Unit 2 Physiology - Autonomic Nervous System

Front 1

Autonomic physiological effects on the heart

Back 1

Front 2

Receptors allowing SNS function at the heart ?

Back 2

Beta 1

Front 3

Components of the autonomic NS?

Back 3

PSNS

SNS

Enteric NS

Front 4

Coronary filling occurs during?

Back 4

Diastole

Front 5

SNS effect on coronary blood flow?

Back 5

Decrease but usually increases due to the main control being via metabolites which increase with increasing cardiac contractility / work

Front 6

Effect of SNS on SA node pacemaker function?

Back 6

Front 7

Location of preganglionic cell bodies?

Back 7

IML intermediolateral column of the spinal cord and motor nuclei of the brainstem

Front 8

Type of nerve fibers?

1. Motor

2. Preganglionic - autonomic

3. Postganlionic - autonomic

Back 8

1. Motor /Somatic - alpha - large + fast

2. Preganglionic - B fibers, small, myelinated, slow

3. Postganglionic - Unmyelinated C fibers

Front 9

Path of a SNS preganglionic fiber from the IML?

Back 9

Exits with one of the thoracolumbar via the VENTRAL root --> WHITE rami communicans --> paravertebral ganglion and either synapse here or move up or down the chain to synapse (or move to the prevertebral ganglia --> prior to moving towards the target organ.

Toward the limbs etc --> grey communicans and travels with the spinal nerve or goes directly there if to an organ

Front 10

With the SNS - the coeliac ganglion feeds forward via postganglionic nerve to which organs?

Back 10

Stomach, liver, pancreas, spleen

Front 11

With the SNS - the superior mesenteric ganglion feeds forward via postganglionic nerve to which organs?

Back 11

Small intestine and colon

Front 12

With the SNS - the inferior mesenteric ganglion feeds forward via postganglionic nerve to which organs?

Back 12

colon, kidney, bladder, sex organs

Front 13

What are the names of the SNS ganglia?

Back 13

Cervical

Coeliac

Superior mesenteric

Inferior mesenteric

Sacral

Front 14

Which CN nuclei are involved in parasympathetic outflow?

Back 14

CN - III, VII, IX, X

III - Edinger Westphal --> ciliary ganglion

VII - Superior salivatory nucleus --> Sphenopalatine ganglia (lacrimal gland + nasal mucosa) + submandibular ganglia (submanddibular gland)

IX - Glossopharyngeal - Inferior salivatory nucleus --> otic ganglion (parotid)

X - VAGUS - Nucleus Ambiguus (SA + AV nodes) + Dorsal motor vagal nucleus (viscera)

Front 15

What is the effect of activating a nicotininc ACh receptor ?

Back 15

Depolarisation

Opening of Na+ + K+ channels

Initially EPSP - fast excitatory post synaptic potential (depolarisation) then slow-EPSP - modulates transmission through sympathetic ganglia

Note Late, Slow EPSP due to peptide (minutes)

Front 16

Atropine blocks which receptors?

Back 16

mACh

Front 17

What are the main types of Muscarinic receptors? Where are they found?

Back 17

M1-5

M2 --> Heart

M3 --> Smooth muscle and glands

Front 18

How do the main 2 types of muscarinic receptors signal intracellularlly?

Back 18

M2 (HEART) - Opens K channels and inhibits Adenylyl cyclase - ie reduced cAMP

M3 (SMOOTH MUSCLE + GLANDS) - Formation of IP3 + DAG and increase intracellular Ca2+

Front 19

Control of lacrimal glands is via?

Back 19

PSNS --> CNVII

Front 20

Adrenergic receptor in bronchical smooth muscle?

Heart?

Back 20

Bronchial - Beta 2

Heart - mainly Beta 1

Front 21

What causes organophosphate poisoning?

Back 21

Pesticides + Sarin gas

MOA: Inhibit acetylcholinesterase --> increase ACh effects

Signs + Symptoms: miosis, salivation, sweating, bronchial constriction, vomiting, diarrhoea, cognitive disturbance, seizures, coma

Rx: ATROPINE

Front 22

Signs of anticholinergic poisoning

Back 22

"Blind as a bat (cyclopegia, myadriasis), mad as a hatter (delirum), red as a beet (flushed), hot as hare (hyperthermia), dry as a bone (no sweating), bowel and bladder lose their tone and the heart runs alone"

Ie with mushroom poisoning - mycetism --> Inocybe

Front 23

Describe the symptoms of Horner's Syndrome

Back 23

Anhidrosis

Ptosis

Miosis

Enophthalmos (sunken eye)

Due to disruption of sympathetic outflow to the face

Front 24

Give examples of nonadrenergic noncholinergic transmitters.

Back 24

NA - related

ATP

Neuropeptide Y - NPY

ACh - related

VIP - Vasoactive intestinal peptide

Calcitonin gene-related peptide

Substance P

Also Nitric oxide

Front 25

In which organ do the PSNS and SNS work together?

Back 25

Salivary glands

PSNS - watery saliva

SNS - thick saliva

Male ejaculation

Front 26

Which organs have sole SNS or PSNS innvervation?

Back 26

SNS - blood vessels, pilomotor muscles in the skin, adrenal gland, sweat glands

PSNS - lacrimal, ciliary (accommodation for near vision), sublingual

Front 27

Descending inputs to the AUTONOMIC NS?

Back 27

Hypothalamic parventricular Nucleus

Pontine A5 cell group

Rostral ventrolateral medulla

Medullar raphe nucleus

All these send signals to the IML

Front 28

Name the layers of the GIT

Back 28

Mucosa (epithelium, lamina propria, muscularis mucosa)

Submucosa - Miessner's plexus

Muscularis propria ( circular muscle, auerbach's plexus, longitudinal muscle)

Serosa/adventitia

Front 29

Multisystem atrophy is a neurodegenerative disorder associated with loss of which type of neurons?

Back 29

Preganglionic autonomic neurons in the brainstem and spinal cord

Front 30

In addition to classic neurotransmitters, some autonomic fibres also release neuropeptides. In postganglionic noradrenergic neurons, what (in addition to noradrenaline) is in the large granulated vesicles?

Back 30

Neuropeptide Y

ATP in small vesicles

Front 31

Receptors on the liver ?

Back 31

α1β2

adrenergic only

Front 32

How does Resperine work?

Back 32

Blocks Neurotransmitter storage in vesicles

Front 33

How does cocaine work?

Back 33

Blocks reuptake of NA

Same at tricyclic antidepressants

Front 34

What drug prevents inactivation of neurotransmitter - ACh?

Back 34

Edrophonium

Neostigmine

Physostigmine

Inhibits acetylcholinesterase

increased PSNS effects

Reversal of non depolarising muscle relaxants

Front 35

Beta2 agonists?

Back 35

albuterol

salbutamol

Front 36

Beta 1 agonist?

Back 36

Dobutamine

Front 37

Alpha 2 agonist?

Back 37

Clonidine

Front 38

Alpha 1 antagonist?

Back 38

prazosin

Front 39

Muscarinic antagonist?

Back 39

atropine

ipratropium

tropicamide

Front 40

Receptors on the Liver?

Back 40

Adrenergic

Alpha 1

Beta 2

SNS only

Front 41

Receptors on the gallbladder

Back 41

Beta 2

relaxation

SNS

Front 42

Receptors on adipose tissue?

Back 42

Beta 3

adrenergic

Front 43

M2 receptor location?

Back 43

Heart

Front 44

M3 receptor location?

Back 44

Smooth muscle and glands

Front 45

SNS receptors on the eye?

Back 45

alpha 1 - constriction of radial iris muscle

Front 46

Location of of the cell bodies of preganglionic neurons?

Back 46

IML - intermediolateral column of the spinal cord and some cranial nuclei

Front 47

Which of the following are incorrect:

1. alpha neurons examples of myelinated MOTOR neurons

2. Preganglionic autonomic neurons are small, myelinated slow conducting B fibers

3. 1 preganglionic neuron diverges multiple postganglionic neurons

4. All preganglionic neurons use ACh as their neurotransmitter

5. Postganglionic neurons are mostly myelinated c fibers

Back 47

5. Postganglionic neurons are mostly myelinated c fibers - incorrect - C fibers are UNMYELINATED

Front 48

Postganglionc nerves used which neurotransmitter?

Back 48

Noradrenaline

ACh - sweat glands + some blood vessels to produce vasodilation (skeletal muscle)

Dopamine - Renal nerves

Front 49

Describe the path of preganglionic SNS neurons.

Back 49

Leave the IML --> via ventral root with motor neurons --> leave via WHITE rami communicans --> sympathetic paravertebral ganglion

Here some synapse, others leave and move up or down the chain or synapse at paravertebral ganglia (including coeliac, SM, IM ganglia)

Front 50

Which nerves traverse the gray rami communicans?

Back 50

Postganglionic neurons leave the chain and re-enter spinal nerves via the GREY rami

Front 51

Name the cranial PSNS ganglia and the end effector organs.

Back 51

Ciliary ganglion - pupillary constrictor, ciliary muscle

Sphenopalatine - Lacrimal and nasal glands

Submaxillary - Submaxillay, sublingual glands

Otic - Parotid

Front 52

Name the CRANIAL NUCLEI associated with PSNS and the associated CN

Back 52

Edinger-Westphal N. --> III --> Ciliary --> pupil

Superior salivatory nucleus - VII --> Glands

Inferior salivatory N. - IX - - Otic G. --> Parotid

Dorsal Motor N. of Vagus - X --> heart, lungs, GIT

Nucleus Ambiguus - X --> heart

Front 53

Parts of the GIT served by the COELIAC Ganglion (SNS)

Back 53

Stomach

Liver

Pancreas

Spleen

Front 54

Parts of the GIT served by the Superior mesenteric ganglion - SNS ?

Back 54

Small intestine + Colon

Front 55

Parts of the GIT served by the Inferior mesenteric ganglion SNS ?

Back 55

Colon

Kidney

Bladder

Sex organs

Front 56

Which of the following are incorrect -

1. The sex organs, kidneys, bladder and colon receive SNS innervation via the inferior mesenteric ganglia

2. The superior mesenteric ganglia provide PSNS input for only the small intestine

3. Nucleus Ambiguus provides PSNS output to the heart via the vagus nerve

4. Vagal supply to organs is from the dorsal motor nucleus of vagus (except the heart)

5. CNVII serves the lacrimal and nasal glands

Back 56

2. The superior mesenteric ganglia provide PSNS input for only the small intestine - incorrect - provide SYMPATHETIC input to the SI + colon

Front 57

PSNS input to the sex organs?

Back 57

Via S2/3/4 --> to the bladder, colon and sex organs via the pelvic nerves

Front 58

Nicotinic receptors opens ?

Back 58

Na and K channels

Front 59

How are slow EPSP produced?

Back 59

Fast EPSP --> ACh - nAChR - milliseconds

Slow EPSP --> ACh acting on mAChR (Seconds)

Modulate and regulate transmission

NOTE: SLOW, LATE EPSP due to peptides (minutes)

Front 60

Which of the following are incorrect:

1. M2 are located on the heart and open K channels and inhibit adenylyl cyclase

2. M3 receptors are located on smooth muscle and glands --> IP3 + DAG --> Ca2+

3. Activation of alpha 1 results in contraction of the radial muscle of the iris and miosis

4. The ciliary muscle is controlled by the PSNS

5. PSNS results in erection but not ejaculation

Back 60

3. Activation of alpha 1 results in contraction of the radial muscle of the iris and miosis - incorrect - results in mydriasis - Contraction

Front 61

Which of the following are incorrect:

1. PSNS activation results in lacrimal secretion

2. B3 adrenergic receptors result in lipolysis

3. Both SNS and PSNS increase salivary secretion (viscous vs watery)

4. SNS has no effect on insulin production

5. B2 receptor activation results in relaxation of the detrusor

Back 61

4. SNS has no effect on insulin production - incorrect - Alpha decreases secretion but B2 increases secretion

Front 62

SNS effects on the bladder - which receptors?

Back 62

B2 - relaxation detrusor (Gs - increases cAMP)

Alpha 1 - contraction sphincter (IP3, DAG)

Front 63

PSNS effects on the bladder

Back 63

Contraction of the detrusor and relaxation of the sphincter

Front 64

Most vasoconstriction via the SNS is via which receptor?

Intracellular signalling?

Back 64

Alpha 1 - constriction ---> IP3 + DAG = Ca influx

Front 65

Effects of PSNS/SNS on lungs?

Back 65

SNS - B2 - relaxation

PSNS - constriction

Front 66

Examples of mAChR antagonist?

Back 66

atropine

ipratropium

scopolamine

tropicamide

Front 67

Main target of dobutamine

Back 67

Beta 1

Front 68

MOA of alpha 2 signalling?

Back 68

Gi

inhibits adenylyl cyclase

reduced cAMP

Front 69

MOA of pralidoxime ?

MOA Pyridostigmine?

Back 69

Pralidoxime - Breaks the covalent bond between organophosphates and AChE --> must be given early

Pyridostigmine - Preventatively binds AChE and prevents binding of organophosphates (given to soldiers) with atropine and carbamate

Front 70

Function of the ciliary muscle ?

Back 70

accommodation for near vision

under PSNS control

Front 71

Sweat glands contain what type of receptor?

Back 71

Muscarinic but responding to SNS - ACh

resulting in sweating