Unit 2 - ANS A&P Flashcards
makes up the CNS
- spinal cord
- medulla oblongata
- pons
- midbrain
- thalamus
- cerebral hemisphere
included in cerebral hemisphere
- cerebral cortex
- subcortical white matter
- basal nuclei
peripheral nervous system consists of:
spinal and cranial nerves (except CN2) present outside CNS
ultimate responsibility of ANS
ensure physiologic integrity of cells , tissues ,and organs througout the entire body despite challenges from external environment
ANS division that accounts for miosis and eye accommodation
PNS
3 divisions of the ANS
- Sympathetic
- Parasympathetic
- Enteric divisions
which anatomic part of the nervous system is surrounded and covered by meninges?
central nervous system
which type of muscle does NOT receive ANS signals?
skeletal
ANS division responsible for artery tone
SNS
CV effects of SNS stimulation
- increased cardiac force, rate, conduction, excitability
- constriction and dilation of coronary arterioles
pulmonary effects of PNS
bronchial smooth muscle contraction
pulmonary effects of SNS stimulation
relaxation of bronchial smooth muscle
eye effects of SNS stimulation
- mydriasis (pupil dilation)
- ciliary muscle relaxes (far vision)
peripheral neurotransmitters of autonomic efferents
- ACh
- NE
- Epi
peripheral NT of somatomotor efferents
ACh
target organ(s) of somatomotor efferents
skeletal muscle
nerve fiber classification of preganglionic autonomic efferents
lightly myelinated B fibers
nerve fiber classfication of postganglionic autonomic efferents
nonmyelinated c fibers
nerve fiber classification of somatomotor efferents
heavily myelinated A-alpha fiber
moderately myelinated A-gamma fibers
control system of autonomic efferents
- primarily unconscious, involuntary control
- independent with hormonal control
control system of somatomotor efferents
- primarily conscious, voluntary control
- unrelated to hormonal control
neuron routes involved from spinal cord to target in somatic efferent pathways
1
neuron routes involved from spinal cord to target in ANS efferent pathways
2
schema for anatomic organization of ANS
origin → route to relay → relay → distribution → effector (target)
2 synonyms for efferent
motor, outflow
3 structures that comprise brainstem
- medulla
- pons
- midbrain
(mesencephalon)
2 synonyms for afferent
sensory, inflow
pathway assoc. with short preganglionic and long postganglionic fibers
SNS efferent pathways
SNS origin
preganglionic nerve cell body (soma)
characteristic feature of ANS
its efferents emerge as myelinated fibers from spinal cord or brain (CNS), are interrupted in course by synapse in a peripheral ganglion, and are then relayed for distribution as fine, nonmyelinated fibers to their effectors
nerve fiber classification of preganglionic neurons
lightly myelinated B fibers
nerve fiber classification of postganglionic neurons
unmyelinated C fibers
nerve fiber classification of A-alpha motor neurons
heavily myelinated, large fibers
nerve fiber classification of A-gamma motor neurons neurons
modestly myelinated, thinner fibers
where do sympathetic preganglionic neurons arise
thoracolumbar region
T1-L2
where are cell bodies of preganglionic sympathetic fibers located
lateral hord of spinal cord grey matter, specifically within intermediate (IML) nucleus
where does the IML lie
Rexed’s lamina 7
where do parasympathetic preganglionic neurons travel
CN 3, 7, 9, 10 and sacral roots S2-S4
which division of the ANS is called the craniosacral system
parasympathetic
origin of the somatomotor division
ventral horn of the spinal cord
location of cell bodies of alpha and gamma motor neurons
Rexed’s laminae 8 and 9
where do axons of preganglionic SNS neurons leave the spinal cord
segmental level at which their cell bodies are located
what forms the white rami
preganglionic symapthetic axons exiting from ventral root
why are white rami white
preganglionic fibers are lightly myelinated B fibers and myelin imparts a white color
why are grey rami grey
axons are nonmyelinated - these areas contain nerve cell bodies, which are grey
where do white rami exist and why
only at T1-L3, where all preganglionic SNS fibers originate from
what is a nerve plexus
network of afferent and efferent nerve fibers from different spinal nerves
somatic nerve plexuses
- cervical
- brachial
- lumbar
- sacral
visceral nerve plexuses
- cardiac
- abdominal aortic
- hypogastric
where are spinal levels gray rami found
all spinal cord levels
reflex characterized by increased HR in response to increased right atrial volume
example
Bainbridge
ex- autotransfusion during childbirth
enzyme that deactivates cAMP
phosphodiasterase
preganglionic fibers in SNS vs PNS
PNS
- preganglionic: long, myelinated, B-fiber, releases ACh
- postganglionic: short, unmyelinated, C-fiber, releases ACh
SNS
- pre: short, myelinated, B-fiber, releases ACh
- post: long, unmyelinated, C-fiber, releases NE
origin of efferent SNS pathways
T1-L3
cell bodies arise from IML region of spinal cord (rexed’s lamina 7)
where do efferent SNS fibers exit
ventral nerve roots
where do efferent SNS preganglionic fibers synapse with postganglionic fibers
in paired sympathetic ganglia (mass effect)
origin of efferent PNS pathways
CN 3, 7, 9, 10
S2-S4
where do preganglionic fibers synapse with postganglionic fibers in craniosacral division
near or in each effector organ (precise control of each organ)
innervation of adrenal medulla
no postganglionic innervation
preganglionic axon takes a straight shot to adrenal medulla
sympathetic chain ganglia pairs
- 3 cervical (superior, middle, inferior)
- thoracic 11-12
- lumbar 3-5
- sacral 3-5
- single coccygeal
what is the stellate ganglion
combination of inferior cervical ganglion & T1 ganglion
only splanchnic nerves to carry PNS fibers
pelvic splanchnic nerves
function of splanchnic nerves
deliver preganglionic SNS fibers to prevertebral delay ganglia and plexuses distribute postganglionic fibers
the intermediolateral nucleus lies within which of Rexed’s lamina
7
white rami are found only at spinal cord levels:
T1-L2/L3
which ganglia are sites for sympathetic synaptic relays
sympathetic chain ganglia & prevertebral ganglia
what is a ganglion
a peripheral collection of nerve cell bodies (soma)
3 thoracic splanchnic nerves
- greater
- lesser
- least
which plexus may be blocked for relief of pain due to chronic pancreatitis
celiac plexus
how do somatic sympathetic groups generally travel to effectors
via spinal nerves
where do preganglionic SNS neurons to adrenal medulla arise in spinal cord
IML T4-T12
where do ALL preganglionic sympathetic neurons arise from?
T1-L3
what is the largest sympathetic plexus
celiac
ganglia that are sites for sympathetic synaptic relays
sympathetic chain ganglia
prevertebral ganglia
ganglion of spinal segment T1-2
superior cervical
provides SNS innervation to colon, urinary bladder, reproductive organs
lumbar sphanchnic nerves
what do postganglinoic axons of lesser splanchnic nerves innervate
GI tract, kidneys, bladder, reproductive organs
where do postganglionic fibers from cervical ganglia distribute
structures in head, neck, heart, lungs
what forms the greater splanchnic nerve
a group of visceral SNS preganglinoic nerves from T5-T9/10 that traverse the sympathetic trunk ganglia
function of greater splanchnic nerve
synaptic relays in the celiac and superior mesenteric ganglia
from there, postganglionic fibers are distributed to upper GI via prevertebral plexuses
plexus with distribution to smooth muscle of esophagus
cardiac plexus
plexus with distribution of postganglionic sympathetic fibers to sigmoid colon
aortic & hypogastric
plexus with distribution of postganglionic sympathetic fibers to liver & gallbladder
celiac plexus
plexus with distribution to cardiac tissues
cardiac plexus
largest sympathetic plexus
celiac
plexus that lies at L1
celiac
plexus with distribution of postganglionic sympathetic fibers to reproductive organs
hypogastric plexus
another name for stellate ganglion
cervicothoracic ganglion
cranial nerves with PNS components
CN 3, 7, 9, 10
somatic efferents of oculmotor nerve
motor supply to certain extraocular skeletal muscles (levator palpebrae superioris, superior/medial/inferior rectus, inferior oblique
visceral (PNS) efferents of oculomotor nerve
innervate specific intraocular muscles (pupillary sphincter, ciliary muscle)
PNS component of facial nerve
Carries PNS efferent innervation to submandibular, sublingual, and lacrimal glands
main sensory component of CN 7
facial nerve
carries taste from anterior 2/3 tongue via chorda tympani
motor components of CN 9
1) visceral efferents to pharyngeal constrictor skeletal muscles
2) visceral effects – PNS fibers – to parotid glands
sensory components of CN 9
1) somatosensory supplies to posterior 1/3 tongue, soft palate, pharyngeal mucosa, tonsils, eustachian tube, tympanic membrane, external ear
2) special visceral afferents from taste buds to posterior 1/3 tongue
3) general visceral efferents from carotid bodies and carotid sinus
supplies about 75% of PNS outflow to the body
CN 10
motor components of CN 10
1) visceral efferents to pharyngeal skeletal muscles, skeletal muscles of soft palate, and all laryngeal muscles
2) visceral efferents (PNS fibers) to thoracic & abdominal viscera
sensory components of CN 9
1) modest somatosensory supply to ear, dura of posterior fossa
2) special visceral afferents from tastebuds on the epiglottis
3) transmitting sensations from pharynx, larynx, barorecepors, chemoreceptors, thoracic & abdominal viscera
Origin of vagal efferents
nucleus ambiguous & dorsal motor nucleus
PNS outflow arises from spinal cord levels:
S2-S4
list the 4 relay ganglia for CN sympathetic pathways
ciliary (CN 3)
pterygopalatine (CN 7)
submandibular (CN 7)
otic (CN 9)
postganglinoic PNS fibers of CN 7 & 9 reach targest by hitchhiking on branches of which nerve?
CN 5
5 nerve plexuses that distribute PNS fibers to viscera
pharyngeal
cardiac
pulmonary
esophageal
celiac
which CN is superior salivatory nucleus assoc with
CN 7
CN associated with inferior salivatory nucleus
CN 9
2 routes preganglionic fibers originating in superior salivatory nucleus can take
- to pterygopalatine ganglion - petroal nerve = pterygopalatine relay ganglion
- leave via facial n. in chorda tympani branch - joins lingual n. - submandibular ganglion
how do preganglionic fibers originating in inferior salivatory nucleus leave brainstem
with CN 9
most CNS neurons are multipolar are unipolar?
multipolar
where do cell bodies of pseudounipolar sensory neurons lie?
DRG
where do sympathetic efferent pathways start and end
start: CNS
end: effector (target) organs
where do visceral afferent pathways start and end
start: organs
end: CNS
what classification of nerve fibers are visceral afferents
A delta and C
visceral afferents from the heart travel in the vagus nerve to the:
NTS (nucleus tractus solitarius)
cell bodies of sympathetic afferent fibers are in the:
dorsal root ganglia
cell bodies of sympathetic afferent fibers are in the:
dorsal root ganglia
which CN with PNS components does NOT transmit sensory information
CN 3
noxioius visceral sensations generally travel in which division of ANS?
sympathetic
receptors that mediate majority of PNS physiologic effects
mAChRs
muscarinic receptors in PNS division
M1, M2, M3
muscarinic receptor assoc. with cerebral vasoconstriction
M1
muscarinic receptor found in heart
M2
muscarinic receptor assoc with bronchoconstriction
M3
signal transduction of M2 & M4 receptors
Gi, G0
effectors of M2 & M4 receptors
inhibit adenylate cyclase
signal transduction of M1, M3, and M5
Gq
effector of M1, M3, and M5
PLC activation (Gq)
location of N-N receptors
autonomic ganglia
adrenal medulla
muscarinic receptors that cause cerebral vasodilation
M2, M5
muscarinic receptors assoc with increased insulin secretion
M3
location of M1 receptors
autonomic ganglia
glands
location of N-N receptors
Autonomic ganglia
Adrenal medulla
location of M2 receptors
Heart
Smooth muscle
ANS nerve terminals
location of M3 receptors
Smooth muscle
Glands
muscarinic receptors assoc with increased Na+ permeability
NN
what enzyme catalyzes the synthesis of ACh
ChAT - choline acetyltransferase
another name for en passant synapses
neuroeffector junctions
what is stored in postganglionic terminal varicosities
neurotransmitters
signal transduction of alpha 1 receptors
Gq/11
alpha 1 receptor effectors
activates PLC
signal transduction of alpha 2 receptors
Gi; G0
effectors of alpha 2 receptors
inhibit AC
Calcium, K channels
signal transduction of beta receptors
Gs
effectors of beta receptors
stimulates AC
calcium channels
alpha receptor assoc. with vasoconstriction of aorta and coronaries
alpha 1D
alpha receptors assoc with cardiac growth & remodeling
alpha 1B
alpha receptors in blood vessels, heart, lung, liver, smooth muscles, vas deferens, prostate
alpha 1A
molecular/cellular response of alpha 1 receptors
• Coupled to Gq to activate PLC = ↑ IP3/DAG
• Modulate K+ channels
• ↑ Na+/H+ exchanged
adrenergic receptor with central components of baroreceptor reflex
alpha 2A
molecular response of alpha 2A receptors
Coupled to Gi to inhibit AC = ↓ cAMP, PKA
predominant receptor for 2 mediated vasoconstriction
alpha 2B
location of alpha 2 C receptors
presynaptic sympathetic nerve terminals
adrenergic receptor assoc with decreasd NT release from adrena medulla
alpha 2C
adrenergic receptor that activates L type calcium channels
Beta 1
adrenergic receptor assoc with lipolysis in adipocytes & thermogenesis
beta 3
adrenergic receptor assoc with skeletal muscle glycogenolysis & hypertrophy
beta 2
adrenergic receptor responsible for melatonin synthesis
beta
SNS neurotransmission with postganglionic cholinergic fibers
exocrine glands
ACh released from postganglionic SNS to exocrine glands mainly binds to what receptor
M3
how do sweat glands release sweat
exocytosis
co-released with NE from postganglionic fibers to decrease amount of NE released
NPY (neuropeptide Y)
co-localized with ACh in preganglionic neurons to regulate SNS activity at ganglia
NO
co-released with NE for SNS stim of vascular smooth muscle
ATP
adrenergic receptor assoc with decreased preganglionic NE release
alpha 2
adrenergic receptor assoc with decreased preganglinoic ACh release
alpha 2
adrenergic receptor assoc with increased renin release
beta 1
intraocular muscle contraction that causes mydriasis
radial muscle
intraocular muscle contraction that causes miosis
spincter pupillae (circular) muscle
3 typical features of horners syndrome
- miosis
- partial ptosis
- ipsilateral anhidrosis
what causes miosis in horners syndrome
paralysis of dilator pupillae muscle
what causes ptosis in horners syndrome
- paralysis of superior tarsal muscle of levator palaprae superior
- ascending SNS outflow blockade at stellate ganglion
what causes ipsilateral anhidrosis in horners syndrome
absence of sweating d.t absence of innervation to sweat glands
innervates orbitalis muscle
superior cervical ganglion (SNS fibers)
cardioaccelerator nerves
T1-T4
complementary SNS & PNS innervation in salivary glands
- SNS = NE acts on alpha 1 and beta = thick secretions
- PNS = CN 7 & 9 = copious watery secretions via ACh acting on M3
PNS only innervation
lacrimal glands, ciliary muscle (near vision accommodation), nasopharyngeal glands
SNS only innervation
adrenal medulla, most blood vessels, erector pili, gallbladder, kidney, exocrine sweat glands
most important integrator of ANS & endocrine function
hypothalamus
most important factors controlled by brainstem
arterial pressure, HR, resp control
major lower brainstem command center for visceral control
NTS in brainstem
greatest concentration of autonomic centers
hypothalamus
mediates interactions between limbic system and brainstem
hypothalamus
major lower brainstem control center for visceral control
NTS
ANS influences all tissues EXCEPT:
skeletal muscle tissues
ANS influences all tissues EXCEPT:
skeletal muscle tissues
1st line defense against arterial BP changes
baroreceptor reflex
procedures that affect baroreceptor reflex
CEA
mediastinoscopy
what indicates that baroreceptor reflex is preserved
heart rate increases with hypotension or decreases with HTN
what is the bainbridge reflex
tachycardia r/t increased venous return
reflex that prevents damming or sludging of veins, atria, and pulm circulation
bainbridge
counterbalance to baroreceptor reflex
bainbridge
cardioinhibitory reflex
Bezhold-Jarisch
triad of bezhold jarisch reflex
Bradycardia, hypotension, & coronary dilation
↓ HR & BP during spinal epidural attributed to what reflex
Bezhold-Jarisch
strongest drive at peripheral chemoreceptors
hypoxia
what causes vasovagal syncope
- transient decreased perfusion to the brain
- massive PNS stimulation, abolition of SNS tone
effector response of oculocardiac reflex
decreased activity of SA and AV nodes
Reflex that fatigues with subsequent occurrences
oculocardiac
what is the CNS ischemic reflex
blood flow to medullary vasomotor center decreases enough to cause cerebral ischemia
massive SNS activation = vasoconstriction and increased BP
one of the most powerful of all activators of SNS vasoconstriction
CNS ischemic reflex
when does CNS ischemic reflex response become signifncant
MAP < 50
greatest degree of CNS ischemic reflex stimulation
MAP 15-20
control center for thermoregulatory reflexes
hypothalamus
how is nonshivering thermogenesis in newborns & infants modulated
by NE from adrenergic nerve terminals
what is the mass reflex
simultaneous excitation of all segmental spinal reflexes
(autonomic hyperreflexia)