Human Physiology 2024/10/09

The Autonomic Nervous System

Dr. Wafaa Fawzi Lec.4 College of Pharmacy

The Autonomic Nervous System and Homeostasis

The autonomic nervous system contributes to homeostasis by responding to subconscious
visceral sensations and exciting or inhibiting smooth muscle, cardiac muscle, and glands.
The peripheral nervous system (PNS) includes cranial and spinal nerves and is divided
into a somatic nervous system (SNS), autonomic nervous system (ANS), and enteric
nervous system (ENS). Like the somatic nervous system, the autonomic nervous system
(ANS) operates via reflex arcs.
the output part of the ANS has two divisions: the sympathetic division and the
parasympathetic division. Most organs have dual innervation; that is, they receive impulses
from both sympathetic and parasympathetic neurons.
A continual flow of nerve impulses from (1) autonomic sensory neurons in visceral organs
and blood vessels propagate into (2) integrating centers in the CNS. Then, impulses in (3)
autonomic motor neurons propagate to various effector tissues, thereby regulating the activity
of smooth muscle, cardiac muscle, and many glands. (4) The enteric division is a specialized
network of nerves and ganglia forming an independent nerve network within the wall of the
gastrointestinal (GI) tract. However, centers in the hypothalamus and brain stem do regulate
ANS reflexes.
Autonomic Nervous System
The main input to the ANS comes from autonomic (visceral) sensory neurons. Mostly, these
neurons are associated with interoceptors, which are sensory receptors located in blood
vessels, visceral organs, muscles, and the nervous system that monitor conditions in the
internal environment. Examples of interoceptors are chemoreceptors that monitor blood CO2
level and mechanoreceptors that detect the degree of stretch in the walls of organs or blood
vessels.
In some organs, 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. Changes in the diameter of the pupils, dilation
and constriction of blood vessels and adjustment of the rate and force of the heartbeat are
examples of autonomic motor responses.
Unlike skeletal muscle, tissues innervated by the ANS often function to some extent even if
their nerve supply is damaged. For example, the heart continues to beat when it is removed
for transplantation into another person, smooth muscle in the lining of the gastrointestinal
tract contracts rhythmically on its own, and glands produce some secretions in the absence of
ANS control.
Anatomy of autonomic motor pathways
Anatomical Components
Each division of the ANS has two motor neurons. The first of the two motor neurons in any
autonomic motor pathway is called a preganglionic neuron (Fig.1b). Its cell body is in the
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brain or spinal cord; its axon exits the CNS as part of a cranial or spinal nerve. The axon of a
preganglionic neuron is myelinated fiber that usually extends to an autonomic ganglion (is a
collection of neuronal cell bodies in the PNS), where it synapses with a postganglionic
neuron, the second neuron in the autonomic motor pathway. Its cell body and dendrites are
located in an autonomic ganglion, where it forms synapses with one or more preganglionic
axons.
The axon of a postganglionic neuron is unmyelinated fiber that terminates in a visceral
effector. Thus, preganglionic neurons convey nerve impulses from the CNS to autonomic
ganglia, and postganglionic neurons relay the impulses from autonomic ganglia to visceral
effectors (smooth muscle, cardiac muscle, or a gland). Alternatively, in some autonomic
pathways, the first motor neuron
extends to specialized cells
called chromaffin cells in the
adrenal medullae (inner portions
of the adrenal glands) rather
than an autonomic ganglion. In
addition, all somatic motor
neurons release only
acetylcholine (ACh) as their
NT, but autonomic motor
neurons release either ACh or
norepinephrine (NE).

Figure.1 Motor neuron

pathways in the (a) somatic
nervous system and (b)
autonomic nervous system
(ANS). Note that autonomic motor
neurons release either
acetylcholine (ACh) or
norepinephrine (NE); somatic
motor neurons release ACh.

Preganglionic Neurons
In the sympathetic division, the preganglionic neurons have their cell bodies in the lateral
horns of the gray matter in the 12 thoracic segments and the first two (and sometimes three)
lumbar segments of the spinal cord (Fig.2). For this reason, the sympathetic division is also
called the thoracolumbar division, and the axons of the sympathetic preganglionic neurons
are known as the thoracolumbar outflow.
Cell bodies of preganglionic neurons of the parasympathetic division are located in the
nuclei of 4 cranial nerves in the brain stem, specifically the oculomotor nerve, facial
nerve, glossopharyngeal nerve, and vagus nerve (III, VII, IX, and X) and in the lateral gray
matter of the second through three sacral segments of the spinal cord (S2–4), referred to as
the pelvic splanchnic nerves, (Fig.3). Hence, the parasympathetic division is also known as
the craniosacral division, and the axons of the parasympathetic preganglionic neurons are
referred to as the craniosacral outflow.

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Autonomic Ganglia: There are two major groups of autonomic ganglia: (1) sympathetic
ganglia, which are components of the sympathetic division of the ANS, and (2)
parasympathetic ganglia, which are components of the parasympathetic division of the ANS.
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 and prevertebral ganglia. Sympathetic trunk ganglia (also called vertebral
chain ganglia or paravertebral 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 (Fig.2).
Postganglionic axons from sympathetic trunk ganglia primarily innervate organs above the
diaphragm, such as the head, neck, shoulders, and heart. Sympathetic trunk ganglia in the
neck have specific names. They are the superior, middle, and inferior cervical ganglia.
The remaining sympathetic trunk ganglia do not have individual names. Because the
sympathetic trunk ganglia are near the spinal cord, most sympathetic preganglionic axons are
short and most sympathetic postganglionic axons are long.
The second group of sympathetic ganglia, the prevertebral (collateral) ganglia, lies
anterior to the vertebral column and close to the large abdominal arteries. In general,
postganglionic axons from prevertebral ganglia innervate organs below the diaphragm.
There are five major prevertebral ganglia (Fig.2):
(1) The celiac ganglion (2) The superior mesenteric ganglion (3) The inferior mesenteric
ganglion (4) The aorticorenal ganglion and (5) the renal ganglion.
A single sympathetic preganglionic fiber has many axon collaterals (branches) and may
synapse with 20 or more postganglionic neurons. This pattern of projection is an example of
divergence and helps explain why many sympathetic responses affect almost the entire body
simultaneously. After exiting their ganglia, the postganglionic axons typically terminate in
several visceral effectors.
Parasympathetic ganglia
Preganglionic axons of the parasympathetic division synapse with postganglionic neurons in
terminal ganglia. Most of these ganglia are located close to or actually within the wall of a
visceral organ, axons of parasympathetic preganglionic are long.
Terminal ganglia in the head have specific names. They are the ciliary ganglion,
pterygopalatine ganglion, submandibular ganglion, and otic ganglion (Fig.3).
In the ganglion, the presynaptic neuron usually synapses with only four or five postsynaptic
neurons, all of which supply a single visceral effector, allowing parasympathetic responses to
be localized to a single effector. this pattern is called convergence.
Autonomic Plexuses
In the thorax, abdomen, and pelvis, axons of both sympathetic and parasympathetic neurons
form tangled networks called autonomic plexuses, many of which lie along major arteries.
The autonomic plexuses also may contain axons of autonomic sensory neurons. The major
plexuses in the thorax are the cardiac plexus, which supplies the heart, and the pulmonary
plexus, which supplies the bronchial tree (Fig.5). The abdomen and pelvis also contain major
autonomic plexuses (Fig.4). The celiac plexus is the largest autonomic plexus and surrounds
the celiac trunk (is the first major branch of the abdominal aortas) the abdominal aortas
largest artery in the abdominal cavity, as part of the aorta, it is a direct continuation of
the descending aorta (of the thorax). The celiac plexus contains two large celiac ganglia,
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two aorticorenal ganglia, and a dense network of autonomic axons and is distributed to
the stomach, spleen, pancreas, liver, gallbladder, kidneys, adrenal medullae, testes, and
ovaries. The superior mesenteric plexus contains the superior mesenteric ganglion and
supplies the small and large intestines. The inferior mesenteric plexus contains the inferior
mesenteric ganglion, which innervates the large intestine. Axons mesenteric ganglion also
extends through the hypogastric plexus to supply the pelvic viscera. The renal plexus
contains the renal ganglion and supplies the renal arteries within the kidneys and ureters.
ANS neurotransmitters and receptors
Based on the NT they produce and release at synapse as well as at point of contact with
visceral effectors, autonomic neurons are classified as either cholinergic or adrenergic. The
receptors for the NTs are integral membrane proteins located in the plasma membrane of the
postsynaptic neuron or effector cell.
Cholinergic neurons and receptors
Cholinergic neurons release the NT acetylcholine (ACh). In the ANS, the cholinergic
neurons include (1) all sympathetic and parasympathetic preganglionic neurons, (2)
sympathetic postganglionic neurons that innervate most sweat glands, and (3) all
parasympathetic postganglionic neurons (Fig.5). ACh binds with specific cholinergic
receptors, in the postsynaptic plasma membrane. The two types of cholinergic receptors,
both of which bind ACh, are nicotinic receptors and muscarinic receptors.
Nicotinic receptors are present in the plasma membrane of dendrites and cell bodies of both
sympathetic and parasympathetic postganglionic neurons (Fig.6 a, b), the plasma membranes
of chromaffin cells of the adrenal medullae, and in the motor end plate at the
neuromuscular junction.
Muscarinic receptors are present in the plasma membranes of all effectors (smooth
muscle, cardiac muscle, and glands) innervated by parasympathetic postganglionic axons. In
addition, most sweat glands receive their innervation from cholinergic sympathetic
postganglionic neurons and possess muscarinic receptors (Fig.6 b).
Activation of nicotinic receptors by ACh causes depolarization and thus excitation of the
postsynaptic cell, which can be a postganglionic neuron, an autonomic effector.
Activation of muscarinic receptors by ACh sometimes causes depolarization (excitation) and
sometimes causes hyperpolarization (inhibition), depending on which particular cell bears the
muscarinic receptors. For example, binding of ACh to muscarinic receptors inhibits (relaxes)
smooth muscle sphincters in the gastrointestinal tract. By contrast, ACh excites muscarinic
receptors in smooth muscle fibers in the circular muscles of the iris of the eye, causing them
to contract.
Adrenergic neurons and receptors
In the ANS, adrenergic neurons release norepinephrine (NE), also known as
noradrenalin (Fig.5 a). Most sympathetic postganglionic neurons are adrenergic. NE
causing either excitation or inhibition of the effector cell.
Adrenergic receptors bind both norepinephrine and epinephrine. The norepinephrine can
be either released as a NT by sympathetic postganglionic neurons or released as a hormone
into the blood by chromaffin cells of the adrenal medullae; epinephrine is released as a
hormone.
The two main types of adrenergic receptors are alpha (α) receptors and beta (β) receptors,
which are found on visceral effectors innervated by most sympathetic postganglionic axons.

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These receptors are further classified into subtypes- α1, α 2, β 1, β 2, and β 3. Cells of most
effectors contain either alpha or beta receptors; some visceral effector cells contain both.
Norepinephrine stimulates alpha receptors more strongly than beta receptors; epinephrine is a
potent stimulator of both alpha and beta receptors. Compared to ACh, norepinephrine lingers
in the synaptic cleft for a longer time. Thus, effects triggered by adrenergic neurons typically
are longer lasting than those triggered by cholinergic neurons.

Fig.2 Structure
of the
sympathetic
division of the
autonomic
nervous
system. Solid
lines represent
preganglionic
axons; dashed
lines represent
postganglionic
axons. Although
the innervated
structures are
shown for only
one side of the
body for
diagrammatic
purposes, the
sympathetic
division actually
innervates
tissues and
organs on both
sides.

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Fig.3 Structure of the
parasympathetic division of the
autonomic nervous system. Solid
lines represent preganglionic axons;
dashed lines represent postganglionic
axons. Although the innervated
structures are shown only for one
side of the body for diagrammatic
purposes, the parasympathetic
division actually innervates tissues
and organs on both sides.

Fig.4 Autonomic plexuses in the thorax,

abdomen, and pelvis.

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Fig.5. Cholinergic neurons and adrenergic neurons
in the sympathetic and parasympathetic divisions.

Physiology of the ANS

Autonomic tone
Most body organs receive innervation from both
divisions of the ANS, which typically work in
opposition to one another. The balance between
sympathetic and parasympathetic activity, called
autonomic tone, is regulated by the hypothalamus.
Typically, the hypothalamus turns up sympathetic
tone at the same time it turns down parasympathetic
tone, and vice versa. The two divisions can affect
body organs differently because their
postganglionic neurons release different neurotransmitters and because the effector
organs possess different adrenergic and cholinergic receptors.
Sympathetic Responses
During physical or emotional stress, the sympathetic division dominates the
parasympathetic division. High sympathetic tone favors body functions that can support
vigorous physical activity and rapid production of ATP.
Besides physical exertion, various emotions-such as fear, embarrassment, or rage-
stimulate the sympathetic division. Visualizing body changes that occur during “E
situations” such as exercise, emergency, excitement, and embarrassment will help you
remember most of the sympathetic responses. Activation of the sympathetic division and
release of hormones by the adrenal medullae set in motion a series of physiological
responses collectively called the fight-or-flight response, which includes the following
effects:
• The pupils of the eyes dilate.
• Heart rate, force of heart contraction, and blood pressure increase.
• The airways dilate, allowing faster movement of air into and out of the lungs.
• The blood vessels that supply the kidneys and gastrointestinal tract constrict, which
decreases blood flow through these tissues. The result is a slowing of urine formation and
digestive activities, which are not essential during exercise.
• Blood vessels that supply organs involved in exercise or fighting off danger-skeletal
muscles, cardiac muscle, liver, and adipose tissue-dilate, allowing greater blood flow
through these tissues.
• Liver cells perform glycogenolysis (breakdown of glycogen to glucose), and adipose
tissue cells perform lipolysis (breakdown of triglycerides to fatty acids and glycerol).
• Release of glucose by the liver increases blood glucose level.
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• Processes that are not essential for meeting the stressful situation are inhibited. For
example, muscular movements of the gastrointestinal tract and digestive secretions slow
down or even stop.
The effects of sympathetic stimulation are longer lasting and more widespread than the
effects of parasympathetic stimulation for three reasons: (1) Sympathetic postganglionic
axons diverge more extensively; as a result, many tissues are activated simultaneously.
(2) Acetylcholinesterase quickly inactivates acetylcholine, but norepinephrine lingers in
the synaptic cleft for a longer period. (3) Epinephrine and norepinephrine secreted into
the blood from the adrenal medullae intensify and prolong the responses caused by NE
liberated from sympathetic postganglionic axons. These blood-borne hormones circulate
throughout the body, affecting all tissues that have alpha and beta receptors. In time,
blood-borne NE and epinephrine are destroyed by enzymes in the liver.
Parasympathetic Responses
The parasympathetic division enhances rest-and-digest activities. Parasympathetic
responses support body functions that conserve and restore body energy during times of
rest and recovery.
In the quiet intervals between periods of exercise, parasympathetic impulses to the
digestive glands and the smooth muscle of the gastrointestinal tract predominate over
sympathetic impulses.
This allows energy-supplying food to be digested and absorbed. At the same time,
parasympathetic responses reduce body functions that support physical activity.
The acronym SLUDD can be helpful in remembering five parasympathetic responses. It
stands for salivation (S), lacrimation (L), urination (U), digestion (D), and defecation (D).
All of these activities are stimulated mainly by the parasympathetic division.
Besides the increasing SLUDD responses, other important parasympathetic responses are
“three decreases”: decreased heart rate, decreased diameter of airways
(bronchoconstriction), and decreased diameter of the pupils.