PNS and CNS Review

Question 1

Sympathetic Activity?

Answer 1

Fight or Flight

Question 2

Parasympathetic Activity?

Answer 2

Discrete, finely tuned control of daily functions

Question 3

Sympathetic nervous system neurotransmitters?

Answer 3

1. Acetylcholine at ganglionic
2. Norepi at receptor

Question 4

Parasympathetic Neurotransmitters?

Answer 4

Acetylcholine at all sites

Question 5

Mechanisms for
Neurotransmitter
Inactivation for the sympathetic nervous system?

Answer 5

COMT and MAO enzymes;
Uptake 1 & 2;
Auto-receptors

Question 6

Mechanisms for
Neurotransmitter
Inactivation for the parasympathetic nervous system?

Answer 6

Cholinesterase enzymes

Auto-receptors

Question 7

Sympathetic receptors?

Answer 7

Alpha, Beta, and Dopaminergic (Adrenergic)

Question 8

Parasympathetic receptors?

Answer 8

Muscarinic and Nicotinic (Cholinergic)

Question 9

Add pages slide 4 and 5 on Cholinergic and adrenergic receptor sites

Question 10

Where are Nicotinic Receptors found?

Answer 10

Receptors are found in autonomic ganglia, neuromuscular junctions, and CNS

Question 11

What does activation of Nicotinic receptors at the neuromuscular junction and CNS lead to?

Answer 11

1. Neuromuscular = muscle contraction
2. CNS (Brain) = excitation

Question 12

How many Muscarinic receptors types are there?

• which two are most relevant to us?

Answer 12

5 receptors, M2 and M3

Question 13

where are M2 receptors found and what does activation cause?

Answer 13

M2 are found in the heart and activation causes bradycardia

Question 14

where are M3 receptors found and what does activation cause?

Answer 14

M3 are found on bronchial and vascular smooth muscles, mucous glands, mast cells. Activation causes:

• Bronchoconstriction
• Increased mucus production
• Mast Cell Degranulation

Question 15

What are 3 types of Adrenergic receptors?

Answer 15

Alpha, Beta, Dopaminergic

Question 16

What does activation of A1 and A2 receptors do?

Answer 16

• A1 = vasoconstriction of smooth muscles
• A2 = Less norepinephrine release and vasodilation

Question 17

Where are A1 and A2 receptors found?

Answer 17

1. Found on peripheral vascular smooth muscle
2. Centrally located and activation causes less norepinephrine release

Question 18

What are Beta 1 and Beta 2 receptors found?

• Activation?

Answer 18

• B1 found on the heart = Increased HR and Contractility
• B2 found on bronchial and vascular smooth muscles = bronchodilation and vasodilation

Question 19

Where are Dopaminergic receptors found?

Answer 19

Dopamine receptors are found throughout the body

• similar to norepinephrine and can activate A and B receptors
• Dose dependant

Question 20

Activation of Dopaminergic receptors?

Answer 20

Activation can cause multiple effects:

1. Vasoconstriction
2. Increased HR
3. CNS excitation

Question 21

What are common inotropes that would be used in the CVICU?

• Why are they selected in place of other vasopressors?

Answer 21

Looking for a positive increase in contraction without affecting other systems.

1. Moderate dose dopamine, stimulates beta 1 receptors to contraction
2. Dobutamine: selective beta 1 receptor
3. Milirone: positive inotrope/vasodilator in short term management of severe CHF/low output states

Question 22

Why is Norepinephrine commonly selected for refractory hypotension?

Answer 22

Endogenous neurotransmitter that has a moderate beta 1 stimulant with potent alpha stimulation

• Increases SVR and decreases venous return to the heart and elevate BP

Question 23

what receptors get stimulated by ephedrine

• Primary use?

Answer 23

Antihypotensive agent

• Stimulates moderate alpha and beta 1 and 2 stimulation

Question 24

When would Phenylephrine be used instead of norepinephrine or ephedrine?

Answer 24

Pure alpha agonist; produces intese peripheral vasoconstriction

• Increases BP and reflex bradycardia
• antihypotensive agent