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ANS
| Question | Answer |
|---|---|
| What are two main divisions of our nervous system? | CNS / PNS |
| The Peripheral Nervous System is divided into what two parts? | Somatic Nervous System / Autonomic Nervous System |
| What are three divisions of the Autonomic Nervous System? | Sympathetic / Parasympathetic / Enteric* |
| T/F: The Enteric system may or may not be part of the Autonomic Nervous System depending on certain literature? | True - However, the enteric system can be effected by the ANS. |
| What two organs make up the Central Nervous System? | Brain / Spinal Cord |
| Which part of the brain is more responsible for ANS functions? | Hypothalamus |
| Which part of the brain is more responsible for CNS functions? | Cerebral Cortex |
| What is another name for the functions of the Cerebral Cortex? | Higher Brain Functions |
| What are the three sections of the brain? | Hindbrain / Midbrain / Forebrain |
| What is another name for the Hindbrain? | Reptilian Brain |
| What structures make up the Hindbrain? | Medulla / Pons / Cerebellum |
| What does the medulla control? | Ventilation / HR / BP |
| What does the Pons control? | Sensory Information / Facial Expressions |
| What does the cerebellum control? | Movement / Coordination / Balance / Muscle tone / Learning motor skills |
| What does the Reticular Formation regulate? | Hindbrain activity / Sleep / Wakefulness |
| What structure relays sensory information from the spinal cord to the forebrain? | Midbrain |
| What two sections make up the Midbrain? | Superior Colliculus / Inferior Colliculus |
| Which part of the brain is responsible for circadian rhythm? | Pineal Gland |
| What is significant about the pineal gland? | Postulated to be important in sex organ maturation. |
| What sections of the brain make up the Limbic System? | Hypothalamus / Thalamus / Amygdala / Hippocampus / Entorhinal Cortex |
| What does the Thalamus do? | Relays information to the appropriate parts of the brain? |
| What is the exception to the Thalamus? | Does not relay information to the olfactory portion of the brain. |
| What are the functions of the Hypothalamus/Pituitary Gland | Basic Biological drives / Hormonal Levels/ Sexual behavior / Autonomic Function |
| Name some basic autonomic functions? | Hunger / thirst / body temp |
| What part of the brain is important for the visual field? Explain. | Optic Chiasm - the left and right cross over point |
| T/F: The septum stimulates sexual pleasure? | True |
| What is the Hippocampus responsible for? | Learning and new memory |
| What part of the brain do Benzodiazepam drugs effect? | Hippocampus |
| What functions does the amygdala regulate? | Anxiety / emotion / fear |
| What is another name for the Mamillary body? What functions are regulated? | Fornix - emotional behavior / Learning / motivation |
| What parts of the brain are responsible for movement, emotions and integration of sensory data? | Basal Ganglia/ Caudate Nucleus/ Putamen/ Globus Pallidus |
| What creates a cushion for brain protection? | CSF |
| What parts of the brain contain CSF? | Ventricles / Central Canal |
| What is the Cingulate gyrus responsible for? | Internal Stimuli / Sense of self |
| What is another name for internal stimuli? | Pain |
| What are the nerves bundles that link the cerebral hemispheres? | Corpus collosum |
| What part of the brain controls movement, thinking and feeling? | Frontal Lobe |
| What is another name for the frontal lobe? | Conscious brain |
| The movement that the frontal brain controls is (voluntary/involuntary)? | Voluntary |
| What part of the brain causes children to make inappropriate decisions? | Prefrontal cortex - it is still developing. |
| What are the functions of the Pre-frontal Cortex? | Inhibits Inappropriate Actions/ Conceptual thinking / planning/ focus attention / adds meaning to perceptions |
| What part of the brain manages skin sensation? | Parietal Lobe |
| What part of the brain manages vision? | Occipital Lobe |
| What part of the brain manages hearing and speech? What is another name for this area? | Temporal Lobe - Auditory Cortex |
| Where is the spinal cord located? | Mid Dorsal line of the body. |
| What are two functions of the spinal cord? | Center for reflex arc. Conduit for communication between brain and spinal nerves. |
| T/F: The reflex arc involves higher conscious thought. | False - it is an action that DOES NOT require higher conscious thought. |
| What does dorsal mean? | Relays sensory information TO the brain. |
| What does ventral mean? | Relays messages FROM (MOTOR) the brain. |
| What does AVM stand for? | Anterior Ventral Motor |
| What does SDP stand for? | Sensory Dorsal Posterior |
| What part of the spinal cord is effected by pain medication? | Dorsal Root |
| T/F: White matter contains myelinated nerves. | True |
| What is the main function of white matter? | COMMUNICATION between areas of gray matter. |
| T/F: Gray matter contains only unmyelinated nerves. | False - has both myelinated and unmyelinated nerves. |
| What is the function of gray matter? | Responsible for processing information. |
| What should we think about with a myelinated nerve? | Fast transmission of signals. |
| What three 3 types of nerves are involved in the CNS/PNS? | Sensory neuron/ Somatic motor neuron/ Automatic motor neuron |
| Sensory neurons receive signals from what? | Sensory organs |
| Somatic motor neurons deliver signals to what? | Skeletal muscles |
| Autonomic motor neurons deliver signals to what? | Smooth muscle/ Cardiac muscle/ Glands (via pre and post ganglionic fibers) |
| ANS deals with (voluntary/involuntary) regulation? | Involuntary |
| What are some functions of the Autonomic nervous system? | Arterial BP/ GI motility & Secretions/ Urinary bladder emptying/Sweating/ Body temp |
| How fast can the ANS regulate BP and HR? Who stated this research? | HR 3-5 seconds BP 10-15 seconds (Guyton) |
| What parts of the body can trigger the ANS? | Spinal cord/ brain/ hypothalamus/ limbic cortex of the cerebral cortex |
| What is the response initiated by the ANS called? | Visceral reflex |
| BONUS: What does viscera mean? | Internal organ |
| What is the Principal site of ANS organization? | Hypothalamus nuclei |
| What are the physiological responses of the hypothalamus? | Stress / BP/ temp regulation |
| When we give anesthetics, why is temperature control so important? | Anesthetics (Volatile) are CNS depressants and inhibit the regulation of temperature. KEEP PATIENTS WARM! |
| What are the key functions of the medulla and pons? | Hemodynamic control/ Automatic ventilatory control |
| What assessment would be made on a patient with a medullary/pons injury (tumor)? | Irregular respirations or wide fluctuations in HR/BP. |
| What is our job in Anesthesia? | To avoid deleterious effects on the ANS. |
| Impaired ANS may cause what? | Alterations in expected outcomes to surgery/anesthesia. |
| What can improve patient outcomes? | Attenuating the stress response to surgery. |
| What do efferent autonomic signals refer to? | Signals being carried away from the CNS. |
| What two parts of the PNS do efferent signals travel too? | SNS/ParaSN |
| What is another name for the sympathetic nervous system? | Fight or flight |
| What is another name for the ParaSN | Rest and digest |
| Where do the fibers of the SNS arise from? | Preganglionic fibers arise from the thoracolumbar region of the spinal cord |
| Where do the fibers of the ParaNS arise from? | Preganglionic fibers arise from the craniosacral region of the spinal cord |
| How are nerves classified? | By the chemical transmitters they contain. |
| Nerves containing Ach are called? | Cholinergic |
| Nerves containing epinephrine/norepi are called? | Adrenergic |
| Drugs that mimic Ach are called what and what response do they have? | Cholinomimetic / Cause a predictable cellular response |
| Drugs that block AcH are called? | Cholinergic antagonist / anticholinergics |
| What are cell membrane proteins that react with AcH? Where do they act? | Cholinergic receptors Muscles/glands |
| What does it mean to have muscarinic effects? | AcH mediated action in the parasympathetic NS |
| Drugs that mimic muscarinic effects (agonist) can also be called? Where do they act? | Muscarinic drugs or Parasympothomimetics (heart/ smooth muscles/glands) |
| Drugs that block muscarinic effects can also be called? | Antimuscarinic / parasympatholytic |
| What receptors refer to the skeletal muscles? | Nicotinic |
| Where are the cholinergic nerves located? | Postganglionic parasympathetic Preganglionic Parasympathetic Some postganglionic sympathetic such as sweat glands/blood vessels and preganglionic sympathetic that arise from the greater splanic nerve and innervate the adrenal medulla. |
| Adrenergic nerves deal with what neurotransmitter and what are those drugs called? | Norepinephrine / Sympatholmimetic |
| What do you call drugs that inhibit NE? | Sympatholytic |
| What is special about the adrenal medulla? | Releases Epi/Norepi into the blood stream. No effector organ |
| What are the main adrenergic receptors? | Alpha 1 Alpha 2 Beta 1 Beta 2 |
| Where is alpha 1 located and what does it cause? | Postsynaptic: mydriasis, bronchoconstriction, vasocontriction, uterine constriction, constriction of gastrointestinal/genitourinary tracts. Inhibits insulin. +Gluconeogenesis/Glycogenolysis |
| Where is alpha 2 located and what does it cause? | Presynaptic: Inhibits further Norepi release. Alpha 2 postsynaptic may cause vasoconstriction but cause sedation in the CNS. |
| Where are beta 1 receptors and what does it cause? | Postsynaptic: mainly in the heart (+chrono/domo/ino) |
| Where are beta 2 receptors and does it cause? | Postsynaptic: Smooth muscles and glands. Smooth muscle relaxation |
| Where do first order neurons originate from? | CNS |
| What is another name for first order neurons? | Preganglionic fibers |
| Where do preganglionic fibers relay impulses to? | Postganglionic fibers (Second order neurons) |
| What are the cell bodies called located on the second order fibers? | Autonomic Ganglia |
| T/F: Preganglionic fibers are myelinated? | True |
| T/F: Postganglionic fibers are myelinated? | False |
| Myelination creates a (fast/slow) conduction? | Fast |
| What part of the spine is the thoracolumbar system? | T1-L3 |
| Where are the preganglionoc sympathetic neuron cell bodies located? What is another name for them? | Horns of the spinal gray matter (intermediolateral columns) |
| Cell bodies from the spinal gray matter can extend to three types of ganglia, what are they? | Paired sympathetic chain Unpaired distal plexus Terminal/collateral ganglia (near target organ) |
| How many paired ganglia are located in the sympathetic chain? Where is this chain located? | 22 / Paravertebral |
| Where do preganglionic nerves exit? | Anterior nerve root |
| Where do the preganglionic nerve roots enter? Via what structure? | Ganglion of the spinal nerve trunk/ White ramus |
| What set of nerves carry signals from sympathetic trunk ganglia to spinal nerves? Via what structure? | Postganglionic nerves/ Gray Ramus |
| Sympathetic division from the head and neck come from what part of the spinal cord? | 3 ganglia of the cervical sympathetic chain. |
| What function does the cervical sympathetic chain have? | The 3 ganglia of the cervical sympathetic chain are responsible for: vasomotor/pupillodilator/ secretory and pilomotor functions. |
| Where do the preganglionic fibers originate from to supply the 3 ganglia of the cervical chain? | Upper thoracic segments |
| What is the stellate ganglion? | Is formed from the fusion of the inferior cervical ganglion and the first thoracic ganglion. |
| What percent of people have a stellate ganglion? | 80% |
| Where is the stellate ganglion located? | Anterior to transverse process of the C7, posterior to the neck of the first rib, just below subclavian artery. |
| What symptoms may be resolved with transection or block of the stellate ganglion? | Raynaud's phenomenon Hyperhydrosis Complex regional pain syndrome |
| What is hyperhydrosis? | Excessive sweating |
| What is a complication of a stellate ganglion block? | Horner's Syndrome |
| What are the three hallmark signs of hornet's syndrome? | Ptosis, miosis, anhydrosis |
| Where do the prevertebral ganglia reside? | Abdomen and pelvis (anterior to vertebral column) |
| What are the ganglia of the prevertebral ganglia? | Celiac, Superior/Inferior mesenteric, Aorticorenal ganglia |
| What is the celiac ganglia innervated by? Innervates what organs? | T5-T12, Liver, spleen, kidneys, pancrease, small bowels, and prox colon. |
| The superior mesenteric/inferior mesenteric ganglia innervate what organs? | SM - distal colon IM - rectum, bladder, genitalia |
| What is the abdomen and pelvis innervated by? | Thoracic sympathetic fibers |
| What does the adrenal medulla secrete? | Norepinephrine, Epinephrine |
| T/F: Autonomic reflexes remain after spinal cord transection. | True |
| How are autonomic reflexes inhibited? | Supraspinal feedback |
| If a transection is made to the autonomic reflexes and the supra spinal feedback is inhibited, what could occur? | Exaggerated sympathetic response |
| How many nerve pairs are located in the spinal cord? | Cervical - 8 Thoracic - 12 Lumbar - 5 Sacrum - 5 Coccygeal - 1 |
| What nerves are responsible for the parasympathetic NS? | III (Oculomotor) VIII (Vestibulocochlear) IX (Glossopharyngeal) V (Vagus) Sacral segments |
| Where are the ganglia located in the parasympathetic NS? | Proximal or within the innervated organ |
| How does the ganglia from the parasympathetic NS differ from the SNS? | Leads to a more targeted response |
| What does the glossopharnygeal nerve innervate? | mucosal, salivary, and lacrimal glands |
| How much of the vagus never supplies the impulses of the ParaNS? | 3/4th |
| What organs are innervated by the vagus nerve? | Heart, tracheobronchial tree, liver, spleen, kidneys and all GI tract. |
| Where does the vagus nerve not innervate in the GI Tract? | Distal colon |
| Where does cranial nerve III innervate? | Iris/ciliary muscle |
| What are the nerves of the sacral segment? What do they innervate? | pelvis splanchnic nerves (rectum and GU) |
| The paraNS has preganglionic fibers that arise from what parts of the spinal cord? What nerves are related to these fibers? | Midbrain - III & IV Medulla Oblongata - IX & X Sacral portion - S1 & S2 |
| What is cranial nerve IV? | Trochlear |
| What is the third division of the nervous system? | Eneteric System |
| T/F: A lot of information exist on the Enteric system of our nervous system. | False |
| How is the Enteric system formed? | Derived from the neuroblast of the neural crest that migrate to GI tract and vagus nerve |
| What does Miller say about the Enteric system? | It has local autonomy |
| T/F: Miller states that if there was a transection of the spinal cord, the enteric system would not work. | False |
| What are some factors that can alter the enteric system? | Mood disturbances, Stress (anxiety/depression) |
| What are some examples of disorders that can occur with mood disturbances effecting the enteric system? | Crohn's Disease Ulcerative colitis |
| Where do the sympathetic preganglionic fibers arise from that innervate the gut? | T5-L1 |
| Sympathetic pregangilonic fibers are (excitatory/inhibitory) to the gut. | Inhibitory |
| What neurotransmitter is present with sympathetic postganglionic fibers of the gut? | NE |
| What are the three types of enteric neurons? | Sensory, associative, motor |
| Sensory enteric neurons are responsible for what? | Monitor intestinal wall tension and chemical content |
| Associative enteric neurons are responsible for what? | Communicate with afferent and efferent nerves |
| What is another name for Associative enteric neurons? | Interneurons |
| Motor enteric neurons are responsible for what? | Muscular contraction vessel dilation, transport of water/lytes |
| T/F: Motor enteric neurons can be inhibitor & excitatory. | True |
| The sympathetic NS is mainly responsible for what type of response? | Stress |
| The parasympathetic NS is mainly responsible for what response? | Energy conservation |
| What parts of our body are exclusive to sympathetic tone? | Certain blood vessels, spleen, piloerector muscles |
| The innervation of most organs by both the SNS/PNS contributes to what? | Resting tone |
| Where are neurotransmitters released from? | Vesicles in the presynaptic neurons. |
| How many classes of neurotransmitters are there? What are they? | 4:Monoamines, Amino acids, Neuropeptides, and AcH |
| What are examples of monoamines? | Epi/Norepi/ Dopamine/Serotonin/ Histamine |
| What are examples of amino acids? | Glycine/GABA/ Aspartate/glutamate |
| What are examples of neuropeptides? | Substance P/opioids/ hormones |
| What is substance P important for? | Pain |
| What are the amino acid neurotransmitters dependent upon? | presynaptic reuptake and Enzymatic breakdown. |
| What enzymes breakdown amino acid neurotransmitters? | Monoamine oxidase Catecholamine methyltransferase |
| What is the main amino acid neurotransmitter in the CNS? Where is it mostly located? Is it excitatory or inhibitory? | Dopamine / Basal ganglia (Inhibitory) |
| Norepinephrine is (excitatory/inhibitory) and located where? | Inhibitory / RAS & hypothalamus |
| Serotonin is (excitatory/inhibitory) and responsible for what? | Inhibitory / affects mood |
| Histamine is (excitatory/inhibitory) and located where? | Inhibitory / RAS & Hypothalamus |
| What is the primary excitatory transmitter? Located where? | Glutamate (cerebral cortex, hippocampus, and substantia gelatinosa of the spinal cord) |
| What does glutamate play a role in? | Learning, memory, pain |
| What is a major inhibitory neurotransmitter in the CNS? Where is it located? | GABA (basal ganglia, cerebral cortex, cerebellum, spinal cord) |
| What is the primary inhibitory transmitter in the spinal cord? | Glycine |
| What is significant about glycine and surgery? | Glycine absorbed during prostate surgery can lead to visual changes |
| Which type of neurotransmitters are important for pain? What are some examples and how do they work? | Neuropeptides: opioids, endorphine, enkephalins, and dynorphins all act on opioid receptors in brain and spinal cord |
| What is cAMP? | Cyclic adenosine monophosphate: a second messenger necessary for intercellular signal conductance. ESP epi/glucagon |
| COMT? | Catechol-O-methyltransferase: enzymatic degradation of Catecholamines ESP epi/norepi/dop |
| MAO? | Monoamine oxidase: deoxidative deamamination (O2 used to remove an amine group) ESP serotonin/epi/norepi |
| What do MAOIs do? | Indirectly increase levels of cop/epi/norepi |
| T/F: Research shows that patients do not need to d/c MAOI medication prior to surgery. | True |
| What do SSRIs do? Surgery issue? | Decrease neuronal reuptake of serotonin. (MAY CONTINUE) |
| Tricyclic Antidepressants do what? | Alpha adrenergic blocking drugs. |
| What can taking Tricyclic antidepressants lead too? | Block neuronal reuptake of norepi which can lead to dysrhythmias and vasodilation. (USE NOREPI to TX HYPOTENSION) |
| Why do certain drugs need to be tapered? | Up/Down regulation |
| What is the function of the midbrain? | Sensory information from spinal cord to forebrain |
Created by:
gmg005
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