MODULE 1C: Neuroanatomy Of The Cardiopulmonary System

Question 1

T or F

Recall that Σ and РΣ function as unconscious motor neurons

Answer 1

T

Question 2

Sympathetic Functions

Answer 2

-reactions to stress
-Increased heart function decreased digestive function, pupillary dilation, vasodilation in vessels of skeletal muscle, vasoconstriction in other vessels (mainly for redirection of blood to areas of need, or to manage peripheral resistance), allows bladder filling, ejaculation

Question 3

Parasympathetic Functions

Answer 3

-recovery of rest, vegetative functions
-Decreased heart function, increased digestion (increased peristalsis, glandular secretion, opening of sphincters), pupillary constriction, specific vasodilation in salivary glands, GI vessels, and erectile tissues, bowel and bladder emptying

Question 4

***Look at drawings of sympathetic innervation, parasympathetic innervation, high threshold GVA Innervation, and low threshold GVA innervation!!!!!!

Question 5

What is the order of travel for sympathetic innervation?

Answer 5

Preggl origin - IML nucleus, T1-T4/5 —> Ventral Root -> white ramus

Preggl Synapse - Sympathetic chain gel 7 involved 3 cervical (sup, mid, inf, T2-5)

Postggl Origin - 7 cardiopulmonary nerves

Postggl Synapse - AV Node/purkinje cells

Question 6

What is the order of travel for the parasympathetic innervation?

Answer 6

Preggl Origin - Nucleus Ambiguus of open medulla

Via CN X

Preggl Synapse - Cardiopulmonary gel

Postggl Origin - Cardiopulmonary ggl

Postggl Synapse - SA Node “pacemaker”

Question 7

** Tissue is damaged

Describe the journey of high threshold GVA innervation

Answer 7

Origin - within the heart

path - following the sympathetic path

Cell body - dorsal root ganglion

Synapse - Spinal cord grey matter (at or near IML)

Question 8

** distension/stretch detected

Describe the low threshold GVA innervation

Answer 8

Origin - Heart

Path - Following parasympathetic path

Cell body- no dose ggl of X

Synapse - medullary grey (nucleus solitarius)_

Question 9

All preganglionic GVE (that is, both Σ and РΣ systems) axon terminals release acetylcholine
which bind nicotinic cholinergic receptors on the postganglionic GVE dendrites,,, resulting in _____

Answer 9

fEPSP

Question 10

Sympathetic GVE postggl axon terminals all release norepinephrine (NE) which bind ___
receptors

Answer 10

β1

Beta-1 receptors are found mainly on modified cardiac muscles of the AV Node and those cells
in the cardiac skeleton called Purkinje cells.

Question 11

What are the actions of beta-1 receptors?

Answer 11

—increased heart rate (positive chronotropic activity),
—- increased strength of contraction (positive inotropic activity), and
—- increased conduction velocity between the SA and AV nodes (positive dromotropic
activity)

Question 12

Beta-1 receptors are mainly found in
the _____ (also the kidney), where they
act via the cAMP second messenger
system to cause increased intracellular
Ca++

Answer 12

Heart

This results in increased actin and myosin interaction

Question 13

Beta-1 action does what overall?

Answer 13

INCREASED strength, rate, and conduction of heart muscle and
activity.

Question 14

Parasympathetic GVE postggl axon terminals all release acetylcholine (ACh) which bind ____ ________

Answer 14

M2 receptors

Question 15

M2 receptors are found mainly on modified cardiac muscles of the __ ____

Answer 15

SA node

Question 16

What are the actions of the M2 receptors?

Answer 16

—decreased heart rate (negative chronotropic activity),
—decreased strength of contraction (negative inotropic activity), and
—decreased conduction velocity between the SA and AV nodes (negative dromotropic
activity)

Question 17

M2 receptors bind ACh and via a
G-protein mechanism, cause the outflow of K+ = _____

Answer 17

sIPSP

Question 18

*in the diagram on slide 15 In the diagram you can see that
both NE and ACh act on the cells
of the nodes, but in an opposite
way: NE is excitatory, where ACh
is inhibitory.

Answer 18

Both systems can be influenced
by antagonists: atropine for the
M2 receptors, and propranolol for
B-1 receptors.

Question 19

T or F

All arterioles and arteries receive sympathetic input, either via peripheral nerves or by the endocrine sympathetic system homologue (the adrenal medulla)

Answer 19

T

Question 20

The body wall and limbs receive __________ input from the VPR and DPR.

Answer 20

Sympathetic

Question 21

The abdominopelvic system receives its sympathetic input via the ______ nerves and visceral branches that follow the vascular pattern of the abdominopelvic viscera,

Answer 21

splanchnic

Question 22

the NTx used by the postganglionic axons is NE, though notably, at vessels perfusing skeletal muscle, the postganglionic axons use ACh.

ACh = _____

Answer 22

Cholinergic sympathetics

Question 23

T or F

The parasympathetic system innervates all arteries, arterioles, and cardiac vessels

Answer 23

F

The sympathetic system innervates all arteries, arterioles, and cardiac vessels.

Question 24

Alpha-1 receptors:

Answer 24

+, second messenger system-driven; widespread: most vessels, sphincteric smooth muscle (GI and Urinary), radial muscle in the iris for pupillary dilation, excitatory action on the immune system (dose dependent), and others.

Question 25

Beta-1 Receptors

Answer 25

+, second messenger system driven; mainly the heart.

Question 26

Beta-2 Receptors

Answer 26

-, second messenger driven; wherever the Σ system is required to be inhibitory: bronchial smooth muscle, most glands, GI smooth muscle (for peristalsis), and bladder and bowel for allowing filling to occur

Question 27

Sympathetic Neurons innervating Vessels perfusing skeletal muscle are largely cholinergic and cause vasodilation by the excitatory receptor M3. M3’s cause _________ by increasing the amount of ___________ _______ available to the vessel.

Answer 27

vasodilation NO (Nitric oxide)

Question 28

NO is a powerful vasodilator. When skeletal muscles are required to contract continually, they require more ___.this is delivered by increasing the vascular diameter: _________ is caused by inhibition of smooth muscle contraction.

Answer 28

O2 vasodilation

Question 29

T or F The Σ system has a endocrine homologue in the adrenal medulla, the РΣ system does not.

Answer 29

T

Question 30

T or F The innervation of sympathetic input is the same as heart?

Answer 30

T Preggl origin: T1-T4-5 IML Preggl path: VR -> WR ->Sympathetic chain gel Postggl path: from the seven cardiopulmonary nerves to T and through the cardiopulmonary ggl -> smooth muscle and glands of the brachial tree

Question 31

Innervation of the Bronchi Preggl Origin Preggl Path Postggl Path

Answer 31

• Preganglionic Origin: Dorsal Motor Nucleus of X, open medulla of the brainstem • Preganglionic Path: Exiting the jugular foramen of the skull as the vagus nerve (CN-X) passing inferiorly through the carotid sheath, and the thoracic outlet, through the superior and posterior mediastinum to the pulmonary ganglia (note that the cardiac and pulmonary ganglia are very near to each other and often are discussed as the same group of ganglia). Here, the preggl parasympathetic axons synapse of the postggl cells. • Postganglionic path: leaving the pulmonary ggl, which are very near to the bifurcation of the trachea, these project to all portions of the bronchial tree.

Question 32

Parasympathetic GVE postggl axon terminals all release acetylcholine (ACh) which bind __ __ _______

Answer 32

M3 receptors

Question 33

M3 receptors are found on ______ ______ and on______ structures where they cause increased smooth muscle contraction and increased mucous secretion.

Answer 33

Smooth muscle Glandular structures

Question 34

During parasympathetic action and innervation of the bronchi __ receptors bind ___ and via second messenger system, cause smooth muscle contraction and glandular secretion.

Answer 34

M3 ACh

Question 35

Which one of these is a primary function of cholinergic sympathetic input to vascular smooth muscle of vessels perfusing skeletal muscles? neither of these vasodilation vasoconstriction

Answer 35

Vasodilation

Question 36

What three motor axons can be found traversing the cardiopulmonary ganglion? CHOOSE THREE!! A. postganglionic parasympathetic B. postganglionic sympathetic C. preganglionic sympathetic D. preganglionic parasympathetic

Answer 36

A, B, D

Question 37

What synapse serving the heart occurs in the superior cervical ganglion? A. pre- to postganglionic parasympathetic B. preganglionic to GVA C. pre- to postganglionic sympathetic D. postganglionic to GVA

Answer 37

C

Question 38

What neurotransmitter binds receptors at the SA node resulting in negative chronotropic activity? NE ACh Substance P EPI

Answer 38

ACh

Question 39

What is the primary effect of the sympathetic input on the strength of heart muscle contraction called? A. negative inotropic activity B. negative dromotropic activity C. positive chronotropic activity D. positive inotropic activity

Answer 39

D

Question 40

What receptors are found predominantly on the SA node of the heart? M2 Beta-1 Beta-2 M1

Answer 40

M2

Question 41

What receptors are found predominantly on the AV Node and Purkinje fibers of the heart? Beta-2 M2 Beta-1 M1

Answer 41

Beta-1

Question 42

Choose the correct origin for the sympathetic preganglionic outflow to the heart. A. Dorsal motor nucleus of X B. IML T1-T4,5 C. Nucleus ambiguus D. IML T6-T12

Answer 42

B

Question 43

The postganglionic parasympathetic neurons to the heart arise from the: A. sympathetic chain ganglia B. seven cardiopulmonary nerves C. cardiopulmonary ganglion D. Dorsal motor nucleus of X

Answer 43

C

Question 44

The preganglionic parasympathetic axonal input to the heart make up the: IXth cranial nerve cardiopulmonary nerves white ramus Xth cranial nerve

Answer 44

Xth CN

Question 45

Which one of these is the major function of alpha-one adrenergic receptors on vascular smooth muscle? Vasodilation Neither of these Vasoconstriction

Answer 45

Vasoconstriction

Question 46

What classical neurotransmitter receptor is found on the dendrites of all postganglionic GVE neurons? A. Mu receptors B. Nicotinic receptors C. Muscarinic receptors D. beta-2 adrenergic receptors

Answer 46

B

Question 47

The postganglionic sympathetic axonal input to the heart make up the: A. the seven cardiopulmonary nerves B. the superior cervical ganglion C. vagus nerve D. the white ramus

Answer 47

A

Question 48

What type of GVA axons accompany the sympathetic outflow back to the spinal cord from the heart? A. no GVA fibers follow the sympathetic B. high-threshold GVA C. low threshold GVA D. both high and low threshold GVA

Answer 48

B

Question 49

What type of GVA axons accompany the parasympathetic outflow back to the medulla from the bronchi? A. no GVA fibers follow the sympathetic B. high-threshold GVA C. low threshold GVA D. both high and low threshold GVA

Answer 49

C

Question 50

What classical neurotransmitter receptor is found on the dendrites of all postganglionic GVE neurons? A. beta-2 adrenergic receptors B. Muscarinic receptors C. Mu receptors D. Nicotinic receptors

Answer 50

D

Question 51

Choose the correct origin for the sympathetic preganglionic outflow to the bronchi. A. Nucleus ambiguus B Dorsal motor nucleus of X C. IML T1-T4,5 D. IML T6-T12 .

Answer 51

C

Question 52

The preganglionic parasympathetic neurons to the bronchi arise from the: A. seven cardiopulmonary nerves B. sympathetic chain ganglia C. Dorsal motor nucleus of X D. cardiopulmonary ganglion

Answer 52

C

Question 53

The preganglionic parasympathetic axonal input to the bronchi make up the: A. IXth cranial nerve B. cardiopulmonary nerves C. white ramus D. Xth cranial nerve

Answer 53

D

Question 54

What receptors are found predominantly on the bronchial mucous glands of the bronchial tree causing increased secretion of mucous? M2 M3 Beta-2 Beta-1

Answer 54

M3

Question 55

What receptors are found predominantly on the bronchial smooth muscle causing bronchodilation? M2 Beta-2 Beta-1 M1

Answer 55

Beta-2

Question 56

What is the primary effect of the sympathetic input to the bronchial tree? A. bronchodilation and increased glandular secretion B. bronchodilation and decreased glandular secretion C. bronchoconstriction and increased glandular secretion D. decreased airflow and increased ability to trap particulates .

Answer 56

B

Question 57

What synapse serving the bronchi occurs in the inferior cervical ganglion? A. pre- to postganglionic sympathetic B. pre- to postganglionic parasympathetic C. preganglionic to GVA D. postganglionic to GVA

Answer 57

A

Question 58

The postganglionic sympathetic axonal input to the bronchi make up the: A. the seven cardiopulmonary nerves B. vagus nerve C. the white ramus D. the superior cervical ganglion

Answer 58

A