Physiology Autonomic Nervous System

Front 1

How are sympathetic and parasympathetic divisions divided?

Back 1

Based on anatomic distribution and origin of nerves, effects on organs, NT released by postganglionic fibers, discharge pattern

Front 2

What are alpha and beta receptors for?

Back 2

Norepinephrine and Epinephrine

Front 3

What are muscarinic and nicotinic receptors for?

Back 3

Ach

Front 4

What kind of receptors are on ALL postganglionic neurons?

Back 4

Nicotinic (b/c Ach released from preganglionic fibers)

Front 5

What kind of receptors are on parasympathetic target organs?

Back 5

Muscarinic receptors (because Ach released from postganglionic fibers)

Front 6

What kind of receptors are on sympathetic target organs?

Back 6

alpha and beta receptors (because NE and Epi released from postganglionic fibers)

Front 7

What percentage NE and Epi released from sympathetic postganglionic fibers?

Back 7

90% NE, 10% Epi

Front 8

Preganglia of sympathetic NS/length of preganglionic fiber

Back 8

T1-T12; L1-L2; short

Front 9

Preganglia of parasympathetic NS/length of preganglionic fiber

Back 9

Cranial nerves 3, 7, 9, 10; S1-S2; long

Front 10

NT from preganglionic fibers of sympathetic AND parasympathetic NS

Back 10

Ach

Front 11

Postganglionic fibers of sympathetic NS length and NT released

Back 11

long, NE (90%), Epi (10%)

Front 12

Postganglionic fibers of parasympathetic NS length and NT released

Back 12

short, Ach

Front 13

ANS effects on ciliary muscle of eye

Back 13

SNS - B2 relaxes
PNS - contracts

Front 14

ANS effects on Heart, SA, AV nodes, atria and ventricles

Back 14

SNS - B1 increase
PNS - decreases

Front 15

ANS effects on arterioles

Back 15

SNS - A1, 2 constrict; B2 dilates
PNS - ?

Front 16

ANS effects on veins

Back 16

SNS - A1 constricts, B2 dilates
PNS - ?

Front 17

ANS effects on GFR

Back 17

SNS - decrease
PNS - increase

Front 18

ANS effects on lung/bronchiole muscles

Back 18

SNS - B2 relax
PNS - contracts

Front 19

Which is greater effected by ANS, arterioles or veins?

Back 19

Arterioles

Front 20

How do discharge patterns of SNS and PNS differ?

Back 20

SNS - massive mechanisms to prepare you for action
PNS - more discrete

Front 21

Adrenal Medulla

Back 21

modified sympathetic post-ganglionic fiber (chromaffin cells produce NE and Epi)
derived from the same neuronal crest cell line as the sympathetic nervous system

Front 22

What percentages of NE and Epi does the adrenal medulla secrete?

Back 22

10% NE, 90% Epi (switched at birth!)

Front 23

What is Epi useful for?

Back 23

The longterm coping with stress

Front 24

Epi is more dominant with ____

Back 24

age

Front 25

What do neuromodulators of pain do?

Back 25

alter the environment so it becomes easier to excite/inhibit

Front 26

Clinical approach to pain can be defined according to the Seattle model (4 things)

Back 26

nociception
pain
suffering
pain behavior

Front 27

Nociception

Back 27

2 types of pain fibers with freely branching nerve endings are activated

Front 28

Larger A delta fibers

Back 28

6-8 micrometers in length, thinly myelinated
conduct impulses relatively fast (12-30 M/sec)
specialized to provide info such as: mechanical distortion, touch, temperature, chemicals
indicates intensity and location
some are polymodal (respond to stimuli at high threshold with tissue damage)

Front 29

Smaller C fibers

Back 29

unmyelinated, 0.3 to 1 micrometer in diameter
conducts impulses slowly at 0.4-1.0 M/sec
mostly polymodal, activated with tissue damage
cutaneous area of each nociception neuron overlaps with other neurons
provides a sophisticated peripheral alarm system

Front 30

In general, A delta nerve fibers respond to...

Back 30

quick, intense pain

Front 31

In general, C delta nerve fibers respond to...

Back 31

chronic, throbbing pain

Front 32

Where does most sensory input go?

Back 32

Thalamus

Front 33

What is dorsal horn composed of?

Back 33

6 specialized layers with different nerve input

Front 34

What is layer 2 of dorsal horn?

Back 34

substantia gelatinosa, destination for both A delta and C fibers

Front 35

What are the two ascending pain fibers to the brain?

Back 35

Paleospinothalmic and neospinothalmic tracts

Front 36

What is the NT released by A delta fiber?

Back 36

Glutamate (NDMA receptor)

Front 37

What is the NT released by C fiber?

Back 37

Glutamate (NMDA and AMPA receptors) as well as substance P

Front 38

PAG (periaqueductal gray) area from brain

Back 38

extends descending fibers into dorsal horn synapsing with interneurons that synapse with axonal terminals of the C-fibers

Front 39

What do interneurons secrete and what does it do?

Back 39

enkephalin (leu or met-enkephalins) that bind to mu receptor on C-fiber synaptic knob

Front 40

What do enkephalins function as and what do they do?

Back 40

Neuromodulators that:
induce local depolarization
inhibit calcium influx into synaptic knob of C fibers
also modulate the synaptic terminals of C fiber which limits glutamate and substance P production

Front 41

What are endogenous opioids of the body?

Back 41

Enkephalins, endorphins, dynorphins

Front 42

What mimics the effect of opioids?

Back 42

Opiates

Front 43

What do opiates affect?

Back 43

Mu receptor in the brian

Front 44

What are 4 examples of opiates?

Back 44

Morphine, codeine, fentanyl, heroin

Front 45

How does heroin (diacetylmorphine HCl) differ from morphine?

Back 45

Has increased hydrophobicity - crosses the BBB more quickly than morphine and produces more rapid and intense euphoria

Front 46

What does tolerance result from and what are the implications?

Back 46

Down regulation of mu receptors - receptors move away from the surface so there are less receptors on the surface, larger doses required to find and bind to limited number of receptors

Front 47

Why do some people develop dependency while others do not?

Back 47

Reasons are not well understood

Front 48

Dependence may induce increase in what?

Back 48

CAMP

Front 49

Narcotic Addict Treatment Act

Back 49

1974 - strictly controlled methadone therapy to federally specified centers

Front 50

Drug Abuse Treatment Act

Back 50

2000 - addicts can be managed on out-patient basis by private physicians who must be properly trained

Front 51

Withdrawal - medication options

Back 51

Clonidine (alpha 2 agonist), dimishes NE actions during withdrawll
NSAIDS
antiemetics
antacids

Front 52

Dependence - medication options

Back 52

Buprenorphine (subutex), a partial opioid agonist in combination with naxolone (narcan)