Autonomic nervous

system

The autonomic nervous system (ANS), formerly the vegetative nervous system, is a division
of the peripheral nervous system that supplies smooth muscle and glands, and thus
influences the function of internal organs.[1] The autonomic nervous system is a control
system that acts largely unconsciously and regulates bodily functions, such as the heart rate,
digestion, respiratory rate, pupillary response, urination, and sexual arousal.[2] This system is
the primary mechanism in control of the fight-or-flight response.
 Autonomic nervous system

Autonomic nervous system innervation.

Details

Identifiers

Latin Autonomici systematis nervosi

MeSH D001341 (https://meshb.nlm.nih.gov/record/ui?

ui=D001341)

TA98 A14.3.00.001 (http://www.unifr.ch/ifaa/Public/E

ntryPage/TA98%20Tree/Entity%20TA98%20EN/
14.3.00.001%20Entity%20TA98%20EN.htm)

TA2 6600 (https://ta2viewer.openanatomy.org/?id=6

600)

FMA 9905 (https://bioportal.bioontology.org/ontologi

es/FMA/?p=classes&conceptid=http%3A%2F%2
Fpurl.org%2Fsig%2Font%2Ffma%2Ffma9905)

Anatomical terminology

The autonomic nervous system is regulated by integrated reflexes through the brainstem to
the spinal cord and organs. Autonomic functions include control of respiration, cardiac
regulation (the cardiac control center), vasomotor activity (the vasomotor center), and certain
reflex actions such as coughing, sneezing, swallowing and vomiting. Those are then
subdivided into other areas and are also linked to autonomic subsystems and the peripheral
nervous system. The hypothalamus, just above the brain stem, acts as an integrator for
autonomic functions, receiving autonomic regulatory input from the limbic system.[3]

The autonomic nervous system has three branches: the sympathetic nervous system, the
parasympathetic nervous system and the enteric nervous system.[4][5][6][7] Some textbooks do
not include the enteric nervous system as part of this system.[8] The sympathetic nervous
system is often considered the "fight or flight" system, while the parasympathetic nervous
system is often considered the "rest and digest" or "feed and breed" system. In many cases,
both of these systems have "opposite" actions where one system activates a physiological
response and the other inhibits it. An older simplification of the sympathetic and
parasympathetic nervous systems as "excitatory" and "inhibitory" was overturned due to the
many exceptions found. A more modern characterization is that the sympathetic nervous
system is a "quick response mobilizing system" and the parasympathetic is a "more slowly
activated dampening system", but even this has exceptions, such as in sexual arousal and
orgasm, wherein both play a role.[3]

There are inhibitory and excitatory synapses between neurons. A third subsystem of neurons
has been named as non-noradrenergic, non-cholinergic transmitters (because they use nitric
oxide as a neurotransmitter) and are integral in autonomic function, in particular in the gut
and the lungs.[9]

Although the ANS is also known as the visceral nervous system, the ANS is only connected
with the motor side.[10] Most autonomous functions are involuntary but they can often work
in conjunction with the somatic nervous system which provides voluntary control.

Structure
Autonomic nervous system, showing splanchnic nerves in middle, and the vagus nerve as "X" in blue. The heart and
organs below in list to right are regarded as viscera.

The autonomic nervous system is divided into the sympathetic nervous system and
parasympathetic nervous system. The sympathetic division emerges from the spinal cord in
the thoracic and lumbar areas, terminating around L2-3. The parasympathetic division has
craniosacral “outflow”, meaning that the neurons begin at the cranial nerves (specifically the
oculomotor nerve, facial nerve, glossopharyngeal nerve and vagus nerve) and sacral (S2-S4)
spinal cord.

The autonomic nervous system is unique in that it requires a sequential two-neuron efferent
pathway; the preganglionic neuron must first synapse onto a postganglionic neuron before
innervating the target organ. The preganglionic, or first, neuron will begin at the “outflow” and
will synapse at the postganglionic, or second, neuron's cell body. The postganglionic neuron
will then synapse at the target organ.

Sympathetic division
…
The sympathetic nervous system consists of cells with bodies in the lateral grey column from
T1 to L2/3. These cell bodies are "GVE" (general visceral efferent) neurons and are the
preganglionic neurons. There are several locations upon which preganglionic neurons can
synapse for their postganglionic neurons:

Paravertebral ganglia (3) of the sympathetic chain (these run on either side of the vertebral
bodies)
1. cervical ganglia (3)

2. thoracic ganglia (12) and rostral lumbar ganglia (2 or 3)

3. caudal lumbar ganglia and sacral ganglia

Prevertebral ganglia (celiac ganglion, aorticorenal ganglion, superior mesenteric ganglion,
inferior mesenteric ganglion)

Chromaffin cells of the adrenal medulla (this is the one exception to the two-neuron
pathway rule: the synapse is directly efferent onto the target cell bodies)

These ganglia provide the postganglionic neurons from which innervation of target organs
follows. Examples of splanchnic (visceral) nerves are:

Cervical cardiac nerves and thoracic visceral nerves, which synapse in the sympathetic
chain

Thoracic splanchnic nerves (greater, lesser, least), which synapse in the prevertebral
ganglia

Lumbar splanchnic nerves, which synapse in the prevertebral ganglia

Sacral splanchnic nerves, which synapse in the inferior hypogastric plexus

These all contain afferent (sensory) nerves as well, known as GVA (general visceral afferent)
neurons.

Parasympathetic division
…
The parasympathetic nervous system consists of cells with bodies in one of two locations:
the brainstem (Cranial Nerves III, VII, IX, X) or the sacral spinal cord (S2, S3, S4). These are
the preganglionic neurons, which synapse with postganglionic neurons in these locations:

Parasympathetic ganglia of the head: Ciliary (Cranial nerve III), Submandibular (Cranial
nerve VII), Pterygopalatine (Cranial nerve VII), and Otic (Cranial nerve IX)

In or near the wall of an organ innervated by the Vagus (Cranial nerve X) or Sacral nerves
(S2, S3, S4)

These ganglia provide the postganglionic neurons from which innervations of target organs
follows. Examples are:
 The postganglionic parasympathetic splanchnic (visceral) nerves

The vagus nerve, which passes through the thorax and abdominal regions innervating,
among other organs, the heart, lungs, liver and stomach

Sensory neurons
…
The sensory arm is composed of primary visceral sensory neurons found in the peripheral
nervous system (PNS), in cranial sensory ganglia: the geniculate, petrosal and nodose
ganglia, appended respectively to cranial nerves VII, IX and X. These sensory neurons monitor
the levels of carbon dioxide, oxygen and sugar in the blood, arterial pressure and the
chemical composition of the stomach and gut content. They also convey the sense of taste
and smell, which, unlike most functions of the ANS, is a conscious perception. Blood oxygen
and carbon dioxide are in fact directly sensed by the carotid body, a small collection of
chemosensors at the bifurcation of the carotid artery, innervated by the petrosal (IXth)
ganglion. Primary sensory neurons project (synapse) onto “second order” visceral sensory
neurons located in the medulla oblongata, forming the nucleus of the solitary tract (nTS), that
integrates all visceral information. The nTS also receives input from a nearby chemosensory
center, the area postrema, that detects toxins in the blood and the cerebrospinal fluid and is
essential for chemically induced vomiting or conditional taste aversion (the memory that
ensures that an animal that has been poisoned by a food never touches it again). All this
visceral sensory information constantly and unconsciously modulates the activity of the
motor neurons of the ANS.

Innervation
…
Autonomic nerves travel to organs throughout the body. Most organs receive
parasympathetic supply by the vagus nerve and sympathetic supply by splanchnic nerves.
The sensory part of the latter reaches the spinal column at certain spinal segments. Pain in
any internal organ is perceived as referred pain, more specifically as pain from the
dermatome corresponding to the spinal segment.[11]
Autonomic nervous supply to organs in the human body
Organ Nerves[12] Spinal column origin[12]

PS: anterior and posterior vagal trunks T5, T6, T7, T8, T9, sometimes
stomach
S: greater splanchnic nerves T10

PS: vagus nerves T5, T6, T7, T8, T9, sometimes

duodenum
S: greater splanchnic nerves T10

jejunum and PS: posterior vagal trunks

T5, T6, T7, T8, T9
ileum S: greater splanchnic nerves

spleen S: greater splanchnic nerves T6, T7, T8

PS: vagus nerve

gallbladder and
S: celiac plexus T6, T7, T8, T9
liver
right phrenic nerve

PS: vagus nerves and pelvic splanchnic T10, T11, T12 (proximal
colon nerves colon)

S: lesser and least splanchnic nerves L1, L2, L3, (distal colon)

PS: vagus nerves

pancreatic head T8, T9
S: thoracic splanchnic nerves

appendix nerves to superior mesenteric plexus T10

PS: vagus nerve

kidneys and
S: thoracic and lumbar splanchnic T11, T12
ureters
nerves

Motor neurons
…
Motor neurons of the autonomic nervous system are found in ‘’autonomic ganglia’’. Those of
the parasympathetic branch are located close to the target organ whilst the ganglia of the
sympathetic branch are located close to the spinal cord.

The sympathetic ganglia here, are found in two chains: the pre-vertebral and pre-aortic
chains. The activity of autonomic ganglionic neurons is modulated by “preganglionic
neurons” located in the central nervous system. Preganglionic sympathetic neurons are
located in the spinal cord, at the thorax and upper lumbar levels. Preganglionic
parasympathetic neurons are found in the medulla oblongata where they form visceral motor
nuclei; the dorsal motor nucleus of the vagus nerve; the nucleus ambiguus, the salivatory
nuclei, and in the sacral region of the spinal cord.

Function

Function of the autonomic nervous system [13]

Sympathetic and parasympathetic divisions typically function in opposition to each other. But
this opposition is better termed complementary in nature rather than antagonistic. For an
analogy, one may think of the sympathetic division as the accelerator and the
parasympathetic division as the brake. The sympathetic division typically functions in actions
requiring quick responses. The parasympathetic division functions with actions that do not
require immediate reaction. The sympathetic system is often considered the "fight or flight"
system, while the parasympathetic system is often considered the "rest and digest" or "feed
and breed" system.

However, many instances of sympathetic and parasympathetic activity cannot be ascribed to

"fight" or "rest" situations. For example, standing up from a reclining or sitting position would
entail an unsustainable drop in blood pressure if not for a compensatory increase in the
arterial sympathetic tonus. Another example is the constant, second-to-second, modulation
of heart rate by sympathetic and parasympathetic influences, as a function of the respiratory
cycles. In general, these two systems should be seen as permanently modulating vital
functions, in a usually antagonistic fashion, to achieve homeostasis. Higher organisms
maintain their integrity via homeostasis which relies on negative feedback regulation which,
in turn, typically depends on the autonomic nervous system.[14] Some typical actions of the
sympathetic and parasympathetic nervous systems are listed below.[15]
 Target
Parasympathetic Sympathetic
organ/system

Digestive Increase peristalsis and amount of

Decrease activity of digestive system
system secretion by digestive glands

Causes glucose to be released to

Liver No effect
blood

Lungs Constricts bronchioles Dilates bronchioles

Urinary
bladder/ Relaxes sphincter Constricts sphincter
Urethra

Kidneys No effects Decrease urine output

Heart Decreases rate Increase rate

Constricts blood vessels in viscera;

Blood vessels No effect on most blood vessels
increase BP

Salivary and
Stimulates; increases production of Inhibits; result in dry mouth and dry
Lacrimal
saliva and tears eyes
glands

Stimulates constrictor muscles; Stimulate dilator muscle; dilates

Eye (iris)
constrict pupils pupils

Eye (ciliary Stimulates to increase bulging of Inhibits; decrease bulging of lens;

muscles) lens for close vision prepares for distant vision

Adrenal Stimulate medulla cells to secrete

No effect
Medulla epinephrine and norepinephrine

Sweat gland of
No effect Stimulate to produce perspiration
skin

Sympathetic nervous system

…
Promotes a fight-or-flight response, corresponds with arousal and energy generation, and
inhibits digestion

Diverts blood flow away from the gastro-intestinal (GI) tract and skin via vasoconstriction

Blood flow to skeletal muscles and the lungs is enhanced (by as much as 1200% in the
case of skeletal muscles)
 Dilates bronchioles of the lung through circulating epinephrine, which allows for greater
alveolar oxygen exchange

Increases heart rate and the contractility of cardiac cells (myocytes), thereby providing a
mechanism for enhanced blood flow to skeletal muscles

Dilates pupils and relaxes the ciliary muscle to the lens, allowing more light to enter the eye
and enhances far vision

Provides vasodilation for the coronary vessels of the heart

Constricts all the intestinal sphincters and the urinary sphincter

Inhibits peristalsis

Stimulates orgasm

Parasympathetic nervous system

…
The parasympathetic nervous system has been said to promote a "rest and digest" response,
promotes calming of the nerves return to regular function, and enhancing digestion.
Functions of nerves within the parasympathetic nervous system include:

Dilating blood vessels leading to the GI tract, increasing the blood flow.

Constricting the bronchiolar diameter when the need for oxygen has diminished

Dedicated cardiac branches of the vagus and thoracic spinal accessory nerves impart
parasympathetic control of the heart (myocardium)

Constriction of the pupil and contraction of the ciliary muscles, facilitating accommodation
and allowing for closer vision

Stimulating salivary gland secretion, and accelerates peristalsis, mediating digestion of

food and, indirectly, the absorption of nutrients

Sexual. Nerves of the peripheral nervous system are involved in the erection of genital
tissues via the pelvic splanchnic nerves 2–4. They are also responsible for stimulating
sexual arousal.

Enteric nervous system

…
The enteric nervous system is the intrinsic nervous system of the gastrointestinal system. It
has been described as "the Second Brain of the Human Body".[16] Its functions include:

Sensing chemical and mechanical changes in the gut

Regulating secretions in the gut

Controlling peristalsis and some other movements

Neurotransmitters
…

A flow diagram showing the process of stimulation of adrenal medulla that makes it release adrenaline, that further
acts on adrenoreceptors, indirectly mediating or mimicking sympathetic activity.

At the effector organs, sympathetic ganglionic neurons release noradrenaline

(norepinephrine), along with other cotransmitters such as ATP, to act on adrenergic
receptors, with the exception of the sweat glands and the adrenal medulla:

Acetylcholine is the preganglionic neurotransmitter for both divisions of the ANS, as well
as the postganglionic neurotransmitter of parasympathetic neurons. Nerves that release
acetylcholine are said to be cholinergic. In the parasympathetic system, ganglionic neurons
use acetylcholine as a neurotransmitter to stimulate muscarinic receptors.
 At the adrenal medulla, there is no postsynaptic neuron. Instead, the presynaptic neuron
releases acetylcholine to act on nicotinic receptors. Stimulation of the adrenal medulla
releases adrenaline (epinephrine) into the bloodstream, which acts on adrenoceptors,
thereby indirectly mediating or mimicking sympathetic activity.

A full table is found at Table of neurotransmitter actions in the ANS.

History

The specialised system of the autonomic nervous system was recognised by Galen. In 1665,
Willis used the terminology, and in 1900, Langley used the term, defining the two divisions as
the sympathetic and parasympathetic nervous systems.[17]

Caffeine effects

Caffeine is a bioactive ingredient found in commonly consumed beverages such as coffee,

tea, and sodas. Short-term physiological effects of caffeine include increased blood pressure
and sympathetic nerve outflow. Habitual consumption of caffeine may inhibit physiological
short-term effects. Consumption of caffeinated espresso increases parasympathetic activity
in habitual caffeine consumers; however, decaffeinated espresso inhibits parasympathetic
activity in habitual caffeine consumers. It is possible that other bioactive ingredients in
decaffeinated espresso may also contribute to the inhibition of parasympathetic activity in
habitual caffeine consumers.[18]

Caffeine is capable of increasing work capacity while individuals perform strenuous tasks. In
one study, caffeine provoked a greater maximum heart rate while a strenuous task was being
performed compared to a placebo. This tendency is likely due to caffeine's ability to increase
sympathetic nerve outflow. Furthermore, this study found that recovery after intense exercise
was slower when caffeine was consumed prior to exercise. This finding is indicative of
caffeine's tendency to inhibit parasympathetic activity in non-habitual consumers. The
caffeine-stimulated increase in nerve activity is likely to evoke other physiological effects as
the body attempts to maintain homeostasis.[19]

The effects of caffeine on parasympathetic activity may vary depending on the position of
the individual when autonomic responses are measured. One study found that the seated
position inhibited autonomic activity after caffeine consumption (75 mg); however,
parasympathetic activity increased in the supine position. This finding may explain why some
habitual caffeine consumers (75 mg or less) do not experience short-term effects of caffeine
if their routine requires many hours in a seated position. It is important to note that the data
supporting increased parasympathetic activity in the supine position was derived from an
experiment involving participants between the ages of 25 and 30 who were considered
healthy and sedentary. Caffeine may influence autonomic activity differently for individuals
who are more active or elderly.[20]

See also

Dysautonomia

International Society for Autonomic Neuroscience

Medullary ischemic reflex

References

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 External links

Autonomic nervous system (http://www.scholarpedia.org/article/Autonomic_nervous_sy

stem) article in Scholarpedia, by Ian Gibbins and Bill Blessing

Division of Nervous System (https://www.articlesbazar.com/2020/06/types-of-nervous-sy

stem.html)

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