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12-Mar-17 ADRENAL MEDULLA NERVOUS SYSTEM Anatomical Subdivision Central Nervous System Brain Spinal Cord Peripheral Nervous System Cranial Nerves (12 pairs) Spinal Nerves Associated Ganglia NERVOUS SYSTEM Functional Subdivision Somatic Nervous System Controls voluntary activities Autonomic Nervous System Controls involuntary activities Sympathetic NS Parasympathetic NS 1 12-Mar-17 Adrenal Medulla – modified postganglionic cells of Sympathetic NS 2 12-Mar-17 Sympathetic Nervous System General Organization • Two Paravertebral chains of ganglia • Prevertebral Ganglia • Nerves from ganglia to diff. int. organs Origin of Nerve Fibers • T1 to L2 segments – Lateral Horn Neurotransmitter Secreted • Preganglionic nerve endings Acetylcholine • Postganglionic nerve endings Norepinephrine – 80% Epinephrine – 20% 3 12-Mar-17 Sympathetic Nervous System Preganglionic Neuron May: 1. terminate on postganglionic neuron in the sympathetic chain ganglia 2. ascend or descend to higher or lower ganglia and terminate on postganglionic neuron in the sympathetic chain ganglia 3. pass through the sympathetic chain to prevertebral ganglia (celiac, inferior or superior mesenteric) 4. pass through the sympathetic chain ganglia to adrenal medulla 4 12-Mar-17 EPINEPHRINE / NOREPINEPHRINE (Sympathetic Neurotransmitters / Hormones) POSTGANGLIONIC NERVE ENDINGS Norepinephrine – 80% Epinephrine – 20% ADRENAL MEDULLA Norepinephrine – 20% Epinephrine – 80% 5 12-Mar-17 SYNTHESIS METABOLISM Tyrosine derivative - CATECHOLAMINES 1. HYDROXYLATION Tyrosine Tyrosine Hydroxylase 2. DECARBOXYLATION DOPA Normetanephrine DOPA(Dihydroxyphenylalanine) DOPA Decarboxylase COMT Norepinephrine Dopamine Dihyroxy Mandelic Acid 3. HYDROXYLATION Dopamine Dopamine β-Hydroxylase Norepinephrine 4. METHYLATION MAO Epinephrine Vanillyl Mandelic Acid MAO COMT Phenylethonalamine Norepinephrine N-methyl transferase Metanephrine Epinephrine * Phenylethonalamine N-methyl transferase is not present in Sympathetic Postganglionic Neurons ADRNERGIC RECEPTORS α α1 α2 Epinephrine Norepinephrine β1 > β 2 > α α1 > α2 > β 1 β β1 β2 6 12-Mar-17 Location of Adrenergic Receptors α – receptors α1 • • • • • • • • Arterioles of most organs Sweat glands Salivary glands Iris Uterus Fat cells Coronary arterioles Liver α2 • • • • • • Adrenergic axon terminals Platelets Brain Intestine Pancreatic Islets Coronary arterioles Excitatory & Inhibitory Effects of ‘α’ receptor stimulation Excitatory • Blood Vessels (vasoconstriction) • Smooth muscle sphincter of GIT & Bladder Location of Adrenergic Receptors β – receptors Inhibitory • Pancreas – ↓ Exocrine secretion – ↓ Insulin secretion β1 • Heart – Pacemaker – Myocardium • JG cells • Adipose tissue β2 • Arterioles of • • • • • • • • Heart Skin Lung Skeletal Muscles Lung – airways Intestine / Liver Pancreatic Islets Uterus Excitatory & Inhibitory Effects of ‘β’ receptor stimulation β1 Excitatory • Heart – ↑ chronotropic – ↑ ionotropic • Adipose Tissue – Lipolysis β2 Excitatory β2 Inhibitory • GIT – ↓ Motility – ↓ Blood flow – ↓ secretion • Glycogenolysis 7 12-Mar-17 Effects of ‘α’ and ‘β’ receptor stimulation β – Receptor α – Receptor Normal State – 3 A’s Arouse Awake Alert Vasoconstriction Iris dilatation Intestinal sphincter relaxation Pilomotor contraction Urinary bladder Sphincter contraction Uterus contraction pregnant Epinephrine – 4th A Anxiety Epinephrine Norepinephrine Less Pronounced Pronounced Pronounced Less Pronounced Vasodilatation – β2 ↑ Heart rate – β1 ↑ Myocardial contractility – β1 Intestinal contraction – β2 Calorigenic – β2 Glycogenolysis – β2 Lipolysis – β1 Urinary bladder wall relaxation – β2 Uterus relaxation – β2 (pregnant & non pregnant) α - Receptor Vasoconstriction Intestinal Muscle Relaxation Pupillary dilatation β - Receptor Vasodilatation Heart ( ↑ rate & ↑ force ) Bronchial contraction 8