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The Neuromuscular Junction and Relevant Pathologies - Year 1

The Neuromuscular Junction and Relevant Pathologies - Year 1. Alistair Ward 21/11/12. What will be covered. Revision of the NMJ A look at the parasympathetic and sympathetic response A closer look at the acetyl-choline receptor and its role in the para -sympathetic nervous system

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The Neuromuscular Junction and Relevant Pathologies - Year 1

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  1. The Neuromuscular Junction and Relevant Pathologies - Year 1 Alistair Ward 21/11/12

  2. What will be covered • Revision of the NMJ • A look at the parasympathetic and sympathetic response • A closer look at the acetyl-choline receptor and its role in the para-sympathetic nervous system • Some NMJ clinical applications

  3. Why is the NMJ important clinically? • Drugs to manipulate the sympathetic and para-sympathetic nervous systems. • Understand pathologies affecting the NMJ e.g. myasthenia gravis

  4. Sympathetic Vs Parasympathetic Nervous Systems • Sympathetic response • Fight or Flight. • Para-sympathetic response • Normal bodily functions: Salivation, Lacrimation, Urination, Excretion

  5. The acetyl-choline receptor • Mainly found in the para-sympathetic nervous system • Two types of receptor: Muscarinic and Nicotinic • Each has its own agonists and antagonists

  6. The muscarinic acetyl-choline receptor • Agonist = Muscarine • Antagonist = Atropine

  7. Ionotropic muscarinic acetyl-choline receptor Na+

  8. Muscarinic acetyl-choline receptor in the presence of muscarine (agonist) Na+

  9. Symptoms of muscarine poisoning Salivation Lacrimation Urination Diarrhoea SLUD

  10. Muscarinic acetyl-choline receptor in the presence of atropine (antagonist) Na+

  11. Symptoms of atropine (poisoning)

  12. The nicotinic actetyl-choline receptor • Agonist = Nicotine • Antagonist = Curare

  13. Nicotinic acetyl-choline receptor in the presence of nicotine (agonist) Na+

  14. Nicotinic acetyl-choline receptor in the presence of curare (antagonist)

  15. A look ahead to the next case unit • Asthma = inflammation of the lining of the airways • How can drugs manipulate the sympathetic response to help people with asthma? • Should these drugs be banned in athletes? • How can drugs manipulate the parasympathetic response to help people with asthma?

  16. NMJ Pathologies

  17. Poisons • Organophosphates aka Pesticides • Acetyl-cholinesterase inhibitors • SLUD symptoms • Botox aka Clostridium Botulinumtoxin • SNARE protein inhibitor – prevents vesicles of acetyl-choline fusing with synaptic membrane • Muscle paralysis

  18. Myasthenia gravis • Auto-antibodies against acetyl-choline receptors. • Rare, women in thirties, men in forties. • Ratio F 3 : M 2 • Treatment: Steroids to suppress the immune response and Pyridostigmine

  19. What we’ve covered

  20. Questions?

  21. Resource Survey GnRH CORPUS LUTEUM BREAK DOWN = FALL IN PROGESTERONE = MENSES

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