| Term 
 
        | What are the 2 major divisions of the efferent portion of the nervous system? |  | Definition 
 | 
        |  | 
        
        | Term 
 | Definition 
 | 
        |  | 
        
        | Term 
 | Definition 
 
        | unconscious innervated structures of periphery |  | 
        |  | 
        
        | Term 
 
        | Where does control of the somatic nervous system originate? |  | Definition 
 
        | mortox cortex via corticospinal tracts |  | 
        |  | 
        
        | Term 
 
        | Where do all synapses of the somatic nervous system occur? |  | Definition 
 
        | within CNS (therefore motor neurons run from CNS to skeletal muscles uninterrupted) |  | 
        |  | 
        
        | Term 
 
        | Are somatic motor neurons usually myelinated or unmyelinated? |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | That is the neurotransmitter for skeletal muscle? |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | What happens to skeletal muscles if their innervation is lost? |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | Where does control of the autonomic nervous system originate? |  | Definition 
 
        | hypothalamous, limbic system, & brain stem that integrate at the peripheral ganglia b/w CNS & neuroeffector junction. |  | 
        |  | 
        
        | Term 
 
        | What happens to smooth muscles & glands in the absence of functional autonomic innervation? |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | What are the 2 major portions of the autonomic nervous system? |  | Definition 
 
        | Parasympathetic Sympathetic
 |  | 
        |  | 
        
        | Term 
 
        | What is the PS comprised of? |  | Definition 
 
        | autonomic output of the cranial nerves & sacral portion of the SC |  | 
        |  | 
        
        | Term 
 
        | What is the neurotransmitter at all ganglionic & neuroeffector junctions of the PS? |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | What is the SS comprised of? |  | Definition 
 
        | autonomic output of the thoracic & lumbar portions of the SC |  | 
        |  | 
        
        | Term 
 
        | When is Ach the neurotransmitter in SS? |  | Definition 
 
        | sympathetic ganglia, adrenal medulla, & few sympathetic neuroeffector junctions |  | 
        |  | 
        
        | Term 
 
        | What is the neurotransmitter dominant at the neuroeffector junctions of the SS? |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | Which of the autonomic system is "rest & digest"? 
 "fight or flight"?
 |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | What could be regarded at the 3rd component of the ANS? |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | Where is the enteric nervous system found? |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | What modulates the intrinsic activity of the enteric nervous system? |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | What outputs does the enteric nervous system have? |  | Definition 
 
        | cholinergic & NANC (non-adrenergic, noncholinergic) |  | 
        |  | 
        
        | Term 
 
        | What are the primary neurotransmitters of the enteric nervous system? |  | Definition 
 
        | peptides, purines, & other substances (NO) |  | 
        |  | 
        
        | Term 
 
        | What do peptides, purines, & other substances function as in cholinergic & adrenergic neurons? |  | Definition 
 | 
        |  | 
        
        | Term 
 | Definition 
 
        | any neuron in CNS or periphery that liberates Ach as it's transmitter |  | 
        |  | 
        
        | Term 
 
        | What is the primary signal for all neurons leaving the CNS? |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | What receptor type do all Ach originating from CNS synapse on initially? |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | When are muscarinic Ach receptors used? |  | Definition 
 
        | In SS sweat glands & PS AFTER they initially synapse on a nictotinic Ach receptor |  | 
        |  | 
        
        | Term 
 
        | Where is Ach synthesized? |  | Definition 
 
        | cytoplasm of cholinergic nerve terminals |  | 
        |  | 
        
        | Term 
 
        | What 2 substrates are used to form Ach? |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | What enzyme catalyzes Ach synthesis? |  | Definition 
 
        | ChAT (choline acetyltransferase) |  | 
        |  | 
        
        | Term 
 
        | Where is ChAT synthesized? |  | Definition 
 
        | cell body of neuron & transported down axon |  | 
        |  | 
        
        | Term 
 
        | Why is the rate of Ach synthesis dependent on choline? |  | Definition 
 
        | aceytl CoA is produced via mitochondria in the nerve, choline is selectively pumped into the nerve. |  | 
        |  | 
        
        | Term 
 
        | What amine type is choline? |  | Definition 
 | 
        |  | 
        
        | Term 
 | Definition 
 
        | contents of a single vesicle of Ach |  | 
        |  | 
        
        | Term 
 
        | How does Ach end up in vesicles? |  | Definition 
 
        | packaged into vesicles in nerve terminal |  | 
        |  | 
        
        | Term 
 
        | What singals Ach vesicles to fuse with the membrane & be relesed to synapse? |  | Definition 
 
        | Terminal becomes excited by action potential => Ca2+ channels activated => Ca2+ influx |  | 
        |  | 
        
        | Term 
 
        | What can effect Ca2+-dependent Ach release? |  | Definition 
 
        | Any Ca2+ antagonist interfering with permeability of Ca2+ |  | 
        |  | 
        
        | Term 
 
        | def 
 MEPP (mini end plate potential)
 |  | Definition 
 
        | Sm. transient depolarization of the motor end plate via spontaneous release of individual quanta NOT cauing an AP |  | 
        |  | 
        
        | Term 
 
        | Why are graded responses in Ach release needed in the heart, visceral organs, or glandular tissue? |  | Definition 
 
        | 1) Single AP doesn't provide maximal response 2) released Ach must diffuse more widely due to less organized neuromuscular junction
 |  | 
        |  | 
        
        | Term 
 
        | What is the postsynaptic cholinoreceptor for Ach? |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | What enzyme degrades Ach? |  | Definition 
 
        | AChE (acetylcholinesterase) |  | 
        |  | 
        
        | Term 
 
        | What does the cholinergic mediated response depend on? |  | Definition 
 
        | Ach binding postsynaptic AchR |  | 
        |  | 
        
        | Term 
 
        | How do presynaptic receptors play a role in neurotransmission? |  | Definition 
 | 
        |  | 
        
        | Term 
 | Definition 
 
        | By effects of agonists (muscarine & nicotine) & effects of antagonists (atropine & s-tubocurarine) |  | 
        |  | 
        
        | Term 
 
        | What does the flexibility of Ach allow it to bind to? |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | What does the flexibility of Ach allow it to bind to? |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | What on all cholinoreceptors allows the + charged Ach to orient over the binding site? |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | Why do Ach analogs tend to have preference over receptor type/subtype? |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | What stimulates muscarinic receptors (mAch)? 
 What blocks mAch?
 |  | Definition 
 
        | Stimulates: Ach Blocks: atropine
 |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | alkaloid isolated from Amanita muscaria mushroom |  | 
        |  | 
        
        | Term 
 
        | What 5 locations does muscarine mimic Ach? |  | Definition 
 
        | 1) visceral smooth muscle GI, LUT, uterus, bronchi 2) heart/vasculature
 3) secondary glands
 4) CNS
 5) autonomic ganglia (primary cholinoreceptor is nicotinic, tho)
 |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | an alkaloid from the leaves of atopine belladonna |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | all cholinoreceptors that are activated by muscarine & blocked by atropine.  They traverse the membrane 7 times. |  | 
        |  | 
        
        | Term 
 | Definition 
 | 
        |  | 
        
        | Term 
 | Definition 
 
        | mAchR predominant in the heart |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | mAchR predominant in secretory signals |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | a liquid alkalois isolated from tobacco |  | 
        |  | 
        
        | Term 
 
        | What are the 4 cholinoreceptor sites where nicotine acts as an agonist? |  | Definition 
 
        | 1) Neuromuscular junction of somatic muscles 2) all autonomic ganglia on dendrites of post-ganglionic neurons
 3) CNS
 4) adrenal medulla
 |  | 
        |  | 
        
        | Term 
 
        | What happens when nictotine binds to AchR in low concentrations? |  | Definition 
 
        | stimulation followed by recovery |  | 
        |  | 
        
        | Term 
 
        | What happens when nictotine binds to AchR in high concentrations? |  | Definition 
 
        | stimulation followed by depression |  | 
        |  | 
        
        | Term 
 
        | What causes the depression seen in high nicotine concentrations after stimulation? |  | Definition 
 
        | sustained depolarization of receptor membrane due to ionic channels being kept open |  | 
        |  | 
        
        | Term 
 
        | def 
 depolarization blockade
 |  | Definition 
 
        | effect of large nicotine cocentrations |  | 
        |  | 
        
        | Term 
 
        | What blocks the stimulatory action of nicotine? |  | Definition 
 | 
        |  | 
        
        | Term 
 | Definition 
 | 
        |  | 
        
        | Term 
 
        | def 
 nicotinic AchR (nAchR)
 |  | Definition 
 
        | cholinoreceptor stimulated by nicotine & blocked by d-turbocurarine 
 They are pentameric complexes that span the membrane several times.
 |  | 
        |  | 
        
        | Term 
 
        | What are mAchR coupled with to transduce signals & cellular responses? |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | Which mAchR's are coupled through Gi? |  | Definition 
 | 
        |  | 
        
        | Term 
 | Definition 
 
        | increased K+ conductance => inhibitory to cellular activity
decreased cAMP => decreased AC |  | 
        |  | 
        
        | Term 
 
        | What are the 3 subunits of the G protein? |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | What subunit of G protein is responsible for it's function? |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | When does the G protein α subunits dissociate from the βγ subunits? |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | When does G protein α subunit rejoin βγ subunits? |  | Definition 
 
        | After GTP hydolyzed to GDP by α subunit |  | 
        |  | 
        
        | Term 
 
        | Which mAchR's are coupled through Gq? |  | Definition 
 
        | Odd mAchR's (M1, M3, & M5) |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | increase cytosolic calcium => stimulatory to cellular activity
(via phospolipase C activation => conversion of PIP2 to PIPG3 & DAG => intracellular stroage release of calcium) |  | 
        |  | 
        
        | Term 
 
        | What is formed when nictotinic receptors are bound to agonists? |  | Definition 
 
        | conformational change to a poor allowing Na+, K+, & Ca2+ permeability |  | 
        |  | 
        
        | Term 
 
        | Why is it possible to selectively block nitotinic receptors either at autonomic ganglia or neuromuscular junction? |  | Definition 
 
        | Though both nAchR's, there are subtle differences at the binding sites. |  | 
        |  | 
        
        | Term 
 
        | Why does synaptically released Ach have a very short half life? |  | Definition 
 
        | presence of cholinesterases |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | hydrolyze ester linkage of Ach => choline & acetic acid |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | cholinergic/effector cell membranes & RBC membranes |  | 
        |  | 
        
        | Term 
 
        | Why is AchE so rapid to degrade Ach? |  | Definition 
 
        | to limit duration of action of Ach at cholinergic junctions |  | 
        |  | 
        
        | Term 
 
        | Where are pseudocholinesterases found? |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | Function 
 pseudocholinesterases
 |  | Definition 
 
        | less selective hydrolyzation of esters |  | 
        |  | 
        
        | Term 
 
        | Why is Ach relatively ineffective as a drug? |  | Definition 
 
        | it's rapidly metabolized in plasma |  | 
        |  | 
        
        | Term 
 
        | What are the 2 primary sites that Ach interacts contained on AchE? |  | Definition 
 
        | anionic site & esteratic site |  | 
        |  | 
        
        | Term 
 
        | What attracts the Ach to AchE? |  | Definition 
 
        | the (-) charge of anionic site draws in the (+) charge of quaternary amine of Ach => orients Ach over esteratic site for ester link hydrolysis |  | 
        |  | 
        
        | Term 
 
        | What releases choline from Ach in AchE? |  | Definition 
 
        | enzyme transfer of acetyl group to serine residue |  | 
        |  | 
        
        | Term 
 
        | What causes acetic acid release from AchE after choline leaves? |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | What happens to the free choline after Ach breakdown by AchE? |  | Definition 
 
        | pumped back into nerve terminal or diffused away |  | 
        |  | 
        
        | Term 
 
        | What are the common pre-synaptic AchR's? |  | Definition 
 | 
        |  | 
        
        | Term 
 | Definition 
 
        | regulate evoked release of Ach (feedback inhibition) i.e. prevent excessive Ach release |  | 
        |  | 
        
        | Term 
 
        | Why can low doses of atropine produce a paradoxical bradycardia? |  | Definition 
 
        | presynaptic AchR's = mAchR's.  mAchR's are blocked by atropine => less feedback inhibition of presynaptic Ach release |  | 
        |  | 
        
        | Term 
 
        | Function 
 presynaptic nAchR at neuromuscular junction
 |  | Definition 
 
        | stimulatory for Ach release to maintain Ach release during periods of intense neuromuscular transmission |  | 
        |  | 
        
        | Term 
 
        | Pharmacologic sites of action at cholinergic synapses [image]   |  | Definition 
 
        | 1) Ach synthesis
2) Ach storage
3) Prevent nerve terminal activation
4) Interfer with Ca2+ influx to nerve terminal via Ca2+ antagonists (NOT Ca2+ channel blockers)
5) Exocytosis modification
6) AchR Action
7) AchE inhibition |  | 
        |  | 
        
        | Term 
 
        | How do drugs affect Ach synthesis? |  | Definition 
 
        | Inhibit the rate-limiting step (choline uptake to nerve terminal) |  | 
        |  | 
        
        | Term 
 
        | How do drugs affect Ach storage? |  | Definition 
 
        | Prevent Ach packaging into secretory vesicle |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | blocks rate-limiting step of Ach synthesis |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | Inhibit Ach vesicle formation |  | 
        |  | 
        
        | Term 
 
        | What can prevent activation of nerve terminal? |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | What interfers with Ca2+ influx to nerve terminal? |  | Definition 
 
        | hypermagnesia (or other Ca2+ antagonists, NOT Ca2+ channel blockers) |  | 
        |  | 
        
        | Term 
 
        | What inhibits Ach exocytosis? |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | What activated Ach exocytosis? |  | Definition 
 | 
        |  | 
        
        | Term 
 | Definition 
 
        | agents that occupy cholinesterase Ach binding sites |  | 
        |  | 
        
        | Term 
 
        | def 
 reversible indirect Ach agonist
 |  | Definition 
 
        | indirect Ach agonist agents metabolized or removed from binding site within minutes-hours 
 or they are simple, competitive inhibitors of Ach binding
 |  | 
        |  | 
        
        | Term 
 
        | def 
 irreversible indirect Ach agonist
 |  | Definition 
 
        | indirect Ach agonist agents that have stable covalent binding to esterases & remain on the AchE receptor for hours-days |  | 
        |  | 
        
        | Term 
 
        | What is an example of an irreversible indirect Ach agonist? |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | Patient has primary axillary hyperhydrosis (excessive sweating) that has not responded to topical treatment.  What agent may be appropriate for this patient. |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | When can botox be used pharmacologically? |  | Definition 
 
        | strabismus, torticollis, wrinkles, possibly migranes |  | 
        |  |