chApter 13# Automimic NervouS SyStem (ANS)

This is a very lengthy and tough chapter, let’s dedicate a page to understand the
concepts, and then start the subject properly.

Origin of ANS;

There are two components of autonomic nervous system and both have diff
origins. i.e.

 Sympathetic arises from spinal cord (Thoraco lumbar region only &, no
contribution from any cranial nerve) while
 Parasympathetic arises from both cranial nerves and spinal cord (sacral
region), that’s why
sympathetic is also called = Thoraco-lumbar outflow
parasympathetic is called = cranio-sacral ourtflow

Hope by now you understand that, sympathetic has no cranial nerve component,
while parasympathetic has both spinal and cranial component.

Neuronal connections in ANS.

We know that autonomic nervous system has two components i.e. sympathetic and
parasympathetic.

Each of these is primarily consist of two neurons, the first neuron and the second
neuron.
The “the first neuron” that’s coming out of Spinal cord or brain, is called
Preganglionic neuron. This preganglionic neuron ends in ganglion.
The second neuron starts from ganglion and ends up in effector organ. This second
neuron is called postganglionic neuron.

Always remember that, the first neuron coming out of spinal cord will release
“Acetylcholine” as its neurotransmitter, and the receptor for this neuron will be
always nicotinic receptor. For example
  The first neuron (preganglionic neuron) of sympathetic system will release
acetyl choline, that will act on nicotinic receptor present on ganglion
 The preganglionic neuron of parasympathetic nervous system will release
acetyl choline, that will act on nicotinic receptor present on ganglion
 The preganglionic neuron of sympathetic system that ends on “adrenal
gland” will also release acetylcholine and its receptor on adrenal gland will
be a nicotinic receptor
 Also remember that even the first neuron (alpha motor neuron) from the
anterior horn of spinal cord that supplies “skeletal muscles” will also secrete
acetyl choline and its receptor must be nicotinic (this statement is written
just to understand the concept and it’s not part of ANS)

Now the difference comes in the second neuron, i.e. postganglionic neuron.

 The post ganglionic neuron of sympathetic will release nor epinephrine or

epinephrine and its receptors are alpha and beta receptors
 The post ganglionic neurons of parasympathetic will secrete again acetyl
choline, but this time its receptor is muscarinic receptor.

Now hope form this discussion, it must be clear that, all preganglionic fibers
secrete acetyl choline, and receptor is nicotinic receptor, while postganglionic
fibers of sympathetic release nor epinephrine/epinephrine, while post ganglionic
fibers of parasympathetic release acetyl choline

Also remember that, the preganglionic fibers of sympathetic system are short and
postganglionic fibers are long, while the preganglionic fibers of parasympathetic
 Exceptions to the rule
 Sympathetic nervous system
are long, and postganglionic fibers are short. causes constriction of arteries
(for example bronchial
arteries) and sphincters, while
parasympathetic causes
dilation of bronchial arteries,
and relaxes sphincters.
 The post ganglionic
sympathetic fibers to Sweat
gland release acetyl choline ,
and its receptor is muscarinic
receptor
 Parasympathetic brings about
Relaxation of Erectile tissue
of, penis and clitoris thus
causing erection (now think if
parasympathetic causes
erection, sympathetic will
cause ejaculation)

Functional organization of ANS .

We have tried to summarize the action of the whole system into three lines, we will
memorize it for parasympathetic system, and the opposite will be true for
sympathetic system. Now let me tell you what I mean by this statement.

There are three major actions of parasympathetic neurons system

1. Increases secretion of the body. Now no matter, what organ I consider it

will help me memorize its action. Like it acts on lacrimal gland and Inc
tearing, it acts on salivary gland, and Inc saliva production it also increases
secretion of fluid in GIT and can cause diarrhea, while if we consider
bladder it will increase urination. (now memorize opposite for sympathetic
system)
2. It decreases heart i.e. it decreases heart rate, heart contractility etc.
3. It increases smooth muscle contraction, for example if it actions of pupils it
will constrict pupil and that’s called miosis (so sympathetic will dilate pupil
and causes mydriasis), increases GI motility, increases constriction of
 bronchial smooth muscles, causes bladder contraction and causes urination
etc.

Hope you understand by now that, parasympathetic increases body secretions, i.e.
salivation, lacrimation, urination & GIT secretions etc., it decreases heart activity
i.e. causes bradycardia and, causes smooth muscles contractions like muscles of
bronchial tree, GIT, and bladder etc.

One extra point try to remember for this chapter that, any receptor whose number
is 2, will be inhibitory for example Beta2 will be inhibitory, alpha2 will be
inhibitory, M2 will be inhibitory. Even D2 receptors are inhibitory

Now with this background knowledge. Let’s start and enjoy the chapter

ORGANIZATION OF THE AUTONOMIC NERVOUS SYSTEM

The autonomic nervous system is distributed throughout the central and peripheral
nervous systems. It is divided into two parts, the sympathetic and the
parasympathetic.

1. Sympathetic Part of the Autonomic System;

 larger of the two parts of the autonomic system and is widely distributed
throughout the body, innervating the heart and lungs, the muscle in the walls
of many blood vessels, the hair follicles and the sweat glands, and many
abdomino-pelvic viscera.
 The lateral gray columns (horns) of the spinal cord from the first thoracic
segment to the second lumbar segment (sometimes third lumbar segment)
possess the cell bodies of the sympathetic connector neurons.
The myelinated axons of these cells (preganglionic fibers) leave the cord in
the anterior nerve roots and pass via the white rami communicantes (the
white rami are white because the nerve fibers are covered with white
myelin) to the paravertebral ganglia of the sympathetic trunk.
 Now the fibers leaving the paravertebral ganglion are called EFFERENT
fibers (recall e for efferent, and e for exit) and these will take any of the
following course …….
1. Preganglionic fibers synapses in these ganglions, and post ganglionic
fibers leave the ganglion chain via Gray rami communicantes. (In simple
words, the preganglionic fibers enter into ganglion via white rami
communicantes, while the post ganglionic fibers leave ganglion via gray
rami commmunates). These post ganglionic fibers supply following 3 main
structures;

a) Arrector pili
b) blood vessels
c) sweat glands
2. Some fibers travel upward in the sympathetic trunk to synapse in ganglia
in the cervical region, and then form carotid plexus, cardiac, esophageal
and pulmonary plexus..

3. They may pass through the ganglia of the sympathetic trunk without
synapsing.These myelinated fibers leave the sympathetic trunk as the
greater splanchnic, lesser splanchnic, and lowest or least splanchnic
nerves. (Look at the figure, identify and memorize the root values of these
nerves, plus the plexus they form)
Sympathetic Trunks → The sympathetic trunks are two ganglionated nerve trunks
that extend the whole length of the vertebral column
2. Parasympathetic Part of the Autonomic System

The activities of the parasympathetic part of the autonomic system are directed
toward conserving and restoring energy.

The heart rate is slowed, pupils are constricted, peristalsis and glandular activity is
increased, sphincters are opened, and the bladder wall is contracted.

The preganglionic of the parasympathetic part of the autonomic nervous system are
located in the brainstem and the sacral segments of the spinal cord.

Those nerve cells located in the brainstem form nuclei in the following cranial
nerves:
1.the oculomotor(parasympathetic or Edinger-Westphal nucleus),
2.the facial (superior salivatory nucleus and lacrimatory nucleus),
3.the glossopharyngeal(inferior salivatory nucleus), and
4.the vagus nerves (dorsal nucleus of the vagus).
The axons of these connector nerve cells are myelinated and emerge from the brain
within the cranial nerves.

The sacral connector nerve cells are found in the gray matter of the second, third,
and fourth sacral segments of the spinal cord.These cells are not sufficiently
numerous to form a lateral gray horn, as do the sympathetic connector neurons in
the thoracolumbar region.The myelinated axons leave the spinal cord in the
anterior nerve roots of the corresponding spinal nerves.

They then leave the sacral nerves and form the pelvic splanchnic nerves.

The myelinated efferent fibers of the craniosacral outflow are preganglionic and
synapse in peripheral ganglia located close to the viscera they innervate. Here
again, acetylcholine is the neurotransmitter.
The cranial parasympathetic ganglia are the ciliary, pterygopalatine,
submandibular, and otic.
In certain locations, the ganglion cells are placed in nerve plexuses, such as the
cardiac plexus,
pulmonary plexus,
myenteric plexus (Auerbach plexus),
and mucosal plexus (Meissner plexus); the last two plexuses are associated with
the gastrointestinal tract.

The pelvic splanchnic nerves synapse in ganglia in the hypogastric plexuses.

Characteristically, the postganglionic parasympathetic fibers are nonmyelinated
and of relatively short length compared with sympathetic postganglionic fibers.

Following is given a busy figure, but if you focus, it will make the things easier as
both the sympathetic and parasympathetic systems are .
Neurotrasmitters In Ans;
All preganglionic neurons are cholinergic in both the sympathetic and the
parasympathetic nervous systems. Acetylcholine or acetylcholine-like
substances, when applied to the ganglia, will excite both sympathetic and
parasympathetic postganglionic neurons. Either all or almost all of the
postganglionic neurons of the parasympathetic system are also cholinergic.
Conversely, most of the postganglionic sympathetic neurons are adrenergic.

However, the postganglionic sympathetic nerve fibers to the sweat glands and
perhaps to a very few blood vessels are cholinergic.

Thus, the terminal nerve endings of the parasympathetic system all or

virtually all secrete acetylcholine.

Almost all of the sympathetic nerve endings secrete norepinephrine, but a few
secrete acetylcholine. These neurotransmitters in turn act on the different organs to
cause respective parasympathetic or sympathetic effects.

Therefore, acetylcholine is called a parasympathetic transmitter and

norepinephrine is called a sympathetic transmitter.

Receptors in autonomic nervous system.

1. Parasympathetic receptors → muscarinic receptors

M1receptors = Brain
M2 receptors= heart
M3 receptors= all other organs like GI, bronchial muscles, bladder, eye etc
2. Sympathetic receptors→ adrenergic receptors
Alpha1 receptors= mainly in blood vessels, and sphincters
alpha 2 receptors= PPP i.e Pancreases, Platelets, Preganglionic nerves
beta 1 receptors = heart
beta 2 receptors= smooth muscles like bronchial musles, uterus, etc