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Anaesthesia, Analgesia.
Tom Woodcock FRCA
August 2008.
Sedation, anaesthesia and analgesia.
secreting neurons
involved with the control
of arousal, sleep and
circadian rhythm.
TMN
• Axons project to the cerebral cortex,
thalamus, basal ganglia, basal forebrain, and
hypothalamus.
• The histaminergic projections to the cerebral
cortex directly increase cortical activation and
arousal (H1 receptors), and projections to
acetylcholinergic neurons of the basal
forebrain and dorsal pons do so indirectly, by
increasing the release of acetylcholine in the
cerebral cortex.
VLPO
• The ventrolateral preoptic
nucleus is a group of neurons in
the hypothalamus. Active during
sleep, and inhibit other neurons
that are involved in wakefulness.
• The VLPO neurons release the QuickTimeª and a
decompressor
inhibitory neurotransmitters are needed to see this picture.
galanin and GABA to inhibit the
monaminergic cell groups in the
locus ceruleus, the raphe
nucleus, and the
tuberomammillary nucleus.
VLPO
• VLPO is activated by various somnogens
(substances inducing sleep).
• A2A receptor (adenosine) is an important
activator.
• VLPO is inhibited by arousal transmitters
such as norepinephrine and acetylcholine
LC
• The locus ceruleus is in the
dorsal wall of the rostral pons
in the lateral floor of the fourth
ventricle. This nucleus is the
principal site for synthesis of
norepinephrine in the brain
• The norepinephrine from the QuickTimeª and a
LC has an excitatory effect on decompressor
are needed to see this picture.
most of the brain, mediating
arousal and priming the brain
neurons to be activated by
stimuli, while inhibiting the
VLPO.
Raphe nuclei
• a cluster of nuclei found in
the brain stem.
• Release serotonin to the rest
of the brain
• Modulating mood, memory,
sleep and cognition. QuickTimeª and a
decompressor
are needed to see this picture.