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Board Prep > Module 5- PNS > Flashcards

Module 5- PNS Flashcards

1
Q

Fibers responsible for proprioception

A

A-alpha and A-beta

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2
Q

Sensation of throbbing pain, touch, and temperature

A

Type C

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3
Q

Fibers carrying sensations of sharp, prickling pain and temperature

A

A-delta

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4
Q

Sympathetic and parasympathetic pre ganglionic fibers are what type

A

Type B

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5
Q

Post ganglionic sympathetic fibers are what type

A

Type B

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6
Q

Sympathetic outflow arises where

A

T1-L3

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7
Q

Cardioaccelerator fibers arise where

A

T1-T4

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8
Q

Signs and symptoms of Horner’s syndrome

A 
Miosis
Ptosis
Anhydrosis
Enophthalamos
Flushing
Increased skin temperature
Nasal congestion
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9
Q

Horners syndrome is caused by

A

Block at stellate ganglion

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10
Q

Sympathetic preganglionic neurons arise where in SC

A

Intermediolateral horn

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11
Q

All SNS preganglionic fibers pass through what rami

A

White rami communicans in route to paravertebral ganglia

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12
Q

Some SNS preganglionic fibers pass through what additional rami. Significance

A

Gray ramus

Distributed to all spinal nerves from the ganglia
Allow coordinated, mass discharge of SNS

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13
Q

Stimulation of presynaptic A2 receptors what happens

A

NE synthesis and release is decreased

NEGATIVE FEEDBACK

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14
Q

Synthesis of epi

A

Tyrosine - L dopa - dopamine - NE - epi

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15
Q

NE receptor complex causes activation of what

A

Adenylate cyclase = increased production of cAMP

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16
Q

Termination of acts of NE

A

1- 80% reuptake
2- metabolism by MAO in synaptic cleft
3- metabolized by COMT in plasma

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17
Q

Patient taking MAOI should avoid

A

Ephedrine and Demerol

Both trigger release of NE

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18
Q

Adrenergic receptor found on presynaptic nerve terminals of sympathetic postganglionic neurons and in tissues on postsynaptic membranes in brainstem and peripheral tissues.

Inhibitory

A

Alpha 2

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19
Q

Adrenergic receptors found peripherally in a variety of tissues innervated by sympathetic postganglionic neurons

Excitatory response generally

Arterial and venous vasoconstriction

A

Alpha 1

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20
Q

Adrenergic receptors found in heart, kidney, and adipose tissue

Excitatory

A

Beta 1

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21
Q

Adrenergic receptor found in smooth muscle and glandular tissue

Inhibitory- dilation

Glycogenolysis and gluconeogenesis

A

Beta 2

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22
Q

Stimulation results in increased insulin secretion

A

Beta 2

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23
Q

Stimulation results in decreased insulin secretion

A

Alpha 1&2

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24
Q

Stimulates Na-K pump

A

Beta 2

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25
Q

Uterine relaxation

Contraction

A

Relax beta 2

Contract alpha 1

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26
Q

Increased renin release

A

Beta 1

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27
Q

2 important stimuli for aldosterone release

A

Angiotensin II and high serum potassium

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28
Q

Increases potassium secretion and increases sodium reabsorption

A

Aldosterone

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29
Q

Renin release occurs in response to

A

Decreased renal blood pressure and increased SNS activity, and Chloride

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30
Q

Ritrodine is a beta 2 agonist used to treat preterm labor side effects

A

Hyperglycemia
Hypokalemia
Tachycardia

It does cross the placenta so fetal effects may be seen

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31
Q

Long acting non selective alpha adrenergic agonist used to control BP in pt with pheochromocytoma

A

Phenoxybenzamine

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32
Q

Selective alpha 2 adrenergic antagonist used to treat impotence

A

Yohimbe

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33
Q

Selective alpha 1 adrenergic antagonist that lowers BP without increaseing release of NE (because does not. Block alpha 2)

A

Prazosin

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34
Q

Non selective beta 2 agonists

Avoid in pt with irritable airway bc B2 block can cause bronchoconstriction

A 
Propanolol
Timolol
Esmolol
Nadolol
Pindolol
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35
Q

Mixed alpha and beta adrenergic antagonists

A

Labetalol

Carvedilol

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36
Q

Which receipt depresses activity of Na-K pump

A

Beta 2

37
Q

Chronic exposure to agonist results in what

A

Down regulation of receptors

38
Q

Chronic exposure to antagonist results in

A

Up regulation

39
Q

Parasympathetic outflow arises from

A

CN III, VII, IX, X and sacral cord S2-S4

40
Q

Drug class Xanthines

Example

MOA

A

Theophylline and aminophylline

Non specific inhibition of PDE = accumulation of cAMP = bronchodilation

41
Q

Drug class mast cell inhibitors

A

Cromolyn

42
Q

Respiratory stimulant agent used to reverse respiratory depression

A

Doxapram

43
Q

Drug class leukotriene antagonists

Ex

MOA

A

Montekukast and Zafirlukast

Impair conversion of arachidonic acid to leukotrienes

44
Q

Cholinergic crisis is treated with

A

Atropine

45
Q

Anticholinergic syndrome is treated with

A

Phyostigmine

46
Q 
Which agonist listed is devoid of beta 2 adrenergic activity
Isoprel
Terbutaline
Epi
NE
A

NE

47
Q

3 common glutamate receptors in CNS

A

NMDA

AMPA

Kainate

48
Q

What is the rate limiting step in synthesis of catecholamines

A

Tyrosine to DOPA by tyrosine hydroxylase

49
Q

Where does the SC end in adults?

Neonates?

A

L1 in adults

L3 in neonates

50
Q

In supine position what is the highest point of the spinal column?

Lowest?

A

Highest L3

Lowest T6

51
Q

What is the major inhibitory NTS in spinal cord?

CNS?

A

Spinal cord- glycine

CNS- GABA

52
Q

The epidural space is bound by what cranially, causally, anteriorly, and posteriorly

A

Top- foramen magnum

Bottom- sacrococcygeal ligament

Anterior- posterior longitudinal ligament

Posterior- ligamentum flavum

53
Q

Type of fiber that serves touch and pressure

A

Myelinated A- beta fibers

Also proprioception

54
Q

Which nerve fibers carry only motor information

A

B

C

A gamma

55
Q

Which fibers carry sensory and motor information

A

A alpha

A beta

56
Q

What higher center regulates the SNS

A

Hypothalamus

57
Q

Pelvic pain caused by inflammatory disease or CA can be relieved with what block

A

Superior hypogastric plexus block

58
Q

Sympathetic nerves innervating organs in the abdomen arise where

A

T5-T12

59
Q

Sympathetic nerves innervating bladder, colon, and rectum arise wehre

A

L1-L2

60
Q

What class of drugs interrupt muscarinic transmission peripherally

A

Antimuscarinic aka anticholinergic

61
Q

Nicotinic receptors are found where

A

Cell bodies of SNS and PNS postganglionic neurons, chromaffin cells of adrenal medulla, motor end plate of skeletal NMJ

62
Q

3 drugs that block nicotinic receptors at autonomic ganglion

A

Trimethaphan

D-tubocurarine

Metocurine

63
Q

NE stimulates what adrenergic receptors

A

alpha 1

Alpha 2

Beta 1

64
Q

What adrenergic receptors are stimulated by epi

Which are most sensitive

A

Alpha 1

Alpha 2

Beta 1

Beta2

Beta receptors are more sensitive to epi

65
Q

At lower doses of epi which receptors effects predominate

A

Beta

66
Q

How does cocaine alter sympathetic function

A

By blocking reuptake of NE

67
Q

What should you avoid in treating hypotension in a cocaine addict

A

Indirect acting agents such as ephedrine

68
Q

Phenylephrine produces which more arterial or veno constriction

A

Venoconstriction more than arterial constriction

69
Q

Tachyphylaxis to ephedrine develops why

A

Depletion of NE from sympathetic post ganglionic nerve terminals

70
Q

Dobutamine acts on what receptors

A

Primarily Beta 1

Some Neta 2 and alpha

Increases contractility more than HR

71
Q

Where in cardiovascular system are Beta 2 receptors mostly located

A

Smooth muscle of vasculature of skeletal muscle

72
Q

Low dose dopamine stimulates what

A

Dopamine 1 receptors of renal vasculature = renal vasodilation

73
Q

Intermediate doses of dopamine stimulate

A

Dopamine receptors and beta 1 receptors

74
Q

High doses of dopamine stimulate

A

Dopamine, beta 1, and vascular alpha 1

75
Q

What drugs and contradictions associated with increased resistance to NDNMB

A

Antiepileptic drugs

Burns

76
Q

MOA of gabapentinoids analgesic effect

A

Reduce hyperexcitaility of dorsal horn neurons caused by tissue damage

77
Q

What drugs should be avoided in patient taking L-DOPA. Why

A

Any drug that antagonizes dopamine- doperidol, reglan, comparing, alfentanil

Bc dopamine is deficient in Parkinson’s patient

78
Q

Diphenhydramine interacts with what receptors

A

H1 blocking histamine

Also has anticholinergic activity so can treat Parkinson’s crisis

79
Q

What drug can be used to treat extrapyramidal symptoms

A

Diphenhydramine

80
Q

What drugs are prohibited in patient taking MAOI for depression

A

TCA

Opioids (especially Demerol)

Indirect sympathomimetics

Fluoxetine

81
Q

How many days before surgery should MAOI be stopped

A

14-21 days

82
Q

St Johns Wort effect

A

Induces cytochrome P450

Increases metabolism of drugs

83
Q

In addition to lithium level what lab values are concerning for a patient taking lithium

A

Sodium (sodium depletion = decreased renal excretion of lithium)

Avoid fluid restriction and excessive diuresis

84
Q

Caffeine stimulant effect MOA

A

Antagonist at adenosine receptor

Inhibit PDE

85
Q

Position for patient with VAE

A

Left lateral decubitus with slight trendelenburg

86
Q

Location of appropriate placement of doppler for detecting VAE

A

Over RA

87
Q

Does alkalosis increase or decrease the seizure threshold

A

Decreases the threshold. Seizures are more likely

88
Q

4 electrolyte disorders that lower the seizure threshold

A

Hypocalcemia

Hypomagnesemia

Hyponatremia

Hypernatremia

89
Q

Combination of aminophylline and ketamine can cause what

A

Seizures

Board Prep (19 decks)

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