Peripheral Nervous System 2:

The Autonomic System

Somatic vs. Visceral

attribute

Somatic System

Visceral System

embryological
origin of tissue

body wall: somatic (parietal)

mesoderm (dermatome,
myotome)

organs: splanchnic
(visceral) mesoderm,
endoderm

examples of
adult tissues

dermis of skin, skeletal muscles,

connective tissues

glands, cardiac muscle,

smooth muscle

perception

conscious, voluntary

unconscious, involuntary

Langmans Embryo 9 2004

Sensory/Motor + Somatic/Visceral
Somatic

Visceral

Sensory
(Afferent)

somatic sensory

visceral sensory

[General Somatic
Afferent (GSA)]

[General Visceral
Afferent (GVA)]

Motor
(Efferent)

somatic motor

visceral motor

[General Somatic
Efferent (GSE)]

[General Visceral
Efferent (GVE)]

Somatic
Nervous
System

Autonomic
Nervous
System

(Aug 4)

(today)

THE AUTONOMIC NERVOUS SYSTEM

1. Organization of the Autonomic Nervous System (ANS)

Central components
hypothalamus
brain stem
spinal cord

Peripheral components
sympathetic nerves
parasympathetic nerves

Overview of the Autonomic Nervous System

Similarities between Sympathetic & Parasympathetic

Both are efferent (motor) systems: visceromotor

Both involve regulation of the internal environment generally
outside of our conscious control: autonomous
Both involve 2 neurons that synapse in a peripheral ganglion
Innervate glands, smooth muscle, cardiac muscle
glands
CNS

ganglion
smooth
muscle

preganglionic
neuron

postganglionic
neuron

cardiac
muscle

Overview of the Autonomic Nervous System

Differences between Sympathetic & Parasympathetic
Location of Preganglionic Cell Bodies

Sympathetic

Parasympathetic

Thoracolumbar

Craniosacral

T1 L2/L3 levels
of the spinal cord

Brain: CN III, VII, IX, X

Spinal cord: S2 S4

Overview of the Autonomic Nervous System

Differences between Sympathetic & Parasympathetic

Relative Lengths of Neurons
Sympathetic
CNS

target

ganglion

short preganglionic
neuron

long postganglionic
neuron

Parasympathetic
CNS

long preganglionic
neuron

ganglion

target

short postganglionic
neuron

Overview of the Autonomic Nervous System

Differences between Sympathetic & Parasympathetic

Neurotransmitters
NE (ACh at sweat glands),
Sympathetic
ACh, +

+ / -, & receptors

All preganglionics release acetylcholine (ACh) & are excitatory (+)

Symp. postgangl. norepinephrine (NE) & are excitatory (+) or inhibitory (-)
Parasymp. postgangl. ACh & are excitatory (+) or inhibitory (-)
Excitation or inhibition is a receptor-dependent & receptor-mediated response

Parasympathetic

ACh, +

Potential
Potential for
for pharmacologic
pharmacologic
modulation
modulation of
of autonomic
autonomic responses
responses

ACh, + / muscarinic receptors

Overview of the Autonomic Nervous System

Differences between Sympathetic & Parasympathetic

Target Tissues
Sympathetic
Parasympathetic
Organs of head, neck,
Organs of head, neck,
trunk, & external genitalia
trunk, & external genitalia
Adrenal medulla
Sweat glands in skin
Arrector muscles of hair
ALL vascular smooth muscle
Sympathetic system is distributed to essentially all
tissues (because of vascular smooth muscle)
Parasympathetic system never reaches limbs or
body wall (except for external genitalia)

Overview of ANS

Functional Differences
Sympathetic

Fight or flight
Catabolic (expend energy)

Parasympathetic
Feed & breed, rest &
digest
Homeostasis
Dual innervation of many
organs having a brake
and an accelerator provides
more control

Structure of spinal nerves: Somatic pathways

dorsal
ramus

dorsal root
ganglion

dorsal root

spinal
nerve

dorsal
horn

CNS
interneuron

somatic
sensory
nerve
(GSA)

ventral somatic
ramus motor

ventral
horn

nerve

ventral root

Mixed Spinal
Nerve

gray ramus
communicans
sympathetic
ganglion

(GSE)

white ramus
communicans

Structure of spinal nerves: Sympathetic pathways

dorsal
ramus

intermediolateral
gray column

spinal
nerve

ventral
ramus
gray ramus
communicans
sympathetic
ganglion

white ramus
communicans

Sympathetic System: Preganglionic Cell Bodies

Preganglionic cell bodies in
intermediolateral gray
T1 L2/L3
Somatotopic organization

somatic tissues
(body wall, limbs)

visceral tissues
(organs)

intermediolateral
gray columns

T1
L2/L3

lateral
horn

Clinical Relevance
dysfunction due to cord injury
spinal nerve impingement & OMM
referred pain

Moores COA5 2006

Sympathetic System: Postganglionic Cell Bodies

1. Paravertebral ganglia

Located along sides of vertebrae

United by preganglionics into Sympathetic Trunk
Preganglionic neurons are thoracolumbar (T1L2/L3)
but postganglionic neurons are cervical to coccyx
Some preganglionics ascend or descend in trunk

Paravertebral
ganglia

sympathetic
trunk (chain)
synapse at
same level

Prevertebral
ganglia

celiac ganglion
sup. mesent. g.
inf. mesent. g.
ascend to
synapse at
higher level

descend to
synapse at
lower level

aorta
Moores COA5 2006

Sympathetic System: Postganglionic Cell Bodies

2. Prevertebral (preaortic) ganglia
Located anterior to abdominal aorta, in plexuses
surrounding its major branches
Preganglionics reach prevertebral ganglia via
abdominopelvic splanchnic nerves

Paravertebral
ganglia

sympathetic
trunk (chain)

Prevertebral
ganglia

abdominopelvic
splanchnic
nerve

celiac ganglion
sup. mesent. g.
inf. mesent. g.

aorta
Moores COA5 2006

Sympathetic System: Summary

visceral tissues
(organs)

Cardiopulmonary Splanchnics:
postganglionic fibers to thoracic
viscera

somatic tissues
(body wall, limbs)

T1

postganglionics
via 31 spinal
nerves
to somatic tissues
of neck, body wall,
and limbs
sympathetic
trunk

Moores COA5 2006

Abdominopelvic Splanchnics:
preganglionic fibers to
prevertebral ganglia,
postganglionic fibers to
abdominopelvic viscera

L2

prevertebral
ganglia

Parasympathetic
Pathways
Cranial outflow
CN III, VII, IX, X
Four ganglia in head
Vagus nerve (CN X) is major
preganglionic parasymp.
supply to thorax & abdomen
Synapse in ganglia within
wall of the target organs (e.g.,
enteric plexus of GI tract)

Sacral outflow
S2S4 via pelvic splanchnics
Hindgut, pelvic viscera, and
external genitalia
Clinical Relevance
Surgery for colorectal cancer
puts pelvic splanchnics at risk
Damage causes bladder &
sexual dysfunction
Moores COA5 2006

Visceral Afferents and Referred Pain

dorsal root ganglion

Visceral sensory nerves [GVA]

run with sympathetic &
parasympathetic nerves
cell bodies in dorsal root ganglion
nerve ending in viscera

Somatic sensation:
conscious, sharp, well-localized
touch, pain, temperature, pressure, proprioception
Visceral sensation:
often unconscious; if conscious: dull, poorly-localized
distension, blood gas, blood pressure, cramping, irritants

Visceral Afferents and Referred Pain

Referred Pain:
Pain originating in a visceral structure
perceived as being from an area of skin
innervated by the same segmental
level as the visceral afferent
Results from convergence of somatic &
visceral afferents on the same
segmental level of the spinal cord
Cross-talk in the dorsal horn
somatic afferent

convergence &
cross-talk

www.merck.com

visceral afferent
Kandel et al. 2000

Visceral Afferents and Referred Pain

Maps of Referred Pain

Grants Atlas 11 2005

References
Agur, A. M. R. and A. F. Dalley. 2005. Grants Atlas of Anatomy, 11th
Edition. Lippincott, Williams & Wilkins, New York.
Kandel, E. R., J. H. Schwartz, and T.M. Jessell. 2000. Principles of
Neural Science, 4th Edition. McGraw-Hill, New York.
Moore, K. L. and A. F. Dalley. 2006. Clinically Oriented Anatomy, 5th
Edition. Lippincott, Williams & Wilkins, New York.
Sadler, T. W. 2004. Langmans Medical Embryology, 9th Edition.
Lippincott, Williams & Wilkins, New York.

2. The Peripheral Autonomic nervous system

Sympathetic nervous system

coordinates the bodys responses to stress

nerve fibers emerge from the spinal

segments T1-L2

preganglionic nerve cells are located in the

interomedial lateral nuclei (IML)

postganglionic cells are located in ganglia

near the spinal cord

neurotransmitters:
- preganglionic fibers: acetylcholine (Ach)
- postganglionic fibers: norepinephrine
(NE)
- exceptions: sweet glands, piloerector
muscle and a few blood vessels also
called adrenergic fibers

receptors that NE activates

receptors
1, 2

receptors (greater sensitivity to

isoproterenol)
1 , 2

Parasympathetic nervous system

coordinates the bodys more vegetative

activities such as digestion

nerve fibers exit from the brain stem and

sacral level of the spinal cord

preganglionic fibers have long axons

ganglia are near or in target organs

neurotransmitters:
preganglionic fibers: acetylcholine
postganglionic fibers: acetylcholine
also called cholinergic fibers

Autonomic neurons release their

neurotransmitter from enlarged areas
known as varicosities

The varicosities of autonomic

neurons are found along the distal
end of the postganglionic axon

Action potential arriving at varicosity

opens voltage-gated Ca2+
channels, causing exocytosis of
synaptic vesicles

Any NE transported back into axon

can be metabolized by monoamine
oxidase (MAO) or taken back into
synaptic vesicles for re-release

receptors that Ach activates:

nicotinic receptors located on the
postganglionic neurons
muscarinic receptors
M1, M2
located on target cells

Reciprocal regulation of bodily organs by

sympathetic and parasympathetic systems

reciprocal regulation at effector organs

e.g.
blood pressure
heart
blood vessels

antagonistic actions are controlled at the

site of the target organ
2 on presynaptic terminals of
cholinergic neurons
NE

Ach

- M2 on presynaptic terminals of
adrenergic neurons
Ach

M2

NE

3. Actions of the ANS on organs

Heart

Sympathetic fibers: increase the overall

activity of the heart
by increasing the rate and the force of heart
contraction

Parasympathetic fibers: the opposite effects

Lungs

Bronchial muscles

Bronchial glands

Blood vessels

effects on target organs

Gastrointestinal system

stomach
motility and tone
sphincters
secretion

intestine
motility and tone
sphincters
secretion

Intrinsic eye muscles

iris muscles

ciliary muscle
Blood vessels: coronary, skeletal muscle, etc

4. Function of the adrenal Medulla

Release norepinephrine (20%) and epinephrine

(EP, 80%) into circulating blood

Stimulated by sympathetic nerves

Differences of EP from NE

Similar effects as sympathetic stimulation except

of 5-10 times longer

greater effect on heart ( receptor effects)

weak constriction of the blood vessels in

the muscles

greater metabolic effect (5-10 times)

Importance of the adrenal medulla

supports the sympathetic system and

provides a safety factor

can stimulate the structures that are not

innervated by sympathetic fibers