Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Pharmacology for Anesthesia > 08 - Autonomic Nervous System 1, Cholinergic System > Flashcards

08 - Autonomic Nervous System 1, Cholinergic System Flashcards

1
Q

The ANS is the part of the nervous system that regulates ______ muscle, _____ and _____ function.

A

cardiac/smooth
visceral
gland

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

The ANS controls _____ functions and reflexes

A

involuntary

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

The ANS influences homeostasis of every tissue and organ system using

A

only 3 substances

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

The sympathetic nervous system is also known as the

A

adrenergic system (adrenaline = epinephrine)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

The parasympathetic nervous system is also known as the

A

cholinergic system (acetylcholine)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

The principle site of organization of the CNS is found in the

A

brainstem and hypothalamus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

The _____ is the main nerve of the CNS. It transmots sensory input from the ____ and ____ organs

A

Vagus (CN X)

throracic, abdominal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

HR, BP, GI, temp, hunger, thirst, osmolarity, and gland secretions are regulated by the

A

CNS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Emotional responses (blushing, fainting, anxiety) are controlled by the CNS in the

A

cortex

limbic system

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

The peripheral nervous system is the ______ component of the CNS

A

efferent (motor)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the difference between autonomic and somatic nerves?

A

Autonomic - two neuron unit: 1. myelinated neuron from CNS to ganglion, 2. unmyelinated neuron from ganglion to target organ

Somatic - single myelinated axon with cell body in spinal cord

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Both SNS and PNS are

A

tonically active - have baseline activity that can increase or decrease -> more than one way to accomplish effect

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

The SNS is also known as the

A

thoraco-lumbar system

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

In the SNS, ____ preganglionic fibers originate from the spinal cord at ______ and synapse at the

A

short
T1-L3
paravertebral sympathetic ganglionic chain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

The preganglionic fibers of the SNS can synapse with the postganglionic neuron at the _____ or

A

same level

course of and down the ganglionic chain and synapse at another level

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

The paravertebral sympathetic ganglionic chain is

A

paired

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

The sympathetic collateral ganglia are

A

unpaired

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Examples of the sympathetic collateral ganglia

A

celiac plexus

inferior mesenteric plexus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Special paired ganglia of the SNS are formed at _____. Examples?

A

T1-T4

Superior cervical, middle cervical, stellate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

SNS ganglia are closer to the _____ than the

A

spinal cord

target organ

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Some preganglionic fibers of the SNS go directly to _____ where ______ take the place of postganglionic neurons

A

adrenal gland

adrenal chromaffin cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Adrenal stimulation releases ____ epi and ____ NE into circulation

A

80%

20%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Postganglionic fibers of the SNS originate at the sympathetic ganglion and synapse at effector tissues. They travel within

A

spinal nerves

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Postganglionic fibers of the SNS outnumber preganglionic fibers by

A

20-30:1

Concurrent stimulation of many organs at once = mass sympathetic discharge

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Postganglionic fibers of the SNS release ______ at the effector tissues. Exceptions are the
NE sweat glands - Ach adrenal medulla - NE + Epi
26
CNS neurotransmitter
Dopamine
27
Synthesized/stored in postganglionic neurons and adrenal medulla
Norepinephrine
28
Synthesized/stored in adrenal medulla
Epinephrine
29
Phenylalanine -> Tyrosine -*-> DOPA -> DA -> NE -> Epi * represents
tyrosine hydroxylase - the rate limiting step
30
NE causes _____ at the point of tyrosine hydroxylase
negative feedback
31
Almost all endogenous NE undergoes ____ into the presynaptic terminal and is metabolized by
``` reuptake monoamine oxidase (MAO) ```
32
Reuptake of NE is inhibited by
``` tricyclic antidepressants (TCA) cocaine ```
33
Circulating catecholamines (NE + Epi) are metabolized in the ______ by
liver and kidneys | Catechol-O-methyltransferase (COMT)
34
What is the metabolite of NE and epi? It is used in the diagnosis of
Vanillylmandelic acid | Pheochromocytoma
35
Systemic catecholamines ____ cross the blood brain barrier
do NOT
36
Sympathomimetics are
drugs that act like catecholamines but have a different structure
37
The PNS is also known as the ______. Preganglionic fibers originate in
cranio-sacral system | bainstem or sacral segments (S2-S4) of the spinal cord
38
The Vagus Nerve (CN X) accounts for ____ of all parasympathetic fibers
>75%
39
PNS ganglia are near the
target organ
40
Unlike the SNS, there is ______ of pre to post ganglionic fibers in the PNS
``` little divergence (1:1) PNS effects are more discrete and localized ```
41
What is released at the effector tissues of the PNS?
Ach
42
How long does it take Ach to be removed by acetylcholinesterase?
<1 msec
43
What are the two types of cholinergic receptors?
Nicotinic and muscarinic | but both respond to Ach
44
Nicotinic (n-Ach-r) receptors are found on cell bodies of
all postganglionic neurons | within ganglia of both SNS and PNS
45
Ach (nicotine) excites
the PNS and SNS
46
A low dose of Ach ->
adrenal medulla -> Epi, NE -> HTN, tachy
47
A high dose of Ach ->
ganglionic blocker -> hypotension, weakness
48
Ach in the NMJ is blocked by
nondepolarizing neuromuscular blocking agents
49
Muscarinic (m-Ach-r) receptors are found on
cell membranes of effector tissues
50
Ach (muscarine) will ______ and be ________, depending on the target tissue
mimic the PNS | excitatory or inhibitory
51
Stimulation of muscarinic receptors on the presynaptic membrane of the SNS nerve terminals
inhibits the release of NE
52
Anticholinergic drugs act specifically at the
muscarinic receptor
53
What is a prototype muscarinic blocker that causes sympathomimetic activity?
Atropine
54
Anticholinergic drugs are ______ that competitively bind to _______ and block activity by Ach
aromatic acid esters | muscarinic receptors
55
CV effects of anticholinergics
reversing brady due to vagal reflexes transient slowing of HR at low doses block vagal activity in SA node facilitate conduction through AV node
56
Pulmonary effects of anticholinergics
relaxation of bronchial smooth muscle
57
Ophthalmic effects of anticholinergics
mydriasis (pupillary dilation)
58
GU effects of anticholinergics
urinary retention
59
Which anticholinergic is the first choice for bradyarrhthmias? It has the side effect of
atropine | tachycardia
60
Why should atropine be used with caution in CAD?
It causes an increased O2 demand
61
The inhaled derivative of atropine is called ________. It has minimal systemic absorption due to its
ipratropium (atrovent) | quaternary ammonium structure
62
Does atropine cross the BBB? It can cause
Yes memory deficits, CNS excitement central anticholinergic syndrome usually minimal effect
63
Central anticholinergic syndrome caused by atropine can be treated with
physostigmine (also crosses the BBB)
64
What is an antisialagogue?
a substance that prevents the production of saliva
65
Which anticholinergic is the strongest antisialagogue?
scopalamine
66
Which anticholinergic is a good premedication for antisialagogue?
Glycopyrrolate
67
Atropine should be used with CAUTION in
narrow angle glaucoma | benign prostate hyperplasia (BPH)
68
Usual adult dose of atropine
0.4-.06 mg IV | 1-2 mg/kg for total vagal blockade
69
Duration of action for atropine?
30 min
70
Scopalamine has ____ CNS effects than atropine
greater: sedation, amnesia
71
Which anticholinergic is an antiemetic?
scopolamine (patch commonly used for PONV)
72
Scopalamine should be used with CAUTION in
closed angle glaucoma
73
Why doesn't glyco cause CNS/ophthalmic activity?
It does not cross the BBB due to its charged quaternary ammonium structure Atropine and scopolamine are tertiary amines
74
The concentration and dose of glycopyrrolate is
half of atropine
75
Duration of action of glyco?
2-4 hours
76
Adrenergic receptors are subdivided into
``` alpha and beta and DA (dopaminergic) ```
77
Which adrenergic receptor is the most abundant? Where are they found?
a1 only found on post synaptic membrane smooth muscles of coronary arteries, skin, uterus, intestines, renal/splanchnic beds
78
a1 receptors are _____ and cause
excitatory | increased intracellular Ca++
79
The effect of a1 receptors
vasoconstriction and GI relaxation | cardiac contractility
80
a2 receptors are ___ that cause
inhibitory | decrease in cAMP
81
Presynaptic effects of a2 receptors
inhibit NE release -> reduce sympathetic outflow; vasodilation; sedation
82
Postsynaptic effects of a2 receptors
arterial/venous vasoconstriction, platelet aggrgation, inhibiton of insulin release and gut motility, inhibition of ADH
83
b receptors cause
increased cAMP
84
b1 receptors are only
postsynaptic
85
b1 receptors are found mostly in the ____, causing
heart increased HR and contractility renin release coronary dilation
86
How does the affinity for epi compare with NE in b1 receptores?
Equal
87
b2 receptors are primarily ____ and tend to be
postsynaptic | inhibitory
88
b2 receptors cause
vasodilation brochodilation renal vessel relaxation
89
b2 receptor affinity is greater for
Epi than NE | It is stimulated by circulating epi instead of direct sympathetic activity
90
Cardiac effects of b2 receptors
increased HR and contractility
91
Presynaptic b2 receptors cause
accelerated NE release | vasoconstriction
92
The resting HR of a person who has had a heart transplant is
90-100 bpm
93
Pt with heart transplants cannot respond to drugs that _____ because
block the parasympathetic system | connections are severed during the transplant
94
Heart transplant patients do not have
baseline parasympathetic innervation and therefore lack vagal tone
95
Patients who have had heart transplants need to have adequate intravascular volume because
they lack normal tachycardia and contractility response to hypotension/hypovolemia
96
What drugs can treat bradycardia in pt with heart transplant?
Isoproterenol and glucagon | They directly affect the heart
97
Epi/NE may have _______ in pt with heart transplant
exaggerated beta mimetic effects on HR
98
Increased BP will _____ reflex slowing of HR in pt with heart transplant
not lead to

Pharmacology for Anesthesia (9 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions