NEUROTRANSMISSION: THE AUTONOMIC AND SOMATIC MOTOR NERVOUS SYSTEMS

(1) The autonomic nervous system, also called the visceral, vegetative, or involuntary nervous system, (2) Regulates autonomic functions that occur without conscious control (3) It consists of nerves, ganglia, and plexuses (4) Innervate the heart, blood vessels, glands, other visceral organs, and smooth muscle in various tissues. Differences between Autonomic and Somatic Nerves: (1) The efferent nerves of the involuntary system supply all innervated structures of the body except skeletal muscle, which is served by somatic nerves. (2) The most distal synaptic junctions in the autonomic reflex arc occur in ganglia that are entirely outside the cerebrospinal axis.Somatic nerves contain no peripheral ganglia, and the synapses are located entirely within the cerebrospinal axis. (3) These autonomousganglia are small but complex structures that contain axodendritic synapses between preganglionic and postganglionic neurons. (4) Many autonomic nerves form extensive peripheral plexuses, but such networks are absent from the somatic system. (5) Whereas motor nerves to skeletal muscles are myelinated, postganglionic autonomic nerves generally are nonmyelinated. (6) When the spinal efferent nerves are interrupted, the denervated skeletal muscles lack myogenic tone, are paralyzed, and atrophy, whereas smooth muscles and glands generally retain some level of spontaneous activity independent of intact innervation. Divisions of the Peripheral Autonomic System: On the efferent side, the autonomic nervous system consists of two large divisions: (1) The sympathetic or thoracolumbar outflow and (2) The parasympathetic or craniosacral outflow. A brief outline of those anatomical features is necessary for an understanding of the actions of autonomic drugs. (1) The neurotransmitter of all preganglionic autonomic fibers, all postganglionic parasympathetic fibers, and a few postganglionic sympathetic fibers is acetylcholine (ACh). (2) The adrenergic fibers comprise the majority of the postganglionic sympathetic fibers; here the transmitter is norepinephrine (noradrenaline, levarterenol). (3) Substance P and glutamate are thought to mediate many afferent impulses; both are present in high concentrations in the dorsal spinal cord.

Sympathetic Nervous System: (1) The cells that give rise to the preganglionic fibers of this division lie mainly in the intermediolateral columns of the spinal cord and extend from the first thoracic to the second or third lumbar segment. (2) The axons from these cells are carried in the anterior (ventral) nerve roots and synapse, with neurons lying in sympathetic ganglia outside the cerebrospinal axis. (3) Sympathetic ganglia are found in three locations: paravertebral, prevertebral, and terminal.