Ganong's Review of Medical Physiology, 23rd Edition

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270 SECTION III Central & Peripheral Neurophysiology TABLE 17–2 Some drugs and toxins that affect autonomic activity. a Site of Action Compounds That Augment Autonomic Activity Compounds That Depress Autonomic Activity Autonomic ganglia Stimulate postganglionic neurons Block conduction It contains sensory neurons innervating receptors in the mucosa that respond to mechanical, thermal, osmotic, and chemical stimuli. Motor neurons control motility, secretion, and absorption by acting on smooth muscle and secretory cells. Interneurons integrate information from sensory neurons and feedback to the enteric motor neurons. Nicotine Hexamethonium (C-6) Low concentration of acetylcholine Mecamylamine (Inversine) Inhibit acetylcholinesterase Pentolinium DFP (diisopropyl fluorophosphate) Trimethaphan (Arfonad) Physostigmine (Eserine) High concentration of acetylcholine Neostigmine (Prostigmin) Parathion Postganglionic sympathetic terminals Release norepinephrine Block norepinephrine synthesis Tyramine Metyrosine (Demser) Ephedrine Interfere with norepinephrine storage Amphetamine Reserpine Guanethidine b (Ismelin) Prevent norepinephrine release Bretylium (Bretylol) Guanethidine b (Ismelin) Form false transmitters Methyldopa (Aldomet) Muscarinic receptors Atropine, scopolamine α adrenergic receptors Stimulate α 1 receptors Block α receptors Methoxamine (Vasoxyl) Phenoxybenzamine (Dibenzyline) Phenylephrine (Neosynephrine) Phentolamine (Regitine) Prazosin (Minipress) blocks α 1 Yohimbine blocks α 2 β adrenergic receptors Stimulate β receptors Block β receptors aOnly the principal actions are listed. bGuanethidine is believed to have two principal actions. Isoproterenol (Isuprel) Propranolol (Inderal) blocks β 1 and β 2 Atenolol (Tenormin) blocks β 1 Butoxamine blocks β 2 Parasympathetic and sympathetic nerves connect the central nervous system to the enteric nervous system or directly to the digestive tract. Although the enteric nervous system can function autonomously, normal digestive function often requires communication between the central nervous system and the enteric nervous system.
Cortex Heart Amygdala Parasympathetic input CHAPTER SUMMARY Hypothalamus Nucleus ambiguus Ventrolateral medulla Sympathetic input ■ Preganglionic sympathetic neurons are located in the IML of the thoracolumbar spinal cord and project to postganglionic neurons in the paravertebral or prevertebral ganglia or the adrenal medulla. Preganglionic parasympathetic neurons are located in motor nuclei of cranial nerves III, VII, IX, and X and the sacral IML. ■ Nerve terminals of postganglionic neurons are located in smooth muscle (eg, blood vessels, gut wall, urinary bladder), cardiac muscle, and glands (eg, sweat gland, salivary glands). ■ Acetylcholine is released at nerve terminals of all preganglionic neurons, postganglionic parasympathetic neurons, and a few postganglionic sympathetic neurons (sweat glands, sympathetic vasodilator fibers). The remaining sympathetic postganglionic neurons release norepinephrine. ■ Sympathetic activity prepares the individual to cope with an emergency by accelerating the heartbeat, raising blood pressure (perfusion of the vital organs), and constricting the blood vessels of the skin (limits bleeding from wounds). Parasympathetic activity is concerned with the vegetative aspects of day-to-day living and favors digestion and absorption of food by increasing the activity of the intestinal musculature, increasing gastric secretion, and relaxing the pyloric sphincter. CHAPTER 17 The Autonomic Nervous System 271 FIGURE 17–6 Pathways that control autonomic responses. Direct projections (solid lines) to autonomic preganglionic neurons include the hypothalamic paraventricular nucleus, parabrachial nucleus, nucleus of the solitary tract, ventrolateral medulla, and medullary raphé (not shown). Indirect projections (dashed lines) include the cerebral cortex, amygdala, and periaqueductal grey matter. (From Kandel ER, Schwartz JH, Jessell TM [editors]: Principles of Neural Science, 4th ed. McGraw-Hill, 2000.) Intermediolateral cell column Periaqueductal gray matter Parabrachial nucleus Dorsal motor vagal nucleus Nucleus of the solitary tract ■ Ganglionic transmission is blocked by N2 nicotinic antagonists. Postganglionic cholinergic transmission is blocked by muscarinic antagonists. Postganglionic adrenergic transmission is blocked by antagonists of α 1 , β 1 , or β 2 adrenoreceptors, depending on the target organ. ■ The enteric nervous system is located within the wall of the digestive tract and is composed of the myenteric plexus (control of digestive tract motility) and the submucosal plexus (regulates gastrointestinal blood flow and epithelial cell function). MULTIPLE-CHOICE QUESTIONS For all questions, select the single best answer unless otherwise directed. 1. Which of the following drugs would not be expected to increase sympathetic discharge or mimic the effects of increased sympathetic discharge? A) Prazosin B) Neostigmine C) Amphetamine D) Isoproterenol E) Methoxamine
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Ranges of Normal Values in Human Wh
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Copyright © 2010 by The McGraw-Hil
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iv Key Features of the 23rd Edition
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About the Authors KIM E. BARRETT Ki
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viii CONTENTS 27. Digestion, Absorp
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2 SECTION I Cellular & Molecular Ba
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10 SECTION I Cellular & Molecular B
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80 SECTION II Physiology of Nerve &
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100 SECTION II Physiology of Nerve
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168 SECTION III Central & Periphera
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Page 314 and 315: 302 SECTION IV Endocrine & Reproduc
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320 SECTION IV Endocrine & Reproduc
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430 SECTION V Gastrointestinal Phys
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490 SECTION VI Cardiovascular Physi
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588 SECTION VII Respiratory Physiol
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640 SECTION VIII Renal Physiology T
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642 SECTION VIII Renal Physiology m
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644 SECTION VIII Renal Physiology F
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646 SECTION VIII Renal Physiology N
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650 SECTION VIII Renal Physiology G
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652 SECTION VIII Renal Physiology t
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654 SECTION VIII Renal Physiology I
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660 SECTION VIII Renal Physiology C
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662 SECTION VIII Renal Physiology d
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668 SECTION VIII Renal Physiology p
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670 SECTION VIII Renal Physiology l
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672 SECTION VIII Renal Physiology A
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676 SECTION VIII Renal Physiology E
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678 SECTION VIII Renal Physiology o
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680 SECTION VIII Renal Physiology I
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682 SECTION VIII Renal Physiology C
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688 Answers to Multiple Choice Ques
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690 INDEX Angiotensin III, 671 Angi
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692 INDEX Cannabinoids, 145, 179 Ca
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694 INDEX Climbing fibers, 255 Clin
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696 INDEX Endocrine functions of pa
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698 INDEX Flaccid paralysis, 244 Fl
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700 INDEX Hearing (continued) affer
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702 INDEX Intrinsic system, 532 Int
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704 INDEX Monoamines (continued) hi
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706 INDEX Pacemaker (continued) imp
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708 INDEX Proprioceptors, 632-633 P
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710 INDEX Respiratory compensation,
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712 INDEX Supratentorial lesions, 2
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714 INDEX Vestibular system, 213-21
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Ganong's Review of Medical Physiology, 23rd Edition

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