Autonomic Nervous SystemSystemThe Sympathetic Division

The Autonomic Nervous System

Regulates activity of: y Smooth muscle y Cardiac muscle y Certain glands Activity expressed y Regulation of BP, body temperature y Cardio-respiratory rate y Gastro-intestinal motility y Glandular secretions Sensations General Hunger , thirst , nausea y y Special -- Smell, taste and visceral pain
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Comparison of Somatic Motor and Autonomic Motor Innervations

Features

Somatic Motor Innervation

Skeletal muscle tissue

Autonomic Motor Innervation

Cardiac muscle tissue, smooth muscle tissue, and glandular epithelium Cell bodies of postganglionic autonomic neurons located in paravertebral, prevertebral, and terminal ganglia Two

Effector organs (target sites)

Presence of ganglia

No ganglia

Number of neurons from CNS to effector organs Structure of neuromuscular junction

One

Motor end plates

No specialization of postsynaptic membrane; all areas of smooth muscle fibers contain receptor proteins for neurotransmitters

Effect of action potentials on muscle fibers Type of nerve fibers

Excitatory only Fast-conducting, thick and myelinated (913 )

Either excitatory or inhibitory Slow-conducting; preganglionic fibers lightly myelinated but thin (3 ); postganglionic fibers unmyelinated and very thin (about 1.0 )

Effect of denervation (temporary or permanent )

Flaccid paralysis and atrophy

Minimal effect on muscle tone and function; target tissues show denervation hypersensitivity

TYPICAL SPINAL NERVE

Autonomic and Somatic Motor Systems

Divisions of the Autonomic Nervous System

y

Sympathetic fight, flight, or fright

Activated during exercise, excitement, and emergencies

Parasympathetic rest and digest

Concerned with conserving energy
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Anatomical Differences in Sympathetic and Parasympathetic Divisions

Issue from different regions of the CNS

Sympathetic also called the thoracolumbar division Parasympathetic also called the craniosacral division
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SYMPATHEIC PATHWAY

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PARASYMPATHEITC PATHWAY

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DIFFERENCES
Action

SYMPATHETIC
Prepares body for emergency

PARASYMPATHETIC
Conserves and restores energy

Outflow

T1-L2 (3)

Cranial nerves III, VII, IX, and X; S24

Preganglionic fibers

Myelinated

Myelinated

Ganglia

Paravertebral (sympathetic trunks), prevertebral (e.g., celiac, superior mesenteric, inferior mesenteric)

Small ganglia close to viscera (e.g., otic, ciliary) or ganglion cells in plexuses (e.g., cardiac, pulmonary)

Neurotransmitter within ganglia Neurotransmitter at postganglionic endings

Acetylcholine

Acetylcholine

Norepinephrine at most endings and acetylcholine at few endings (sweat glands, salivary glands, vasodilatory fibers of skeletal muscles)

Acetylcholine at all endings

Characteristic activity

Widespread due to many postganglionic fibers and liberation of epinephrine and norepinephrine from suprarenal medulla Hypothalamus

Discrete action with few postganglionic fibers Hypothalamus

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Higher control

Sympathetic trunk (lateral ganglia)

Paravertebral in position Extend from base of skull to coccyx Both trunk unite to form ganglion impar Preganglionic fibers from the lateral grey horn T 1-L 2 Total Ganglia Cervical-3 Thoracic-11 Lumbar-4 Sacral-4

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Preganglionic fibres (white rami): Thinly myelinated; reach ganglia; terminate y Synapse in corresponding ganglia y Ascend or descend along symp. trunk and synapse accordingly y Pass uninterrupted through symp. trunk & synapse with collateral or terminal ganglia

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Postganglionic fibres: Nonmyelinated From sympathetic ganglia : y Pass back to corresponding spinal nerve via grey rami y Pass via medial branches to supply deeply placed viscera y Some ascend/descend and join grey rami/medial branches

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Subsidiary Ganglia
Collateral ganglia Unpaired, not segmentally arranged Occur only in abdomen and pelvis Lie anterior to the vertebral column ExamplesCoeliac Superior mesenteric Inferior mesenteric Aortico-renal Sup.hypogastric plexus Terminal ganglia Chromaffin cells of suprarenal glands
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Sympathetic Trunk Ganglia

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Sympathetic Division of the ANS

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Sympathetic Pathways to Periphery

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Sympathetic Pathways to the Head

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Sympathetic Pathways to Thoracic Organs

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Sympathetic Pathways to the Abdominal Organs

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Sympathetic Pathways to the Pelvic Organs

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The Role of the Adrenal Medulla in the Sympathetic Division

Major organ of the sympathetic nervous system y Secretes great quantities epinephrine (a little norepinephrine) y Stimulated to secrete by preganglionic sympathetic fibers
y

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The Adrenal Medulla

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Effects of Autonomic Nervous System on Organs of the Body

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ORGAN
Eye Pupil Ciliary muscle Glands Lacrimal, parotid, sublingual, submandibular, nasal Sweat Heart Cardiac muscle Coronary arteries (mainly controlled by local metabolic factors) Lung Bronchial muscle Bronchial secretion Bronchial arteries Muscle in walls Gastrointestinal tract Muscle in sphincters Glands Liver Gallbladder

SYMPATHETIC
Dilates Relaxes Reduce secretion Increases secretion Increases force of contraction Dilates (beta receptors), constricts (alpha receptors) Relaxes (dilates bronchi) Increases secretion Constricts Decreases peristalsis Contracts Reduces secretion Breaks down glycogen into glucose Relaxes

PARASYMPATHETIC
Constricts Contracts Increase secretion

Decreases force of contraction

Contracts (constricts bronchi)

Dilates Increases peristalsis Relaxes Increases secretion

Contracts

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Kidney

Decreases output

Bladder wall (detrusor) Urinary bladder Sphincter vesicae Erectile tissue of penis and clitoris Ejaculation

Relaxes Contracts

Contracts Relaxes Relaxes, causes erection

Contracts smooth muscle of vas deferens, seminal vesicles, and prostate

Systemic arteries
Skin Abdominal Muscle Arrector pili muscles Constrict Constrict Constrict (alpha receptors), dilate (beta receptors), dilate (cholinergic) Contract

Suprarenal
Cortex Medulla Stimulates Liberates epinephrine and norepinephrine

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ADRENERGIC RECEPTORS

Alpha a1
Vessels

Beta a2 1
Heart

2
Eye Lungs Gut Liver Pancreas Coronaries

Vessels

Pre-ganglionic- a2 Post- ganglionic- a1, 1, 2

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CHOLINERGIC RECEPTORS

Nicotinic
N1 Neuronal N2 NMJ

Muscarinic

M1 LES

M2 Heart

M3-M5 Smooth muscles & glands

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DRUGS ACTING ON AUTONOMIC NERVOUS SYSTEM

Adrenergic Drugs
Catecholamines - Adr , Nor-adr, DA Non- catechol - Phenylephrine, Clonidine Indirectly acting - Tyramine, Amphetamines Mixed - Ephedrine
Directly

acting

Anti-Adrenergic Drugs

Reversible

Selective- Prazocin,Yohimbine Non-selective- Phentolamine

Irreversible - Phenoxybenzamine

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Cholinergic drugs Directly acting Acetylcholine Pilocarpine Indirectly Acting (Anticholinesterase) Neostigmine Parathion

Anticholinergic drugs Natural Atropine Semi-synthetic Ipratropium Synthetic Dicyclomine

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Visceral Sensory Neurons

y

General visceral sensory neurons monitor:

Stretch, temperature, chemical changes, and irritation

Cell bodies are located in the dorsal root ganglia y Visceral pain perceived to be somatic in origin
y

Referred pain
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A Map of Referred Pain

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Visceral Reflexes
y

Visceral sensory and autonomic neurons participate in visceral reflex arcs Defecation reflex Micturition reflex

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Visceral Reflex Arc

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Central Control of the ANS

y y

y y

Hypothalamus -- regarded as a higher nervous centre for control of lower autonomic centres in brain stem and spinal cord. Stimulation of the hypothalamus Anterior part- parasympathetic responses Posterior part- sympathetic responses. Lower brainstem centers such as vasopressor, vasodilator, cardioaccelerator, cardiodecelerator and respiratory centres have been found in the reticular formation. Levels of control are exerted as the result of interconnections of the different regions by ascending and descending pathways. Stimulation of different parts of the cerebral cortex and the limbic system produces autonomic effects, it is brought about through the hypothalamus.
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Disorders of the Autonomic Nervous System

Autonomic disorders with brain involvement Parkinsons with autonomic failure Cardiac arrythmias Seizures partial complex Autonomic with spinal cord involvement Traumatic tetraplegia Tetanus Autonomic neuropathies Guillain- Barre syndrome Diabetic neuropathy
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Raynauds disease characterized by constriction of blood vessels Provoked by exposure to cold or by emotional stress

Hypertension Can result from overactive sympathetic vasoconstriction.

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Primary Hyperhidrosis Excessive sweating of palms and soles. Reflex Sympathetic Dystrophy- Regional pain after tissue trauma.e.g. MI

Achalasia of the cardia Defect in the autonomic innervation of the esophagus

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