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99 Cards in this Set

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describe the functional components of the nervous system
Peripheral
1. autonomic (involuntary)
- sympathetic
- parasympathetic
2. sensory/somatic motor (voluntary)

Central
- cerebrum, diencephalon, cerebellum, brainstem, spinal cord
what are the three components of the peripheral nervous system?
1. sensory
2. somatic motor
3. autonomic
where are the cell bodies of the sensory neurons?
1. dorsal root ganglia
where are the cell bodies of the somatic motor neurons?
1. ventral horn
where are the cell bodies of the autonomic motor neurons?
ventral horn
what is another name for the sympathetic NS?
thoracolumbar (T1-L3)
where do the cell bodies originate for sympathetic neurons?
intermediolateral column
what are the names of the first three sympathetic ganglia?
1. superior cervical ganglion
2. middle cervical ganglion
3. inferior cervical ganglion
what does the superior cervical ganglion innervate?
- pupil
- salivary glands
- lacrimal glands
- blood vessels and sweat glands of the face
where do the postganglionic neurons that innervate the GI tract originate?
in the ganglia foudn around the celiac, superior mesenteric and inferior mesenteric vessels
- they are named the celiac, superior mesenteric and inferior mesenteric ganglia respectively.
describe the functional components of the nervous system
Peripheral
1. autonomic (involuntary)
- sympathetic
- parasympathetic
2. sensory/somatic motor (voluntary)

Central
- cerebrum, diencephalon, cerebellum, brainstem, spinal cord
what are the three components of the peripheral nervous system?
1. sensory
2. somatic motor
3. autonomic
where are the cell bodies of the sensory neurons?
1. dorsal root ganglia
where are the cell bodies of the somatic motor neurons?
1. ventral horn
where are the cell bodies of the autonomic motor neurons?
ventral horn
what is another name for the sympathetic NS?
thoracolumbar (T1-L3)
where do the cell bodies originate for sympathetic neurons?
intermediolateral column
what are the names of the first three sympathetic ganglia?
1. superior cervical ganglion
2. middle cervical ganglion
3. inferior cervical ganglion
what does the superior cervical ganglion innervate?
- pupil
- salivary glands
- lacrimal glands
- blood vessels and sweat glands of the face
where do the postganglionic neurons that innervate the GI tract originate?
in the ganglia foudn around the celiac, superior mesenteric and inferior mesenteric vessels
- they are named the celiac, superior mesenteric and inferior mesenteric ganglia respectively.
what's the difference between neuroendocrine cells of the adrenal medulla and sympathetic postganglionic neurons?
sympathetic postganglion: release NorEpi
adrenal medulla: primarily release Epi (85%)
what does albuterol do?
dilate bronchioles
sympathetic agonist
what does metoprolol do?
decrease HR and contractility
alpha antagonist
what's another name for the parasympathetic system?
craniosacral system
where does CN III (oculomotor) originate? what does it do?
edinger-westphal nucleus.
pupillary constriction (parasympathetics)
what do parasymapthetic fibers of CN VII do?
- slivary secretion by submaxillary and sulingual glands
- tear production by lacrimal glands
what does the parasympathetic fibers of CN IX do?
stimulate parotid gland
what does the vagus nerve do?
parasympathetics to
- heart
- traheobronchial tree
- kidnies
- GI
what innervates the urinary bladder, genitalia, and remainder of the colon?
parasympathetics of the sacral region
what does bethanechol do?
parasympathomimetic that promotes GI and urinary tract motlility
what does atropine do?
antagonist of parasympathetic activity:
- dilates pupils
- increase HR
what does ipratroprium do?
parasympathetic antagonist
- dilate bronchioles
what are the four lobes of the cortex?
1. frontal
2. temporal
3. parietal
4. occipital
what are the three deep nuclie of grey matter in the basal ganglia?
1. caudate
2. putamen
(1+2 = striatum)
3. globus pallidus
what do the grey deep nuclei of the basal ganglia do?
- make sure that planned actions are carried out, and that irreleant movements are inhibited
what are the start and endpoints of the dopaminergic pathway?
starts: substantia nigra
ends: striatum
'nigrostriatal tract'
what happens in parkinson's disease?
degeneration of dopaminergic pathway in the striatum--> basal ganglia cannot initiate movement
- decreased movement
- tremor
where does levodopa act?
in the striatum
what makes up the limbic system?
1. cingulate gyrus
2. hippocampal formation
3. amygdala
what ist the limbic system responsible for?
- emotion
- social behavior
- perception of pain
- memory
- autonomic control
what are the 2 parts of the diencephalon?
1. thalamus
2. hypothalamus
what are the three regions of the cerebellum?
1. vermis
2. hemispheres
3. flocculonodule lobe
what do neurons in the periaqueductal gray do?
send descending projections to the spinal cord --> modulates pain perception
what are the main components of the reticular activating system?
- locus ceruleus
- raphe nucleus
responsible for consciousness
how many connections does a preganglionic neuron make?
1- thousands
'divergent signaling'
what type of NT does the raphe nucleus use? where is it found?
serotonin
medlla, pons, midbrain
What type of NT does the substantia nigra use? where is it found?
dopamine
midbrain
what type of NT does the locus ceruleus use? where is it found?
NorEpi
pons
what type of NT does the basal nucleus of Meynert use?
ACh
what type of NT does the peduculopontine nucleus use? where is it found?
ACh
what type of NT does the tuberomamillary nucleus use?
histamine
what are the board categories of small molecule NTs?
1. amino acid NTs
2. biogenic amine NTs
3. ACh
4. Purines
5. NO
name the amino acids NTs
- glutamate
- aspartate
- gamma amino butyric acid (GABA)
- glycine
name the biogenic amine NTs
- norepi
- dopamine
- epinephrine
- serotonin
- histamine
which types of NTs are derived from tyrosine?
catecholamines:
- dopamine
- norepi
- epi
name the 2 primary inhibitory NTs
- glycine
- GABA
how do you make norepi?
dopamine is converted to norepi via dopamine-beta-hydroxylase in synaptic vesicles
how is epi formed?
norepi is transported from synaptic vesicles into the cytoplasm and methylated into epi
what do tricyclic antidepressants (TCAs) act on?
inhibit reuptake of norepi and seratonin
how is histamine formed?
decarboxylation of histadine
where does ACh act in the autonomic NS?
used by all preganglionic neurons and by parasympathetic postganglionic neurons
what does ACh do in the CNS?
regulates sleep and wakefulness
How is NO different from other small molecule neurotransmitters?
- diffuses through neuronal membranes and binds to receptors within the cell
- many receptors for NO are in the presynaptic neurons, allowing NO to act as a retrograde messenger
how does glucose pass through the BBB?
via the hexose transporter
why might L-Dopa treatment be impaired after high protein meals?
transport of L-dopa into the brain relies on large neurla amino acid transporters, which may be overwhelmed after a large meal
what do multiple drug resistance transporters do?
pump hypdrophobic compounds out of the brain and back into the blood
why is carbidopa added to L-dopa treatment?
dopamine decarboxylase constitutes part of the metabolic blood brain barrier (transforms L-dopa to dopamine). by giving carbidopa, you inhibit this.
what are many common pesticides and nerve gases?
acetylcholinesterase inhibitors
what does G6PD do?
prevent red blood cells from oxidative injury
describe the pentose phosphate pathway
The pentose phosphate pathway is a process that serves to generate NADPH and the synthesis of pentose (5-carbon) sugars. There are two distinct phases in the pathway. The first is the oxidative phase, in which NADPH is generated, and the second is the non-oxidative synthesis of 5 carbon sugars. The pathway is one of the three main ways the body creates reducing molecules to prevent oxidative stress, accounting for approximately 10% of NADPH production in humans. It reduces the coenzyme glutathione which converts reactive H2O2 into H2O.
why is G6PD important?
Glucose-6-phosphate dehydrogenase is an enzyme in the pentose phosphate pathway, a metabolic pathway that supplies reducing energy to cells (most notably erythrocytes) by maintaining the level of NADPH. The NADPH in turn maintains the level of glutathione in these cells that helps protect the red blood cells against oxidative damage. G6PD converts glucose-6-phosphate into 6-phosphoglucono-δ-lactone and is the rate-limiting enzyme of the pentose phosphate pathway.
what happens in G6PD deficinecy?
Patients with G6PD deficiency are at risk of hemolytic anemia in states of oxidative stress. This can be in severe infection, medication and certain foods.
In states of oxidative stress, all remaining glutathione is consumed. The hemoglobin is metabolized to bilirubin (causing jaundice at high concentrations) or excreted directly by the kidney (causing acute renal failure in severe cases).
build up of glucose and thus there is an increase of advanced glycation endproducts (AGE). The deficiency also causes a reduction of NADPH which is necessary for the formation of Nitric Oxide (NO).
Although female carriers can have a mild form of G6PD, homozygous females have been described; in these females there is co-incidence of a rare immune disorder termed chronic granulomatous disease (CGD).
which medications put oxidative stress on RBCs?
- sulfonamide
- antimalarial
- acetaminophen
- ibuprofen
what are the four classes of anticoagulants?
1. heparin
2. warfarin
3. hirudin (direct inhibitor of thrombin)
4. activated protein C
how is heparin administered, and how fast does it act?
parenterally. immediate acting
how is warfarmin administered, and how fast does it act?
orally. delayed acting
where is heparin found?
in the secretory granules of mast cells
describe the heparin molecule
very negatively charged. highly sulfatd polymer
what does heparin act on?
antithrombin III, which inactivates thrombin and serine proteases (factors IXa, Xa, XIa, and XIIa).
heparin accelerates the binding reaction between antithrobin II and protease by 1000 fold
why is only a little bit of heparin so effective?
the coagulation cascade has a built in amplification function. i unite of factor Xa --> 40 units of thrombin
what is heparin often administered with?
antiplatelet agents
how do you monitor heparin levels in the blood?
using the activated partial throboplastin time (aPTT)
- add patient's plasma to phospholipid and time fibrin formation
what do some patients develop from heparin treatment?
heparin-induced thrombocytopenia
(low platelet count). patients develop antibodies against platelets
what is a heparin antagonist?
protamine
where do oral anticoagulants act?
blocks the epoxide reductase that is necessary for regeneration of the active reduced vit K.
what is vit K necessary for?
hepatic synthesis of:
1. coagulation factors (II, VII, IX, and X)
2. protein C
3. protein S
what does vit K do?
mediates gamma-carboxylation of coagulation factors, protein C and protein S so that these residues are able to bind to Ca2+, which is necessary for binding to phospholipid surfaces
how long does it take for warfarin to act?
18-24 hours. need to wait for active coagulation factors to run out.
when is warfarin administered?
to complete a course of anticoagulation therapy that was started by heparin.
how much of warfarin is bound to plasma?
99%
why must you be careful of drug drug interactions with warfarin?
- is an inducer of the P450 system
- coadminstration can increase the free plasma concentrations of both drugs since they compete for binding with albumin
can warfarin be given to pregnant women?
no! can cross the placenta and cause hemorrhagic disorders
what is a paradoxical effect of warfarin?
can actually cause thrombosis b/c it impairs the synthesis of bioactive protein C & S. there's a window around day 3 when patients may be hypercoagulable (also a probelm in people deficient in protein C and S)
how do you monitor warfarin?
prothrombin time (PT)
warfarin prolongs PT b/c it decreases amount of active factor VII in plasma
what does hirudin do?
directly inhibits thrombin
what does thrombin do?
1) converts fibrinogen to fibrin
2) activates factor XIII
3) activates platelets
4) induces endothelial release of PGI2, t-PA, and PAI-1
what does factor XIII do?
cross links fibrin polymers to form a stable clot
how does protein C work?
- inhibits factors Va and VIIIa
- reduce inflmamation by inhibiting release of TNF-a from monocytes
on what types of patients is protein C used?
high risk of death from septic shock
(anti coagulability and inflammatory properties)