Exam 3 Material
Exam 3 Material PHCL2600
Popular in Funct Anat and Pathophysiol I
Popular in Pharmaceutical Sciences
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Date Created: 11/01/15
Lecture 21 Wednesday October 7 2015 1158 AM The Central Nervous System Introduction gill H r l i introduction in Twin parts i Brain anti Spinal Cort m 2 u Neurons and lial Cells exiting from the brain and spinal enrol These are maple up of cranial newest and spinal nemes lie Cranial and Spinal Nerves Twelve pairs of nerves connect to th brain and are called quot Most have two types of neurons afferent and efferent however some do not have efferents Thirtyone pairs of nerves connect with the spinal cord and are called All have afferent and efferent neurons Example OCOC OV39 nerves do wo R hoole eggsWCV t SOMC 7046 only sensesq in hav39FLAIe LSCDSCSD quotquotT he OHM diFCeicncc lociween hc wo S Where hei xilie he CNS PHCL 2600 Page 1 pinal nerves branch upon exiting the spinal cord and form a ventral anterior root and a dorsal posterior root e contained in the and bring information to the CNS from the outside Cell bodies are re found outside the CN In structures called nglia dorsal root gangliaga re found in th an ke information to the periphery Cell bodies are with cell les in the ma cor aE QFQVQH TS 29Qltc 0 e Cec39kDV ce LmuSCleSe CD Peripheral nervous system Two functional branches Transmits conscious grceptions of environment All afferents are sensing vision taste hearino painl temperature Efferents connect CNS to the skeletal muscle I QCHS are very lo Cell bodies of efferents are in CNS go directly to skeletal muscle without synapsing anywhere Abe I I 396 Veagoh For m ek hod oh else vl YOLA m6r VCV 90w was pangs Re C lcgtlteS NOLAC no k be 4306 ChOgkfsh 0v read qtQCK ehOLkah s Peripheral nervous system Two functional branches I Transmit information from internal organs via afferent sensory neurons Not consciously perceived materm Efferent neurons comm the CNS to smooth muscle gammussle and glands Efferents are two neuron chain with one synapse Cell body of rst neuron is in the CNS synapse is outside of CNS second cell body is in group call s CNS Brain and Spinal Cord Types of tissue cell bodies dendrite and axons of unmyelinated neurons Considered the processing center of CNS Where mos l dalsVDl S in ne CNS are We e M hm quot WWZS o F ha CNS Ceecrica Co caafcr 5 71st arm mkes Ucp gracing because hel In a IA An AP AP C PHCL 2600 Page 2 cell Domes dendrite and axons of unmyelinated neurons Considered the processing center of CNS mostly myelinated axons from cell bodies located in the gray matte Considered the conducting area of the CNS r 39 ymres 09 ha CNS exec irrica wV fCX TB Tvus arm mkes up 9min MQLA Q hel aveuuwcde o ems ms area NOS ire Prme o he stOJH mam xl ms chmx Cwiu ho Mtge 8mm Forms an H shape in spinal cord and IS surrounded by white matter Forms a surface covering the entire exterior of the brain with white matter towards the interior of the brain Interior of the brain contains small clum s of QM wit int e w ite matter Called val 39Irnon quotor r 1 Mn new an no gt Revel3c SkOdh Linot oxcrucodki Whi CC a 3mg W lquot Sham is where Qs are OCOc Vedi 1 Supporting structures Two layers of support for the CNS m skull or cranium Vertebral column Intervertebral discs Um m i ev a e hp mickeSk mos r IQQCUAOM Alfaonnoiol 9 camer in ow oomines Pia max rev 9 Q lool oinnJ AhirxweS m IOLQCUQOKY Mean ir 0 dietusel veggies c bucvaviixcs beast g Two major functions Protect and support the brain Bony layer is hard and functions as a case for the brain Isolate cerebral blood vessels from extracranial variations in pressure Again hard case will isolate brain and anything supplying it from outside 11 PHCL 2600 Page 3 Vertebrae the bony structure that surrounds and protects the entire length of the spinal cord Consist of b structuies called mebrae 39 made up of connective 7 tissue separate the vertebrae Tissue surrounds semi uid material Act as shock absorbers keep vertebrae from rubbing against one another wear and tear quot39 H one rwpmg or p ouer eye Frame pain Niacin 01 ver l clome cEs Sneak absorbed Lidia Three layers next to bone thickest layer Made up of two sublayers A and B middle layer Thinner weblike layer next to nervous tissue Thinnest layer of meninges 3 mod Over0ps 2 pin 2ch brain cevetceJchwng lt19on Diseases quot Mani iHs blood is Co o torcum gcszdwoq erCka t oW H aura and lotood hag eSCoxpzd Oxbm e bvo araChhoid io Smbmchho hemorrmae Wad cud blood has escaped L0x lot3 loll0 Pia Mam cw PHCL 2600 Page 4 s Meninges I this is space between pia mater and arachnoid layers Filled with uid called cerebral spinal uid CSF gt Provides a little extra protection to the nervous tissue Layers surround both the brain and the spinal cord LIInigh Three structures created by Dura mater Sickle shaped fold that separates the cerebral hemispheres in the longitudinal ssure an extension of the falx cerebri that forms a midline partition in the cerebellum along the vermis g a tent over the cerebellum 1 Usually quite small Can get larger with large pools of cerebral Spinal uid in structures called y pool of cerebral spinal gt ltiiidat the end or the spinal cord This ie where most spinal tape for ESP are performed to avoid doing much damage to the FIE WUU E HES E PHCL 2600 Page 5 helps Moria some CXH ox preswa Where Maids ave wileoh awn ltgt Aes x InPeCPlo ns cm Mr i Wrong p Opc S ogre w Arius ctucid blood eveAS Lecture 22 Monday October 12 2015 1204 PM 1 Nervous system reading i vai ew chapter 12 it CNiS brain and cranial nerves chap 14 ii Brain I Cerebelluinni iE Major divisions of the brain Develops into telencephalon cerebral cortex and diencephalon thalamus and hypothalamus Develops into the superior and inferior colliculi and the cerebral peduncles Develops into metencephalon cerebellum and pons and the myeiencephalon medulla oblongata Di Geeierxce ooa ow bracin 9 o l ineir var rem animals is developmenl oF PVCWW OW Even brain has mesencephaclon 91 Vhom loancephadoh quot Meduguoe oblonfgci m is Con nuous w lhe SplhaxA COV a 39 HOU3 WW develop r Nearest Pocampe WK move gt Netgrad who Becomes d39v iom o M w quotquot iMi V o sesame Hoot PHCL 2600 Page 1 Lug Brain s stalk made up of cerebral peduncles superior and inferior colliculi midbrain Pons Medulla oblongata Rests between and connects spinal cord and higher brain centers Midbraln Coma Wis h m S ho cl cure LJho W m radar quot ConnecH Gen her Cal DeHULm is elm 0 broqn Stem LIAJM bradw Section below the pons and continuous with the spinal cord Functions as relay between the spinal cord and upper brain stem mid brain Contains nuclei that control heart rate respiration and vasoconstriction Point of exit of cranial nerve VIII Lilii Between midbrain and medulla Wider and thicker than medulla Consists mostly of white matter ascending XII l l and descending tracts and a few nuclei Serves as relay center from medulla to higher brain centers midbrain etc Point of exit for cranial nerves V hi h BP zeSSeLS CoinsHack anomr ac onS lon CF brmih darkd Ar owuwmds Mve Sivvx axw Whots 2 sches here Ascchdih i 0GFcrltrsenorl in F o Arobra nw D s cndir3 cF eercnkmo tor vxfo 0 PNS i W SngvallI r no a 3her brown genbars we COMP gtlt IJJJ Comes Oudr Swenion bUO medem at Pops PHCL 2600 Page 2 H Smaller portion of the brainstem On top of pons corpora quadrigemina Point of exit of cranial nerves III and IV Contains visual re ex centers coordinates information to adjust head and eye turn towards stimulus COHtainS auditory re ex centers response to loud startling noise Contains connecting fore and 9 COhmJ ch b mm 2 WW Pours o hindbrain motor activities omlw uklamow winvases quot Ill 3m 1 3 oli Geren i nerves For 33033 olfactory smell a II optic sight III oculomotor IV trochlear IK 2 El glossomeoshs mngue V trigeminal face and chewing VI abducens ye movement VII fac face s VIII vestibulocochlear hearing and balance IX glossophagngeal jtongueland pharynx X mu thorax and abdomen XI accessog spinal accessory to vagal XII hypoglossal tongue Inovements 3 I rq imporm For ANS C erebellum EPituitary gland ponslMcdulla I Midbrain piml Cord Hypothalamus PHCL 2600 Page 3 it Core or center of hrainstem n Numerous neurons that receive and integrate information from the cranial nerves spinal r1ewesr and other names from the brain gr Large and small neurons synapse on each other providing means for integration of information Functions of Reticular s Formation RF Essential for initiating waking cycle alertness consciousness and initiating sleep cycle Waking cycle MS controls alertness reticular formation and other neurons midbrain RF initiates and maintains alertness pons RF initiates and maintains sleep Lesion to midbrain RF coma lesion to pontine RF constantly awake d2 J Functions of the Reticular formation RF Some neurons in the RF are important for motor control speci cally balance and support of the body against gravity Some nuclei in the RF are cardiovascular respiratory and vomiting centers inw rmir8 neurons PHCL 2600 Page 4 Cerebellum 39o Pituitary gland Pom Mc39duna 39 Midbrain Rcticular fonnation Spinal cord I Iypothalamus gm Part of metencephalon of hindbrain Separated physically from cerebrum by them 39gt Oval in shape central constriction called the m39 w are enlargements on either side of vermis 0g alum0Q covering Cerebellum Surface of cerebellar hemispheres is gray matter consisting of a series of folds Interior is made up of some gray matter and bands of white matter forming the tree like structure Connected to all other parts of the CNS by neurons 3 bundles of bers 9 connecting cerebellum to the brainstem quot39 m tnFo From brain 9 Push WK 0in COOrdi node3 Movement 9 H does not Unam 9 o gte C line Crude C erebellum Amer lobe PHCL 2600 Page 5 Anterior lobe Primarv ssunc Q 7 Posterior lobe Horizontal 1amp3 Vennis ee i39 lee QWCluxrcs Planning of movement Posture control Functions of the cerebellum Equilibrium control Limb movement control Helps integrate voluntary muscle movement or coordination Maintains smooth movement of balance with directed movements v0 help From MGom h VI S cows a Kn baJocrNce Cr 39CC 5 Damageto cerebellum jerky uncoordinated movements as seen in drunks alcohol affects the cerebellum tremors which increase with movement feeding oneself inability of judgment where body is in relationship to other things in space hand goes toward an object but overshoots or undershoots the item tremors of eyes beating All of these abnormalities are not evident unless there is movement not seen at rest mlcoho dcpvcsses cmxacuucm 0o vacl S C r Ms W odouHRes hoF smkths yamh hokdi gameHm39inaj bog VQVULW MOVle Food quotl owm WORK Ns mus dizziness C Be thing 0 f COGSFe angom s is ac core MOVW PHCL 2600 Page 6 9 No l coovdiroc ow e le39brioc ovx Lecture 23 Tuesday October 13 2015 1200 PM Part of the forebrain telencephalon Largest part of brain 80 of brain tissue Contains nerve centers governing sensory and motor activities Contains areas responsible for reason memory and intelligence Core of white matter dotted with gray matter nuclei surrounded by gray matter cortex 35 mm thick quot mum mcxlccs us diFfelr r H rom o l her var ireme oxxxmoqs makes 0L decisions Halloquot SUPERCP RJSTE IIOQ ANIERJOH Se mm anus64m a F Diana Pha 0n 6 above hwwdeOUW DIENCEF HALON 39Mlamui quoty r hdnu BRAIN STEM Midbran CENEBELLUM 6 P00 Momma otkmgxa 53mm 011 HFEPICR b Sagmal 1amp1ch mecelvuew id 01 F s Cerebrum Cortex rolls on itself folds are referred to asor convolution Gyri is distinguishable in a pattern and serve as landmarks in the brain Grooves are also landmarks Shallow groove is Deep groove is COWFCX is a pacc in m Ccvcbmm gt cud1ch quot Ficus Wad Mauccs dccjsiovxs Deep furrow extending from front to rear of I 44 r I A PHCL 2600 Page 1 F Deep furrow extending from front to rear of the cerebrum which divides it into two hemispheres left and right Anatomically appear as same but hemispheres have some very speci c differences size speci c boundaries greater control of speci c functions Each hemisphere has centers speci c for sensory and motor activities Large ssuregrow in Wiw quot Wk ouo W Z WKSPWeS Fla 1506 valal wequot in war Prepmgrmmed Wis NM I Some nerve pathways cross in the medulla allowing the cerebrum to have control of motor activities of the opposite side of body dosoondli ng i Ascending tracts cross over at the medulla or in spinal cord quot 907 o decschdina Weeks w cross over 39 207s oP h m will no l Si aw on Same side PHCL 2600 Page 2 a One hemisphere may take more control of a ipaihticular functicih lMc hanicai ii i ir39tiStill 1 Mathematical Ii cc w s Fine motor control Pathways cross here as well Left hemisphere controls right side 80 of all individuals have left hemisphere dominance over ne motor control right handedness 10 of all individuals have right hemisphere dominance left handedness 10 are u equal control s Language and analytical ability Almost all right handers and about 70 of left handers have language and analytical ability dominated by the left hemisphere Other 30 of lefties right hemisphere or both and ambidextrous is a 601030 split for left right both Ec WW is i ig has dominoch in one hexwig pineie AMbid X H OLks eqml com vol of bol Ii hands quot Pabalom Occakence PHCL 2600 Page 3 Other examples tasks faces arranging blocks drawing 30 right hemisphere Mathematics left hemisphere Creative ability may be related to interaction between hemispheres which is greater in lefties Injury to one hemisphere often leads to the development of the corresponding area in the opposite hemisphere to gain control of those functions There is cross talk between the 2 hemispheres by nerves called the largest tracts are in the this allows sharing of learning and memory functions between the two hemispheres d gt anUklr iCS SKACJn as S rroKC Neurological disease and diagnosis In the 21St century neurological disease may be able to be diagnosed by simple methods such as physical exams More and more however tests are necessary to show or complete a diagnosis Three possible tests are Show5 gac magnetic resonance imaging positron emission tomography electroencephalography 70qu Show loch isue Uses high energy Used to show ne detail Not used for bone Can be used to NLL magnetic waves of softer tissues differentiate between abnormal and normal tissues also measure blood ow sagmal sechm i brain quot V V lava ma he owe used l eot blood PHCL 2600 Page 4 LEE Used to study physiology of a structure Positron emitting substance is injected and used in the tissues when it does the image is more colored indicating activity of that tissue sci Electrodes are used to record electrical activity in the brain Detect brainwaves or activity in the brain Alpha beta theta and delta waves have speci c origins 9 kn cream a a iquot 1quotquot Mn Input EN 39rtwwm an M Na MVM W 1 MV jwm WMMM WN 39I cow s on Hne mc iodooUSM 09 m UQ00xerC mom Wad gub win he used quot EKG Pow law s Brain waves activity found in adults while awake quot quiet and resting still awake m thinking waves shows mental usually found in children can mean stress or mental disorders in adults usually mark deep sleep in adults occur in infants while they are awake and can mean brain damage if Sleep smicS Calm hep vol Hm Wh A hev Dir hisk someth is mW awake PHCL 2600 Page 5 l Liter layer of gray matter is lrell39ierred to as cortex or cortical tissue 1 Integrating center for processing afferent information received from body 1 ividecl into 4 major lobes or sections Howl named f lr39 the skull bones that covers 2 OCLipH OA 3 3939c mporoJ Ur Peoriated Four major lobes of cerebral cortex anterior portion of each hemisphere quot posterior to the frontal lobe far side lobe of each hemisphere most posterior portion of the hemispheres Lei Motor area particularly controls voluntary movement Controls reasoning and intellect thinking Controls emotions and behavior sexual Controls aids olfaction Controls speech articulation writing of words motor activity PHCL 2600 Page 6 Prcccntral gyms gu tqah ggii rgc i a onlal lobe 3 an I r w 391 u w 1 6 l u l Broca s area of speech Receiving area for ne sensory stimuli Allows for discrimination between stimuli eceives sensory impulses related to pain taste touch and temperature Language center M association cortex involving ang age Postccntml evrus Parietal lobe PHCL 2600 Page 7 Lecture 24 Wednesday October 14 2015 1203 PM Receives auditory stimuli Involved in hearing memory learning of language understanding speech deciphering words Involved in oral and written communication Olfaction center OW acF h oe Separated from frontal and parietal lobes by 0 56 93 3mg APP4Lolr as 0 pair o F W3 Lateral ssure 8 Temporal lobe a Receives visual stimuli Allows discrimination of visual stimuli Separated from parietal lobe by the m PHCL 2600 Page 1 7 Visual area lt L u39l arid other regims 1 Cau udate mugEMS u Lentitullar nucleus I m Glnbus palliatile internal capsule 2 basod x I an 0 on h Side 0 haamu PHCL 2600 Page 2 Zareas Qov 2 ngCS Functions of basal ganglia l Motor Entirva l f39 slow smooth movement a Cerebellurn maintains after initiation ii originate in brain stem and synapse on basal ganglia neurons 1 lReleses inhibitory neurotransmitter essential for function of basal ganglia s I l winvolves degeneration of neurons in Substantia nigra Leads to less dopamine release Leads to less inhibition of dopamine on the basal gangha Leads to rigidity and tremor at rest Leads to extreme dif culty in initiating movement Leads to unemotional face mask because of gt inability to change rigidity Can be bedridden and have dementia 1015 and m make up area of the diencephalon Acts as a relay system for sensory impulses without involving the cortex Act to regulate many activities that do not reguire cortical tissue input INOst 0 diagnose Can Sce le0ovv CubbecAKves PHCL 2600 Page 3 iihilimui Two masses of gray matter just below the corpus callosum Functions of the thalamus Relay of sensory input other than olfactory olfactory rst must go through the cortex 0 Crude identi cation of some stimuli without k cortical input pain W Several ti htl packed nuclei ju be ow the thalamus Functions of the hypothalamus Regulate body temperature ix Control fullnessnunger W Metabolism Emotional expressio and behavror L l y 1mg Endocrine function y produces hormones that control pituitary secretion Individual components of the brain can function together hypothalamus thalamus portions of frontal and temporal lobes all connecting neurons Involved with expression and integration of strong emotions Fear aggression depression rage and regulation of sex drive and behavior know Scherod Qle Cannd pin pow PHCL 2600 Page 4 Cavities in the brain that are continuous with similar cavities in the spinal cord containing contains 0 Lateral ventricles 3rd ventricle u 4 ventricle Interventricular foramen ml 94 mm View Cerebral aqueduct gDescriptions 39 2 irregularly shaped cavities located deep inside cerebral hemispheres smaller slitlike cavity in the diencephalon M lies between the cerebellum and the pons and medulla structures Descriptions g 2 Channels connecting the lateral ventricles and the third ventricle 39 quot quot quot channel running lengthwise threuglh the midbrain cannectingi the rd and fauirth ventricles The 4th ventricle enntracta at its peaterier ant to farm the he llew central canal that runs threugih the medulla and the spinal tart PHCL 2600 Page 5 i Fills the ventricular system and the subaraehneid space surreunding the brain and spinal cercl CSF is celorlessf cnsists mlestly of water and traces of inunatelinir sugar hermenes and a few lympihectrtes is Only 15 milliliters int 100 milliliters of CSF is found in the 39uimsr39i eiles rest is in the su arachnoid space Formation of CSF Activer secreted by capillaries which line the ventricles Tissues that surround the ventricles and secrete CSF is the CSF circulates in the ventricles and is reabsorbed into the brain via large blood vessels called CSF makes its way back into the vascular system through oneway valves in the sinuses that are projections of arachnoid CSF 1 Cerebrespinal fluid is constantly being made and there is continuous reabseriotien intro the vascular system of the CSF t i The movement of the CSF is aided by pressure Chanes due to circulation aresioirat39inn and posture Flow 01 C8 PHCL 2600 Page 6 tread chapter 13 V Consists of gray matter in an Hshaped core surrounded by white matter Gray matter is cell bodies of efferent peripheral neurons and the nonmyelinated axons of afferent neurons small neurons and glial cells White matter is myelinated axons running longitudinally through the spinal cord the ascending and descending ber tracts PHCL 2600 Page 7 Lecture 25 Thursday October 15 2015 1154 AM 522 s read chapter 13 Z 39iii Consists of gray matter in an Hshaped core surrounded by white matter is cell bodies of efferent peripheral neurons and the nonmyelinated axons of afferent neurons small neurons and glial cells is myelinated axons running longitudinally through the spinal cord the ascending and descending ber tracts Fiber tracts that are found in the spinal cord are two types which do not synapse on way from cortex to motor neurons which synapse once or twice on the way to the brain from the periphery Fro M bruitx CVOSSeS med Hoe a CMSOC KOV1 received enor tvvpud Wornx bodxl crosses G Wuhm symme C2 mst owe gt usucoJMOCZ mtaws F awn 30 cornex Descending tracts Ascending tracts PHCL 2600 Page 1 i Spinal cord Baseol Poxx names of ihe weir iebm Colpuww 0th 0f m f0r 31m 0f Ceyui Cat L2 spinal peripheral nerves moiwe Li I Functions 5 Transport of information to L Ame 39 aCrocl LS brain centers 39 39 r l 39 Transmit information to the periphery from brain Some afferent information can lead to direct activation if of an efferent neuron and stimulation of an effect0r 9 A39 re ex LIIill Example of an instance of direct activation of an efferent neuron without the participation of the brain is a motor re ex motor re ex example is monosqnocPHcsz one 94 MpSQ the knee jerk re ex strike patellar gt lowered in spiked Lord tendon with mallet and get a jerk of leg A Morgans WM aspen c5 gums in response very quick 39a 146 Seen131132 Exiensor muscle Neurolendinous organ Muscle spindle t 439 AI 39 lt 1 Paiellar ligament PHCL 2600 Page 2 ovemg i isorders 393 iui Frederick E Williams PhD 0 Typical symptoms mistaken as depression no smile worse handwriting tremor at rest pillrolling rigidity advanced tremor enbloc turns postural instability dementia 1 Arm o f braith Woe F sevxo S slswds o loosOJ awal k 6h39 tom mmg 39 V6443 ovo angled Movemen ls wwme books MHS Q W wcn a39 movie starring Robin 13933611 De Niro 0 5g new People With rigid form of Parkinson s Disease thought to hate an encephalitis Treated patients with and woke them up Later could not control themselves and a decided to go back to their rigid state Hlsl er claws a bushel fesskarma More side es cks urs rpe need both because IZHDOPA is metabolized 39 39 39 Ropinorole Requip and Pramipexole Mirapex these act at the dopamine receptors in the Basal ganglia t nMTan nMT PHCL 2600 Page 3 y HMS Cowuoinodiovx blc L39DoPA is MWVM 00 we UPHWWW nuiww and Pramipexole Mirapex these act at the dopamine receptors in the Basal ganglia HOMTam COMT inhibitor e i beOmal domnw maf imcleus 1055 of G39ABA39neurotransmitter to the globus pallidus inhibitory Results in chorea uncontrollable writhing movements and early dementia 40 s 0 Problem is trinucleotide repeats on gt chromosome 5 Ck MCJ IwAH Wm9Fcr09L quot mc iodooisvv enszW k lelmllai rS his heredi l ocns does wol dead val sex Cells all o l hels HULnHna ton 3cm quot mosk PromoMoch 103 rem quot lav sur a o C aMiwo acids OK pro kebth m iwCarYeC l mct poorly effective 39 Atypical s antipsychotics Risperidone Risperdal 39 Lorazepam usually not very helpful COUUSQS ll iUK Farina 2 wow 0amp0va toq rs Seroth 2 dopowlnc dlSmp l39S ow OF N39l s usualho yaw DUQS drown V i treated longterm with drug like halop ridol IIaldol which is a dopamine antagonist will get this disorder It Shows up as tics and chorea like movements of face and tongue would be to replace or not use a typical antipsychotic newer agents less likely to cause these symptoms mlking 2 is diF Fx39cmH PHCL 2600 Page 4 39 9035 SLR laclcvo amtmtwus omit HEWDH swim m Fall 33113 WE i What we will cover Anatomy of the ANS Sympathetic system Parasympathetic system Receptors involved and drugs used g The Nervous Systems PHCL 2600 Page 5 Controllable conscious I Works below our consciousness gm m Sensev a am a MW 4 mm Bar Sum We can use this to order our body to do something these functions are controllable Composed of brain and spinal cord afferent and efferent nerves L w u sensory transmits information from the muscle or other organ to the brain motor transmits information from the brain to the muscles usually skeletal as this is usually voluntary movement 55 h 04 2 e wV 3 I SCYTSOYN brain 9 modor SWW VWUWle6OVd5 Regulates bodily functions and other processes that are necessary for survival Regulates the functions of internal organs and the other viscera PHCL 2600 Page 6 Lecture 26 Monday October 19 2015 1154 AM Autonomic ganglia are subdivided into 39 Cancun o 392 Sympathetic chain of ganglia Prevenebral ganglia 39 ThC mee l OWFS lde WCNS Sm og33V 1 Divided into whithf 39 w 39 il39lll39il iiE aa its primary ineiuretralnemitter which uses ate IEh lili lE a5 ita purin iaw neurotransmitter i 39 is s 3 e40 DWIFB LA ed 0 WC more hm Pmn NT aczext ichorc is used 0 the My K hY DL lx i Every organ has 1 except the bleed veaaeis and aweat glands which are only inhewated by the sympathetic nervoua system 5 lhpw F Prom loo Hm NS OHM vex3 1 3N8 inputl Innervation of body by the autonon ic nervous system involves alth0ugh there is coverage 0 most of the body by both parasympathetic sympathetic systems regions are used to do this PHCL 2600 Page 1 AVeek are inneVVock eo i mead DV where he mace F Aime epihod cprol AVEdKS are innerwaged waged am where he mee l Hre going coral Innervation of body by the autonomic nervous system lnvolves alth0ugh there is coverage 0 most of the body by both parasympathetic sympathetic systems regions are used to do this 9 GFFCmr sm Nerve bers emerge from the spinal cord in segments of thoracic T1 T12 and lumbar L1 L2 Called the thoracolumbar system are usually very short are usually very long Motor Nerve Fibers Cell bodies owe restricted to the lateral horns of the spinal cord Axons leave the spinal cord via the ventral root join the spinal nerves for a short distance and turn to enter the sympathetic chain of ganglia via the rmi Smcx shoc 0 new myelinated PHCL 2600 Page 2 I Once the preganglionic bers are in the sympathetic chain they can do one of four things 1 Synapse with a postganglionic neuron at the same level of the chain 2 Ascend and synapse higher in chain 3 Descend and synapse lower in chain 4 Pass through the chain l quotdo nO tdoi pmsqmpwhel c chain occaqulia 1i If They Pass Through 4 is formed Nerve runs from the chain to the front of the vertebral column Synapse is usually formed with a postganglionic nerve in front of the vertebral column in the prevertebral gangha Motor Nerve Fibers Sympathetic chain of ganglia Located bilaterally alongside the vertebral column O akj Cmuy one m eiwr Sim 09 VC FE white because ber racts axons are myelinated within the chain leave via the unmyelinated sect a every spl gment Post anglionilc neurons from h trave in Fon Iguration to t e awe supp y quot Demonstrated in gure 155 quot Nol Whom C PHCL 2600 Page 3 mi of Different Organs Preganglionic neurons splanchnic nerves Postganglionic neurons go out to Head and neck Thoracic and abdominal viscera Skin and sweat glands Blood vessels Pelvic perineal viscera E r s i I 39 51 KDE 1 COH S thAOUS gram L L2 2 Tl Til 1 l 21 1 it Exw 2 so 0 OVQOJWS 39 1 39 Ympa etic innervation 7 523 I takes place usingachain 45 of ganglia and innervates 12 39 5quot 1 V rmstofthebody Different 1 1 Ti 51quot areas are typically innervated 3 V i39 quot l by certain areas of the chain 4 4 23995 Ix 39 J i g 4J3 39 39 4 I J 3 4 Stimulation Of the SNS or Retireruling a epinePiUine are We produces pi M or we mg W 2 hem3 f3 Po Increase in heart rate and contractile force Decrease intestinal motility Contract sweat gland amp pilomotor muscles chaculation male sex organs liver W3 na 31 co evx PHCL 2600 Page 4 Stimulation of SNS Stimulation of the SNS or adrenergic system pancreas adipose tissue Secrete kidney Inhibition of insulin secretion 9 quot lhuqih sK ore txrc b em 39 quO eh 39 heeded dWlP oxcHvi lx widening of the pupil eye Stress you up Under stress of either physical or emotional causes sympathetics increase output to effectors This initiates a complex defense mechanism against the stress ght or ight Faster heart rate Bronchodilation Vasoconstriction39k Increase blood sugar A boosh 5P ebrood mug k W W Paw s 0 he UA ChOF steak04 quot t v 0 96 gmeo muScWS Drugs that work at atlrenerglc sites quot 39 39 vasoerESsor arti lrit39giur and nasal oeoogestantf works at or reoeptors 39 easopressor and B receptors works short term 344 hrs a V lllllEElS SoloafTerlJ hot with ill 12 hours effEctiueriess bronohoolilator nasal CIEEUQEStE t works at orquot gt4 Ye ep0 egg Congest QR 9 COV SA39l lC so HneYels less eluc tol eaqccoxcs VCCCp39l39OiS 4 Ihcrecc zx av ohchod octiow PHCL 2600 Page 5 Drugs that work at adrenergic sites u treats hypertension 39by decreasing tension of arteri mooth musc e M d tissue usually given whei 39s comorbid works at a receptors treats quot a es not a ow 1 s mild to moderate hypertensuon works at 5 O l 0 5 lopeW We do receptors 00b Drugs that work at adrehergir sites k a 2 agonists I iI w m Nerve bers exit from Brain stem cranial associated with cranial nerves oculomotor III facial VII glossopharyngeal IX and vagus X Spinal cord sacral level 5254 segments PHCL 2600 Page 6 Parasympathetic Nervous System PNS Nerve bers 2 go to Eye Nasal and oral cavities Salivary glands Thoracic and abdominal viscera Pelvic and perineal viscera leave brain stem with cranial nerves III VII and IX Synapse at one of the tend to be short and terminate in salivary glands and other glands in the nasopharyngeal area 1w are usually very long Descend through the neck and along the esophagus to the gastrointestinal tract Axons travel as far as the descending colon Ganglia are in the muscle surrounding the organ that is being supplied are very short terminating in the smooth muscles and glands PHCL 2600 Page 7 Lecture 27 Tuesday October 20 2015 1153 AM i a Cell bodies located in the lateral horns of sacral areas of the spinal cord Axons leave the spinal cord via the anterior rami and form their own nerves called quot gt poa quMpod heHQ Revue clussrer Project to pelvis islacral Neurons s a Synapse with phatganglihnie neurone in the intramural ganglia in the muscle walls of the organ being innervated 1 Stimulate cantractiah of recital muscles anti vaaaclilation Elf bleed ussels in the penis and clitoris erecti nnjl g Antagonistic Sympathetic and parasympathetic divisions are not antagonistic Fwd synchronized to achieve optimized function of the body during functions such as eating running fear relation 9 Mpocheic weave Vuwwu ryss sew 6 and so on Woo not etcrive catHaj VcSl lr 439th do 00k WK a oimsl39 66 Wk i I i i H I m Coordinate more vegetative activities like digestion with each organ being activated independently but in succession PHCL 2600 Page 1 iii I m Coordinate more vegetative activities like digestion with each organ being activated independently but in succession Dominant controller of visceral effectors Not as dominant in stressful conditions gt Acetylcholine tends to slow the heart beat promotes digestion and elimination stimulate digestive gland secretion increases peristalsis SV Nmheic VS Oppos 36 0 SNS Increase intestinal motility Relax sphincters and stimulate secretions intestine Increase sweat gland secretions Increase glycogen synthesis liver Increase salivary secretions Erection sex organs 2 docs hell mean iouc are sw iod39incs mu lms are CQ Parasympathetic Stimulation Responses are associated with feeding Activates dorsal hypothalamus which Decreases peripheral blood pressure Increases Intestinal motility Increases Intestinal blood supply Decrease blood su I to skeletal muscle This enhancesm PHCL 2600 Page 2 Parasympathetic Stimulation BUTW so Also Stimulates ventral hypothalamus Leads to Secreti phrine and norepinephrine ormona Increase in blood pressure Increase blood supply to skeletal muscle 39emolocrihe hermo me C lobaq ask 609 A Wo lr WCCCSSCKHH swim sqs s Drugs and Poisons used Bullocarpilne we 0 me used for intestinal muscle parasympathetic tone after surgery to allevlate pressure due to glaucoma icotine poison found in many items including tobacco Yields sympathetic overactivityuscular dysfunction W so and 39 Wpertensuon dilated YWdlos racfh f V pupils musce ascucua and muscle WMCle CoacukocHon musdc weazens bC weakness loteating doww dLLe s o S hresgcrs Drugs and Poisons used e a onn glam r liiigrogiycenlnl Neurotransmitters and receptors of the ANS Two neurotransmitters involved in the A Epinephrine gt W JV hi PHCL 2600 Page 3 W Epinephrine gt Wquot JV W Norepinephrine Dopamine Preganglionic and postganglionic bers relay at a ganglion Preganglionic bers of SNS are short and postganglionic bers are long Preganglionic bers of the PSNS are long and postganglionic bers are short In the ganglia there are receptors that mediate the synapse of the two In I llrrul Moment and Wm IMM Witt In both cases of SNS and PSNS activation acetylcholine is released Interacts with receptors initiating an impulse At the organ if postganglionic ber is from the SNS norepinephrine will be released and interact with receptors at that organ If the postganglionic ber is from the PSNS acetylcholine is released and interact at the target organ PHCL 2600 Page 4 W receptors in the ganglia that react to acetylcholine being released ioccurs with both divisions ICO lnl receptors present in the motor end plate in the skeletal muscle Somatic nervous system Tyes of receptors I Stimulation hf sympathetic system will release salteehellamihesr l l39ieinllilr norepinephrine by ipestgahglionic bers Release is at the organ er effector cell in the ergen norepinephrine OLLWCl8hS expih phrinc s Types of receptors There are several types of receptors that interact with norepinephrine at the organ or effector cell two groups Di d further a1 located on post synaptic target cells of pathetic innervated organs quot 12 located on presynaptic terminals end of the preganglionic adrenergic nerve terminals also synaptic sites platelets and lipocytes activated by circulating hormones rather than by sympathetic stimulation on organs PHCL 2600 Page 5 Lecture 28 Wednesday October 21 2015 1200 PM Alpha 1 Postsynaptic effector cellssmooth muscle Adrenergic terminals 39 nonsynaptic sites Activated by circulating hormones rather than sympathetic input Transmission I M Main neurotransmitters are epinephrine gt PMS ms lt norepinephrine and dopamine gt 093 Dopamine is the main neurotransmitter of the extrapyramidal system mesolimbic and cortical neuronal pathways pathways of movement behavior and learning i H 2 V quot W le a L Q baced on C tweakemisd39ky quotIT 1 Se r VioL o co dame PHCL 2600 Page 1 4 Synthesis of catecholamines Stimulation of the SNS activates an enzyme called which converts tyrosine to DOPA the main precursor for the catecholamines DOPA is converted to dopamine by L Dopamine enters a vesicle and is converted to norepinephrine Miat Synthesis of catecholamines Norepinephrine is often stored in the Vesicles contain high concentrations of catecholamines and ATP il Iii Other things found in these vesicles are dopamine Bhydroxylase ascorbic acid peptides such as enkephalin and chromogranins adoL H39iom 04C s Cells containing catecholamines Those cells containing norepinephrine Those cells containing epinephrine and H u Wis formed in granules diffuse away is methylated to epinephrine is stored in granules until released 4 gt PHCL 2600 Page 2 39 M43 oi Vomslocstes 1 14 Vosine L Fovm on axelevid 04 carbon8Q 63 gt W36 oesKleg in 5N3 does 00 canoe1A A epkarinz Lth achocled 3067 Mme M ANS 20 70 M iv MS w The enzymes involved in these conversions are synthesized in the cell body soma Enzymes are then transported along the axons to their terminals 39 t4 Triggered by the release of u from the preganglionic bers This generates an impulse causing a local depolarization at the postganglionic terminals Allows entrance of Ca2 LCXOUJAioSis Results in extrusion of granules and their material from the axon by I Creation release and breakdown V N9 is bVD eh dDUDN w 5 of an town lamquot 5rqu 3116 I murals an gt1Jlj J ru39upneu t E A31 504m he run al law mn THE l 1 4 71ch Cats arraan CCUY ma Nut LNG mythri p PHCL 2600 Page 3 1H Stimulation of postganglionic bers of the PSNS leads to acetylcholine release at the organ or effector cell The receptors that interact with acetylcholine at these sites are PgNg Kg coMpLe l ele Cho thV iO Muscarinic receptor Typical location and effect Parasympathetic effector cells gastric mucosa neurons cerebral cortex Parasympathetic effector cells cardiac muscle Parasympathetic effector cells intestinal smooth muscle and glands Involved in pain Involved in dopamine release I The enzyme that synthesizes acetylehnline is m This enzyme is also synthesized in the some and transported tn tlhe terminal along the BEEN by anterogrede transport Avce MUN TS W n metabolismk A sis PHCL 2600 Page 4 Particulars on the reaction Acetyl CoA comes from mitochondria near or in the axon terminals It is synthesized there from glucose Choline is supplied from the general circulation Once formed acetylcholine is stored in vesicles until releaee l When aetin potential arrives at the terminals it induces depolarization allows in ux of Ca2 i The influx of Ca2 theoretically will bind up the negative Charge on the internal aunfaoe and facilitate the extrusion f veaicle contents lav vesirzirrlanl outer membrane fusion Storage and release of acetylcholine The amount of acetylcholine that is deposited into the synaptic cleft ranges from of 300000 I W in a latent period of approximately 075 milliseconds PHCL 2600 Page 5 ilil Once acetylcholine is released and begins to interact with receptors it needs to be destroyed quickly The time required for destruction is about a millisecond The enzyme that is responsible is M It is contained in most body uids and hydrolyses acetylcholine to choline ermination of catecholamine action quotrs a PHCL 2600 Page 6 Lecture 29 Thursday October 22 2015 1204 PM After the neurotransmitter is released and interacts with the receptor action is terminated 4 1 Reuptake in nerve terminals 2 Dilution by diffusion out of the cleft and uptake at another site 3 Metabolic transformation using two enzymes Enzymatic termination of action found on the outer surface of the mitochondria in extraneural tissue and within the adrenergit terminals not present in axon termina s pays a major role in the liver in the metabolism of Circulating oatecholamines hoth endogenous and administered I continued PHCL 2600 Page 1 continued COMT Epinephrine 1 COMT step Norepinephrine9 mm continued MAO I Epinephrine quotquot9 Norepinephrine gt H This involves a In both cases the metabolites produced by MAO or COMT are converted so they can be excreted Hypothalamic control of i adrenals During stress adrenergic response is mediated in part by neural activation of the adrenals which then secrete catecholamines from the adrenal medulla If stimulate 5 I I If stimulate l r M 39 The governing bodies a Release of catecholamines is carried out by fha a PHCL 2600 Page 2 Adreml Gland lALOLH r l39lloxn 639 Shaped locSCcxkyqr VQSOWW3 hGLS ampbood guqopk gt POWl OWS vacdux oo ivxvucr cor ixi Qtcrew 4 l k 5 V iak r odoovd Kldhesd e Release bf catecholamines is carried out by the The eatedhblamine secreting tells of the adrenal medulla act as pestganglidhic sympathetic cells because they e re directly innervated Endocri s Epinephrine synthesizing cells 9 093i bf CEIlIS Hormonad gr Merepineplhrine cells5 31 cells l Nemm r Memo Warns Mer Circulating catecholamines Act at same receptors and targets as the sympathetic postganglionic nerves Because they circulate the effects are not as discrete Increase blood supply of oxygen to brain heart and skeletal muscle by dilating lungs In CNS cause the heart to beat faster and more forcefully Circulating catecholamines Cause constriction of the arteries in skin mesentery and kidney Arteries in skeletal and heart muscles dilate Net effect is toward the physical side of the ANS and away from the viscera w Emotion hypothalamus stress increases input to the adrenal medulla from the hypothalamus and cause secretion of epinephrine and norepinephrine 7 PHCL 2600 Page 3 input to the adrenal medulla from the hypothalamus and cause secretion of epinephrine and norepinephrine Loss of blood Hypothermia lo gs oC heck e QAPPI Hypoglycemia loss o Sugar I Hypoxia 1093 GP oxV eW gwppmk PHCL 2600 Page 4 Lecture 1 0 Comparison of Nervous and Endocrine Systems Characteristics Nervous System Endocrine System Mediator molecules Site of mediator action Types of target cells Time to onset of action Duration of action Neurotransmitter released locally Hormones release into the blood circulation At synapse close to the release site Binds to receptors in post synaptic membrane Usually far from site of release Binds to receptors on or in target cells organ or tissue Muscle cells gland cells other neurons Cells throughout the body Within milliseconds Seconds to hours or days Generally brief action milliseconds Generally long action sec to days o The nervous and endocrine systems coordinate all body systems 0 Endocrine System 0 Consists of and containing hormonesecreting cells 0 I Pituitary thyroid adrenal parathyroid and pineal glands o I Hypothalamus thymus pancreas ovaries testes kidneys stomach liver small intestine skin heart adipose tissue and placenta o Endocrine System 0 Controls body activities 0 Function is mediated by molecules called 39 Controls volume control metabolism muscle contraction immune activities growth and development and reproduction o Slower responses effects last longer and broader in uence 0 Hormones o Body s chemical o by cells into the interstitial uid tissue uid and diffuse into the 0 Act 0n o In target tissues hormones bind to specific proteins called o Hormone Concentrations 0 Effects depend on the hormone concentration 0 Types 0 Normal range that produces normal response 0 Small amounts 9 nanomolar to picomolar o Abnormally high or low concentrations 0 Can elicit different responses to normal 39 0 Concentration When a hormone is taken as a drug or medication 0 Exaggerated or noncharacteristic effects 0 Possible adverse side effects Hormone Types 0 Two types 9 and 0 Most hormones are circulating hormones Circulating Hormones o Secreted into o Carried to distant 0 They bind to in target cells 0 They are inactivated by the liver and excreted by the kidney 0 thyroid hormones I Produced and secreted by the thyroid gland I They act on bones growth neurons and other target tissues Local Hormones Autocrines o Secreted into the I They do not enter the blood 0 Hormones act on the that secretes them I Short or no distance from the release site to the target cell 0 Cytokine interleukin1 I Released by monocytes and act on monocytes Local Hormones Paracrines o Secreted into the I They do not enter the blood 0 Act on neighboring cells 9 Diffuse short distance 0 Testosterone I Released from the testes I Acts on adjacent seminiferous tubules to stimulate spermatogenesis Chemical Classes of Hormones o The two classes 0 Classification is based on chemical structure 0 Classification I Watersoluble hormones o Amine 0 Peptideprotein 0 Eicosanoid I Lipidsoluble hormones 0 Steroid 0 Thyroid o Nitric oxide NO 0 WaterSoluble Hormones o Amine hormones I Synthesized by modification of certain amino acids I Examples 0 Norepinephrine epinephrine and dopamine from tyrosine 0 Histamine from histidine 0 Serotonin from tryptophane o Peptideprotein hormones I Amino acid polymers 0 Peptide lt 100 aa 0 Protein gt 100 aa I Examples 0 Oxytocin insulin growth hormone o Stored in secretory vesicles granules inside the cells 0 Stimulus of the cells cause their release I Bind to receptors on the surface of target cells 0 WaterSoluble Hormones o I Derived from fatty acid Arachidonic Acid I Local hormones and may also act as circulating hormones I Not Stored 0 Synthesized rapidly as needed 0 In response to stimuli I Inactive quickly near site of synthesis 0 I Prostaglandins and leukotrienes 0 In ammation 0 WaterSoluble Hormones Transport and Excretion o Free in plasma I Quickly broken down by enzymes or are taken up by tissues I Regulate activities With a rapid onset and a short duration 0 I Hormones are metabolized in liver and excreted by the kidneys o LipidSoluble Hormones o Stimulus causes synthesis and secretion into the blood I Bind to receptors in the cytoplasm or nucleus of the cell o I Synthesized from 39 0 Testosterone aldosterone cortisol estrogen o I Synthesized by attaching I T3 triiodothyrosine and T4 thyroxine o LipidSoluble Hormones Transport and Excretion o I They circulate bound to 0 TP makes them water soluble 0 Not quickly removed from the blood 0 Produce a prolonged effect 0 I Kidneys or liver Lecture 2 0 Carrier Proteins for Lipid Soluble Hormones 0 General carrier proteins I Albumin 0 Steroids 0 Some thyroid hormones I Transthyretin o Thyroid hormones 0 Some steroids 0 Specific carrier proteins I Cortisol binding globulin CBG 0 Cortisol and aldosterone I Thyroxine binding globulin TBG o Thyroid hormones I Sex steroid binding globulin TEBG 0 Testosterone and estradiol 0 They require carrier proteins to make them soluble 0 Control of Hormone Secretion o I Signals from nervous system I Chemical changes of molecules in the blood I Other hormones o I Negative feedback 9 most common I Positive feedback 0 Control of Hormone Secretion o 0 Most endocrine glands under 0 Cells can sense the magnitude of the biological effect produced by the hormone and decrease response 0 Based on magnitude of the effect produced by the hormone cell can decrease response 0 hypothalamuspituitaryorgan axis 0 Control of Hormone Secretion o I Less common 0 I Increases production and release of oxytocin to o Enhance milk production and release 0 Enhance contractions during childbirth o Hormone Activity 0 Hormones affect only specific target tissues 0 Only target tissues or cells With a receptor for a specific hormone respond to the hormone Response depends on both hormone and target cell 0 Target cells respond differently to the same hormone I Hormonal effects vary 0 Hormone Activity Receptor 0 o Hormone locks onto a specific receptor 0 Binding of hormone to the receptor unlock the cell s response producing an effect Lecture 30 Mmday b r 26 2MB 121 PM PHCL 2600 Fall 2015 From Bench to Bedside or firm Hecture to Hive Martirw J hilingen P harmD FCCM quotOn the up side you39re the healthiest patient on ICU quot PHCL 2600 Page 1 Neuromuscular Junction Presynaptic Axon of terminal Synap c vesicles Neuromuscular motor junction junction k Sarcotemm 39 Syrup Muscle fiber clequot Mitochondrion Postsynaptic Capillary Myofibrils membrane PHCL 2600 Page 2 pqgu og VOUS W 239 I Patient Case 9mm 0PM yogi 0 Vog l oldie l EFF a 72 up femaleF POD 10 sip GREG for CAD In the SICU intuljated and mechanically ventilated sedated and quotparalyzed Meals include mpri hinej CNS 04 Iorazepam urcuro iu quotquot antibiotics TlPNlr W hydrpc0rtisune and cum 9 DW m hiquotlaiisil iltempts to oi an patient are unsuccessful aAQCVease domg What happened fake Wmd Mum Neurollogic Medicatiwns liilililifl l llllil Ii Opiate EMElQESIC Stimulateg pentria p iuid rape t cauges CNS depressipn tum I in i u Nundepplari u 39 r i H 39 EFFEClI Elli Ac v PHCL 2600 Page 3 What Happened to EF Likel39y a combination at events aton Vegp n Critical iliness pelvneurepathy CIP 5550quot d g quot changesleadin tr n aicliuretulatlelnf elf drug n gta elites 39 1 cu e rena an Lire wf Decreased eliminatierlt Di vecurenium and mierphirie metabeiite Slow have 473 WWW A n Drugdrug and drugedisease imteract i eris E Merphime lere zepem int CNS depression 1 Vecurei1iiir hydrecertisene cel isti ri tebraimycin preliemged paralysisfmyepathy 2 0 m ptions for managing EF n Tim AIIGW For reversal qt problem and ci39iscnntiriuatie arid eliimiinatie erquot drugs 39 ects of veeure iu t P39Widestigiminer ED ver 5e Eff PHCL 2600 Page 4 What did we do I Time CD Trial of pyridostigmine gt Good ef cacy if problem is excessive blockade cholinergic side effects weenAN 19y No naloxone Good ef cacy however short duration and may preciitate oioid withdrawal Lows No flumazenil GD U M WW 0 Good ef cacy however also short duration may precipitate benzodiazepine withdrawal Takehomequot Points CNSactive medications may potentiate or antagonize effects of each other Systems eg CNS CV GI are interconnected Physiology and pharmacology must be considered within clinical context of situation Anatomy physiology pharmacology and pharmacy practice are all connected You must have a thorough understanding of anatomy physiology and pharmacology to be a good pharmacist PHCL and MBC courses are building blocks for PHPR courses With basic and pharmaceutical sciences back round and cliniclatl training pharmacists are expected to e the drug expe s PHCL 2600 Page 5 Lecture 31 Tuesday October 27 2015 1230 PM PHCL 2600 Page 1 Table 6 1 Responses of Effector Organs to Autonomic Nerve lmpulses 10232006 1121 AM McGrawHill s m Close Window Note Large images and tables on this page may necessitate printing in landscape mode Copyright 2006 The McGrawHill Companies All rights reserved Goodman amp Gilman39s Pharmacology gt II Drugs Acting at Synaptic and Neuroefiector Junctional Sittjb gt Chapter 6 Neurotransmissmn The Autonomic and Somatic Motor Nervous Systems fr Anatomy and General Functions of the Autonomic and Somatic Motor Nervous Systems gt Responses of Effector Organs to Autonomic Nerve lmpulses gt Table 6 1 Responses of Effector Organs to Autonomic Nerve Impulses ORGAN SYMPATHETIC ADRENERGIC PARASYMPATHETIC CHOLINERGIC SYSTEM EFFECTa RECEPTOR EFFECTB RECEPTOR TYPE TYPEquot Eye Radial muscle Contraction E 1 iris mydriasis Sphincter Contraction miosis M3 M2 muscle iris Ciliary muscle Relaxation for far 32 Contraction for near M3 M2 Lacrimal glands Secretion 393quot Secretion M3 M2 Heartc Sinoatrial node Increase in heart 31 gt 32 Decrease in heart rate M2 gtgt M3 rate Atria Increase in 51 gt 32 Decrease in contractility M2 gtgt M3 contractility and and shortened AP duration conduc on velocity Atrioventricular Increase in 31 gt 32 Decrease in conduction M2 gtgt M3 node automaticity and velocity AV block conduc on velocity HisPurkinje Increase in 51 gt 32 Little effect M2 gtgt M3 system automaticity and conduction velocity Ventricle Increase in 31 gt 32 Slight decrease in M2 gtgt M3 httpwwwaccessmedicinecomezproxymeduohioedulpopupaspxalD959769 contractility conduction velocity automaticity and PHCL 2600 Page 2 contractility Page 1 of 6 Table 61 Responses of Effector Organs to Autonomic Nerve Impulses Blood vessels Arteries and arteriolesd Coronary Skin and mucosa Skeletal muscle Cerebral Pulmonary Abdominal viscera Salivary glands Renal Veinsd Endothelium Lung Tracheal and bronchial smooth muscle Bronchial glands Stomach Motility and tone Sphincters Secretion rate of idioventricular pacemakers Constriction dilatione Constriction Constriction dilationeIf Constriction slight Constriction dilation Constriction dilation Constriction Constriction dilation Constriction dilation Relaxation Decreased secretion increased secretion Decrease usual ly Contraction usually Inhibition a1 a2 32 R1 2 a1 32 cL1 a1 Bz 0L1 Bz a1 02 a1a251 32 Cl1 0L2 32 52 011 1 0392 31 52 1 Cl2 httplwwwaccessmedicinecomezproxymeduohioedupopupaspxalD959769 PHCL 2600 Page 3 No innervation No innervation Dilationglh No innervationquot No innervation No innervation Dilationh No innervation Activation of NO synthase Contraction Stimulation Increasei Relaxation usually Stimulation 10232006 1121 AM M3 M3 M2 M3 M3 M2 M2 M3 M3 M2 M3 M2 Page 2 of 6 Intestine lirilet iliter anti telne Sphinctere Secretian Gaiitriadeier and create Kidney Re n iii eee retie n Urinanr bladder Detrueer T rigane and Sphincter Ureter Matility and tune UEEFUS Sex ergane maie Skin Pi lier39rreter m L eel ee Sweat gianee Spleen eepseie Dreereaeeh 1 Centrattienar Iinnibitierr Reilexetieni De i reeeeJir inereeee Relaxatien Centraetien Increase Pregnant ea n tire Ct i e n Reilaxetien Nenpregnant relenatien Ejeeuleten Cnntraetien Laeaheed eetretienk Gene re Iii nee eeeretien r Centraetien Reilaxatinni Table 6 11 Reeeenees ef Effecter Greene te atelierremit Nerve Irneeleee r1p Ell Elil2 El 1 ill e 111 l Ii 1 i 5392 httpwawtemceeeemediitinerernaee arewineclunhineidimmepu nese al 959mg PHCL 2600 Page 4 I nerea eelquot Relaxetien usually Stimuletien Centre etien Ne innervation Centre etien Rvexlaxat ien Increase r Variable Erectien IUEEZEIFEDUE 1121 AM M3 W112 are in MEF MEFME MBF Page 3 at E Table 61 Responses of Effector Organs to Autonomic Nerve Impulses Adrenal medulla Secretion of egineghrine and gorepinephrine Increased contractility Skeletal muscle glycogenolysis KJr uptake Liver Glycogenolysis and gluconeogenesis Pancreas Acini Decreased secretion Islets B cells Decreased secretion Increased secretion Fat cels UPOIYSlS thermogenesis Inhibition of lipolysis Salivary glands K and water secretion Nasopharyngea glands Pineal glands Melatonin synthesis Posterior pituitary DH secretion Autonomic nerve endings Sympathetic terminals Autoreceptor Inhibition of NE release Heteroreceptor 0L1 BZ Secretion II 2 B2 Cl lr Bl B2 B3 12 a 1 K and water secretion Secretion 2A gt 042C 123 Inhibition of NE release httplwwwaccessmedicinecomezproxymeduohioedupopupaspxalD959769 PHCL 2600 Page 5 10232006 1121 AM N 39132B43 M secondarily M3 M2 M3 M2 M3 M2 M2 M4 Page 4 of 6 Table 6 1 Respenses ef Elfecter Dreans te suitenemic Nerve Impulses ltifEiEfE iee 1121 AM Parasvmpathetic terminal AU SWEEE DEDF Inhibi tien ef ace reilease Mgr M4 lletererecepter Inhibitien ef tCh Its2a I lav2 release a espenses are designated te te previde an appresimate indicatien ef the impertance ref svmpathetic and parasvmpathetic nerve activitv in the centre at the varieus ergans and functiens listed bddrenergic recapters e1 I12 and subtvpes thereef Bl I352F i513 Chelinerdic recepters nicetinic N muscarinic hi with subtvpes 1 4 The recepter subtvpes are described mere fullv in Chatters Zr and m and in Tables 64 5 3 and 6 8 When a desigina39ti en ef subtvpe is net previdedr the nature ef the subtvpe has net been determined uneeuivecallv Univ the principal recepter subtvpes are shewn Transmitters ether than acetvlcheline and here tine hrine centribute te manv ef the respenses f339ln the heman heart the ratie at El te i5 is abeut 32 in atria and dirt in ventricles While his recepters predeminate M3 recepters are aise present Wane et al 2004 dThe predeminant e1 recepter subtvpe in meat bleed vessells beth arteries and veins is em see Table gag altheugh ether tel subtvpes are present in speciflc bleed vessels The tam is the predeminant subtvpe in the aerta Micheletti et al2filili3i EDiIEtl il39l predeminates in site ewind te metabelic auteregiulaterv mechanisms Jri iliverthe usual cencentratlen range ef phvslelegicallvr released circulating epinephrine tihe Brecepter respense vasedilatienl predeminates in bleed vessels ef skeletal musclie and liver EEiFECEDtDF respense vasecenstrictien in bleed vessels ef ether abdeminal viscera The renal and mlesienteric vessels alse centain specific depaminerdic recep ters whese activatien causes dilatien see review bv Geldberg et at 19TH g39Svmpathetic chelinergic neurens cause vasediilatien in skeletal muscle beds but this is net invelved in meat phvsielegical respenses illThe endetheli um ef mest bleed vessels releases ND which causes vaseclilatien in respense te muscarin ic stimuli i ieweverr unliite the recepters innervated bv svmpathetic chelinergic fibers in skeletal muscle bleed vessels these muscarinic recepters are net innervated and respend enlv te esegeneuslv added muscarinic agenists in tihe circulatien iquotiill i iile39 acirenergic fibers terminate at inhib iterv Elsii39ECEptDFS en smeeth muscle fibers and at inhibiterv earecepters en parasympathetic chelinergiicj escitaterv danglien cells ef the mventeric plexus the primarv inhibi terv respense is mediated we enteric neurens threueh new Pat recepters and peptide recepters jUterine respenses depend en stages ef menstrual cycle ameunt ef circulating estregen and re esterene and ether facters kFalms ef hands and same ether sites 39quotadrenergiic sweating39 39 Theireiis significant variatien amend species in the recepteir tvpes that mediatecertain metabeiic respenses all three 5 adrenergic recepters have been faced in human fat celils exdivatien cf 53 adrenergic recepters prexduces a vigereus thermegenic respense as well as lipelvsis The significance is unclear ectlvatien ef B adrenergic recepters alse inhibits leptin release frem ad39ipese tissue httpwawaccessmedlciheterneapresvmeduehieediufpepu pa5peaDEngEEl Page 5 ref IE PHCL 2600 Page 6 Table 6 11 RE EFDI ISES ref Effecter Dream te memmie Nerve Impul ee IDIEIMEDDE 1121 AM ADIHI emt diuret e hermene erginine veengreeeir u Cl ipt right 2 l The McGraJwHill Cle mtpamiiee ll rights lf39ESEWEd Privaex Notice Any we is 594 eject te the Terms ef Use and Notice dditieme Credits and Comment Im Fetmetien quot Mammal 3 silverch ir mmindium rutam A rhMc r w m empenmj httpIfwwwuemcee5Smediicinemmezerenemeduehieeldmmepu pe5mlteD959EEl Page E at E PHCL 2600 Page 7
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