introduction Autonomics Dr Shams . . . .pptx

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1. AUTONOMIC NERVOUS SYSTEM INTRODUCTION DR. SHAMS SULEMAN

2. Autonomic Nervous System Anterograde, Retrograde Motor functions Anatomic designations: not the type of chemicals or the kind of effect Paravertebral ganglia Prevertebral ganglia Satellite ganglia: Ciliary , Pterygopalatine , Otic , Pelvic etc. Innervated organs

3. Autonomic Nervous System Sensory input==== enteric plexus, autonomic ganglia, parts of the CNS Final relay ==== hypothalamus, medulla ENS === from esophagus to distal colon Both secretory and motor Auerbach and Meissner plexuses receive input from the wall of the gut, preganglionic para - sympathetic and post ganglionic sympathetics . IPAN: selective gut denervation of the gut !!!!

4. Autonomic Nervous System Anatomy of autonomic junctions/clefts Chain of varicosities in post ganglionic nerves around effector smooth muscles Wider clefts == slower onset, multiple effector cells VERSUS Classical synapses == “tight”---- small boutons Rapid, localized action

5. NEUROTRANSMITTERS CHOLINERGIC (Acetylcholine) All preganglionic efferent parasympathetic and sympathetic fibers Trophotropic Somatic motor fibers to skeletal muscles Most post ganglionic parasympathetic fibers Sympathetic post ganglionic fibers to skin Acetyl CoA, Choline, Choline Acetyltransferase Choline transporter == hemicholinium

6. CHOLINERGIC…. VAT === proton efflux=== Vesamicol “quanta”== 1000 to 50000 molecules/vesicle VAMPs, Vesicle Associated Membrane protein SNAPs, Synaptosomal Nerve Associated Prote .. Release == Calcium == Botulinum toxin Receptors == activators/ blockers Acetylcholineterases , Butyrylcholinesterase

7. NEUROTRANSMITTERS ADRENERGIC Most sympathetic post ganglionic fibers Noradrenaline/Adrenaline/Dopamine Adrenal medulla: NA---Ad. == ERGOTROPIC Tyrosine Hydroxylase– Dopamine– Metyrosine VMAT– Reserpine NET– Reuptake 1– Cocaine, TCA==== Calcium dependent release Tyramine , Ephedrine, Amphetamine == calcium independent release

8. RECEPTORS Cholinergic == M1, M2, M3, M4, M5….N N , N M Adrenoceptor == α 1 α 2 β 1 β 2 β 3 O Dopamine == D1, D2, D3, D4, D5

9. PRESYNAPTIC REGULATION α 2 == Central==activated by NA ( AUTO RECEPTORS )= majorly inhibitory Cholinergic somatic auto receptors == stimulatory HETERO RECEPTORS == vagus in myocardium inhibiting NA nerve terminals Inhibitory modulators == α 2, M1, M2 , D2, 5-HT1, 5-HT2, 5-HT3, P1, P2, H3, δ Enkephalin , Y1, Y2, EP3 Excitatory modulators == β 2 , NM, AT1

10. POSTYNAPTIC REGULATION Up regulation; denervation super sensitivity, Reserpine Down regulation; Tolerance EPSP== Excitatory Post Synaptic Potential IPSP == Inhibitory Post Synaptic Potential