AUTONOMIC NERVOUS

SYSTEM
- CONTROLS VISCERAL FUNCTIONS
- RAPID AND INTENSE EFFECTS
- 2 PARTS: SYMPATHETIC AND
PARASYMPATHETIC SYSTEMS
AUTONOMIC NERVOUS SYSTEM and somatic
nervous systems
 AUTONOMIC NERVOUS SYSTEM

PHYSIOLOGIC ANATOMY:

SYMPATHETIC NERVOUS
SYSTEM:
 pairs of PARAVERTEBRAL CHAINS
OF GANGLIA originating from T1 to
L2
 two PREVERTEBRAL GANGLIA:
– HYPOGASTRIC GANGLIA
– CELIAC GANGLIA
AUTONOMIC NERVOUS SYSTEM
– neurons originate from the
INTERMEDIOLATERAL HORN of the
spinal cord gray mater
– composed of 2 neurons:
PREGANGLIONIC &
POSTGANGLIONIC
– Short Preganglionic fibers synapse
in the ganglia then Postganglionic
neurons proceed to its destination
organ
– Some Postganglionic fibers pass
back the chain entering the Spinal
Nerves at all levels of the Spinal
Cord
– Approximate Segmental
Distribution:
 T1 = head; T2 = neck; T3 – T6 =
thorax; T12 – L2 = legs
– Sympathetic fibers going to the
Adrenal Medulla are all
Preganglionic fibers only
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PARASYMPATHETIC
NERVOUS SYSTEM:

– ORIGIN of the
Preganglionic Fibers:
– CRANIAL NERVES III,
VII, IX, X
– S2 & S3 occasionally
also S1 & S2
– 75% of all fibers
originate from the
VAGUS NERVE
– PREGANGLIONIC fibers
pass uninterrupted all the
way to the end organ
– Short POSTGANGLIONIC
fibers originate from the
wall of the end organ
– Nervi Erigentes – sacral
parasympathetic fibers
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 SYNAPTIC NEUROTRANSMITTERS:
ACETYLCHOLINE (Cholinergic)
NOREPINEPHRINE (Adrenergic)

 All Preganglionic neurons are CHOLINERGIC

 Parasympathetic Postganglionic neurons are

CHOLINERGIC

 Sympathetic Postganglionic neurons are

ADRENERGIC
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 NEUROTRANSMITTER
SYNTHESIS:
 MECHANISM OF
SECRETION:
– Action Potential 
permeability of calcium
 secretory vesicles
react with presynaptic
membrane to release its
content
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FATE OF NEUROTRANSMITTER AFTER SECRETION:
– ACETYLCHOLINE:
 Split in Acetate ion and Choline by Acetylcholinesterase
 Choline is brought back to nerve terminal ending for reuse
– NOREPINEPHRINE:
 Reuptake
 Diffusion away
 Destruction by enzymes ( MAO & COMT )
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MECHANISM OF
NEUROTRANSMITTER
EFFECTS: 2 Effects:
– Neurotransmitter binds to Opens or Closes Ion
RECEPTOR at post synaptic Channels:
membrane Excitation: Opens
– Conformational Change in the Sodium and/or
Receptor causes its Effects Calcium channels
Inhibition: Opens
Potassium &/or
Chloride channels
Alteration of Intracellular
Enzymes:
Epinephrine
activation of
Adenylcyclase
causing the
formation of Cyclic
AMP
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RECEPTORS:
– Acetylcholine Receptors:
– MUSCARINIC receptors:
 Found in all effector cells stimulated by the PNS
– NICOTINIC receptors:
 Found in the synapses of both SNS, PNS and skeletal muscle membranes
– Adrenergic Receptors:
– Alpha Receptors ( Alpha1 & Alpha2)
– Beta1 & Beta2 receptors
– Epinephrine excites both receptors
– Nonepinephrine excites mainly Alpha receptors
– FUNCTION of Adrenergic Receptors
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AUTONOMIC EFFECTS TO THE DIFFERENT
ORGANS OF THE BODY
ORGAN SYMPATHETIC EFFECT PARASYMPATHETIC EFFECT
EYE
Pupil Dilated Constricted
Ciliary Muscle Relaxation (Far Vision) Constriction (Near Vision)

GLANDS Vasoconstriction with Copious secretion for

slight secretion enzyme secreting glands
Sweat Glands Copious sweating Sweating of palms of hands
Apocrine Glands Thick Odoriferous sec None

HEART
Muscle ↑ rate , ↑ force ↓ rate , ↓ force
Coronaries Dilated (β2) Dilated
Constricted (α)
LUNGS
Bronchi Dilated Constricted
Blood Vessels Mildly Constricted ? Dilated
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ORGAN SYMPATHETIC EFFECT PARASYMPATHETIC EFFECT
Gall Bladder & Ducts Relaxed Contracted
Kidneys ↓ output & renin sec None
Bladder
Detrussor Relaxed Contracted
Trigone Contracted Relaxed
Penis Ejaculation Erection
Systemic Arterioles
Abdominal Viscera Constricted None
Muscle Constricted (α adrenergic) None
Dilated (β2 adrenergic)
Dilated (cholinergic)
Skin Constricted None
Blood ↑ Coagulation None
↑ Glucose & Lipids None
Basal Metabolism ↑ up to 100% None
Adrenal Medullary Secretion All increased None
Mental Activity Increased None
Piloerector Muscle Contracted None
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ROLE OF THE ADRENAL MEDULLAE:

– secretes both EPINEPHRINE (80%) &
NOREPINEPHRINE (20%)
– effects of its neurotransmitters is 5 – 10X
longer than its synaptic counterpart 
removed from the blood only slowly
– Epinephrine with greater effect on Beta
Receptors, lesser effects on the vessels and
muscles, & with 5-10X greater metabolic
effect than Norepinephrine
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CHARACTERISTIC OF ANS ORGAN STIMULATION:

Sympathetic Stimulation:
 Discharges almost as a complete unit ( MASS DISCHARGE )
Parasympathetic Stimulation:
 Discharges are usually highly specific

“ALARM OR STRESS RESPONSE” OF THE SNS

(Fight or Flight Reaction)
– Due to MASS DISCHARGE
– Characteristics:
  arterial pressure;  blood flow to muscles;  blood flow
to visceral organs;  cellular metabolism;  glycolysis; 
blood glucose;  muscle strength;  mental activity;  rate
of blood coagulation
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PHARMACOLOGY OF THE NERVOUS SYSTEM:

SYMPATHETIC NERVOUS SYSTEM DRUGS:
 Direct Sympathomimetic Drugs:
– Epinephrine & Methoxamine
– Phenylephrine (alpha receptors)
– Isoproterenol (beta receptors)
– Albuterol (beta2 receptors)
 Indirect Sympathomimetic Drugs:
– Releases NE from nerve endings
– Ephedrine, Tyramine, Amphetamine
 Adrenergic Blockers:
– Reserpine – prevents synthesis & storage of NE
– Guanethidine – blocks release of NE from nerve endings
– Phenoxybenzamine & Phentolamine – blocks alpha receptors
– Propranolol – non specific beta blocker
– Metoprolol – beta1 receptor blocker
 Blocking of Sympathetic & Parasympathetic nerve transmission:
– Hexamethonium, Pentolinium, Tetraethyl Ammonium ion
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PARASYMPATHETIC NERVOUS SYSTEM DRUGS:

– Parasympathomimetic Drugs:
 Pilocarpine (muscarinic)
 Metacholine (muscarinic & nicotinic)
– Parasympathetic Potentiating Drugs:
 AntiCholinesterase drugs:
– Neostigmine, Pyridostigmine, Ambenonium

– Cholinergic Blockers (Antimuscarinic Drugs)

 Atropine, Homatropine, Scopolamine

– Drugs that Stimulate Autonomic Ganglia:

 Nicotine: effects are the same as acetylcholine stimulation
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