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Corissa.Stovall
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SNS post ganglionic neurons outnumber the preganglionic neurons by how much
20:1 or 30:1
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What does large sympathetic ganglion at adrenal medulla release
80% epi and 20% nor epi
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What is mass sympathetic discharge
increase in arterial bp, heart rate and contractility, blood flow to muscles, blood glucsose, metabolic rate, muscle strength, mental activity, and blood coagulation
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What does mass sympathetic discharge prepare the body for
vigorous activity needed to deal with life threatening situations
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Sympathetic stimulation can also occur in isolated parts such as where (3)
heat regulation- control sweating
local reflexes
many of the sympathetic reflexes that control GI funtion
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The Vagus nerve transmits what % of traffic of the PNS
75%
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PNS pre post ganglionic fiber ratio
1:1 or 1:2 except in enteric plexus
very different from SNS
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Where are preganglionic cell bodies of SNS located
in visceral motor region of spinal gray matter
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What is the highest level of intergration of ANS
Cerebral cortex
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What is the principle ANS organizational area of the brain
hypothalmus
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SNS functions are controlled by nuclei in the
posterior-lateral hypothalmus
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PNS functions are controlld by the nuclei in the
midline and portions of anterior nuclei of hypothalmus
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The anterior hypothalamus is responsible for what
temp regulation
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The supra optic hypothalamus is responsible for what
regulates water metabolism
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Where does efferent SNS cell body originate
Where does it pass through
Dorso-lumbar- in intermedio-lateral gray column of T1-L2 and L1-L3
It passes through anterior root of cord to corresponding spinal nerve
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Each sympathetic pathway from the cord is composed of how many neurons
2
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Control by PSN is
highly specific
ex: cardiovascular reflex work to only increase or decrease the rate of beating
rectal emptying does not affect other portions of the bowel
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Origin of PNS
- Craniosacral
- Cranial nerves III, VII, IX, and X
And sacral areas S2-S4
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Distribution of PNS
Limited to head, neck, and trunk
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SNS ganglia are where
away from organs
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PNS ganglia are where
on or close to organ
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Post ganglionic fibers of SNS long or short
long
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Post ganglionic fibers of PNS long or short
short
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Transmitter of SNS
nor-adrenaline (nor epi)-- major one
acetylcholine --- minor
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Transmitter of PNS
acetylcholine
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Stability of neurotransmitter of SNS
stable, differ for wider activity
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stability of neurotransmitter of PNS
ACH is rapidly destroyed locally
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Important function of SNS
- tackling stress and emergency
- Fight or flight
- "E" division
- exercise, excitement, emergency, and embaressment
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Important fx of PNS
processing of food, conservation of energy
Rest and digest
- "D" division
- Digestion, defecation, and diuresis
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What is an example of antagonist control of ANS
- when PNS and SNS both exhibit response
- SNS increases heart rate, and PNS decreases heart rate
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What is exception to antagonism rule of ANS
PNS and SNS work together to achieve male sexual fx
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What to all autonomic preganglionic neurons release what
ACH onto cholinergic nicotinic receptors
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Most post ganglionic SNS release what
NE onto adrenergic receptors
except sweat glands and BV
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Most post ganglionic neurons of PNS release what
ACH onto cholinergic receptors
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What are the endogenous catecholamines in humans
dopamine, NE (stored in nerve endings), and EPI
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The release of NE is dependent upon
•depolarization of the nerve and an increase calcium ion permeability.
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Inactivation of catecholamines (3)
** the first one is highlighted in notes
reuptake into the presynaptic terminals (an active energy requiring temperature dependent process that can be inhibited)
extraneuronal uptake
diffusion into circulation
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Where are muscarinic receptors located
on all effector cells
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where are nicotinic receptors located
at the autonomic ganglia between the pre and post ganglionic neurons in BOTH THE SNS AND THE PNS
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where are Nicotinic M receptors located and what are they
neuromuscular junction
they are ligand gated ion channels
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Where are Nicotinic N receptors located and what do they do
located in autonomic ganglia
they decrease cardiac activity
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Muscarine receptors work at what site
all post ganglionic PNS
few post ganglionic in SNS
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Nicotinic N work at what site
Ganglia of both PNS and SNS
Adrenal medulla
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Nicotinic M works at what site
skeletal muscle
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Muscarinic and nicotinic both work at what sites
CNS (cortex, basal ganglia, spinal cord, and other sites)
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Adrenergic receptors are broken down into what two categories
alpha receptors and beta receptors
- alpha= a1 and a2
- beta= b1, b2, and b3
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cholinergic receptors are broken down into what two categories
muscarinic= m1, m2, m3, m4, and m5
nicotinic= nm, and nn
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alpha receptors are _______ -coupled receptors
G
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Alpha 1 receptors result in increased in intracellular _____ which leads to smooth muscle ______
calcium
contraction
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alpha 2 receptors decrease _______ activity and result in smooth muscle ______.
cAMP
contraction
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What secretes Epi and NE
adrenal medulla
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adrenergic means
method of transmission that has to do with adrenaline (epi) or dopamine
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non-adrenergic means
method of transmission that does not have to do with adrenergic neurotransmitters (epi, nor epi, and dopamine)
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Stimulating a1 adrenergic receptor (post synaptic) in uterus causes
contraction
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stimulating a1 adrenergic receptor (post synaptic) in liver causes
increase in glycogenesis
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presynaptic activation of a2 leads to
inhibition of NE release and produces vasodilation
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what is the most potent vasoconstrictor of all the catecholamines
norepi
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a2 agonists=____
post synaptic activation and response:
kidney tubules
pancreatic islets
smooth muscle of most veins
nerve terminals
- agonists=epi>nor epi> Iso clonidine
- Kidney tubules= H2O and Na secretion (a1= Na and H20 reabsorption)
- Pancreas= decreased insulin release
- Smooth muscle= contraction
- nerve terminals= decreased release of Epi
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B2 receptors usually cause
relaxation and dilation
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B2 agonist=
Post synaptic B2 receptor tissue and response
blood vessels
airway
liver hepatocytes
pancreas
- Iso>Epi>NE terbutaline
- blood vessels=dilation
- airway=dilation
- liver hepatocytes= glycogenolysis
- pancreas= increased glucagon= high blood sugar
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how does b2 post synaptic receptor effect K+ levels
increase potassium uptake= HYPOKALEMIA
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presynaptic b2 receptors release
NE leads to vasoconstriction
**post synaptic = vasodilation
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Where are b1 and b2 receptor present in
myocardium
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B1 agonist=
tissue response of
juxtaglomerular cells
heart
Iso>epi>NE dobutamine
juxt= increased renin secretion
heart= increased force and rate of contraction, and av nodal conduction velocity
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a1 agonists=
Tissue and response=
vascular smooth muscle
GU smooth muscle
Liver
Intestinal smooth muscle
Heart
epi>NE>Iso phenlyepherine
- Vascular smooth muscle= contraction
- GU smooth muscle=contraction
- Liver= glycogenolysis
- Intestinal smooth muscle= hyperpolarization and relaxation
- Heart=increased contractile force, arrythmias
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Oculo-cardiac reflex is stimulated by what
What are effects of this
- traction or extaoccular muscle
- pressure on eyeball
- increase in intraocular pressure
Sinus brady, cardiac dysrhythmia, ventricular fibrillation, and asystole
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Carotid sinus reflex is stimulated by what
What are effects of this
- Increased heart rate and blood pressure
- ***can stimulate with intubation or if patient is scared
decreased bp and heart rate
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Nasocardiac reflex is stimulated by what? **highlighted in notes
What are effects of this
irritation of nasal canal (by nasal specules, nasal retractor, or ET tube) WHEN ANESTHESIA IS INADEQUATE
Decreased heart rate and blood pressure
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pharyngeal reflex is stimulated by what
what are effects of this
an airway introduced in anesthesia that is to light, irritation by mucosa
swallowing followed by laryngospasm
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tracheal reflex is stimulated by what
what is effect of this
et intubation, cuff irritation, suctioning, or foreign body in trachea
laryngospasm, bronchospasm, bucking, cardiac arrhythmia, hypotension
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All autonomic reflexes during anesthesia and surgery the efferent nerve that is stimulated is what
vagus nerve
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adrenergic or sympathominmetic drugs act like
nor epi and epi b/c they do not rely on reuptake
*these drugs have an effect which is much more prolonged than that of either epi or nor epi
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phenylephrine stimulates what receptors
alpha
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albuterol stimulates what receptors
beta 2 receptors
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which drugs act indirectly by increasing the release of norepi from its storage terminals
ephedrine, tyramine, amphetamine
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Which drugs are cholinesterase inhibitors
What do they do
neostigmine, pyridostimine, and ambenontium
potentiates the effect of acetylcholine
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Phenylephrine, adrenergic, or non adrenergic?
Stimulates what receptors
adrenergic
alpha receptors
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Isoproterenol adrenergic, or non ?
stimulates what receptors
adrenergic
beta1 and beta 2
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albuterol adrenergic or non
stimulates what receptors
adrenergic
beta 2 only
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antiadrenergic drugs block the effects of what
epi and nor epi
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resperine adrenergic or non
what does it do
non
blocks the synthesis and storage of epi and NE
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guanethidine adrenergic or non
blocks what
non
blocks the release of epi and ne from nerve terminal
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alpha blockers phentaolamine and phenoxybezamine
beta blockers propranolol, and metoprolol are all what type of drugs
anti adrenergic
block effects of epi and ne
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parasympathomimetic drugs
nicotine does what
pilocarpine and metacholine do what
nicotine- activates nictotinic receptors
pilocarpine and metacholine active muscarinic receptors, can cause perfuse sweating
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anti muscarinic drugs are what
atropine and scopalamine
block the effect of ACH on effector cells
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