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PRIN > PRIN 11 ANS > Flashcards

PRIN 11 ANS Flashcards

1
Q

What contributes to Hydrostatic Pressure?

A

(1) Viscous Resistance

(2) Gravity

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2
Q

What is Pulse Pressure?

A

PP = SP - DP

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3
Q

What is Mean Arterial Pressure?

A

MAP is the average arterial pressure during the cardiac cycle

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4
Q

How can MAP be approximated?

A

Mean Arterial Pressure

MAP = DP + (PP/3)

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5
Q

What are the two baro-receptors?

stretch receptors

A

Carotid Body
(located at bifurcation of carotid artery)

Aortic Baroreceptors
(located on Aortic Arch)

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6
Q

How are the baro-receptors innervated?

A

carotid sinus - CNIX
aortic arch - CNX

Mix of both myelin & non-myelinated fibres

MO: nucleus tractus solitarius (NTS)

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7
Q

Do veins contain some smooth muscle?

A

YES!

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8
Q

Neurotransmitter Pathway

A 
TYROSINE
(via Hydroxylation)
DOPA
(via decarboxylation)
DOPAMINE
(Hydroxylation)
NE
(via methylation)
E
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9
Q

MAO

A

Mono-amine Oxidase
Converts Dopamine to NE

Therefore, a MAO inhibitor would allow for more Dopamine (used as anti-depressant)

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10
Q

What controls the blood vessels?

A

Sympathetic ONLY. There is NO parasympathetic innervation of blood vessels

Parasympathetic simply exerts its effects by INHIBITING the sympathetic system (although there is always some Sympathetic Tone)

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11
Q

What do the Baroreceptors actually detect?

A

Baroreceptors are sensitive to the RATE OF CHANGE of pressure, rather than absolute pressure

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12
Q

a1

What is the effect?

A 
NE...IP3/Ca2+
Constriction of Smooth Muscles
*piloerectors
*spincters: bladder & GI
*uterus contractions
eye
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13
Q

a2

What is the effect?

A

E…Inhibits cAMP
(inhibits SNS)

pre-synaptic terminals (autoreceptors)

relax the smooth muscle in the walls … decreases GI motility

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14
Q

B1

What is the effect?

A

E…Stimulates cAMP
Increases Cardiac Output & Heart Rate (SA Node)
Kidney: release renin to conserve water

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15
Q

B2

What is the effect?

A

E …. Stimulates cAMP
Relaxation of Smooth Muscles and liberation of energy
Dilate Bronchioles
Dilate vessels in Muscles
Relax Uterus
Relax GI (no peristalsis)
Relax Bladder
Relax ciliary muscle … cycloplegia (loss of visual accomadation)
Stimulate Liver to perform glucogenolysis: LIBERATION OF ENERGY

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16
Q

B3

What is the effect?

A

Stimulates cAMP

Fat Cells

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17
Q

Sympathetic vs Parasympathetic

Where are the ganglia located?

A

Sympathetic: Ganglia located in sympathetic chain, far away from organs

Parasympathetic: Ganglia are located close to the organs they innervate

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18
Q

Where are Muscarinic & Nicotinic Receptors located?

A

M receptors are on ORGANS which receive paraympathetic innervation

N receptors are in ANS ganglia and also in NMJ

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19
Q

What is the function of Muscarinic receptors?

A

FUNCTION: to oppose most SNS actions at the level of the organs

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20
Q

What is the distribution of Muscarinic receptors?

A 
Constrict Bronchioles
Decrease HR
Relax GI (rest & digest)
Relax Bladder
Increased salivation
Uterus Contractions
Contract Circular muscle of Iris ... pupil constriction
Contract Ciliary Muscle  ... accomadation of near vision
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21
Q

Sex Glands

A

Arousal: PNS
Orgasm: SNS

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22
Q

What do sweat glands use?

A

Innervated by SNS but use M receptors via Ach

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23
Q

Term for agonist to increase stimulation of a & B receptors

A

Sympatho-mimetic

Increase SNS

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24
Q

Term for agonist to decrease stimulation of a & B receptors

A

Sympatho-lytic

Decrease SNS

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25
Q

Term for agonist to increase stimulation of M receptors

A

Vago-tonic

```
Increase PNS
note: Vago = CNX
~~~

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26
Q

Term for agonist to decrease stimulation of M receptors

A

Vago-lytic

```
Decrease PNS
note: Vago = CNX
~~~

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27
Q

What are the THREE fates of Ach?

A

(1) Broken down by AChE
(2) Re-uptake
(3) Diffusion & metabolized

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28
Q

What are the THREE ways to manipulate the PNS?

A

(1) M Agonist: (inc. PNS)
PILOCARPINE

(2) M Antagonist (dec. PNS)
ATROPINE

(3) AChE Inhibitor (inc. PNS)
NEOSTIGMINE

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29
Q

What are the main uses for AChE inhibitors?

aka. Anti-cholinesterases

A

(1) Treat Myasethenia Gravis

(2) Reverse Neuromuscular blocking drugs used for Anesthesia

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30
Q

What are the main uses for Muscarinic Agonists?

A

(1) constrict pupils

(2) promote salivation

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31
Q

What are the main uses for Muscarinic Antagonists?

A
  • dilate the pupils
  • decrease oral secretions
  • increase HR
  • dilate bronchioles
  • treat incontinence
  • relax GI spasms
  • treat movement disorders (Parkinsons)
  • to treat poisoning of insecticide or chemical warfare (ATROPINE)
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32
Q

What is the effect of Atropine on the bladder?

A

Relaxes bladder & GI (constricts sphincter)

Atropine is a Muscarinic Antagonist and causes mimic of SNS

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33
Q

What is the effect of Pilocarpine on the bladder?

A

Contracts bladder & GI (relaxes sphincter)

Pilocarpine is a Muscarinic Agonist and causes mimic of PNS

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34
Q

Who should NOT receive a B2 Antagonist?

A

Asthmatics

B2 Antagonist will constrict the bronchioles

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35
Q

Where are NE and E active?

A

E is released from adrenal medulla and circulates blood stream (conc is low)

NE is released into a synapse (high conc)

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36
Q

What is Isoproterenol?

A

Iso-pro-terenol
Pure a1 agonist

Structurally similar to E

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37
Q

What is Phenylephrine?

A

Phenyl-ephrine
Pure a1 agonist

Can be administered locally to act on a specific site

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38
Q

Circular Iris muscles

contracts to cause …

A 
Pupil constrcition
(miosis)
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39
Q

Radial Muscle

contracts to cause …

A

Pupil dilation

Mydriasis

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40
Q

Cillary Muscle

contracts to cause …

A

accomadation of near/far vision

41
Q

Single-unit Smooth Muscle

Examples…

A

GI tract
Uterus (at time of labour), s
Small diameter blood vessels (<200 μm),

Numerous Gap junctions, cells behave electrically and mechanically like a single unit.

42
Q

Multi-unit Smooth Muscle

Examples…

A 
Large airways
Large arteries
Uterus (other than labour)
Iris
Pilomotor muscles in the skin.

No gap junctions
Cells are electrically ISOLATED.
APs do not occur in these cells.

43
Q

What does Smooth Muscle NOT have?

A

Troponin

44
Q

How can Ca2+ accumulate in the myoplasm of smooth muscle?

A

(1) Direct Entry / Electrochemcial
(2) Ca-induced Ca release
(3) Pharmaco-mechanical Coupling

45
Q

What is Hyperemia?

A

Increased blood flow to tissues

46
Q

Effect of Ca2+ on smooth muscle cell

Progression of Events

A

Ca binds to Calmodulin
Ca-Calm complex DE-phosphorylates (activates) MLCK which then phosphorylates the myosin head. Myosin then binds to actin.

(this gets tropomyosin out of the way)

(Myosin Like Chain Kinase)

47
Q

What happens if we remove Ca?

A

If we remove Ca2+ the smooth muscle will not relax

48
Q

What is needed for the muscle to relax?

A

To make the muscle relax we must hyrdolyze the Myosin via MLCP

(Myosin-like Chain Phosphatase)

49
Q

How is sympathetic tone achieved?

A

MLCP removes Phosphate from myosin.

Dephosphorylated myosin will continue through the contraction cycle at roughly 1/20th the rate.

There is always some MLCK present to keep some measure of contraction.

50
Q

How does MLCK becomes inactivated?

A

MLCK is INACTIVE when phoshorylated by:

PKA (B-agonists)

PKG (NO, Atrial Natri-uretic Peptide)

51
Q

When is MLCP inactive?

A

MLCP is inactive when phosphorylated. This can occur by:
**Removing P from myosin
**Rho Kinase (NE, AT-II, E-1)
(Pharmaco-mechanical coupling)

52
Q

What IS Pharmacomechanical Coupling?

A

Change in tension in the muscle cell without changes in membrane potential

Via Rho-Kinase, certain ligands can inactivate MLCP. This causes vasoconstriction WITHOUT a there having been a membrane potential.

(only smooth muscle does this!)

53
Q

How much Ca2+ is present in the SR of smooth muscle cells?

A

Very little. Becomes depleted rapidly and therefore, extracellular Ca is soon required.

54
Q

How can Ca2+ accumulate in the myoplasm of smooth muscle?

A

(1) Direct Entry / Electrochemcial
(2) Ca-induced Ca release
(3) Pharmaco-mechanical Coupling

55
Q

How can Ca2+ enter directly?

A

(1) Ca2+ leak channels
(2) Voltage gated
(3) Receptor gated

56
Q

What is Ca-induced Ca release?

A

Ca2+ in the myosplasm binds to RyR-2 receptors on the SR to release MORE Ca2+

57
Q

What is the difference between RyR-1 and RyR-2?

A

RyR-1: Skeletal Muscle
(makes physical contact with Ca channel)

RyR-2: Smooth Muscle
(does not make physical contact … called Ca induced Ca release)

58
Q

What is the progression of events that occurs in Pharmaco-Mechanical coupling?

A 
Ligand binds to receptor. 
Activates G Protein
Activates PLC
Activates IP3 & DAG
IP3 releases sequestered Ca from SR.
59
Q

SO …. what is the mechanism by which Angiotensin II causes vasoconstriction?

A

Ang-II is a ligand that binds to smooth muscle cell receptor.

60
Q

What is PL?

A

Phospho-lambon (PL)

When in the de-phosphorylated form, PL inhibits the action of SERCA (SR Ca ATPase)

61
Q

What is the result of the action of active PL

A

Ca-ATPase will NOT be operational. Therefore, Ca will not be taken back into the SR by SERCA. Myosplasm concentration will stay high.

Explanation:
Activated (dephosphorylated) PL inhibits the Ca-ATPase pumping Ca back into the SR.

62
Q

How can PL be inactivated?

A

Phospholambin can be turned off by being phosphorylated

Done by PKA or PKG

63
Q

SO, what is the result of PKA and PKG?

A

(1) Inactivates MLCK
RESULT: prevents contraction)

(2) Inactivates PL
RESULT: Ca is shoved back in the SR via SERCA

64
Q

What is the relatiomship between SERCA & PL?

A

When activated (dephosphorylated), Phospholambin prevents SERCA from pumping Ca back in SR.

65
Q

Is the uterus Single or Multi Unit Smooth Muscle?

A

Normally Multi-unit, BUT, during the labor it can turn into a single unit to cause more uniform and powerful contractions.

66
Q

Vascular Smooth Muscle is almost entirely under the control of ….

A

Postganglionic Sympathetic Neurons

very little parasympathetic

67
Q

ATP concentration…

Smooth vs Skeletal Muscle

A

Smooth Muscle can have large changes of of ATP conc

Skeletal Muscle: stays very consistent

68
Q

Ligand Gated Channels In Smooth Muscle

A

(1) K-ATP Channel
(2) Ca-activated K Channel
(3) Purinergic

69
Q

Ligand Gated Channels In Smooth Muscle:

(1) K-ATP Channel

A

Ligand: Intracellular ATP

When ATP is present, it binds to receptor and prevents K+ export

When ATP is not present, K+ exits… hyperpolarization … closes Ca channels … relaxation

70
Q

Ligand Gated Channels In Smooth Muscle:

(2) Ca-activated K Channel

A

Senses intracellular Ca conc.

High Ca conc … channel opens … K exits … hyperpolarization … closes Ca channels … relaxation

71
Q

Ligand Gated Channels In Smooth Muscle:

A

allows Na and Ca to ENTER the cell

Depolarizes the cell and opens voltage-gated Ca channels.

Responsible for the early, fast, phase of smooth muscle contraction.

72
Q

During Sympathetic Activation, what progression of events occurs in the cutaneous vessels?

A

*Varicosities release ATP & NE

ATP:

(1) ATP opens lingand gated channels
(2) Na & Ca enter cell
(3) More Ca enters (via RyR-2)
(4) MLCK activated
(5) Increased Sympathetic Tone

NE:

(1) NE binds to a-1 adrenergic receptors
(2) PLC … IP3 … Ca released from SR

73
Q

Mydriasis vs Miosis

A

Miosis:
Constriction of pupils

Mydriasis:
dilation of pupils

74
Q

What occurs at the axon hillock?

A

This is the location where action potentials are initiated

75
Q

Oligodendrocytes
VS
Schwann cells

A

Oligodendrocytes (CNS)
can myelinate multiple axons

Schwann cells (PNS)
can only myelinate one axon
76
Q

How and where is Ach synthesized?

A

synthesized from the condensation of acetyl-CoA and choline

occurs in motor neurons and their axons

77
Q

In order to make Ach, where does the motor neuron get acetyl-CoA and choline?

A

Acetyl-CoA: from inside cell

Choline: from ECF

78
Q

What is a long-term compensation to blood loss?

weeks

A

Synthesis of Eryrthropoietin

occurs weeks after blood loss to help replace hemoglobin loss

79
Q

How does the rate of firing from the carotid & aortic receptors correlate to arterial pressure.

A

Rise and fall together

An acute fall in arterial pressure results in a decrease in firing of the afferent nerves from the carotid sinus baroreceptors and thus, a reflex increase in arterial pressure and heart rate

80
Q

Where do the baroreceptors first synapse?

A

The baroreceptor afferents first synapse in the cardiovascular centre of the brain, at the Nucleus of the Tractus Solitarius (NTS), which is in the medulla.

81
Q

Baroreceptors respond to:

A

Deformation (stretch)

82
Q

Why does a karate chop to the neck result in fainting?

A

The brain perceives an increase in BP via carotid sinus and aortic arch baroreceptors

Leads to a decrease in BP, causing fainting

83
Q

What steps are involved in smooth muscle contraction>

A

(1) Ca binding to calmodulin
(2) Ca-calm binding to MLCK
(3) Ca-calm-MLCK phosphorylating myosin
(4) Myosin binding to actin

84
Q

What does Smooth Muscle NOT use?

A

troponin

85
Q

What is the effect of Endothelial-1 on smooth muscle?

A

E-1 causes Rho kinase to phosphorylate MLCP

Therefore … turns off the inhibitor of contraction

86
Q

Which receptors is primarily responsible for inhibiting production of cAMP?

A

a1

87
Q

When are the different G proteins used?

A

Gq: a1 - PLC pathway

Gi: a2 - inhibit cAMP

Gs: B1&B2 - activate cAMP

88
Q

muscarinic agonist
Beta-2 antagonist

What is their effect on:

(1) bronchioles?
(2) muscle vasculature?
(3) bladder?

A

Both cause:
bronchoconstriction
bladder constriction

Beta-2 antagonist would cause vasoconstriction in muscles

muscarinic agonist would NOT cause
vasoconstriction in muscles

89
Q

Man has difficulty peeing … what are we going to do?

A

a1 causes urinary sphincter constriction

Therefore, prescribe an a1 antagonist

90
Q

What is the effect of alpha-1 stimulation at the uterus?

A

contraction

91
Q

What is the effect of beta-1 blockade at the liver?

A

No major effect

92
Q

What are the upper limits of normal diastolic and systolic blood pressure (DBP and SBP) with the patient seated and at rest?

A

140 / 90

93
Q

Oligodendrocytes vs Schwann Cells

Which cells can myelinate multiple axons?

A

Oligodendrocytes:
can multiple many axons

Schwann cells:
can support many unmyelinated axons, however, when they produce myelin, are limited to ONLY ONE axon

94
Q

What is the pathway of the baroreceptor afferents?

A

Synapse & and are integrated in the NTS of the MO

Then, they are relayed to the following:

  • *Medulla (N. Ambiguus)
  • *Hypothalamus
  • *Cerebellum
95
Q

True of False:

In some blood vessels, there are spontaneous depolarizations that resemble those in the sino-atrial (SA) node; this excitation spreads from cell to cell, producing rhythmic contractions.

A

TRUE!
This phenomenon can be described by the term “automaticity.” Because of automaticity, some vessels retain a degree of tone even when the nerve supply is interrupted. This is referred to as “basal tone.”

96
Q

Do veins have smooth muscle?

A

YES,

This can help regulate the filling pressure of the heart

97
Q

True of False:

In smooth muscle, muscle contraction does not use ATP

A

FALSE

Smooth muscle uses ATP in muscle contraction.

98
Q

True of False:

Smooth muscle uses crossbridge cycling, which is also used in striated muscle

A

TRUE

99
Q

In a normal healthy individual, from a sitting position to an upright position, what would you expect to happen to the diastolic blood pressure (DBP) and heart rate?

A

DBP increases; heart rate increases

In the upright posture, there is decreased venous return and decreased stroke volume, which leads to decreased cardiac output. The decreased SP leads to a REFLEX increase in DP (due to increased peripheral vascular resistance) and HR increases.

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