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Cell Physiology & Pharmacology > The Autonomic Nervous System > Flashcards

The Autonomic Nervous System Flashcards

1
Q

What does the autonomic nervous system control?

A

Involuntary movements

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2
Q

How may the autonomic nervous system be divided?

A

The sympathetic and parasympathetic nervous system

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3
Q

Which regions of the spinal column are associated with the sympathetic nervous system?

A

The thoracic and lumbar regions

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4
Q

Which branch of the autonomic nervous system is the vagus nerve generally associated with? Which organs does this influence?

A

The vagus nerve is generally associated with the parasympathetic branch of the autonomic nervous system - it deals with parasympathetic control of the heart, lungs, and digestive tract

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5
Q

From which specific part of the spinal cord does the vagus nerve stem?

A

The 10th cranial nerve

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6
Q

What specific region of the spinal cord is associated with the parasympathetic nervous system?

A

The medullary portion

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7
Q

How do the pre-ganglionic and post-ganglionic structures differ in the sympathetic and parasympathetic branches of the autonomic nervous system?

A

In the parasympathetic branch the pre-ganglionic nerve is fairly long and stems deep into the peripheral nervous system, while its post-ganglionic nerve is far shorter - conversely, in the sympathetic branch the pre-ganglionic nerve is short and stems only slightly into the peripheral nervous system, while its post-ganglionic nerve stems the majority of the peripheral nervous system

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8
Q

Where specifically are the ganglia of sympathetic and parasympathetic nerves located?

A

Parasympathetic ganglia are located in innervated tissues, while sympathetic ganglia are located in the paravertebral chain close to the spinal chord

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9
Q

Describe the myelination of pre- and post-ganglionic nerves in sympathetic and parasympathetic systems.

A

Both sympathetic and parasympathetic pre-ganglionic nerves are myelinated, while both sympathies and parasympathetic post-ganglionic nerves are unmyelinated

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10
Q

What neurotransmitter do pre-ganglionic nerves use? Is this the same in sympathetic and parasympathetic nerves?

A

Acetylcholine is the neurotransmitter used in pre-ganglionic nerves of both sympathetic and parasympathetic nervous systems

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11
Q

What receptors are situated on the post-ganglionic nerves?

A

Nicotinic acetylcholine receptors

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12
Q

What type of receptor are nicotinic acetylcholine receptors?

A

Ligand-gated ion channels

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13
Q

What type of receptor are adreno-receptors and muscarininc acetylcholine receptors?

A

They are all G protein-coupled receptors

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14
Q

What neurotransmitter do post-ganglionic nerves of parasympathetic and sympathetic nerve branches release?

A

Post-ganglionic nerves release acetylcholine in the parasympathetic branch, while they release noradrenaline in the sympathetic branch

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15
Q

What receptors are found on target tissues of sympathetic and parasympathetic nerves?

A

Muscarininc acetylcholine receptors are found on target tissues of parasympathetic nerves (as their post-ganglionic nerves are cholinergic) and adrenoreceptors are found on target tissues of sympathetic nerves (as their post-ganglionic nerves are noradrenergic)

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16
Q

How does a ligand activate a G protein-coupled receptor?

A

It binds and causes an allosteric change, causing the G protein to release GDP and bind GTP, activating it

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17
Q

In which cases do sympathetic nerve fibres release acetylcholine onto their target tissue as opposed to noradrenalin?

A

Those innervation sweat glands and hair follicles

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18
Q

Where in the body do chromaffin cells reside?

A

In the adrenal medulla

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19
Q

What branch of the nervous system controls voluntary movement (opposite to the autonomic nervous system)?

A

The somatic nervous system

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20
Q

How does the sympathetic nervous system act differently at the adrenal medulla?

A

The post-ganglionic fibres differentiate of form chromaffin cells - instead of secreting neurotransmitter onto a target tissue, they secrete adrenalin into the bloodstream to act on a wide variety of target organs

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21
Q

Does the somatic branch of the nervous us have pre- and post-ganglionic nerve fibres?

A

No

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22
Q

In the somatic nervous system, list the neurotransmitter used, the type of receptor it acts on, and on which tissue these receptors are located.

A

In the somatic nervous system acetylcholine is used, which binds nicotinic acetylcholine receptors on the surface of skeletal muscle

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23
Q

Which muscarininc receptor is located at the heart? Which muscarininc receptor is located at the lungs?

A

M2 muscarininc acetylcholine receptors are located at the heart, while M3 muscarininc acetlycholine receptors are located at the lungs

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24
Q

Which gas is involved with penile erection?

A

Nitric oxide

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25
Q

What is the collective term used to describe disorders of the autonomic nervous system?

A

Dysautonomia

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26
Q

Which G protein-coupled receptors are associated with noradrenergic release at the heart and the lungs?

A

B1 adrenoreceptors at the heart and B2 adrenoreceptors at the lungs

27
Q

What body specifically monitors the components of blood? How is this relayed to the CNS?

A

The carotid body can monitor the blood for O2, CO2, and pH, which it relays information on back to the CNS via the glossopharyngeal nerve

28
Q

Where is all sensory information eventually localised?

A

The nucleus tractus solitarius

29
Q

Which area can detect toxins and relays this information back to the nucleus tractus solitarius to induce chemically-induced vomiting?

A

The area postrema

30
Q

State 4 distinct part of neurotransmission that are targeted by drugs.

A
  • degradation of neurotransmitter
  • interaction with the post-synaptic receptor
  • re-uptake of neurotransmitter
  • inactivation of the neurotransmitter
31
Q

What equation describes acetylcholine synthesis?

A

Acetyl CoA + choline —> acetylcholine + CoA

32
Q

What enzyme is involved in acetylcholine synthesis? What enzyme is involved in its degradation?

A

Choline acetyltransferase is involved in acetylcholine synthesis - acetylcholinesterase is involved in its degradation

33
Q

What products are produced from the breakdown of acetylcholine?

A

Acetate & choline

34
Q

Give an example of an acetylcholinesterase.

A

Neostigmine

35
Q

How many different types of muscarininc acetylcholine receptors are there?

A

5

36
Q

Why do some drug interventions act differently at autonomic nervous system ganglia and at skeletal muscle neuromuscular junctions?

A

The nicotinic acetylcholine receptors at the 2 different regions differ in structure

37
Q

What can be used to enhance the action of endogenous acetylcholine? List 2 examples.

A

Acetylcholinesterase inhibitors, such as pyridostigmine & donepezil

38
Q

What is a consequence of the relative lack of specificity of drugs affecting the muscarininc cholinergic system?

A

Various side effects

39
Q

What are some of the pathological effects indicative of a massive parasympathetic discharge. What mnemonic does this spell?

A
  • Secretion - increased salivary gland secretion
  • Lacrimation - stimulation of the lacrimal glands
  • Urination - relaxation of the urethral interior sphincter muscle
  • Defecation
  • Gasrtointestinal - smooth muscle tone changes leading to problems
  • Emesis - vomiting
40
Q

How do nerve gases (eg sarin) and some insecticides (e.g. parathion) lead to the ‘SLUDGE’ symptoms?

A

The covalently modify acetylcholinesterases to prevent their activity, greatly increasing levels of acetylcholine

41
Q

What is the pathology behind the ‘SLUDGE’ symptoms? What specific drugs may be used to treat these symptoms?

A

Chronic stimulation of muscarininc acetylcholine receptors may lead to the ‘SLUDGE’ symptoms - they may be treated by atropine & pralidoxime

42
Q

describe the synthesis of adrenaline from tyrosine, stating all enzymes and intermediates.

A

Tyrosine -> tyrosine hydroxylase -> DOPA -> DOPA decarboxylase -> dopamine -> dopamine B-hydroxylase -> noradrenaline -> phenylethanolamine N-methyltransferase - > adrenaline

43
Q

Where in the body is noradrenaline converted into adrenaline? What enzyme facilitates this conversion?

A

In the adrenal medulla, by phenylethanolamine N-methyltransferase

44
Q

What receptors does noradrenaline interact with?

A

Adrenoreceptors

45
Q

How is adrenergic transmission terminated?

A

It is terminated via reupatake into the pre-synaptic vehicle via a Na-dependent, high affinity transporter - a lower affinity mechanism also exists for any that are missed

46
Q

List 2 enzymes involved in the metabolism of noradrenaline that can be targeted by drug therapy.

A

Monoamine oxidase

Catechol-O-methyl transferase

47
Q

What type of molecules are used to combat asthma?

A

B2-adrenoreceptor-selective agonists are used in asthma to oppose bronchoconstriction (e.g. salbutamol)

48
Q

What molecules are used to treat cardiovascular disorders such as hypertension?

A

A1-adrenoreceptor-selective antagonists (e.g. doxasosin)and B1-adrenoreceptor-selective antagonists (e.g. atenolol)

49
Q

Describe the pathology of asthma.

A

Asthma is a chronic condition that stems from airway hyper-responsiveness to allergens such as cigarette smoke and pollen - these trigger eosinophils to release cytokines and other mediators which cause inflammation of the conducting part of the airway (bronchi and bronchioles) - there is also increased mucus secretion, making it harder to breath -

50
Q

What adrenoreceptors are found in the conducting portion of the airways?

A

Beta-2 adrenoreceptors

51
Q

What is the consequence of stimulating adrenoreceptors in the airways?

A

Stimulation of B2 adrenoreceptors in the airways by adrenaline/noradrenaline will lead to a Gs G protein activating adenyl cyclase, cAMP, and finally protein kinase A - this will act overall to cause smooth muscle in the airways to relax (bronchodilation)

52
Q

What are the 2 main categories used to treat asthma? Give 2 examples of each.

A
  • relievers, such as beta agonists and antocholinergics

- preventers, such as glucocorticosteroids and leukotrine receptor antagonists

53
Q

Put simply, how to preventers aim to prevent asthma?

A

They are anti-inflammatory drugs

54
Q

Describe when short-acting and long-acting bronchodilators would be used in asthma.

A
  • short-acting bronchodilators are used immediately in an asthma attack in order to open the airways of an individual
  • long-acting bronchodilators are often used at night, to give a steady and consistent peak flow during the night and the following morning
55
Q

What is hypertension?

A

Abnormally high blood pressure

56
Q

Describe in detail the physiological reflexes involved in controlling normal blood pressure.

A

Renin is produced by the kidneys in response to a decrease in blood pressure - this cleaves angiotensin produced by the liver to angiotensin 1, which is cleaved by ACE to form angiotensin 2 - this acts on the adrenal glands and blood vessels, stimulating vasoconstriction (in order to increase blood pressure)

57
Q

What is normal blood pressure? What is the clinical criteria for diagnosis of hypertension?

A

Normal blood pressure is 120/80mmHg - the clinical criteria for hypertension is 140/90mmHg

58
Q

Suggest 4 drug types that may be used to reduce hypertension, stating how they act.

A
  • ACE inhibitors - inhibit ACE, meaning no angiotensin 2 is formed, and the cascade leading to vasoconstriction is blocked
  • diuretics - increase Na+ and water loss, decreasing water volume in the blood and hence decreasing blood pressure
  • Ca2+ channel blockers - prevent Ca2+ entry into cells, preventing contraction of skeletal and smooth muscle, and slowing the contraction of the heart
  • beta-2 adrenoreceptor antagonist - slows heart rate
59
Q

What are the major population of adrenoreceptors that mediate vasoconstriction of the vasculature?

A

Alpha-1 adrenoreceptors

60
Q

State 3 ways in which beta-2 antagonists exert their anti-hypertensive action.

A
  • reduced ionotropy (force of contraction of muscle)
  • reduced chronotropy (reduced heartbeat)
  • reduced renin release from the kidneys (preventing the cascade leading to vasoconstriction)
61
Q

Why should consideration be given to the potential side effects when administering a drug?

A

Side effects are not normally well-received, and lead to poor compliance

62
Q

What is thyrotoxicosis?

A

Thyrotoxicosis relates to an overactive thyroid

63
Q

What class of drug are normally given to an individual who presents with thyrotoxicosis? Why?

A

Usually non-selective beta-adrenoreceptor antagonists are used - these can be administered intravenously in patients presenting acutely with thyrotoxicosis crisis

64
Q

Describe the main steps when circulating adrenaline binds it’s appropriate receptors on cardia tissue.

A
  • adrenaline binds beta-1 adrenoreceptors at the heart
  • this stimulates a Gs protein to adopt GTP, which gives it the energy to activate adenyl cyclase
  • adenyl cyclase converts ATP to cAMP, which binds and activates protein kinase A
  • protein kinase opens T-type Ca2+ channels, releases stored Ca2+ from the sarcoplasmic reticulum, and phosphorylates myosin heads to increase their activity
  • overall, this all leads to an increased heartbeat

Cell Physiology & Pharmacology (5 decks)

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