PHRM 240: Lecture 7

OVERVIEW
THE NERVOUS SYSTEM
Central Nervous System (CNS)
The CNS is the control center of the body and is composed of:
 Brain
 Spinal cord
Function of the CNS:
- The CNS receives sensory information from the body and the external
environment, processes this information, and then decides on an appropriate
response.
- It is the primary decision-maker that controls thoughts, movements,
emotions, and bodily functions.
Main Structures:
Brain:
- The brain is the command center for the entire body.
- It interprets sensory data, stores memory, processes thoughts, and initiates
voluntary and involuntary movements.
- It is divided into various parts, such as the cerebrum, cerebellum,
brainstem, and other regions, each responsible for specific functions like
memory, balance, movement, and basic life support functions like heart rate
and breathing.

Spinal Cord:
- The spinal cord is a long, thin bundle of nerve tissue extending from the
brain down through the backbone (vertebral column).
- It connects the brain to the rest of the body.
- It acts as a major relay station for information traveling between the brain
and the PNS.
- It also controls simple reflexes (such as pulling your hand away from
something hot).
Peripheral Nervous System (PNS)
The PNS acts as a communication network between the CNS and the rest of the
body.
It consists of:
Nerves: These are bundles of axons (nerve fibers) that transmit information
between the CNS and other parts of the body.
Ganglia: These are clusters of nerve cell bodies located outside the CNS that
relay signals in the PNS
Function of the PNS:
- The PNS connects the CNS to limbs, organs, and other parts of the body.
- It sends sensory information to the CNS and carries motor commands from
the CNS to muscles and glands.
- The PNS also plays a key role in reflex actions (both voluntary and
involuntary) and regulates bodily functions like heartbeat and digestion.
Divisions of the PNS:
Somatic Nervous System (SNS):
- Controls voluntary movements by innervating skeletal muscles. For
example, it allows you to move your hand or walk.
- It also mediates reflexes, which are fast, automatic responses to stimuli (such
as the knee-jerk reflex)
Autonomic Nervous System (ANS):
- Regulates involuntary functions (such as heartbeat, digestion, and breathing,
by controlling smooth muscles, cardiac muscles, and glands)
- The ANS is further divided into:
 Sympathetic Nervous System: Activates the "fight or flight" response in
emergencies (increases heart rate, dilates pupils, etc.).
 Parasympathetic Nervous System: Promotes the "rest and digest" state,
reducing heart rate, increasing digestion, and conserving energy

Somatic Nervous System (SNS) & Autonomic Nervous System (ANS)

Function
Somatic Nervous System (SNS):
- The SNS controls voluntary movements of skeletal muscles.
- It allows you to perform conscious actions, such as walking, lifting objects,
or speaking.
- It also controls reflex arcs (involuntary actions in response to stimuli), such
as pulling your hand away from a hot surface.
- Denervation of the SNS can lead to paralysis
 Autonomic Nervous System (ANS):
- The ANS regulates involuntary functions in the body (Ex: heart rate,
digestion, respiratory rate, pupil dilation, and glandular secretions)
- You don't have conscious control over these actions
- Denervation of the ANS does not completely stop visceral organ function.
Instead, it causes dysregulation, meaning the organs can still function but
not as efficiently or properly as before.
- The ANS is divided into 2 branches:
 Sympathetic Nervous System: Controls "fight or flight" responses,
preparing the body for stress or emergency.
 Parasympathetic Nervous System: Controls "rest and digest" responses,
promoting relaxation and normal bodily functions during restful states

Functions of the Autonomic Nervous System (ANS):

Heart:
Mechanical control:
- The ANS regulates the rate and force of heart contractions.
- The SNS increases heart rate and force of contraction
- The PNS decreases heart rate and force of contraction
Electrical control:
The ANS also influences the pacemaker cells of the heart (Ex: the sinoatrial node),
modulating the heart's rhythm and pace
Smooth muscles (Ex: bronchi, blood vessels, GI, genitourinary):
- The sympathetic system relaxes smooth muscles in some areas (Ex: dilating
bronchi for more airflow) while constricting others (Ex: vasoconstriction of blood
vessels to raise blood pressure).
- The parasympathetic system generally does the opposite, such as constricting
bronchi (reducing airflow) and promoting GI motility by contracting smooth
muscles in the gut.
Secretory glands:
- The ANS controls glands that secrete fluids like gastric juices, sweat, saliva, and
mucus
- The sympathetic system typically reduces digestive secretion while stimulating
sweat production.
- The parasympathetic system promotes secretion of saliva, gastric juices, and other
digestive enzymes.

Effector Organs
SNS: Targets skeletal muscles, which are under conscious control.
ANS:
- Targets smooth muscles, cardiac muscles, and glands.
- These muscles and glands are responsible for regulating functions like blood
vessel constriction, heartbeats, and saliva production
Pathways

SNS:
- Uses a single-neuron pathway.
- The motor neurons originate in the CNS (brain or spinal cord) and extend
directly to the skeletal muscles they control.
ANS:
Uses a two-neuron pathway:
- Preganglionic neuron: Originates in the CNS and travels to a ganglion.
- Postganglionic neuron: Extends from the ganglion to the target organ
(smooth muscle, cardiac muscle, or gland)

Neurotransmitters
SNS:
The neurotransmitter used by the somatic system is primarily acetylcholine
(ACh), which stimulates skeletal muscle contraction.
ANS:
Sympathetic division:
Primarily uses norepinephrine (noradrenaline) and epinephrine (adrenaline) to
excite or inhibit target organs, except for sweat glands, which use acetylcholine.
Parasympathetic division:
Uses acetylcholine (ACh) to inhibit or excite target organs
Control Centers
SNS:
Voluntary movement is controlled by motor areas in the cerebral cortex (the
part of the brain responsible for conscious thought and voluntary actions).
ANS:
Involuntary control is regulated by the hypothalamus, brainstem, and spinal
cord (These areas process and send signals for maintaining homeostasis)
Examples of Actions
SNS:
- Voluntary Movements (Moving your hand, typing on a keyboard or walking)
- Touching a hot stove and quickly pulling your hand away (a reflex action
still controlled by the SNS).
ANS:
Involuntary Actions (Increasing heart rate during exercise (sympathetic),
slowing heart rate after a meal (parasympathetic), or regulating blood pressure.
Response Time and Nature
SNS:
- Generally, has a faster response because it is directly linked to skeletal
muscles through a single neuron pathway.
- The muscles receive and act upon signals almost immediately.
ANS:
- Response can be slower due to the two-neuron pathway (preganglionic and
postganglionic neurons).
- The ANS modulates ongoing processes (e.g., digestion, heart rate), so the
effects are more long-lasting and steadier compared to somatic movements.
 THE AUTONOMIC NERVOUS SYSTEM
Anatomy & Organization
Components of the ANS
Afferent Sensory Input:
- Sensory signals from visceral organs (internal organs) are transmitted to the
CNS
- These inputs come from receptors that detect changes such as stretch,
temperature, chemical composition, or pain in organs.
Central Nervous System (CNS) Integrating Nuclei:
- The CNS processes sensory input from visceral organs and integrates this
information in areas like the hypothalamus, brainstem, and spinal cord.
- These nuclei decide how to respond to changes, regulating functions such as
heart rate, digestion, and glandular secretion
Efferent Motor Output:
The motor output from the ANS consists of a 2-neuron chain:
Presynaptic (preganglionic) neuron:
The cell body is located in the CNS (either in the brainstem or spinal cord) and
its axon projects to an autonomic ganglion outside the CNS.
Postsynaptic (postganglionic) neuron:
This neuron resides in the autonomic ganglion and sends its axon to the target
organ.
This pathway results in 2 Visceral Reflexes:
synapses:
- The ANS controls visceral reflexes, which are
First synapse
Occurs between the unconscious, automatic responses to stimuli from
preganglionic neuron and internal organs.
the postganglionic neuron - These reflexes maintain homeostasis by
(in the autonomic regulating visceral functions such as blood
ganglion). pressure, digestion, and temperature control.
Second synapse
Is between the Visceral Reflex Arc
postganglionic neuron and The visceral reflex arc steps:
the target effector organ
(e.g., heart, smooth 1. Sensory Receptors: Detect changes in the
muscle, or gland). internal environment such as stretch, temperature,
or chemical composition (e.g., baroreceptors
detecting blood pressure changes).
2. Afferent Neurons: Transmit sensory information from receptors to the CNS
for processing.
3. Interneurons: Located in the CNS, they integrate the sensory information
and coordinate an appropriate response.
4. Efferent Neurons: Send motor signals from the CNS to the effector organs
(via the two-neuron chain described above) to modify their activity.
5. Effectors: The organs or tissues that respond to the motor output, such as
smooth muscles, cardiac muscles, or glands.

Baroreflex (Visceral Reflex to High Blood Pressure)

1. Receptors (Baroreceptors):
- Baroreceptors, which are specialized stretch receptors, detect increased BP
by sensing the stretch of blood vessel walls.
- These receptors are primarily located in the carotid sinus (in the neck) and
the aortic arch (near the heart).
2. Afferent Neurons:
When BP increases, the baroreceptors send sensory signals through afferent
neurons to the medulla oblongata in the brainstem, which acts as the control
center for autonomic regulation.
3. Integrating Center (Medulla Oblongata):
- In the medulla, the signals are processed, and the brainstem integrates this
information.
- The medulla will initiate a response to lower the blood pressure by
decreasing sympathetic activity and increasing parasympathetic activity.
4. Efferent Neurons:
- Parasympathetic signals are transmitted via the vagus nerve to the heart to
reduce heart rate, a process known as vagal stimulation.
- Sympathetic signals are reduced to lower the force of heart contractions and
cause vasodilation (widening of blood vessels), decreasing peripheral
resistance.
5. Effectors:
- Heart: The parasympathetic stimulation decreases heart rate (negative
chronotropic effect), which lowers cardiac output and consequently BP
- Blood Vessels: Reduced sympathetic tone causes the blood vessels to dilate
(vasodilation), further reducing resistance and lowering BP
- Kidneys: Over time, the kidneys respond by reducing the amount of blood
volume through the excretion of water and sodium, helping to lower BP
Summary of the Baroreflex Pathway:
1. Stimulus: High blood pressure.
2. Receptors: Baroreceptors in the carotid sinus and aortic arch.
3. Afferent Pathway: Sensory signals sent to the medulla oblongata.
4. Integrating Center: Medulla oblongata processes the information.
5. Efferent Pathway: Increased parasympathetic output (via vagus nerve) and decreased
sympathetic output.
6. Effectors: Heart (decreases heart rate), blood vessels (vasodilation), and kidneys (fluid
excretion).
7. Response: Blood pressure decreases back to a normal range.

Autonomic Tone
The ANS maintains a normal background rate of activity known as autonomic
tone which reflects a balance between the sympathetic and parasympathetic
systems
1. Parasympathetic System:
- The parasympathetic system helps to maintain smooth muscle tone in the
intestines, ensuring the continuous movement of food and digestion.
- It also plays a key role in regulating the heart rate, typically maintaining it at
around 70 beats per minute when the body is at rest.
2. Sympathetic System:
- The sympathetic system works to keep blood vessels partially constricted,
which helps maintain adequate blood pressure.
- This partial constriction ensures that blood flow is sufficient to meet the
body's needs under normal conditions.

Anatomy & Function: Sympathetic Outflow

Location of Preganglionic Neurons:
- The cell bodies of the preganglionic sympathetic neurons are located in the
thoracolumbar division of the spinal cord (Specifically between T1 and L2
vertebrae)
- This is why the sympathetic nervous system is also referred to as the
thoracolumbar division.
Axonal Pathways to Sympathetic Ganglia:
- The preganglionic neurons send axons (nerve fibers) from the spinal cord to
the sympathetic ganglia.
- These ganglia serve as relay stations where the preganglionic neurons
synapse with postganglionic neurons.
Types of Sympathetic Ganglia:
There are 2 types of sympathetic ganglia:

Vertebral (Paravertebral) Ganglia:

- These are located alongside the vertebral column, forming a chain of 22-23
pairs (one pair for each vertebra from the cervical to the sacral region).
- This chain is also known as the sympathetic trunk or chain.
Prevertebral (Collateral) Ganglia:
These are found in front of the vertebral column near major arteries and include
4 main ganglia:
- Celiac ganglion
- Superior mesenteric ganglion
- Inferior mesenteric ganglion
- Aorticorenal ganglion
Sympathetic Ganglia Cells:
- The postganglionic neurons in the sympathetic ganglia send their axons to
peripheral organs such as the heart, lungs, blood vessels, and sweat glands,
where they exert the sympathetic effects.
- These axons travel to various target organs, stimulating responses that
increase heart rate, dilate airways, and constrict blood vessels, helping the
body respond to stress or emergency situations
Pathways of the Sympathetic Nervous System (SNS)
Paravertebral Ganglia:
Located along both sides of the spine, these ganglia form a chain and have
specific pathways to various regions of the body:
 Cervical Ganglia (3 pairs): Innervate the head, neck, and heart.
 Thoracic Ganglia:
 T1-T4: Innervate the thorax (chest area).
 T5-T12: Innervate the abdomen (stomach and surrounding organs).
 Lumbar Ganglia (4 pairs): Innervate the pelvic viscera (organs in the
pelvis).
 Sacral Ganglia (4 pairs): Innervate the lower limbs (legs and feet).
Prevertebral Ganglia:
Located in front of the spine, these ganglia primarily contribute to the
abdominal aortic plexus, which innervates the organs of the abdomen.
Adrenal Glands (Suprarenal glands)
The adrenal glands are situated on top of each kidney
They are small, triangular-shaped glands that play a significant role in hormone
production.
Cortex:
- The outer layer of the adrenal gland.
- Composed of 3 zones, each responsible for producing different types of
steroid hormones:
 Zona Glomerulosa: Secretes aldosterone (mineralocorticoid) for fluid and electrolyte
balance.
 Zona Fasciculata: Produces cortisol (glucocorticoid) for stress response and
metabolism regulation.
 Zona Reticularis: Secretes androgens that influence sexual characteristics
Medulla:
- The inner part of the adrenal gland.
- Functions similarly to a sympathetic ganglion.
- It contains modified postganglionic sympathetic neurons that lack typical
dendrites and axons.
- The adrenal medulla is stimulated by preganglionic sympathetic fibers that
originate in the spinal cord
The adrenal medulla releases catecholamines into the bloodstream:
Epinephrine (Adrenaline):
- Accounts for about 80% of the secretion.
- Increases heart rate, dilates airways, and boosts energy availability by
mobilizing glucose and fat stores.
Norepinephrine (Noradrenaline):
- Accounts for about 20% of the secretion.
- Primarily involved in increasing blood pressure and enhancing blood flow to
muscles.

Role of the Adrenal Glands in Stress Response

The adrenal glands are crucial in the "fight or flight" response
1) Activation of the Sympathetic Nervous System:
Preganglionic sympathetic fibers activate the adrenal medulla, leading to the release
of catecholamines (epinephrine and norepinephrine).
2) Systemic Effects:
- Increased Heart Rate: Epinephrine acts on heart receptors, increasing the heart rate
and strength of contractions, which boosts blood flow to essential organs and
muscles.
- Bronchodilation: Epinephrine relaxes the smooth muscles of the bronchi, allowing
for increased airflow to the lungs.
- Increased Blood Glucose: Glucocorticoids (especially cortisol) stimulate
gluconeogenesis in the liver, increasing blood sugar levels for immediate energy.
- Increased Blood Pressure: Norepinephrine constricts blood vessels, raising blood
pressure to enhance blood flow to muscles and vital organs.
- Suppression of Non-Essential Functions: Functions like digestion and immune
responses are temporarily suppressed to prioritize immediate survival.
The Sympathoadrenal System
- Refers to the combined actions of the sympathetic nervous system and
adrenal medulla during stress, enhancing the body’s ability to respond
quickly to threats.
- This system allows the body to prepare quickly for situations requiring
heightened alertness, physical activity, or energy expenditure.
Anatomy of Parasympathetic Outflow
Origin of Nerve Fibers:
The preganglionic neurons of the PNS originate from two main areas:
- Brainstem (Specifically, from the nuclei of certain cranial nerves)
- Sacral Spinal Cord (From spinal segments S2 to S4)
Cranial Nerves:
The PNS utilizes 4 cranial nerves for its functions:
Cranial Nerve III (Oculomotor):
Controls functions related to the eye, such as pupil constriction and lens
adjustment for focusing.
Cranial Nerve VII (Facial):
- Innervates the salivary glands aiding in digestion
- Innervates the lacrimal glands aiding in eye moisture.
Cranial Nerve IX (Glossopharyngeal):
- Primarily involved in saliva production from the parotid gland
- Has a role in swallowing.
Cranial Nerve X (Vagus):
- The most extensive, innervating various organs including the heart, lungs,
and most of the digestive tract.
- It plays a significant role in regulating heart rate, respiratory rate, and
digestive processes.
Sacral Nerves:
The fibers from the sacral spinal cord innervate structures in the lower abdomen
and pelvis, including:
- The bladder, promoting urination.
- The lower part of the colon, aiding in bowel movements.
- Reproductive organs, contributing to sexual arousal and function.
Parasympathetic Ganglia
- Parasympathetic ganglia are situated either near or within the target organs
they innervate
- This proximity allows for more direct control over organ function
- The long preganglionic fibers extend from the CNS to these ganglia, where
they synapse with short postganglionic fibers that then innervate the target
organs.
- This configuration results in a more localized and specific response in the
target tissues
Formation of Pelvic Splanchnic Nerves
- Fibers from S2 to S4 form the pelvic splanchnic nerves.
- These nerves are part of the sacral outflow of the PNS and are responsible
for innervating pelvic organs.
Connection to the Inferior Hypogastric Plexus
- The pelvic splanchnic nerves join the inferior hypogastric plexus, a
network of nerve fibers located in the pelvis.
- This plexus serves as a relay center, integrating input from both sympathetic
and parasympathetic fibers.
Pelvic Nerves to Terminal Ganglia
Pathway to Target Organs:
Most fibers from the inferior hypogastric plexus form pelvic nerves, which
travel to their respective target organs.
Target Organs:
The efferent pathways innervate various pelvic and abdominal structures,
including:
- Regulates bowel movements and secretions.
- Promotes defecation (Rectum)
- Stimulates bladder contraction, facilitating urination
- Supports functions such as erection in males and lubrication in females.
Dual Innervation: Parasympathetic and Sympathetic Systems
Many of the body's organs receive signals from both the sympathetic and
parasympathetic divisions of the autonomic nervous system.
This relationship is called dual innervation, and the effects of these two
systems can be either antagonistic (opposing) or cooperative (working
together).
Antagonistic Effects: Competing for Control
Same Effector, Opposite Effects:
When both systems act on the same effector, they typically produce opposite
outcomes.
For example:
The heart's SA node receives signals from both systems:
- Sympathetic stimulation increases heart rate.
- Parasympathetic stimulation decreases heart rate.
Different Effectors, Opposite Outcomes:
Sometimes the systems innervate different muscles in the same organ, but their
effects still oppose each other
For example:
In the iris of the eye, the two systems control different muscles to affect pupil
size:
- Sympathetic division stimulates the radial muscle, causing pupil dilation
(mydriasis) to let in more light
- Parasympathetic division stimulates the circular muscle, causing pupil
constriction (miosis) to reduce light entering the eye

Cooperative Effects:
In some cases, the two systems work together to achieve a unified result, often
affecting different structures but coordinating a single function.
For example:
During sexual activity in males:
- The parasympathetic division is responsible for erection by causing
vasodilation and increased blood flow to the penile tissue.
- The sympathetic division triggers ejaculation, contributing to the completion
of the sexual response
Effectors with No Dual Innervation: Sympathetic Control Only
Some organs and tissues are exclusively regulated by the sympathetic nervous
system, without parasympathetic involvement.
Blood Vessels:
- Increased sympathetic tone → vasoconstriction (narrowing of blood
vessels).
- Decreased sympathetic tone → vasodilation (widening of blood vessels).
This allows blood flow to shift between different areas of the body, depending
on the need
Left Ventricle:
The left ventricle of the heart is mainly under sympathetic control, which
increases heart contractility and output.
Receptor-Specific Effects:
Skin blood vessels:
Sympathetic stimulation activates alpha-1 receptors, causing vasoconstriction.
This minimizes bleeding and redirects blood flow away from the skin.

Skeletal muscle blood vessels:

Sympathetic activation of beta-2 receptors causes vasodilation, increasing blood
flow to muscles during physical activity for more oxygen and glucose
Enteric Nervous System (3rd Division of ANS)
 Located in the walls of the GI tract, the enteric nervous system (ENS) is
often referred to as the third division of the autonomic nervous system
(ANS).
 Functions independently but communicates with the CNS via the
sympathetic and parasympathetic systems.
 Regulates:
 Smooth muscle activity (motility).
 Gland function (secretion).
 Contains a huge number of neurons.
 Has its own reflex arcs, allowing for autonomous function.
 2 main plexuses:
 Auerbach’s (myenteric) plexus: controls muscle contractions.
 Meissner’s (submucosal) plexus: regulates secretions and blood flow.
 Uses many neurotransmitters, such as acetylcholine (Ach), serotonin, and
VIP (vasoactive intestinal peptide), to mediate its actions
Neurotransmitters and Receptors in the ANS
The effects of the autonomic nervous system (ANS) are determined by:
1. The type of neurotransmitter released.
2. The type of receptor on the target (post-junctional) membrane.
This combination explains how the same neurotransmitter can have opposite
effects in different tissues
Neurotransmitters:
 Acetylcholine (Ach): Used by parasympathetic nerves and some
sympathetic pathways (Ex: sweat glands)
 Norepinephrine (NE): The primary neurotransmitter of sympathetic nerves
 Epinephrine (Epi): Released by the adrenal medulla in response to
sympathetic stimulation
Types of Receptors:
1. Cholinergic receptors (respond to Ach):
 Nicotinic receptors: Found in autonomic ganglia and the adrenal
medulla.
 Muscarinic receptors: Found in target organs of the parasympathetic
system (Ex: heart, glands)
2. Adrenergic receptors (respond to NE and Epi):
 Alpha receptors:
 Alpha-1: Cause vasoconstriction (Ex: in skin, GI tract).
 Alpha-2: Inhibit further release of NE.
 Beta receptors:
 Beta-1: Increase heart rate and force of contraction.
 Beta-2: Cause vasodilation (Ex: in skeletal muscle, bronchi)

https://nursekey.com/physiology-of-the-peripheral-nervous-system/
Acetylcholine (Ach)
Acetylcholine is a neurotransmitter secreted by:
- All preganglionic autonomic neurons (both sympathetic and
parasympathetic).
- All postganglionic parasympathetic neurons.
- These neurons are referred to as cholinergic fibers.
Types of Acetylcholine Receptors:
Muscarinic Receptors:
- Found in cardiac muscle, smooth muscle, and glands.
- Can be excitatory or inhibitory, depending on the target organ.
Nicotinic Receptors:
- Located in autonomic ganglia, the adrenal medulla, and the neuromuscular
junction.
- Always excitatory, leading to stimulation of the target tissue
Norepinephrine (Noradrenaline)
Norepinephrine (NE) is a neurotransmitter secreted by:
- Almost all sympathetic post-ganglionic neurons, except those innervating
sweat glands, which use acetylcholine (Ach)
- These neurons are referred to as adrenergic fibers.
Types of Norepinephrine Receptors:
Alpha Receptors:
- Usually excitatory.
- Two subclasses:
 Alpha-1: Typically cause vasoconstriction (e.g., in blood vessels).
 Alpha-2: Often inhibit further release of NE through a feedback
mechanism.
Beta Receptors:
- Usually inhibitory, but can also be excitatory depending on the organ.
- Three subclasses:
 Beta-1: Excitatory, found in the heart (increases heart rate and
contraction strength).
 Beta-2: Inhibitory, causes bronchodilation and vasodilation in smooth
muscles.
 Beta-3: Involved in lipolysis in fat cells