NURS 6015 LATEST QUESTIONS AND ANSWERS.
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autonomic nervous system (ANS)
Parasympathetic and Sympathetic Nervous System
it is involuntary-little conscious awareness
ANS regulates
the heart
secretory glands
smooth muscle
the ANS regulates secretory glands examples are?
salivary
gastric
sweat
bronchial
the ANS regulates smooth muscles examples are
bronchi
blood vessels
urogenital system
GI tract
parasympathetic nervous system
Rest and digest
or feed and breed
conservation of energy, absorption of nutrients, building of essential proteins
in the parasympathetic nervous system the main neurotransmitter is
acetylcholine
acetylcholine
acts at cholinergic receptors (nicotinic n , nicotinic m, and muscarinic) causes
parasympathetic response and sweating
once effector cell has been stimulated by acetylcholine what occurs
acetylcholine can either be taken back up into the nerve terminal or degraded
acetylcholine is degraded by
acetylcholinesterase or sometimes just called cholinesterase
muscarinic receptors effects when stimulated
decreased heart rate
bronchial constriction
pupils constriction
increased GI motility and secretions increased urinary bladder contraction
male erection
sweating
sympathetic nervous system
fight or fight
sympathetic nervous system neurotransmitters are
epinephrine and norepinephrine
,epinephrine and norpeinperhine acts as
adrenergic receptors (alpha 1, alpha2, beta1, beta2) causes sympathetic response
epi stimulates all four receptor types norepinephrine does not stimulate beta 2 this
explains why epi is given for anaphylaxis
norepinephrine is degraded by
the enzymes MAO & COMT
norepinephrine can also be taken back up into the nerve terminal
Alpha 1 receptors response when stimulated
-vasoconstriction
-pupillary dilation
-contraction of urinary bladder sphincter
Alpha 2 receptors
located on presynaptic nerve membranes
modulate norepinephrine release helps prevent overstimulation of effector sites
beta 1 receptors response when stimulated
-increased force of contraction
-increased heart rate
-increased conduction velocity
-release of renin from kidney
beta 2 receptors response when stimulated
-vasodilation of arterioles in heart, lung, skeletal muscles (diverts blood away from the
GI tract)
-bronhcial dilation
-release of glucagon from pancreas
-glycogenolysis in liver
-relaxation of uterus
-relaxation of smooth muscles in GI tract, bladder
Adrenergic agonists
dopamine
epinephrine
phenylephrine
isoproterenol
dopamine is a __ agonist
adrenergic
dopamine
receptors that it stimulates are dose dependent (alpha 1, beta 1, dopamine receptors)
when dopamine stimulates dopamine receptors what should you see?
increased renal perfusion and increase urine output
when dopamine stimulates beta 1 receptors this causes?
increased heart rate
when dopamine stimulates alpha 1 receptors this causes?
increased blood pressure
side effects when dopamine stimulates beta 1
are arrhythmias, tachycardia, chest pain
side effects when dopamine stimulates alpha 1 receptors
hypertension can cause necrosis of tissues if infiltrated
,what are other side effects of dopamine
GI side effects due to depressant side effects on the GI tract
epinephrine stimulates
all adrenergic receptors
drug of choice for anaphylaxis
when epi stimulates beta 2 receptors what occurs?
can cause increased glucose levels
phenylephrine stimulates __ receptors
alpha 1
phenylephrine
used in sinus medications-vasoconstricts and helps with nasal congestion
can be used to dilated pupils for eye exam or to relieve pressure in glaucoma
what patients would you want to be cautious with when using phenylephrine
cautious use in patients with hypertension and those on MAOI
Isoproternol stimulates
Beta 1 and Beta 2 receptors
isoproterenol not used often anymore because
of its side effects
CNS
CARDIAC
RESPIRATORY
who do you want to be cautious with when using isoproterenol
thyroid disease
diabetes
vasomotor problems
degenerative heart disease
ensure a beta blockers is readily available in case severe reactions occurs
examples of adrenergic antagonists
labetolol
phentolamine
doxazosin
propranolol
atenolol
which adrenergic antagonist is indicated for treating severe hypertension blocks
alpha 1 beta 1 and beta 2 receptors
labetolol
phentolamine blocks
both alpha receptors
phentolamine is used to
reverse tissue necroses when an alpha 1 agonist infiltrates
side effects with phentolamine
vasodilation and will see reflex tachycardia
Doxazosin
blocks alpha 1 receptors
vasodilators but don't see reflex tachycardia
Doxazosin side effects
, from vasodilation headache, flushing, postural hypotension
can also be used to treat BPH
propranolol blocks
both beta receptors
propranolol can be used for
arrhythmias, decreases workload of heart, hypertension
propranolol is used in caution with patients who have?
diabetes and asthma and those with a history of severe allergy can block effects of epi
side effects of propranolol
CNS, CV, pulmonary effects
decreased beta blocker effect if given with NSAIDs
atenolol is selective to which receptor
beta 1
atenolol is used for
preferred for asthmatics
most of the same side effects as propranolol
nerves send messages by conducting electrical impulses called
action potentials
neurotransmitters
stimulate postsynaptic cells either by exciting or by inhibiting them
___ which communicates between nerves and muscles it also importnat as the
pregangiolonic neurotransmitter throughout the Ans and as the postganglionic
neurotransmitter in the parasympathetic nervous system and several pathways in
the brain
acetylcholine
__ and __ are catecholamines, which are released by nerves in the sympathetic
branch of the ANS and are classified as hormones when they are released from
cells in the adrenal medulla. these neurotransmitters also occur in high levels in
particular areas of the brain such as the limbic system
norepinephrine and epinephrine
__ which is found in high concentrations in certain areas of the brain is involved
in the coordination of impulses and responses both motor and intellectual
dopamine
action potential
is a sudden change in membrane charge from negative to positive that is triggered
when stimulation of a nerve opens sodium channels and allows positive sodium ions to
flow into the cell
when sodium ions flow into a nerve the nerve membrane __
depolarizes
dceplariziaiton this is recorded as a
flow of positive electrical charges
__ immediately follow depolarization with the sodium potassium pump in the cell
membrane pumping sodium and potassium ions out of the cell, leaving the inside
of the membrane relatively negative to the outside returning the resting
membrane potential
repolarization
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autonomic nervous system (ANS)
Parasympathetic and Sympathetic Nervous System
it is involuntary-little conscious awareness
ANS regulates
the heart
secretory glands
smooth muscle
the ANS regulates secretory glands examples are?
salivary
gastric
sweat
bronchial
the ANS regulates smooth muscles examples are
bronchi
blood vessels
urogenital system
GI tract
parasympathetic nervous system
Rest and digest
or feed and breed
conservation of energy, absorption of nutrients, building of essential proteins
in the parasympathetic nervous system the main neurotransmitter is
acetylcholine
acetylcholine
acts at cholinergic receptors (nicotinic n , nicotinic m, and muscarinic) causes
parasympathetic response and sweating
once effector cell has been stimulated by acetylcholine what occurs
acetylcholine can either be taken back up into the nerve terminal or degraded
acetylcholine is degraded by
acetylcholinesterase or sometimes just called cholinesterase
muscarinic receptors effects when stimulated
decreased heart rate
bronchial constriction
pupils constriction
increased GI motility and secretions increased urinary bladder contraction
male erection
sweating
sympathetic nervous system
fight or fight
sympathetic nervous system neurotransmitters are
epinephrine and norepinephrine
,epinephrine and norpeinperhine acts as
adrenergic receptors (alpha 1, alpha2, beta1, beta2) causes sympathetic response
epi stimulates all four receptor types norepinephrine does not stimulate beta 2 this
explains why epi is given for anaphylaxis
norepinephrine is degraded by
the enzymes MAO & COMT
norepinephrine can also be taken back up into the nerve terminal
Alpha 1 receptors response when stimulated
-vasoconstriction
-pupillary dilation
-contraction of urinary bladder sphincter
Alpha 2 receptors
located on presynaptic nerve membranes
modulate norepinephrine release helps prevent overstimulation of effector sites
beta 1 receptors response when stimulated
-increased force of contraction
-increased heart rate
-increased conduction velocity
-release of renin from kidney
beta 2 receptors response when stimulated
-vasodilation of arterioles in heart, lung, skeletal muscles (diverts blood away from the
GI tract)
-bronhcial dilation
-release of glucagon from pancreas
-glycogenolysis in liver
-relaxation of uterus
-relaxation of smooth muscles in GI tract, bladder
Adrenergic agonists
dopamine
epinephrine
phenylephrine
isoproterenol
dopamine is a __ agonist
adrenergic
dopamine
receptors that it stimulates are dose dependent (alpha 1, beta 1, dopamine receptors)
when dopamine stimulates dopamine receptors what should you see?
increased renal perfusion and increase urine output
when dopamine stimulates beta 1 receptors this causes?
increased heart rate
when dopamine stimulates alpha 1 receptors this causes?
increased blood pressure
side effects when dopamine stimulates beta 1
are arrhythmias, tachycardia, chest pain
side effects when dopamine stimulates alpha 1 receptors
hypertension can cause necrosis of tissues if infiltrated
,what are other side effects of dopamine
GI side effects due to depressant side effects on the GI tract
epinephrine stimulates
all adrenergic receptors
drug of choice for anaphylaxis
when epi stimulates beta 2 receptors what occurs?
can cause increased glucose levels
phenylephrine stimulates __ receptors
alpha 1
phenylephrine
used in sinus medications-vasoconstricts and helps with nasal congestion
can be used to dilated pupils for eye exam or to relieve pressure in glaucoma
what patients would you want to be cautious with when using phenylephrine
cautious use in patients with hypertension and those on MAOI
Isoproternol stimulates
Beta 1 and Beta 2 receptors
isoproterenol not used often anymore because
of its side effects
CNS
CARDIAC
RESPIRATORY
who do you want to be cautious with when using isoproterenol
thyroid disease
diabetes
vasomotor problems
degenerative heart disease
ensure a beta blockers is readily available in case severe reactions occurs
examples of adrenergic antagonists
labetolol
phentolamine
doxazosin
propranolol
atenolol
which adrenergic antagonist is indicated for treating severe hypertension blocks
alpha 1 beta 1 and beta 2 receptors
labetolol
phentolamine blocks
both alpha receptors
phentolamine is used to
reverse tissue necroses when an alpha 1 agonist infiltrates
side effects with phentolamine
vasodilation and will see reflex tachycardia
Doxazosin
blocks alpha 1 receptors
vasodilators but don't see reflex tachycardia
Doxazosin side effects
, from vasodilation headache, flushing, postural hypotension
can also be used to treat BPH
propranolol blocks
both beta receptors
propranolol can be used for
arrhythmias, decreases workload of heart, hypertension
propranolol is used in caution with patients who have?
diabetes and asthma and those with a history of severe allergy can block effects of epi
side effects of propranolol
CNS, CV, pulmonary effects
decreased beta blocker effect if given with NSAIDs
atenolol is selective to which receptor
beta 1
atenolol is used for
preferred for asthmatics
most of the same side effects as propranolol
nerves send messages by conducting electrical impulses called
action potentials
neurotransmitters
stimulate postsynaptic cells either by exciting or by inhibiting them
___ which communicates between nerves and muscles it also importnat as the
pregangiolonic neurotransmitter throughout the Ans and as the postganglionic
neurotransmitter in the parasympathetic nervous system and several pathways in
the brain
acetylcholine
__ and __ are catecholamines, which are released by nerves in the sympathetic
branch of the ANS and are classified as hormones when they are released from
cells in the adrenal medulla. these neurotransmitters also occur in high levels in
particular areas of the brain such as the limbic system
norepinephrine and epinephrine
__ which is found in high concentrations in certain areas of the brain is involved
in the coordination of impulses and responses both motor and intellectual
dopamine
action potential
is a sudden change in membrane charge from negative to positive that is triggered
when stimulation of a nerve opens sodium channels and allows positive sodium ions to
flow into the cell
when sodium ions flow into a nerve the nerve membrane __
depolarizes
dceplariziaiton this is recorded as a
flow of positive electrical charges
__ immediately follow depolarization with the sodium potassium pump in the cell
membrane pumping sodium and potassium ions out of the cell, leaving the inside
of the membrane relatively negative to the outside returning the resting
membrane potential
repolarization
