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Autonomic N System

Autonomic Nervous System

ANS function Provides the ability to maintain homeostasis Functions at subconscious level, involved in regulating, adjusting, and coordinating vital visceral function-BP, temp, respirations, digestion, metabolism, elimination Strongly affected by emotional state
ANS components Sympathetic: fight or flight Parasympathetic: rest and digest
Ganglia Group of neurons that work together and are geographically close together
Functions of Parasympathetic Nervous System slowing heart rate, increase gastric secretion, emptying bladder and bowel, focus of eye for near vision, constriction of pupil, contraction of bronchial smooth muscle
Functions of Sympathetic Nervous System Regulation of cardiovascular system, regulation of body temp, implementing fight or flight response
Patterns of autonomic innervation and regulation Innervation by both divisions of ANS in which the effects of the 2 divisions are opposed. Innervation by both divisions of ANS in which the effects of the 2 divisions are complementary. Innervation and regulation by ne one division of the ANS.
Preganglionic neurons and Postganglionic neurons in both PNS and SNS Pre: neurons that go from the spinal cord to the ganglia Post: Neurons that go from the ganglia to the effector organs
Adrenal medulla's function in SNS It can be looked on as the functional equivalent of a postganglionic neuron. Releases Epi which then produces effects much like those that occur in response to the stim of postganglionic sympathetic nerves. The nerve to the medulla is referred to as pre
Somatic Motor System pathway One one neuron from spinal cord to muscles innervated by somatic motor nerves. They only have the neuromuscular junction (between somatic nerve and muscle).
Cholingeric receptor function Mediate responses to ACh transmitter
Adrenergic receptor function Mediate responses to epinephrine (adrenaline) and norepinephrine transmitters
Transmitters employed at specific junctions of PNS. All pregang neurons of PSN and SNS release ACh All postgang neurons of para release ACh Most postgang of Symp release NE Postgang of SNS that innervate sweat gland release ACh Adrenal medulla releases Epi All motor neurons to skeletal muscles releas
Cholinergic receptor subtypes Nictinic (n), nicotinic (m), and muscarinic.
Nicotinic N (neuronal) Promotes ganglionic transmission at all gangli of SNS and PNS. Promotes release of EP from adrenal medulla.
Nicotinic M (muscle) Cause contraction of skeletal muscle. Located at neuromuscular junction.
Muscarinic Located on target organs of parasymp nervous system. Target organs: eye, heart, lung, bladder, GI tract, sweat glands, sex organs, blood vessels
Eye response for muscarinic (parasympathetic) Constriction for near vision
Heart response for muscarinic (parasympathetic) Decrease rate
Lung response for muscarinic (parasympathetic) Constriction of bronchi
Bladder response for muscarinic (parasympathetic) Relaxation
GI tract response for muscarinic (parasympathetic) Increase tone, peristalsis
Glands response in parasympathetic vasodilation
Peripheral vessels response in parasympathetic Dilate
Adrenergic receptor subtypes Alpha 1, Alpha 2, Beta 1, Beta 2
Alpha 1 locations and response Eye: increase pupils, far vision, dilation. Aterioles: constriction non vitals, Veins: constriction, Male sex: ejaculation, Prostate capsule: contraction; Bladder: contraction (retention)
Alpha 2 locations and response (sympathetic) Presynatpic nerve terminals; Inhibition of transmitter release
Beta 1 locations and response (sympathetic) Heart: increased rate, force of contraction, AV conduction velocity. Kidney: renin release
Beta 2 location and response (sympathetic) Arterioles (vital): dilation; Bronchi: dilation; Uterus: relaxation; Liver: glycogenolysis (need more energy); skeletal muscle: enhanced contraction and glycogenolysis.
Dopamine location and response (sympathetic) Dilation of kidney vasculature
Adrenergic transmitter receptor specificity range Epi: A1, A2, B1, B2 NE: A1, A2, B1 DA: A1 (high doses), B1 (mod doses) Isoproterenol: B1, B2
Cholinergic drugs parasympathomimetic: Muscarinic agonist: bethanechol and pilocarpine. Mimics parasymp actions, directly activate muscarinic receptors on target organs
Anticholinergic drugs Muscarinic antagonist: atropine. parasympatholytic. Will block actions of parasymp
Adrenergic drugs Adrenergic agonist: Epi, NE, DA, Isoproterenol, sympathomimetic. Directly stimulate adrenergic receptos (A1-> B2)
Antiadrenergic drugs Adrenergic Antagonists: “sympatholytics”. Will block sympathetic actions
Neuromuscular blocking agents Nicotinic (M) Antagonists: Turbocurarine, Succinylcholine. Blocking receptor at neuromuscular synapse
Bethanechol Muscarinic Agonist; Stim PNS actions; uses: Glaucoma, urinary retention, intestinal paralysis; S/E: Much higher when give SC vs oral. Hypotension, bradycardia, salivation, diarrhea, abdominal cramps, bronchoconstriction, sweating
Atropine: Action and uses Muscarinic Antagonist; Uses: Preop prep, eye disorders, bradycardia, intestinal hypermotility, muscarinic agonist poisoning; Block parasymp: lwr gland secretion (esp salivating, so decrease issues when intubated) Decrease heart tone= heart to speed up
Atropine: side effects Xerostomia (dry mouth), blurred vision and photophobia, increased Intraocular pressure (IOP), urinary retention, constipation, anhidrosis (inability to sweat), tachycardia
Alpha 1 activation: uses and side effects Uses: Hemostasis (local bleed), nasal decongestion, adjunct to local anesthesia (vasoconst will keep anesthesia because it can’t diffuse away quickly), decreased BP, mydriasis (pupil dilation)SE: HTN, necrosis, bradycardia (baroreceptor reflex)
Alpha 2 activation central activation only, decreases symp outflow to heart and vessels Decrease symp outflow: decrease SNS even though you’re stimulating A2
Beta 1 activation: Uses and side effects Uses: Cardiac arrest, heart failure, shock, AV heart block. You will increase heart rate, contraction, BP so it's good to use for these issues. SE: dysrhythmias, angina (if you inc work, you may not get enough blood)
Beta 1 activation: uses and side effects uses: delay preterm labor, asthma SE: Hyperglycemia: mobilized glucose stores-> inc blood glucose; tremor: albuterol for asthma
Adrenergic Antagonists-Alpha: uses Essential hypertension: block A2, reversal of A1 agonist toxicity, benign prostatic hypertrophy (BPH), Raynaud’s, pheochromocytoma (malignant tumor of adrenal medulla: secreting excessive epi, meantime trying to stabilize for surgery of removal of tumor)
Adrenergic Antagonists-Alpha: side effects Mostly due to α-1 blockade; orthostatic hypotension, reflex tachycardia, nasal congestion, inhibition of ejaculation
Adrenergic Antagonists-Beta: uses and side effects Uses: Angina, HTN, dysrhythmias, MI, heart failure Adverse effects: β-1: Bradycardia, reduced CO, AV block, rebound cardiac excitation Β-2: Bronchoconstriction, inhibition of glycogenolysis
Tubocurarine Prototype for nicotinic M antagonist Actions: Compete with ACH for binding to nicotinicM receptors on the motor end plate Uses: skeletal muscle relaxation for surgery and intubation SE: Respiratory arrest, hypotention
Botulism Toxins from the botulism organism produce paralysis by blocking Ach release Found in soil-grown foods not cooked to 100C Botox-form of toxin, injected into small muscle group areas. spasmodic torticollis (neck on shoulder), overactive sweat glands
Vasovagal Response Vagus exerts a inhibitory effect on HR In persons with quadriplegia or high level paraplegia, visceral afferent stim can elicit vagal response (deep ET tube suctioning, rapid position change)
Vasovagal Response: side effects and preventative measures SE: Severe bradycardia or asystole Hyperoxygenate during suctioning to prevent Anticholinergic drugs to counteract
Autonomic Dysreflexia: Definition and treatment In persons with spinal cord injury above T6 Visceral stimuli that normally cause pain in the abdominopelvic region will trigger inappropriate, exaggerated sympathetic response. Med emerg. Drug to reduce BP as well as drugs that block autonomic function
Autonomic Dysreflexia: symptoms HTN, bradycardia, HA. Below the level of injury, get vasospasm, skin pallor. HTN activates baroreceptor reflex, = bradycardia then vasodilation with sweating above level of injury.
Raynaud’s Disease Possible autonomic dysfunction; Intense vasoconstr of art. in fingers, sometimes toes Response to normal conditions that cause mild vasoconstr Exacerbations during stress Can lead to gangrene Treat with Ca channel blockers, alpha adrenergic blockers
Created by: Marissagostanian