Autonomic Nervous System

Physiology
Unit

1
 Outline
• Organization of the Nervous System
• Physiology of the Autonomic Nervous System
– ANS Division:
• Sympathetic Division
• Parasympathetic Division
– Autonomic Ganglia
– Neurotransmitter & Receptors in ANS
– Effects of ANS
– Autonomic Reflex
– Pharmacology of ANS

2
 Objectives
• Identify the functions of cranial nerves
• Compare the differences between Somatic Nervous System and
Autonomic Nervous System
• Compare Sympathetic Nervous System and Parasympathetic
Nervous System
• Describe the neurotransmitters and receptors involved in Autonomic
Nervous System
• Describe effects of Autonomic Nervous System on different organs
of the body

3
 Nervous system
CNS PNS

Brain Spinal cord Autonomic Dorsal root Peripheral nerves

ganglia ganglia
Myelencephalon Gray matter Paravertebral Cranial nerves

Medulla Interneurons Prevertebral Sensory nerve

oblongata
Motor neurons Terminal Motor nerve
Metencephalon
White matter Autonomic
Pons

Cerebellum Sensory fibers Somatic

Mesencephalon Motor fibers Mixed nerves

Midbrain Spinal nerves

Diencephalon 8 Cervical

Thalamus 12 Thoracic

Hypothalamus 5 Lumbar

Telencephalon 5 Sacral

Basal ganglia 1 Coccygeal

Cerebral cortex

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Classification of Nervous System…

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 Classification of Nervous System…
 Nervous system consists of two main subdivisions:
1. Central Nervous System-CNS
• The brain & spinal cord
– Processes many different kinds of incoming sensory
information/The center of integration and control.
– It is also the source of thoughts, emotions, and memories.
– Most nerve impulses that stimulate muscles to contract and
glands to secrete originate in the CNS.
2. Peripheral Nervous System -PNS
• The nervous system outside of the brain and spinal cord
• Carry info to CNS and from the CNS to periphery
• Consists of:
– 12 pairs of Cranial nerves
– 31 pairs of Spinal nerves
– Ganglia, and sensory receptors 6
 The Cranial Nerves-PNS components
• There are 12 pairs of cranial nerves
• Contain neurons from somatic & ANS
• Each of them are designated by the Roman numbers
(I-XII)
• Majority are mixed nerves (sensory, motor)
– Three cranial nerves (I, II, and VIII) contain only axons of
sensory neurons.
– Five cranial nerves (III, IV, VI, XI, and XII) contain only
axons of motor neurons as they leave the brainstem.
– The other four cranial nerves (V, VII, IX, and X) are mixed
nerves.
– Cranial nerves III, VII, IX, and X have both somatic and
autonomic motor axons.
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 Cranial nerves (I-III)
Autonomic
 Nerve  Name  Sensory  Motor
Parasympathetic
Carry smell signals
Arises in olfactory
 I  Olfactory mucosa & passes to    
olfactory areas of
cerebral cortex.

Carry visual signals

Arises in the retina of the
 II Optic eye, passes to the primary
 
visual area

Originates in the Pupillary

Proprioception  midbrain and passes constriction
to muscles of the (circular muscles of
Proprioceptive sensory upper eyelid and 4 iris contract)
 III Oculomotor axons from the extrinsic extrinsic eyeball Accommodation
eyeball muscles enter the muscles (superior of lens for near
midbrain via the rectus, medial rectus, vision (contraction
trigeminal nerve inferior rectus, and of ciliary muscle of
inferior oblique) the eyeball )
 Cranial nerves (IV-VI)
 Nerve  Name  Sensory  Motor

Proprioception
Proprioceptive sensory axons from 1 Extrinsic Eye
 IV Trochlear the superior oblique muscle and they muscle
enter the midbrain via the trigeminal (Superior Oblique)
nerve
Carry somatic senses from facial area
Consists of three branches, all of Innervates
which end in the pons. muscles of
 V Trigeminal
•The ophthalmic nerve mastication
•The maxillary nerve (Chewing )
•The mandibular nerve
1 Extrinsic Eye
Proprioception 
muscle (Lateral
 VI Abducens Proprioceptors in the lateral rectus rectus)
muscle join the ophthalmic branch of
lateral rotation of
the trigeminal nerve.
eyeball
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 Cranial nerves (VII-XII)
 Autonomic
 Nerve  Name  Sensory  Motor
Parasympathetic
Muscles of facial
 Taste & somatic
expression(innervate Salivary glands
 VII Facial sense on the tongue
facial, scalp, and Tear glands
Proprioception
neck muscles)
Vestibulo
 VIII Hearing & Balance    
cochlear
Sensory
Taste & somatic •Blood gases
Swallowing
Glossopharyn sense on the tongue
Elevates the pharynx •Blood pressure
 IX geal Proprioceptors
during swallowing & Motor
in swallowing
speech •Salivary glands
muscles
(parotid)

Motor
Taste & somatic Many visceral organs
Innervate skeletal
sensations (touch, (innervate smooth
muscles in the throat
pain, temperature, muscle in the heart,
 X Vagus and neck
and proprioception) gut, lungs)
•Speech
from epiglottis and Sensory
•Swallowing 10
pharynx. Blood pressure
 Cranial nerves (XI-XII)
 Nerve  Name  Sensory  Motor

Neck muscles:
Sternocleidomastoid
 XI Accessory Proprioception 
Trapezius
Coordinate head movements

Tongue muscles
 XII  Hypoglossal Proprioception 
Speech and swallowing

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 Cranial Nerves...
 Cranial Nerves Mediate 5 Special Senses:
• Smell: CN-I (Olfactory)
• Vision: CN- II (Optic)
• Hearing: CN-VIII (Cochlear division)
• Equilibrium: CN-VIII (Vestibular division)
• Taste: CNs -VII, IX, X (minor) (Facial, Glossopharyngeal,
Vagus)
 Cranial nerves that carry somatic sense (Skin & Muscle) [Sensory]
– Trigeminal (V) is the sensory nerve for the face & corneal
sensitivity.
Cranial nerves that carry muscle sense (proprioception) [Sensory]
– Oculomotor (III), Trochlear (IV), Abducens (VI), Facial (VII), Spinal
accessory (XI) and Hypoglossal (XII)
 Three Nerves Are Concerned With Eyeball Movements
– Oculomotor (III): superior rectus, medial rectus, inferior rectus,
inferior oblique
– Trochlear (IV): superior oblique
– Abducens (VI): lateral rectus 12
Eyeball Movements: Extrinsic Eye Muscles

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 Cranial Nerves...
 Several of the Nerves Innervate Skeletal Muscles
– Trigeminal (V) - Innervate Chewing muscles (masseter, temporalis)
– Facial nerve (VII)- Controls muscles of facial expression
– Spinal accessory (XI)- Stimulates the trapezius and
sternocleidomastoid muscles
– Vagus (X) - Control speech muscles (larynx)
– Hypoglossal (XII) - Moves the tongue

 Four of the Cranial nerves that Carry Parasympathetic Fibres

– Oculomotor (III): innervates iris sphincter muscle (causes pupil
constriction); also controls ciliary muscle (focuses the lens)
– Facial (VII) and Glossopharyngeal (IX): stimulate salivary glands
to secrete
– Vagus (X): the major nerve of the parasympathetic system: goes to
most visceral organs (heart, lungs, kidneys, liver, stomach,
intestines) 14
Spinal Nerves

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 Classification of Nervous System…
• PNS can be divided further into:
1. Somatic Nervous System -SoNS
• Generally voluntary
• Includes both sensory and motor neurons
• Somatic sensory nerve fibers
– Convey input from receptors for somatic senses (tactile, thermal, pain, and
proprioceptive sensations) and from receptors for the special senses (vision,
hearing, taste, smell, and equilibrium) to CNS
 Somatic motor nerve fibers
– Conduct impulses from the CNS to skeletal muscles (effectors)
– The effect is excitation (causes muscle to contract)
2. Autonomic Nervous System -ANS
• Generally involuntary
• Contain sensory & motor neurons
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 Classification of Nervous System…
• Sensory neurons (visceral afferent fibers)
– Conducts impulses from the visceral receptors (interoceptors) to CNS
– Mostly, these neurons are associated with sensory receptors located in:
• Blood vessels, visceral organs, muscles, and the nervous system
• Sensory signals are not consciously perceived most of the time,
although intense activation of interoceptors may produce conscious
sensations (pain).
• Somatic sensory and special sensory neurons sensations can
produce changes in some autonomic activities.
• Motor neurons
– Autonomic motor neurons regulate visceral activities
– Conducts impulses from the CNS to smooth muscles, cardiac muscle
and glands
– The effect can be either excitation or inhibition
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 Classification of Nervous System…
– Motor part of the ANS has two divisions:
 Sympathetic Nervous System (“Fight or Flight”)
 Parasympathetic Nervous System (“Rest and Digest”)

3. Enteric nervous system (ENS) - “brain of the gut”

 Submucosal plexus (plexus of Meissner)

 Myenteric plexus (plexus of Auerbach)

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 Comparison of Somatic NS Vs ANS
Somatic NS ANS
1. Controls voluntary activities such as 1. Controls involuntary activities such as CVS, GIT,
contraction of the skeletal muscle. glands

2. Receives information mainly from interoceptors; some

2. Receives information from receptors for from somatic senses and special senses
somatic senses and special senses
3. Nerve fibres are originated from the lateral horn of the
3. Nerve fibres are originated from the anterior Gray Matter of the spinal cord and nuclei in the brain.
horn of the Gray Matter of the spinal cord.
4. Autonomic fibres contain two neurons (pre-&post-
4. The motor nerve contains single, long, thick ganglionic neurons)
and myelinated axon.
5. The NTs are both acetylcholine and norepinephrine and
the receptors are adrenergic and cholinergic receptors
5. All somatic motor neurons release
acetylcholine and the receptor is always
6. Effectors are smooth muscles, cardiac muscles and glands.
nicotnic receptor.

7. Responses can be contraction or relaxation of smooth

6. Effectors are skeletal muscle. muscle; increased or decreased rate and force of
contraction of cardiac muscle; increased or decreased
7. Responses is contraction of skeletal muscle. secretions of glands.

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Comparison of Somatic NS Vs ANS…

Somatic Nervous System

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Autonomic Nervous System 21
Comparison of Somatic NS Vs ANS…

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Anatomical Components of Autonomic Motor
Pathways
• There are two motor neurons in any autonomic motor pathway
(preganglionic neuron and postganglionic neuron).
• Cell body of preganglionic neuron is in the brain or spinal cord,
and its axon exits the CNS as part of a cranial or spinal nerve.
• Preganglionic neuron is myelinated type B fiber.
• Postganglionic neuron lies entirely outside the CNS.
• Cell body of postganglionic neuron lies in an autonomic ganglion,
where it forms synapses with one or more preganglionic axons.
• Postganglionic neuron is unmyelinated type C fiber.
• Thus, preganglionic neurons convey nerve impulses from the CNS
to autonomic ganglia, and postganglionic neurons relay the
impulses from autonomic ganglia to visceral effectors.

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 Autonomic Nervous System (ANS)
• ANS is the part of the nervous system that controls most visceral
functions of the body.
• The output (motor) part of the ANS has two divisions:
– Sympathetic Nervous System
• “Fight or Flight”
– Parasympathetic Nervous System
• “Rest and Digest”

• Most organs have dual innervation; that is, they receive impulses from
both sympathetic and parasympathetic neurons.
• In general, nerve impulses from one division of the ANS stimulate the
organ to increase its activity (excitation), and impulses from the other
division decrease the organ’s activity (inhibition).
• For example, an increased rate of nerve impulses from the sympathetic
division increases heart rate, and an increased rate of nerve impulses from
the parasympathetic division decreases heart rate.
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Dual Innervation of the
Iris.
• Shows antagonistic
effects of the
sympathetic (yellow)
and parasympathetic
(blue) divisions on the
iris.
• A person in a state of
fear, would have dilated
pupils.

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 Autonomic Nervous System
• The following structures do not receive dual innervations:

→The sweat glands Only sympathetic

→ Adrenal medulla

→ Skin pilo erectors

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SYMPATHETIC NERVOUS
SYSTEM

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 SYMPATHETIC NERVOUS SYSTEM

 Responsible for “fight or flight”.

 Is activated during emergency situation in the sense the body can
either quickly flee or “take a stand”.
 It tends to arouse the body for action, e.g. accelerating the
heartbeat and ↑respiratory airflow, but it inhibits digestion.
 In our own lives, this reaction occurs in many situations involving
arousal, competition, stress, danger, anger, or fear.

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 The Adrenal Glands
Inner core:- adrenal medulla, is a modified sympathetic ganglion.
It consists of modified postganglionic neurons without dendrites or
axons (Chromaffin cells).
When stimulated it secrets:
 Epinephrine (adrenaline)
 Norepinephrine (noradrenaline) Catecholamines
 Dopamine.

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 Special feature of sympathetic fibers on adrenal medulla

• Preganglionic fiber terminated on

adrenal medulla, Chromaffin cells,
that are:
– Modified neurons originated
from nerve tissue
– Contain rudimentary nerve fibers
called postganglionic fibers
– Release mixed catecholamine;
= 80% Epinephrine,
= 20% Nor-epinephrine (hormones)

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31
 Sympathetic Division: Thoraco-lumbar Division
• Thoraco-lumbar division
– Originates from T1-T12 and L1-L2 region of spinal cord. 
Organization of the Sympathetic Neurons
• Cell bodies of preganglionic motor neurons are located in the lateral horns
of the gray matter of thoracic and lumbar part of the spinal cord.
• The sympathetic preganglionic neurons are known as the thoracolumbar
outflow
• Preganglionic axons synapse in sympathetic ganglia in (paravertebral
/prevertebral ganglia), which are located near the spinal cord far away
from the organs being innervated.
• Contains short preganglionic neurons which are cholinergic.
• Sympathetic postganglionic axons travel from the paravertebral
/prevertebral ganglia to the target organ.
• Contains long postganglionic neurons which are adrenergic (most) and
cholinergic (some).
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 Sympathetic Division…
Sympathetic ganglia
• The sympathetic ganglia are the sites of synapses between sympathetic
preganglionic and postganglionic neurons.
• There are two major types of sympathetic ganglia:
– Sympathetic trunk ganglia/paravertebral ganglia/ vertebral chain
ganglia and
– Prevertebral ganglia
 Sympathetic trunk ganglia-lie in a vertical row on either side of the
vertebral column.
• These ganglia extend from the base of the skull to the coccyx in both sides.
• Postganglionic axons from sympathetic trunk ganglia primarily innervate
organs above the diaphragm.
• Sympathetic trunk ganglia includes:
– Superior cervical ganglia
– Middle cervical ganglia
– Inferior cervical ganglia
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 Sympathetic Division…
Sympathetic ganglia…
 Prevertebral (collateral) ganglia-lies anterior to the vertebral column
and close to the large abdominal arteries.
 Postganglionic axons from prevertebral ganglia innervate organs
below the diaphragm.
 There are five major prevertebral ganglia:
1. The celiac ganglion is on either side of the celiac trunk, an artery
that is just inferior to the diaphragm.
2. The superior mesenteric ganglion is near the beginning of the
superior mesenteric artery in the upper abdomen.
3. The inferior mesenteric ganglion is near the beginning of the
inferior mesenteric artery in the middle of the abdomen.
4. The aorticorenal ganglion and
5. The renal ganglion are near the renal artery of each kidney.
• A single sympathetic preganglionic fiber may synapse with
20 or more postganglionic neurons. 34
Sympathetic Division…

35
Sympathetic Division…

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 Sympathetic Division
• The axons of the postganglionic
neurons are mostly unmyelinated
C fibers and terminate on the
visceral effectors.
• The adrenal medulla is essentially
a sympathetic ganglion in which
the postganglionic cells have lost
their axons.

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PARASYMPATHETIC NERVOUS
SYSTEM

38
 PARASYMPATHETIC NERVOUS SYSTEM

It tends to have a calming effect

↓heartbeat
Stimulate digestion.

• The balance between sympathetic tone and

parasympathetic tone shifts in accordance
with the body’s changing needs.

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 Function of Parasympathetic Nervous System

• Regulation of digestion, defecation and micturition.

• Conservation of energy, anabolic.
• Enhance “resting and digesting" activities
• Parasympathetic neurons in general have inhibitory effect on
almost all body tissues except in the GIT.
– They have excitatory effects on the GIT.

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Parasympathetic Division: Cranio-sacral Division
• Cranio-sacral division
– Originates from cranial and sacral regions.
– Supply the visceral structures in the head and the thorax
and abdomen.
 Cranial components are part of:
– CN III (Oculomotor),
– VII (Facial),
– IX (Glossopharyngeal), and
– X (Vagus)
 Sacral components arise from S2 - S4 segments of the
spinal nerves.

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Parasympathetic Division: Cranio-sacral Division

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43
Parasympathetic Division

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 Organization of the Parasympathetic Neurons
1. Cell bodies of preganglionic neurons of the parasympathetic
division are located in the nuclei of four cranial nerves in the
brain stem (III, VII, IX, and X) and in the lateral gray matter of
the second through fourth sacral segments of the spinal cord.
2. Parasympathetic preganglionic neurons are referred to as the
craniosacral outflow.
3. Preganglionic axons of the parasympathetic division synapse
with postganglionic neurons in terminal ganglia which are
located close to or on the organ being innervated
4. Contains long preganglionic neurons which are cholinergic
5. Parasympathetic postganglionic axons travel from the terminal
ganglia to the target organ
6. Contains short postganglionic cholinergic neuron.

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 Parasympathetic Division
Parasympathetic ganglia:
• Preganglionic axons of the parasympathetic division synapse with
postganglionic neurons in terminal (intramural) ganglia
• Terminal ganglia: are parasympathetic ganglia, located
near/within the organ that they innervate.
• Terminal ganglia in the head have specific names:
– Ciliary ganglion,
– Pterygopalatine ganglion
– Submandibular ganglion
– Otic ganglion
• In the ganglion, the presynaptic neuron usually synapses with only
4-5 postsynaptic neurons, all of which supply a single visceral
effectors.

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Cranial nerves that carry PaNS

1. Oculomotor nerve (III).

• Oculomotor nerve carries parasympathetic
fiber that control the lens and pupil of the eye.
• Postganglionic fibers innervate
pupillary constrictor narrows the pupil
ciliary muscle for accommodation

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2. Facial nerve (VII).
It carries parasympathetic fibers that regulate
tear glands
salivary glands, and
nasal gland
3. Glossopharyngeal nerve (IX).
• It carries parasympathetic fibers concerned with
salivation.

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 Regulation of salivary secretion

FN= Facial nerve

GPN= Glossopharyngeal nerve
SLG= Sublingual gland,
SMG= Submandibular gland 49
4. Vagus nerve (X)
It carries about 90% of all parasympathetic
preganglionic fibers.
forms three networks in the mediastinum
Cardiac plexus:- supplies the heart
Pulmonary plexus:- supplies the
bronchi and blood vessels into the lungs
Esophageal plexus:-regulate
swallowing.

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07/05/2022 52
53
Symphathetic Vs Parasympathetic NS

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55
Symphathetic Vs Parasympathetic NS

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 Symphathetic Vs Parasympathetic NS

Short Long
preganglionic preganglionic
neuron neuron

Long
Postganglionic
neuron
Short
postganglionic
neuron

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 Autonomic Ganglia
 A ganglion (ganglia = pl) is a collection of cell bodies outside the CNS
 A nucleus (nuclei = pl) is a collection of cell bodies within the CNS
Types of the autonomic ganglia
1. Lateral (paravertebral) ganglia
- Are sympathetic ganglia
- Form sympathetic chains on both sides of the vertebral column
2. Collateral (prevertebral) ganglia
- Are also sympathetic ganglia
- Located  in front of the vertebral column
- 5 types: celiac ganglia, superior mesenteric ganglia, inferior mesenteric
ganglia, aorticorenal ganglion and renal ganglion

3. Terminal ganglia: a parasympathetic ganglia, located near/within the organ

that they innervate.
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 Lateral
(paravertebral)
ganglion

Collateral
(prevertebral)
ganglion

Terminal
ganglion

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 Neurotransmitter & Receptors in ANS
Neurotransmitter in ANS
• NTs are chemical substances released by neurons at synapses.

• Autonomic neurons release NT at synapses:-

– between neurons
preganglionic to postganglionic.
– with autonomic effectors
smooth muscle, cardiac muscle, and glands.
• Some ANS neurons release Ach; others release NE.

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 Neurotransmitter & Receptors in ANS…
Neurotransmitter in ANS
• The principal chemical transmitters are Acetylcholine and
Norepinephrine.
– All preganglionic neurons release Ach.
– All postganglionic parasympathetic neurons & some
postganglionic sympathetic neurons release Ach.
– Most postganglionic sympathetic neurons release norepinephrine.
 Both preganglionic and postganglionic neurons in the
parasympathetic division release acetylcholine and thus are called
cholinergic.

 All preganglionic axon and a few postganglionic neurons in the

sympathetic division are also cholinergic.

 Most of the postganglionic neurons of the sympathetic division

release nor epinephrine and are called adrenergic.
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Neurotransmitter & Receptors in ANS…

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Neurotransmitter & Receptors in ANS…
 Acetylcholine
• Synthesized in the cholinergic neuron from choline & acetate,
with the help of an enzyme choline acetyltransferase or
choline acetylase.

– This enzyme is localized in the cytoplasm of cholinergic

neurons, especially in the vicinity of storage vesicles, and
it is an identifying marker of the cholinergic neuron.

• All the components for the synthesis, storage, and release of

ACh are localized in the terminal region of the cholinergic
neuron.

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Neurotransmitter & Receptors in ANS…
 Acetylcholine…
• The storage vesicles & choline acetyltransferase are produced in
the soma & are transported to the axon terminals.

• Once Ach is secreted into a tissue by a cholinergic nerve ending,

it persists in the tissue for a few seconds while it performs its
nerve signal transmitter function.

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 Neurotransmitter & Receptors in ANS…
 Acetylcholine…
• The enzyme acetylcholinesterase (AChE) hydrolyzes ACh back to
choline & acetate after the release of ACh.

– This enzyme is found in both presynaptic & postsynaptic cell

membranes, allowing rapid & efficient hydrolysis of
extracellular ACh.

• The choline generated from ACh hydrolysis is taken back up by the

cholinergic neuron by a high-affinity, Na-dependent uptake
mechanism.
• An additional source of choline is the low-affinity transport used by
all cells to take up choline from the ECF for use in the synthesis of
phospholipids.
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Neurotransmitter & Receptors in ANS…

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Neurotransmitter & Receptors in ANS…

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 Neurotransmitter & Receptors in ANS …
 Norepinephrine
• Synthesis of NE begins in the axoplasm of the terminal nerve endings
of adrenergic nerve fibers, but is completed inside the secretory
vesicles.
 The basic steps are the following:
1. Tyrosine Hydroxylation Dopa
2. Dopa Decarboxylation Dopamine
3. Transport of dopamine into the vesicles
4. Dopamine Hydroxylation Norepinephrine
• In the adrenal medulla, this reaction goes still one step further to
transform about 80% of the NE into E, as follows:

5. Norepinephrine Methylation Epinephrine

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Neurotransmitter & Receptors in ANS

tyrosine DOPA dopamine b

hydroxylase decarboxylase hydroxylase

Tyrosine DOPA DA NE

• DA= Dopamine

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 Neurotransmitter & Receptors in ANS
 Norepinephrine
 After secretion of NE by the terminal nerve endings,
it is removed from the secretory site in three ways:

1. Reuptake into the adrenergic nerve endings themselves by

an active transport process— accounting for removal
of 50 —80% of the secreted NE. (large amounts)

2. Diffusion away from the nerve endings into the surrounding

body fluids & then into the blood—accounting for removal of
most of the remaining NE. (moderate amounts)

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 Neurotransmitter & Receptors in ANS
 Norepinephrine

3. Destruction of small amounts by tissue enzymes;

– Monoamine oxidase (MAO), which is found in the
nerve endings, &
– Catechol-O-methyl transferase (COMT), which is
present diffusely in all tissues.

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 Mechanism:
Norepinephrine release & recycling in the nerve endings

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Neurotransmitter & Receptors in ANS…
Receptors in ANS:
A. Cholinergic receptors
• There two receptors of acetylcholine
– Nicotinic receptors
– Muscarinic receptors
• Acetylcholine activates both receptors.
Nicotinic receptors
• Nicotinic receptors are found in:
– Autonomic ganglia (between pre- and post ganglionic neurons
(ganglia) of both parasympathetic and sympathetic nervous
system).
– Also found at many non- autonomic nerves e.g.,
Neuromuscular junction
– The nicotinic acetylcholine receptors are ligand-gated channel
for Na+ & other cations.
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 Neurotransmitter & Receptors in ANS
Muscarinic receptors
• Muscarinic receptors:
– are found on all effector cells stimulated by postganglionic
cholinergic neurons of both parasympathetic and
sympathetic nervous system.
• G proteins coupled receptors
• That couples receptor activation to:
– Adenylyl cyclase,
– K+ channels,
– Phospholipase C
• There are five types of muscarinic cholinergic receptors:
– M1 is abundant in the brain -excitatory (↑Ca2+)
– M2 receptor is found in the heart-inhibitory (↑K+.)
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Neurotransmitter & Receptors in ANS
– The M4 receptor is found in pancreatic acinar and
islet tissue.
– The M3 and M4 receptors are associated with
smooth muscle –excitatory (M3 - ↑Ca2+) or
inhibitory (M4 - ↑K+)
– M5 is found in vascular smooth muscles of
cerebral vessels; CNS neurons.
• Increased intracellular Calcium.

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Cholinergic Receptors

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Neurotransmitter & Receptors in ANS…

B. Adrenergic receptors
Alpha- adrenergic receptors : subtypes include alpha1 and alpha2
Beta receptors- subtypes include beta1 and beta2

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 Neurotransmitter & Receptors in ANS
Adrenoceptors Typical Locations Result of Ligand
Binding
  Alpha1 Smooth muscle fibers in blood vessels that Formation of IP3 and
serve salivary glands, skin, kidneys, and DAG, ↑cytosolic calcium
abdominal viscera; radial muscle in iris of
eye; sphincter muscles of stomach and
urinary bladder; salivary gland cells;
sweat glands
  Alpha2 Presynaptic adrenergic nerve terminals; Inhibition of adenylyl
cells of pancreatic islets that secrete the cyclase, decreased cAMP
  hormone insulin (beta cells); pancreatic
acinar cells
  Beta1 Cardiac muscle fibers; brain (posterior Stimulation of adenylyl
pituitary); adipose cells; cyclase, increased cAMP
  Juxtaglomerular cells of kidneys
  Beta2 Smooth muscle in walls of airways; in Stimulation of adenylyl
blood vessels that serve the heart; skeletal cyclase and increased
  muscle, adipose tissue, and liver cAMP.  

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 Neurotransmitter & Receptors in ANS
 Both epinephrine and norepinephrine act on α and 
receptors.
 Norepinephrine have greater affinity for α -adrenergic
receptors.
– Stimulates alpha receptors more strongly than beta receptors
 Epinephrine receptors approximately equally for  -
adrenergic receptors.
 Epinephrine stimulate both alpha and beta receptors
approximately equally.

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Neurotransmitter & Receptors in ANS
Neurotransmitter in ANS
• The principal chemical transmitters are acetylcholine
and norepinephrine.
– All preganglionic neurons release Ach.
– Almost all postganglionic parasympathetic
neurons & some postganglionic sympathetic
neurons release Ach.
– Most postganglionic sympathetic neurones release
norepinephrine.
• Additional transmitters –neuropeptides, NO & ATP
are also released from ANS as neuromodulators or
neurotransmitters.
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 Effects of ANS
Effectors Sympathetic Activity Parasympathetic Activity

Smooth muscles

 Eyes Through 1 receptor contracts the radial
  muscle of the iris → pupilary dilation
Through 2 receptors causes relaxation of
ciliary muscle → lens accommodation for
far sight
Contracts the circular muscle
of the iris to constrict the pupil
Contracts the ciliary muscle by
acting on M3

 Lung  Through 2 receptor stimulation bronchial Contraction bronchial muscle

muscle relaxation M3

Heart Increase heart rate and force of atrial and Decrease heart rate; decreased
ventricular contractions through (1, 2) force of atrial contraction M2
receptors.

Blood vessels •Dilate (2); constrict through (1)

receptors

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 Effects of ANS…
Effectors Sympathetic Activity Parasympathetic Activity

Smooth muscles
Gallbladder Bladder wall -Relaxation (2) Contraction: increased
release of bile into small
intestine M3.
Stomach and Decreased motility and tone (2, 2); Increased motility and tone
intestine contraction of sphincters (1). M3 ; relaxation of
sphincters M4.
Spleen Contraction of sinusoids and discharge
of stored blood into general circulation
(1).
Urinary bladder Relaxation of bladder wall (2); Contraction of muscular
contraction of sphincter (1). wall M3; relaxation of
sphincters M4.
Uterus Inhibits contraction in non-pregnant Promotes contraction in
women (2); promotes contraction in pregnant women M3
pregnant women (1) minimal effect
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 Effects of ANS…
Effectors Sympathetic Activity Parasympathetic Activity
Smooth muscles
Sex organs In males: contraction of smooth Vasodilation; erection of
muscle of ducts (1) clitoris (females) and penis
(males)
Arrector pili Contraction → erection of hairs (1)
muscle

GLANDS
Adrenal Secretion of epinephrine and
medullae norepinephrine through (nicotinic ACh
receptors)
Lachrymal (tear) Secretion of tears
Pancreas Inhibits secretion of digestive enzymes Secretion of digestive
and the hormone insulin (2); enzymes and the hormone
Promotes secretion of the hormone insulin M4.
glucagon (2)
Kidney, ↑secretion of renin (1)
 Effects of ANS…
Effectors Sympathetic Activity Parasympathetic Activity
Sweat Increases sweating in most body
regions (muscarinic Ach receptors);
Sweating on palms and soles (1).

Metabolic functions
Liver Glycogenolysis; gluconeogenesis; Glycogen synthesis;
decreased bile secretion (1 and 2). increased bile secretion.

Adipose tissue Lipolysis-release of fatty acids into

blood (1 and 3).

Enteric Nervous System

•Parasympathetic and sympathetic nerves connect the CNS to the
ENS or directly to the digestive tract.
• ENS receive preganglionic fibers from the parasympathetic
system as well as postganglionic sympathetic axons.
85
Autonomic innervation

86
87
 Autonomic Reflex
 A reflex is a fast and involuntary response to a stimulus
 A reflex action consists of an action that is signalled to CNS and a reaction sent by
the CNS
 Any reflex is transmitted through a reflex arc
 A reflex arc of any reflex has 5-components
1. Receptor - that detects changes and generates action potential (AP)

2. Afferent (sensory) pathway- Conducts AP to CNS

3. Integrating centre- (spinal cord, brain stem, hypothalamus, cerebral cortex)

4. Efferent (motor) pathway-Conducts AP to effectors

5. Effectors organs (Cardiac muscles, smooth muscles and glands) –Receive

feedback and respond accordingly.

88
 Autonomic Reflex…
Representative autonomic reflexes
- The Baroreceptor reflex-maintaining blood pressure
- The chemoreceptor reflex-the carotid bodies and aortic
bodies monitor blood O2, CO2 and pH
- Defecation reflex-stretch receptors in the rectal wall
stimulate the desire to defecate when waste fill the rectum
- Micturition reflex-causes contraction of the detrusor
muscle and relaxation of the external and internal sphincter
result in emptying bladder

89
 Autonomic Control by Higher Centers

• Activity of autonomic nerves is dependent on both reflexes

and descending excitatory and inhibitory input from several
brain regions.
 The hypothalamus is the major control and integration center
of the ANS
– Posterior parts of the hypothalamus control the sympathetic
division
– Anterior parts of the hypothalamus control the
parasympathetic division.
 Centers in the brainstem (pons & medulla)

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 Pharmacology of ANS
 Neuropharmacology is a branch of medicine that deals with the effects of drugs
on the nervous system, especially drugs that mimic, or inhibit the action of NTs
 Drugs that act on adrenergic effector organs
1. Symphathomimetics (adrenergic drugs):- drugs that enhance
sympathetic action.
 They stimulate adrenergic receptors or promote NE release.
• These drugs have sympathetic- like effects.
E.g. Phenylephrine
Epinephrine
Norepinephrine
Methoxamine
2. Drugs that cause release of catcholamines from the nerve endings
(indirect sympathomimetics).

E.g. Ephedrine
Tyramine
Cathinon/cathin
Amphetamine 91
92
3. Drugs that block adrenergic activity (sympatholytics)
are:
1. Synthesis and storage of NE can be prevented by:
– Reserpine
2. Release NE can be blocked by
– Guanethidine
3. Alpha receptors can be blocked by:
– Phenoxybenzamine
– Phentolamine
4. Drugs Blocking beta1 and beta2 receptors
– Propranolol/drug that blocks β1-& β2-receptors
– Metoprolol/drug mainly blocks β1-receptors
5. Drugs that block nerve impulse transmission through
autonomic ganglia of both PaNS and SyNS
- Hexamthonium
93
 Drugs that act on cholinergic effector organs
1. Parasympathomimetic Drugs(cholinergic drugs)
Pilocarpine
Methacholine
– They act directly on the muscarinic type of cholinergic receptors.
2. Drugs that have a parasympathetic potentiating effect
— Anticholinesterase drugs
• Some drugs can potentiate the effect of the naturally secreted Ach at
the parasympathetic endings by inhibiting acetylcholinesterase
• These include
– Neostigmine,
– Pyridostigmine, &
– Ambenonium.
94
3. Drugs that block cholinergic activity at effector organs
—Antimuscarinic drugs
• Drugs that block the action of Ach on the muscarinic type of
cholinergic effector organs.
• These drugs do not affect the nicotinic action of Ach on the
postganglionic neurons or on skeletal muscle.
• Cholinergic blockers at the effector organs
• These include
– Atropine
– Homatropine &
– Scopolamine

95
 Mechanism of action of ACh

A Cholinergic fibre

ACh ACh

Ach-E
ACh
M3 ACh
M3

Activation of
Phospholipase-C
PIP2 IP3 + DAG
• M3 in the bronchial SM and in the GIT
• M2 in the heart and BVs Inhibition of cAMP production, ↑Ca influx
activation of K+ channels 96
Mechanism of action of Catecholamines
Tyrosine

Dopamine

Noradrenaline

NA NA
NA

NA NA NA
NA
α1 β2
α2 β1

↑IP3 ↑cAMP

97
Thank You!

98