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Causes of Death in England and Wales 2003: Circulation Related 32.4%
Causes of Death in England and Wales 2003: Circulation Related 32.4%
Causes of Death in England and Wales 2003: Circulation Related 32.4%
Males 1 Ischaemic heart diseases 2 Cerebrovascular diseases 3 MN of trachea, bronchus and lung 4 Chronic lower respiratory diseases 5 Influenza and pneumonia 6 MN of prostate 7 MN of colon, sigmoid, rectum and anus 8 MN of lymphoid, haematopoietic and related tissue 9 Aortic aneurysm and dissection 10 Dementia and Alzheimers disease All causes of death Females 1 Ischaemic heart diseases 2 Cerebrovascular diseases 3 Influenza and pneumonia 4 Dementia and Alzheimers disease 5 Chronic lower respiratory diseases 6 MN of trachea, bronchus and lung 7 MN of breast 8 Heart failure and complications and ill-defined heart disease 9 MN of colon, sigmoid, rectum and anus 10 Diseases of the urinary system All causes of death 44,901 35,825 21,277 13,307 13,294 11,610 11,209 8,377 6,571 5,157 284,402 15.8 12.6 7.5 4.7 4.7 4.1 3.9 2.9 2.3 1.8 100.0 No of deaths 54,889 21,983 17,155 14,611 13,200 9,166 7,480 5,878 5,403 5,149 253,852 % of all deaths 21.6 8.7 6.8 5.8 5.2 3.6 2.9 2.3 2.1 2.0 100.0
Hormonal mechanisms
Responses graded over wide range Responses relatively slow onset Responses turn off slowly Responses occur in any cell which has an adequate number of receptors Responses vary as the hormone-receptor interaction can produce different effects depending on how the receptor is coupled Total response time seconds to days
Langley 1898
the word 'visceral' is unsatisfactory, for the word loses its proper meaning if applied to nerve fibres such as those which run to the skin. In consequence, it seems to me advisable to adopt some new term. I propose to substitute the word 'autonomic"'. The word implies a certain degree of independent action, but exercised under control of a higher power. The 'autonomic' nervous system means the nervous system of the glands and of the involuntary muscle; it governs the 'organic' functions of the body. J.Physiol 23 240-270 (1898)
Preganglionic fibres
Small myelinated fibres with an average diameter of about 2.5mm in humans Cholinergic Nicotinic receptors N1
N1 ACh
N1
N1
Non-specific increase in permeability to small cations (reversal potential slightly below zero) Depolarises the post-synaptic membrane. Local current spread from the chemically activated region to the axon Two alpha binding sites 1nm apart at ganglion, 2 nm apart at nmj C6 at ganglion, C10 at nmj, Why?
Sympathetic Nerves
long postganglionic fibres - spread out over a wide area. many postganglionic fibres for each preganglionic (variously estimated at 1:20 to as many as 1:250 in human cervical sympathetic ganglia) mainly adrenergic - release noradrenaline (and NPY).
Act on adrenoceptors (a1, a2, b)
Parasympathetic Nerves
the post ganglionic fibres tend to be short highly localised relatively few postganglionic fibres to each pre-ganglionic (variously estimated as 1:1 up to 1:10 in human and cat) cholinergic release acetylcholine (and VIP)
act on muscarinic receptors
Muscarinic Receptors
Higher affinity than nicotinic. Stimulated by muscarine. Blocked by atropine.
Adrenoceptors
Stimulated by nor-adrenaline/adrenaline Blocking depends on receptor type:
b1 blocker b2 blocker a1 blocker a2 blocker atenolol butoxamine prazosin yohimbine
General a- blocker - ergot But also causes intense vasoconstriction and uterine muscle contraction.
ERGOT (a-antagonist)
Other transmitters
Adrenergic
nor-adrenaline, Neuropeptide-Y (NPY) and probably adenosine different patterns of stimulation will cause different patterns of transmitter release.
Cholinergic
co-release of V-I-P, vasoactive-intestinal polypeptide. proportion of acetylcholine and V-I-P varies with pattern of firing
Is there a functional as well as an anatomical difference between sympathetic and parasympathetic? Parasympathetic responds only to reflex stimulation. Parasympathetic reflexes well defined anatomically Parasympathetic nerves turn off when they are not in use. Vagal tone is only PNS tone
Modified post-ganglionic cell, secretes adrenaline and noradrenaline (and NPY) contained in vesicles Adrenal cortex
Circulation
Bulk transport Diffusion, limited by distance, gradient and molecular mass Circulation ensures exchange vessels in all tissues provided with nutrients All cells linked via the capillary exchange vessels