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Autonomics (Cardio Block)
Autonomics
40
Medical
Graduate
01/09/2010

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Term
Parasympathetic Cranial Nerves
Definition
CN 3, 7, 9, 10
Sacral 3rd & 4th
Term
Parasympathetic ganglia
Definition
ciliary, submandibular, otic, pterygopalatine and pelvic ganglia
Term
All preganglionic fibers release what transmitter?
Definition
ACh N (acetycholine nicotinic)
Term
Somatic fibers release what transmitter?
Definition
ACh N
Term
All POSTganglionic PARASYMPATHETIC fibers are?
Definition
ACh M (acetylcholine muscarinic)
Term
Almost all POSTganglionic SYMPATHETIC fibers are
Definition
NE [ADRENERGIC (norepinephrine)]
Term
A few POSTganglionic SYMPATHETIC fibers (i.e.sweat glands) are
Definition
ACh M
CHOLINERGIC (muscarinic;
Term
The ADRENAL MEDULLA secretes what when stimulated? What transmitter stimulates the adrenal medulla?
Definition
secretes EPI & NE - Epinephrine and Norepinephrine
ACh N
Term
sympathetic NS (SNS)
Definition
Activated in response to stress--diffuse discharge, tends to discharge as a unit

“fight or flight”--an over-simplification

Can also discharge more discretely to perform certain functions (I.e. baroreceptor reflex)
Term
Parasympathetic nervous system
Definition
Vegetative
“rest and digest”
Term
Eye sympathetic:
Pupillary Radial m. (iris)
Definition
pupil radial m. contract (mydriasis, alpha1) --> excess pupil dilation
Term
Eye :
Pupillary Sphincter m. (iris)
Ciliary m.
Definition
pupil sphincter m. contract (parasympathetic) --> miosis (constricted pupil - small pupil)

ciliary m. contracts (near vision; parasympathetic)
Term
Organ where SNS & PNS are antagonistic
Definition
pupillary aperture (SNS stimulates the radial m. for dilation, the PNS stimulates the sphincter m. for miosis)
Term
Organ/biological event where PNS & SNS are complementary
Definition
male sexual response (symp. - ejaculation; parasymp. - erection)
Term
Instance when SNS discharges more discretely and not as a unit
Definition
baroreceptor reflex
Term
Step in synthetic pathway blocked by reserpine
Definition
vesicular storage of DA
Term
enzyme of RLS or RDS in EPI synthetic pathway
what drug inhibits this RLS?
Definition
tyrosine hydroxylase

Metyrosin - used to tx pheochromocytoma
Term
Interferes with excitation-release coupling to inhibit NE release in peripheral adrenergic nerve terminals.

Can also interfere with vesicular storage and act as a false transmitter.

Use: to tx hypertension
Definition
Guanethidine
Term
Prevents invasion of APs into nerve terminals—interferes with normal excitation-release coupling.

Used for treatment of arrhythmias
Definition
Bretylium
Term
Interference with synthesis
Definition
metyrosine
Term
Interference with release of neurotransmitter
Definition
bretylium, guanethidine
Term
Interference with vesicular storage
Definition
reserpine
Term
Promote release of neurotransmitter
Definition
tyramine, ephedrine
Term
Interference with reuptake 1
Definition
cocaine, fluoxetine (tricyclic antidepressants)
Term
Interference with metabolic breakdown; increase catecholamine levels
Definition
MAO inhibitors
Term
decreased responsiveness during prolonged exposure to drug, frequently indirect-acting agonists. Occurs rapidly. May be related to the pool of neurotransmitter available for release by the drug.
Definition
Tachyphylaxis
Term
Desensitization

tolerance
Definition
Desensitization: loss of receptor function following agonist activation

Tolerance: decreased effectiveness of a drug after repeated or prolonged exposure
Term
upregulation
downregulation
Definition
up-reg: increase in number of receptors
down=reg: decrease in number of receptors
Term
D1
D2
Definition
D1: important for dilation of renal vasculature
D2: modulates release of neurotransmitter
Term
MAO
COMT
Definition
Monoamine Oxidase (MAO): in brain, liver, kidney

Catechol-O-methyltransferase (COMT): in liver and non-neuronal tissues.
Term
methoxy-4-hydroxymandelic acid (VMA)
Definition
An estimate of catecholamine (CAs) turnover can be obtained from laboratory analysis of CAs and total metabolites in a 24 hour blood or urine specimen; useful for diagnosis of pheochromocytoma
Term
Corresponding end-product of degradation of DA
Definition
homovanillic acid (HVA)
Term
catecholamine (sympathetic)
rapid (high dose) IV infusion vs. slow (low dose) IV infusion
Definition
EPI, NE
rapid/high - direct increase B1 HR & a1 BP increase; vagal reflex BP drop
slow/low - no vagal reflex
Term
positive chronotropic effect
positive dromotropic effect
positive inotropic effect
Definition
Pacemaker activity—both normal (sinoatrial node) and abnormal (eg, Purkinje fibers)—is increased (positive chronotropic effect: increase in HR).

Conduction velocity in the atrioventricular node is increased (positive dromotropic effect), and the refractory period is decreased.

Intrinsic contractility is increased (positive inotropic effect: increased force of contraction), and relaxation is accelerated.
Term
EPI reversal
Definition
EPI with alpha blocker like Phenoxybenzamine, Phentolamine, Tolazoline
Prazosin
unopposed b2 vasodilation BP falls due to decreased TPR
Term
location of a1 receptors
Definition
postsynaptic; excitatory, effector organs postsynaptic, mediate vasoconstriction and smooth muscle contraction
Arterioles--skin, viscera, kidneys
Veins
Uterus, spleen, iris
Liver--increase gluconeogenesis, glycogenolysis
Term
location of a2 receptors
Definition
Presynaptic: autoreceptors
Postsynaptic: in CNS, decreases sympathetic outflow
Increase platelet aggregation (blood)
Term
location of b1 receptors
Definition
myocardium, excitatory.
Also in JG cells in kidneys (increase renin
release)
Term
location of b2 receptors
Definition
Skeletal muscle arterioles
Veins
Bronchial and uterine smooth muscle
Metabolic processes (gluconeogenesis, glyogenolysis)
Term
location of b3 receptors
Definition
adipose tissue
Increase FFA production
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