ANS midterm

Question 1

What are three membrane bound receptors?

Answer 1

Ion Channel

G protein

Enzyme linked

Question 2

Example of an Ion Channel?

Answer 2

Voltage gated

Ions travel along concentration gradient

Question 3

Example of a G protein linked coupled receptor?

Answer 3

M2 in the SA node

Question 4

Example of an enzyme linked receptor?

Answer 4

Insulin in skeletal muscle
*linked to tyrosine kinase

Question 5

Examples of intracellular receptors?

Answer 5

Steroids in the cytoplasm

Question 6

Order of G protein coupled receptors?

Answer 6

1. First messenger
2. G protein receptor
   3.Effector
3. Second messenger
   5.Cellular response

Question 7

Examples of effectors?

Answer 7

Adenylate cyclase
Phospholipase C

Question 8

Examples of Second messengers?

Answer 8

cAMP
cGMP
IP3
DAG
Ca

Question 9

Sweat glands are which G coupled receptor?

Answer 9

Alpha 1

Question 10

Bladder sphincter is which G coupled receptor?

Answer 10

Alpha 1

Question 11

Bladder detrusor is which G coupled receptor?

Answer 11

Beta 2

Question 12

Where are alpha 2 non synaptic receptors located?

Answer 12

Platelets

Question 13

How does alpha 2 affect insulin release?

Answer 13

Decreases

Question 14

How does alpha 2 affect renal tubules ?

Answer 14

Inhibits ADH - Diuresis

Question 15

How does alpha 2 affect GI tract?

Answer 15

Decreased motility

Question 16

What are the five steps of norepi release?

Answer 16

Tyrosine
Dopa
Dopamine
Norepi
Epi

Question 17

Which percent of Norpi is reuptaken into the synaptic cleft?

Answer 17

80%

Question 18

What are the three ways Norepi is removed?

Answer 18

1. Reuptake into presynaptic nerve
2. Reuptake by other tissues
   3.Diffuses away

Question 19

What metabolizes norepi and epi?

Answer 19

COMT and MAOI

Question 20

What is the final metabolite of norepi and epi?

Answer 20

VMA - vanillylmandelic acid

Question 21

what does high levels of VMA indicate?

Answer 21

Pheochromocytoma

Question 22

What is the primary transmitter in the PNS?

Answer 22

norepi

Question 23

What is the primary transmitter in the SNS?

Answer 23

acetylcholine

Question 24

What type of receptors are nicotinic?

Answer 24

Ion channels

Question 25

What type of receptors are muscarinic?

Answer 25

G linked protein

Question 26

How is Ach synthesized?

Answer 26

Choline + Acetyl CoA with the help of acetyltransferase

Question 27

What is a antagonist of Ca at the presynaptic terminal?

Answer 27

Mag

Question 28

What does the preganglionic neuron always release? What type of fiber?

Answer 28

Always Ach Myelinated B fiber

Question 29

What does the postganglionic neuron release in the SNS? What type of fiber?

Answer 29

Norepi C fiber

Question 30

What does the postganglionic neuron release in the PNS? What type of fiber?

Answer 30

Ach C fiber

Question 31

Where does the SNS originate from?

Answer 31

T1-L3

Question 32

Where are ganglia located in the SNS?

Answer 32

Near the spinal cord

Question 33

Length of pre and post ganglion in the SNS

Answer 33

Short Pre Long Post

Question 34

Where does the PNS originate from?

Answer 34

Craniosacral CN 3,5,9,10 S2-S4

Question 35

Length of pre and post ganglion in the PNS

Answer 35

Short Pre Long Post

Question 36

Organ response to PNS and SNS?

Answer 36

SNS 30:1 (mass response) PNS 1:1 (precise control)

Question 37

What is the sympathetic ganglia?

Answer 37

Efferent limb- where the pre and post ganglion synapse

Question 38

What are the three paths a preganglionic fiber can take?

Answer 38

Synapse on the same level Ascend or descend Bypass entirely and move to a different collateral ganglion

Question 39

***Know the Stellate Ganglion. What is it?

Answer 39

Provides sympathetic innervation to the ipsilateral upper extremity and neck

Question 40

When might the stellate ganglion be blocked? (what nerve block)

Answer 40

Brachial Plexus

Question 41

Signs of Horners syndrome?

Answer 41

Very Horny PAM -Vasodilation -Horner -Ptosis -Anhidrosis -Miosis

Question 42

Which part of the adrenal gland secretes catecholamines?

Answer 42

Medulla

Question 43

Are there post ganglionic fibers in the Adrenal gland?

Answer 43

NO - just pre

Question 44

How much epi and norepi is secreted by the Adrenal Gland?

Answer 44

Epi - 80% Norepi - 20% Epi - .2mcg/kg/min Norepi- .05mcg/kg/min

Question 45

**What us critical to remember when managing pheochromocytoma?

Answer 45

MUST ALPHA BLOCK FIRST

Question 46

What happens after the tumor is removed from the adrenal gland?

Answer 46

-Hypotension and hypoglycemia because the tumor isn't secreting it

Question 47

What does the hepatocyte release when the SNS is activated?

Answer 47

-Glucose and Potassium -Insulin is also released in response to the glucose

Question 48

What happens to the potassium levels once it is released?

Answer 48

1. Initial increase 2. Decreases due to the K/Na Pump and shifts it back into the cells

Question 49

What shifts K out of the cell?

Answer 49

Succ ACIDOSIS Hyperosmolarity Cell lysis

Question 50

What shifts K into the cell?

Answer 50

Insulin or Epi Beta 2 Alkalosis Theophylline

Question 51

Where are stretch receptors located?

Answer 51

Aortic Arch and carotid sinus

Question 52

Afferent pathway of the aortic arch?

Answer 52

Vagus

Question 53

Afferent pathway of the carotid bodies?

Answer 53

Carotid sinus Glossopharyngeal (nerves of herring)

Question 54

How does a mediastinoscopy affect the baroreceptor reflex?

Answer 54

Scope presses on the aortic arch causing bradycardia

Question 55

What keeps the baroreceptor reflex intact?

Answer 55

Thiopental Nitro + Nipride Ketamine?

Question 56

What is the Bezold-Jarisch reflex?

Answer 56

Empty heart - Slow the heart down Venous return low

Question 57

How to treat the Bezold Jarisch reflex?

Answer 57

Fluids Trendelenburg Elevate legs Atropine Epi Ephedrine

Question 58

What is the Bainbridge reflex?

Answer 58

Increased Preload - increases HR No treatment

Question 59

When is ANP released?

Answer 59

increased volume Leads to diuresis

Question 60

What is the oculocardiac reflex? (Five and Dime)

Answer 60

Traction on extraocular muscles -Pressure on eye -Retrobulbar blook

Question 61

What are the pathways for the oculocardic reflex?

Answer 61

Afferent - 5 (trigeminal) Efferent - 10 (Vagus)

Question 62

What happens when the 5 and dime reflec occurs? Treatment?

Answer 62

M2 - Bradycardia, hypotension, AV block, junctional Treatment- Remove stimulus 1000% Anticholinergic

Question 63

What is Cushing's reflex?

Answer 63

(Crushing) Intracranial HTN HTN, bradycardia, irregular respirations

Question 64

What is celiac reflex?

Answer 64

Traction on mesentery or other abdominal organs - Bradycardia and hypotension

Question 65

What drugs can be used in a heart transplant?

Answer 65

Isoproterenol Glucagon Epi

Question 66

What does stimulation of V1 cause?

Answer 66

Vasoconstriction

Question 67

What does stimulation of V2 cause?

Answer 67

Water reabsorption

Question 68

Beta 1 selective drugs?

Answer 68

Beginning of the alphabet + metoprolol

Question 69

Beta non selective drugs?

Answer 69

End of alphabet + carvedilol

Question 70

Which beta blocker is metabolized by RBS Esterases?

Answer 70

Esmolol???

Question 71

How is a beta blocker overdose treated?

Answer 71

Glucagon Isoproterenol PDEIII Epi Cardiac pacing

Question 72

Which beta blockers have membrane stabilizing properties?

Answer 72

Propranolol + acebutolol

Question 73

Which beta blockers have intrinsic sympathomimetic activity?

Answer 73

Labetalol and Pindolol

Question 74

Primary drug for treating pheochromocytoma?

Answer 74

phenoxybenzamine - nonselective alpha blocker

Question 75

Primary drug for medication infiltration ?

Answer 75

phentolamine

Question 76

Which beta blocker is excreted by the kidneys?

Answer 76

Atenolol