AUTONOMIC NERVOUS

SYSTEM
 Topic Outline
GENERAL ORGANIZATION OF AUTONOMIC NERVOUS SYSTEM
AUTONOMIC REFLEXES
DISCRETE AND MASS STIMULATIONS OF PARASYMPATHETIC
AND SYMPATHETIC SYSTEMS
PHARMACOLOGY OF AUTONOMIC NERVOUS SYSTEM
 SOMATIC NERVOUS SYSTEM
vs
AUTONOMIC NERVOUS SYSTEM
 SOMATIC VS AUTONOMIC SYSTEMS
FEATURES SOMATIC AUTONOMIC
Target Tissues Skeletal mm Smooth mm, cardiac
mm, exocrine glands
Regulation Conscious & Unconscious, some
unconscious influence by conscious
movement mental fxn (ie
(reflexes) sphincters)
Reaction to Contraction Stimulation / inhibition
stimulation
 SOMATIC VS AUTONOMIC SYSTEMS

FEATURES SOMATIC AUTONOMIC

# of Neuron 1 neuron 2 neurons

Axon sheaths Myelinated Pre: myelinated; Post:

unmyelinated
Neurotransmitter Ach Pre: Ach;
Post: Ach or NE
 AUTONOMIC NERVOUS SYSTEM
controls visceral functions
a regulatory structure that
helps people adapt to
changes in their environment
For homeostasis
functions in an involuntary,
reflexive manner
(subconscious)
 AUTONOMIC NERVOUS SYSTEM
 The part of the nervous system that regulates
cardiac muscle, smooth muscle, and glands.
 Modulated by: brainstem, hypothalamus and
spinal cord
 Consists of autonomic motor neurons that
regulate visceral activities by either increasing
(exciting) or decreasing (inhibiting) ongoing
activities in their effector tissues.
 Usually operates without conscious control Also
receive sensory input from sensory neurons
associated with interoceptors, sensory receptors
located in blood vessels, visceral organs,
muscles, and the nervous system that monitor
conditions in the internal environment
AUTONOMIC NERVOUS
SYSTEM

 two main division:

 Sympathetic nervous system
 parasympathetic nervous system
 The ANS is also comprised of a third
division known as the enteric
plexuses
 ANS
Unlike the somatic nervous system, this reaches its effector organs by a two-neuron chain

Preganglionic Postganglionic

1.Brainstem (CN III, VII, IX, X) At the outlying ganglion

2.Spinal Cord: intermediolateral connecting with the
gray RL VII of T1-L2 and S2-S4 effector organ
Autonomic Outflow
Preganglionic postganglionic target organ
 Visceral/Autonomic Pathway
AFFERENT

EFFERENT
 ANS VS. ENDOCRINE SYSTEM

ANS Endocrine

Autonomic Nerves Hormones

Smooth Muscles, Cardiac Muscles, Glands

 AUTONOMIC MOTOR NEURONS:
TWO NEURON PATHWAY

PRE-GANGLIONIC POST-
GANGLIONIC
CELL BODY CNS Autonomic
Ganglia
MYELINATION + -
SYNAPSE Post-ganglionic (N) Visceral Effector
 PRE-GANGLIONIC NEURON VS. POST-GANGLIONIC
NEURON

PRE-GANGLIONIC POST-
GANGLIONIC

NUMBER Few Many

NEUROTRANS Sympa & Para: Sympa: NE

-MITTER Ach Para: Ach
 PREGANGLIONIC NEURONS

sympathetic division
the preganglionic neurons have their cell bodies in the lateral horns of the
gray matter in the 12 thoracic segments and the first two (and sometimes
three) lumbar segments of the spinal cord.
Parasympathetic division
Cell bodies of preganglionic neurons of the parasympathetic division are
located in the nuclei of four cranial nerves in the brainstem (III, VII, IX, and X)
and in the lateral gray matter of the second through fourth sacral segments
of the spinal cord.
 AUTONOMIC GANGLIA

SYMPATHETIC GANGLIA
sites of synapses between sympathetic preganglionic and
postganglionic neurons
two major types of sympathetic ganglia:
SYMPATHETIC TRUNK GANGLIA
PREVERTEBRAL GANGLIA

PARASYMPATHETIC GANGLIA
 POSTGANGLIONIC NEURONS

1. An axon may synapse with postganglionic neurons in the ganglion it first

reaches.
2. An axon may ascend or descend to a higher or lower ganglion before
synapsing with postganglionic neurons. The axons of incoming
sympathetic preganglionic neurons pass up or down the sympathetic
trunk from ganglion to ganglion.
3. An axon may continue, without synapsing, through the sympathetic trunk
ganglion to end at a prevertebral ganglion and synapse with
postganglionic neurons there.
4. An axon may also pass, without synapsing, through the sympathetic trunk
ganglion and a prevertebral ganglion and then extend to chromaffin
cells of the suprarenal medullae that are functionally similar to
sympathetic postganglionic neurons.
 AUTONOMIC PLEXUSES
They are slender bundles of preganglionic or
postganglionic fibers arranged in a branching
network.
Found in the thorax, abdomen, and pelvis

Cardiac Celiac/solar
Pulmonary Superior mesenteric Hypogastric
Esophageal Inferior mesenteric
 ANS NEUROTRANSMITTERS AND RECEPTORS:
CHOLINERGIC NEURONS AND RECEPTORS
the cholinergic neurons include:
all sympathetic and parasympathetic preganglionic neurons
sympathetic postganglionic neurons that innervate most sweat
glands
all parasympathetic postganglionic neurons
two types of cholinergic receptors:
Nicotinic receptors
Muscarinic receptors
 ANS NEUROTRANSMITTERS AND RECEPTORS:
ADRENERGIC NEURONS AND RECEPTORS
Most sympathetic postganglionic neurons are
adrenergic
two main types of adrenergic receptors:
alpha (α) receptors
Beta (β) receptors
These receptors are further classified into subtypes—𝛼1,
𝛼2, β1, β2, and β3—based on the specific responses they
elicit and by their selective binding of drugs that
activate or block them.
PHYSIOLOGY OF THE AUTONOMIC
NERVOUS SYSTEM
The balance between sympathetic and
parasympathetic activity, called autonomic
tone, is regulated by the hypothalamus
the hypothalamus turns up sympathetic tone at
the same time it turns down parasympathetic
tone, and vice versa.
SYMPATHETIC RESPONSE
 FIGHT-OR-FLIGHT RESPONSE
 effects:
 The pupils dilate.
 Heart rate, force of heart contraction, and blood pressure increase.
 The airways dilate, allowing faster movement of air into and out of the lungs.
 The blood vessels that supply the kidneys and gastrointestinal tract constrict, which decreases blood flow
through these tissues. The result is a slowing of urine formation and digestive activities, which are not
essential during exercise.
 Blood vessels that supply organs involved in exercise or fighting off danger—skeletal muscles, cardiac
muscle, liver, and adipose tissue—dilate, allowing greater blood flow through these tissues.
 Liver cells perform glycogenolysis and adipose tissue cells perform lipolysis.
 Release of glucose by the liver increases blood glucose level.
 The effects of sympathetic stimulation are longer lasting and more widespread than the effects
of parasympathetic stimulation
PARASYMPATHETIC RESPONSE
 REST-AND-DIGEST
 support body functions that conserve and restore body energy
during times of rest and recovery
 parasympathetic responses:
 salivation
 Lacrimation
 urination
 digestion
 defecation
 decreased heart rate
 decreased diameter of airways
 decreased diameter (constriction) of the pupils
 NEUROTRANSMITTERS
OF THE ANS

Cholinergic Neurons
Secrete Ach
Bind to cholinergic receptors (Nicotinic & Muscarinic)
Adrenergic Neurons
Secrete Adrenalin (E)
Binds to adrenergic receptors (a or b)
 PRINCIPAL TRANSMITTER AGENTS

ACETYLCHOLINE
- Released at all preganglionic endings
- Released by parasympathetic post ganglionic neurons and
sympathetic post ganglionic neurons that project to sweat glands or
mediate vasodilation.
 PRINCIPAL TRANSMITTER AGENTS

NOREPINEPHRINE
- Found at most sympathetic postganglionic endings
- Secreted by adrenal medulla
 NEUROTRANSMITTERS
OF THE ANS

NEURON SYMPATHETIC PARASYMPATHETIC

Pre- Nicotinic Ach Nicotinic Ach

Ganglionic
Post- Alpha/Beta Muscarinic Ach
Ganglionic Adrenergic
 Sympathetic vs
Parasympathetic

Arisa Takagi, PTRP, PT

 SYMPATHETIC PARASYMPATHETIC
Prepares body for emergency, For rest and digest
Fight and flight response

noradrenergic cholinergic
Catabolic nervous system Anabolic nervous system
Thoracolumbar division Craniosacral division
- T1-L2/L3 - CN: X IX VII III
- S2-S4
Long postganglionic fibers Short postganglionic fibers
Arisa Takagi, PTRP, PT
 postganglionic

preganglionic

Arisa Takagi, PTRP, PT

ORGAN SYMPATHETIC PARASYMPATHETIC

EYE Pupil and Ciliary Dilates, Relaxes Constricts, Contracts

muscle
GLANDS Lacrimal, salivary, Vasoconstriction🡪 Increased secretion
nasal reduced secretion

Sweat Increased Reduced Secretion

secretion
ORGAN SYMPATHETIC PARASYMPATHETIC

HEART Myocardium Increased force of Decreased force of

contraction contraction
Coronary Dilates (Beta)
arteries

LUNG Bronchial Relaxes🡪 Contracts🡪

muscles bronchodilation bronchoconstriction
Bronchial Decreased secretion Increased
secretion
Bronchial Constricts Dilates
arteries
ORGAN SYMPATHETIC PARASYMPATHETIC

GASTRO Liver Glycogenolysis

INTESTINAL Gallbladder Relaxes Contracts
Pancreas Decreased pancreatic Increased pancreatic
enzymes, insulin, enzymes, insulin,
glucagon glucagon
Stomach Motility: decreased Motility: increased
Sphincters: contraction Sphincters: relaxation
Secretion: inhibition Secretion: stimulation

Intestines Motility: decreased Motility: increased

Sphincters: contracts Sphincters: relaxes
Secretion: inhibition Secretion: stimulation
GENITO Sympathetic Parasympathetic
URINARY
Adrenal glands Liberates
catecholamines

Kidneys Renal arteries Increased output

constriction 🡪
decreased output
Urinary bladder Detrusor muscle: Detrusor muscle:
relaxes contracts
Trigon and sphincter: Trigon and sphincter:
contracts relaxes

Male sex organ Ejaculation Erection

ORGAN SYMPATHETIC PARASYMPATHETI
C
SYSTEMIC ARTERIES Skin All systemic
Abdominal arteries will
viscera constrict except
Muscle for muscles
AUTONOMIC REFLEXES

 responses that occur when nerve impulses pass through an

autonomic reflex arc.
 Component of a reflex arc:
 Sensory receptor
 Sensory neuron
 Integrating center
 Motor neurons
 Effector
Hypothalamus
 This is the major control and integration center
of the ANS.
 It receives sensory input related to visceral
functions, olfaction (smell), and gustation
(taste), as well as changes in temperature,
osmolarity, and levels of various substances in
blood.
 It also receives input relating to emotions from
the limbic system.
 Output from the hypothalamus influences
autonomic centers in both the brainstem (such
as the cardiovascular, salivation, swallowing,
and vomiting centers) and the spinal cord (such
as the defecation and urination reflex centers in
the sacral spinal cord).
CARDIOVASCULAR AUTONOMIC
REFLEXES
 Reflexes in the cardiovascular system help control the arterial blood
pressure and heart rate. One of these reflexes is the baroreceptor reflex.
 Stretch receptors called baroreceptors are located in the walls of several
major arteries, including especially the internal carotid arteries and the
arch of the aorta.
 When these become stretched by high pressure, signals are transmitted
to the brain stem, where they inhibit the sympathetic impulses to the
heart and blood vessels and excite the parasympathetics; this allows the
arterial pressure to fall back toward normal.
Gastrointestinal Autonomic Reflexes

 The uppermost part of the gastrointestinal tract

and the rectum are controlled principally by
autonomic reflexes.
When fecal matter fills the rectum at the other end of
the alimentary canal, sensory impulses initiated by
stretching the rectum are sent to the sacral portion of
the spinal cord, and a reflex signal is transmitted back
through the sacral parasympathetics to the distal
parts of the colon; these signals result in strong
peristaltic contractions that cause defecation.
Other Autonomic Reflexes

 Emptying of the urinary bladder is controlled in the same way as

emptying of the rectum; stretching of the bladder sends impulses
to the sacral cord, which in turn causes reflex contraction of the
bladder and relaxation of the urinary sphincters, thereby promoting
micturition.
 Also important are the sexual reflexes, which are initiated both by
psychic stimuli from the brain and by stimuli from the sexual
organs. Impulses from these sources converge on the sacral cord
and, in the male, result first in erection, mainly a parasympathetic
function, and then ejaculation, partially a sympathetic function.
 SELECTIVE STIMULATION OF TARGET ORGANS BY
SYMPATHETIC AND PARASYMPATHETIC SYSTEMS OR
“MASS DISCHARGE”
almost all portions of the sympathetic nervous
system discharge simultaneously as a complete
unit
frequently occurs when the hypothalamus is
activated by fright or severe pain
“ALARM” OR “STRESS” RESPONSE OF
THE SYMPATHETIC NERVOUS SYSTEM
 Increased arterial pressure
 Increased blood flow to active muscles concurrent with decreased blood
flow to organs such as the gastrointestinal tract and the kidneys that are
not needed for rapid motor activity
 Increased rates of cellular metabolism throughout the body
 Increased blood glucose concentration
 Increased glycolysis in the liver and in muscle
 Increased muscle strength
 Increased mental activity
 Increased rate of blood coagulation
Pharmacology of the Autonomic Nervous
System
Drugs That Act on Adrenergic Effector Organ

Sympathomimetic Drug
 Norepinephrine (aka: adrenergic drug)
 Epinephrine
 Methoxanine
Important drugs that stimulate specific adrenergic receptors:
 phenylephrine (alpha receptors)
 Isoproterenol (beta receptors)
 albuterol (only beta2 receptors).
Drugs That Cause Release of
Norepinephrine From Nerve Endings.
Ephedrine
Tyramine
Amphetamine
Drugs That Block Adrenergic Activity (Sympatholytic)
 Reserpine
 best known drug
 Prevents synthesis and storage of norepinephrine in the sympathetic nerve endings

 Guanethidine
 Blocks the release of norepinephrine from the sympathetic nerve endings
 Phenoxybenzamine & phentolamine
 Blocks alpha 1 and alpha 2 adrenergic receptors

 Prazosin & terazosin – alpha 1 receptors

 Yohimbine – alpha 2 receptors
 Propanolol
 Blocks both beta 1 & 2 receptors

 Nebivolol, Metoprolol, & atenolol

 Mainly beta 1 receptors only
 Hexamethonium & pentolinium
 Drugs that block both sympathetic and parasympathetic transmission through the ganglia
Drugs That Act on Cholinergic Effector Organs
(Parasympathomimetic drugs)
Pilocarpine and Methacholine
Directly act on muscarinic type of cholinergic receptors
Most commonly used parasympathomimetic drugs

Drugs That Have a Parasympathetic Potentiating Effect

Anticholinesterase Drugs
Neostigmine
Pyridostigmine
Ambenonium
- potentiate the effect of acetylcholine at the
neuromuscular junction
Drugs That Block Cholinergic Activity at Effector
Organs (parasympatholytic)
 Atropine
 Homatropine
 Scopolamine

- blocks the action of acetylcholine on the muscarinic type

of cholinergic effector organs
Drugs That Stimulate or Block Sympathetic and
Parasympathetic Postganglionic Neurons

Drugs That Stimulate Autonomic Postganglionic

Neurons

Injected acetylcholine
Nicotine
Ganglionic Blocking Drugs

Tetraethyl ammonium ion

Hexamethonium ion
Pentolinium
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 ORGAN SYMPATHETIC PARASYMPATHETIC

EYE Pupil and Ciliary 1. -

muscle
HEART Myocardium - 2.
Sweat 3. -
GLANDS
LUNGS Bronchial secretion - 4.
REPRODUCTIVE Male sex organ 5. -
ORGAN
GASTROINTESTINAL Stomach - 6. Motility:
7. Sphincters:
8. Secretion:
GENITOURINARY Kidneys 9. -
Lacrimal, salivary, 10.
nasal