Dr. Ingrim Materials for Exam 1 Flashcards

Review materials for Neuro quiz 1

1
Q

Autonomic division of the peripheral nervous system controls which types of muscles?

A

Smooth muscles
Cardiac muscles
Glands

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2
Q

Which neurons take information from the CNS and carries impulses to the effector organs?

A

Efferent Neurons

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3
Q

What are the functions of afferent neurons?

A

Afferent neurons carry information from the peripherals such as sensory and brings the impulse to the CNS.

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4
Q

In the sympathetic nervous system, preganglionic neurons originate where?

A

In the thorocolumbar region: thoracic and lumbar region

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5
Q

Where does preganglionic neurons originate in the parasympathetic system?

A

craniosacral region: brain and sacral area of the spinal cord

THINK:
to relax you need to relax your brain and sit on your sacrum

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6
Q

Short preganglionic fibers but long post ganglionic fibers is a characteristic of which nervous system?

A

Sympathetic nervous system

REMEMBER:

SL for sympathetics
LS for parasympathetics

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7
Q

Parasympathetic nervous system has ____ preganglionic fibers and _____ post ganglionic fibers.

A

long, short

REMEMBER:
SL for sympathetics
LS for parasympathetics

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8
Q

What are the divisions of autonomic nervous system?

A

Sympathetics
Parasympathetics

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9
Q

Which targets one specific effector organ rather than postganglionic neuron innervating more than one organ

A

Parasympathetic

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10
Q

What neurotransmitter does the post ganglionic neuron of the sympathetic nervous system release?

A

Norepinephrine

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11
Q

Neurons of both the parasympathetic and sympathetic system release which preganglionic neurotransmitter?

A

Acetylcholine

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12
Q

Which autonomic division binds acetylcholine to a muscarinic receptor?

A

The parasympathetics

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13
Q

Which division of the ANS responds to hypoglycemia?

A

Sympathetic nervous system

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13
Q

Adrenergic receptor is related to

A

The sympathetic system

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14
Q

Constriction of the pupils is caused by which division of the ANS?

A

Parasympathetic
because its allowing less light in

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15
Q

Which cranial nerve supplies the PAROTID gland and through which ganglion?

A

CN IX through the otic ganglion

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16
Q

CN VII innervates which secretory glands? Through which ganglion?

A
  1. The lacrimal gland through the pterygopalatine ganglion.
  2. Submandibular and sublingual glands by the submandibular ganglion.
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17
Q

Which adrenoreceptor does Albuterol bind to?

A

beta-2

REMEMBER:
beta1 mainly targets the heart
beta 2 mainly affects the bronchial

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18
Q

What are three catecholamine agonist

A

epinephrine
norepinephrine
dopamine

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19
Q

Does epinepherine have affects on alpha or beta receptors?

A

It has affects on both alpha and beta

Low beta affects (vasodilation)
High alpa affects (vasoconstriction)

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20
Q

alpha-1 adrenoreceptors

A
  1. Vasoconstriction
  2. Increased peripheral resistance (increase bp)
  3. Mydriasis (eye dilation)
  4. Constriction of the bladder sphincter

HINT:
mainly constricts except for the eyes

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21
Q

alpha-2 adrenoreceptors

A
  1. Inhibits release of NE
  2. Inhibits the release of acetylcholine
  3. Inhibits insulin release

HINT:
Inhibits neurotransmitters

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22
Q

beta-1 adrenoreceptors

A
  1. Tachycardia
  2. Lipolysis
  3. myocardial contractility
  4. Increase release of renin

HINT:
mainly cardiac functions
increases functions

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23
Q

beta-2 adrenoreceptors

A
  1. Vasodilation
  2. Decreased peripheral resistance
    (decrease bp)
  3. Bronchodilation
  4. Increase liver and muscle glycogenolysis
  5. Relax uterine smooth muscle

HINT:
functions with the lungs (dilator)

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24
Q

Describe epinephrine

A

Synthesized by tyrosine in the adrenal medulla

Direct acting (interacts with both alpha and beta receptors)

Higher dose of alpha affects

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25
Q

What are the effects of epinephrine?

A

increase myocardium contractibility
increase release of renin
constricts arterioles
bronchodialation (beta-2)

hyperglycimia
lipolysis

HINT:
Epinephrine speeds up the heart, raise blood sugar, bp and lung flow

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26
Q

Therapeutic use of Epinephrine

A

Acute asthma

Heart attacks

Anesthetics
it causes vasoconstrictions resulting in lasting affects.

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27
Q

What types of neurotransmitters are directing acting? What adrenoreceptors do they affect.

A

Catecholamines such as epinephrine, norepinephrine and dopamine are direct acting.

They are both alpha and beta acting

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28
Q

Norepinephrine

A

Direct acting catecholamine
mainly alpha-adrenergic affects

vasoconstrictor, increases blood pressure

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29
Q

Dopamine

A

Direct acting catecholamine
mainly beta-adrenergic affects

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30
Q

Therapeutic uses of Dopamine

A

Severe heart failure

Hypotension

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31
Q

What are alpha-adrenergic agonist

A

Drugs that bind to the alpha receptors only and elicit a positive effect

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32
Q

What are examples of selective alpha-adrenergic drugs?

A

Phenylephrine
Clonidine

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33
Q

Why does Phenylephrine have lasting affects?

A

lasting effects because it is not a catecholamine (alpha-2 inhibits NT)
COMT uptakes catecholamines)

34
Q

What are therapeutic use of Phenylephrine?

A

Vasoconstriction (decrease bp)
Mydriasis
Nasal decongestion

HINT:
it acts on the alpha-1 receptor, which constricts everything but the pupil

35
Q

Clonidine

A

an alpha-2 adrenergic agonist
used to lower blood pressure

36
Q

When would you prescribe Clonidine to a patient?

A

If they are hypertensive

37
Q

Which drugs are selective beta-adrenergic agonist?

A

Isoprteronol
Dobutamine
Albuterol (terbutaline, saleterol)

38
Q

What do beta adrenergic antagonist drugs do?

A
39
Q

List the order of affinity to alpha-adrenoreceptor from greatest to least.

A

EPI, NE, ISO

40
Q

List the order of affinity to beta-adrenoreceptor from greatest to least.

A

ISO,EPI,NE

41
Q

What effect does adrenergic blockers have

A
42
Q

efficacy

A

measures pharmaceutical response of the drug, how well it works.

43
Q

potency

A

refers to how much drug is needed to create maximum affect

44
Q

What the drug does to the body

A

pharmacodynamic

45
Q

What the body does to the drug

A

pharmacokinetics

46
Q

Kd

A

disassociation constant
represents the amount of free drug at half-maximal binding.

47
Q

What does ow Kd represent?

A

Drug has a good affinity to the receptor.

48
Q

What NT is mainly released during sympathetic ANS

A

Epinephrine and lesser amounts of NE

49
Q

True or false, the Parasympathetics functions as a unit

A

False, it does not function as a unit

50
Q

What is epinephrine synthesized from and where is it synthesized?

A

It is synthesized from tyrosine in the adrenal medulla

51
Q

Epinephrine has both alpha and beta effects, which is strongest?

A

Epinephrine’s alpha receptor is more dominant making it a greater heart constrictor.

its low beta affects make it a low bronchial dilator.

52
Q

Renin release

A

Is seen on beta-1 receptor

53
Q

Adverse effects of Epinephrine

A

CNS (anxiety, fear)
Hemorrhage* due to elevated bp
Cardiac arrhythmias
Pulmonary edema

54
Q

Therapeutic use of Epinephrine

A

Bronchospasm from acute asthma
anaphylactic shock
Cardiac arrest
Anesthetics

55
Q

What are interactions with epinephrine?

A

Hyperthyroidism
Cocaine
Diabetes
beta-blockers* unopposed alpha receptors will lead to increase PR & BR
inhalation anesthetics

56
Q

Therapeutic use of Norepinephrine

A

NE increases vascular resistance
and BP

57
Q

Why does Norepinephrine trigger baroreceptor reflex?

A

The increase in systolic and diastolic blood pressure trigger baroreceptor effects

58
Q

What receptors does Albuterol bind to?

A

beta receptors 1 and 2
mainly beta-2 affects

59
Q

What is the clinical use of Albuterol

A

Asthma and COPD
It is a bronchial smooth muscle relaxer

60
Q

Which of the following would be the most likely physiologic result of alpha-1 receptors blockade

A

Tachycardia
Blocking alpha-1 receptor would lead to cardiac dilation and a fall in blood pressure.
This will increase the amount of NE in the blood causing increase in heart rate.

61
Q

Which of the following structures is most affected by alpha 1 blockade

A

Prostate

62
Q

A drug binding reversible vs irreversible

A
63
Q

Succinylcholine

A

A Depolarizing Nueromuscular Blocking Agent.

It acts like acetylcholine binds tightly to the receptor, illicit depolarization however stays bind, long term muscle contraction, causing muscle paralysis

64
Q

Cisatracurium

A

A Nondepolarizing Nueromuscular Blocking Agent

Binds to the Ach receptor, prevents acetylcholine from binding . Does not ilicit depolarization or muscle contraction.

65
Q

Neuromuscular Blocking Agent drugs

A

IV drugs usually given during surgery to prevent movement of the muscles during surgery.

66
Q

Which Nueromuscular Blocking Agent is most often used for endotracheal intubation?

A

Succylcholine (Depolarizing)

67
Q

Adverse effect of NDMB (Succinylcholine)

A

Hyperkalemia (Potassium)
Hypercalcemia (calcium)
Acute tachycardia and bradycardia
Prolonged QT interval

68
Q

Adverse effect of NMB

A

Histamine release
rash
hypotension
bronchospasm
respiratory depression

69
Q

Tizanidine

A

alpha-2 agonist
Reduces the release of excitatory NT

70
Q

Clinical use of Tizanidine

A

lowers muscle spacisity in AML

71
Q

Adverse effects of Tizanidine

A

Hepatotoxicity, do not give to patients with liver disease.

Sedation
Hypotension
Hallucinations
Dizziness
Muscle weakness

72
Q

Benzodiazepine

A

Positive allosteric modulator
binds in an allosteric position when GABA is bind and enhances signaling

73
Q

What does Benzodiazepine treat?

A

Muscle spasms due to cerebral palsy, stroke, spinal cord injury

muscle spasm

anxiety and panic disorders

74
Q

Botulinum Toxin

A

Inhibits release of ACh from the nerve terminals.

redues muscle spasm in cerebral paslsy and MS, overactive bladder, migraine, facial spasm

75
Q

Adverse affect of Botulinum Toxin

A

Respiratory tract infections
Muscle weakness
Urinary
Falls
Fever
Pain

76
Q

Adverse Effects of Benzodiazepines

A

CNS depression due to crossing the blood brain barrier

77
Q

Which drug can be used to treat pheochromocytoma (tumor of catecholamines)?

A

Phenoxybenzamine
Phenolamine (short-term)

78
Q

Clonodine

A

decreases norepinephrine

79
Q

Which neuromuscular blocking agent is safest for patients who have chronic kidney disease?

A

Cisatracurium (nondepolarizing)

80
Q

Does parasympathetic act as a unit?

A

No, it has specific effector units

81
Q

During the sympathetic autonomic nervous system what does the adrenal medulla release more of?

A

more Norepinephrine the epinephrine

82
Q

Albuterol treats what?

A

Asthma and COPD via bronchial relaxation

83
Q

Adverse affect of Benzodiazepines

A

CNS depression and hallucinations