ERRNVPHGLFRVRUJ

4 Sympathetic Division of the ANS

The ANS is divided into the sympathetic and parasympathetic

divisions. In contrast to the somatic division of the PNS, the
ANS is a two-neuron system with a preganglionic neuron in the
CNS that sends its axon into a peripheral nerve to synapse on a
postganglionic neuron in a peripheral autonomic ganglion. The
postganglionic neuron then sends its axon to the target (smooth
muscle, cardiac muscle, and glands). The ANS is a visceral
system because many of the body’s organs are composed of
smooth muscle walls and/or contain secretory glandular tissue.
The sympathetic division is also known as the thoracolumbar
division because:
• Its preganglionic neurons are found only in the T1-L2 spinal
cord levels
• Its preganglion neurons lie within the intermediolateral gray
matter of the spinal cord in the 14 segments defined above
COLOR the sympathetic preganglionic neuron and its axons
red (solid lines), and color the postganglionic neuron and its
axons green (dashed lines).
Preganglionic axons release acetylcholine (ACh) at their syn-
apses, whereas norepinephrine (NE) is the transmitter released
by postganglionic axons (except on sweat glands where it is
ACh). The cells of the adrenal medulla (modified postganglionic
sympathetic neurons) release epinephrine and some NE not as
neurotransmitters but as hormones into the blood. The sympa-
thetic system acts globally throughout the body to mobilize it in
“fright-flight-fight” situations. The specific functions are summa-
rized in the following table.

Preganglionic axons exit the T1-L2 spinal cord in a ventral root,

and enter a spinal nerve and then a white ramus communicans
STRUCTURE EFFECTS
to enter the sympathetic chain. The sympathetic chain is a bilat-
eral chain of ganglia just lateral to the vertebral bodies that runs Eyes Dilates the pupil

from the base of the skull to the coccyx. Once in the sympathetic Lacrimal glands Reduces secretion slightly (vasoconstriction)
chain, the preganglionic axon may do one of three things: Skin Causes goose bumps (arrector pili muscle
• Synapse on a sympathetic chain postganglionic neuron at the ­contraction)
T1-L2 level or ascend or descend to synapse on a sympathetic Sweat glands Increases secretion
chain neuron at any of the 31 spinal nerve levels Peripheral vessels Causes vasoconstriction
• Pass through the sympathetic chain, enter a splanchnic Heart Increases heart rate and force of contraction
(visceral) nerve, and synapse in a collateral ganglion (celiac,
Coronary arteries Assists in vasodilation
superior mesenteric, inferior mesenteric) in the abdominopelvic
Lungs Assists in bronchodilation and reduced secretion
cavity
• Pass through the sympathetic chain, enter a splanchnic nerve, Digestive tract Decreases peristalsis, contracts internal anal
sphincter muscle, causes vasoconstriction to shunt
pass through a collateral ganglion, and synapse on the cells of blood elsewhere
the adrenal medulla Liver Causes glycogen breakdown, glucose synthesis
and release
Axons of the postganglionic sympathetic neurons may do one of Salivary glands Reduces and thickens secretion via
four things: ­vasoconstriction
• Those axons from sympathetic chain neurons re-enter the Genital system Causes ejaculation and orgasm, and remission of
spinal nerve via a gray ramus communicans and join any one erection
of the 31 spinal nerves as they distribute widely throughout the Constricts male internal urethral sphincter muscle
body Urinary system Decreases urine production via vasoconstriction
• Do the same as in the previous option but course along blood
Constricts male internal urethral sphincter muscle
vessels in the head or join cardiopulmonary or hypogastric
Adrenal medulla Increases secretion of epinephrine or
plexuses of nerves to distribute to head, thorax, and pelvic ­norepinephrine
viscera
• Arise from postganglionic neurons in collateral ganglia and
course with blood vessels to abdominopelvic viscera
• The postganglionic cells of the adrenal medulla are differenti-
ated endocrine cells (paraneurons) that do not have axons
but release their hormone (epinephrine and norepinephrine)
directly into the bloodstream

Plate 4-19 See Netter: Atlas of Human Anatomy, 6th Edition, Plate 163 Nervous System
 ERRNVPHGLFRVRUJ

Sympathetic Division of the ANS 4

Preganglionic sympathetic
Postganglionic sympathetic

Eye

C1 Cardiac
C2 plexus
C3
C4
C5 Heart
C6
C7
C8
T1
T2 Lungs
T3
T4 Pulmonary
plexus
T5 Liver and gallbladder
T6 Celiac
T7 ganglion
Spleen
T8
Thoracic Stomach
T9 splanchnic nerves
Pancreas
T10
Superior
T11 mesenteric Small intestine
ganglion
T12
Lumbar
L1 splanchnic nerves Colon
L2
Inferior
L3 Adrenal medulla
mesenteric
Postganglionic L4 ganglion
fibers to spinal L5 Kidney
nerves S1
(to blood
vessels, sweat S2 Sympathetic
glands, and S3 chain Dorsal root
arrector pili S4 ganglion Dorsal root Thoracic part
muscles S5 Sympathetic trunk ganglion of spinal cord
in skin) Co
Urinary
bladder

Ovary Sympathetic
trunk ganglion
Penis
Uterus Scrotum
Spinal nerve to vessels
and glands of skin
Ventral root
Sympathetic trunk ganglion
White ramus communicans
Thoracic splanchnic nerve
Gray ramus communicans

Celiac
Sympathetic trunk ganglion ganglion Enteric
plexus

Red Superior
Green mesenteric
(Motor fibers only) ganglion

Netter’s Anatomy Coloring Book Plate 4-19

 ERRNVPHGLFRVRUJ
4 Parasympathetic Division of the ANS
The parasympathetic division of the ANS also is a two-neuron
system with its preganglionic neuron in the CNS and postgan-
glionic neuron in a peripheral ganglion. The parasympathetic
division also is known as the craniosacral division because:
• Its preganglionic neurons are found in cranial nerves III, VII, IX
and X, and in the sacral spinal cord at levels S2-S4
• Its preganglionic neurons reside in the four cranial nuclei asso­
ciated with the four cranial nerves listed previously, or in the
lateral gray matter of the sacral spinal cord at levels S2-S4
Preganglionic parasympathetic axons may do one of two things:
• Exit the brainstem in the cranial nerve (except CN X, see
below) and pass to a peripheral ganglion in the head (ciliary,
pterygopalatine, submandibular, and otic ganglia) to synapse
on the parasympathetic postganglionic neurons residing in
these ganglia
• Exit the sacral spinal cord via a ventral root and then enter
the pelvic splanchnic nerves to synapse on postganglionic
neurons in terminal ganglia located in or near the viscera to
be innervated
Axons of the postganglionic parasympathetic neurons may do
one of two things:
• Pass from the parasympathetic ganglion in the head on ex-
isting nerves or blood vessels to innervate smooth muscle and
glands of the head
• Pass from terminal ganglia in or near the viscera innervated
and synapse on smooth muscle, cardiac muscle, or glands in
the neck, thorax, and abdominopelvic cavity
CN X (vagus nerve) is unique. Its preganglionic axons exit the
brainstem and synapse on terminal ganglia in or near the targets
in the neck, thorax (heart, lungs, glands, smooth muscle), and
abdominal cavity (proximal two thirds of the GI tract and its
accessory organs). Axons of the terminal ganglia neurons then
synapse on their targets.
Plate 4-20 See Netter: Atlas of Human Anatomy, 6th Edition, Plate 164
COLOR the preganglionic parasympathetic neurons and
their axons (solid lines) arising from a cranial nerve or S2-S4
red, and color the postganglionic neuron and axon (dashed
lines) in the peripheral or terminal ganglion green.
The sympathetic axons pass into the limbs, but the parasym-
pathetic axons do not. Therefore the vascular smooth muscle,
arrector pili muscles of the skin (attached to hair follicles), and
sweat glands are all innervated only by the sympathetic system.
ACh is the neurotransmitter at all parasympathetic synapses.
The parasympathetic system is concerned with feeding and
sexual arousal and acts more slowly and focally than the sympa-
thetic system. For example, CN X can slow the heart rate without
affecting input to the stomach. In general, the sympathetic and
parasympathetic systems maintain homeostasis, although as
a protective measure, the body does maintain a low level of
“sympathetic tone” and can activate this division on a moment’s
notice. ANS function is regulated ultimately by the hypothala-
mus. The specific functions of the parasympathetic division of
the ANS are summarized in the table below.
STRUCTURE EFFECTS
Eyes Constricts pupil
Ciliary body Constricts muscle for accommodation (near vision)
Lacrimal glands Increases secretion
Heart Decreases heart rate and force of contraction
Coronary arteries Causes vasoconstriction with reduced metabolic
demand
Lungs Causes bronchoconstriction and increased secretion
Digestive tract Increases peristalsis, increases secretion, inhibits
internal anal sphincter for defecation
Liver Aids glycogen synthesis and storage
Salivary glands Increases secretion
Genital system Promotes engorgement of erectile tissues
Urinary system Contracts bladder (detrusor muscle) for urination,
inhibits contraction of internal urethral sphincter,
increases urine production
Nervous System
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Parasympathetic Division of the ANS 4

CN III

CN VII Eye
Ciliary ganglion

C1 Pterygopalatine ganglion Lacrimal gland

CN IX
C2
Nasal mucosa
C3
Submandibular ganglion
C4 Paranasal sinuses
C5 CN X
C6 Otic ganglion
C7 Salivary glands
C8
T1
T2
T3 Spinal cord
T4 Heart

T5
T6
T7
T8 Lungs

T9 Preganglionic
parasympathetic (red)
Liver and
T10 gallbladder
Postganglionic
T11 parasympathetic (green)
Spleen
T12
Stomach
L1
L2 Pancreas

L3
Small
L4 intestine
L5
Pelvic splanchnic nerves
S1 Colon
S2
S3
S4
Kidney
S5
Co

Ovary Urinary
bladder
Penis
Uterus Scrotum

Netter’s Anatomy Coloring Book Plate 4-20