AUTONOMIC NERVOUS

SYSTEM
Dr. Ayisha Qureshi
Assistant Professor,
MBBS, MPhil
DIVISIONS OF THE PERIPHERAL NERVOUS
SYSTEM
DIFFERENTIATING BETWEEN THE
SOMATIC & AUTONOMIC NERVOUS
SYSTEM
 SOMATIC AUTONOMIC
NERVOUS NERVOUS SYSTEM
SYSTEM
Somatic senses & special Mostly interoceptors; some
SENSORY
senses somatic senses & special
INPUT senses

CONTROL Voluntary control; cerebral Involuntary control;

cortex, basal ganglia, hypothalamus, limbic system,
OF MOTOR cerebellum, spinal cord. brainstem. Limited control
OUTPUT from cerebral cortex.
MOTOR One-neuron pathway, Two-neuron pathway.
NEURON
PATHWAY
NEUROTRAN All Somatic neurons All preganglionic fibers
secrete Ach. release Ach. Postganglionic
SMITTERS & fibers release different NT in
HORMONES case of Sym. & Paras.
Skeletal muscles. Smooth muscles, cardiac
EFFECTORS muscles, and glands.
Contraction or relaxation of
smooth muscle; Increased or
decreased strength of
Somatic & Autonomic nervous
system
The autonomic nervous system is the part of the peripheral
nervous system that is responsible for regulating involuntary body
functions, such as heartbeat, blood flow, breathing and digestion.

AUTONOMIC NERVOUS
SYSTEM
Divisions of ANS
SYMPATHETIC NERVOUS PARASYMPATHETIC NERVOUS
SYSTEM/ Thoracolumbar Division SYSTEM/ Craniosacral Division

Fight, flight or Fright.

Rest and Digest.
Activated during
Concerned with
exercise, excitement
conserving energy.
and emergencies.
 ANS

Sympathetic Parasympath
Nervous etic Nervous
System System

Preganglionic Postganglioni Preganglionic Postganglioni

Fibers c Fibers Fibers c Fibers
 Characteristics of ANS
Nerve fibers: Both divisions have pre- & postganglionic fibers.
- Preganglionic neuron is myelinated.
- Postganglionic neuron is unmyelinated.
(In contrast to the large diameter and rapidly conducting -motor
neurons, preganglionic axons are small-diameter, myelinated,
relatively slowly conducting B fibers.)
(The axons of the postganglionic neurons are mostly unmyelinated
C fibers and terminate on the visceral effectors.)
Neurotransmitters:
Autonomic nerves release NT that may be excitatory or
inhibitory.
Divergence:
Preganglionic fibers branch to synapse with an average of 8-9
postganglionic neurons.
Convergence:
Postganglionic neuron receives synaptic input from a large
number of preganglionic fibers.
Divisions of the ANS
 Fight or Flight Response
Thoracolumbar Division
Shows mass activation

THE SYMPATHETIC
SYSTEM
The Sympathetic System
Outflow
 Sympathetic Chain Ganglion
Paravertebral Ganglia
Most of the sympathetic ganglia lie
close to the spinal cord and form the
two chains of ganglia, linked by short
nerves one on each side of the cord
known as the Sympathetic Trunks.
Because the ganglia lie close to the
spinal cord, thus, the preganglionic
neurons are short while the
postganglionic neurons reaching the
target organs are very long.
Joined to ventral rami by white and
gray rami communicans.
In contrast, the parasympathetic
ganglia lie within or very close to the
organs innervated and ,thus, have
very short preganglionic and long
postganglionic neurons.
See Next slide for figure
Prevertebral Ganglia
Also called the Collateral
ganglia.
Unpaired, not segmentally
arranged.
Occur only in abdomen and
pelvis, closer to the
innervated organ.
Lie anterior to the vertebral
column.
Main ganglia:
Celiac, superior mesenteric,
inferior mesenteric, inferior
hypogastric ganglia.
See Next slide for figure
The Sympathetic System
Outflow

Myelinated preganglionic
fibers exit spinal cord in
ventral roots from T1 to
L2 levels.
They exit from the
Lateral horn of the spinal
cord.
Most sympathetic nerve
fibers separate from
somatic motor fibers and
synapse with
postganglionic neurons
within paravertebral
ganglia.
Ganglia within each row
are interconnected,
forming a chain of ganglia
that parallels spinal cord
to synapse with
postganglionic neurons.
Sympathetic System
Outflow
Termination of Sympathetic Termination of Sympathetic
Preganglionic Fibers Postganglionic fibers
1. Postganglionic fibers in the
paravertebral ganglion of the Axons leave the chain
same segment. ganglia and re-enter
2. Postganglionic fibers of the
paravertebral ganglion of an the spinal nerves via
upper or lower segment. gray rami
3. Pass thru the paravertebral communicans to reach
ganglion chain & end on
postganglionic neurons in
the:
prevertebral ganglion close to 1. Visceral targets
the viscera (celiac, superior
and inferior mesenteric 2. Smooth muscles
ganglion).
3. Sweat glands
4. Adrenal Medulla.
Sympathetic System
Outflow
To the Periphery To the Head
Sympathetic System
Outflow
To the Thoracic To the Abdominal
regions Organs
 The Adrenal
Gland
The Adrenal gland is the
major organ of the
sympathetic nervous system.
When stimulated, the adrenal
medulla secretes large
quantities of epinephrine and
a little norepinephrine directly
into the blood stream.
Sympathoadrenal
system:
Stimulated by mass
activation of the
sympathetic nervous
system.
Innervated by
preganglionic sympathetic
fibers.
 Rest or Digest
Craniosacral Division
Shows stimulation of separate parasympathetic nerves

THE PARASYMPATHETIC
SYSTEM
 The
Parasympatheti
c Division
Preganglionic fibers are
located in several cranial
nerve nuclei (III, VII, IX and X)
and in the IML column of the
sacral spinal cord (2-4 sacral
segments).
Preganglionic fibers synapse in
terminal ganglia located next
to or within organs innervated.
Thus, the parasympathetic
preganglionic fibers are longer
while the parasympathetic
postganglionic fibers are
short.
Most parasympathetic fibers
do not travel with the spinal
nerves.
Do not innervate blood
vessels, sweat glands, and
arrector pili muscles.
 PARASYMPATHETIC
DIVISION (Cranial
Outflow)

1. 3. 4.
2.
Cranial Nerve Cranial Nerve Cranial Nerve
Cranial Nerve X
III- IX
VII
Occulomotor GlossoPharyn Vagus Neve
Facial Nerve
Nerve geal Nerve
 Parasympathetic Division
(continued)

4 of the 12 pairs of cranial nerves (III, VII, X,

XI) contain preganglionic parasympathetic
fibers.
III, VII, XI synapse in ganglia located in the
head.
X synapses in terminal ganglia located in
widespread regions of the body.
Vagus (X):
Innervates heart, lungs, esophagus,
stomach, pancreas, liver, small intestine
and upper half of the large intestine.
Preganglionic fibers from the sacral level
innervate the lower half of large intestine, the
There are 3 main types of neurotransmitters used
extensively in ANS:
1. Acetylcholine
2. Norepinephrine
3. Epinephrine

CHEMICAL TRANSMISSION
AT AUTONOMIC
JUNCTIONS
NEUROEFFECTO
R JUNCTION
The synapse between an
autonomic
postganglionic neuron
and its target cell is
called a Neuroeffector
Junction.
The postganglionic axons
end in nerve terminals
that show swellings
called varicosities that
consist of vesicles
containing the
Neurotransmitters.
The diffuse release of NT
means that a single
postganglionic neuron
can affect a large area of
target tissue.
 Acetylcholine is the
neurotransmitter released
by all neurons whose
axons exit the CNS,
including cranial motor
neurons, -motor
neurons, -motor
neurons, preganglionic
sympathetic neurons and
preganglionic
parasympathetic neurons.
Postganglionic
parasympathetic neurons
also release Ach, whereas
postganglionic
sympathetic neurons
release either
Norepinephrine or Ach.
Ach is degraded by
Acetylcholinesterase.
Norepinephrine is
degraded by monoamine
oxidase.
Neurotransmitters in
ANS
CHOLINERGIC
RECEPTORS
The principal transmitter is
ACETYLCHOLINE and include:
1. All preganglionic neurons.
2. All parasympathetic
postganglionic neurons.
3. Sympathetic postganglionic
neurons that innervate sweat
glands.
4. Sympathetic postganglionic
neurons that end on blood vessels
in skeletal muscles.
The Cholinergic receptors are further
subdivided into:
. Nicotinic Cholinergic receptors.
. Muscarinic Cholinergic receptors.
ADRENERGIC
RECEPTORS
The principal transmitter is
EPINEPHRINE & NOREPINEPHRINE
and include:
1. All remaining sympathetic
postganglionic neurons.
2. The adrenal medulla is
essentially a sympathetic
ganglion & secretes NE and
Epinephrine directly into the
blood stream.
The Adrenergic receptors are
further subdivided into:
. Alpha receptors (1 and 2)
. Beta receptors (1, 2 and 3)
Responses to Cholinergic
Stimulation(continued)
 Other Autonomic
Neurotransmitters
Certain noradrenergic, norcholinergic
postganglionic autonomic axons
produce their effects through other
NTs. These include:
Adenosine triphosphate (ATP).
Vasoactive Intestinal peptide (VIP).
Nitric Oxide (NO).
Neuropeptide Y (NPY)
COMPARISON OF SYMPATHETIC &
PARASYMPATHETIC NERVOUS SYSTEM
RESPONSES OF EFFECTOR
ORGANS TO AUTONOMIC
NERVE IMPULSES
 Organs With Dual
Innervation
Most visceral organs receive dual innervation
(innervation by both sympathetic and
parasympathetic fibers).
Antagonistic effects:
Sympathetic and parasympathetic fibers innervate the
same cells.
Actions counteract each other.
Heart rate.
Complementary:
Sympathetic and parasympathetic stimulation produces
similar effects.
Salivary gland secretion.
Cooperative:
Sympathetic and parasympathetic stimulation produce
different effects that work together to produce desired
 Organs Without Dual
Innervation

Regulation achieved by increasing or

decreasing firing rate.
Adrenal medulla, arrector pili muscle,
sweat glands, and most blood vessels
receive only sympathetic innervation.
Nonshivering thermogenesis.
 Control of the ANS by Higher Brain
Centers

Sensory input transmitted to brain centers that

integrate information.
Can modify activity of preganglionic autonomic
neurons.
Medulla:
Most directly controls activity of autonomic system.
Location of centers for control of cardiovascular,
pulmonary, urinary, reproductive and digestive
systems.
Hypothalamus:
Regulates medulla.
Cerebral cortex and limbic system:
Responsible for visceral responses that are
characteristic of emotional states.
DISORDERS OF ANS
 HORNERS SYNDROME

Horner syndrome is a rare

disorder resulting from
interruption of preganglionic
or postganglionic sympathetic
innervation to the face.
CAUSE:
Injury to the nerves.
Injury to the carotid artery.
A stroke
Lesion in the brain

SYMPTOMS:
The hallmark of Horners
syndrome is the TRIAD of:
1. Anhidrosis (reduced
sweating)
2. Ptosis (drooping eyelids)
3. Miosis (constricted pupil)
Symptoms may also include
Enophthalmos (sunken eyes)
and vasodilation.
 Raynauds
Phenomenon
Raynauds Phenomenon refers to
an episodic reduction in blood flow
primarily to the fingers, often
during exposure to cold or during
a stressful condition.
CAUSE:
It is a vasospastic disorder. There
can be many causes:
Exaggeration of response to
cold, temperature or stress.
Secondary to another disorder
as Rheumatoid arthritis,
Sjogrens syndrome, carpal
tunnel syndrome, anorexia.
SYMPTOMS:
1. Triphasic color change in the
fingers from white to cyanotic
blue to deep red.
2. When there is vasospasm, the
fingers are pale and cold; then
due to reduced blood flow, the
color turns blue and there is
intense pain; and finally, once
blood flow recovers, there is
tingling and swelling.