Seeley−Stephens−Tate: III. Integration and Control 16.

Autonomic Nervous © The McGraw−Hill

Anatomy and Physiology, Systems System Companies, 2004
Sixth Edition

Autonomic
Nervous
System

16
C H A P T E R

During a picnic on a sunny spring day,

it is easy to concentrate on the deli-
cious food and the pleasant surround-
Light photomicrograph from a section of the
small intestine, showing the nerve cells of the ings. Maintenance of homeostasis,
enteric plexus. These nerve cells regulate the however, requires no conscious thought.
contraction of smooth muscle and the secretion of The autonomic nervous system (ANS) helps
glands within the intestinal wall. to keep body temperature at a constant level
by controlling the activity of sweat glands and the
amount of blood flowing through the skin. The ANS

Part 3 Integration and Control Systems

helps to regulate the complex activities necessary for the digestion of food. The
movement of absorbed nutrients to tissues is possible because the ANS controls
heart rate, which helps to maintain the blood pressure necessary to deliver blood
to tissues. Without the ANS, all of the activities necessary to maintain homeosta-
sis would be overwhelming.
A functional knowledge of the ANS enables you to predict general re-
sponses to a variety of stimuli, explain responses to changes in environmental
conditions, comprehend symptoms that result from abnormal autonomic func-
tions, and understand how drugs affect the ANS. This chapter examines the au-
tonomic nervous system by contrasting the somatic and autonomic nervous
systems (548); describing the anatomy of the autonomic nervous system (549),
the physiology of the autonomic nervous system (555), and the regulation of the
autonomic nervous system (559); and examining functional generalizations
about the autonomic nervous system (562).
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548 Part 3 Integration and Control System

Contrasting the Somatic and Their cell bodies are located within either the brainstem or the
spinal cord, and their axons extend to autonomic ganglia located
Autonomic Nervous Systems outside the CNS. The autonomic ganglia contain the cell bodies of
Objective the second neurons of the series, which are called postganglionic
■ Compare the structural and functional differences between neurons. The preganglionic neurons synapse with the postgan-
the somatic and autonomic nervous systems. glionic neurons in the autonomic ganglia. The axons of the post-
ganglionic neurons extend to effector organs, where they synapse
The peripheral nervous system (PNS) is composed of sen- with their target tissues.
sory and motor neurons. Sensory neurons carry action potentials Many movements controlled by the somatic nervous system
from the periphery to the central nervous system (CNS), and mo- are conscious, whereas ANS functions are unconsciously con-
tor neurons carry action potentials from the CNS to the periphery. trolled. The effect of somatic motor neurons on skeletal muscle is
Motor neurons are either somatic motor neurons, which innervate always excitatory, but the effect of the ANS on target tissues can be
skeletal muscle, or autonomic motor neurons, which innervate excitatory or inhibitory. For example, after a meal, the ANS can
smooth muscle, cardiac muscle, and glands. stimulate stomach activities, but during exercise, the ANS can in-
Although axons of autonomic, somatic, and sensory neurons hibit those activities. Table 16.1 summarizes the differences be-
are in the same nerves, the proportion varies from nerve to nerve. tween the somatic nervous system and the ANS.
For example, nerves innervating smooth muscle, cardiac muscle, Sensory neurons are not classified as somatic or autonomic.
and glands consist primarily of autonomic neurons; and nerves in- These neurons propagate action potentials from sensory receptors
nervating skeletal muscles consist primarily of somatic neurons. to the CNS and can provide information for reflexes mediated
Some cranial nerves such as the olfactory, optic, and vestibulo- through the somatic nervous system or the ANS. For example,
cochlear nerves are composed entirely of sensory neurons. stimulation of pain receptors can initiate somatic reflexes such as
The cell bodies of somatic motor neurons are in the CNS, the withdrawal reflex and autonomic reflexes such as an increase in
and their axons extend from the CNS to skeletal muscle (figure heart rate. Although some sensory neurons primarily affect so-
16.1a). The ANS, on the other hand, has two neurons in a series ex- matic functions and others primarily influence autonomic func-
tending between the CNS and the organs innervated (figure 16.1b). tions, functional overlap makes attempts to classify sensory
The first neurons of the series are called preganglionic neurons. neurons as either somatic or autonomic meaningless.

Spinal
nerve

Somatic
motor neuron Skeletal
Spinal cord muscle

(a)

Spinal nerve

Autonomic ganglion

Preganglionic
neuron
Spinal cord
Postganglionic
neuron
Effector organ
(e.g., smooth muscle
(b) of colon)

Figure 16.1 Organization of Somatic and Autonomic Nervous System Neurons

(a) The cell body of the somatic neuron is in the CNS, and its axon extends to the skeletal muscle. (b) The cell body of the preganglionic neuron is in the CNS, and its
axon extends to the autonomic ganglion and synapses with the postganglionic neuron. The postganglionic neuron extends to and synapses with its effector organ.
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Chapter 16 Autonomic Nervous System 549

Table 16.1 Comparison of the Somatic and Autonomic Nervous Systems

Features Somatic Nervous System Autonomic Nervous System
Target tissues Skeletal muscle Smooth muscle, cardiac muscle, and glands
Regulation Controls all conscious and unconscious Unconscious regulation, although influenced by conscious
movements of skeletal muscle mental functions
Response to stimulation Skeletal muscle contracts Target tissues are stimulated or inhibited
Neuron arrangement One neuron extends from the central Two neurons in series; the preganglionic neuron extends
nervous system (CNS) to skeletal muscle from the CNS to an autonomic ganglion, and the
postganglionic neuron extends from the autonomic ganglion
to the target tissue
Neuron cell body location Neuron cell bodies are in motor nuclei Preganglionic neuron cell bodies are in autonomic nuclei of
of the cranial nerves and in the ventral the cranial nerves and in the lateral part of the spinal cord;
horn of the spinal cord postganglionic neuron cell bodies are in autonomic ganglia
Number of synapses One synapse between the somatic Two synapses; first is in the autonomic ganglia; second is at
motor neuron and the skeletal muscle the target tissue
Axon sheaths Myelinated Preganglionic axons are myelinated; postganglionic axons are
unmyelinated
Neurotransmitter substance Acetylcholine Acetylcholine is released by preganglionic neurons; either
acetylcholine or norepinephrine is released by postganglionic
neurons
Receptor molecules Receptor molecules for acetylcholine In autonomic ganglia, receptor molecules for acetylcholine
are nicotinic are nicotinic; in target tissues, receptor molecules for
acetylcholine are muscarinic, whereas receptor molecules for
norepinephrine are either α- or β-adrenergic

1. Contrast the somatic nervous system with the ANS for each The enteric nervous system is a complex network of neuron
of the following: cell bodies and axons within the wall of the digestive tract. An im-
a. the number of neurons between the CNS and effector portant part of this network is sympathetic and parasympathetic
organ neurons. For this reason, the enteric nervous system is considered
b. the location of neuron cell bodies to be part of the ANS.
c. the structures each innervates
d. inhibitory or excitatory effects
e. conscious or unconscious control
Sympathetic Division
2. Why are sensory neurons not classified as somatic or Cell bodies of sympathetic preganglionic neurons are in the lateral
autonomic? horns of the spinal cord gray matter between the first thoracic (T1)
3. Define the terms preganglionic neuron, postganglionic and the second lumbar (L2) segments (figure 16.2). Because of the
neuron, and autonomic ganglia. location of the preganglionic cell bodies, the sympathetic division
is sometimes called the thoracolumbar division. The axons of the
preganglionic neurons pass through the ventral roots of spinal
nerves T1–L2, course through the spinal nerves for a short dis-
Anatomy of the Autonomic tance, leave these nerves, and project to autonomic ganglia on ei-
Nervous System ther side of the vertebral column behind the parietal pleura. These
ganglia are called sympathetic chain ganglia, because they are
Objectives
connected to one another and form a chain, or paravertebral gan-
■ Compare the structural differences between the
glia, because they are located along both sides of the vertebral col-
sympathetic and parasympathetic divisions.
umn. Only the ganglia from T1–L2 receive preganglionic axons
■ Describe the structure of the enteric nervous system.
from the spinal cord, although the sympathetic chain extends into
■ Describe how sympathetic and parasympathetic axons are
the cervical and sacral regions so that one pair of ganglia is associ-
distributed to organs.
ated with nearly every pair of spinal nerves. The cervical ganglia
The ANS is subdivided into the sympathetic and the parasym- usually fuse during fetal development so only two or three pairs ex-
pathetic divisions and the enteric (en-ter⬘ik; bowels) nervous ist in the adult.
system (ENS). The sympathetic and parasympathetic divisions differ The axons of preganglionic neurons are small in diameter
structurally in (1) the location of their preganglionic neuron cell bod- and myelinated. The short connection between a spinal nerve and
ies within the CNS and (2) the location of their autonomic ganglia. a sympathetic chain ganglion through which the preganglionic
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550 Part 3 Integration and Control System

Preganglionic neuron neurons. The postganglionic axons leaving the sympathetic

Postganglionic neuron chain ganglion form sympathetic nerves.
3. Splanchnic (splangk⬘nik) nerves (figure 16.3c). Some
preganglionic axons enter sympathetic chain ganglia and,
without synapsing, exit at the same or a different level to
Preganglionic cell body form splanchnic nerves. Those preganglionic axons extend
in lateral horn of to collateral, or prevertebral, ganglia, where they synapse
gray matter
with postganglionic neurons. Axons of the postganglionic
Preganglionic neuron neurons leave the collateral ganglia through small nerves
to sympathetic chain that extend to target organs.
ganglion
4. Innervation to the adrenal gland (figure 16.3d). The
splanchnic nerve innervation to the adrenal glands is
T1 Postganglionic neurons
different from other ANS nerves because it consists of only
Preganglionic neuron
preganglionic neurons. Axons of the preganglionic neurons
to collateral ganglion do not synapse in sympathetic chain ganglia or in collateral
ganglia. Instead, the axons pass through those ganglia and
synapse with cells in the adrenal medulla. The adrenal
medulla (me-dool⬘ă) is the inner portion of the adrenal
Postganglionic neurons gland and consists of specialized cells derived during
L2
embryonic development from neural crest cells (see figure
13.13), which are the same population of cells that give rise
to the postganglionic cells of the ANS. Adrenal medullary
cells are round in shape, have no axons or dendrites, and are
Collateral ganglia divided into two groups. About 80% of the cells secrete
Sympathetic epinephrine (ep⬘i-nef⬘rin), also called adrenaline
chain ganglia
(ă-dren⬘ă-lin), and about 20% secrete norepinephrine
(nōr⬘ep-i-nef⬘rin), also called noradrenaline (nōr-ă-dren⬘ă-
Figure 16.2 Sympathetic Division lin). Stimulation of these cells by preganglionic axons causes
The location of sympathetic preganglionic (solid blue) and postganglionic the release of epinephrine and norepinephrine. These
(dotted blue) neurons. The preganglionic cell bodies are in the lateral gray substances circulate in the blood and affect all tissues having
matter of the thoracic and lumbar parts of the spinal cord. The cell bodies of receptors to which they can bind. The general response to
the postganglionic neurons are within the sympathetic chain ganglia or within
collateral ganglia.
epinephrine and norepinephrine released from the adrenal
medulla is to prepare the individual for physical activity.
Secretions of the adrenal medulla are considered hormones
because they are released into the general circulation and
axons pass is called a white ramus communicans (rā⬘mı̆s kŏ-
travel some distance to the tissues in which they have their
mū⬘ni-kans; pl., rami communicantes, rā⬘mı̄ kŏ-mū-ni-kan⬘tēz)
effect (see chapters 17 and 18).
because of the whitish color of the myelinated axons (figure 16.3).
Sympathetic axons exit the sympathetic chain ganglia by the Parasympathetic Division
following four routes:
Parasympathetic preganglionic neurons are located both supe-
1. Spinal nerves (figure 16.3a). Preganglionic axons synapse rior and inferior to the thoracic and lumbar regions of the spinal
with postganglionic neurons in sympathetic chain ganglia cord where sympathetic preganglionic neurons are found. The
at the same level that the preganglionic axons enter the cell bodies of parasympathetic preganglionic neurons are either
sympathetic chain. Alternatively, preganglionic axons pass within cranial nerve nuclei in the brainstem or within the lateral
either superiorly or inferiorly through one or more ganglia parts of the gray matter in the sacral region of the spinal cord
and synapse with postganglionic neurons in a sympathetic from S2–S4 (figure 16.4). For that reason, the parasympathetic
chain ganglion at a different level. Axons of the postgan- division is sometimes called the craniosacral (krā⬘nē-ō-sā⬘krăl)
glionic neurons pass through a gray ramus communicans division.
and reenter a spinal nerve. Postganglionic axons are not Axons of the parasympathetic preganglionic neurons from
myelinated, thereby giving the gray ramus communicans its the brain are in cranial nerves III, VII, IX, and X; and from the
grayish color. The postganglionic axons then project spinal cord in pelvic nerves. The preganglionic axons course
through the spinal nerve to the organs they innervate. through these nerves to terminal ganglia where they synapse with
2. Sympathetic nerves (figure 16.3b). Preganglionic axons enter postganglionic neurons. The axons of the postganglionic neurons
the sympathetic chain and synapse in a sympathetic chain extend relatively short distances from the terminal ganglia to the
ganglion at the same or a different level with postganglionic target organs. The terminal ganglia are either near or embedded
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Chapter 16 Autonomic Nervous System 551

Dorsal root
ganglion

Preganglionic
Preganglionic neuron neuron
White ramus
Postganglionic communicans
neuron
Sympathetic
Ventral nerves
Gray ramus root
communicans Postganglionic
neuron
White ramus
communicans

Spinal nerve

Sympathetic chain
ganglion Heart
(a) (b)

Preganglionic neuron
Postganglionic neuron

Gray ramus
communicans White ramus
communicans
White ramus
communicans Preganglionic
neuron

Sympathetic
chain ganglion
Splanchnic nerve
Adrenal gland
Collateral
Preganglionic neuron ganglion
Collateral ganglion
Postganglionic neuron

Viscera

(c) (d)

Figure 16.3 Routes Taken by Sympathetic Axons

(a) Preganglionic axons enter a sympathetic chain ganglion through a white ramus communicans. Some axons synapse with a postganglionic neuron at the level of
entry; others ascend or descend to other levels before synapsing. Postganglionic axons exit the sympathetic chain ganglia through gray rami communicantes and
enter spinal nerves. (b) Like part (a), except that postganglionic axons exit through a sympathetic nerve (only an ascending axon is illustrated). (c) Preganglionic
neurons do not synapse in the sympathetic chain ganglia but exit in splanchnic nerves and extend to collateral ganglia, where they synapse with postganglionic
neurons. (d ) Like part (c), except that preganglionic axons extend to the adrenal medulla, where they synapse. There are no postganglionic neurons.
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Preganglionic neuron within the walls of the organs innervated by the parasympathetic
Postganglionic neuron neurons. Many of the parasympathetic ganglia are small in size, but
some, such as those in the wall of the digestive tract, are large.
Table 16.2 summarizes the structural differences between the
sympathetic and parasympathetic divisions.
4. For both the sympathetic and parasympathetic divisions,
Midbrain state (a) the locations of their preganglionic neuron cell
Cranial bodies and (b) the names and locations of their ganglia.
nerves Pons Brainstem 5. What types of axon (preganglionic or postganglionic,
myelinated or unmyelinated) are found in white and gray
Medulla
rami communicantes?
6. Where do preganglionic neurons synapse with
postganglionic neurons that are found in spinal and
sympathetic nerves?
7. Where do preganglionic axons that form splanchnic nerves
(except those to the adrenal gland) synapse with
postganglionic neurons?
Postganglionic
8. What is unusual about the splanchnic nerve innervation to
neurons
the adrenal gland? What do the specialized cells of the
Terminal
ganglia adrenal medulla secrete, and what is the effect of these
Preganglionic substances?
neurons
Enteric Nervous System
The enteric nervous system consists of nerve plexuses within the
Sacral region wall of the digestive tract (see figure 24.2). The plexuses have con-
of spinal cord tributions from three sources: (1) sensory neurons that connect the
(S2–S4) digestive tract to the CNS, (2) ANS motor neurons that connect the
Pelvic CNS to the digestive tract, and (3) enteric neurons, which are con-
nerves
fined to the enteric plexuses. The CNS is capable of monitoring the
digestive tract through sensory neurons and controlling its smooth
muscle and glands through ANS motor neurons.
Figure 16.4 Parasympathetic Division There are several major types of enteric neurons: (1) Enteric
sensory neurons can detect changes in the chemical composition of
The location of parasympathetic preganglionic (solid red) and postganglionic
(dotted red ) neurons. The preganglionic neuron cell bodies are in the the contents of the digestive tract or detect stretch of the digestive
brainstem and the lateral gray matter of the sacral part of the spinal cord, and tract wall. (2) Enteric motor neurons can stimulate or inhibit
the postganglionic neuron cell bodies are within terminal ganglia. smooth muscle contraction and gland secretion. (3) Enteric

Table 16.2 Comparison of the Sympathetic and Parasympathetic Divisions

Features Sympathetic Division Parasympathetic Division
Location of preganglionic cell Lateral horns of spinal cord gray matter Brainstem and lateral parts of spinal
body (T1–L2) gray matter (S2–S4)
Outflow from the CNS Spinal nerves Cranial nerves
Sympathetic nerves Pelvic nerves
Splanchnic nerves
Ganglia Sympathetic chain ganglia along spinal Terminal ganglia near or on effector organ
cord for spinal and sympathetic nerves;
collateral ganglia for splanchnic nerves
Number of postganglionic Many (much divergence) Few (less divergence)
neurons for each
preganglionic neuron
Relative length of neurons Short preganglionic Long preganglionic
Long postganglionic Short postganglionic
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Chapter 16 Autonomic Nervous System 553

interneurons connect enteric sensory and motor neurons to each 4. Abdominopelvic nerve plexuses. Sympathetic chain ganglia
other. Although the enteric neurons are capable of controlling the from T5 and below mainly supply the abdominopelvic
activities of the digestive tract completely independently of the organs. The preganglionic axons of splanchnic nerves
CNS, normally the two systems work together. synapse with postganglionic neurons in the collateral
ganglia of abdominopelvic nerve plexuses. Postganglionic
P R E D I C T
axons from the collateral ganglia innervate smooth muscle
Would the ANS ganglia found in the enteric plexus be chain ganglia,
and glands in the abdominopelvic organs. There are several
collateral ganglia, or terminal ganglia? What type (preganglionic or
abdominopelvic nerve plexuses (see figure 16.5). The celiac
postganglionic) of sympathetic and parasympathetic axons contribute
(sē⬘lē-ak) plexus has two large celiac ganglia and other
to the enteric plexus?
smaller ganglia. It supplies the diaphragm, stomach, spleen,
liver, gallbladder, adrenal glands, kidneys, testes, and
The Distribution of Autonomic Nerve Fibers ovaries. The superior mesenteric (mez-en-ter⬘ik) plexus
Sympathetic Division includes the superior mesenteric ganglion and supplies the
pancreas, small intestine, ascending colon, and the
Sympathetic axons pass from the sympathetic chain ganglia to
transverse colon. The inferior mesenteric plexus includes
their target tissues through spinal, sympathetic, and splanchnic
the inferior mesenteric ganglion and supplies the transverse
nerves. The sympathetic and splanchnic nerves can join auto-
colon to the rectum. The hypogastric plexuses supply the
nomic nerve plexuses, which are complex, interconnected neural
descending colon to the rectum, the urinary bladder, and
networks formed by neurons of the sympathetic and parasympa-
reproductive organs in the pelvis.
thetic divisions. In addition, the axons of sensory neurons con-
tribute to these plexuses.
The autonomic nerve plexuses typically are named accord- Parasympathetic Division
ing to organs they supply or to blood vessels along which they are Parasympathetic outflow is through cranial and sacral nerves.
found. For example, the cardiac plexus supplies the heart and Branches of these nerves either supply organs or join nerve
the thoracic aortic plexus is found along the thoracic aorta. plexuses to be distributed to organs. The major means by which
Plexuses following the route of blood vessels is a major means by parasympathetic axons reach organs include the following:
which autonomic axons are distributed throughout the body.
1. Cranial nerves supplying the head and neck. Three pairs of
The major means by which sympathetic axons reach organs
cranial nerves have parasympathetic preganglionic axons that
include the following:
extend to terminal ganglia in the head. Postganglionic neurons
1. Spinal nerves. From all levels of the sympathetic chain, some from the terminal ganglia supply nearby structures. The
postganglionic axons project through gray rami parasympathetic cranial nerves, their terminal ganglia, and
communicates to spinal nerves. The axons extend to the the structures innervated are (see figure 16.5 and table 14.1):
same structures innervated by the spinal nerves and supply a. The oculomotor (III) nerve, through the ciliary
sweat glands in the skin, smooth muscle in skeletal and (sil⬘ē-ar-ē) ganglion, supplies the ciliary muscles and the
skin blood vessels, and the smooth muscle of the arrector iris of the eye.
pili. See figure 12.14 for the distribution of spinal nerves to b. The facial (VII) nerve, through the pterygopalatine
the skin. (ter⬘i-gō-pal⬘ă-tı̄n) ganglion, supplies the lacrimal gland
2. Head and neck nerve plexuses. Most of the sympathetic and mucosal glands of the nasal cavity and palate. The
nerve supply to the head and neck is derived from the facial nerve, through the submandibular ganglion, also
superior cervical ganglion of the sympathetic chain (figure supplies the submandibular and sublingual salivary
16.5). Postganglionic axons of sympathetic nerves form glands.
plexuses that extend superiorly to the head and inferiorly to c. The glossopharyngeal (IX) nerve, through the otic
the neck. The plexuses give off branches to supply sweat (ō⬘tik) ganglion, supplies the parotid salivary gland.
glands in the skin, smooth muscle in skeletal and skin blood 2. The vagus nerve and thoracic nerve plexuses. Although
vessels, and the smooth muscle of the arrector pili. Axons cranial nerve X, the vagus nerve, has somatic motor and
from the plexuses also join branches of the trigeminal sensory functions in the head and neck, its parasympathetic
nerves (cranial nerve V) to supply the skin of the face, the distribution is to the thorax and abdomen. Preganglionic
salivary glands, the iris, and the ciliary muscles of the eye. axons extend through the vagus nerves to the thorax, where
3. Thoracic nerve plexuses. The sympathetic supply for organs they pass through branches of the vagus nerves to
of the thorax is mainly derived from the cervical and contribute to the cardiac plexus, which supplies the heart,
upper five thoracic sympathetic chain ganglia. and the pulmonary plexus, which supplies the lungs. The
Postganglionic axons in sympathetic nerves contribute to vagus nerves continue down the esophagus, and give off
the cardiac plexus, supplying the heart, the pulmonary branches to form the esophageal plexus.
plexus, supplying the lungs, and other thoracic plexuses 3. Abdominal nerve plexuses. After the esophageal plexus passes
(see figure 16.5). through the diaphragm, some of the vagal preganglionic
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Oculomotor nerve
Facial nerve
Glossopharyngeal nerve Ciliary ganglion
Pterygopalatine ganglion
Internal carotid plexus
Otic ganglion
Superior cervical sympathetic
chain ganglion Submandibular ganglion

Vagus nerve
Sympathetic nerves

Pulmonary plexus
Cervicothoracic ganglion
Cardiac plexus
Sympathetic nerves
Fifth thoracic sympathetic Esophagus and esophageal plexus
chain ganglion
Heart
Greater splanchnic nerve
Aorta and thoracic aortic plexus
Spinal nerve
White ramus communicans Stomach

Gray ramus communicans Celiac ganglion and plexus

Lesser splanchnic nerve Superior mesenteric ganglion
and plexus
Kidney
Aorta and abdominal aortic plexus
Second lumbar sympathetic Small intestine
chain ganglion
Inferior mesenteric ganglion
Lumbar splanchnic nerves and plexus

Superior hypogastric plexus

Colon
Sacral splanchnic nerves

Pelvic nerves Inferior hypogastric plexus

Sacral plexus
Urinary bladder

Rectum Prostate gland

Sympathetic

Parasympathetic

Figure 16.5 Distribution of Autonomic Nerve Fibers

Sympathetic supply: (1) spinal nerves to limbs and body, (2) head and neck by sympathetic nerves from the superior cervical chain ganglia, (3) thoracic organs by
sympathetic nerves from the cervical and thoracic chain ganglia (to T5) supplying thoracic nerve plexuses, and (4) abdominopelvic nerves by splanchnic nerves
from chain ganglia below T5 supplying abdominopelvic nerve plexuses. Parasympathetic supply: (1) head and neck by cranial nerves and their ganglia, (2) thoracic
organs by vagus nerves supplying thoracic plexuses, (3) abdominal organs by vagus nerves supplying abdominal nerve plexuses, and (4) pelvic nerves from S2–S4.
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Chapter 16 Autonomic Nervous System 555

axons supply terminal ganglia in the wall of the stomach,

while others contribute to the celiac and superior
Physiology of the Autonomic
mesenteric plexuses. Through these plexuses, the Nervous System
preganglionic axons supply terminal ganglia in the walls of
Objective
the gallbladder, biliary ducts, pancreas, small intestine,
■ Describe the major neurotransmitters and receptors of
ascending colon, and the transverse colon.
the ANS.
4. Pelvic nerves and pelvic nerve plexuses. Parasympathetic
preganglionic axons whose cell bodies are in the S2–S4
region of the spinal cord pass to the ventral rami of spinal
Neurotransmitters
nerves and enter the pelvic nerves. The pelvic nerves supply Sympathetic and parasympathetic nerve endings secrete one of
the transverse colon to the rectum, and they also contribute two neurotransmitters. If the neuron secretes acetylcholine, it is a
to the hypogastric plexus. The hypogastric plexus and its cholinergic (kol-in-er⬘jik) neuron, and if it secretes norepi-
derivatives supply the lower colon, rectum, urinary bladder, nephrine, it is an adrenergic (ad-rĕ-ner⬘jik) neuron. All pregan-
and organs of the reproductive system in the pelvis. glionic neurons of the sympathetic and parasympathetic
divisions and all postganglionic neurons of the parasympathetic
division are cholinergic. Almost all postganglionic neurons of the
Sensory Neurons in Autonomic Nerve Plexuses sympathetic division are adrenergic, but a few postganglionic
Although not strictly part of the ANS, the axons of sensory neu- neurons that innervate thermoregulatory sweat glands are
rons run alongside ANS axons within ANS nerves and plexuses. cholinergic (figure 16.6).
Some of these sensory neurons are part of reflex arcs regulating or- In recent years, substances in addition to the regular neuro-
gan activities. Sensory neurons also transmit pain and pressure transmitters have been extracted from ANS neurons. These sub-
sensations from organs to the CNS. The cell bodies of these sensory stances include nitric oxide; fatty acids, such as prostaglandins;
neurons are found in the dorsal root ganglia and in the sensory peptides, such as gastrin, somatostatin, cholecystokinin, vasoactive
ganglia of certain cranial nerves, which are swellings on the nerves intestinal peptide, enkephalins, and substance P; and monoamines,
close to their attachment to the brain. such as dopamine, serotonin, and histamine. The specific role that
many of these compounds play in the regulation of the ANS is un-
Effects of Spinal Cord Injury on ANS Functions clear, but they appear to function as either neurotransmitters or
Spinal cord injury can damage nerve tracts and interrupt control of neuromodulator substances (see chapter 11).
autonomic neurons by ANS centers in the brain. For the parasympathetic
division, effector organs innervated through the sacral region of the Receptors
spinal cord are affected, but most effector organs still have normal
Receptors for acetylcholine and norepinephrine are located in the
parasympathetic function because they are innervated by the vagus
plasma membrane of certain cells (table 16.3). The combination of
nerve. For the sympathetic division, brain control of sympathetic
neurotransmitter and receptor functions as a signal to cells, caus-
neurons is lost below the site of the injury. The higher the level of injury,
ing them to respond. Depending on the type of cell, the response
the greater the number of body parts affected.
can be excitatory or inhibitory.
9. Where is the enteric nervous system located? Describe the Cholinergic Receptors
types of neurons found in it.
Receptors to which acetylcholine binds are called cholinergic
10. Define autonomic nerve plexuses. How are they typically
receptors. They have two major structurally different forms.
named?
Nicotinic (nik-ō-tin⬘ik) receptors also bind to nicotine, an alka-
11. Describe the four major ways by which sympathetic axons
loid substance found in tobacco; and muscarinic (mŭs-kă-
pass from sympathetic chain ganglia to reach organs.
rin⬘ik) receptors also bind to muscarine, an alkaloid extracted
Name four thoracic and four abdominopelvic autonomic
from some poisonous mushrooms. Although nicotine and mus-
nerve plexuses.
carine are not naturally in the human body, they demonstrate
12. List the four major means by which parasympathetic axons
differences in the two classes of cholinergic receptors. Nicotine
reach organs. List the cranial nerves and ganglia that
binds to nicotinic receptors but not to muscarinic receptors,
supply the head and neck. What cranial nerve supplies the
whereas muscarine binds to muscarinic receptors but not to
thoracic and abdominal nerve plexuses? To what plexus do
nicotinic receptors. On the other hand, nicotinic and muscarinic
pelvic nerves contribute?
receptors are very similar because acetylcholine binds to and ac-
P R E D I C T tivates both types of receptors.
Starting in the small intestine and ending with the ganglia where their The membranes of all postganglionic neurons in autonomic
cell bodies are located, trace the route for sensory axons passing ganglia and the membranes of skeletal muscle cells have nicotinic
alongside sympathetic axons. Name all of the plexuses, nerves, receptors. The membranes of effector cells that respond to acetyl-
ganglia, etc. that the sensory axon passes through. Also trace the choline released from postganglionic neurons have muscarinic
route for sensory neurons passing alongside parasympathetic axons. receptors.
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Sympathetic division

Most target tissues innervated Cell of target tissue

by the sympathetic division Location of
have adrenergic receptors. nicotinic
When norepinephrine (NE) Location of
receptors adrenergic
binds to adrenergic receptors,
some target tissues are receptors
NE
stimulated, and others are released
inhibited. For example, smooth ACh released
muscle cells in blood vessels
are stimulated to constrict, and
stomach glands are inhibited. Preganglionic neuron Postganglionic neuron

Sympathetic division

Some sympathetic target Location of

tissues, such as sweat glands, muscarinic
have muscarinic receptors, Location of receptors
which respond to acetylcholine nicotinic
(ACh). Stimulation of sweat receptors
glands results in increased
sweat production. ACh released
ACh released
Cell of
target
Preganglionic neuron Postganglionic neuron tissue

Parasympathetic division

All parasympathetic target Cell of target

Location of tissue
tissues have muscarinic nicotinic
receptors. The general receptors
response to ACh is excitatory, Location of
but some target tissues, such muscarinic
as the heart, are inhibited. receptors

ACh released ACh released

Preganglionic neuron Postganglionic neuron

Figure 16.6 Location of ANS Receptors

Nicotinic receptors are on the cell bodies of both sympathetic and parasympathetic postganglionic cells in the autonomic ganglia. Abbreviations: NE,
norepinephrine; ACh, acetylcholine.

P R E D I C T
Adrenergic Receptors
Would structures innervated by the sympathetic division or the
Norepinephrine or epinephrine can bind to adrenergic receptors.
parasympathetic division be affected after the consumption of
Norepinephrine that is released from adrenergic postganglionic
nicotine? After the consumption of muscarine? Explain.
neurons of the sympathetic division (see figure 16.6) diffuses across
Acetylcholine binding to nicotinic receptors has an excita- the synapse and binds to receptor molecules within the plasma
tory effect because it results in the direct opening of Na⫹ channels membranes of effector organs. Epinephrine and norepinephrine re-
and the production of action potentials. When acetylcholine binds leased from the adrenal glands and carried to effector organs by the
to muscarinic receptors, the cell’s response is mediated through G blood can also bind to adrenergic receptors. The response of cells to
proteins (see chapters 3 and 17). The response is either excitatory norepinephrine or epinephrine binding to adrenergic receptors is
or inhibitory, depending on the target tissue in which the receptors mediated through G proteins (see chapters 3 and 17).
are found. For example, acetylcholine binds to muscarinic recep- Adrenergic receptors are subdivided into two major cate-
tors in cardiac muscle, thereby reducing heart rate; and acetyl- gories: alpha (␣) receptors and beta (␤) receptors, each of which
choline binds to muscarinic receptors in smooth muscle cells of the has subtypes. The main subtypes for alpha receptors are ␣1- and
stomach, thus increasing its rate of contraction. ␣2-adrenergic receptors and for beta receptors are ␤1- and
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Chapter 16 Autonomic Nervous System 557

Table 16.3 Effects of the Sympathetic and Parasympathetic Divisions on Various Tissues
Sympathetic Effects and Parasympathetic Effects and
Organ Receptor Type* Receptor Type*
Adipose tissue Fat breakdown and release of fatty acids (α2, β1) None
Arrector pili muscle Contraction (α1) None
Blood (platelets) Increases coagulation (α2) None
Blood vessels
Arterioles (carry blood
to tissues)
Digestive organs Constriction (α1) None
Heart Dilation (β2), constriction (α1)† None
Kidneys Constriction (α1, α2); dilation (β1, β2) None
Lungs Dilation (β2), constriction (α1) None
Skeletal muscle Dilation (β2), constriction (α1) None
Skin Constriction (α1, α2) None
Veins (carry blood Constriction (α1, α2), dilation (β2)
away from tissues)
Eye
Ciliary muscle Relaxation for far vision (β2) Contraction for near vision (m)
Pupil Dilated (α1)‡ Constricted (m)‡
Gallbladder Relaxation (β2) Contraction (m)
Glands
Adrenal Release of epinephrine and norepinephrine (n) None
Gastric Decreases gastric secretion (α2) Increases gastric secretion (m)
Lacrimal Slight tear production (α) Increases tear secretion (m)
Pancreas Decreases insulin secretion (α2) Increases insulin secretion (m)
Decreases exocrine secretion (α) Increases exocrine secretion (m)
Salivary Constriction of blood vessels and slight Dilation of blood vessels and
production of a thick, viscous saliva (α1) thin, copious saliva (m)
Sweat
Apocrine Thick, organic secretion (m) None
Merocrine Watery sweat from most of the skin (m); None
sweat from the palms and soles (α1)
Heart Increases rate and force of contraction (β1, β2) Decreases rate of contraction (m)
Liver Glucose released into blood (α1, β2) None
Lungs Dilates air passageways (β2) Constricts air passageways (m)
Metabolism Increases up to 100% (α, β) None
Sex organs Ejaculation (α1), erection§ Erection (m)
Skeletal muscles Breakdown of glycogen to glucose (β2) None
Stomach and intestines
Wall Decreases tone (α1, α2, β2) Increases motility (m)
Sphincter Increases tone (α1) Decreases tone (m)
Urinary bladder
Wall (detrusor) None Contraction (m)
Neck of bladder Contraction (α1) Relaxation (m)
Internal urinary sphincter Contraction (α1) Relaxation (m)

*When known, receptor subtypes are indicated. The receptors are α1- and α2-adrenergic, β1- and β2-adrenergic, nicotinic cholinergic (n), and muscarinic cholinergic (m).
†Normally blood flow increases through coronary arteries because of increased demand by cardiac tissue for oxygen (local control of blood flow is discussed in chapter 21). In experiments

that isolate the coronary arteries, sympathetic nerve stimulation, acting through α-adrenergic receptors, causes vasoconstriction. The β-adrenergic receptors are relatively insensitive to
sympathetic nerve stimulation but can be activated by epinephrine released from the adrenal gland and by drugs. As a result, coronary arteries vasodilate.
‡Contraction of the radial muscles of the iris causes the pupil to dilate. Contraction of the circular muscles causes the pupil to constrict (see chapter 15).
§Decreased stimulation of alpha receptors by the sympathetic division can cause vasodilation of penile blood vessels, resulting in an erection.
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558 Part 3 Integration and Control System

Clinical Focus The Influence of Drugs on the Autonomic Nervous System

Some drugs that affect the ANS have impor- and are mainly of interest to researchers, Drugs that bind to and block nicotinic
tant therapeutic value in treating certain nicotine is medically important because of receptors are called ganglionic blocking
diseases because they can increase or de- its presence in tobacco. Nicotinic agents agents because they block the effect of
crease activities normally controlled by the bind to the nicotinic receptors on all post- acetylcholine on both parasympathetic and
ANS. Chemicals that affect the ANS are also ganglionic neurons within autonomic gan- sympathetic postganglionic neurons. The
found in medically hazardous substances glia and produce stimulation. Responses to effect of these substances on the sympa-
such as tobacco and insecticides. nicotine are variable and depend on the thetic division, however, overshadows the
Direct-acting and indirect-acting drugs amount taken into the body. Because nico- effect on the parasympathetic division. For
influence the ANS. Direct-acting drugs bind tine stimulates the postganglionic neurons example, trimethaphan camsylate (trı̄-
to ANS receptors to produce their effects. of both the sympathetic and parasympa- meth⬘ă-fan kam⬘sil-āt), used to treat high
For example, stimulating agents bind to thetic divisions, much of the variability of its blood pressure, blocks sympathetic stimu-
specific receptors and activate them, and effects results from the opposing actions of lation of blood vessels, causing the blood
blocking agents bind to specific receptors these divisions. For example, in response to vessels to dilate, which decreases blood
and prevent them from being activated. The the nicotine contained in a cigarette, the pressure. Ganglionic blocking agents have
main topic of this Clinical Focus is direct- heart rate may either increase or decrease. limited uses because they affect both sym-
acting drugs. It should be noted, however, Heart rate rhythm tends to become less reg- pathetic and parasympathetic ganglia.
that some indirect-acting drugs produce a ular as a result of the simultaneous actions Whenever possible, more selective drugs,
stimulatory effect by causing the release of on the sympathetic division, which in- which affect receptors of target tissues, are
neurotransmitters or by preventing the creases the heart rate, and the parasympa- now used.
metabolic breakdown of neurotransmitters. thetic division, which decreases the heart
Other indirect-acting drugs produce an in- rate. Blood pressure tends to increase be- Drugs That Bind to Muscarinic
hibitory effect by preventing the biosynthe- cause of the constriction of blood vessels, Receptors
sis or release of neurotransmitters. which are almost exclusively innervated by Drugs that bind to and activate muscarinic
sympathetic neurons. In addition to its influ- receptors are muscarinic, or parasympa-
Drugs That Bind to Nicotinic ence on the ANS, nicotine also affects the thomimetic (par-ă-sim⬘pă-thō-mi-met⬘ik),
Receptors CNS; therefore, not all of its effects can be agents. These drugs activate the mus-
Drugs that bind to nicotinic receptors and explained on the basis of action on the ANS. carinic receptors of target tissues of the
activate them are nicotinic agents. Although Nicotine is extremely toxic, and small parasympathetic division and the mus-
these agents have little therapeutic value amounts can be lethal. carinic receptors of sweat glands, which

␤2-adrenergic receptors. Activation of ␣1 and ␤1 receptors generally ter plays an important role in the regulation of blood flow and
produces a stimulatory response. For example, stimulation of ␣1 re- blood pressure (see chapter 20).
ceptors in most smooth muscle and ␤1 receptors in cardiac muscle The ␣2 and ␤2 receptors are typically found in parts of the
results in contraction. The response to the activation of ␣2 and ␤2 membrane that are not near nerve terminals releasing norepineph-
receptors varies so much with different target cells that no simple rine. These receptors respond to epinephrine and norepinephrine
generalization about their effects is appropriate. Activation of ␣2 re- released from the adrenal glands into the blood. During exercise,
ceptors on platelets promotes blood clotting but decreases insulin epinephrine and norepinephrine bind to ␤2 receptors and causes
secretion by the pancreas; activation of ␤2 receptors stimulates the blood vessel dilation in skeletal muscles.
liver to release glucose but causes smooth muscle relaxation.
The ␣1 and ␤1 receptors are typically found in the mem-
Dopamine and the Treatment of Shock
branes of target cells in the vicinity of sympathetic nerve termi-
Norepinephrine is produced from a precursor molecule called dopamine.
nals. Thus, the sympathetic division controls target cells with ␣1
Certain sympathetic neurons release dopamine, which binds to
and ␤1 receptors through sympathetic nerves. For example, at
dopamine receptors. Dopamine is structurally similar to norepinephrine
rest, stimulation of ␣1 receptors at sympathetic nerve terminals
and also binds to beta receptors. Dopamine hydrochloride has been
in smooth muscle cells of blood vessels results in partial constric-
used successfully to treat circulatory shock because it can bind to
tion of the vessels. The sympathetic division regulates blood flow
dopamine receptors in kidney blood vessels. The resulting vasodilation
by slightly increasing or decreasing stimulation of the blood ves-
increases blood flow to the kidneys and prevents kidney damage. At the
sels. Increased stimulation causes further constriction and re-
same time, dopamine can bind to beta receptors in the heart, causing
duces blood flow, whereas decreased stimulation results in
stronger contractions.
dilation and increases blood flow. Control of blood vessel diame-
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Chapter 16 Autonomic Nervous System 559

are innervated by the sympathetic divi- pă-thō-mi-met⬘ik) agents. Drugs such as high blood pressure, some types of car-
sion. Muscarine causes increased sweat- phenylephrine (fen-il-ef⬘rin) stimulate al- diac arrhythmias, and patients recovering
ing, increased secretion of glands in the pha receptors, which are numerous in the from heart attacks. Blockage of the beta
digestive system, decreased heart rate, smooth muscle cells of certain blood ves- receptors within the heart prevents sud-
constriction of the pupils, and contraction sels, especially in the digestive tract and den increases in heart rate and thus de-
of respiratory, digestive, and urinary sys- the skin. These drugs increase blood pres- creases the probability of arrhythmic
tem smooth muscles. Bethanechol sure by causing vasoconstriction. On the contractions.
(be-than⬘ĕ-kol) chloride is a parasympatho- other hand, albuterol (al-bū⬘ter-ol) is a
mimetic agent used to stimulate the uri- drug that selectively activates beta recep- Future Research
nary bladder following surgery, because tors in cardiac muscle and bronchiolar Our present knowledge of the ANS is more
the general anesthetics used for surgery smooth muscle. ␤-adrenergic-stimulating complicated than the broad outline pre-
can temporarily inhibit a person’s ability to agents are sometimes used to dilate bron- sented here. In fact, each of the major re-
urinate. chioles in respiratory disorders such as ceptor types has subtype receptors. For
Drugs such as atropine that bind to asthma and are occasionally used as car- example, ␣-adrenergic receptors are sub-
and block the action of muscarinic recep- diac stimulants. divided into the following subgroups:
tors are muscarinic, or parasympathetic, Drugs that bind to and block the action ␣1A-, ␣1B-, ␣2A-, and ␣2B-adrenergic recep-
blocking agents. These drugs dilate the of alpha receptors are ␣-adrenergic-block- tors. The exact number of subtypes in hu-
pupil of the eye and are used during eye ing agents. For example, prazosin (prā⬘zō- mans is not yet known; however, their
examinations to help the examiner see the sin) hydrochloride is used to treat existence suggests the possibility of de-
retina through the pupil. They also de- hypertension. By binding to alpha receptors signing drugs that affect only one sub-
crease salivary secretion and are used dur- in the smooth muscle of blood vessel walls, type. For example, a drug that affects the
ing surgery to prevent patients from prazosin hydrochloride blocks the normal blood vessels of the heart but not other
choking on excess saliva while they are effects of norepinephrine released from blood vessels might be developed. Such
anesthetized. sympathetic postganglionic neurons. Thus, drugs could produce specific effects yet
the blood vessels relax, and blood pressure would not produce undesirable side ef-
Drugs That Bind to Alpha and Beta decreases. fects because they would act only on spe-
Receptors Propranolol (prō-pran⬘ō-lōl) is an ex- cific target tissues.
Drugs that activate adrenergic receptors ample of a ␤-adrenergic-blocking agent.
are adrenergic, or sympathomimetic (sim⬘- These drugs are sometimes used to treat

13. Define cholinergic and adrenergic neurons. Which neurons

of the ANS are cholinergic and adrenergic?
Regulation of the Autonomic
14. Name the two major subtypes of cholinergic receptors. Where Nervous System
are they located? When acetylcholine binds to each subtype, Objectives
does it result in an excitatory or inhibitory cell response? ■ Explain how autonomic and local reflexes help to maintain
15. Name the two major subtypes of adrenergic receptors. homeostasis.
Where are they located? ■ Describe the role of the hypothalamus in controlling the
16. On what part of a cell are ␣1- and ␤1-adrenergic receptors ANS.
typically found? How are they typically stimulated? What
type of response is generally produced when they are Much of the regulation of structures by the ANS occurs
stimulated? through autonomic reflexes, but input from the cerebrum, hypo-
17. On what part of a cell are ␣2- and ␤2-adrenergic receptors thalamus, and other areas of the brain allows conscious thoughts
typically found? How are they typically stimulated? What and actions, emotions, and other CNS activities to influence auto-
type of responses are produced when they are stimulated? nomic functions. Without the regulatory activity of the ANS, an in-
dividual has limited ability to maintain homeostasis.
P R E D I C T Autonomic reflexes, like other reflexes, involve sensory re-
Injection of a small dose of epinephrine causes vasodilation of ceptors; sensory, association, and motor neurons; and effector cells
skeletal muscle blood vessels. An injection of a large dose, however, (figure 16.7; see chapter 12). For example, baroreceptors (stretch
causes vasoconstriction. Explain. receptors) in the walls of large arteries near the heart detect
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Glossopharyngeal
nerve

Increase in blood pressure

detected by carotid
baroreceptors
Integration in Common carotid artery
medulla oblongata

Vagus
nerve

Terminal
ganglion
Heart rate
decreases, causing Heart
blood pressure
(a) to decrease

Glossopharyngeal
nerve

Decrease in blood pressure

detected by carotid
baroreceptors

Common carotid artery

Integration
in medulla
oblongata

Spinal cord

Sympathetic
nerve

Heart rate
increases,
causing blood
Sympathetic pressure
chain ganglia to increase
(b)

Figure 16.7 Autonomic Reflexes

Sensory input from the carotid baroreceptors is sent along the glossopharyngeal nerves to the medulla oblongata. The input is integrated in the medulla, and motor
output is sent to the heart. (a) Parasympathetic reflex. Increased blood pressure results in increased stimulation of the heart by the vagus nerves, which increases
inhibition of the heart and lowers heart rate. (b) Sympathetic reflex. Decreased blood pressure results in increased stimulation of the heart by sympathetic nerves,
which, in turn, increases stimulation of the heart and increases heart rate and the force of contraction.
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Chapter 16 Autonomic Nervous System 561

changes in blood pressure, and sensory neurons transmit informa- blood pressure increases; and if they dilate, blood pressure de-
tion from the baroreceptors through the glossopharyngeal and creases. Thus, altering the frequency of action potentials delivered
vagus nerves to the medulla oblongata. Interneurons in the to blood vessels along sympathetic neurons can either raise or
medulla oblongata integrate the information, and action potentials lower blood pressure.
are produced in autonomic neurons that extend to the heart. If
P R E D I C T
baroreceptors detect a change in blood pressure, autonomic re-
How would sympathetic reflexes that control blood vessels respond to
flexes change heart rate, which returns blood pressure to normal. A
a sudden decrease and a sudden increase in blood pressure?
sudden increase in blood pressure initiates a parasympathetic re-
flex that inhibits cardiac muscle cells and reduces heart rate, thus The brainstem and the spinal cord contain important auto-
bringing blood pressure down toward its normal value. Conversely, nomic reflex centers responsible for maintaining homeostasis (fig-
a sudden decrease in blood pressure initiates a sympathetic reflex, ure 16.8). The hypothalamus, however, is in overall control of the
which stimulates the heart to increase its rate and force of contrac- ANS. Almost any type of autonomic response can be evoked by
tion, thus increasing blood pressure. stimulating some part of the hypothalamus, which, in turn, stimu-
lates ANS centers in the brainstem or spinal cord. Although there is
P R E D I C T
overlap, stimulation of the posterior hypothalamus produces sym-
Sympathetic neurons stimulate sweat glands in the skin. Predict how
pathetic responses, whereas stimulation of the anterior hypo-
they function to control body temperature during exercise and during
thalamus produces parasympathetic responses. In addition, the
exposure to cold temperatures.
hypothalamus monitors and controls body temperature.
Other autonomic reflexes participate in the regulation of The hypothalamus has connections with the cerebrum and is
blood pressure (see chapter 21). For example, numerous sympa- an important part of the limbic system, which plays an important
thetic neurons transmit a low but relatively constant frequency of role in emotions. The hypothalamus integrates thoughts and emo-
action potentials that stimulate blood vessels throughout the body, tions to produce ANS responses. Pleasant thoughts of a delicious
keeping them partially constricted. If the vessels constrict further, banquet initiate increased secretion by salivary glands and by

Cerebrum and Thoughts and emotions can influence

limbic system ANS functions through the hypothalamus

Hypothalamus ANS integrating center that interacts

with the cerebrum, limbic system,
brainstem, and spinal cord; also
regulates body temperature

Brainstem ANS reflex centers for controlling pupil

size, accommodation, tear production,
salivation, coughing, swallowing,
digestive activities, heart rate and force of
contraction, blood vessel diameter, and
respiration

Spinal cord ANS reflex centers for regulating

defecation, urination, penile and
clitoral erection, and ejaculation

Figure 16.8 Influence of Higher Parts of the Brain on Autonomic Functions

The hypothalamus and the cerebrum influence the ANS. Neural pathways extend from the cerebrum to the hypothalamus and from the hypothalamus to neurons of
the ANS.
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Clinical Focus Biofeedback, Meditation, and the Fight-or-Flight Response

Biofeedback takes advantage of electronic relax by learning to reduce their heart rate The fight-or-flight response occurs
instruments or other techniques to monitor or change the pattern of their brain waves. when an individual is subjected to stress,
and change subconscious activities, many The severity of some stomach ulcers, high such as a threatening, frightening, embar-
of which are regulated by the ANS. Skin blood pressure, anxiety, and depression rasing, or exciting situation. Whether a
temperature, heart rate, and brain waves may be reduced by using biofeedback person confronts or avoids a stressful situ-
are monitored electronically. By watching techniques. ation, the nervous system and the en-
the monitor and using biofeedback tech- Meditation is another technique that docrine system are involved either
niques, a person can learn how consciously influences autonomic functions. Although consciously or unconsciously. The auto-
to reduce heart rate and blood pressure and numerous claims about the value of medi- nomic part of the fight-or-flight response
regulate blood flow in the limbs. For exam- tation include improving one’s spiritual results in a general increase in sympa-
ple, people claim that they can prevent the well-being, consciousness, and holistic thetic activity, including heart rate, blood
onset of migraine headaches or reduce their view of the universe, it has been estab- pressure, sweating, and other responses,
intensity by learning to dilate blood vessels lished that meditation does influence auto- that prepare the individual for physical ac-
in the skin of their forearms and hands. In- nomic functions. Meditation techniques are tivity. The fight-or-flight response is adap-
creased blood vessel dilation increases useful in some people in reducing heart tive because it also enables the individual
skin temperature, which is correlated with a rate, blood pressure, severity of ulcers, and to resist or move away from a threatening
decrease in the severity of the migraine. other symptoms that are frequently associ- situation.
Some people use biofeedback methods to ated with stress.

glands within the stomach and increased smooth muscle contrac-

tions within the digestive system. These responses are controlled by
Functional Generalizations About
parasympathetic neurons. Emotions like anger increase blood the Autonomic Nervous System
pressure by increasing heart rate and constricting blood vessels Objective
through sympathetic stimulation. ■ Describe the generalizations that can be made about the
The enteric nervous system is involved with autonomic and ANS, and explain the limitations of these generalizations.
local reflexes that regulate the activity of the digestive tract. Auto-
nomic reflexes help control the digestive tract because sensory neu- Generalizations can be made about the function of the
rons of the enteric plexuses supply the CNS with information ANS on effector organs, but most of the generalizations have
about intestinal contents and ANS neurons to the enteric plexuses exceptions.
affect the responses of smooth muscle and glands within the diges-
tive tract wall. For example, sensory neurons detecting stretch of Stimulatory Versus Inhibitory Effects
the digestive tract wall send action potentials to the CNS. In re- Both divisions of the ANS produce stimulatory and inhibitory ef-
sponse, the CNS sends action potentials out the ANS, causing fects. For example, the parasympathetic division stimulates con-
smooth muscle in the digestive tract wall to contract. traction of the urinary bladder and inhibits the heart, causing a
The neurons of the enteric nervous system also operate inde- decrease in heart rate. The sympathetic division causes vasocon-
pendently of the CNS to produce local reflexes. A local reflex does striction by stimulating smooth muscle contraction in blood vessel
not involve the CNS, but it does produce an involuntary, uncon- walls and produces dilation of lung air passageways by inhibiting
scious, stereotypic response to a stimulus. For example, sensory smooth muscle contraction in the walls of the passageways. Thus,
neurons not connected to the CNS detect stretch of the digestive it is not true that one division of the ANS is always stimulatory and
tract wall. These sensory neurons send action potentials through the other is always inhibitory.
the enteric plexuses to motor neurons, causing smooth muscle
contraction or relaxation. See chapter 24 for more information on Dual Innervation
local reflexes.
Most organs that receive autonomic neurons are innervated by
18. Name the components of an autonomic reflex. Describe the both the parasympathetic and the sympathetic divisions (fig-
autonomic reflex that maintains blood pressure by altering ure 16.9). The gastrointestinal tract, heart, urinary bladder, and re-
heart rate or the diameter of blood vessels. productive tract are examples (see table 16.3). Dual innervation of
19. What part of the CNS stimulates ANS reflexes and integrates organs by both divisions of the ANS is not universal, however.
thoughts and emotions to produce ANS responses? Sweat glands and blood vessels, for example, are innervated by
20. Define a local reflex. Explain how the enteric nervous sympathetic neurons almost exclusively. In addition, most struc-
system operates to produce local reflexes. tures receiving dual innervation are not regulated equally by both
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Chapter 16 Autonomic Nervous System 563

Preganglionic neuron
Postganglionic neuron
Lacrimal gland Ciliary ganglion
III
Eye

Nasal Pterygopalatine
mucosa ganglion

Sublingual and
submandibular
Submandibular VII
glands
ganglion
Parotid gland IX

Otic ganglion Medulla

Sympathetic X
nerves

Spinal Trachea
cord
T1

Lung

Celiac
Heart
ganglion
Greater
splanchnic Liver
nerve Superior
mesenteric
ganglion Stomach

Adrenal Spleen
Lesser
gland
splanchnic
nerve Pancreas
L2 Small
intestine
Lumbar
Inferior Kidney
splanchnic
nerves mesenteric
ganglion Large
intestine
S2
Sacral Pelvic nerve S3
splanchnic Hypogastric S4
nerves ganglion Large intestine
Sympathetic
chain
Urinary Preganglionic neuron
system
and genitalia Postganglionic neuron

Sympathetic (Thoracolumbar) Parasympathetic (Craniosacral)

Figure 16.9 Innervation of Organs by the ANS

Preganglionic fibers are indicated by solid lines, and postganglionic fibers are indicated by dashed lines.
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564 Part 3 Integration and Control System

divisions. For example, parasympathetic innervation of the gas- neous blood vessels in a cold hand is not always associated with
trointestinal tract is more extensive and exhibits a greater influence an increased heart rate or other responses controlled by the sym-
than does sympathetic innervation. pathetic division.

Opposite Effects Functions at Rest Versus Activity

When a single structure is innervated by both autonomic divi- In cases in which both sympathetic and parasympathetic neurons
sions, the two divisions usually produce opposite effects on the innervate a single organ, the sympathetic division has a major in-
structure. As a consequence, the ANS is capable of both increasing fluence under conditions of physical activity or stress, whereas the
and decreasing the activity of the structure. In the gastrointestinal parasympathetic division tends to have a greater influence under
tract, for example, parasympathetic stimulation increases secre- resting conditions. The sympathetic division does play a major role
tion from glands, whereas sympathetic stimulation decreases se- during resting conditions, however, by maintaining blood pressure
cretion. In a few instances, however, the effect of the two divisions and body temperature.
is not clearly opposite. For example, both divisions of the ANS in- In general, the sympathetic division decreases the activity of
crease salivary secretion: the parasympathetic division initiates organs not essential for the maintenance of physical activity and
the production of a large volume of thin, watery saliva, and the shunts blood and nutrients to structures that are active during
sympathetic division causes the secretion of a small volume of vis- physical exercise. This is sometimes referred to as the fight-or-
cous saliva. flight response (see preceding Clinical Focus on “Biofeedback,
Meditation, and the Fight-or-Flight Response”). Typical responses
Cooperative Effects produced by the sympathetic division during exercise include:
One autonomic division can coordinate the activities of different 1. Increased heart rate and force of contraction increase blood
structures. For example, the parasympathetic division stimulates pressure and the movement of blood.
the pancreas to release digestive enzymes into the small intestine 2. As skeletal or cardiac muscle contracts, oxygen and nutrients
and stimulates contractions to mix the digestive enzymes with are used and waste products are produced. During exercise,
food within the small intestine. These responses enhance the diges- a decrease in oxygen and nutrients and an accumulation of
tion and absorption of the food. waste products are stimuli that cause vasodilation of muscle
Both divisions of the ANS can act together to coordinate blood vessels (see local control of blood vessels in chapter
the activity of different structures. In the male, the parasympa- 21). Vasodilation is beneficial because it increases blood
thetic division initiates erection of the penis, and the sympa- flow, bringing needed oxygen and nutrients and removing
thetic division stimulates the release of secretions from male waste products. Too much vasodilation, however, can cause
reproductive glands and helps initiate ejaculation in the male re- a decrease in blood pressure that decreases blood flow.
productive tract. Increased stimulation of skeletal muscle blood vessels by
sympathetic nerves during exercise causes vasoconstriction
General Versus Localized Effects that prevents a drop in blood pressure (see chapter 21).
The sympathetic division has a more general effect than the 3. Increased heart rate and force of contraction potentially
parasympathetic division because activation of the sympathetic di- increases blood flow through tissues. Vasoconstriction of
vision often causes secretion of both epinephrine and norepineph- blood vessels in tissues not involved in exercise, such as
rine from the adrenal medulla. These hormones circulate in the abdominopelvic organs, reduces blood flow through them,
blood and stimulate effector organs throughout the body. Because thus making more blood available for the exercising tissues.
circulating epinephrine and norepinephrine can persist for a few 4. Dilation of air passageways increases air flow into and out
minutes before being broken down, they can also produce an effect of the lungs.
for a longer time than the direct stimulation of effector organs by 5. The availability of energy sources increases. Skeletal muscle
postganglionic sympathetic axons. cells and liver cells (hepatocytes) are stimulated to break
The sympathetic division diverges more than the parasym- down glycogen to glucose. Skeletal muscle cells use the
pathetic division. Each sympathetic preganglionic neuron synapses glucose and liver cells release it into the blood for use by
with many postganglionic neurons, whereas each parasympathetic other tissues. Fat cells (adipocytes) break down triglycerides
preganglionic neuron synapses with about two postganglionic and release fatty acids into the blood, which are used as an
neurons. Consequently, stimulation of sympathetic preganglionic energy source by skeletal and cardiac muscle.
neurons can result in greater stimulation of an effector organ. 6. As exercising muscles generate heat, body temperature
Sympathetic stimulation often activates many different increases. Vasodilation of blood vessels in the skin brings
kinds of effector organs at the same time as a result of CNS stim- warm blood close to the surface, where heat is lost to the
ulation or epinephrine and norepinephrine release from the ad- environment. Sweat gland activity increases, resulting in
renal medulla. It’s possible, however, for the CNS to selectively increased sweat production, and evaporation of the sweat
activate effector organs. For example, vasoconstriction of cuta- removes additional heat.
 Seeley−Stephens−Tate: III. Integration and Control 16. Autonomic Nervous © The McGraw−Hill
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Sixth Edition

Chapter 16 Autonomic Nervous System 565

Clinical Focus Disorders of the Autonomic Nervous System

Normal function of all components of the sympathetic nerves innervating blood ves- trolling contraction of the esophagus where
ANS is not required to maintain life, as long sels. Consequently, on standing, blood it enters the stomach, therefore interrupting
as environmental conditions are constant pools in dilated blood vessels in the lower normal peristaltic contractions of the
and optimal. Abnormal autonomic func- extremities, less blood returns to the heart, esophagus. The swallowing reflex is con-
tions, however, markedly affect an individ- and the amount of blood the heart pumps trolled partly by somatic reflexes and partly
ual’s ability to respond to changing decreases. Blood pressure decreases, re- by parasympathetic reflexes. The cause of
conditions. Sympathectomy, the removal of sulting in reduced blood flow to the brain, achalasia can be abnormal parasympa-
sympathetic ganglia, demonstrates this. which causes fainting because of a lack of thetic regulation of the swallowing reflex.
The normal regulation of body temperature oxygen. The condition is aggravated by emotions.
is lost following sympathectomy. In a hot Raynaud’s disease involves the spas- Dysautonomia (dis⬘aw-tō-nō⬘mē-ă), an
environment, the ability to lose heat by in- modic contraction of blood vessels in the inherited condition involving an autosomal-
creasing blood flow to the skin and by periphery of the body, especially in the dig- recessive gene, causes reduced tear gland
sweating is decreased. When exposed to its, and results in pale, cold hands that are secretion, poor vasomotor control, trouble
the cold, the ability to reduce blood flow to prone to ulcerations and gangrene because in swallowing, and other symptoms. It is the
the skin and conserve heat is decreased. of poor circulation. This condition can be result of poorly controlled autonomic re-
Sympathectomy also results in low blood caused by exaggerated sensitivity of blood flexes.
pressure caused by dilation of peripheral vessels to sympathetic innervation. Pregan- Hirschsprung’s disease, or megaco-
blood vessels and in the inability to in- glionic denervation (cutting the pregan- lon, is caused by a functional obstruction in
crease blood pressure during periods of glionic neurons) is occasionally performed the lower colon and rectum. Ineffective
physical activity. to alleviate the condition. parasympathetic stimulation and a pre-
Orthostatic hypotension is a drop in Hyperhidrosis (hı̄ ⬘per-hı̄ -drō⬘sis), or dominance of sympathetic stimulation of
blood pressure that occurs when a person excessive sweating, is caused by exagger- the colon inhibit peristaltic contractions,
who was sitting or lying down suddenly ated sympathetic innervation of the sweat causing feces to accumulate above the in-
stands up. It is sometimes caused by disor- glands. hibited area. The resulting dilation of the
ders, such as diabetes mellitus, that de- Achalasia (ak-ă-lā⬘zē-ă ) is character- colon can be so great that surgery is re-
crease the frequency of action potentials in ized by difficulty in swallowing and in con- quired to alleviate the condition.

7. The activities of organs not essential for exercise decrease. 23. When a single organ is innervated by both ANS divisions,
For example, the process of digesting food slows as digestive do they usually produce opposite effects?
glands decrease their secretions and the contractions of 24. Explain how the ANS coordinates the activities of different
smooth muscle that mix and move food through the organs.
gastrointestinal tract decrease. 25. Which ANS division produces the most general effects? How
does this happen?
Increased activity of the parasympathetic division is gener-
26. Use the fight-or-flight response and the acronym SLUDD to
ally consistent with resting conditions. The acronym SLUDD can
describe the responses produced by the ANS.
be used to remember activities that increase as a result of parasym-
pathetic activity. SLUDD stands for salivation, lacrimation (tear P R E D I C T
production), urination, digestion, and defecation. Activities that Bethanechol (be-thanⴕĕ-kol) chloride is a drug that binds to
decrease as a result of increased parasympathetic activity are heart muscarinic receptors. Explain why this drug can be used to promote
rate, diameter of air passageways, and diameter of the pupils. emptying of the urinary bladder. Which of the following side effects
would you predict: abdominal cramps, asthmatic attack, decreased
21. What kinds of effects, excitatory or inhibitory, are produced
tear production, decreased salivation, dilation of the pupils, or
by the sympathetic and parasympathetic divisions?
sweating.
22. Give two exceptions to the generalization that organs are
innervated by both divisions of the ANS.
 Seeley−Stephens−Tate: III. Integration and Control 16. Autonomic Nervous © The McGraw−Hill
Anatomy and Physiology, Systems System Companies, 2004
Sixth Edition

566 Part 3 Integration and Control System

S U M M A R Y

Contrasting the Somatic and Autonomic 2. Parasympathetic axons reach organs through cranial nerves,
Nervous Systems (p. 548) thoracic nerve plexuses, abdominopelvic nerve plexuses, and pelvic
nerves.
1. The cell bodies of somatic neurons are located in the CNS, and their 3. Sensory neurons run alongside sympathetic and parasympathetic
axons extend to skeletal muscles, where they have an excitatory neurons within nerves and nerve plexuses.
effect that usually is controlled consciously.
2. The cell bodies of the preganglionic neurons of the ANS are located Physiology of the Autonomic Nervous System (p. 555)
in the CNS and extend to ganglia, where they synapse with
postganglionic neurons. The postganglionic axons extend to smooth
Neurotransmitters
muscle, cardiac muscle, or glands and have an excitatory or 1. Acetylcholine is released by cholinergic neurons (all preganglionic
inhibitory effect that usually is controlled unconsciously. neurons, all parasympathetic postganglionic neurons, and some
sympathetic postganglionic neurons).
Anatomy of the Autonomic Nervous System (p. 549) 2. Norepinephrine is released by adrenergic neurons (most
Sympathetic Division sympathetic postganglionic neurons).
1. Preganglionic cell bodies are in the lateral horns of the spinal cord Receptors
gray matter from T1–L2.
1. Acetylcholine binds to nicotinic receptors (found in all
2. Preganglionic axons pass through the ventral roots to the white rami
postganglionic neurons) and muscarinic receptors (found in all
communicantes to the sympathetic chain ganglia. From there, four
parasympathetic and some sympathetic effector organs).
courses are possible.
2. Norepinephrine and epinephrine binds to alpha and beta receptors
• Preganglionic axons synapse (at the same or a different level) with
(found in most sympathetic effector organs).
postganglionic neurons, which exit the ganglia through the gray
3. Activation of nicotinic receptors is excitatory, whereas activation of
rami communicantes and enter spinal nerves.
the alpha and beta receptors are either excitatory or inhibitory.
• Preganglionic axons synapse (at the same or a different level) with
4. The main subtypes for alpha receptors are ␣1- and ␣2-adrenergic
postganglionic neurons, which exit the ganglia through
receptors, and for beta receptors are ␤1- and ␤2-adrenergic
sympathetic nerves.
receptors.
• Preganglionic axons pass through the chain ganglia without
synapsing to form splanchnic nerves. Preganglionic axons then Regulation of the Autonomic Nervous System (p. 559)
synapse with postganglionic neurons in collateral ganglia.
• Preganglionic axons synapse with the cells of the adrenal medulla. 1. Autonomic reflexes control most of the activity of visceral organs,
glands, and blood vessels.
Parasympathetic Division 2. Autonomic reflex activity can be influenced by the hypothalamus
and higher brain centers.
1. Preganglionic cell bodies are in nuclei in the brainstem or the lateral
3. The sympathetic and parasympathetic divisions can influence the
parts of the spinal cord gray matter from S2–S4.
activities of the enteric nervous system through autonomic reflexes.
• Preganglionic axons from the brain pass to ganglia through cranial
The enteric nervous system can function independently of the CNS
nerves.
through local reflexes.
• Preganglionic axons from the sacral region pass through the pelvic
nerves to the ganglia. Functional Generalizations About the Autonomic
2. Preganglionic axons pass to terminal ganglia within the wall of or Nervous System (p. 562)
near the organ that is innervated.
1. Both divisions of the ANS produce stimulatory and inhibitory
Enteric Nervous System effects.
1. The enteric nerve plexus is within the wall of the digestive tract. 2. Most organs are innervated by both divisions. Usually each division
2. The enteric plexus consists of sensory neurons, ANS motor neurons, produces an opposite effect on a given organ.
and enteric neurons. 3. Either division alone or both working together can coordinate the
activities of different structures.
The Distribution of Autonomic Nerve Fibers 4. The sympathetic division produces more generalized effects than
the parasympathetic division.
1. Sympathetic axons reach organs through spinal nerves, head and 5. Sympathetic activity generally prepares the body for physical
neck nerve plexuses, thoracic nerve plexuses, and abdominopelvic activity, whereas parasympathetic activity is more important for
nerve plexuses. vegetative functions.
 Seeley−Stephens−Tate: III. Integration and Control 16. Autonomic Nervous © The McGraw−Hill
Anatomy and Physiology, Systems System Companies, 2004
Sixth Edition

Chapter 16 Autonomic Nervous System 567

R E V I E W A N D C O M P R E H E N S I O N

1. Given these statements: 7. Which of the following statements regarding the adrenal gland is
1. neuron cell bodies in the nuclei of cranial nerves true?
2. neuron cell bodies in the lateral gray matter of the spinal cord a. The parasympathetic division stimulates the adrenal gland to
(S2–S4) release acetylcholine.
3. two synapses between the CNS and effector organs b. The parasympathetic division stimulates the adrenal gland to
4. regulates smooth muscle release epinephrine.
Which of the statements are true for the autonomic nervous system? c. The sympathetic division stimulates the adrenal gland to release
a. 1,3 acetylcholine.
b. 2,4 d. The sympathetic division stimulates the adrenal gland to release
c. 1,2,3 epinephrine.
d. 2,3,4 8. The parasympathetic division
e. 1,2,3,4 a. is also called the craniosacral division.
2. Given these structures: b. has preganglionic axons in cranial nerves.
1. gray ramus communicans c. has preganglionic axons in pelvic nerves.
2. white ramus communicans d. has ganglia near or in the wall of effector organs.
3. sympathetic chain ganglion e. all of the above.
Choose the arrangement that lists the structures in the order an 9. Which of these is not a part of the enteric nervous system?
action potential passes through them from a spinal nerve to an a. ANS motor neurons
effector organ. b. neurons located only in the digestive tract
a. 1,2,3 c. sensory neurons
b. 1,3,2 d. somatic neurons
c. 2,1,3 10. Sympathetic axons reach organs through all of the following
d. 2,3,1 except
e. 3,2,1 a. abdominopelvic nerve plexuses.
3. Given these structures: b. head and neck nerve plexuses.
1. collateral ganglion c. thoracic nerve plexuses.
2. sympathetic chain ganglion d. pelvic nerves.
3. white ramus communicans e. spinal nerves.
4. splanchnic nerve 11. Which of these cranial nerves does not contain parasympathetic
Choose the arrangement that lists the structures in the order an fibers?
action potential travels through them on the way from a spinal a. oculomotor (III)
nerve to an effector organ. b. facial (VII)
a. 1,3,2,4 c. glossopharyngeal (IX)
b. 1,4,2,3 d. trigeminal (V)
c. 3,1,4,2 e. vagus (X)
d. 3,2,4,1 12. Which of the following statements concerning the preganglionic
e. 4,3,1,2 neurons of the ANS is true?
4. The white ramus communicans contains a. All parasympathetic preganglionic neurons secrete acetylcholine.
a. preganglionic sympathetic fibers. b. Only parasympathetic preganglionic neurons secrete
b. postganglionic sympathetic fibers. acetylcholine.
c. preganglionic parasympathetic fibers. c. All sympathetic preganglionic neurons secrete norepinephrine.
d. postganglionic parasympathetic fibers. d. Only sympathetic preganglionic neurons secrete
norepinephrine.
5. The cell bodies of the postganglionic neurons of the sympathetic
division are located in the 13. A cholinergic neuron
a. sympathetic chain ganglia. a. secretes acetylcholine.
b. collateral ganglia. b. has receptors for acetylcholine.
c. terminal ganglia. c. secretes norepinephrine.
d. dorsal root ganglia. d. has receptors for norepinephrine.
e. both a and b. e. secretes both acetylcholine and norepinephrine.
6. Splanchnic nerves 14. When acetylcholine binds to nicotinic receptors,
a. are part of the parasympathetic division. a. the cell’s response is mediated by G proteins.
b. have preganglionic neurons that synapse in the collateral b. the response can be excitatory or inhibitory.
ganglia. c. Na⫹ channels open.
c. exit from the cervical region of the spinal cord. d. it occurs at the effector organ.
d. travel from the spinal cord to the sympathetic chain ganglia. e. all of the above.
e. all of the above.
 Seeley−Stephens−Tate: III. Integration and Control 16. Autonomic Nervous © The McGraw−Hill
Anatomy and Physiology, Systems System Companies, 2004
Sixth Edition

568 Part 3 Integration and Control System

15. Nicotinic receptors are located in 18. A sudden increase in blood pressure
a. postganglionic neurons of the parasympathetic division. a. initiates a sympathetic reflex that decreases heart rate.
b. postganglionic neurons of the sympathetic division. b. initiates a local reflex that decreases heart rate.
c. membranes of skeletal muscle cells. c. initiates a parasympathetic reflex that decreases heart rate.
d. both a and b. d. both a and b.
e. all of the above. e. both b and c.
16. The activation of ␣1- and ␤1-adrenergic receptors 19. Which of these structures is innervated almost exclusively by the
a. generally produces a stimulatory response. sympathetic division?
b. generally produces an inhibitory response. a. gastrointestinal tract
c. most commonly occurs when epinephrine from the adrenal b. heart
glands binds to them. c. urinary bladder
d. occurs when acetylcholine binds to them. d. reproductive tract
17. The sympathetic division e. blood vessels
a. is always stimulatory. 20. Which of these is expected if the sympathetic division is activated?
b. is always inhibitory. a. Secretion of watery saliva increases.
c. is usually under conscious control. b. Tear production increases.
d. generally opposes the actions of the parasympathetic c. Air passageways dilate.
division. d. Glucose release from the liver decreases.
e. both a and c. e. All of the above.
Answers in Appendix F

C R I T I C A L T H I N K I N G

1. When a person is startled or sees a “pleasurable” object, the pupils of salivation, dilation of the pupils, sweating, and difficulty in taking a
the eyes may dilate. What division of the ANS is involved in this deep breath?
reaction? Describe the nerve pathway involved. 6. A patient has been exposed to the organophosphate pesticide
2. Reduced secretion from salivary and lacrimal glands could indicate malathion, which inactivates acetylcholinesterase. Which of the
damage to what nerve? following symptoms would you predict: blurring of vision, excess
3. In a patient with Raynaud’s disease, blood vessels in the skin of the tear formation, frequent or involuntary urination, pallor (pale skin),
hand may become chronically constricted, thereby reducing blood muscle twitching, or cramps? Would atropine be an effective drug to
flow and producing gangrene. These vessels are supplied by nerves treat the symptoms (see p. 559 for the action of atropine)? Explain.
that originate at levels T2 and T3 of the spinal cord and eventually 7. Epinephrine is routinely mixed with local anesthetic solutions. Why?
exit through the first thoracic and inferior cervical sympathetic 8. A drug blocks the effect of the sympathetic division on the heart.
ganglia. Surgical treatment for Raynaud’s disease severs this nerve Careful investigation reveals that after administration of the drug,
supply. At which of the following locations would you recommend normal action potentials are produced in the sympathetic
that the cut be made: white rami of T2–T3, gray rami of T2–T3, preganglionic and postganglionic neurons. Also, injection of
spinal nerves T2–T3, or spinal nerves C1–T1? Explain. norepinephrine produces a normal response in the heart. Explain, in
4. Patients with diabetes mellitus can develop autonomic neuropathy, as many ways as you can, the mode of action of the unknown drug.
which is damage to parts of the autonomic nerves. Given the 9. A drug is known to decrease heart rate. After cutting the white rami
following parts of the ANS—vagus nerve, splanchnic nerve, pelvic of T1–T4, the drug still causes heart rate to decline. After cutting the
nerve, cranial nerve, outflow of gray ramus—match the part with vagus nerves, the drug no longer affects heart rate. Which division of
the symptom it would produce if the part were damaged: the ANS does the drug affect? Does the drug have its effect at the
a. impotence synapse between preganglionic and postganglionic neurons, at the
b. subnormal sweat production synapse between postganglionic neurons and effector organs, or in
c. gastric atony and delayed emptying of the stomach the CNS? Is the effect of the drug excitatory or inhibitory?
d. diminished pupil reaction (constriction) to light
e. bladder paralysis with urinary retention 10. Make a list of the responses controlled by the ANS in (a) a person
who is extremely angry and (b) a person who has just finished
5. Explain why methacholine, a drug that acts like acetylcholine, is eating and is relaxing.
effective for treating tachycardia (heart rate faster than normal).
Which of the following side effects would you predict: increased Answers in Appendix G
 Seeley−Stephens−Tate: III. Integration and Control 16. Autonomic Nervous © The McGraw−Hill
Anatomy and Physiology, Systems System Companies, 2004
Sixth Edition

Chapter 16 Autonomic Nervous System 569

A N S W E R S T O P R E D I C T Q U E S T I O N S

1. Terminal ganglia are found near or embedded within the wall of 4. The low dose of epinephrine stimulates ␤2 receptors and causes
organs supplied by the parasympathetic division and contribute to vasodilation. Although the large dose also stimulates ␤2 receptors, it
the enteric nervous system. Postganglionic parasympathetic axons stimulates so many ␣1 receptors that the vasoconstriction effect
from the terminal ganglia also contribute to the enteric nervous dominates the vasodilation effect.
system. Chain ganglia and collateral ganglia contain the cell bodies
5. The frequency of action potentials in sympathetic neurons to the
of sympathetic neurons. They are not embedded within the walls of
sweat glands increases as the body temperature increases. The
organs supplied by the sympathetic division. Instead, postganglionic
increasing body temperature is detected by the hypothalamus,
neurons extend from them to organs. Thus, postganglionic
which activates the sympathetic neurons. Sweating cools the body by
sympathetic axons are found in the enteric nervous system.
evaporation. As the body temperature declines, the frequency of
2. For a sensory axon running alongside sympathetic axons, the action potentials in sympathetic neurons to the sweat glands
sensory axon leaves the wall of the small intestine, joins the superior decreases. A lack of sweating helps prevent heat loss from the body.
mesenteric plexus, and passes through the superior mesenteric
6. In response to an increase in blood pressure, information is
ganglion and from there through a splanchnic nerve to a
transmitted in the form of action potentials along sensory neurons
sympathetic chain ganglion. From the sympathetic chain ganglion
to the medulla oblongata. From the medulla oblongata, the
the sensory axon passes through a white ramus communicans, the
frequency of action potentials delivered along sympathetic nerve
ventral rami of a spinal nerve, a spinal nerve, the dorsal root of a
fibers to blood vessels decreases. As a result, blood vessels dilate,
spinal nerve, to a dorsal root ganglion. For a sensory axon running
causing the blood pressure to decrease.
alongside parasympathetic axons, the sensory axon leaves the wall of
In response to a decrease in blood pressure, fewer action
the small intestine, joins the superior mesenteric plexus, and passes
potentials are transmitted along sensory neurons to the medulla
to the esophageal plexus. From there, the sensory axon passes
oblongata, which responds by increasing the frequency of action
through a vagus nerve to its sensory ganglion.
potentials delivered along sympathetic nerves to blood vessels. As a
3. Nicotinic receptors are located within the autonomic ganglia as result, blood vessels constrict, causing blood pressure to increase.
components of the membranes of the postganglionic neurons of the
7. The parasympathetic division releases acetylcholine, which binds to
sympathetic and parasympathetic divisions. Nicotine binds to the
muscarinic receptors on organs. Bethanechol chloride produces
nicotinic receptors of the postganglionic neurons, resulting in action
effects similar to stimulation of organs by the parasympathetic
potentials. Consequently, the postganglionic neurons stimulate their
division. Thus, this drug should stimulate the urinary bladder to
effector organs. After consumption of nicotine, structures innervated
contract. Side effects can be produced by stimulation of muscarinic
by both the sympathetic and parasympathetic divisions are affected.
receptors elsewhere in the body. Stimulation of smooth muscle in
After the consumption of muscarine, only the effector organs
the digestive tract can produce abdominal cramps. Stimulation of
that respond to acetylcholine are affected. This includes all the
air passageways can cause an asthmatic attack. Decreased tear
effector organs innervated by the parasympathetic division, and the
production, salivation, and dilation of the pupils are not expected
sweat glands, which are innervated by the sympathetic division.
side effects because parasympathetic stimulation causes increased
tear production, salivation, and constriction of the pupils. Sweat
glands are innervated by the sympathetic division but have
muscarinic receptors. Bethanechol chloride can increase sweating.

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