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ESA 2- Cardiovascular System > The Autonomic Nervous System and the CVS > Flashcards

The Autonomic Nervous System and the CVS Flashcards

1
Q

What is the ANS important for?

A

Many physiological functions

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2
Q

Give 4 physiological functions the ANS is responsible for?

A

Heart rate
Blood pressure
Body temperature
Co-ordinating the body’s response to exercise and stress

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3
Q

What does the ANS exert control over?

A

Smooth muscle
Exocrine secretion
Rate and force of contraction of heart

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4
Q

What smooth muscle is under ANS control?

A

Vascular

Visceral

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5
Q

What are the two divisions of the ANS?

A

Parasymphathetic

Sympathetic

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6
Q

What is the division of the ANS based on?

A

Anatomical grounds

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7
Q

What is sometimes given as the third division of the ANS?

A

Enteric

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8
Q

What is the enteric division?

A

A network of neurones surrounding the GI tract

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9
Q

What is the enteric division normally controlled via?

A

Sympathetic and parasympathetic fibres

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10
Q

How are the sympathetic and parasympathetic systems organised?

A

Two neurones are arranged in series.
One starts in the CNS
The two neurones synapse in the peripheral nervous system

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11
Q

Where is the cell body of the preganglionic neurone?

A

In the CNS

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12
Q

Where is the cell body of the postganglionic neurone?

A

In the PNS

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13
Q

Give 12 organs innervated by the sympathetic nervous system

A 
Eyes
 Blood vessels
 Salivary glands
 Heart
 Lungs
 Adrenal medulla
 Liver
 GI tract
 Bladder
 Genitalia
 Blood vessels
 Sweat glands
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14
Q

Give 9 organs innervated by the parasympathetic nervous system, and what nerve innervates them

A 
Eye- III
 Lacrimal glands- VII
 Salivary glands- IX
 Heart- X
 Lungs- X
 Upper GI tract- X
 Lower GI tract- Nervi erigentes
 Bladder-Nervi erigentes
 Genitalia-Nervi erigentes
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15
Q

What is the origin of the sympathetic division?

A

Thoracolumbar origin

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16
Q

Where do the preganglionic neurones of the sympathetic division arise from?

A

Segments T1 to L2 (or L3)

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17
Q

Where do most preganglionic neurones in the sympathetic division synapse with postganglionic neurones?

A

In the paravertebral chain of ganglia

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18
Q

Which sympathetic nerve synapse in a number of prevertebral ganglia?

A

Coeliac
Superior mesenteric
Inferior mesenteric ganglia

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19
Q

What is the original of parasympathetic nerve?

A

Craniosacral

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20
Q

What is meant by craniosacral?

A

Medulla part of brain stem and region of spinal cord

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21
Q

Where do preganglionic parasympathetic nerves travel?

A

In cranial nerves (III, VII, IX and X), or sacral outflow from S2-S4

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22
Q

Where do parasympathetic preganglionic synapse?

A

In ganglia close to target tissue

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23
Q

How long are the postganglionic neurones of the parasympathetic division?

A

Short

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24
Q

What do preganglionic neurones release?

A

Acetylcholine (ACh)

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25
Q

What is ACh?

A

An excitatory neurotransmitter

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26
Q

What do ACh do?

A

Acts on certain nicotinic acetylcholine receptors in postganglionic membranes

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27
Q

What do nicotinic ACh receptors have?

A

An integral ion channel that permeable to K and Na ions

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28
Q

What does the ion channel in nicotinic ACh receptors cause?

A

An overwhelming influx of Na ions, causing depolarisation and therefore the firing of an action potential

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29
Q

What are postganglionic sympathetic neurones usually?

A

Noradrenergic

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30
Q

What is meant by noradrenergic?

A

Use noradrenaline as a transmitter

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31
Q

What are postganglionic parasympathetic neurones usually?

A

Cholinergic

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32
Q

What is meant by cholinergic?

A

Have ACh as a transmitter

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33
Q

What is the exception to sympathetic neurones being noradrenergic?

A

Sympathetic innervation of sweat glands, where postganglionic neurones release ACh, which acts on muscarinic ACh receptors

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34
Q

What is released from preganglionic neurones in the sympathetic nervous system?

A

ACh

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35
Q

What happens to ACh once it has been released from the preganglionic neurone?

A

It is picked up by nicotinic ACh receptors on the postganglionic neurone

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36
Q

Is it always ACh that is released from preganglionic neurones in the SNS?

A

No

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37
Q

What is released from the postganglionic neurone in the SNS?

A

Noradrenaline

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38
Q

What happens to noradrenaline one it’s been released from the postganglionic neurone?

A

It’s picked up by adrenergic receptors on effector cells

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39
Q

Where are chromaffin cels located?

A

In the adrenal medulla

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40
Q

What are chromaffin cells?

A

Like specialised postganglionic sympathetic neurones

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41
Q

What do adrenal chromaffin cells do?

A

Release adrenaline, which circulates in the blood stream as a hormone

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42
Q

What do noradrenaline and adrenaline act on?

A

Adrenoreceptors called G protein-coupled receptors

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43
Q

Do G protein-coupled have an integral ion channel?

A

No

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44
Q

How do G protein-coupled receptors differ in their response to adrenaline to noradrenaline?

A

They respond with different affinities

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45
Q

What are the types of adrenoreceptors?

A

α and ß

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46
Q

What are the subtypes of α adrenoreceptor?

A

α1

α2

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47
Q

What are the subtypes of ß adrenoreceptors?

A

ß1
ß2
Other subtypes exist

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48
Q

What can different tissues have with respect to adrenoreceptors?

A

Different subtypes

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49
Q

What do different subtypes of adrenoreceptors allow?

A

Diversity of action

Selectivity of drug action

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50
Q

What are co-transmitters?

A

Other transmitters that are released with noradrenaline or adrenaline at synapse of post-ganglionic neurone with effect cells

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51
Q

Give two examples of co-transmitters

A

Neuropeptide Y

ATP

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52
Q

What is released from the preganglionic neurone in the PNS?

A

ACh

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53
Q

What happens to ACh in the PNS once its been released from the preganglionic neurone?

A

Its picked up by nicotinic ACh receptor on the postganglionic neurone

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54
Q

What is released from the postganglionic neurone in the PNS?

A

ACh

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55
Q

What happens once ACh has been released from the postganglionic neurone in the PNS?

A

It is picked up by muscarinic ACh receptor on effector cell

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56
Q

What kind of receptors are the muscarinic ACh receptors?

A

G protein-coupled receptors

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57
Q

What subtypes of G protein-coupled receptors are the muscarinic ACh receptors?

A

M1, M2 and M3

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58
Q

What happens when parasympathetic and sympathetic divisions both innervate a tissue?

A

They often have a opposite effect

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59
Q

When is sympathetic activity increased?

A

Under stress

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60
Q

When is parasympathetic activity more dominant?

A

Under basal conditions

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61
Q

What do the PNS and SNS work together to do?

A

Maintain balance

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62
Q

Give 5 examples of SNS control

A 
Dilation of pupil of eye
 Relaxation of lungs
 Rate and force of contraction of heart increases
 Localised secretion from sweat glands
 Generalised secretion from sweat glands
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63
Q

How does the pupil of the eye dilate?

A

Contraction of radial muscle

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64
Q

What does dilation of the pupil use?

A

α1 receptor

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65
Q

What does relaxation of the airways of the lungs use?

A

ß2 receptor

66
Q

What does the control of rate and force of contraction of the heart use?

A

ß1 receptor

67
Q

What does localised secretion from sweat glands use?

A

α1 receptor

68
Q

What does generalised secretion from sweat glands use?

A

M3 receptor

69
Q

Give 3 examples of things controlled by the PNS

A

Contraction of the pupil
Contration of the airways
Decrease in the heart rate

70
Q

How does the pupil contract?

A

Contraction of sphincter muscle

71
Q

What does contraction of the pupil use/

A

M3 receptor

72
Q

What does contraction of airways in the lungs use?

A

Usually M3 receptor

73
Q

What does the PNS use to decrease heart rate?

A

M2 receptor

74
Q

Where is sympathetic drive different?

A

In tissues that are independently regulated

75
Q

What does the ANS control in the CVS?

A

Heart rate
Force of contraction of heart
Peripheral resistance of blood vessels

76
Q

What does the ANS not do in the CVS?

A

Initiate electrical activity in the heart

77
Q

What happens to a denervated heart?

A

It still beats, but at a faster rate

78
Q

What is the heart under at rest?

A

Vagal influence

79
Q

What supplies PNS input into the heart?

A

10th (X) cranial nerve vagus

80
Q

Where does the PNS preganglionic fibre inputting to the heart synapse with postganglionic cells?

A

On the epicardial surface, or within the walls of the heart at the SA and AV node

81
Q

What is the result of the synapse of the nerve supplying the heart being where it is?

A

It allows time for the atria to fully contract

82
Q

What do postganglionic cells of the PNS in the heart nerves release?

A

ACh

83
Q

What does ACh act on in the heart?

A

M2 receptors

84
Q

What is effect of ACh on the heart?

A

Decreases heart rate

Decrease AV node conduction velocity

85
Q

What is the effect of a decrease in heart rate called?

A

A negative chronotropic effect

86
Q

Where do the postganglionic fibres for the SNS input into the heart from?

A

The sympathetic trunk

87
Q

What does the SNS input into the heart innervate?

A

SA node, AV node and myocardium

88
Q

What does SNS activation of the heart cause?

A

Release of noradrenaline

89
Q

Where does noradrenaline act in the heart?

A

Mainly ß1 adrenoreceptors

90
Q

What is the effect of noradrenaline in the hear?

A

Positiv chronotropic effect (increases heart rate)

Increases force of contraction

91
Q

What is the effect of an increase of contraction called?

A

Positive inotropic effect

92
Q

Other than ß1, what other adrenoreceptors are present in the heart?

A

ß2 and ß2, but the main effect is mediated by ß1 receptors

93
Q

What are the autonomic inputs into the heart?

A

Medulla oblongata sympathetic motor neurone
Motor vagus nerve (cranial nerve X, PNS)
Sensory vagus nerve
Sensory glossopharyngeal (cranial nerve IX)

94
Q

Where does the medulla oblongata sympathetic motor neurone go?

A

From the cardiovascular centre and to the spinal cord

95
Q

Where does the medulla oblongata sympathetic motor neurone synapse?

A

The spinal cord

96
Q

What does themedulla oblongata sympathetic motor neurone synapse with?

A

The cardiac accelerator nerve in the sympathetic trunk ganglion

97
Q

What does themedulla oblongata sympathetic motor neurone innervate?

A

The ventricular myocardium, the AV node, and the SA node

98
Q

What does the motor vagus nerve innervate?

A

SA node and AV node

99
Q

What does the sensory vagus nerve innervate?

A

Baroreceptors in the arch of the aorta

100
Q

What does the sensory glossopharyngeal nerve innervate?

A

Baroreceptors in the carotid sinus

101
Q

What is the pacemaker of the heart?

A

Cells in the SAN

102
Q

What do cells in the SAN do?

A

Steadily depolarise towards towards threshold- the slow depolarising pacemaker potential

103
Q

What happens in the pacemaker potential?

A

There is turning on of a slow Na conductance, called the funny current.
Opening of Ca channels

104
Q

What sets the rhythm of the heart?

A

AP firing in the SA node

105
Q

What effect does sympathetic activity have on the pacemaker potential?

A

It increases the slope of the pacemaker potential

106
Q

What is the effect of the SNS on the pacemaker potential mediated by?

A

ß1 receptors that are G-protein coupled receptors

107
Q

How do ß1 receptors mediate the effect of the SNS on the pacemaker potential?

A

They increase cAMP production by stimulating adenyl cyclase.

108
Q

What effect does parasympathetic activity have on the pacemaker potential?

A

In decrease the slope

109
Q

What is the effect of the PNS on the pacemaker potential mediated by?

A

M2 receptors, which are G protein-coupled receptors

110
Q

How do M2 receptors mediate their effect on the pacemaker potential?

A

They increase K conductance, and decrease cAMP by inhibiting adenyl cyclase. K brings the membrane potential down, further from threshold

111
Q

What effect does noradrenaline have on the force of contraction?

A

It increases it

112
Q

How does noradrenaline exert its effect on the force of contraction?

A

It acts on ß1 receptors in the myocardium, which causes an increase in cAMP, activating protein kinase A

113
Q

How does the activation of PKA lead to an increased force of contraction?

A

Phosphorylation of Ca channels open them, increasing Ca entry during the plateau of the AP.
This leads to an increased uptake of Ca into the SR
Leads to increased sensitivity of contractile machinery to Ca

114
Q

How does increased uptake of Ca into the SR increase the force of contraction?

A

It increases build up, so there is more Ca to be released

Increased uptake reduced duration of contraction, which is necessary if need the heart to fire at a faster rate

115
Q

What do most vessels receive?

A

Sympathetic innervation

116
Q

What vessels do not receive sympathetic innervation?

A

Apart from some specialised tissue, such as erectile tissue, which receives parasympathetic tissue

117
Q

What receptors do most arteries and veins have?

A

α1 adrenoreceptors

118
Q

What vessels also have ß2 receptors?

A

Coronary, liver and skeletal muscle vasculature

119
Q

How does the affinity of circulating adrenaline differ between α1 and ß2 receptors?

A

It has a higher affinity for ß2 receptors

120
Q

What does adrenaline do at physiological concentrations?

A

Preferentially bind to ß2 adrenoreceptors

121
Q

What will adrenaline do at higher concentrations?

A

Activate α1 receptors

122
Q

What does vasomotor tone allow for?

A

Vasodilation to occur

123
Q

What leads to vasodilation?

A

Decreased sympathetic output

124
Q

What leads to vasomotor tone?

A

Normal sympathetic output

125
Q

What leads to vasoconstriction?

A

Increased sympathetic output

126
Q

What effect does activating ß2 receptors have on vessels?

A

It causes vasodilation

127
Q

How does activation of ß2 receptors lead to vasodilation?

A

Causes an increase in cAMP, which activates PKA. This opens K channels, and inhibits MLCK, leading to relaxation of smooth muscele

128
Q

What effect does activating α1 receptors have on vessels?

A

Causes vasoconstriction

129
Q

How does activation of α1 receptors cause vasoconstriction?

A

It stimulates IP 3 production, causing an increase in intracellular [Ca] from stores and via influx of extracellular calcium, causing contraction of smooth muscle

130
Q

What does active tissue produce?

A

More metabolites

131
Q

Give 4 examples of metabolites produced by active tissues

A

Adenosine
K+
H+
Increased PCO 2

132
Q

What effect do local increases in metabolites have?

A

Strong vasodilator effect

133
Q

What is the effect of local metabolites on vasodilation important for?

A

Ensuring adequate perfusion of skeletal and coronary muscle

134
Q

How are changes in the state of the CVS communicated to the brain?

A

Via the afferent nerves

135
Q

What detects changes in the state of the CVS?

A

Baroreceptors

Atrial receptors

136
Q

What are baroreceptors involved in?

A

The high pressure side of the system

137
Q

What are atrial receptors involved with?

A

The low pressure side of the system

138
Q

What are cardiac baroreceptors?

A

Nerve endings in the carotid sinus and aortic arch that are sensitive to stretch

139
Q

What stretches the baroreceptors?

A

Increased arterial pressure

140
Q

What happens when baroreceptors detect an increase in blood pressure?

A

It communicates this to the medulla via the afferent pathway.
The coordinating centre of the medulla then sends efferent signals to the heart and the vessels, causing bradycardia and vasodilation

141
Q

What are the effects of bradycardia and vasodilation?

A

Counteracts the increased mean arterial pressure

142
Q

What are the types of drugs that act on the CVS?

A

Sympathomimetics
Adrenoreceptor antagonists
Cholinergenics

143
Q

What do sympathomimetics do?

A

Mimic the action of the sympathetic nervous system

144
Q

What are the types of sympathomimetics?

A

α-adrenoreceptor agonists

ß-adrenoreceptor agonist

145
Q

What are cardiovascular uses of sympathomimetics?

A

Administration of adrenaline to restore function in cardiac arrest
Dobutamine (ß1 agonist) may be given in cardiogenic shock (pump failure)
Adrenaline administered for anaphylatic shock

146
Q

Give a non-cardiovascular use for sympathomimetics?

A

ß2 agonist (salbutomal) used in treatment of asthma

147
Q

What does salbutamol cause?

A

Relaxation of bronchiole smooth muscle

148
Q

What do α-adrenoreceptor antagonists do?

A

Prevents constriction, therefore dilation, therefore decreases pressure

149
Q

Why can α-adrenoreceptor antagonists be used as an anti-hypertensive agent?

A

Because they inhibit NA action on vascular smooth muscle

150
Q

Give an example of an α1-adrenoreceptor antagonist

A

Prazosin

151
Q

Give two examples of ß-adrenoreceptor antagonists

A

Propranalol

Atenolol

152
Q

What does propranolol do?

A

Activates both ß receptors, leading to slowed heart rate and reduced force of contraction (ß1), and acts on bronchial smooth muscle (ß2), leading to bronchoconstriction

153
Q

Why is propranolol dangerous for use with asthmatics?

A

It’s not selective

154
Q

What is atenolol selective do?

A

ß1, and therefore the heart

155
Q

What are the types of cholinergics?

A

Muscarinic agonists

Muscarinic antagonists

156
Q

What do muscarinic agonists do?

A

Activate the receptors

157
Q

Give an example of a muscarinic agonist

A

Pilocarpine

158
Q

What is pilocarpine used in?

A

The treatment of gluacacoma

159
Q

What is glaucacoma?

A

Pressure build up in eyeball

160
Q

Why is pilocarpine used in the treatment of glucacoma?

A

It activates constrictor pupillae muscle, and so drains and reduces pressure in the eye

161
Q

Give two examples of muscarinic antagonists

A

Atropine

Tropicamide

162
Q

What are muscarinic antagonists used to do?

A

Increase heart rate

Bronchial dilation- used to dilate pupils for examination of eye

ESA 2- Cardiovascular System (18 decks)

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