splits ACh into
    choline and acetate
28
Q

What happens during organophosphate poisoning?

A

it will irreversibly bind to the enzyme aceytlcholinesterase

29
Q

symptoms of organophosphate poisoning?

A

muscarinic: diarrhea, urination, miosis, bronchospasm, bradycardia, emesis, lacrimation, sweating, salivation

Nicotinic: neuromuscular blockade

CNS effects: respiratory depression, lethargy, seizures, coma

30
Q

How to treat organophosphate poisoning?

A

Atropine + Pralidoxime

31
Q

What are the two types of cholinergic receptors?

A

nicotinic receptors and muscarinic receptors

32
Q

what are the types of nicotinic receptors?

A

muscle type (Nm) and neuronal type (Nn)

ligand gated channels!!!

33
Q

What are the different types of muscarinic receptors?

A

M1, M2, M3, M4, M5

34
Q

Which muscarinic receptors are Gq-protein-linked?

A

M1, M3,M5

all use IP3, DAG, Ca pathway (increase)

35
Q

Which muscarinic receptors are Gi-protien-linked?

A

M2 and M4

decrease in cAMP

36
Q

Where are M1 receptors found? what do they do?

A

nerve endings, brain neurons and autonomic ganglia (DAG cascade)

higher cognitive functioning and stimulates ENS

37
Q

Where are M2 receptors found? what do they do?

A

Heart and some nerve endings (less cAMP)

inhibit the release of ACh
decrease heart rate
decrease aortic contraction

38
Q

Where are M3 receptors found? What do they do?

A

smooth muscle, glands, and endothelium (DAG
cascade)

increase exocrine gland secretion 
increase gut movement 
increase bladder contraction 
pupillary and bronchial constriction 
vasodilation in endothelium
39
Q

Where are Nn receptors found?

A

ANS ganglia (evokes AP)

learning, memory, chromaffin release, and neuronal activation

40
Q

Where are Nm receptors found?

A

neuromuscular end plate (evokes AP)

muscle contraction

41
Q

Explain the synthesis of NE?

A
  1. Tyrosine is transported into the adrenergic neuron by system L.
  2. Tyrosine is then converted to LDOPA by the enzyme tyrosine hydroxylase.
  3. DOPA is converted to dopamine by DOPA decarboxylase.
  4. Vesicular monoamine transporter (VMAT) translocate dopamine into synaptic vesicles
  5. Intravesicular dopamine-βhydroxylase converts dopamine to NE.
42
Q

what is the rate limiting step of NE synthesis?

A

Tyrosine conversion to DOPA by tyrosine hydroxylase

is the rate-limiting step in the formation of NE

43
Q

explain adrenergic transmission?

A

Norepinephrine (NE):

  1. Released NE binds adrenergic receptors: alpha or beta on the postsynaptic membrane
  2. Released NE binds to presynaptic alpha2 autoreceptors which inhibits NE release
  3. Termination of the action of NE results from diffusion away from the receptor site and reuptake into the nerve terminal, mediated by the Na+
  4. dependent NE transporter (NET).
44
Q

What are the two broad types of adrenergic receptors?

A
  1. alpha receptors (G-protein linked)

2. Beta receptors (G-protein linked)

45
Q

Types of alpha adrenergic receptors?

A
  1. alpha 1

2. alpha 2

46
Q

What are the types of adrenergic alpha 1 receptors? and what do they do?

A

Alpha 1 A

alpha 1 B

alpha 1 D

Gq-protein linked…. thus increased calcium

47
Q

what are the types of adrenergic alpha 2 receptors and what do they do?

A

alpha 2 A

alpha 2 B

alpha 2 C

Gi-linked…. thus decrease in cAMP

48
Q

What are the types of adrenergic beta receptors?

A

beta 1, 2, and 3

Gs-linked…. thus increase in cAMP

49
Q

Where are adrenergic alpha 1 receptors found?

A

smooth muscle and glands! (leads to constriction and secretion)

50
Q

Where adrenergic alpha 2 receptors found?

A

nerve endings some smooth muscle (causes contraction)

51
Q

Where are beta 1 adrenergic receptors found?

A

cardiac muscle and juxtaglomerular apparatus

increase heart rate, increase force, increase renin release

52
Q

Where are beta 2 adrenergic receptors found?

A

smooth muscle, liver, and heart

relax smooth muscle, increase heart rate

53
Q

Where are beta 3 adrenergic receptors found?

A

adipose tissue

increase lipolysis

54
Q

Where are dopamine 1 receptors found?

A

smooth muscle

relax renal vascular smooth muscle

55
Q

What receptor controls aqueous humor production in the eye?

A

Beta 1 adrenergic

56
Q

what receptor controls mydriasis

A

alpha 1 adrenergic

57
Q

What receptor controls miosis and aqueous humor outflow?

A

M3

58
Q

Explain Horner syndrome?

A

sympathetic denervation of the face

59
Q

What are the symptoms of Horner syndrome?

A

Ptosis (slight drooping of the
eyelid)

Anhidrosis (absence of
sweating)

Miosis (pupil constriction)

60
Q

What are the causes of Horner syndrome?

A

1st neuron: Pontine hemorrhage

2nd neuron: Pancoast tumor
(stellate ganglion compression)

3rd neuron: Carotid dissection