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Anaesthetic FRCA Primary - Teaching Days > Basic Sciences - Autonomic Nervous System Physiology > Flashcards

Basic Sciences - Autonomic Nervous System Physiology Flashcards

(49 cards)

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1
Q

Global constituents of autonomic nervous system (ANS)

A

Afferent pathways
Efferent pathways

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2
Q

Role of afferent pathways in ANS

A

Transmit sensory information from visceral structures
Also chemical and mechanical data from chemo- and baro- receptors

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3
Q

Role of efferent pathways in ANS

A

Control cardiac muscle, smooth muscle and glands

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4
Q

Central components of the ANS

A

Midbrain
Medulla
Limbic system
Hypothalamus
Brainstem
Spinal cord

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5
Q

Limbic system

A

Emotion

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6
Q

Two main divisions of the ANS

A

Sympathetic nervous system (SNS)
Parasympathetic nervous system (PNS)

Often antagonistic

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7
Q

Parts of the body supplied by SNS

A

All parts of body including trunk and limbs

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8
Q

Parts of the body supplied by PNS

A

Viscera only
(except adrenal glands and gonads - only SNS supply)

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9
Q

Efferent pathways of both SNS and PNS structure

A

Preganglionic neurones
Intermediary ganglion
Postganglionic neurones

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10
Q

Preganglionic neurones features

A

Cell bodies in brain or lateral horns of spinal cord
Myelinated axons
Slow conducting B fibres

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11
Q

Number of postganglionic neurones innervated by each preganglionic neurone

A

8 to 9 postganglionic cells
Produces diffuse responses characteristic of ANS

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12
Q

Postganglionic neurones features

A

Unmyelinated
C fibres

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13
Q

Outflow of sympathetic efferent neurones

A

Thoracolumbar outflow
T1 - L2

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14
Q

Methods of preganglionic neurone axon termination

A

1) Most synapse in paravertebral sympathetic chain

2) Some pass through sympathetic chain via splanchnic nerves to synapse in a peripheral autonomic ganglion in abdo / pelvis

3) Few preganglionic fibres synapse directly with chromaffin cells in medulla of adrenal gland

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15
Q

Examples of peripheral autonomic ganglions in the abdomen or pelvis

A

Coeliac ganglion
Superior mesenteric ganglion
Inferior mesenteric ganglia

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16
Q

Location of preganglionic cell bodies in SNS

A

Lateral horns of spinal cord levels T1 - L2

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17
Q

Outflow of efferents in PNS

A

Cranio-sacral outflow from:
- Cranial nerves 3, 7, 9 and 10
- Spinal roots S2-4

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18
Q

Location of preganglionic cell bodies of PNS

A

Cranial nerve nuclei or lateral horns of sacral spinal cord

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19
Q

Parasympathetic ganglia sites from vagus an sacral efferents where preganglionic neurones synapse

A

Diffusely located in the walls of the viscera they supply

Eg. heart, gut, lungs

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20
Q

Parasympathetic ganglia sites from cranial nerve 3, 7 and 9 efferents where preganglionic neurones synapse

Study These Flashcards
A

4 discrete intermediary ganglia:
- Ciliary
- Sphenopalatine
- Submaxillary
- Otic ganglion

21
Q

Sympathetic efferent outflow to head and neck

Study These Flashcards
A

Indirect through sympathetic chain via superior, middle or inferior cervical ganglia

22
Q

Location of inferior cervical ganglion

Study These Flashcards
A

Often fused with 1st thoracic ganglion to form the stellate ganglion at level C6

Just anterior to neck of first rib

23
Q

Approximate spinal level origin of sympathetic supply of different organs

24
Q

Visceral autonomic afferent and pain fibre course of travel

Study These Flashcards
A

Travel with autonomic efferent nerves:

  • Pain fibres from lungs, bronchi and pelvis travel with PNS nerves
  • Pain fibres from abdo an heart travel with SNS nerves
25
Referred pain
Pain from viscera is poorly localised and often 'referred' to corresponding somatic segment
26
Use of thoracic sympathectomy
Treat severe Reynaud's or hyperhidrosis of palms
27
Use of lumbar sympathectomy
Treat circulatory insufficiency of lower limb or phantom limb pain
28
Use of coeliac plexus bloack
Treat pain associated with upper GI malignancy or acute / chronic pancreatitis
29
Neurotransmitters in the ANS
Acetylcholine Noradrenaline
30
Neurones in ANS which use ACh as neurotransmitter
- All preganglionic neurones - All postganglionic PNS neurones - Postganglionic SNS neurones that innervate sweat glands and skeletal muscle blood vessels
31
Neurones in ANS which use noradrenaline as neurotransmitter
All postganglionic SNS neurones EXCEPT postganglionic SNS neurones that innervate sweat glands and skeletal muscle blood vessels
32
Types of ACh receptor
Muscarinic (M1 - M5) Nicotinic
33
Muscarinic ACh receptor location
Smooth muscle, glands, heart and the brain
34
Muscarinic ACh receptor type
G protein linked Blocked by atropine
35
Nicotinic ACh receptor location
Sympathetic ganglia Motor end plates of skeletal muscle
36
Nicotinic ACh receptor type
Ligand gated ion channel Unaffected by atropine
37
Nicotinic ACh receptor actions mimicked by...?
Nicotine
38
Muscarinic ACh receptor actions mimicked by...?
Muscarine
39
Types of adrenergic receptor, their site and G protein type
Alpha 1, Vascular smooth muscle, Gi Alpha 2, Brain, Gq Beta 1, Heart, Gs Beta 2, Lungs, Gs Beta 3, Adipose tissue, Gs
40
Adrenergic receptors and secondary messengers
41
Adrenergic receptors with higher affinity for Noradrenaline
Alpha receptors
42
Adrenergic receptors with higher affinity for Adrenaline
Beta receptors
43
Effects of ANS on cardiovascular system
44
Effects of ANS on lungs, GI and skin
45
Side effects of atropine
Pyrexia Confusion Bronchodilation Dry mouth Dilated pupils Tachycardia Dry secretions
46
Side effects of neostigmine
GI spasms Bradycardia Nausea Salivation Bronchorrhoea Bronchoconstriction
47
Side effects of propranolol
Cold extremities Worsened intermittent claudication Wheeze
48
Mechanism of action of propranolol (and therefore reason for side effects caused)
Non selective beta antagonist
49
Reason for regional anaesthesia inducing sympathetic block
Sympathetic nerves travel with the somatic nerves

Anaesthetic FRCA Primary - Teaching Days (64 decks)

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