Cholmerg ic systeyn By: Zakivullah yousufzai All nevions which velease Acetyicholine as a meure transmitter are Colled Cholinergic neu vens Chelinergic system 1s -yeloted — wsith sympathetic Ey porasympathic neurons cut flew Ric. paints Parasympatheric menrens Come out of cng at spec seeped 5— ganytion By sph tin gangiien ~ ciliaris mucesed gland ose, Plate & Sub-mandibeler coal cavity ‘Pengien Sublingual & Submanaibulay Salivary yard ra Hoke Har site etd Paras ympathetic th f out Pow ae frome agus ewe ncn - phat, EsePhS% eo : aa OR Smaiy mtestine,, large antes NJ ale lf Blood. fo Transverse Celen, heart (sa b7 right = fe io CAT Bityyy ae pancrease , livey, cholinergic preganglionic + Postganglionic neuron beth secret Acaty(chelin All Preganglionic sympathetic neurons aye cholinergic, while pest angiionic axe adyenexgic but Some Exception : . ee ganglionic sympathetic which wnervate Bleed vessehes + on es © pest ganglionic sympathetic waengy rs Sweat glands. alse reteose AcAy| chetin For more high quality medical notes contact with whatsapp:+93728888256All the menotronsmmitter ushich ave synthesized im call body All the meuotyamsmifters which Sgnthesized in wewe ending: ave — peptide (larger meigadter weight) ave symall meleuboy wright are merve ending are spesilins structove nich cen synthesigg, Store, & velease small amount -nenrotransmitter: eg Acetyl cholin, Nev Epinephun, Epinephyin histamin, serotonin. How Acatyt cholin ove synthes' yet [Ree ot nenionad ait ao] cd Black ppoance omen ex we Chota ACEH BS atests Choline ne =» HOWE enelih oe ram diet ya cheli t _ yams Porte J Ocheline come Prom diet | & enter te aa) end by Na~chelin Tram sPertey, cheiine ave abundant extracailecularty, © Acetyl CoA veleosed Yrom mitochondria @ cholin & Acetyl CoA ave Combined bY Choline-actty! Transferose % make acetyl Cholin, Which enter le vesicle by Ach—H Antipert, within the vesicle HSq pr ave —ve & Achave +ve So attvact sneanather ATP within the vesicle ave also ~ve chovged Se aitvact mere Ach @ duving action Potentiat when ma Come inte call, the call became depcerizel than” tan Gat depolovize sensitive chammel opens & alot tt Come bivd with syntaxin, die to which the qmeuth of” Symtanin opens s “by <8 oe Oe ee pec = oS Oa ace! (may nceyichol, @O,% © mbit cot | @ Yelense Acely cheline For more high quality medical notes contact with whatsapp:+93728888256Factors which wm with Acty Cotine pelea ® Hemicholinivom acts om cholinergic meres at Not~ choline TwomsPortey, & block the tran sparter, go ne choline enter ® inside Ovesimicad mbibit Acety\cheline— preter (Rem) Antivert se thus Reskilcholin Camit enter te vesicle, tor stevoge: © Butitinivn Toxin will Guse paralysis of Muscle by decreasing the velease 9, acetylcholine at Cholinergic nerve ending Cholinergic ewe ending which are at netemusal Junction hove special “ transpaters which transport Butilinium Toxin inwovd» Butilinivm Toxin Wwe an endyme (Bvtilinium pretese) which Gn brek down the synaptebyavin & syntarin Proteins go than vesicle Can't “Jose with membrane So, A cetyicholine is there but net veleased, at necro muscular junction, So no muscle Contraction occur, Leading te Pavalysis of Muscles. @ Back wide spider preduce @ fexin called Lateyotoxin Latevetorin Increase (teraction Bis synaptebravin &y synterin & with also other Ppretdms, se when these proteins interact Strongly large — ayncunt of preteen acetyicholin 15 yeleased, so acdylcheline crisis oCcuf; There wit be lacvimation, salivation, Brady cardia abdeminal Cramps, defication Go Micturabion ~----- ete Choline Cawt Cross BBB, How It veaches te CNS? In Pevephral part ef the becly Cholin Join a protein Coed phosphatidyl choline than this Phosphatidy| — choline enter inte CNS, & break down into Cheline cholinergic mere ending ave very active metobels cally For more high quality medical notes contact with whatsapp:+93728888256 @eateries Ove elated wid eels aa au the Hime ak nenromuserlay junction + loge amount —yelease when action potential con Y =Paction potential is a osave of depolarization = Jolloued by Wove of yepolavization | A gor Ey Like wiowmup & dary | Transmission | amount release 13 ahem ocfermation EEE Mit tre cise Pass Yrom one newe ending te ameter membyane is Ampulses moving Lrom Pre synophe cmembrane to Pest synaptic membrane conduction Movement — of lmpulse along the muscle or nexwe endings E Choli ecePtors Be" ot, 8 er ee icotini Muscarinic fata Nicotinic 2 lace Jor Ach “ siciatte Meatehey bingin’ . “ te us cavin suprexe suppose Ach. shoje ack micetine is hike Shape is . coe awe tat wo Micotinic cheti: ics _ve ov © Te this receptor Nicotin & Acetylcholine Gareth cam bind All micotionic chamels ave Ton channd Mechanism of BH wicctine/ach bind vibe Receptor, the vecepter opens % Menocatenic exchange take Lace om Anwar yavins erect Move meh teach feted BE he SZ amore me eone & | + goes out: eut ward against concentys ° (ei EE Sr cP Rate Se RB; Side ies excitahin' ef aait fane Tpacer ite 2 ea by) Ach §, Muscaxine. 1) FiuFeavinic_cret cepior, stimu STE AYE G protern eouppled -F- Pass VEC, For more high quality medical notes contact with whatsapo:+93728888256Mechomism of action ok newromuscatey guaction © NA move tm thyugh Ton channel (Ni Cotinic weceptes) if Sma amount N& move im it will mot fes potentia mere Fem RMP (Resting membrane Potential) , gut if loge amount ef Ach act on xecepter large amount of Nat move in fes Potential fam RMP: [Besshete., Voltage at uihich tet veltage gated nl Channels cpens: They will Geen voltage from Rep te EPP (End Plate patented) if EPP is greater enough te veach te threshold, than large Nombey of Not channel OPens & na aneve in, go Potential tes upto action Potentiol § action potential take Place , cell become depelavired, such cei open K' Gunna amd KK wush out ,ojaim inside elechonegativity tes && Cal become vepolani zed on this woy wave of depolarization move on muscle membrane. this vecepter om muscle membrane is Glad Nm Cictinic receptey on muscle end plate) @ Another way of nicotinic yecepter action on post synaptic meuronal membrane: presynaptic—yach—+ Nicotinic Tecepter on Pestsynaptic membrane nd move tm post synaptic “membrane & ‘es Petentiat from RMP te Eps CExcitadery pest synaptic Potente) ae EPP €, EPSP ane same, If Produced an seummusculer June Called EPP, a produced en nerve membrane is called EPSP ees —— ee Dewy im bind ty Na teal “) wicotinic muscavinis Corrass G~cepuied) Nw neta) Na SSM Des (present ninemevmuscala) tien) meneStimulation of Nw «Ach e Nicotine « succinyl choline If Ach bind te this vecepter, (f wiill altew this vecepter te allow Life Neb fe move Im after tat wrecapter will be automat blocked iP we want “this vecepter te — stimulate again Ack should be yermoved & than bind again, bot the old Adk is destyoy eo by Acely\Choline Estevase, which is Present abundantly on pest synaptic membrane. Acetyl choline Set Het ssoeity Acetyl Co-A + Choline inrtiall these -yecepters aye stimulated 8 than Desemsitized- succinyl Choline is used as Paralysing agent it is ack used te Stimulate the -recapter but, its ever stimuahon Cause imbibition ef Yurthey Stimulation, so mo ‘further centyaction occey There is me emyyme at vecePter te destroy SUCENY| chetn se It Cause over Stimulatiiny cy evemt vally desensitization ef vecepter Tubotuvarin | Fubocwvann bloCK Nm, this dwg bind €. bleox A ceta| chelin eceptey om meuromusutay Chemergic receptor Dvugs which block Nn @ Trimethopan ® Bengare toxin ‘ Cholinergic Pathway im CNS axe concemed with Learning & memory For more high quality medical notes contact with whatsapp:+93728888256 ©Muscarinic REcer Tors Muscovinic —-veceptors are present — on those tissues which ave Imnewated — by Poviasym pathetic post Aemplionic. nevwens. “ ws JExcitatary 4 Celt activity tthe Pik ri Units opens Kechannels, alot of Kiet tlue occur, cet beceme amore negative, & thus (nnivitied Due te me cate wher, 5 Tetlox of catine Cell become more elechonyative, 4 imbibited 4 tential oe Potent 7k 1G My weceptes Come ite action , Cat bece ey per polarized % me ERE ¥ = -s| Ome cbne tee, 2) mel § = Z efRlon, ae ae tauy The Ackion potential Sin es it ee ackions OA THIS Gay b¥ad'y Cardin For more high quality medical notes contact with whatsapp:+93728888256A regulation of Acetylcholin ote excitate ee AT the presynaptic ‘membrane have Mz vecepter, cohen it is Stimulated by Ach, so the call become inhibited ~ % The excitatory vecepter Presynaptic membrane mx be: # Nicotinic -ecePter oR i, Receg ter uernrititey bohen these one shilaled by Ach, Cotines in cebt T, coll aye shynulated nS ¥ sympathetic TSA nede activity x Parasympathetic sa nede actiity + when sympathetic Excite heart ) excitation of same time \k Cause — mhibition of Paracympathetic Nervous system % when — Powasympathetic — imbibit heart, it syst also nhibit advenengic stem Beth Sympathetic & Porasympatelic have auto recephs alte Stimulated by the same mew transmitter. £4 PSNS= Ace SNS=> E-pinephyine Adyenergic yecepter ow PSNS is Catted Hetroreceptes chelineygic vecepter on SNS js cated Hetvo vecepfer alte % Post gunctionol membrane are ivtlvence de by Neuro transmitter. * Pre dunctemal membrane are alse witluenced by > ” *Y hoving Avtovecepter & Hehe vecePters Clonidine => Stimulate AR, Coupled with x Se cell beceme inhibited. @ For more high quality medical notes contact with whatsapp:+93728888256* DGS Which — stimulate <<, will Vee “Ae \nhibit Yorther release of ee .) Newretyan smi thers é 4 pwugf which inhibit a wil Incyease urtker yeleage of mewrotyansmitlers Tissue distvibution Cholinergic vecepters a Muscavinic Nw nett ee Present in eee RY gens eae ME Ma os ‘Ganglion Cbetl ssyemp + Pores) ®@ all fh moseminie ® M,— CNS, ganglion Mi—> CNS, Iheavt tissues Ma— CNS, smocthe muscles, glands, Enaatistit RNs Concerned with Rest, digest & chemi nation Ma — | only present in M5—7 ens These fissves en which Para sympathetic Post ganglionic fibes ends: 2 & yelease Ach these Mssue hove Muscarinic vecepter Musavinic vecepter Ore Present ons O ens @ effecter tissue @ Muscavinic vecepter ave alse present on tissues wheve postganglionic Cholinergic sympathetic Fibers ends Cie: sweat gland There ave Some Hsue wheve there is no divect cholinergic supply but they have Huscaviwe veceptey: @ gz endothelium of Bleed vessele has My For more high quality medical notes contact with whatsapp:+93728888256 ©Ww blood = vessele © there ise signifi cant acetyicholine act be Ach ave destrayed by choline esterase rapidly Cholinestevase Buty! cholin estevase Acelylcholin egtevase apresent plasma False Called Pseudecholiv estevasre athese ave alto calted mon- speci fic chelinesterase Present tn Hissucs, % alse Called Tave cholinesterase 4 Tre ave also called SPecific choline esterase Dwugs which aye cholinergic —agenist (Muscarinic ) awe aie Ged Povasympathomemitic — drugs “ + parasympathetic activalel dusying vest —> A sympathene ocivetat dues NOTE stress howe FAN Parasympathehc mevrweffector sites Rest Muscarinic ye ceptor aiges x sympathediic werk diffusla a ei \cape Jn eens) work Jocotized 3, desevete Climivedtion IG this wes diffuge ot the Some Ume dacrimitior, Selivebow, Sweating | urination defecation et occurs Frnction of pava wmpatheric Hows Pava sympathetic wert SSS O_EYE © pupil. constriction = sphincter pupili has Ma weepter, go when stimulated , [¢ will consticted giver Citiowis Contract= Cillion’s ave pupils ® Contracted & make tha dems glabvier Pialuter Quali So Person accomudade Yor neow Vision © tlacvimation ~ - oe For more high quality medical notes contact with whatsapp:+93728888256Q) ResPivat, oy ® Slightly brencho constriction bz durivy rest less Q ave needed © tmucocitiary mechanism AL Thyronchiol secretions $o cholinergic dsugs should met be given in Rsthana patients @) Cardiac Lede vogys ———— peves @© LHR CGradycardiny due te Inhibition of | SA-node © pv-bleck > due © decrease inhibition of Av-wode contractility, © Chromo tropic (by onbibition of sA-redi) © Dremotw pic (ey thibition of Av-ned’) © motopic CY mbibitin ef atvie) SA Av-node § AtviO has My mre ceptens 4 ventricaday tiyecaraives is mot significantly when Ma recepter Om atta ave Action potential of atvin is atva is decreased BK & Colt be Come electronegakive , there Not stimulated mevessed, shi Mz attivation ele Chm megaxive le refractive period of Cam lead to loss of © , when Cell become too MCh opening veltage gates cat is automatic chanmads & it Stimulate the Way vascular system There. SigriPicent amount Aceylcholine in the bleed % Ag Newrotransmitler is ne € Ue is destroyed - But ever is weleosed oF enter we bleed as adm Tk acts om My receptor of — undothelium: Most 9 voicday system it met suppl a | by drelinergic® system bss when stimuli come te My recep ter 4 vessde Endetheivm, activate the Evdothelium, in which Nityc o crggme ave ‘er For more high quality medical notes contact with whatsapp:+93728888256 aactivestedThe mitvicoride synthase (wis) Convert Arginine te citvel Ree NO, the NO diffuse in media & Ane Which convert ‘ & SHrmviate Guangl cy clase. GTP inte ¢ of — smooth muscle & BP ey COMP cause relaxahsn Previously No were cottedl Endsthelist srmecth muscle relosant Arginin Peete within endethations : clok [Media No—> G-cyelese sear —> gmect muscle RE x\' axe ¢ SLGiT @ Salivary gland has Ms Ct seerekion) ae © Gastric secretion (My) C(t secretions) : © ducdenum, jeyonum, tliom, Pancresse, billions system has Ma (i secuetions) i @ F Peristolsis @ ta Tene @® sphincters has ra &rlg while My dominant ox @ lage wtestine Cr) > defecotion we (6) urogenital system SO detwsay Contraction = Bladder centraction hnecead Sphincter ® Internal sphencter is under powertel contwle of sympathetic Newvous spstem but When My vecepter of detwsor Ore Stimulated by Acebyicholin, it will alse imbibit sympathetic speceptor , go sphincter velox & vyinalion occur 5S system activity ave mot stimelatal Ach => Mg2NO ——> ROK Srvertie muscle [Lab cation AN Poxasympathele Newe¥: Vk once. © Penile erection > @ ted Veginel secretion Cv swest gland has My veceptr : 4 ic over! what happend te bedy when theve (5 sheliner gts oy close the pupil, Inbrbit the heart ay! a oe sdlvete & dleminate oe aa / ge a ® For more high quality medical notes contact with whatsapo:+93728888256