Week 2 Flashcards

1
Q

Functions of autonomous
nervous system

A

No conscious control – involuntary nervous system

  • Homeostasis
  • Alters intrinsic activity of tissues, e.g.
    Regulation of
  • body temperature
  • cardiovascular activity
  • respiratory functions
  • digestive functions
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2
Q

Division and functions of the ANS

A

1) Sympathetic Nervous System
Flight or Fight –anxiety and attention

2) Parasympathetic Nervous System
Rest and digest – relaxation and pleasure (chillin’)

ANS is organized in ganglions,
nerves and plexuses.

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3
Q

ANS control by CNS

A

Brainstem and hypothalamus (via medulla)
- control centers for:
– body temperature (H., medulla)
– water balance (H.)
– food intake (H.)
– vasomotor control of blood pressure (H., medulla)
– respiratory center (brainstem)

  • Input to ANS control centers:
    1) Periphery (chemoreceptors, baroreceptors)
    2) Cortex-thalamus-hypothalamus
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4
Q

Hypothalamus

A

Sympathetic autonomic center:
Control of heart rate, BP via medulla

look at picture

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5
Q

Visceral organs

A

2 motor neurons:
1. Preganglionic neuron
2. Postganglionic neuron

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6
Q

Skeletal muscle

A

1 somatic motor neuron

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7
Q

“Generic” neurotransmitter mechanism

A
  1. an action potential is spread to the terminal of a presynaptic neuron
  2. Ca2+ enters the presynaptic axon terminal
  3. neurotransmitter is released by exocytosis into the synaptic cleft
  4. neurotransmitter binds to receptor sites on the postsynaptic neuron
  5. specific ion channels open up in the subsynaptic membrane
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8
Q

Cholinergic receptors

A

Nicotinic AChR (N)
- cation channel normally closed
- when agonist binds it opens
- influx of sodium and calcium = depolarising the cell and activates it
- in muscle if activated = contractions
- if a neuron is activated = release of other neurotransmitters

Muscarinic AChR (M)
- The even receptors m2 and m4 are inhibitory receptors and they work by activating a … and inhibitory protein and that then blocks the activity of adenelate cyclase.
So less camp production.
With less camp our heart rate increases

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9
Q

Parasympathetic nervous system

A

rest and digest

Eyes: pupil constriction

Heart: decreased heart rate
(negative chronotropy and no
significant inotropic effects)

Arteries and veins (indirect): decreased blood pressure & redistribution of blood flow toward GI tract

Stomach and intestines:
increased motility and secretions to promote digestion
Relaxation of sphincters

Liver: decreased glycogenolysis

Lungs: constriction of trachea
& bronchi

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10
Q

How to memorise effects of muscarine
(parasympathetic innervation)?

A

DUMBELS

Diarrhea/diaphoresis
Urination
Miosis
BBB (Bronchorrhea Bronchospasm Bradycardia)
Emesis
Lacrimation
Salivation

All effects elicited by the parasympathetic NS in the
end organs are though muscarinic effects!

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11
Q

Sympathetic nervous system: adrenergic receptors

A

Eyes: M. pupil dilation

Heart: increased heart rate & force of beating (positive chronotropy and inotropy)

Lungs: relaxation of trachea & bronchi to facilitate respiration

Liver: increased glycogenolysis

Adrenals: NA and A release

Stomach & GI: decreased motility
sphincter constriction

α2 is mainly presynaptic and inhibits NA release

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12
Q

Sympathetic Nerves

A
  • Originate in thoracic-lumbar sections of spinal cord
  • Synapse in paravertebral ganglia or prevertebral ganglia or in adrenal medulla
  • Pre-ganglionic neurons release acetylcholine onto nACHR on the post-ganglionic neurons
  • Post-ganglionic neurons release noradrenaline onto various adrenergic receptors on the end organs

Exception:
release of ACh by postganglionic fibers: sweat glands

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13
Q

Catecholamines:
Tyrosine-derived neurotransmitters

A

Tyrosine
DOPA
dopamine
Noradrenaline (Norepinephrine)
Adrenaline (Epinephrine)

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14
Q

Adrenal Medulla

A
  • Preganglionic fibers from the hypothalamus pass through
    the sympathetic ganglionic chain without synapsing into the
    adrenal medulla.
  • They synapse directly onto chromaffin cells, modified neurons,
    which release noradrenaline (NA) and adrenaline (A) into the blood.
  • The action of NA and A in blood are longer lasting than if the hormones were released at synapses. The hormones can reach organs that are not innervated by the ANS, such as
    the lung.
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15
Q

Pupillary muscles and their response

A

constrictor: sphincter

Parasympathetic NS; Miosis
Muscarinic ACh rec

dilator: radial

Sympathetic NS; Mydriasis
Alpha1 adrenergic rec

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16
Q

Transmitters and Receptors in the ANS

A

Noradrenaline / Adrenaline =
Adrenergic receptors GPCR
- α (α1, α2)
- β (β1, β2)

Acetylcholine =
Nicotinic ACh receptors
- cation channel
Muscarinic ACh receptors
- M1-M5 GPCR

Muscarinic Ach receptors are
1000x more sensitive to Ach
than nicotinic receptors

17
Q

Muscarinic acetylcholine receptors

A

M1 M3 M5
= IP3/DAG
CNS, glands,
smooth muscle, GIT

M2 M4
=cAMP
Heart , CNS:
K + conductance ↑
Ca2+ conductance ↓

18
Q

Pharmacology of drugs targeting
the muscarinic receptors

A

Muscarinic agonists:
e.g. carbachol (experimental), pilocarpine

Muscarinic antagonists:
- atropine, scopolamine

What are the effects and side effects?

What would be an antidote to Atropine?

19
Q

Uses of muscarinic agonists

A

Pilocarpine:
Treatment of glaucoma, dry mouth
Side effects/poisoning:
muscarinic side effects and seizures!

How do we treat poisoning?
Atropine or a muscarinic antagonist.

20
Q

Regulation of aqueous humor pressure

A

Muscarinic rec. increase aqueous
humor outflow by constriction of
ciliary muscle and pupil constriction

Treatment of glaucoma: enhance
muscarinic activity (pilocarpine,
ACHEI) or beta-blockers

Beta2 adrenergic rec. mediate aqueous humor production

21
Q

Muscarinic antagonist effects

A

Atropine:
- mydriasis, blurred vision
- Tachycardia (80-90 bpm)
- Bronchodilation
- Dry mouth and skin (no sweating)
- Urinary retention
- Constipation

CNS: excitement, hyperactivity, rise in body temperature

Scopolamine: sedation, hallucinations, anti-emetic

22
Q

Uses of muscarinic antagonists

A

Atropine and derivatives:
- To induce mydriasis (ophtalmologist - homatropine)
- Asthma (ipratropium)
- During surgery: to inhibit vagal reflexes
(Inhibit bronchoconstriction + bradycardia)

Hyoscine (scopolamine) patch:
- To prevent motion sickness

23
Q

Drugs changing cholinergic transmission

A

Botulinum toxin A: Clostridium botulinum = strongest known poison!
0.1-1 ng/kg lethal dose
(100 g can kill mankind)

-Treatment for wrinkles and
dystonia, strabismus,
spasticity
-Inhibition of exocytosis
proteins and block of release
of ACh (and other NTs)->
Flaccid paralysis of muscles

Acetylcholinesterase inhibitors:
(indirect parasympthomimetic
agents):
Irreversible: Insecticides
Organophosphates
(soman, sarin)

Enhanced ACH neurotransmission
(Nicotinic +) Muscarinic
(DUMBBBELS)

Skeletal muscle, Postganglionic cell or
effector organ innervated by
parasympathetic NS

24
Q

Acetylcholinesterase inhibitors

A

“Agonistic” effects on
neuromuscular junction:
 greater muscle tension
 Treatment of myasthenia
gravis

“Agonistic” effects on
muscarinic synapses:
 Treatment of glaucoma, GIT
immobility

Effect on CNS:
 Treatment for Alzheimer’s
Disease (e.g. donezepil)

25
Q

High dose of ACHE inhibitors or
nerve gases

A

 Muscarinic effects: Pinpoint pupils, blurred vision, Hypersecretion by salivary, lacrimal, sweat, and bronchial glands, Bowel and bladder incontinence Nausea, vomiting, or diarrhea, Bradycardia, hypotension, difficulties breathing

 Nicotinic effects: depolarisation block
Skeletal muscle twitching and cramping, followed
by weakness and flaccid paralysis
(also may lead to Tachycardia and Hypertension – WHY?)
 Central Nervous System
Seizures, Respiratory depression
 ANTIDOTE:

26
Q

Muscarinic antagonist effects are
also called anti-cholinergic effects.

A
27
Q
A