NEUROANATOMY
1D Autonomic Nervous System
Dr. Antonio T. Parong Jr.
Autonomic Nervous System
 Cells of the ANS located in both the central and peripheral
nervous systems, innervate smooth muscles, cardiac
muscles, and glands
 perform their functions below the conscious levels
Functional components of autonomic nervous system:
1. Sympathetic NS - “fight or flight”
2. Parasympathetic NS- “digest and rest”
3. Enteric NS- “overseeing the digestive process”
 usually treated as a motor system—the general visceral
efferent(GVE) system and possess afferent components
 two neurons are required to effect a contraction of
smooth muscle or cardiac muscle, or to elicit secretion
from the cell of a gland
 cell body of the first neuron is in the Central Nervous
System
 cell body of the second neuron is in a ganglion in the
peripheral nervous system
 postganglionic neuron (postsynaptic neuron) -
second nerve cell body resides in an autonomic
ganglion
 preganglionic neuron (presynaptic neuron) - first
neuron in this two neuron chain
 preganglionic fiber - axon of the preganglionic
neuron, myelinated and it synapses with the
postganglionic neuron’s soma
 postganglionic fiber - axon of the postganglionic
neuron, is not myelinated
 Somatic sensory ganglia do not have synapses,
whereas synapses do occur in autonomic ganglia
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 may be stated that the length of preganglionic and
postganglionic fibers differ in that in the sympathetic
nervous system the preganglionic fibers are short and
the postganglionic fibers are long
 parasympathetic nervous system the opposite is
usually true, in that the preganglionic parasympathetic
fibers are long and the postganglionic parasympathetic
fibers are usually short
Anatomy of the ANS
 Efferent neurons
 carries nerve impulses from the CNS to the
effector organs by way of two types of efferent
neurons
A. preganglionic neurons
B. postganglionic neurons
Preganglionic neuron -cell body of the first nerve cellis
located within the CNS
 emerge from the brainstem or spinal cord and make a
synaptic connection in ganglia (an aggregation of
nerve cell bodies located in the peripheral nervous
system)
 ganglia function as relay stations between the
preganglionic neuron and the second nerve cell, the
postganglionic neuron
Postganglionic neuron- cell body of the postganglionic
neuron originates in the ganglion
 generally nonmyelinated and terminates on effector
organs, such as smooth muscles of the viscera,
cardiac muscle, and the exocrine glands
 Afferent neurons
 important in the reflex regulation of this system (for
example, by sensing pressure in the carotid sinus and
 Neuro AUTONOMIC NERVOUS SYSTEM
Aefferent branch of the system to respond
aortic arch) and in signaling the CNS to influence the
Characteristic of Autonomic Nervous System
 Under unconscious, involuntary control
 Control is generally shared with the endocrine system
 Used to respond to the internal environment
 Relevant sensory input primarily derived from
interoreceptors = visceroreceptors
 Primary responses are activities by effectors to deal
with maintaining homeostasis in the internal
environment
 Effectors are smooth muscle tissues, cardiac muscle,
exocrine glands and endocrine gland
 Origin of the visceral motor commands may come from
the limbic system of the cerebrum, the diencephalon,
or the brain stem
 visceral motor neuron (the ANS preganglionic neuron)
cell body typically resides in the brain stem or the
ventral/anterior horn of a spinal cord segment and its
axon extends to a peripheral autonomic ganglion
where it synapes with a second visceral motor neuron
(the ANS postganglionic neuron) whose axon then
extends the remaining distance to the visceral effector
(a two cell motor pathway)
 visceral motor neurons may be cholinergic, or
adrenergic, i.e., they release the neurotransmitter
norepinephrine [Note: all ANS parasympathetic
preganglionic and postganglionic neurons are
cholinergic; all ANS sympathetic preganglionic
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neurons are cholinergic; the majority of ANS
sympathetic postganglionic neurons are adrenergic,
but a minority are cholinergic
 neurotransmitters acetyl choline and norepinephrine
can act to stimulate/excite or to suppress/inhibit the
effector because different effector cells possess
different types of acetyl choline and norepinephrine
receptors (excitatory neurotransmitter-gated sodium
ion channels or inhibitory neurotransmitter-gated
potassium or chloride ion channels)
 almost all visceral effectors receive a dual innervation,
i.e., any one visceral effector cell is 'hard-wired" to both
a parasympathetic postganglionic neuron and a
sympathetic postganglionic neuron
NEUROTRANSMITTERS
 neurotransmitter substance at the parasympathetic
preganglionic and postganglionic and sympathetic
preganglionic synapse is acetylcholine
 sympathetic postganglionic synapse it is
norepinephrine (noradrenaline)
 only exception to this rule is that the postganglionic
sympathetic fibers serving the eccrine sweat glands
release acetylcholine
 primary neurotransmitter, co-transmitters are also
usually releasedfibers of the sensory (or afferent)
limb of the sympathetic and parasympathetic
 their cell bodies (unipolar/pseudounipolar) are located
in the sensory ganglia of the cranial and spinal nerves
Somatic nervous system/SNS/Voluntary Nervous
System
 part of the peripheral nervous system associated with
the voluntary control of body movements via
skeletal muscles
 consists of afferent nerves or sensory nerves, and
efferent nerves or motor nerves
 cell body of the lower motoneuron is located in the
ventral horn of the spinal cord
 axon of that neuron leaves the spinal cord via the
ventral rootlets and passes directly to the muscle fibers
it is destined to innervate
 only a single neuron is required to relay the signal for
muscle contraction.
 Neuro AUTONOMIC NERVOUS SYSTEM

A Relevant sensory input primarily derived from
exteroreceptors and proprioreceptors
 Primary responses are actions by effectors to deal with
changing circumstances in the external environment
 Effectors are skeletal muscles
 origin of the somatic motor commands may come from
the cerebral cortex, the diencephalon, the brain stem
or the cerebellum
 somatic motor neuron cell body typically resides in the
brain stem or the ventral/anterior horn of a spinal cord
segment and its axon extends the entire distance to the
skeletal muscle effector (a one cell motor pathway)
 somatic motor neurons are cholinergic, i.e., they
release the neurotransmitter acetyl choline
 neurotransmitter acetylcholine always acts to
stimulate/excite the effector (the skeletal muscle at the
neuromuscular junction) because skeletal muscle cells
all possess the same type of acetyl choline receptors
(acetyl choline-gated sodium ion channels)
 skeletal muscles receive a single innervation, i.e., any
one skeletal muscle cell is 'hard-wired" to just one
somatic motor neuron

SYMPATHETIC NERVOUS SYSTEM

 also known as the thoracolumbar outflow

 soma of the preganglionic neurons of the sympathetic
nervous system are located in the lateral cell column of
spinal cord levels T1 to L2,3
 axons of these neurons exit the vertebral canal in the
ventral root of the spinal nerve at the levels of their
origin
 cell bodies of the postganglionic sympathetic neurons
reside in the sympathetic chain ganglia
(paravertebral ganglia located on either side of the
vertebral column)
 pelvic ganglia, the preaortic ganglia, and the small
renal ganglia
 bilaterally symmetric sympathetic chain ganglia, also
Characteristics of Somatic Nervous System called the paravertebral ganglia, are located just
 Primarily under conscious, voluntary control ventral and lateral to the spinal cord. The chain extends
from the upper neck down to the coccyx, forming the
 Control is not shared with the endocrine system
unpaired coccygeal ganglion
 Primarily used to respond to the external environment

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 Neuro AUTONOMIC NERVOUS SYSTEM
A synapse in one of the prevertebral sympathetic chain ganglia,
Preganglionic fibers and paravertebral ganglia
of the sympathetic nervous system
Preganglionic fibers (preganglionic efferent axons)
 enter the spinal nerve via the ventral rootlets; they
subsequently leave the spinal nerve via 14 pairs of
small branches, known as white rami
communicantes (white because the axons are
myelinated) to reach one of the sympathetic chain
ganglia
Once preganglionic sympathetic fibers have entered the chain
ganglion they have one of three options:
1. To form synapses with postganglionic, sympathetic soma in
the chain ganglion at the level of entry.
2. To proceed superiorly or inferiorly in the sympathetic chain
and synapse in a ganglion above or below the point of entry.
This may be as far superiorly as the cervical level or as far
inferiorly as the sacral level.
3. To pass through the chain ganglion without synapsing in any
of the paravertebral ganglia, joining with other preganglionic
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fibers to form the greater, lesser, or least splanchnic nerves to
specifically the pelvic, renal, or preaortic ganglia.
The paravertebral ganglia in the neck fuse to form three ganglia:
 largest of which is the superior cervical ganglion
 smaller middle cervical ganglion
 smallest inferior cervical ganglion
 Inferior cervical ganglion fuses with the first thoracic
sympathetic chain ganglion to form the enlarged stellate
ganglion.
 Caudal-most ganglia of the right and left paravertebral
chains fuse with each other in the coccygeal region, thus
forming the unpaired ganglion impar.
Sympathetic neurons:
The efferent ANS is divided into the sympathetic and the
parasympathetic nervous systems, as well as the enteric
nervous system.
Anatomically, the sympathetic and the parasympathetic neurons
originate in the CNS and emerge from two different spinal cord
regions. The preganglionic neurons of the sympathetic system
come from the thoracic and lumbar regions (T1 to L2) of the
spinal cord, and they synapse in two cord-like chains of ganglia
that run close to and in parallel on each side of the spinal cord.
The preganglionic neurons are short in comparison to the
postganglionic ones. Axons of the postganglionic neuron extend
from these ganglia to the tissues that they innervate and
regulate.
In most cases, the preganglionic nerve endings of the
sympathetic nervous system are highly branched, enabling one
preganglionic neuron to interact with many postganglionic
neurons. This arrangement enables this division to activate
numerous effector organs at the same time.
SYMPATHETIC NEURONS
Efferent ANS is composed of
 Sympathetic nervous system
 Parasympathetic nervous system
 Enteric nervous system
 sympathetic and the parasympathetic neurons originate in
the CNS and emerge from two different spinal cord regions
 Neuro AUTONOMIC NERVOUS SYSTEM

A the thoracic and lumbar regions (T1 to L2) of the spinal
preganglionic neurons of the sympathetic system come
from
cord, and they synapse in two cord-like chains of ganglia
that run close to and in parallel on each side of the spinal
cord
 preganglionic neurons are short in comparison to the
postganglionic ones. Axons of the postganglionic neuron
extend from these ganglia to the tissues that they innervate
and regulate.
 preganglionic nerve endings of the sympathetic nervous
system are highly branched, enabling one preganglionic
neuron to interact with many postganglionic neurons
 arrangement enables this division to activate numerous
effector organs at the same time
[Note: The adrenal medulla, like the sympathetic ganglia, receives
preganglionic fibers from the sympathetic system. The adrenal medulla,
in response to stimulation by the ganglionic neurotransmitter
acetylcholine, secretes epinephrine (adrenaline), and lesser amounts of
norepinephrine, directly into the blood.]
Distribution of the postganglionic fibers of the sympathetic
nervous system
 Postganglionic fibers (axons of the postganglionic soma)
arise from the sympathetic chain ganglia and are distributed
as branches to the spinal nerves or cranial nerves, or they
may travel wrapped around arteries, or they may proceed
directly to specific organs or to autonomic plexuses.
1. Branches to spinal nerves re-enter the spinal nerve through
connections known as gray rami communicantes (gray
because the postganglionic axons are unmyelinated). Unlike
white rami communicantes, there are 31 pairs of gray rami
communicantes, one for each spinal nerve. The postganglionic
sympathetic fibers are distributed with the cutaneous branches
of the spinal nerves, reaching the sweat glands, arrector pili
muscles, and smooth muscles of peripheral blood vessels.
2. Branches to cranial nerves may reach the cranial nerves
directly, namely, the glossopharyngeal (CN IX), vagus (CN X),
and hypoglossal (CN XII) nerves or they may follow blood
vessels until they are in the vicinity of the cranial nerve that they
use to reach their final destination.
3. Branches wrapped around arteries travel with these
vessels, such as the internal and external carotid arteries and
the vertebral artery. There are numerous other arteries that
possess postganglionic sympathetic fibers in their tunicae
adventitia and they are discussed below.
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4. Branches proceeding directly to specific organs may travel
on arteries, in nerves, or through plexuses, but they travel on
their own, at least for a while. These include postganglionic
sympathetic fibers destined for the eyes and the heart.
5. Branches that proceed to autonomic plexuses possess
either postganglionic or preganglionic fibers, depending on the
plexus. Those that serve the heart, lungs, and pelvis are
probably postganglionic, whereas those that are destined for the
abdominal plexuses are preganglionic sympathetic fibers
destined for the postganglionic soma in the walls of the organ to
be innervated. The greater, lesser, and least splanchnic
nerves are the major nerve fibers that contain preganglionic
sympathetic axons destined for the abdominal plexuses.
CEPHALIC REGION OF THE SYMPATHETIC NERVOUS
SYSTEM
 composed only of postganglionic sympathetic fibers
whose cell bodies are located in the superior cervical
ganglia
 primarily associated with the tunica adventitia of blood
vessels passing from the neck into the head, are named
according to their vessel of association or by their location,
or by the localized region that they serve
INTERNAL CAROTID NERVES
 composed of postganglionic sympathetic fibers derived
from the superior cervical ganglion
 travel with the internal carotid arteries as two separate
plexuses, the internal carotid plexus and the cavernous
plexus
INTERNAL CAROTID PLEXUS
 travels on the lateral aspect of the artery and has the
following branches:
 Branches communicating with cranial nerve V
(trigeminal nerve) and cranial nerve VI(abducent
nerve).
 deep petrosal nerve: this pierces the cartilage of the
foramen lacerum and accompanies the greater
petrosal nerve as the two nerves enter the pterygoid
canal to form the nerve of the pterygoid canal (vidian
canal).
 caroticotympanic nerves: these are small fibers that
are destined to serve regions of the middle ear
CAVERNOUS PLEXUS
 travels on the medial aspect of the artery and has the
following branches
 Branches communicating with cranial nerve IV
(trochlear nerve) and cranial nerve V1 (ophthalmic
division of the trigeminal nerve)
 Branches destined for the dilator pupillae muscle of
the iris
 Branches serving the vessels of the pituitary gland,
brain, meninges, and orbit.
EXTERNAL CAROTID NERVES
 composed of postganglionic sympathetic fibers derived
from the superior cervical ganglion, travel with the external
 Neuro AUTONOMIC NERVOUS SYSTEM

theAfollowing:
carotid artery and its branches in the head. These include
 Nerve fibers that follow the facial artery: these travel to
and serve the submandibular gland and, using the
lingual nerve, reach and serve the sublingual gland.
 Nerve fibers that travel on branches of the facial and
superficial temporal arteries, serving them as well as
arrector pili muscles and sweat glands of the facial
region.
 The small deep petrosal nerve: this leaves the middle
meningeal artery to pass through (without synapsing
in) the otic ganglion. It joins the auriculotemporal nerve
and serves the parotid gland
CERVICAL REGION OF THE SYMPATHETIC NERVOUS
SYSTEM
 composed of the superior, middle, and inferior
sympathetic cervical ganglia as well as the sympathetic
cord that connects them to each other
 superior cervical ganglion is the largest sympathetic
ganglion in the neck. is located deep to the carotid sheath,
at the level of the atlas
 Branches traveling with cranial nerves IX,X, and XII
 Branches traveling with the first four cervical nerves
 Four to six pharyngeal branches that form the
pharyngeal plexus in unison with cranial nerves IX and
X level of the chain ganglia or in a sympathetic ganglion
 Intercarotid plexus that proceeds to the carotid sinus
and carotid body to innervate the smooth muscle of the
regional blood vessels
 Superior cardiac nerves of the right and left side:
these join the cardiac plexus and innervate the cardiac
muscle of the heart. They function in concert with the
middle and inferior cardiac nerves to accelerate the
rate of heart beat
MIDDLE CERVICAL GANGLION
 smallest of the ganglia, has an inconstant location and is
occasionally absent
Branches arising from the middle cervical ganglion are those
that join the cervical spinal nerves, the middle cervical nerve,
and the thyroid nerves:
 Gray rami communicantes to the fifth and sixth cervical
nerves that are distributed with the branches of these
cervical nerves
 middle cardiac nerve/ great cardiac nerve: this
communicates with the superior cardiac nerve to join
the cardiac plexus. It functions, in concert with the
superior and inferior cardiac nerves, to accelerate the
rate of the heart beat
 thyroid nerves: these travel on the tunica adventitia of
the inferior thyroid artery to reach and supply
the thyroid gland
 sympathetic cord connecting the middle and inferior
cervical ganglia. This is usually split into an anterior
and a posterior portion; the anterior portion passes
around the subclavian artery, forming a loop—the ansa
subclavia
INFERIOR CERVICAL GANGLION
 located at the level of the transverse process of the 7th
cervical vertebra
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branches arising from the inferior cervical ganglion are the
ones that join the cervical spinal nerves, the inferior cardiac
nerves, and the vertebral nerve:
 Gray rami communicantes to cervical spinal nerves 6–
8: these are distributed with the branches of these
cervical nerves
 Inferior cardiac nerves: these join the cardiac plexus
and function, in concert with the superior and middle
cardiac nerves, to accelerate the rate of heart beat
 Vertebral nerve: this travels on the tunica adventitia of
the vertebral artery and serves it as well as its
intracranial branches with vasomotor function
 inferior cervical and first thoracic ganglia frequently fuse to
form the stellate ganglion. This fused ganglion fulfills all the
functions of the inferior cervical ganglion and also gives rise
to the gray rami communicantes of spinal nerves T1 and T2
THORACIC REGION OF THE SYMPATHETIC
NERVOUS SYSTEM
 only region with white rami communicantes. White rami
communicantes are connections between the thoracic
spinal nerves and the thoracic chain ganglia
 carry preganglionic sympathetic fibers from the lateral
column of the spinal cord, which enter each thoracic
sympathetic ganglion to synapse with postganglionic
sympathetic soma residing in a sympathetic ganglion at any
located elsewhere in the body
 Branches arising from the thoracic sympathetic ganglia are
the gray rami communicantes, the visceral branches, and
the splanchnic nerves
 gray rami communicantes arise from each thoracic
ganglion to unite with their associated thoracic spinal nerve,
carrying postganglionic sympathetic fibers that will be
distributed with the branches of the spinal nerve
VISCERAL BRANCHES
 composed of postganglionic sympathetic fibers that are
distributed to plexuses on or in the vicinity of the heart,
esophagus, lungs, and aorta:
 Cardiac branches arise from the first through fifth
thoracic ganglia and are destined for the cardiac
plexus. They mix with fibers from the superior, middle,
and inferior cardiac nerves. They also function in
accelerating the rate of the heart beat
 Esophageal branches arise from many of the thoracic
ganglia and serve to modify the function of the enteric
nervous system.
 Fibers destined for the pulmonary plexus arise from the
second through fourth thoracic ganglia and enter the
hilum of the lung. They serve the blood vessels of the
lung as well as the bronchial musculature.
 The aortic plexus is served by fibers arising from the
fifth to tenth (or eleventh) thoracic ganglia. These fibers
distribute with the branches of the aorta and probably
function to modulate the enteric nervous system
SPLANCHNIC NERVES
 composed of mostly myelinated preganglionic sympathetic
fibers (as well as large myelinated visceral afferent fibers
bringing information from the viscera), because they have
 Neuro AUTONOMIC NERVOUS SYSTEM
A the ganglia on their way to the preaortic ganglia.
not synapsed in the chain ganglia; instead they passed
through
CN IX (Glossopharyngeal), and
CN X (Vagus)
b. sacral region (S2 to S4) of the spina(l cord and synapse
There are three splanchnic nerves: the greater, lesser, and least in ganglia near or on the effector organs. Three spinal
splanchnic nerves nerves in the sacrum (S2-4), commonly referred to as
a. GREATER SPLANCHNIC NERVES the pelvic splanchnic nerves, also act as
 formed into a single trunk from preganglionic parasympathetic nerves.
sympathetic fibers that pass through the fifth The vagus nerve accounts for 90% of preganglionic
to ninth thoracic ganglia, penetrate the crus of parasympathetic fibers in the body. Postganglionic neurons
the diaphragm to synapse in the celiac from this nerve innervate most of the organs in the thoracic
ganglion (and splanchnic ganglion, if and abdominal cavity.
present). Some fibers continue through the
celiac ganglion without synapsing, and  sympathetic system, the preganglionic fibers are long, and
continue to the suprarenal gland medullaand the postganglionic ones are short, with the ganglia close to
synapse there on chromaffin cells. or within the organ innervated. In most instances, there is a
b. LESSER SPLANCHNIC NERVE one-to-one connection between the preganglionic and
 formed into a single trunk from preganglionic postganglionic neurons, enabling discrete response of this
sympathetic fibers that pass through the tenth system.
and eleventh thoracic ganglia, penetrates the
crus of the diaphragm and synapses in the
aorticorenal ganglion.
c. LEAST SPLANCHNIC NERVE
 formed from preganglionic sympathetic fibers
that pass through the twelfth thoracic
ganglion, passes through the diaphragm and
synapses in the renal plexus.

ABDOMINOLUMBAR REGION OF THE SYMPATHETIC

NERVOUS SYSTEM

 composed of two to six ganglia and the intervening trunk.

Branches of the abdominolumbar trunk are composed of gray
rami communicantes, lumbar splanchnic nerves, and branches
of the celiac ganglion:
 Gray rami communicantes in the lumbar area are
somewhat longer than those of the thoracic region.
They join the spinal nerves to be distributed with them
to innervate the smooth muscle of blood vessels as
well as the glands and arrector pili of the skin
 Lumbar splanchninc nerves, preganglionic
sympathetic fibers that are located caudal to the least
splanchnic nerve, synapse in the inferior mesenteric
ganglion.
 Branches of the celiac ganglion are postganglionic
sympathetic fibers that follow the aorta and its
branches and form a large plexus of nerve fibers, the
celiac plexus.

PARASYMPATHETIC NERVOUS SYSTEM CRANIAL PORTION OF THE PARASYMPATHETIC

 Called the “rest and digest” system, the parasympathetic
system conserves energy as it slows the heart rate, sexual
arousal, increases intestinal and gland activity, and relaxes
sphincter muscles in the gastrointestinal tract.
Functions of the parasympathetic nervous system is SLUDD
(salivation, lacrimation, urination, digestion, and defecation)
The Nerve fibers of the parasympathetic nervous system
(preganglionic) arise from the central nervous system:
a. Specific nerves include
CN III (Oculomotor)
CN VII (Facial),
NERVOUS SYSTEM
 travel with four cranial nerves, the oculomotor, facial,
glossopharyngeal, and vagus nerves.
OCULOMOTOR NERVE (CN III)
 Edinger–Westphal nucleus houses preganglionic
parasympathetic soma whose axons travel in the
branches of cranial nerve III.
 When these preganglionic fibers reach the orbit they
synapse with postganglionic parasympathetic soma in
the ciliary ganglion (the parasympathetic ganglion of
the oculomotor nerve)
 postganglionic parasympathetic fibers, known as the
short ciliary nerves, exit the ciliary ganglion, pierce the

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 Neuro AUTONOMIC NERVOUS SYSTEM

Amuscle, which constricts the pupils
orb (eyeball) to innervate the sphincter pupillae Postganglionic parasympathetic soma along the
gastrointestinal tract extending from the esophagus to
 innervate the muscles of the ciliary body, which the end of the transverse colon. These postganglionic
function in accommodating the lens of the eye when parasympathetic cell bodies are housed in Meissner’s
focusing on nearby objects. submucosal and Auerbach’s myenteric plexus
(ganglia) located within the wall of the alimentary canal.
FACIAL NERVE (CN VII) Moreover, many of the preganglionic parasympathetic
 lacrima land superior salivatory nuclei of the brainstem axons synapse with the intrinsic soma of the enteric
house the preganglionic parasympathetic soma associated nervous system. Parasympathetic activity facilitates
with cranial nerve VII the digestive process and relaxes sphincter muscles.
 Preganglionic parasympathetic fibers from the lacrimal
nucleus reach the pterygopalatine ganglion (a
parasympathetic ganglion of the facial nerve) where they
synapse with postganglionic parasympathetic soma.
 Postganglionic parasympathetic fibers leave the ganglion
and serve the lacrimal gland, eliciting the production of
tears, as well as glands in the nasal mucosa, eliciting the
production of mucus.
 Preganglionic parasympathetic fibers from the superior
salivatory nucleus proceed to the submandibular ganglion
where they synapse with postganglionic parasympathetic
soma.
 Postganglionic parasympathetic fibers leave the ganglion to
innervate the submandibular and sublingual glands,
eliciting the flow of saliva.

GLOSSOPHARYNGEAL NERVE (CN IX)

 inferior salivatory nucleus (nucleus of the glossopharyngeal
nerve) of the brainstem houses the preganglionic
parasympathetic cell bodies associated with cranial nerve
IX.
 Preganglionic parasympathetic fibers from this nucleus
reach the otic ganglion to synapse with postganglionic
parasympathetic soma
 postganglionic parasympathetic fibers leave the ganglion to
innervate the parotid gland as well as minor salivary glands
in the oral mucosa, eliciting the flow of saliva.
VAGUS NERVE (CN X)
 nucleus ambiguus and the dorsal motor nucleus of the
vagus nerve house the preganglionic parasympathetic
soma associated with cranial nerve X.
 Preganglionic parasympathetic nerve fibers from the
nucleus ambigus synapse with postganglionic
parasympathetic soma located in the cardiac ganglia
distributed around the great vessels of the heart.
 Postganglionic parasympathetic axons leave the ganglia
and innervate the sinoatrial (SA) node. Additionally these
fibers also serve occasional atrial and ventricular cardiac
muscle fibers. The parasympathetic nervous system
decreases the rate of the heart beat.
Preganglionic parasympathetic nerve fibers from the dorsal
motor nucleus of the vagus synapse with the following
soma:
 Postganglionic parasympathetic soma located in
ganglia surrounding the bronchial passages.
Postganglionic parasympathetic fibers derived from
these ganglia serve to elicit bronchioconstriction.
 Postganglionic parasympathetic soma located in
the vicinity of the pancreas. Postganglionic
parasympathetic fibers derived from these ganglia
serve to elicit the release of pancreatic enzymes and
buffer.
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SACRAL PORTION OF THE PARASYMPATHETIC
NERVOUS SYSTEM
 lateral cell column of the second to fourth segments of the
sacral spinal cord houses the preganglionic
parasympathetic cell bodies composing the sacral division
of the parasympathetic nervous system.
 preganglionic axons join their corresponding spinal nerves
and travel to the pelvic plexus and to scattered small
ganglia in the vicinity of the pelvic organs, where they
synapse with the enteric nervous system and with
postganglionic cell bodies of the parasympathetic ganglia.
 Postganglionic parasympathetic fibers from the pelvic
plexus and the additional small ganglia serve the urinary
bladder, penis, prostate, and seminal vesicles in the male
as well as the bladder, uterus, clitoris, and vagina in the
female.
 bladder, prostate, and seminal vesicles receive their motor
innervation from the small ganglia in their vicinity, except for
the sphincter muscle controlling the bladder, which is
inhibited by the parasympathetic nervous system.
 uterus and vagina receive inhibitory postganglionic
parasympathetic fibers via the uterovaginal plexus.
Although in the pregnant female the same fibers are
believed to have excitatory roles.
 external genitalia of the male and the clitoris of the female
receive postganglionic parasympathetic fibers from the
pelvic plexus via the pudendal nerve; these fibers are
responsible for dilation of the cavernous blood sinuses
resulting in the erection of the penis and clitoris.
 Neuro AUTONOMIC NERVOUS SYSTEM
A ENTERIC NERVOUS SYSTEM
ENTERIC NEURONS
 a collection of nerve fibers that innervate the
gastrointestinal (GI) tract, pancreas, and gallbladder, and it
constitutes the “brain of the gut.”
 functions independently of the CNS and controls the
motility, exocrine and endocrine secretions, and
microcirculation of the GI tract. It is modulated by both the
sympathetic and parasympathetic nervous systems.
 Meissner’s submucosal plexus and Auerbach’s myenteric
plexus house the intrinsic components of the enteric
nervous system. The neurons and neuroglial cells of the
enteric nervous system originate from neural crest cells.
Meissner’s submucosal plexus
 located in the submucosa at its interface with the
inner circular layer of the muscularis externa. It is
responsible for peristalsis and global, rather than
local, actions
Auerbach’s myenteric plexus
 located between the inner circular and outer
longitudinal layers of the muscularis externa.
Auerbach’s plexus
 responsible for localized phenomena and for
movement of, and glandular secretions from, the
mucosa.
Two sets of plexuses interact with the sympathetic and
parasympathetic nervous systems as well as with each other
and function together to ensure that the alimentary canal
performs its functions properly.
 Extrinsic components
o the sympathetic and parasympathetic fibers
that modulate the functioning of the intrinsic
components
o Parasympathetic innervation facilitates
digestion by increasing peristalsis and
relaxing sphincters.
o Vigorous activity from the sympathetic
innervation slows down peristalsis and
increases sphincter muscle tonus.
 Intrinsic components
o regulate much of the digestive processes by
innervating the smooth muscles, glands, as
well as the diffuse neuroendocrine system
(DNES) cells residing in the epithelial lining of
the alimentary canal
o There are at least 20 different types of DNES
cells and each releases a specific paracrine
hormone (although many of these hormones
also enter the bloodstream to remote target
cells). These hormones act in concert to
regulate much of the digestive process.
NEUROTRANSMITTERS AND RECEPTORS OF THE
AUTONOMIC NERVOUS SYSTEM
Two primary neurotransmitters are acetylcholine and
norepinephrine, it is customary to speak of cholinergic and
adrenergic divisions of the autonomic nervous system.
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Preganglionic and postganglionic parasympathetic neurons,
preganglionic sympathetic neurons, and those postglanglionic
sympathetic neurons that innervate eccrine sweat glands are all
cholinergic. All other postganglionic sympathetic neurons are
adrenergic.
AUTONOMIC RECEPTORS
Autonomic receptors are classified as cholinergic or
adrenergic(noradrenergic), based on their ability to bind and
to be activated by acetylcholine or norepinephrine, respectively.
CHOLINERGIC RECEPTORS
Two types of cholinergic receptors:
a. MUSCARINIC RECEPTORS - activated by muscarine,
a toxin derived from toadstools. Muscarinic receptors
are located in the membranes of cells synapsing with
postganglionic parasympathetic fibers and in the
membranes of eccrine sweat glands (innervated by
postganglionic sympathetic fibers).
b. NICOTINIC RECEPTORS - activated by nicotine.
Nicotinic receptors are located in the membranes of
postganglionic sympathetic and postganglionic
parasympathetic soma where they synapse with their
preganglionic counterparts. They are also located in
the sarcolemma of the myoneural junctions of skeletal
muscle cells.
It is important to note that nicotine will not activate muscarinic
receptors and muscarine will not activate nicotinic receptors, but
both types will be activated by acetylcholine.
ADRENERGIC RECEPTORS
Two types of adrenergic receptors,
a. ALPHA ADRENERGIC RECEPTORS- activated by
epinephrine than by norepinephrine and are least
activated by isoproterenol. Alpha receptors are located
in the plasma membranes of vascular smooth muscle
cells, dilatator pupillae muscle cells, and soma of
enteric neurons controlling sphincter muscle
contraction.
b. BETA ADRENERGIC RECEPTORS- responsive to
isoproterenol than to epinephrine and are least
activated by norepinephrine.Beta receptors are located
in the plasma membranes of cardiac muscle cells,
bronchiolar smooth muscle cells, and soma of enteric
neurons that facilitate peristaltic activity of the
alimentary canal.
PELVIC AUTONOMIC FUNCTIONS
 somatic and autonomic nervous systems interact with each
other to perform numerous functions, among them those
that control urination, defecation, and erection and
ejaculation.
Urine retention and urination
 require the interaction of the sympathetic,
parasympathetic, and somatic motor nervous systems
and are controlled by the cerebral cortex and pons
 urinary bladder distends, nociceptors and stretch
receptors in its wall transmit the information to the
dorsal horn of the spinal cord
Neuro AUTONOMIC NERVOUS SYSTEM

Aneurons whose cell bodies are located in the dorsal
afferent nerves are unipolar (pseudounipolar) peristaltic action of the sigmoid colon, and the
intra-abdominal pressure created by contraction of
root ganglia. the anterior abdominal wall musculature
 volume of urine in the bladder is low, the skeletal cooperate in expelling the feces from the sigmoid
muscles of the external sphincter undergo reflex colon and the rectum through the anus.
contraction in response to stimulation by axons of
somatic motoneurons whose cell bodies are located in Erection and ejaculation
the Onuf nucleus (ventral horn of spinal cord levels  Erection of the penis and of the clitoris is an autonomic
S2–S4). Cell bodies of the motor neurons in the Onuf function initiated by tactile or psychogenic stimulation
nucleus are activated by projections from the pons and and mediated by parasympathetic innervation derived
cerebral cortex from sacral spinal cord levels.
 smooth muscle cells of the internal sphincter also  parasympathetic fibers are responsible for
undergo reflex contraction and the detrusor engorgement of the spongy tissue of the penis and
muscles, smooth muscles located in the wall of the clitoris as well as of the vascular channels of the labia
urinary bladder, undergo reflex relaxation, due to the minora, and cause the release of secretions from the
activities of preganglionic sympathetic innervation from vaginal glands, lubricating the vagina.
the intermediate cell column at spinal cord levels T12  preganglionic sympathetic fibers from spinal cord
to S2. levels T10 to L2 synapse on postganglionic
 process of urination is facilitated by the micturition sympathetic nerve cell bodies housed in the inferior
centers located in the cerebral cortex and the pons. As mesenteric ganglion. Postganglionic sympathetic
the bladder distends and the urine volume reaches a fibers from that ganglion are responsible in females for
threshold level, sensory information reaches the rhythmic contractions of the vagina and uterus, and in
ventral posterolateral (VPL)nucleus of the thalamus males for the release of secretions from the prostate
traveling via the medial lemniscal pathway, the dorsal gland and seminal vesicles as well as for ejaculation.
column, and the anterolateral column. The information
is transmitted by tertiary neurons from the thalamus to
the postcentral sulcus and the individual becomes
conscious of the need to urinate.
 individual is ready to void the retentive reflexes
described above become inhibited, thus the internal
and external sphincters relax. Additionally, projections
from the pons activate the preganglionic
parasympathetic neurons in the lateral horn of spinal
cord levels S2–S4, whose post-ganglioic counterparts
stimulate the detrusor muscles of the bladder to
undergo contraction, thus emptying the urinary
bladder.

Defecation
 feces accumulate, the sigmoid colon distends and
the individual becomes conscious of the need to
defecate, but the feces are retained in the colon by
the two sphincter muscles, the internal smooth
muscle sphincter, is supplied by postganglionic
sympathetic fibers from the hypogastric plexus as
well as by postganglionic parasympathetic fibers
located in Auerbach’s plexus (whose
preganglionic fibers arise from the sacral spinal
cord)
 external skeletal muscle sphincter, is supplied by
the somatic nervous system, namely the inferior
rectal nerve.
 when the sigmoid colon becomes distended, the
internal sphincter muscle relaxes (due to the
parasympathetic nerve supply) and at the same
time the external sphincter muscle contracts,
preventing the feces from exiting the bowel
 While the individual is asleep, this contraction of
the external sphincter muscle is a reflex response.
When the individual is awake, the contraction of
the external sphincter is a voluntary response.
When the individual is ready to defecate, the
voluntary relaxation of the external sphincter, the

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