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Pharm II Unit I > 1 ANS Intro > Flashcards

1 ANS Intro Flashcards

1
Q

The peripheral nervous system is divided into what two major subdivisions?

A

Autonomic and Somatic

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2
Q

The _______ division is independent of conscious thought or control

A

Autonomic

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3
Q

Autonomic pathways originate in the:

A

Brain or Spinal Cord

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4
Q

Autonomic pathways involve a __________ nerve and a ___________ nerve, connected in series by a ___________.

A

A PREGANGLIONIC nerve and POSTGANGLIONIC nerve connected by a GANGLION

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5
Q

In the __________ system, there is no peripheral ganglia.

A

Somatic nervous system

A single motor neuron projects from the CNS directly to the skeletal muscle

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6
Q

The ANS is subdivided into:

A

The PARASYMPATHETIC, or craniosacral division, and

the SYMPATHETIC, or thoracolumbar division

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7
Q

The parasympathetic nerves leave the spinal cord with…

A

With the cranial and sacral nerves (hence the “craniosacral” name)

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8
Q

The sympathetic pathways leave the CNS…

A

From the spinal cord at thoracic and lumbar levels (hence the “thoracolumbar” name)

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9
Q

ANS fibers leaving the brain stem or spinal cord terminate in ___________.

A

Autonomic ganglia

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10
Q

Autonomic ganglia contain the nerve endings of ____________ fibers and the cell bodies of __________ fibers.

A

Pre-ganglionic, post-ganglionic

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11
Q

All pre-ganglionic fibers release the neurotransmitter ____________ onto ____________ receptors in the autonomic ganglia.

A

Acetylcholine, nicotinic receptors

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12
Q

Describe the pathway of parasympathetic innervation

A

Pre-ganglionic fibers leave the CNS with the CRANIAL nerves and the third and fourth SACRAL spinal roots.

The pre-ganglionic fibers may terminate on ganglia located in the wall of an innervated organ, on diffuse ganglia, or on autonomic ganglia outside the innervated organ.

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13
Q

Postganglionic parasympathic fibers are very ______ compared to those in the sympathetic system.

A

Short

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14
Q

Both pre- and post-ganglionic neurons in the parasympathetic system release ….

A

Acetylcholine

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15
Q

Describe the pathway of sympathetic innervation

A

Pre-ganglionic fibers leave the CNS with THORACIC and LUMBAR spinal nerves. Cell bodies are in the LATERAL horn of the gray matter in the thoracic and lumbar spinal cord.

Most of the pre-ganglionic fibers terminate in ganglia in the PARAVERTEBRAL chains, which run alongside the spinal column.

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16
Q

Broad interconnections provided by the paravertebral chains allow the whole sympathetic system to …

A

Activate in a coordinated discharge

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17
Q

Post-ganglionic sympathetic fibers project to various tissues and are ________ than those in the parasympathetic system.

A

Longer

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18
Q

The majority of post-ganglionic fibers release _________, except for ….

A

Most release norepinephrine (NE) except:

Sweat glands release acetylcholine (ACh)
Renal vasculature releases dopamine
Adrenal medulla releases epinephrine

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19
Q

The main neurotransmitters involved in the autonomic nervous system:

A

Acetylcholine (ACh), norepinephrine (NE) and dopamine (DA)

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20
Q

All pre-ganglionic fibers of both the parasympathetic and sympathetic systems are _________.

A

Cholinergic, i.e. they release ACh, which acts on nicotinic receptors in the ganglion.

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21
Q

Post-ganglionic fibers of the parasympathetic system are _____________, releasing _________, which acts on ___________ receptors.

A

Cholinergic —> release ACh —> act on muscarinic receptors.

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22
Q

Post-ganglionic fibers in the sympathetic system are primarily ______________, and release ______, which acts on ____________ receptors

A

Noradrenergic —> release NE —> acts on alpha and beta receptors

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23
Q

The sympathetic post-ganglionic innervation of ___________ is cholinergic, with ACh stimulating muscarinic receptors, even though these neurons are considered sympathetic.

A

Sweat glands

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24
Q

Sympathetic neurons to the _____________ release dopamine

A

Renal vascular smooth muscle

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25
Innervation to the adrenal medulla from the spinal cord is ___________, with ______ acting on a __________ receptor to cause release of _____________.
Cholinergic —> ACh acts on nicotinic receptor —> releases Epinephrine
26
____________ released from the adrenal medulla circulates in the body and acts on both alpha and beta receptors.
Epinephrine (Epi)
27
Motor neurons to the skeletal muscle are ____________, with ________ acting on ________ receptors
Cholinergic —> ACh acts on nicotinic receptors
28
Blood vessels receive _________ innervation but not __________.
Sympathetic but not parasympathetic. Blood vessel tone is predominantly sympathetic.
29
The _____________ are innervated by neurons from the sympathetic chain that release _________.
Sweat glands, ACh
30
The parasympathetic system has been called __________, meaning it facilitates growth
Trophotropic It’s the “rest and digest” system.
31
Parasympathetic stimulation causes:
Slowing of the heart Increased secretion of saliva and gastric acid Increased GI activity, promoting digestion Relaxation of sphincters, promoting elimination Pupils and ciliary muscles both contract —> accommodation
32
The sympathetic system is designed so that it can...
Fire all at once
33
In the sympathetic system, there is a nearly ______ ratio of pre- to post-ganglionic innervation
1:20 —> allowing for massive activation of the whole system at once.
34
The sympathetic system is referred to as ________, meaning facilitating energy expenditure.
Ergotropic - it allows for “fight or flight”
35
Sympathetic stimulation causes:
Heart to beat more rapidly and CO increases Blood vessels supplying skeletal muscles relax, allowing for more blood flow to muscles Blood vessels to the skin constrict, reducing bleeding in response to energy Bronchioles dilate, allowing for easier breathing GI system less active, sphincters contract Pupils dilate, ciliary muscles relax (distance vision) Glycogenolysis and gluconeogensis are stimulated, lipolysis occurs and renin released from kidney
36
Acetylcholine is formed from ...
Cholinergic and acetyl CoA by the enzyme choline acetyltransferase (ChAT)
37
ACh is stored in _______ within the nerve terminal
Synaptic vesicles
38
The action of ACh within the synaptic cleft is rapidly terminated via ...
Hydrolysis by acetylcholinesterase (AChE), which converts ACh back into choline and acetate
39
What happens to choline after ACh is broken down by AChE?
It is taken back up into the nerve terminals and recycled back into ACh.
40
Besides AChE, what else can affect circulating ACh?
Pseudo holiness erase can also inactivate circulating ACh
41
ACh binds to _______ receptors, which are located either on the postsynaptic cell or on presynaptic terminals
Cholinergic
42
What are the two subgroups of cholinergic receptors?
Muscarinic and nicotinic
43
M1 muscarinic receptors are found...
In the CNS and in sweat glands Gq protein linked —> activate phospholipids C —> IP3 and DAG —> Ca2+ release and activation of protein kinases
44
M2 muscarinic receptors are found
In the heart, some smooth muscle, and presynaptically on neurons Gi protein linked, INHIBIT adenylyl cyclase, open K+ channels, hyperpolarizing neurons
45
M3 muscarinic receptors are found...
In exocrine glands, smooth muscle, and endothelium Gq protein linked, same mechanism as M1
46
What are the two kinds of nicotinic receptors?
Nn are found on postganglionic neurons and presynaptic terminals Nm are found at NMJs of skeletal muscles For both, binding of ACh opens Na+ channels, depolarizing the cell
47
Parasympathetic innervation of the heart
The vagus nerve projects to the atrium of the heart M2 receptors slow the heart by decreasing SA node activity, AV conduction, directly and by inhibiting release of NE from incoming sympathetic neurons
48
Parasympathetic innervation of the lungs
M2 receptors cause bronchoconstriction and increase mucous secretion in the lungs
49
Secretions from the salivary and lacrimal glands are increased by both _____ and _____ receptor activation
M1 and M3 (parasympathetic)
50
M3 receptors cause _______ and ________ in the eye
Mitosis (constricting pupil) Accommodation of the lends for near vision
51
In the stomach, M3 receptor activation increases...
Gastric acid secretion
52
M3 receptors stimulate the GI tract by
Stimulating the GI tract wall, increasing motility Relaxing the sphincters, allowing for defecation Contract the bladder wall, increasing the urge to urinate, as well as relaxing the base of the bladder and urinary sphincter
53
In men, M3 receptors do what to the penis?
Promote erection “Point”
54
How do the nicotinic receptors at NMJs differ from the muscarinic/nicotinic receptors of the parasympathetic system?
The nicotinic receptor is an ion channel, and which ACh binds, it opens, allowing Na+ to enter the cell, resulting in depolarization, leading to an action potential (some K+ also leaves the cell)
55
______ is hydroxylated to become I-dopa, which is then decarboxylated to dopamine (DA)
Tyrosine
56
DA is a neurotransmitter on its own, but what else can happen to it?
In noradrenergic neurons, DA is hydroxylated to form NE in the synaptic vesicles NE is converted to epinephrine in the adrenal medulla.
57
NE is stored in vesicles and released when?
When the cell depolarizers, the vesicles fuses with the presynaptic membrane and NE is released
58
Drugs such as _______ and ______ cause release of NE from the pre-synaptic terminal and will have effect only if noradrenergic terminals are intact
Tyramine and amphetamine
59
What is the main mechanism for the termination of action of NE in the synaptic cleft?
Reputable into the presynaptic terminal
60
Reputable of NE into the presynaptic terminal is blocked by drugs such as ...
Antidepressants and cocaine
61
NE is metabolized by what two enzymes?
monoamine oxidase (MAO) and catechol-0-methyl transferase (COMT) The end product, measured as a diagnostic marker, is vanilla-Mandela’s acid (VMA)
62
Alpha1 receptors are found in....
Smooth muscle Gq protein linked —> activation of PLC increases IP3 and DAG —> Ca2+ increases and cell depolarizes
63
Alpha2 receptors are found ...
On presynaptic terminals, in platelets, lipocytes, and some smooth muscle Gi protein linked, inhibits adenylyl cyclase
64
Beta1 receptors are found
On many pre- and post-synaptic sites, most specifically in the HEART
65
Beta2 receptors are found...
On some smooth mucscle, specially the bronchioles (and the heart)
66
Beta3 receptors are found...
On lipocytes, causing lipolysis | In the urinary bladder, causing relaxation
67
All beta receptors are _____ protein linked
Gs - stimulate adenylyl cyclase to increase cAMP
68
Dopamine receptors are found in ....
Renal vascular bed and some blood vessels Stimulate adenylate cyclase
69
The “fight or flight” response of the sympathetic nervous system includes responses such as:
Increase in both heart rate and force of contraction Dilation of blood vessels to heart and skeletal muscle Constriction of blood vessels to skin and other areas Dilation of bronchioles Decrease in GI activity and constriction of GI and GU sphincters Increases in lipolysis, glycogenolysis, and blood glucose Increase in the release of renin Dilation of pupils, with a slight increase in distance vision
70
Sympathetic innervation to the heart
Beta1 (and some B2) receptors increase heart rate, AV conduction, and contractility
71
Sympathetic innervation of the lungs
B2 receptors relax the bronchioles
72
Sympathetic innervation of the blood vessels
alpha1 receptors constrict blood vessels in the skin and skeletal muscle Beta2 receptors relax blood vessels in the skeletal muscle
73
Sympathetic innervation of the glands and eyes
M3 receptors increase sweating (ACh) Alpha1 receptors increase activity of apocrine and salivary glands Alpha1 receptors cause dilation of pupils (mydriasis) Alpha1 receptors cause constriction of nasal blood vessels, decreasing congestion
74
Sympathetic innervation of GI and GU tracts
Alpha2 and Beta2 receptors relax the walls of the GI tract B2 receptors relax the pregnant uterus B3 receptors relax the urinary bladder Alpha1 receptors contract the urinary sphincter, making it harder to urinate (esp men) Alpha1 receptors promote ejaculation
75
Presynaptic ____ receptors on noradrenergic nerve terminals decrease NE release
Alpha2
76
Presynaptic ____ receptors on cholinergic nerve terminals decrease ACh release
M2
77
Autoreceptors refer to...
when the presynaptic receptor is for the type of transmitter within the terminal
78
Heteroreceptors refer to
when the presynaptic receptor is for other types of neurotransmitters other than the type within the terminal
79
A decrease in receptor number (either through internalization or destruction) that occurs in response to repeated, high frequency stimulation.
Down regulation
80
Receptors for a neurotransmitter increasing either in number or affinity in response to inhibition or removal of an input/stimulus
Up regulation
81
An extreme example of up-regulation in which a total loss of input may cause a large increase in receptor number
Enervation supersensitivity
82
If a drug increases BP by constricting the blood vessels, the body will attempt to compensate for the increased pressure by slowing heart rate and decreasing cardiac output. This is called...
Reflex bradycardia
83
If a drug dilates blood vessels and drops blood pressure, the level of signal at the baroreceptrs is decreased and the brain will increase sympathetic output, so that the body can compensate by increasing heart rate. This is called...
Reflex tachycardia
84
The net effect of NE on the heart is an increase in peripheral resistance (diastolic pressure), but some increase in BP is moderated to some degree by...
The decrease in heart rate due to vagal stimulation (reflex bradycardia)
85
A blockage of ____ receptors with atropine will prevent...
The reflex bradycardia resulting from NE stimulation
86
Contraction of the ciliary muscle and constriction of the pupil by __________ stimulation widens the space in the trabecular meshwork and allows aqueous humor to be cleared more easily
Parasympathetic stimulation This decreases intraocular pressure
87
Activation of ______ receptors by sympathetic stimulation also increases clearance of aqueous humor and decreases ocular pressure
Alpha
88
Stimulation of ___________ increases production of aqueous humor, increasing intraocular pressure
Beta receptors Therefore, a blockade of beta receptors is used to decrease intraocular pressure
89
The size of the pupil is controlled by the ...
Iris radial muscle and the circular muscle
90
Contraction of the radial muscle in response to ______ stimulation _______ the pupil
Sympathetic —> dilates
91
Contraction of the circular muscle in response to ________ stimulation causes the pupil to ________
Parasympathetic —> pupillary constriction
92
Contraction of the ciliary muscle relaxes tension on the suspensory ligaments, allowing the lens to...
Become more convex and shift forward, increasing accommodation for near vision
93
The iris circular and ciliary muscles are controlled by _________
Cholinergic inputs Stimulation of muscarinic receptors contracts the iris sphincter and ciliary muscles —> miosis and increased accommodation for near vision
94
If the ciliary muscle is blocked with cholinergic antagonists, what will happen?
Cycloplegia, or loss of accommodation Pupil dilation
95
___________ can be used to treat glaucoma. How?
Cholinergic agonists Cholinergic stimulation increases removal of aqueous humor through the trabecular meshwork, decreasing intraocular pressure.
96
Because the iris radial muscles contract in response to alpha receptor stimulation, alpha receptor agonists can cause
Mydriasis (dilation of the pupil)
97
Alpha receptor agonists can also be used to treat glaucoma because...
Contraction of the radial muscle promotes drainage of intraocular fluid and can decrease pressure
98
___________ increase production of aqueous humor, resulting in an increase in intraocular pressure
Beta receptors Beta receptor blockers can also be used to treat glaucoma

Pharm II Unit I (4 decks)

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