NERVOUS SYSTEM: Autonomic Nervous sytem and
Cranial Nerves
I. Introduction
A. The 2 main Pathways for Autonomic
Nervous System
1. General Visceral Motor (Efferent)
Neurons
2. General Visceral Sensory (Afferent)
Neurons
― The entire system is involuntary.
― Some degree of cerebral control is possible during
times of extreme fear and anxiety
― Modern biofeedback methods have achieved some
control in trained individuals.
II. Differences between the Autonomic and Somatic
A. Somatic Nervous System
― Motor activity is always excitatory: muscles
at rest are signaled to perform specific task
― Sensory input is Conscious
― There is only one neuron between the control
nervous system and a given effector making
for a very, very long cell in some cases.
B. Autonomic Nervous System
― Motor activity is either excitatory or
inhibitory
― Sensory input is generally unconscious,
although extremes of sensation may be
consciously perceived
― There are 2 neurons between the CNS and an
effector organ, with a synapse in the
paraspinal ganglian
III. Divisions of Autonomic Nervous System
A. Parasympathetic System
― promotes rest, recovery, and relaxation and
promoted energy observation
― it is an inhibitory pathway
― it is mediated by acetylcholine at the end
organ
― it has a craniosacral orogin in the CNS
― there is very little divergence (1:3) at the
ganglia
B. Sympathetic System
― promotes fright, fight and flight
― excitatory pathway
― mediated by norepinephrine at the effector
organ
― has thoracolumbar origin in the CNS
― there is extreme divergence (1:20) at the
ganglia
― stimulates adrenal glands which excite
effector organs in the entire body
IV. Comparative Functions of the Sympathetic and
Parasympathetic NS
A. Sympathetic System
― pupils dilate
― heart rate and force of contraction increase
― Clinical Application: Accidental injection
of adrenaline (epinephrine), into the
bloodstream, causes not only physical
excitation but also extreme terror in the
patient.
― Blood glucose levels rise
― Respiratory effort increases in rate and depth
― Blood is shunted away from non-essential
organs
― Blood is shunted to the skeletal; muscles,
myocardium, liver(for making glucose and
fatty acids)
― The GI tract is slowed down or stopped
― Adrenal medulla is stimulated to release
epinephrine and norepinephrine.
 Norepinephrine is the chemical
mediator at the junction between the
Somatic Nervous System axon and
the target organ
B. Parasympathetic
― Pupils cpnstrict
― Heart rate and force of contraction disease
― Blood glucose levels fall
― Repiratory effort decreases in rate and depth
― GI tract resumes normal function: it is ready
for digestion and absorption
― Paradoxical parasympathetic fear reactions
include involuntary defecation and urination
V. Introduction to Cranial Nerves
― There are 12 pairs of cranial nerves
― 10 of these pairs originate in the brain stem and exit
the cranium through openings called foramina (s:
foramen)
― Mixed nerves contain sensory and motor fibers
― Sensory nerves contain only sensory fibers
― Both viscera and somatic fibers are represented
― Motor neurons originate within the brain itself
 In regard to the cranial nerves, both
of these mptor fibers are represented
by viscera and somatic.
CRANIAL NERVES
1. Olfactory (I)
2. Optic (II)
3. Oculomotor (III)
4. Trochlear (IV)
5. Trigominal (V)
6. Abducens (VI)
7. Facial (VII)
8. Vestibulocochlear (VIII)
9. Glossopharyngeal (IX)
10. Vagus (X)
11. Accessory (XI)
12. Hypoglossal (XII)
URINARY SYSTEM
― Composed of kidneys, ureters, bladders and urethra
― URETERS: conduits to the bladder from the kidney;
convey wastes from kidney to bladder
― BLADDER: stores urine and wastes until a
conventional time for disposal; stores wastes until
excretion
― has functions not related to waste elimination and
recycling
― FUNCTIONS: maintaining blood volume, normal
blood pressure, normal blood composition and normal
body and blood Ph, AS WLL AS SYNTHESIZING
 CARCITRIOL AND SECRETING
ERYTHROPOIETIN
― KIDNEYS: are paired organs lying to the right and
left of dpinal column
― Retroperitoneal
― Both supplied by one blood vessel (an end II. Exocrine Pancreas components and functions
vessel) with no collated circulation
― Necessary organs
― Acute (short term)
― Chronic (long term)
― Filter out wastes and recycle needed
elements
― NEPHRON: kidney’s major functioning unit;
composed of renal corpuscle, a renal tubule, and
collecting ducts
― Their primary function is to maintain homeostasis
― They filter and excrete wastes, solutes and toxins and
absorb water, electrolytes and buffer
― They recycle necessary elements and maintain normal
blood volume, blood pressure and buffer
― Synthesize calcitriol and erythropoietin which
stimulates production of red blood cells
― Word beginning referring to kidneys include –renal
& nephron-
― They are protected by the ribs and thick back muscles
― Renal Cortex: outer layer
― Renal Medulla: inner layer
― The latter consists of 10-15 medullary pyramids
― The medial tip of the renal pyramid is the RENAL
PAPILLA
― RENAL PELVIS: composed of calyces (calyx=cup),
minor calyces and major calyces
― RENAL HILUS: only entry way for the vessels and
ureter. It faces the medial side of the kidney
― Vascular supply
― Renal Arteries: one to each kidney, coming directly
from aorta
― Renal Veins: draining directly to the inferior vena
cava
NEPHRON
― Renal Corpuscle: composed of an afferent arteriole,
the glomerulus (little ball) and an efferent arteriole
― Renal Tubule and Collecting Ducts: composed of
peritubular cappilaries, the vasa recta, and the renal
tubule
― The microstructures include the
proximal convoluted tubule (PCT), the
loop of Henle (Nephron loop), the distal
tubule (DCT), the collecting ducts, and
the juxtaglomerular apparatus
― The afferent arteriole is larger than the efferent
― Glomerulus: is a group of capillaries covered in a
double layer (visceral and parietal) of epithelium
called Bowman’s Capsule
― Bowman’s Capsule: blood runs across and into the
convoluted tubule
― Proximal Convoluted Tubule: lined with blood
vessel that reabsorb nutrients from it and excrete
wastes into it
― Juxtamedullary: extend deep into the medulla and
have longer of Henle than normal nephrons and fine-
tune blood composition
DIGESTIVE SYSTEM: Pancreas, Liver, Biliary Tree
I. Small intestine
― Primary processes of digestion and absorption
occur. However these functions depend heavily
on the digestive juices and hormones secreted by
the pancreas and the liver.
A. Pancreatic Juice
― Produces 1000-1500 ml/day
― Consists mainly of water NACl (sodium chloride
or salt) and NaHCO3 (sodium bicarbonate)
― Sodium bicarbonate buffers the juice and makes
it alkaline (Ph 1.1-8.2)
― Alkalinity stops the action of gastric pepsin and
prepares chime for the milieu of the small
intestine
B. Pancreatic Hormones
1. Amylase
― Digests the remaining carbohydrates into
simpler sugars.
― Released into the blood in cases of
pancreatitis
― Acts on 3 main sugars: these sugars
composed of other, simpler sugar molecules.
a. Maltose: acted on by maltase and
broken down into molecules of glucose
b. Sucrose: acted on by sucrose and
broken down into glucose and fructose
c. Lactose: is acted on by lactase and
broken down into glucose and galactose.
2. Trypsin, Chymotrypsin, and elastase
― All digest proteins
3. Lipase
― Digests triglycerides into fatty acids and
monoglycerides
C. Physiological Considerations
― Almost all pancreatic enzymes are secreted in
an inactive form to prevent autodigestion
(pancreas literally means “eats all flesh”)
― Inactive forms end in -gen such as trypsinogen
― In severe pamcreatitis, activated enzymes may
travel back into the pancreas and digest it
― Acinar cells also contain a trypsin inhibitor
that inactivates any active trypsin accidentally
released in the pancreatic tissues
― Enterokinase : from small intestine activates
the enzymes once they are in the safe confines
of the small intestine)
III. Basic Pancreatic function
― Chemical production
― Food consists of generally complex molecules that
are broken down into simple molecules and
reassembled into necessary compounds by the
pancreas, liver, and other organs
― The body has evolved to favor molecules with
similar structures.
1. for example, the cyclopentanophenanthrene ring structure
is common to cholesterol, estradiol, testosterone and
cortisol
2. the only differences between these compounds are one or
two groups attached to the outside of a ring structure
3. these compounds have enormously different functions in
the body
-- the body can replace a particular missing compound by
modifying the creation process of a similar compound
IV. Regulation of Pancreatic secretion
― Parasympathetic stimulation to the pancreas (via the
vagus nerve) occurs in response to the digestive
processes of the stomach
― It stimulates the secretion of all pancreatic enzymes
― This is a preparation respose
― The acid chime enters the duodenum, along with
partially digested fats, proteins and carbohydrates.
― Enteroendocrine cells of the small intestine release
cholecystokinin (CCK) and secretin
― These 2 enzymes circulate into bloodstream
― These enzymes stimulate secretion of pancreatic
enzymes into the small intestine and raise the Ph
― SECRETIN DECREASES GASTRIC SECRETION
― CKK INHIBITS GASTRIC EMPTYING
V. What can go wrong?
― Pancreatitis
― Cancer of the pancreas
― The causes of the rising incidence of pancreatic cancer
are not known, though this disorder is linked to
smoking
― There are some 25000 cases per year with 95%
mortality
VI. Liver
― portal circulation is the place of absorption and excretion
of the liver
― liver has a reserve capacity of some 50-80%
― liver is one of the few human organs that can regenerate
itself. Though it grows faster than any known cancer,
regeneration does not become malignant, and the liver
will stop growth at approximately its normal size.
― It is a vital organ, without it the organism will die
within days
VII. functions of liver
1. protein metabolism
― the liver synthesizes proteins.
― It makes almost all prothrombin & fibrinogen (clotting
factors_, as well as albumin, the major blood protein.
― it also converts forms of amino acids when needed for
specific proteins
― it converts toxic ammonia (from amino acid
conversions) into less toxic urea (excreted)
― it uses amino acids and proteins for energy production
or storage as fats and carbohydrates
2. Carbohydrate Metabolism
― the liver is the storehouse of carbohydrates as
glycogen(glycogenesis) and lipids (lipogenesis)
― it can rapidly breakdown large amounts of
carbohydrates and release it as glucose into
bloodstream
― it can create glucose from lactic acid (gluconeogenesis)
3. lipid (fat) Metabolism
― the liver can store fats in various forms
― it can break down and release stored fat extraordinary
needs
― it synthesizes cholesterol from fatty acids and vice
versa
― current therapy for high cholesterol uses stain drugs to
block hepatocyte ,mechanisms for cholesterol synthesis
4. excretion of Bilirubin
― Bilirubin: removes broken down pigments from dead
red blood cells
― It is metabolized with bile salts and excreted in the
feces
― In obstructive jaundice, bilirubin is not excreted,
producimg clay-colored feces
5. Processing of hormones and Drugs
― The liver detoxifies drugs and alcohol
― It can be up or downregulated to meet demand
― It excretes toxins into bile and hence into the intestine
for excretion
― It alters the molecular structures of hormones to
deactivate them
6. Storage Depot
― The liver stores all the fat-soluble vitamins (A, B12, D,
E and K)
― It stores iron and copper
― The liver stores fat under stress or damage, too much
storage of fat, iron, or copper can damage liver cells
7. vitamin D activation
8. Synthesis of bile salts: the bile salts emulsify fats to
make them more water-soluble and easier to absorb.
Endocrine System
I. Introduction
A. Exocrine Glands
― Ex-"out"; Krinein-"to secrete"
― Are glands that secrete into ducts (digestive
part;salivary glands; pancreas) which in turn carry
the secretions out of the glands and into the lumens
of certain body cavities.
B. Endocrine Glands
― Endo-"within"
― Glands that are secrete into the spaces around the
cells and whose product are picked up and circulated
by the bloodstream
― Includes some organs that are wholly endocrine
function---this includes PITUITARY GLAND,
THYROID GLAND, PARATHYROID GLAND,
ADRENAL GLANDS, PINEAL GLAND
― Functions: Pancreas, ovaries, lover, stomach,
hypothalamus of brain, small intestine, kidneys,
testes and placenta ---COMPOUND
GLANDS/ORGANS
II. Differences between the functions controlled by the
Nervous System and Endocrine System
― Both system: Coordinate functions of the body
system and are mutually interconnected
A. Endocrine System
 ― Releases chemical messengers called HORMONES
(hormon-"urge on") which act on other organs in all
parts of the body.
― Some hormones promoteor inhibit nerve impulses
― Others such as Epinephrine and norepinephrine may
be neurotransmitters themselves
― These hormones act as hormone in other places
rather than neurotransmitters
― Hormones may take SECONDS, MINUTES,
HOURS to work their effects
― their duration of action may be short- or long-lived
― Hormones regulate GROWTH, REPRODUCTION,
METABOLISM
B.Nervous System
― Signalling system
― Acts by tge generation of nerv impulses to stimulate
or inhibit effector organs
― May stimulate the release or inhibition of hormones
themselves from endocrine organs
― Nerve impulses have their effect in
MILLISECONDS
― Effects are also short-lived
― Nerve impulses primarily cause muscle contraction
and the secretion of fluida by certain glands
III. Endocrine Gland Location
― HYPOTHALAMUS, PITUITARY
GLAND,PINEAL GLAND-- Brain
― Thyroid Gland: Neck with 4 parathyroid gland
behind
― Thymus- Chest
― Adrenal (Suprarenal): lie atop the Kidneys
― Stomach, ovaries, testes: Abdominal Cavity and
lower also have endocrine Functions
IV: General Properties of Hormones
― Each of the 50+ hormones affects only a few cell,
though they may reach all the cells of the body via
the BLOODSTREAM
WHAT ACCOUNTS FOr SELECTIVITY
― Targetcells contain highly specific receptors, which
are surface glycoproteins.
― the geometry of molecules allows only for very
specific hormones to attach to the receptor in the
target cell surface.
― Down Regulation: Each target cell has up to 100,000
receptors for a certain hormone. When there is an
axcess of hormone, the number of receptors
decreases, reducing sensitivity.
― Up Regulation: If a low number of hormone
molecules are circulating, the number of receptor
increase, raising the level of sensitivity
― Paracrine Hormones (para- "near" : act on cells next
to the secreting cells without entering bloodstream
― Autocrine Hormones (auto- "self") : act on the cells
that secreted them. Cancer cells use autocrine siging
to trigger growth
V. Pituitary Gland and Hypothalamus
A. Pituitary
― 1cm in diameter
― Lies in the SELA TURCICA ("Turkish Saddle") at
the base if the brain, directlt behind the optic chiasm
― Also called HYPOPHYSIS
― Master Gland
― Controlled all other endocrine glands
― Divided into 2 embryologically and functionally
different parts (Anterior Pituitary and Posterior
Pituitary)
B. Hypothalamus
― Controls the pituitary gland
― Integrates many messages from parts of the brain
and tells pituitary what to do.
#Together, they regulate all processes having to do with
PRIMITIVE REACTIONS (stress,rage,flight,body
temperature,thirst,hunger,sexual activity,survival)
#Between them, the hypothalamus and pineal gland secrete
16 hormones
1. ANTERIOR Pituitary Gland
― Called adenohypophysis
― Makes up 75% of pituitary gland
― PORTAL BLOOD CAPILLARY SYSTEM:
Connects hypothalamus and pituitary before they are
diluted eith blood in larger vessels
― Evolved anatomically up from the floor of the mouth
(in contrast to posterior pituitary--
NEUROHYPOPHYSIS which evolved down from
base of brain)
― Hormones released have flow into the general
circulation for action in far parts of the body
― 7 releasing hormones are secreted by the
hypothalamus and are responsible for the release or
inhibition of the anterior pituitary hormones. This
includes growth-hormone releasing hormone and
growth-hormone inhibiting hormone which are
controlled by NEGATIVE FEEDBACK
MECHANISMS
PRINCIPAL ANTERIOR PITUITARY HORMONES
― TSH: Stimulates the thyroid gland to release thyroid
hormones
― FSH/LH: Together stimulate the release of
estrogens and progesterones which cause maturatiob
pf ova in femake and sperm cell and testosterone in
male
― Prolactin: Stimulates the production of milk by
breasts; can cross the placenta-blood barrier, causing
"withch's milk" or milk production from a baby's
nipples
― ACTH: Stimulates the release of adrenal cortical
hormones by the adrenal glands
― Melanocyte SH: Skin pigmentation
― Human GH (hGH or Somatotropin): body growth
and regukates netabokic process. High hGH
increases the growth of she skelteonin the growing
years of the Child. Maintains muscle and skeletal
size in the adult
Abnormal Conditions Associated with Anterior
Pituitary Hyper- or Hypo-Secretion
A. Pituitary Dwarfism: Low levels of hGH during growth
years causes bone-growth pkate closure before normal size
is achieve. Many organs are small and the person has a
childlike stature. Synthetic hGH produces recombinant
DNA technology in bacteria has resulted in safe,plentiful
sources and can prevent this if diagnosed in time.
B. Pituitary Giantism: Hypersecretion pg hGH during
childhood causes long bones and fall stature but otherwise
normal proportions

C. Acromegaly: Caused by functioning pituitary tumors in

the already normal adult. Causes thickening of bones of the
face, hands and feet (bone can't get longer after closure of
growth centers) and thickeningof tongue, eyelids and nose

D. Goliath: an acromegalic giant. Piyuitry tumor xould

place pressure on peripheral vision nerve fibers, causing
tunnel vision and a rock hurled form the side could hit the
temple at the thinnest part of skull

POSTERIOR PITUITARY GLAND :

― Neurophypophysis
― Anatomically deceived from a down growth of
brain.
― Does not synthesize hormones, but it stores and
secretes 2 of them.
― Hormones made in the brain are transported in small
packets for storage in the posterior pituitary

A. Oxytocin (oxytocia- "rapid child birth"; also Pitocin):

Enhances the strengths of uterine contraction and stimulates
the ejection of milk after delivery. Foster maternal instincts
and sexual pleause during and after intercourse.

B. ADH (also vasopressin): decreases urine production by

increasing reabsorbption by the kidneys. Effectbis to raise
blood volume and to raise blood pressure. Alcohol inhibits
ADH, thus profuse urination after a drinking binge and the
headache and thirst associated with hangover.