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Autonomic Nervous System

Central nervous system

The nervous system with the endocrine system controls and coordinates various functions of the body. The body has to make adjustments according to the changes in its internal and external environments. These adjustments are essential for the maintenance of homeostasis, as well as for existence.

The nervous system can be classified: Anatomically, according to its different structures, Physiologically, according to its functions. Anatomically nervous system formed of (Somatic nervous system, autonomic nervous system and integrative nervous system).

Nervous System

Peripheral NS

Central NS

Efferent Division

Afferent Division





Peripheral Nervous System

Handles the CNSs input and output. Contains all the portions of the NS outside the brain and spinal cord. Contains sensory nerves and motor nerves Divided into autonomic nervous system and somatic nervous system.

Peripheral Nervous System

Sensory Nerves (to the brain)
Motor Nerves (from the brain)

Carry messages from Carry orders from CNS receptors in the skin, to muscles, glands to muscles, and other contract and produce internal and external chemical messengers sense organs to the spinal cord and then to the brain

The ANS is part of the peripheral nervous system and it controls many organs and muscles within the body. In most situations, we are unaware of the workings of the ANS because it functions in an involuntary, reflexive manner. For example, we do not notice when blood vessels change size or when our heart beats faster. However, some people can be trained to control some functions of the ANS such as heart rate or blood pressure.

The ANS is most important in two situations:


In emergencies that cause stress and require us to "fight" or take "flight" (run away).

2- In no emergencies that allow us to "rest" and "digest".

The portion of the nervous system that controls most visceral functions of the body is called the autonomic nervous system (ANS).
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Or it is the motor nervous system that controls glands, cardiac muscle, and smooth muscle.




The primary target organs of the ANS

The viscera of the thoracic and abdominal cavities and some structures of the body wall, including cutaneous blood vessels, sweat glands, and piloerector muscles.
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Autonomic literally means self-governed..

The ANS usually carries out its actions involuntarily, without our conscious intent or awareness, in contrast to the voluntary nature of the somatic motor system.
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Visceral effectors
Visceral effectors do not depend on the ANS to function, but only to adjust their activity to the bodys changing needs.




Visceral effectors
The heart, for example, goes on beating even if all autonomic nerves to it are severed, but the ANS modulates (adjusts) the heart rate in conditions of rest or exercise.
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Visceral effectors
If the somatic nerves to a skeletal muscle are severed, the muscle exhibits flaccid paralysisit no longer functions.
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Visceral effectors
But if the autonomic nerves to cardiac or smooth muscle are severed, the muscle exhibits exaggerated responses (denervation hypersensitivity).
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This system helps to control

arterial pressure, gastrointestinal motility, gastrointestinal secretion, urinary bladder emptying, sweating, body temperature,

and many other activities, some of which are controlled almost entirely and some only partially by the ANS.




striking characteristics of the ANS

The rapidity and intensity. For instance, Within 3 to 5 seconds it can increase the heart rate to twice normal. Within 10 to 15 seconds the arterial pressure can be doubled. The arterial pressure can be decreased low enough within 10 to 15 seconds to cause fainting. Sweating can begin within seconds, and the urinary bladder may empty involuntarily, also within seconds.
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Autonomic System
Two divisions:
sympathetic Parasympatheitic

Control involuntary functions

heartbeat blood pressure respiration perspiration digestion

Can be influenced by thought and emotion

It is usual to divide the nervous system into somatic, autonomic and integrated systems. The somatic nervous system provides voluntary motor control of skeletal muscle. The autonomic nervous system provides an involuntary control of internal environment and the viscera.

Peripheral Nervous System

Somatic NS Autonomic NS

Consists of nerves connected to sensory receptors and skeletal muscles Permits voluntary action (writing your name)

Permits the Involuntary functions of blood vessels, Glands and internal organs e.g.:the bladder stomach heart

Characteristic Effectors General functions

Somatic nervous system Voluntary muscle

Autonomic N. system Cardiac muscle glands, s. muscle

Adjustment to Adjustment within external environment internal environment 2 Chain ganglia, collateral ganglia or terminal ganglia Acetylcholine, adrenaline, noradrenaline

Numbers of neurons 1 Ganglia outside the CNS Neurotransmitter ------------



Anterior Horn cells

Lateral Horn cells

Comparison of Somatic and ANS




Comparison of Autonomic and Somatic Motor Systems

Autonomic nervous system
Chain of two motor neurons
Preganglionic neuron Postganglionic neuron

Conduction is slower due to thinly or unmyelinated axons




Sympathetic N.S.

Parasympathetic N.S.

Like the accelerator of your car

Like the brakes in your car Slows the body down to keep its rhythm Enables the body to conserve and store energy

Mobilized the body for action

Preganglionic: short, synapse Preganglionic: long, synapse within the lateral & collateral within the terminal ganglia ganglia
Postganglionic: long Postganglionic: short

Has a wide distributions

Has a restricted distributions

Often work in opposition Cooperate to finetune homeostasis Regulated by the brain; hypothalamus, pons and medulla

Autonomic Nervous System

Can also be regulated by spinal reflexes; no higher order input Pathways both consist of a two neuron system
Preganglionic neuron from CNS autonomic ganglion outside CNS postganglionic neuron target



General Organization of the ANS

The EFFERENT autonomic signals are transmitted to the various organs of the body through two major subdivisions called

The sympathetic nervous system. The parasympathetic nervous system.

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Sympathetic Nervous System




Physiologic Anatomy of the Sympathetic NS




Each sympathetic pathway from the cord to the stimulated tissue is composed of two neurons, a preganglionic neuron and a postganglionic neuron, in contrast to only a single neuron in the skeletal motor pathway.




Sympathetic Division of the ANS

Parasympathetic Nervous System




Physiologic Anatomy of the Parasympathetic Nervous System Parasympathetic fibers leave the CNS through cranial nerves III, VII, IX, and X. Additional parasympathetic fibers leave the lowermost part of the spinal cord through the second and third sacral spinal nerves and occasionally the first and fourth sacral nerves.
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Physiologic Anatomy of the Parasympathetic Nervous System

About 75 per cent of all parasympathetic nerve fibers are in the vagus nerves (cranial nerve X), passing to the entire thoracic and abdominal regions of the body. Therefore, a physiologist speaking of the parasympathetic nervous system often thinks mainly of the two vagus nerves.
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Sometimes called the thoracolumbar division Short preganglionic neurons; long postganglionic neurons; ganglia are called the chain ganglia Preganglionic neurons secrete Ach onto nicotinic receptors Postganglionic neurons secrete NE on to a or b receptors Target tissues are smooth muscle, cardiac muscle, endocrine glands, brown fat

Sometimes called the cranio-sacral division Long preganglionic neurons;

short postganglionic neurons (often in the target organ)

Preganglionic neurons secrete Ach on to nicotinic receptors Postganglionic neurons secrete Ach on to muscarinic receptors

Target tissues are smooth muscle, cardiac muscle, exocrine glands, brown fat

Anatomical Differences in Sympathetic and Parasympathetic Divisions

Anatomical Differences in Sympathetic and Parasympathetic Divisions

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 and Innervate glands, smooth muscle, cardiac muscle
CNS ganglion smooth muscle preganglionic neuron postganglionic neuron cardiac muscle

Differences between Sympathetic & Parasympathetic Location of Preganglionic Cell Bodies



T1 L2/L3 levels of the spinal cord

Brain: CN III, VII, IX, X Spinal cord: S2 S4

Differences between Sympathetic & Parasympathetic Relative Lengths of Neurons Sympathetic

CNS ganglion target

short preganglionic neuron

long postganglionic neuron

CNS ganglion


long preganglionic neuron

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 (-) Excitation or inhibition is a receptor-dependent & receptor-mediated response


ACh, +

ACh, + / muscarinic receptors

Parasymp. postgangl. ACh & are excitatory (+) or inhibitory (-)

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
Fight or flight Catabolic (expend energy)

Feed & breed, rest & digest Homeostasis

Dual innervation of many organs having a brake and an accelerator provides more control



Sympathetic Nervous System

Main functions of the SNS Regulation of cardiovascular system Regulation of body temperature Implementation of fight or flight reaction

FIGHT OR FLIGHT RESPONSE Stressful Situations ---trauma, fear , hypoglycemia.


Fight or flight response Release adrenaline and noradrenaline Increases heart rate and blood pressure Increases blood flow to skeletal muscles Inhibits digestive functions


Brain Dilates pupil decreases salivation Relaxes bronchi Spinal cord Accelerates heartbeat Inhibits activity

Salivary glands

Heart Stomach Pancreas

Stimulates glucose Secretion of adrenaline, nonadrenaline Relaxes bladder Sympathetic Stimulates ejaculation ganglia in male

Liver Adrenal gland Kidney

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

Structure of spinal nerves: Sympathetic pathways

intermediolateral gray column

dorsal ramus
spinal nerve

ventral ramus

gray ramus communicans

sympathetic ganglion

white ramus communicans

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


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.


Sympathetic Trunk Ganglia

Sympathetic System: Summary

visceral tissues

1- Cervical division 4- somatic tissues

(body wall, limbs)

2- Cardiopulmonary Splanchnics: postganglionic fibers to thoracic viscera

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

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

prevertebral ganglia

1- Cervical division
Origin: T1-2 Course: preganglionic fibres reach the sympathetic chain and then ascend upwards to relay in the superior cervical ganglion. Postganglionic neuron: pass from ganglion to the following organs: EYE: pupil dilatation, widening of palpebral fissure, exophthalmos, Vasoconstriction of eye b.v. and Relaxation of ciliary muscle. Salivary gland : trophic secretion, Vasoconstriction of its blood vessels and Squeezing of salivary secretion. Lacrimal gland: Trophic secretion and Vasoconstriction.

Face skin blood vessel: Vasoconstriction of (Pale color). Sweet secretion: copious secretion. Hair: erection due to contraction of erector pilae muscles.. Cerebral vessels: Weak vasoconstriction

Sympathetic Pathways to the Head

(2) Cardiopulmonary division

Origin: Lateral horn cells of upper 4-5 thoracic segments. Course: Preganglionic neurons reach the sympathetic chain to
relay in the three cervical ganglion and upper four thoracic ganglion. The postganglionic arise from these ganglia supply the following structures:-

Heart: Increase all properties of cardiac muscle (contraction, rhythmicity, excitability, conductivity. Coronary vessels, its sympathetic supply. At first it
causes vasoconstriction, and then it causes vasodilatation due to accumulation of metabolites.

Bronchi: Broncho dilation, decrease bronchial secretions and vasoconstriction of pulmonary blood vessels.

Sympathetic Pathways to Thoracic Organs

3- Splanchnic division
Origin: lateral horn cells of the lower six thoracic and upper four lumber segments. Course: Preganglionic neurons originate from these segments reach the sympathetic chain where they pass without relay, and then they divided into two branches: (1) Greater splanchnic nerve (2) Lesser splanchnic nerve. Greater splanchnic nerve: Origin: Preganglionic nerves fibers emerge from lateral horn cells of lower six thoracic segments and then relay in the collateral ganglion in the abdomen. Course: Postganglionic nerve fibers arise from these ganglia (celiac, superior mesenteric and inferior mesenteric ganglia) and supply the abdominal organs causing the following effects: Vasoconstriction: of most arteries of stomach, small intestine, proximal part of large intestine, kidney, pancreas and liver. Relaxation of the musculature of: stomach, small intestine and proximal part of large intestine. Contraction of sphincters: of the stomach and intestine leading to (food retention). Contraction of the capsule: of the spleen leading to evacuation of about 200 ml of blood. Breakdown of the glucose in the liver: (glycogenolysis) leading to increase of blood glucose level. Stimulation of adrenal medulla: Secrete adrenaline and noradrenalin.

Sympathetic Pathways to the Abdominal Organs

The Adrenal Medulla

The Role of the Adrenal Medulla in the Sympathetic Division

Major organ of the sympathetic nervous system Secretes great quantities epinephrine (a little norepinephrine) Stimulated to secrete by preganglionic sympathetic fibers

Lesser splanchnic nerve

Origin: Preganglionic nerve fibers originate from the lateral horn cells of the 12 thoracic and upper two lumber segments. Course: 2 nerves from both sides unite together forming the presacral nerve, which proceeds to pelvis and divided into two branches (hypogastric nerves), then relay in the inferior mesenteric ganglion. Postganglionic nerve fiber supplies the following pelvic viscera: Urinary bladder: Relaxation of its wall. Contraction of internal urethral sphincter. Leading to urine retention. Rectum: Relaxation of the distal part of large intestine. Relaxation of the rectum wall. Contraction of the internal anal sphincter. Leading to feces retention.

Genital organs: - Vasoconstriction of its blood vessels. Leading to shrinkage of penis and clitoris. Vas deferens: - Contraction of its wall, and wall of seminal vesicles, ejaculatory ducts and prostate - Leading to ejaculation.

Sympathetic Pathways to the Pelvic Organs

(4) Somatic division

Origin: Preganglionic nerve fibers arise from all lateral horn cells of all sympathetic segments, and then relay in the cervical and sympathetic chain ganglia. Course: Postganglionic nerve fibers emerge from these ganglia proceeds outside the central nervous system to return back to spinal cord to join the spinal nerve when it comes out from the anterior horn cells, and supply the following structures: Skin:
Vasoconstriction giving the pale color of the skin. Stimulation of the sweet glands, the eccrine glands give copious secretion, while the apocrine glands give thick odoriferous secretion. Hair erection.

Skeletal muscle:
Its blood vessels show vasodilatation (V.D.) due to cholinergic effect or vasoconstriction (V.C.) due to a adrenergic effect. The type of stimulation depends upon the nature of stimulation. Muscles: its stimulation causing delayed fatigue and early recovery.

4- somatic tissues (body wall, limbs)

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

sympathetic trunk

Sympathetic Pathways to Periphery

Figure 15.9


Adrenal Medulla Kidney Pilomotor muscles Sweat glands Vessels Metabolic processes


Hypothalamus activates Fig. 45.34(TE Art) sympathetic division of nervous system Heart rate, blood pressure, and respiration increase Adrenal medulla secretes epinephrine and norepinephrine

Blood flow to Stomach skeletal muscles contractions increases are inhibited

Flight or fight reaction

Acceleration of heart and lung action Inhibition of stomach and intestinal action Constriction of blood vessels in many parts of the body Liberation of nutrients for muscular action Dilation of blood vessels for muscles Inhibition of tear glands and salivation Dilation of pupil Relaxation of bladder Inhibition of erection

Parasympathetic Nervous System (PNS)

Rest & Digest situations.
The regulatory functions of PNS affect these sites Heart rate Gastric secretions Bladder and bowel Vision Bronchial smooth muscle




Brain Contracts pupil Stimulates salivation Spinal cord Constricts bronchi

Rest and digest system Calms body to conserve and maintain energy Lowers heartbeat, breathing rate, blood pressure

Slows heartbeat Stimulates activity

Stimulates gallbladder Gallbladder Contracts bladder Stimulates erection of sex organs

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

The Parasympathetic Division

Cranial outflow
Comes from the brain Innervates organs of the head, neck, thorax, and abdomen

Sacral outflow
Supplies remaining abdominal and pelvic organs

Cranial Outflow
Preganglionic fibers run via:
Oculomotor nerve (III) Facial nerve (VII) Glossopharyngeal nerve (IX) Vagus nerve (X)

Cell bodies located in cranial nerve nuclei in the brain stem

Sacral Outflow
Origin: Preganglionic nerve fibers arise from the lateral horn cells of the 2nd, 3rd and 4th sacral segments. Course: These preganglionic passes without relay, then the right and left branches unit together to form the pelvic nerve, the pelvic nerve relay in the terminal ganglia, where the postganglionic nerve fibers emerge and supply the following structures:Urinary bladder: parasympathetic stimulation causes: - Contraction of the bladder wall - Relaxation of its sphincter. - These responses lead to micturition.

Rectum and descending colon: parasympathetic stimulation causes: - Contraction of its wall. - Relaxation of internal anal sphincter. - These responses lead to defecation. Seminal vesicles and prostate: parasympathetic stimulation -causes: - Secretion of these glands. Erectile tissue: parasympathetic stimulation causes: - Vasodilatation which lead to erection.

Comparison of sympathetic and Parasympathetic Pathways

Neurotransmitters Receptors

Sympathetic receptors
Adrenergic receptors
Alpha Beta

Alpha 1

Alpha 2

Beta 1

Beta 2

Beta 3

The action of Ach on heart mimic the effects of VAGAL stimulation. v The normal vagal activity regulates the

heart by release of Ach at SA node.

Vasodilatation Decrease in heart rate ( -ve chronotropic effect). Decrease in force of contraction ( -ve Inotropic effect). Decrease in rate of conduction in SA & AV nodes ( -ve dromotropic effect).

Opposing effects of parasympathetic and sympathetic nerves.


Summary of autonomic differences

Autonomic nervous system controls physiological arousal
Sympathetic division (arousing)
Pupils dilate Decreases Perspires Increases EYES SALVATION SKIN RESPERATION

Parasympathetic division (calming)

Pupils contract Increases Dries Decreases

Inhibits Secrete stress hormones


Activates Decrease secretion of stress hormones

Central Control of the ANS

Control by the brain stem and spinal cord
Reticular formation exerts most direct influence
Medulla oblongata Periaqueductal gray matter

Control by the hypothalamus and amygdala

Hypothalamus the main integration center of the ANS Amygdala main limbic region for emotions

Control by the cerebral cortex

Disorders of the Autonomic Nervous System: Hypertension

Hypertension high blood pressure
Can result from overactive sympathetic vasoconstriction

Disorders of the Autonomic Nervous System: Raynauds Disease Raynauds disease characterized by
constriction of blood vessels
Provoked by exposure to cold or by emotional stress

Disorders of the Autonomic Nervous System: Achalasia Cardia

Achalasia cardia
Defect in the autonomic innervation of the esophagus

Disorders of the Autonomic Nervous System: Mass Reflex Reaction

Mass reflex reaction
Uncontrolled activation of autonomic and somatic motor neurons Affects quadriplegics and paraplegics

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