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AUTONOMIC NERVOUS SYSTEM

Introduction
• Autonomic Nervous System is a branch of the peripheral nervous system that regulates
cardiac muscle, smooth muscle, and glands.
• These tissues are often referred to as visceral effectors because they are usually
associated with the viscera (internal organs) of the body
• Impulses originate below the cerebrum.
• Essential for regulation of homeostasis
• ANS includes Autonomic sensory neurons, integrating centers in the CNS and the
autonomic motor neurons.
• autonomic motor neurons that regulate visceral activities by either increasing or
decreasing ongoing activities in their effector tissues.
Eg: an increase and decrease in a heartbeat.
• The autonomic sensory neurons receive inputs from the visceral organs & blood vessels
• The motor neurons supply to smooth muscles, cardiac muscles & glands (effectors)
Autonomic stimulation can lead to
• Changes in rate (chronotropic effect) and force of the heartbeat (ionotropic effect).
• Stimulation or depression of secretion of glands.
• Vasoconstriction/vasodilation.
• Bronchoconstriction/bronchodilation.
• Changes in the size of the pupils of the eyes.
• Efferent (motor) nerves arise from nerve cells in the brain.
• Afferent (sensory) nerves arise from the glands and internal organs.
The motor part of ANS has 2 principal branches
• Sympathetic division (Thoracolumbar outflow)
• Parasympathetic division (Craniosacral outflow)
• All the effector organs have dual innervations (ie; both sympathetic & Parasympathetic)
• Both differ structurally and functionally.

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• Normally work in an opposing fashion, enabling/restoring the balance of involuntary

functions, maintaining homeostasis.
• Eg: neurons of the sympathetic nervous system increase heart rate and neurons of
parasympathetic system slows down.
• Sympathetic activity predominates in stressful situations.
• Parasympathetic activity predominates during rest.

Anatomy of autonomic motor pathways

➢ Most of the autonomic motor pathways consist of two motor neurons.

➢ First neuron (preganglionic neuron) has its cell body in the CNS. Its myelinated axons
extend from the CNS to autonomic ganglia
(Ganglion is a collection of neuronal cell bodies in the PNS)
➢ The cell body of the second neuron (postganglionic neuron) is also in the same
autonomic ganglion. Its unmyelinated axon extends directly from the ganglion to the
effector (smooth muscle, cardiac muscle or a gland)
➢ In some autonomic pathways, the first motor neuron extends to specialized Cells called
chromaffin cells in the adrenal medulla (inner portion of adrenal glands) rather than an
autonomic ganglion
➢ chromaffin cells secrete the neurotransmitters epinephrine and norepinephrine (NE)
➢ All somatic motor neuron release only Ach as their NT, but autonomic motor neurons
release either Ach or epinephrine
➢ Thus, preganglionic neurons convey nerve impulses from the CNS to autonomic ganglia
& post ganglionic neuron relay the impulses from autonomic ganglia to visceral
effectors.

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Summary of somatic & autonomic nervous system

Motor neuron pathways in the (a) somatic nervous system and (b) autonomic nervous system
(ANS)

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Organization
1. Preganglionic neurons
2. Autonomic ganglia
3. Autonomic plexus
4. Post ganglionic neurons

Preganglionic neurons
• Preganglionic neurons are present before the ganglia (CNS to ganglia).
• In the of sympathetic division, the preganglionic neurons have their cell bodies the
lateral gray horn of the grey matter in the 12 thoracic segment and the first two or three
lumbar segments of the spinal cord. (T1-T12 & L1-L2 or L3).
• For this reason, the sympathetic division is also called as Thoracolumbar Division
• The preganglionic axons are myelinated Type-B fibers.
• The axons of sympathetic preganglionic neurons are known as Thoracolumbar outflow

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• The cell bodies of preganglionic neurons of parasympathetic division is in the lateral

gray matter of two sacral segments (S1-S4) of spinal cord & nuclei of four cranial nerves
in the brain stem (III, VII, IX & X)
• The parasympathetic division is also called as craniosacral division
• The axons of parasympathetic preganglionic neurons are known as craniosacral outflow
Autonomic Ganglia
Autonomic ganglia are clusters of neuronal cell bodies and their dendrites. They are essentially
a junction between autonomic nerves originating from the central nervous system and
autonomic nerves innervating their target organs in the periphery.
Autonomic nervous system is characterized by 2 different ganglia.
1, sympathetic ganglia: which are components of the sympathetic division of the ANS
2. Parasympathetic ganglia: which are components of the parasympathetic division of the ANS
The autonomic ganglia is divided into 3 groups
1. Sympathetic trunk/Vertebral chain/Paravertebral ganglia Sympathetic
2. Prevertebral/Collateral ganglia
3. Parasympathetic/Terminal ganglia
1. Sympathetic trunk ganglia/ Paravertebral ganglia
• It lies in a vertical row on either side of the vertebral column.
• The sympathetic trunk preganglionic axons are short as they are near the spinal cord
• The post ganglionic axons from sympathetic trunk ganglia innervate organs above
diaphragm
• They have short preganglionic axons
• 11/12 thoracic ganglia, 4/5 lumbar, 4/5 sacral sympathetic trunk ganglia
Eg :- Superior, middle & inferior cervical ganglia
2. Prevertebral (Collateral) Ganglia
• It lies anterior to the vertebral column & close to the large abdominal arteries
• It innervates organs below diaphragm
• There are 3 major Prevertebral ganglias
a) Celiac Ganglion
b) Superior mesenteric ganglion
c) Inferior mesenteric ganglion

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d). Aorticorenal ganglion

e). Renal ganglion ganglion
3. Parasympathetic Ganglia
▪ It is also called the terminal ganglia
▪ The pre and post ganglionic neurons of parasympathetic system form synapse at the
terminal ganglia
▪ These ganglias are present on the wall of visceral organs/effectors
▪ Eg: cilliary ganglion, ptergopalatine ganglion, submandibular ganglion and otic ganglion
Autonomic plexus
➢ In the thorax, abdomen & pelvis axons of both sympathetic & parasympathetic neurons
form irregular networks called autonomic plexuses.
➢ These are present along major arteries.
➢ The major Plexus in the thorax are the i) Cardiac plexus: - which supplies at the base of
heart and the ii) Pulmonary plexus: - which supplies the bronchial tree. (It is posterior to
each lung)
b) In abdomen & Pelvis

i) Celiac plexus or solar plexus

It is the largest ANS plexus. At the level of T12 &LI. It supplies to Liver, gall bladder,
stomach, pancreas, spleen, kidney, Adrenal gland, testes & ovary
ii) Superior mesenteric plexus: contains the superior mesenteric ganglion and supplies the
small & large intestine (proximal colon)

iii) Inferior mesenteric plexus: characterized by the presence of Inferior mesenteric

ganglion and supplies to the distal colon and rectum

iv) Hypogastric plexus: Anterior to 5th Lumbar vertebrae. Supply to urinary bladder and
genital organs.
v) Renal plexus: contains renal ganglion and located near kidney Supply to arteries in
kidney& ureter
Post ganglionic neurons

• Sympathetic post ganglionic neuron

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• The communication between the preganglionic neurons and the post ganglionic
neurons of the sympathetic nervous system take place in the sympathetic ganglia
• The response of sympathetic nervous system is immediate and simultaneous on the
entire body because of its widespread distribution.
• Such distribution is due to the presence of numerous axon branches known as axon
collaterals on each preganglionic fiber.
• These collaterals synapse with numerous post ganglionic neurons and thus affect the
entire body.
• All the post ganglionic neurons end in the target organs and thus play a role in
conducting motor impulses from the ganglia.
• The preganglionic neuron of sympathetic division synapse with 20/more post ganglionic
neuron. So, innervate multiple organs at the same time
• Parasympathetic post ganglionic neuron
• Axons of preganglionic neurons of parasympathetic nervous system communicate with
the post ganglionic neurons in the terminal ganglia located close to the target organ.
• In the ganglion, the presynaptic neurons usually synapses with only four to five post
ganglionic neurons, all of which supply single visceral effectors, allowing
parasympathetic responses to be localized to a single effector
• The preganglionic neurons of parasympathetic division synapse with only 4/5 post
ganglionic neurons, innervate only a single structure at a time

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Comparison b/w sympathetic & parasympathetic division

sympathetic parasympathetic

Origin thoraco- lumbar ( T1- T12 & Cranio sacral(cranial nerves III,
L1-L3) VII,IX,X & S2-S4)

Preganglionic nerve Short long

Postganglionic nerve Longer shorter

Ganglia Near spinal cord On the wall of the effector organ

preganglionic: post 1:20 more 1:4/5

ganglionic

NT (preganglionic: Acetylcholine Acetylcholine

post ganglionic)

NT (post ganglionic: Adrenaline /Noradrenaline Acetylcholine

effector)

Effector innervation Only one structure at a time Multiple structure at a time

Type of response Fight or flight Rest and digest

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The sympathetic nervous system:

• Sympathetic nervous system extends from thoracic to the lumbar vertebrae
• Sympathetic nervous system prepares individuals to face emergency situations, hence it
is known as the fight or flight division
• The system gets activated in emergency situations like increased physical activity or
emotional stress during which it enhances the metabolic activities and alertness.so that
the body is able to combat the situation
• The motor impulses originate in the hypothalamus, limbic system, reticular formation
and medulla oblongata and conveyed to effector organs/tissue supplied.
• Sympathetic division is also known as thoracolumbar division.
1.The preganglionic neurons:
• The preganglionic axons of the sympathetic nervous system are small in length when
compared to postganglionic axons due to the presence of sympathetic trunk ganglia
close to the spinal cord
• Spinal cord receives the messages through sensory neurons and converts these into
responses.
• These responses are transmitted from the spinal cord to the sympathetic trunk ganglia
via preganglionic fibres (neurons).
• Cell body originates in the lateral column of grey matter in the spinal cord between the
1st thoracic and 2nd or 3rd lumbar vertebrae.
• It leaves the spinal cord by anterior root and terminates in the lateral chains of
sympathetic ganglia or passes through it to one of the prevertebral ganglia.
• Acetylcholine is the neurotransmitter
2. sympathetic ganglia
• Synapse between the preganglionic and postganglionic fibers of sympathetic NS occurs
at ganglia known as sympathetic ganglia.
• Two types of sympathetic ganglia
a) Sympathetic Trunk (Paravertebral) Ganglia:
b) Collateral (Prevertebral) ganglia

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• Sympathetic Trunk (Paravertebral) Ganglia:

• It is also known as vertebral chain ganglia.
• Anterior and lateral aspects of the vertebral column are covered by ganglia known as
sympathetic trunk ganglia.
• These paired ganglia, arranged on either side of the vertebral column, are
interconnected by nerve fibres in the form of a chain.
• The sympathetic trunk ganglia extend from the base of the skull to coccyx region
• The organs superior to diaphragm receive impulses from the postganglionic axons of
sympathetic trunk ganglia.
• Each segment contains one ganglion. However, in certain segments, ganglia tend to fuse
with one another.
• For instance, ganglia of all the cervical segments fuse to form three ganglia known as
superior, middle and inferior cervical ganglia.

Generally, there are 3 cervical, 11 or 12 thoracic, 4 or 5 lumbar and 4 or 5 sacral ganglia

and 1 coccygeal ganglion in sympathetic division
Collateral (Prevertebral) ganglia
• Presence of five collateral ganglia can be found on the anterior surface of the vertebral
column.
• These ganglia are localized in the abdominal cavity near to the origin of arteries.
• Organ’s inferior to the diaphragm receives impulses from the postganglionic axons of
the prevertebral ganglia
• Following are the five prevertebral ganglia, situated in different regions.

Celiac (Coeliac) Ganglion: Ganglia on the lateral sides of the celiac trunk (an artery
below the diaphragm) is known as celiac ganglia.

Superior Mesenteric Ganglion: Somewhere near the origin of superior mesenteric

artery that supplies the upper abdomen is the ganglion known as the superior
mesenteric ganglion.

Inferior Mesenteric Ganglion: Inferior mesenteric ganglion is found near the origin of
inferior mesenteric artery that innervates the middle abdomen.

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Aorticorenal Ganglion and Renal Ganglia: The renal artery of each kidney is
characterized by the presence of ganglia known as aorticorenal and renal ganglia.
3. The postganglionic neurone:
The axons of the postganglionic neurons transmit impulses from the sympathetic trunk
to the effector organs in four different ways.
➢ by entering spinal nerves
➢ by forming cephalic periarterial,
➢ sympathetic or splanchnic nerves.
• Cell body originates in the ganglion and terminates in the organ/tissue supplied.
• Noradrenaline is the neurotransmitter.
a) Spinal Nerves
Some of the postganglionic neurons communicate with the spinal nerves and then transmit
the impulses to the effector organs.
Such communication between the axons of postganglionic neurons and the anterior ramus
of the spinal nerve is mediated through grey ramus communicans.
Finally, from the spinal nerves, axons of postganglionic neurons innervate the neck, trunk,
smooth muscles in blood vessels, arrector pili muscles of hair follicles and sweat glands.
(b) Cephalic Periarterial Nerves

Certain preganglionic neurons synapse with the postganglionic neurons, by moving upwards
from the sympathetic trunk to reach the superior cervical ganglion.
The postganglionic axons from the superior cervical ganglion form the cephalic periarterial
nerves, which extend from neck to head.
Cephalic periarterial nerve provides sympathetic innervation to visceral effectors in the skin
of the face (sweat glands, arrector pili muscles of hair follicles), as well as other visceral
effectors of the head (smooth muscles of blood vessels and eye, pineal gland, salivary
glands, nasal mucosa and lacrimal glands).
c) Sympathetic Nerves
Some of the postganglionic and preganglionic neurons of the sympathetic nervous system
synapse in the ganglia of the sympathetic trunk itself and exit in the form of sympathetic
nerves.
From the sympathetic trunk, axons of postganglionic neurons extend in the form of
sympathetic nerves that innervate the heart via the cardiac plexus

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Similarly innervate the smooth muscles of bronchi and bronchioles of lungs via the
pulmonary plexus.
d) Splanchnic Nerves
Certain preganglionic axons of sympathetic nervous system extend from the sympathetic
trunk to the prevertebral ganglia in the form of splanchnic nerves, which supply to,
(i) Abdominopelvic Organs
Different splanchnic nerves that supply to abdominopelvic organs include, greater
splanchnic nerve lesser splanchnic nerve, least (lowest) splanchnic nerve and lumbar
splanchnic nerve.
(ii) Adrenal Medulla
Adrenal medullae of both the adrenal glands are peculiar in the sense that they do not have
any postganglionic neurons.
The preganglionic axons of sympathetic system extend from the intermediolateral horns of
the spinal cord, through sympathetic trunk, greater splanchnic nerves, celiac ganglion until
the chromaffin cells of the adrenal medullae
These chromaffin cells function as postganglionic neurons
Activation of sympathetic system stimulates the preganglionic axons which in turn stimulate
the chromaffin cells to release epinephrine and norepinephrine directly into the blood

Sympathetic ganglia (the lateral chains of sympathetic ganglia):

Preganglionic neurone originating from spinal cord synapse with the cell body of the
postganglionic neurons at the same level or pass up/down the chain through one or more
level of the ganglia before synapsing.
The sweat glands, the skin and the blood vessels of skeletal muscles are supplied only by
sympathetic fibres.
Some have neurotransmitter acetylcholine, some adrenaline and noradrenaline. Hence
these neurotransmitters have effects on both sympathetic and parasympathetic nerve
supply.
Preganglionic sympathetic fibres pass through lateral chain to reach the prevertebral
ganglia

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In short: Sympathetic division

Cell bodies of preganglionic neurons (myelinated) in lateral gray horn (T1-12 & L1-2)

The preganglionic axons leave the spinal cord through anterior root of spinal nerve

Exit through the intervertebral foramina

Passage way white ramus (intervertebral foramina to ganglia)

(White rami- Because preganglionic are myelinated)
(all white rami together knownas white rami communicantes

Terminate in the symapathetic ganglia

(A).3 cervical ganglias

i) Superior: Near 2nd cervical vertebrae: post ganglionic supply to head & heart
ii) Middle: Near 6th cervical vertebrae; post ganglionic supply to heart
iii) inferior: Near 7th cervical vertebrae; post ganglionic supply to heart

(B) 11/12 Thoracic ganglia: The post ganglionic neurons innervate thoracic viscera

(C) 2/3 Lumbar ganglia: Lateral to lumbar vertebrae

Exit the sympathetic ganglia as post ganglionic neurons (unmyelinated)

The pathway is known as Gray ramus& collectively Gray rami communicantes

They innervate the effector

▪ Few of the preganglionic axons pass through the sympathetic trunk without terminating
in it. Beyond the trunk they form nerve & it is known as splanchnic nerve.
Eg: preganglionic nerves from L1-l4
• Some of the sympathetic preganglionic neurons extend to the adrenal medulla

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Functions of sympathetic nervous system

• The main function is the fight or flight response
• Which mainly involves those bodily activities that increase the energy production as well
as physical activity
the two major sympathetic hormones involved in mediating the fight or flight response
are Adrenaline and Noradrenaline

Effect of sympathetic stimulation on various organ

Nancy Jose, Dept.of Pharmacology, NCP