Autonomic Nervous System

Dr. Sumaira Iqbal

 Introduction
• Auto—self, nomos—control
• ANS is a motor nervous system that controls our glands,
cardiac muscle and smooth muscle
• Know as the visceral motor system
• Autonomic nerve pathway– 2 neuron chain extending from
CNS to innervated organs
• It influence the activities of viscera
• ANS act unconsciously and regulate bodily functions
• ANS regulates the activities of glands, smooth and cardiac
muscles
• Impulses are conducted from the CNS by axon
• The axon of the second neuron innervates the involuntary
effector
• Autonomic areas in cerebral hemisphere, hypothalamus and
limbic system
• Autonomic centers in brain stem
• Autonomic centers in spinal cord
 Autonomic Neurons
• PREGANGLIONIC NEURON
– Cell body in brain or spinal cord
– Axon is myelinated type B fiber that extends to autonomic
ganglion
• POSTGANGLIONIC NEURON
– Cell body lies outside the CNS in an autonomic ganglion
– Axon is unmyelinated type C fiber that terminates in a
visceral effectors
 Ganglia
• Lateral horn to paravertebral ganglia forms spinal nerve =
white communicating ramus (myelinated)
• Signals from the ganglion (to the target tissue) travel along
unmyelinated fibers = grey communicating ramus
• Two divisions
– Sympathetic division
– Parasympathetic division
 Sympathetic division
• Also called Thoracolumbar division of the ANS
• T1-T12,L1 and L2
• Preganglionic fibers exit the spinal cord in the ventral root of
the spinal nerves
• Preganglionic neurons synapse with postganglionic neuron in
the sympathetic ganglia (Paravertebral Ganglia)
• Ganglia within each row are interconnected
 Sympathetic division
• Innervates sweat glands, adrenal medulla, erector pili & blood
vessels
• Thoracolumber outflow has 3 destinations
1. Terminate in the ganglia
2. Travel up & down & then terminate
3. Pass without synapsing & terminate in prevertebral ganglia
 Collateral Ganglia
• Preganglionic fibers below the level of the diaphragm form
splanchnic nerves.
• Splanchnic nerves preganglionic fibers synapse in collateral
(Prevertebral) ganglia
• These include; Celiac, superior mesenteric and inferior
mesenteric ganglia
• These usually innervates organs of the digestive, urinary and
reproductive systems
 Adrenal Gland
• Suprarenal glands, located above each kidney
• modified sympathetic ganglion
• Each adrenal is composed of two parts:
– Cortex
– Medulla
• Adrenal medulla secretes the hormone epinephrine (adrenaline)
• secretes epinephrine into the blood in response to this neural
stimulation
• Both sympathetic ganglion and adrenal medulla –Sympathoadrenal
System
 Sympathetic division
• The ganglia of sympathetic division are classified into three
groups
1. Para vertebral or sympathetic chain ganglia
2. Prevertebral or collateral ganglia
3. Terminal or peripheral ganglia
 Parasympathetic Division
• Also known as craniosacral outflow
• Fibers of this division arise from brain and sacral segments of
spinal cord
• The cranial nerves of the parasympathetic division are:
1. Oculomotor (III) nerve
2. Facial (VII) nerve
3. Glossopharyngeal (IX) nerve
4. Vagus(X)nerve
 FUNCTIONS OF THE ANS
• Blood pressure • Defecation
• Heart and breathing rate • Sexual response
• Body temperature • Balance of water and electrolyte
• Digestion • Production of body fluid
• Energy metabolism
• Urination
 FUNCTIONS OF THE ANS
• Sympathetic division of the ANS activates the body for “Fight
or Flight” response
• Parasympathetic division often produce antagonistic effects
through the release of Acetylcholine, “Rest and Digest
Adrenergic & Cholinergic Synaptic Transmission
• Acetylcholine is the neurotransmitter used by all preganglionic
neurons (PNS & SNS)
• Most parasympathetic postganglionic fibers release Acetylcholine
• Transmission at this synapse is said to be Cholinergic (Ach)
• Most sympathetic postganglionic fibers release Norepinephrine
• Transmission at this synapse is said to be Adrenergic
• Numerous swelling (Varicosities) occurs when the axon of a
postganglionic neuron innervate a target organ
 Responses To Cholinergic Stimulation
All
• Somatic motor neurons Cholinergic
• All preganglionic neurons (SNS & PNS)
• Most postganglionic neurons (PNS) Ach release by somatic
motor neurons or preganglionic neurons (PNS/SNS) are always
Excitatory
• Ach released by most postganglionic neurons (PNS) are;
– Excitatory
– Inhibitory
 Responses To Cholinergic Stimulation
• Ach effects on a target organ depend on the nature of the
Cholinergic Receptor
• Two types of cholinergic receptors
• Nicotinic
• Muscarinic
• Binding of Ach to nicotinic receptors is always excitatory
• Located in the neuromuscular junction of the skeletal muscles
fibers
• Nicotinic Ach receptors are ligand-gated ion channels
 Cholinergic Receptors
• Muscarinic Receptors—G proteins
– Found on effector cells stimulated by post ganglionic cholinergic neurons
– Heart, smooth muscles and glands
– by post ganglionic cholinergic neurons either sympathetic or
parasympathetic
• Nicotinic Receptors– ligand gated ion channels
– Neuromuscular junctions
– All autonomic ganglia
– CNS pathways
 Adrenergic receptors
• Actions via binding with receptors—adrenergic receptors,
present in the target organs
• Adrenergic receptors are of two types:
– Alpha-adrenergic receptors, which are subdivided into alpha-1 and
alpha-2 receptors
– Beta-adrenergic receptors, which are subdivided into beta-1 and
beta-2 receptors
 Receptors
• Adrenaline acts through both alpha and beta receptors equally.
• Nor-adrenaline acts mainly through alpha receptors and
occasionally through beta receptors
 Responses To Adrenergic Stimulation
• Adrenergic stimulation by the release of epinephrine (Blood)
and by norepinephrine (sympathetic nerve ending)
• Neurotransmitters response on a specific cell depends on the
characteristic of the cell
• The presence of different membrane Receptor Proteins
• Two major classes of receptor proteins
– Alpha Adrenergic receptors
– Beta Adrenergic receptors
 Responses To Adrenergic Stimulation
• All adrenergic receptors act via G proteins
• G- protein dissociate into
– Alpha subunits
– Beta & Gamma complex
• Alpha subunits or B/G complex can either
– Cause the opening and closing of ion channels in the plasma
membrane
– Activate an enzyme in the membrane
 Other Autonomic Neurotransmitter
• Certain postganglionic autonomic axons produce their effects
through mechanisms that do not involve either norepinephrine
or acetylcholine
• These axons, consequently, have been termed “nonadrenergic,
noncholinergic fibers.”
• Proposed neurotransmitters for these axons include ATP,
vasoactive intestinal peptide (VIP), and nitric oxide (NO)
• Nitric oxide appears to function as the autonomic
neurotransmitter that causes vasodilation of cerebral arteries.
 Antagonistic Effects
• The effect of sympathetic and parasympathetic innervation of
the pacemaker region of the heart is the best example of the
antagonism of these two systems
 Organs without dual Innervation
• Although most organs receive dual innervation, some receive
only sympathetic innervation. These include;
– Adrenal medulla
– Arrector pili muscles in the skin
– Sweat glands in the skin
– Most blood vessels.
• In these cases, regulation is achieved by increases or decreases
in the tone (firing rate) of the sympathetic fibers
 Autonomic Reflexes
• Cardiovascular:
Baroreceptor reflex:
• It is stretch reflex in the main arteries such as carotid artery to
detect the blood pressure
Gastrointestinal:
• The receptors in the nose and mouth send a signal to
parasympathetic to notify the glands of mouth & stomach to
secrete the digestive juices
 Autonomic Reflexes
• Urinary Bladder:
• Initiate the micturition by parasympathetic innervations
• Sexual reflexes:
– erection by parasympathetic
– ejaculation by sympathetic
• The sympathetic activation often occurs in a mass discharge
such as in fright or severe pain “fight or fright”(sympathetic
stress response)
Organs Effect of Sympathetic Effect of Parasympathetic Stimulation
Stimulation
Organs Effect of Sympathetic Effect of Parasympathetic Stimulation
Stimulation
 Tone
• Basal rate of activity—tone
– Parasympathetic tone
– Sympathetic tone
• Single nervous system controls increase and decrease in
activity
• Sympathetic system keeps the arterioles constricted to 1/3rd all
the time
• Parasympathetic system maintains the GI motility only if the
vagus nerve is intact
 Tone
• Basal rate of secretion of
– Epinephrine–0.2μg/kg/min
– Norepinephrine–0.05μg/kg/min
• Required for maintenance of blood pressure
• Overall sympathetic tone is because of basal secretion of
hormones and direct sympathetic activity
 Denervation Supersensitivity
• During the first week after a sympathetic or parasympathetic
nerve is destroyed, the innervated organ becomes more
sensitive to injected norepinephrine or acetylcholine
• Cause of denervation supersensitivity—partially known
• Number of receptors in the postsynaptic membranes of the
effector cells upregulates when epinephrine and acetylcholine
are not available
 Alarm response
• Mass discharge of sympathetic system
• Simultaneous discharge of all portions of sympathetic system
• Activation of hypothalamus as a result of fight fright
• Prepares the body for emergency
 Alarm Response
• Mass discharge of sympathetic system for survival
– Pupillary dilation
– Increase heart rate and strength of contraction
– Increase blood pressure
– Increase blood flow to active muscles
– Increase rates of metabolism
– Increased blood glucose concentration
– Increased muscle strength
– Increase mental activity
 Regulation
• The neural centers that directly control the activity of
autonomic nerves are influenced by higher brain areas, as well
as by sensory input MEDULLA OBLONGATA
• Centers for the control of the cardiovascular, pulmonary,
urinary, reproductive, and digestive systems are located in the
medulla
• Medulla itself is responsive to regulation by higher brain areas
(hypothalamus)
 Limbic System
• Limbic system is a group of fiber tracts and nuclei that form a
ring around the brain stem
• Includes the cingulate gyrus, hypothalamus, fornix,
hippocampus, and amygdaloid nucleus
• Involved in basic emotional drives
 Drugs
• Main 2 classes
• Mimetics
– Parasympathomimetics
– Sympathomimetics
• Lytics
– Parasympatholytics
– Sympatholytics
 Sympathetic Drugs
• Sympathomimetics
– Enhance release of epinephrine & nor epinephrine
– Ephidrine, tyramine, amphetamine

• Sympatholytics
– Synthesis block—reserpine
– Release block—guanthedine
– Alpha blockers—phenoxibezamine, terazosine
– Beta blocker—propranolol
– NMJ blocker--hexamethonium
 Parasympathetic Drugs
• Parasympathomimetics
– Pilocarpine, methacholine
– Achesterase inhibitors– neostigmine

• Parasympatholytics
– Antimuscarninic--homatropine
THANK YOU