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U N I T XI

Textbook of Medical Physiology, 11th edition

Chapter 60:
The Autonomic Nervous System (ANS); The Adrenal Medulla

By Dr. Mudassar Ali Roomi (MBBS, M.Phil)


GUYTON & HALL

Autonomic Nervous System (ANS)


It is motor system for visceral organs, blood vessels and secretory glands This system helps to control:
arterial pressure, gastrointestinal motility, gastrointestinal secretion, urinary bladder emptying, sweating, body temperature, and many other activities,

One of the most striking characteristics of the autonomic nervous system is the rapidity and intensity with which it can change visceral functions.

Why is ANS called so?


The name was given as it was thought that this system is independent of CNS. But it is controlled by many parts of CNS and these centers are present in the :
medulla oblangata, pons mid brain, hypothalamus, portion of limbic system cerebral cortex. Spinal cord

CNS centres for control of ANS

General Organization of the Autonomic Nervous System

And Limbic cortex

General Organization of the Autonomic Nervous System


Reflex arc afferents control efferents. Efferent part consist of pre-ganglionic and postganglionic fibers. 1. Pre-ganglionic fiber:
a. cell body of preganglionic axon located in brain stem or spinal cord b. axon of this visceral motor neuron is thinly myelinated and projects to an autonomic ganglia

2. Post-ganglionic fiber:
a. cell body of the postganglionic neuron located within the autonomic ganglia, unmyelinated axon projects to visceral effector cell

General Organization of the Autonomic Nervous System

Sympathetic Nervous System


It consists of the thoraco lumbar outflow. The lateral horns of spinal segments T1-L2 contain cell bodies of the pre-ganglionic symp neuron. Sympathetic ganglia can be divided into 2 groups.
1)Paravertebral ganglia (which make the sympathetic chain) 2)Pre-vertebral ganglia which include celiac ganglion, superior mesenteric ganglion, inferior mesenteric ganglion.

Physiologic Anatomy of the Parasympathetic Nervous System


visceral motor neuron located in the intermediolateral horn of the spinal cord from T-1 to L-2 (thoracolumbar outflow)

Axons can take 1 of 3 paths

1. enter the sympathetic chain via the white ramus and terminate there
2. enter the sympathetic chain via the white ramus and ascend or descend a few segments before terminating

3. enter via the white ramus and exit via a splanchnic nerve and terminate in a prevertebral ganglia

Figure 60-2; Guyton & Hall

Segmental Distribution of the Sympathetic Nerve Fibers


the sympathetic fibers from cord segment T-1 generally pass up the sympathetic chain to terminate in the head; from T-2 to terminate in the neck; from T-3, T-4, T-5, and T-6 into the thorax; from T-7, T-8, T-9, T-10, and T-11 into the abdomen; and from T-12, L-1, and L-2 into the legs.

Special Nature of the Sympathetic Nerve Endings in the Adrenal Medullae


Adrenal medulla is a part of the sympathetic nervous syst. Adrenal medulla cells are embryologicaly postganglionic symp neuron lost their N.fibers to become secretory. Instead of giving post ganglionic symp N.fiber these secrete catacholamines (adrenaline & noradrenaline).

Physiologic Anatomy of the Parasympathetic Nervous System


Visceral motor neurons are located in discrete brain stem nuclei and in sacral segments (S2-4). It is also called as craniosaccral outflow. Parasympathetic nerves originate from cranial nerves III, VII, IX, and X and the sacral spinal cord.
occulomotor nerve - fibers to the pupillary sphincters and ciliary muscle facial nerve - fibers to nasal, lacrimal and submandibular gland glossopharyngeal nerve - fibers to parotid gland vagus nerve - motor inputs to visceral organs sacral segments - fibers to descending colon, rectum, bladder and genitalia

Neurotransmitters in ANS
sympathetic nerves release norepinephrine at their nerve endings these nerves are call adrenergic nerves parasympathetic nerves release acetylcholine at their nerve endings these nerves are called cholinergic nerves All preganglionic sympathetic and parasympathetic nerves release acetylcholine. All postganglionic parasympathetic nerves release acetylcholine. almost all postganglionic sympathetic nerves release norepinephrine except for sweat glands, piloerector muscles and select blood vessels which release Ach

Mechanisms of Transmitter Secretion and Subsequent Removal of the Transmitter at cholinergic neuro-effector junction

Mechanisms of Transmitter Secretion and Subsequent Removal of the Transmitter at the adrenergic neuro-effector junction

Receptors of the Autonomic Nervous System


Cholinergic receptors
1. 2. Muscarinic receptors (M1, M2, M3) Nicotinic receptors a. Nn b. Nm Alpha 1,2 Beta 1,2

Adrenergic receptors
1. 2.