Pathophysiology Exam #5 Flashcards Preview

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Flashcards in Pathophysiology Exam #5 Deck (189):
1

The autonomic nervous system is responsible for what parts of the body(5)?

TISSUES AND ORGRANS NOT USUALLY UNDER VOLUNTARY CONTROL: 1. Cardiac muscle 2. Electrical fibers of the heart 3. Smooth muscle of the blood vessels, ducts, urinary bladder, uterus and ect.(any other smooth muscle of the body) 4. Gland(many glands in the body) 5. Visceral muscle(GI)

2

Compare and contrast the differences in nerve pathways between somatic motor and autonomic.

Somatic Motor: -nerve cell body exits out of the anterior horn->rootlets/roots/common nerves to the anterior side and brings about a response to the skeletal muscle Autonomic: -Begins in the lateral horn of the gray matter(where nerve cell body is located) -axon passes through anterior horn/rootlets/anterior root/common spinal nerve and terminates on autonomic ganglion. -the first nerve terminates and synapse with second nerve at the autonomic ganglia -the second nerve exits the autonomic ganglia into a peripheral nerve and terminates on tissues/organs that receive autonomic innervation.

3

How many somatic motor neurons are there between the SC to the target tissue/organ?

1

4

How many autonomic neurons are there between the SC and the target tissue/organ?

2

5

What are the names of the two autonomic neurons between SC and the target tissue/organ?

-preganglionic neuron -postganglionic neuron

6

What are the two divisions of the autonomic nervous system?

-Sympathetic Nervous System(Thoracolumbar Division) -Parasympathetic Nervous System(Craniosacral Division)

7

Where does the name Thoracolumbar come from?

nerve cell bodies of the preganglionic neurons are from T1-L2

8

Where does the name Craniosacral come from?

-4 of the CNs have parasympathetic fibers(3,7,9,10) -the other preganglionic neurons are located in the sacral segments of the SC(S2-S4)

9

What 4 parasympathetic nerves are located in the CN?

-oculomotor(3) -facial(7) -glossopharyngeal(9) -vagus(10)

10

The Thoracolumbar pathways are sympathetic or parasympathetic?

sympathetic

11

In the ANS are the preganglionic axons myelinated or unmyelinated?

Myelinated

12

In the ANS are the postganglionic axons myelinated or unmyelinated?

Unmyelinated

13

What type of nerve fibers are postganglionic axons?

type C neurons(unmyelinated)

14

What are the sympathetic chain ganglia?

-lie on either side of the vertebral column -location where preganglionic neurons synapse and innervate postganglionic neurons

15

What are the collateral ganglia?

-lie anterior to the vertebral column

16

Trace the pathway of the sympathetic neuron from SC to target tissue/organ.

-exits the SC -> spinal nerve and very quickly enters into a sympathetic chain ganglia -at the sympathetic chain ganglia, they synapse with the postganglionic neuron -postganglionic neuron exits the sympathetic chain ganglia and passes out to the target tissue/organs via the spinal nerve/sympathetic nerve/splanchnic nerve

17

What is the function of the splanchnic nerve?

The splanchnic nerve is where the organs and tissues of the abdominal cavity get their autonomic innervation.

18

Is the craniosacral division of the ANS representative of sympathetic or parasympathetic?

parasympathetic

19

What is the most DOMINANT parasympathetic nerve in the body?

CN#10 vagus nerve

20

In the parasympathetic division, where do the preganglionic nerves terminate?

-terminate with the postganglionic neuron in the parasympathetic ganglia(terminal ganglia) -after terminating here the postganglionic neuron terminates and synapse with the target tissue/organ

21

Are there sympathetic chain ganglia or collateral ganglia involved with the craniosacral division of the ANS?

no just the sympathetic division

22

Describe the parasympathetic ganglia.

-called terminal ganglia -specific to the parasympathetic nervous system -ganglia are very close, sometimes even in the walls of the target organs being innervated

23

Are the parasympathetic preganglionic neurons myelinated or unmylenated?

myelinated

24

What type of nerve fibers make up the postganglionic nerves?

Type C

25

The vagus nerve innervates the _____ _____ and part of the _____ _____.

-ascending colon -transverse colon

26

The rest of the transverse colon, the descending colon, sigmoid colon, the bladder, the genitals, the rectum and the anus receives its parasympathetic innervation from the?

sacral division of the parasympathetic nervous system

27

What is the nerve that extends down both sides of the neck giving off collateral to almost all the tissues and organs of the thoracic and the abdominal cavities?

Vagus nerve

28

Where is the nerve cell body of the preganglionic neuron located?

-lateral horns of the gray matter -SC segments T1-S2

29

In the typical SNS, where does the preganglionic neuron terminate?

in a sympathetic ganglion(either side of vertebral column; sympathetic chain ganglia and anterior to the vertebral column before the collateral ganglia)

30

In the typical sequence of events of the SNS, what neurotransmitter if released when the preganglionic neuron terminates and innervates the postganglionic neuron?

acetylcholine

31

In the typical sequence of events of the SNS, the receptors on the dendrites of the postganglionic neurons that respond to acetylcholine are?

Nicotinic TYPE 2 receptors

32

In the typical sequence of events of the SNS, once the postganglionic neuron is innervated the impulse is transmitted along the axon and terminates at the synapse of the target tissue/organ. What neurotransmitter is released at this synapse?

norepinephrine

33

The receptors on the target tissues/organs that respond to NE are?

adrenergic receptors

34

What are two types of adrenergic receptors?

alpha and beta

35

In the typical sequence of events of the SNS, since NE is the neurotransmitter released at the synapse with the target organ/tissue, this is called what type of pathway?

Sympathetic Adrenergic Pathway

36

In a deviation for the typical sequence of events of the SNS, what neurotransmitter is released where the pre ganglion synapse with the post ganglion?

acetylcholine

37

In a deviation for the typical sequence of events of the SNS, what neurotransmitter is released where the post ganglion terminates on the target tissue/organ?

acetylcholine

38

In a deviation for the typical sequence of events of the SNS, the receptors on the dendrites of the postganglionic neurons that respond to acetylcholine are?

they are still NICOTINIC TYPE 2 receptors

39

In this deviation of the normal events of the SNS, what are the neurotransmitter receptors located on the target tissue/organ?

Muscarinic receptors.

40

The deviation of the typical sequence of events of the SNS occurs in very few target tissues/organs. Name 3.

-sweat glands(sweating is a sympathetic outcome -smooth muscle -some blood vessels; causing them to dilate(not all just some) THIS IS A SYMPATHETIC /MUSCARINIC OUTCOME

41

The deviation in the normal sequence of events in the SNS when ACh is released at the synapse of the post ganglia and the target tissue/organ receptor is Muscarinic is called.

Sympathetic Cholinergic Pathway--->because ACh is the neurotransmitter at the final synapse

42

Regarding the parasympathetic nervous system, where are the nerve cell bodies of the preganglionic neurons located?

-medulla -midbrain -sacral divisions of the SC CRANIOSACRAL DIVISION

43

When the preganglionic neuron of the PNS terminates at the parasympathetic ganglion, what neurotransmitter is released?

ACh

44

What types of receptors are located on the dendrites of the post ganglionic neurons that are innervated by the preganglionic neuron of the PNS?

NICOTINIC TYPE 2

45

In the PNS when the postganglionic neuron terminates on the target tissue/organ, what is the neurotransmitter released and what type of receptors does it bind to?

ACh & muscarinic receptors--->this brings about the final response

46

All parasympathetic pathways are parasympathetic cholinergic pathways(t/f) and why?

True; because ACh is the neurotransmitter released at the final synapse and binds to muscarinic receptors

47

At every ganglionic synapse, what is the neurotransmitter released from the preganglionic neuron?

ACh

48

At every ganglionic synapse, what are the receptors on the dendrites of the postganglionic neuron?

Nicotinic type 2 receptors

49

How is the SNS and the PNS involved in the baroreceptor response of the CV autonomic reflex centers?

-there are baroreceptors in the internal carotids and the aortic arch that respond to changes in blood pressure determined by the volume of blood ejected from the LV. -when pressure increases in these areas, baroreceptors are activated which transmits sensations towards the medulla. -when the glossopharyngeal(CN#9) and vagus(CN#10) approach the medulla, they join together to form the tracts solitarius. -this tract terminates in the nucleus solitarius in the medulla and sends impulses to the medullary CV center

50

What is the name of the tract where CN# 9 and 10 combine as they approach the medulla?

tractus solitarius

51

What is the name of the location where the tracts solitarius terminates in the medulla?

nucleus solitarius

52

What specific adrenergic receptor is either excited or not excited based on BP and what is the outcome?

central Alpha-2 receptors -if BP is high alpha-2 is excited--->sympathetic outflow is decreased and parasympathetic outflow is increased -if BP is low, alpha-2 is depressed--->causing sympathetic outflow to increase and parasympathetic outflow is decreased. This response either increases or decreases: HR, CO, SV and can cause veins and arteries to either dilate or constrict.

53

The CF medullary response by the SNS/PNS is only useful for SHORT-TERM regulation of BP(t/f)?

true-if BP increases and stays increased over hours-to-days, then the baroreceptors will reset themselves to that new BP and therefore are no longer useful in regulating BP

54

What is the location of the vagus nerve and what is the function in regards to the autonomic regulation of BP?

CN 10(vagus)-nerve cell body is in the medulla, efferent parasympathetic pathway thru the vagus, directly to the SA node. It is the vagal parasymp stim that slows the HR and plays a very major role in maintaining HR, CO, SV and BP

55

The autonomic nervous system is also regulated by higher brain centers such as the(3)....?

-cerebral hemispheres -various parts of the limbic system -various parts of the hypothalamus ALL CAN HAVE SOMETHING TO DO WITH THE REGULATION OF SYMPATHETIC/PARASYMPATHETIC AUTONOMIC OUTFLOW

56

How are the higher brain centers involved with autonomic regulation as related to the limbic system?

-if a person has changes in their emotional status(fear, joy, anger,etc) can often cause responses within their CV, resp system and other parts of the body under ANS control -these emotions in higher brain centers are transmitted first to the hypothalamus and then autonomic regulatory centers in the hypothalamus regulate para/symp outflow from lower brain centers to target organ/tissues when your happy your happy all over; when your sad your sad all over PROBABLY THE REASON FOR THOSE TOTAL BODY RESPONSES TO EMOTIONS IS EXPLAINED BY THIS INTERACTION

57

True or False: Most organs/tissues have both sympathetic and parasympathetic innervation?

TRUE -usually in a certain organ/tissue, either symp/para predominates at a certain time -just because one or the other is predominate at a given time does not mean the other one is completely absent -there is always interplay between symp/para--->although one maybe predominant dosnet mean the other one is having zero effect at that time

58

In the sympathetic(thoracolumbar) system, where are the nerve cell bodies/preganglionic neurons located?

lateral horns of the gray matter in the SC segments T1-L2

59

How many chain ganglia are there and where are they located? Which ANS are they active in?

-There are two, each located on each side of the vertebral column -Sympathetic

60

How many collateral ganglia are there and where are they located? Which ANS are they active in?

-4 collateral ganglia -anterior to the vertebral column -Sympathetic

61

What are the names of the four collateral ganglia?

-Celiac ganglion -Superior mesenteric ganglion -Inferior mesenteric ganglion -Hypogastric ganglion

62

In the sympathetic division of the ANS, where do the pre ganglion nerve fibers T1-T4 terminate and synapse?

-they terminate in the chain ganglion

63

In the sympathetic division of the ANS, when the pre ganglion nerve fibers T1-T4 terminate and synapse, what type of nerve cell fibers are innervated? ?

preganglionic nerve fibers synapse with the postganglionic neurons; type-C unmyelinated

64

In the sympathetic division of the ANS once the postganglionic fibers(from T1-T4) have been innervated, what happens to the impulse?

-they exit the symp chain ganglia and enter either the spinal nerves or sympathetic nerves terminating on their target tissue/organ

65

In the sympathetic division of the ANS once the postganglionic fibers have been innervated(T1-T4), what six tissues/organs are innervated?

-Eye: SNS regulates the diameter of then pupil and tear production -Nasal mucosa: changes the nature of of the secretions of the nose -Salivary glands(sublingual/submandibular): SNS changes amount and characteristics of saliva -Parotid gland -Sympathetic innervation of the heart: direct symp innervation of the SA node, AV node and the ventricular contractile fibers -Smooth muscle of the tracheobronchial tree: the smooth muscle beginning with the trachea all the way down to the bronchi/bronchioles as significant amounts of smooth muscle(symp regulates diameter of particularly the bronchioles

66

In the sympathetic division of the ANS how is the sequence events of innervation different for T5-L2?

-The preganglionic neurons exits the SC and enter the sympathetic chain ganglion, but they pass through without synapsing

67

In the sympathetic division of the ANS what four specific nerves do the preganglionic neurons from T5-L2 pass through before reaching the collateral ganglia?

-Greater splanchnic nerve -Lesser splanchnic nerve -Lumbar splanchnic nerve -Sacral splanchnic nerve

68

So where in the sympathetic division of the ANS do the preganglionic neurons synapse and terminate?

on the collateral ganglion -celiac ganglion -superior mesenteric ganglion -inferior mesenteric ganglion -hypogastric ganglion

69

How is the adrenal medulla innervated?

-from a preganglionic neuron along the greater splanchnic nerve--->celiac ganglion tract -even though a preganglionic neuron terminates on the celiac ganglion, an additional innervation continues down to the adrenal medulla and terminates on it *The adrenal medulla receives direct innervation from a sympathetic preganglionic neuron*

70

What is the significance of the way the adrenal medulla is innervated?

-by receiving direct innervation from a preganglionic neuron, the adrenal medulla is analogous to a sympathetic postganglionic neuron -So when it is excited, it behaves like and takes the place of a sympathetic postganglionic neuron

71

What is the effect of the adrenal medulla becoming innervated(excited)?

-It secretes catecholamines(NE/EPI/DOP) SECRETION FROM THE ADRENAL MEDULLA INTENSIFIES THE SYMPATHETIC RESPONSES THROUGHOUT THE BODY

72

What tissues/organs are innervated by the sympathetic ANS from T5-L2?

-small intestines -ascending colon -transverse colon -descending colon -sigmoid colon -rectum -anus -smooth muscle of the urinary bladder -genitals

73

What are the four cranial nerves innervated by the parasympathetic division of the autonomic nervous?

3,7,9,10

74

What is the result of the parasympathetic innervation of CN#3?

Oculomotor: innervates/helps regulate the diameter of the pupil

75

Where are the parasympathetic ganglia located?

They are usually located close to or in the wall of the target organ/tissue

76

What is the result of the parasympathetic innervation of CN#7?

Facial: innervates the lacrimal gland(regulates the amount and type of tears), nasal mucosa(regulating the amount and type of nasal secretions), salivary glands(salivary amount and type)

77

What is the result of the parasympathetic innervation of CN#9?

Glossopharyngeal: innervates the parotid glands

78

What is the result of the parasympathetic innervation of CN#10?

Vagus-vagus means "wandering": innervation of the smooth muscle of the tracheobronchial tree, the heart primarily just to the SA node, liver, stomach, spleen, pancreas, all components of the small intestines, kidneys, and large intestines(ascending, part of transverse colon),

79

Besides the 4 cranial nerves, what other parasympathetic innervation happens in the body?

from the sacral segment of the spinal cord(S2-S4): -innervates the rest(transverse, descending, sigmoid colon, rectum, anus, smooth muscle of the urinary bladder and the genitals)

80

Most tissue/organs receive both symp/para innervation. This means that any one time one or the other is predominant on the target tissue/organ. Just because one is dominant dosent mean the other is absent. What two tissues or organs only have one ANS innervation?

-adrenal medulla(sympathetic innervation only) -smooth muscles of blood vessels(sympathetic innervation only-ONLY POSSIBLE EXCEPTION MAY BE THE CORONARY ARTERIES)

81

The medulla is the........... and it sits.......?

center part of the adrenal gland; sits on top of the kidney

82

The outer part of the medulla is the _____, the center part of the _____?

cortex, medulla

83

The adrenal medulla is innervated by?

sympathetic preganglionic neuron

84

What is the neurotransmitter released at the adrenal medulla synapse and what is the receptor it binds to?

ACh and Nicotinic type-2 receptors

85

what is the function of the adrenal medulla once it is innervated?

• Secretes neurohormones: dopamine, norepinephrine, and EPINEPHRINE (80 – 85%) o The adrenal medulla is the only place in the body that epinephrine can be synthesized; because only the adrenal medulla has the enzyme that can convert NE into EPI o EPI, once it is synthesized, it is more potent and longer lasting than NE; so when it gets to receptors of target organs/ tissues it is going to significantly intensify the overall symp response

86

The adrenal medulla is analogous to........?

sympathetic postganglionic fibers

87

Why are the endogenous catecholamines that circulate in the blood to synapses of sympathetic postganglionic neurons with target tissues and bind with adrenergic receptors called neurohormones?

Because it is a little bit like neurotransmitters and a little bit like hormones § Neurotransmitters because they act like neurotransmitters; they bind with same target receptors on organs/ tissue that NT bind with § Hormones because they are secreted into the blood and circulate in through the blood to get to their receptor sites; which is what what hormones do

88

The catecholamines from the adrenal medulla...............effect of sympathetic nervous system effect on target tissues/ organs

Enhances (intensifies the overall)

89

If a person has a bilateral adrenalectomy, what are they losing?

A. They are losing these catecholamines.

90

What are they losing from the adrenal cortex?

A. Cortisol, aldosterone, and adrenal androgens; they have to be replaced

91

So what are the three sympathetic adrenergic neurotransmitters and their receptors

o Dopamine: D-1 and D-2 receptors o Norepinephrine: (exerts its greatest effect on) Alpha-1 > Beta-1 > Beta-2 receptors o Epinephrine: (exerts its primary effect on) Beta-2 > Beta-1 = Alpha-1 receptors (same effect on Alpha-1 as Beta-1)

92

So if you wanted to administer a drug that has a primary Alpha-1 effect, what drug would you administer?

LEVOPHED (primarily Alpha-1, also some Beta-1 and also some Beta-2)

93

What is the parasympathetic cholinergic neurotransmitter and receptors(all the pathways are cholinergic)?

o Acetylcholine: -Nicotinic-2 (receptors at the ganglionic synapse), -Muscarinic receptors (receptors at the target organs/ tissues—many different subtypes of muscarinic receptors; mentioned together as class of muscarinic receptors)

94

What is the mechanism of action, the sequence of events when alpha-1 binds to a receptor site?

• SNS: Starting out with an ALPHA-1 RECEPTOR • There’s a membrane bound receptor; its LIGANDS ARE EPI AND NE • Inside of the cell membrane it’s coupled with a G-PROTEIN (ALPHA, BETA, GAMMA SUBUNIT) • In the inactive state the alpha subunit is attached to GDP • And then that eventually gets coupled with (on the inside of the cell) PHOSPHOLIPASE C • The ligand binds and GDP is replaced by GTP; which activates alpha subunit; which activates PHOSPHOLIPASE C • That leads to the synthesis of the second messengers, DIACYLGLYCEROL (DAG) AND INOSITOL TRIPHOSPHATE (IP3) • DAG activates enzyme PHOSPHOLIPASE C • IP3 CAUSES A RELEASE OF CA INTO THE CYTOPLASM and that further activates Ca dependent processes (some protein kinases) • And that brings about the final target cell response; target responses are unique to each individual cells

95

What is the mechanism of action, the sequence of events when beta-1 and beta-2 are activated?

BETA-1 AND BETA-2 RECEPTORS: IN THIS PICTURE I WOULD PREFER EPI OVER NE AS THE LIGAND • Here is the G-protein in the inactivate state; coupled with the inactivate enzyme adenylyl cyclase • The ligand binds with the receptor; activates the GTP subunit • Activates the enzyme adenylyl cyclase; which converts ATP into the messenger cAMP • cAMP regulates protein kinase A; which brings about the final target cell response

96

What is the action of alpha-1 adrenergic receptors?

o (Lead to) contraction of smooth muscle

97

What is the action of alpha-2 adrenergic receptors?

o Inhibition of a target cell response on either the central or peripheral target receptors

98

How does alpha-2 receptors inhabit centrally?

o Central medullary alpha-2 receptors: § Inhibition of sympathetic outflow from medullary cardiovascular center, which allows parasympathetic (vagal) domination in target organs § When central alpha-2 receptors are activated, that inhibits symp outflow and increases parasymp or vagal outflow § LESS SYMP; MORE PARASYMP § Parasymp vagal response dominates in target organs/ tissues; ex. heart

99

What is an example of central alpha-2 adrenergeric inhibition?

Increased pressure in the aortic arch and internal carotids increases the impulses to the nucleus solitarius; which then in turn activate central alpha-2 receptors in the medullary CV center leading to those outcomes

100

How does alpha-2 receptors inhibit peripherally?

§ Many on presynaptic membrane of sympathetic neurons; when activated usually decrease NE release into synapse § Often are on the presynaptic membrane of symp neurons; what do I mean by that? § Presynaptic membrane synapses with the postsynaptic membrane; so when NE is released from that neuron into that synapse, it is going to bind with receptors of the postsynaptic membrane to bring about a target organ/ tissue response § Also, they bind with alpha-2 receptors on the presynaptic membrane; when those presynaptic alpha-2 receptors are activated, they decrease release of NE into the synapse § So if there’s a decrease release of NE into the synapse, then eventually there will be a decrease response on the postsynaptic receptors

101

What is an example of peripheral alpha-2 adrenergic inhibition?

§ When you administer Levophed over time, patient’s sometimes become refractory to it § The postsynaptic can down regulate over time, but the Levophed is also binding to presynaptic alpha-2 receptors leading to decreased endogenous release of NE; so they actually run out of endogenous NE after a period of time § You have to some other medication other than NE

102

What is the action of beta-1 adrenergic receptors?

o Regulation of (some) metabolic functions (that I will cover later), HEART, and JG CELLS OF KIDNEYS (renin) § Plentiful beta-1 receptors on the SA node, AV node and ventricular contractile fibers of the heart § Juxtaglomerular cells which secrete renin (which has to do with BP regulation) also have beta-1 receptors; so when those beta-1 receptors are activated, renin is released and will increase BP over time

103

What is the action of beta-2 adrenergic receptors?

o Relaxation of vascular and bronchiolar smooth muscles § particularly the medium-sized small bronchioles; beta-2 receptors cause relaxation of those smooth muscle and bronchiolar dilation § And SOME vascular smooth muscle, not all, has beta-2 receptors that lead to vasodilation

104

Where are Nicotinic type-2 receptors found?

• Nicotinic type 2 receptors are on ganglionic synapses on the dendrites of postganglionic neuron

105

What is the neurotransmitter found at the nicotinic type-2 synapse?

ACh is the NT; binds with those receptors, and that’s coupled with an ACh-gated Na+ channel

106

What is the mechanism of action when ACh binds with the Nicotinic type-2 receptor?

• ACh is the NT; binds with those receptors, and that’s coupled with an ACh-gated Na+ channel • The gates open, and Na+ diffuses with its electrochemical gradient; from outside to the inside of the cell • And if Na is diffusing into the inside of the cell membrane; it makes the inside of the membrane less negative, reaches TP and cell membrane depolarizes • When ACh is removed from the receptor site, the gate closes

107

What is the neurotransmitter found at the Muscarinic receptor?

ACh

108

What is the mechanism of action when ACh binds with the Muscarinic recptor?

• Most use same mechanism as Alpha-1 receptors • EXCEPTION: o Muscarinic receptors in sinoatrial node of heart (they do not operate like a typical muscarinic receptor): o (ACh binds with these muscarinic receptors in the SA node), the alpha-GTP subunit (binds with) the G-protein that directly opens potassium channels in the SA node (flows inside to out), which hyperpolarizes/ inhibits the SA node and decreases heart rate. • NT is ACh which is then coupled with a G protein; then phospholipase C, which leads to pretty much that same sequence of events

109

Is the sympathetic ANS always excitatory and the parasympathetic ANS always inhibitory?

NO!!! for example Alpha-2 is sympathetic but it is inhibitory. They both have excitatory and inhibitory mechanisms

110

When the radial and circular muscles of the iris are innervated by the sympathetic ANS what is the response and what receptor is responsible for the response?

• Contracts and pupil dilates; alpha-1 pupils dilate [does not have a CN involved; follows the same path as CN III (A-1)

111

When the ciliary muscle to the lens is innervated by the sympathetic ANS what is the response and what receptor is responsible for the response?

• Relaxes and lens accommodates for far vision; beta-2 lens need to accommodate for far vision (B-2)

112

When the salivary gland is innervated by the sympathetic ANS what is the response and what receptor is responsible for the response?

• Thick, viscous saliva; Alpha-1 Some secretions important: saliva thick, viscous, stringy, sticky (A-1);

113

When the Nasal gland is innervated by the sympathetic ANS what is the response and what receptor is responsible for the response?

• Thick, viscous secretions; Alpha-1 Nasal secretions thick viscous, sticky (A-1)

114

When the Lacrimal gland is innervated by the sympathetic ANS what is the response and what receptor is responsible for the response?

• Decreases; Alpha-1 Lacrimal secretions decrease, not the time to cry (A-1)

115

When the gastric and intestinal gland is innervated by the sympathetic ANS what is the response and what receptor is responsible for the response?

• Decreases; Alpha-1 Not the time to digest or absorb nutrients, so stomach/GI tract secretions decrease (A-1)

116

When the insulin (pancreatic gland) is innervated by the sympathetic ANS what is the response and what receptor is responsible for the response?

• Decreases; Alpha-1 Pancreatic: insulin production decreases (A-1);

117

When the glucagon (pancreatic gland) is innervated by the sympathetic ANS what is the response and what receptor is responsible for the response?

• Increases; Alpha-1 So glucagon increases, breaks glycogen to glucose, also converts fats etc into glucose, blood sugar goes up (A-1)

118

When the exocrine(pancreatic gland) is innervated by the sympathetic ANS what is the response and what receptor is responsible for the response?

• Decreases; Alpha-1 pancreatic exocrine/small intestine digestion decreases (A-1)

119

When the thermoregulatory(sweat gland) is innervated by the sympathetic ANS what is the response and what receptor is responsible for the response?

• Increases (cholinergic pathway) Muscarinic Sweat: thermoregulatory: hot, sweat evaporates from surface of body to decrease temp (this increases in sympathetic- it's symp cholinergic so ACh, muscarinic not NE (M)

120

When the Apocrine(sweat gland) is innervated by the sympathetic ANS what is the response and what receptor is responsible for the response?

• Increases (thick, odoriferous) Alpha-1 Other sweating apocrine (under pits, between legs, stinky sweat)- symp adrenergic, thick, odoriferous (think skunk!) (A-1)

121

When the Adrenal Medulla gland is innervated by the sympathetic ANS what is the response and what receptor is responsible for the response?

• Increases NE and EPI secretion Nicotinic type-2 Adrenal medulla: synapses with symp pregang neuron, releases ACh, receptors on adrenal medulla that responsed are nicotinic type 2, causes secretion of catecholamines dopamine, NE, and LOTS of EPI from adrenal medulla, secreted into blood, bind with adrenergic receptors at targets, intensifies overall symp response heart

122

When the SA Node is innervated by the sympathetic ANS what is the response and what receptor is responsible for the response?

• Increases rate(+ chronotropic) Beta-1 Symp to HEART: SA, AV, ventricular fibers: beta 1 in all these areas so HR increases, speed of conduction thru the AV node increases, strength of contraction increases, objective: increase SV, CO, sustain BP, sustain perfusion of vital organs/tissues.

123

When the AV Node is innervated by the sympathetic ANS what is the response and what receptor is responsible for the response?

• Increases speed of conduction(+ dromotropic); Beta-1 Symp to HEART: SA, AV, ventricular fibers: beta 1 in all these areas so HR increases, speed of conduction thru the AV node increases, strength of contraction increases, objective: increase SV, CO, sustain BP, sustain perfusion of vital organs/tissues.

124

When the Myocardial contractile fibers are innervated by the sympathetic ANS what is the response and what receptor is responsible for the response?

• Increases strength of ventricular contraction (+ inotropic) ;Beta-1 Symp to HEART: SA, AV, ventricular fibers: beta 1 in all these areas so HR increases, speed of conduction thru the AV node increases, strength of contraction increases, objective: increase SV, CO, sustain BP, sustain perfusion of vital organs/tissues.

125

When the Coronary blood vessels are innervated by the sympathetic ANS what is the response and what receptor is responsible for the response?

• Dilation **/ Constriction B-2/ A-1 Blood vessels: some need to dilate, other constrict. blood needs to be shunted to priority organs from non priority organs BV: Coronary arteries: o Beta-2, alpha-1 receptors: beta-2 receptors lead to dilation, alpha-1 leads to constriction § to much constriction from alpha-1 = infarction o IN NORMAL people, beta 2 predominates sympathetic response o If someone is having advanced shock, outpouring of catecholamines, alpha-1 response might take over, constrict coronaries, cause MI, death.

126

When the Skin (blood vessels) are innervated by the sympathetic ANS what is the response and what receptor is responsible for the response?

• Constriction A-1 Skin/periphery: alpha 1: constrict

127

When the abdominal viscera (blood vessels) are innervated by the sympathetic ANS what is the response and what receptor is responsible for the response?

• Constriction A-1 BV: ABD organs: constrict-not priority, alpha-1 (over time, become ischemic, may infarct/become necrotic)

128

When the skeletal muscles (blood vessels) are innervated by the sympathetic ANS what is the response and what receptor is responsible for the response?

• Constriction/ Dilation(adrenergic pathway)A-1/ B-2 • Dilation (cholinergic pathway)M BV: to the skeletal muscle: priority skeletal muscles dilate (A-1), non-priority constrict (B-2). Priorities:large skeletal in arms and legs

129

When the pulmonary blood vessels are innervated by the sympathetic ANS what is the response and what receptor is responsible for the response?

• Constriction A-1 BV: pulmonary: blood vessels CONSTRICT with symp response (A-1): slows down blood flow past alveoli allowing more time for gas exchange to occur since alveoli swell up more than normal. if severe constriction though, alveoli can't get perfused, not good

130

When the renal(and INDIRECTLY renin secretion) blood vessels are innervated by the sympathetic ANS what is the response and what receptor is responsible for the response?

• Constriction A-1 BV: renal: alpha-1: constrict, RENAL BLOOD FLOW DECREASES, SECONDARY TO THE DECREASE BLOOD FLOW THIS RENIN IS SECRETED, leads to angiotensin-2 activation which is a vasoconstrictor (indirect way to activate angiotensin-2)

131

When the systemic veins are innervated by the sympathetic ANS what is the response and what receptor is responsible for the response?

• Constriction A-1 BV: Systemic veins: alpha-1: constrict, increase venous pressure/return to RA, increase preload, increase stretch, SV, CO

132

When the renin secretion(DIRECT effect on the juxtaglomerular cells) are innervated by the sympathetic ANS what is the response and what receptor is responsible for the response?

• Increases B-1 Renin secretion: cells in kidneys that secrete are juxtaglomerular cells: beta-1: when activated directly causes renin secretion. Don’t confuse indirect renin with direct renin secretion; different receptors, different mechanisms

133

When the lungs are innervated by the sympathetic ANS what is the response and what receptor is responsible for the response?

• Bronchi/ bronchiolar smooth muscle relaxes and bronchi/bronchioles dilate B-2 Lungs: bronchioles smooth muscle dilate to enahance gas exchange (B-2)

134

When the stomach and intestinal smooth muscle are innervated by the sympathetic ANS what is the response and what receptor is responsible for the response?

• Smooth muscle relaxes, which decreases peristalsis and tone B-2 GI tract: smooth muscle and intestinal smooth muscle relaxes, peristalsis slows-- if just eaten big meal, and you have a big symp response, it won't move through (B-2)

135

When the sphincters(e.g. sphincter of Oddi) are innervated by the sympathetic ANS what is the response and what receptor is responsible for the response?

• Contract A-1 GI tract. sphincters contract (alpha 1-- sphincter of Oddi (pancreatic and gall bladder secretions, in order for them to enter small intestine, it has to relax, in symp it constricts), smooth muscle from gall bladder and pancreas relaxes which also decreases secretions

136

When the Gall bladder/bile duct/pancreatic duct are innervated by the sympathetic ANS what is the response and what receptor is responsible for the response?

• Relax B-2 GI tract. sphincters contract (alpha 1-- sphincter of Oddi (pancreatic and gall bladder secretions, in order for them to enter small intestine, it has to relax, in symp it constricts), smooth muscle from gall bladder and pancreas relaxes which also decreases secretions

137

When the liver is innervated by the sympathetic ANS what is the response and what receptor is responsible for the response?

• Increases glycogenolysis and gluconeogenesis, which increases blood glucose B-2 Liver: Increases glycogenesis etc (B-2)

138

When the internal sphincter of the urinary bladder is innervated by the sympathetic ANS what is the response and what receptor is responsible for the response?

• Contracts (inhibits urination) A-1 Urinary bladder: Internal sphincter constricts (A-1); smooth muscle relaxes. Symp makes you (B-2)

139

When the smooth muscle of the bladder wall is innervated by the sympathetic ANS what is the response and what receptor is responsible for the response?

• Relaxes B-2 Urinary bladder: Internal sphincter constricts (A-1); smooth muscle relaxes. Symp makes you (B-2)

140

When the male genitals are innervated by the sympathetic ANS what is the response and what receptor is responsible for the response?

• Orgasm and ejaculation in men A-1 Genitals: in order for men to orgasm/ejaculate: symp nervous system has to predominate in the genitals (A-1)

141

When the female genitals are innervated by the sympathetic ANS what is the response and what receptor is responsible for the response?

• ??? Orgasm in women A-1 ???

142

When the skin is innervated by the sympathetic ANS what is the response and what receptor is responsible for the response?

• Piloerector muscles contract (goose bumps) A-1

143

When adipose tissue is innervated by the sympathetic ANS what is the response and what receptor is responsible for the response?

• Lipolysis B-1 Adipose tissue: beta-1: lipolysis

144

When metabolism is innervated by the sympathetic ANS what is the response and what receptor is responsible for the response?

• Increases up to 100% Numerous Metabolism: rate increases (numerous)

145

When blood coagulation is innervated by the sympathetic ANS what is the response and what receptor is responsible for the response?

• Increases platelet activity, hemostasis, and coagulation A-1 Blood tends to coagulate

146

When the radial and circular muscles of the iris are innervated by the parasympathetic ANS what is the response and what receptor is responsible for the response?

-contracts and pupil constricts-Muscarinic Eyes: pupils constrict (CN III),

147

When the ciliary muscle to the lens is innervated by the parasympathetic ANS what is the response and what receptor is responsible for the response?

-constricts and lens accommodates for near vision-Muscarinic lens accommodates for near vision

148

When the salivary gland is innervated by the parasympathetic ANS what is the response and what receptor is responsible for the response?

-copious, watery saliva -Muscarinic Glands: lots of saliva, lots of nasal secretions, lacrimal secretions, GI intestinal secretions increase, insulin increases, glucagon decreases, (insulin favors storing nutrients up to use at a later time), exocrine from pancreas and gallbladder increase

149

When the nasal gland is innervated by the parasympathetic ANS what is the response and what receptor is responsible for the response?

-copious water secretions- Muscarinic Glands: lots of saliva, lots of nasal secretions, lacrimal secretions, GI intestinal secretions increase, insulin increases, glucagon decreases, (insulin favors storing nutrients up to use at a later time), exocrine from pancreas and gallbladder increase

150

When the lacrimal gland is innervated by the parasympathetic ANS what is the response and what receptor is responsible for the response?

-increases-muscarinic Glands: lots of saliva, lots of nasal secretions, lacrimal secretions, GI intestinal secretions increase, insulin increases, glucagon decreases, (insulin favors storing nutrients up to use at a later time), exocrine from pancreas and gallbladder increase

151

When the gastric and intestinal gland is innervated by the parasympathetic ANS what is the response and what receptor is responsible for the response?

-increases-muscarinic Glands: lots of saliva, lots of nasal secretions, lacrimal secretions, GI intestinal secretions increase, insulin increases, glucagon decreases, (insulin favors storing nutrients up to use at a later time), exocrine from pancreas and gallbladder increase

152

When the Insulin (pancreas) is innervated by the parasympathetic ANS what is the response and what receptor is responsible for the response?

-increases-muscarinic Glands: lots of saliva, lots of nasal secretions, lacrimal secretions, GI intestinal secretions increase, insulin increases, glucagon decreases, (insulin favors storing nutrients up to use at a later time), exocrine from pancreas and gallbladder increase

153

When the glucagon (pancreas) is innervated by the parasympathetic ANS what is the response and what receptor is responsible for the response?

-decreases-muscarinic Glands: lots of saliva, lots of nasal secretions, lacrimal secretions, GI intestinal secretions increase, insulin increases, glucagon decreases, (insulin favors storing nutrients up to use at a later time), exocrine from pancreas and gallbladder increase

154

When the exocrine (pancreas) is innervated by the parasympathetic ANS what is the response and what receptor is responsible for the response?

-increases-muscarinic Glands: lots of saliva, lots of nasal secretions, lacrimal secretions, GI intestinal secretions increase, insulin increases, glucagon decreases, (insulin favors storing nutrients up to use at a later time), exocrine from pancreas and gallbladder increase

155

When the sweat glands is innervated by the parasympathetic ANS what is the response and what receptor is responsible for the response?

no effect on sweating or adrenal medulla

156

When the adrenal medulla is innervated by the parasympathetic ANS what is the response and what receptor is responsible for the response?

No effect

157

When the SA Node of the heart is innervated by the parasympathetic ANS what is the response and what receptor is responsible for the response?

-decreases rate(*chronotropic)-muscarinic Heart: PRIMARY PARASYMP TO VAGUS IS DIRECTLY TO THE SA NODE

158

When the AV Node of the heart is innervated by the parasympathetic ANS what is the response and what receptor is responsible for the response?

-decreases speed of conduction(*dromotropic)-muscarinic Heart: Very little if any parasymp innervation of the AV node or ventricular contractile fibers So just really know SA = negative chronotropic (others are minor if existent, so don't worry about them)

159

When the myocardial contractile fibers are innervated by the parasympathetic ANS what is the response and what receptor is responsible for the response?

-decreases strength of contraction(*inotropic)-muscarinic Heart: Very little if any parasymp innervation of the AV node or ventricular contractile fibers So just really know SA = negative chronotropic (others are minor if existent, so don't worry about them)

160

When the coronary blood vessels are innervated by the parasympathetic ANS what is the response and what receptor is responsible for the response?

-dilate-muscarinic Smooth muscles of BV: basically no parasymp innervation, diameter of BV is regulated by sympathetic (causes to constrict) Smooth muscle of the coronary arteries may have some vagal parasymp innervation but it’s very minor if existent

161

When the blood vessels are innervated by the parasympathetic ANS what is the response and what receptor is responsible for the response?

Smooth muscles of BV: basically no parasymp innervation, diameter of BV is regulated by sympathetic (causes to constrict) Smooth muscle of the coronary arteries may have some vagal parasymp innervation but it’s very minor if existent

162

When the lungs are innervated by the parasympathetic ANS what is the response and what receptor is responsible for the response?

-bronchi/bronchiolar smooth muscle contracts lightly and bronchi/bronchioles constrict slightly- muscarinic Bronchiole diameter: constrict to some extent. airway dz: usually uses an anticholinergic drug (i.e., albuterol to offset this

163

When the stomach and intestinal smooth muscle are innervated by the parasympathetic ANS what is the response and what receptor is responsible for the response?

-smooth muscle contracts, which increases peristalsis and tone- muscarinic GI tract: smooth muscle contracts, increased peristalsis, sphincter of Oddi relaxes, pancreatic duct and gall bladder muscle contract

164

When the sphincters(e.g. sphincter of Oddi) are innervated by the parasympathetic ANS what is the response and what receptor is responsible for the response?

-relax-muscarinic GI tract: smooth muscle contracts, increased peristalsis, sphincter of Oddi relaxes, pancreatic duct and gall bladder muscle contract

165

When the gall bladder/pancreatic duct/bile duct are innervated by the parasympathetic ANS what is the response and what receptor is responsible for the response?

-contract-muscarinic GI tract: smooth muscle contracts, increased peristalsis, sphincter of Oddi relaxes, pancreatic duct and gall bladder muscle contract

166

When the liver is innervated by the parasympathetic ANS what is the response and what receptor is responsible for the response?

-increases glycogenesis- muscarinic Liver: favors glycogenesis (glucose to glycogen storage form of glucose)

167

When the internal sphincter of the urinary bladder is innervated by the parasympathetic ANS what is the response and what receptor is responsible for the response?

-relaxes for urination-muscarinic Urinary bladder: internal sphincter relaxes, smooth muscle contracts, enhances urination, also have to consciously control/relax external sphincter

168

When the smooth muscle of the urinary bladder is innervated by the parasympathetic ANS what is the response and what receptor is responsible for the response?

-contracts for urination-muscarinic Urinary bladder: internal sphincter relaxes, smooth muscle contracts, enhances urination, also have to consciously control/relax external sphincter

169

When the male genitals are innervated by the parasympathetic ANS what is the response and what receptor is responsible for the response?

-erection of penis-muscarinic Genitals: parasymp: libido has its way: favors dilation of arteries in penis, favors penile erection, favors vaginal engorgement, erection of clitoris, vaginal lubrication • Orgasm is sympathetic, so at that time, in the genitals, BOTH HAVE TO PREDOMINATE • CO-DOMINATION for orgasm and ejaculation to occur • The other time in life where there is co-domination: few hours before death • French "le petit mort" for orgasm, means the little death

170

When the female genitals are innervated by the parasympathetic ANS what is the response and what receptor is responsible for the response?

-clitoral erection and vaginal engorgement and lubrication-muscarinic Genitals: parasymp: libido has its way: favors dilation of arteries in penis, favors penile erection, favors vaginal engorgement, erection of clitoris, vaginal lubrication • Orgasm is sympathetic, so at that time, in the genitals, BOTH HAVE TO PREDOMINATE • CO-DOMINATION for orgasm and ejaculation to occur • The other time in life where there is co-domination: few hours before death • French "le petit mort" for orgasm, means the little death

171

When the skin is innervated by the parasympathetic ANS what is the response and what receptor is responsible for the response?

the skin is not innervated by the parasympathetic ANS

172

When the adipose tissue is innervated by the parasympathetic ANS what is the response and what receptor is responsible for the response?

adipose tissue is not innervated by the parasympathetic ANS

173

When metabolism is innervated by the parasympathetic ANS what is the response and what receptor is responsible for the response?

the parasympathetic ANS plays no part in metabolism

174

When blood coagulation is innervated by the parasympathetic ANS what is the response and what receptor is responsible for the response?

the parasympathetic ANS plays no part in blood coagulation

175

What are the two broad divisions of muscle?

-striated -smooth

176

What are two types of striated muscle?

-skeletal -cardiac

177

What are two types of skeletal muscle?

FAST(white) muscle fibers § FAST (white) muscle fibers – Centerfold boys, pretty boys with nice muscles. v Pretty to look at but not much function v Weight lifters/ MEAT HEADS SLOW(red) muscle fibers § SLOW (red) muscle fibers – Modified for EXTENDED periods of energy v e.g., Long distance runners, would have lots of SLOW muscles in their legs

178

What are the characteristics of Fast muscle fibers?

• React rapidly for quick, powerful spurts of energy • Larger fibers for strength of contraction • Innervated by larger (in diameter) somatic motor neuron fibers • Extensive sarcoplasmic reticulum for Ca++ storage and release (has lots of Ca++ ions for rapid release) • Large amounts of glycolytic enzymes to produce energy through anaerobic glycolysis (metabolism) • Less extensive blood supply (because they operate primarily anaerobically) • Fewer mitochondria—depend more on anaerobic metabolism for energy source • Less myoglobin o myoglobin is a protein in muscle fibers that is similar to hemoglobin in RBCs o when RBCs deliver O2 to muscle fibers, the O2 inside the muscle fiber binds with myoglobin o and the myoglobin then transports the O2 throughout the muscle fiber

179

What are the characteristics of slow muscle fibers?

• Respond slowly but prolonged contraction for prolonged activity • Smaller fibers • Innervated by smaller (diameter) somatic motor neuron fibers • More extensive blood supply—require more oxygen for aerobic oxidative metabolism • More mitochondria for aerobic oxidative metabolism • More myoglobin to transport oxygen throughout muscle fibers

180

Of the two types of skeletal muscle which one is considered white and which is considered red?

FAST = WHITE SLOW = RED

181

Muscles are attached to bone via _____?

TENDONS

182

Muscles are composed of bundles of fibers, these fibers are called?

o Each one are called FASCICULUS (plural) o Each muscle group has lots of fasciculi (singular)

183

A fasciculi is made up of muscle cells, muscle cells are another name for a _____. What is the name of numerous muscle fibers/cells?

o Muscle cell is another name for a muscle fiber • A fasciculus is made up of NUMEROUS muscle fibers/ cells

184

The cell membrane of muscle fibers is called the

SARCOLEMMA (in muscle fibers) • Each muscle fiber has a blood supply (arterial and venous system)

185

Structures on the INSIDE of the muscle fiber o Instead of calling them endoplasmic reticulum; we call it.......

SARCOPLASMIC reticulum

186

Substructures of the muscle fiber are called......

MYOFIBRILS

187

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