Autonomic Nervous System: Rodina Rivera-Gorospe, M.D

AUTONOMIC NERVOUS
SYSTEM
Rodina Rivera-Gorospe, M.D.

Department of Physiology
FEU - NRMF
NERVOUS SYSTEM
INTRODUCTION
NERVOUS SYSTEM
• CNS – Brain and spinal cord
• PNS – 12 Cranial nerves
31 spinal nerves
 C,T,L,S,C
– Nerves are bundles of nerve fibers
– Most nerves have four types of fibers
SE SOMATIC NS SE
Spinal nerves SA SA Cranial nerves
VE ANS VE
VA VA
SOMATIC VS AUTONOMIC
NERVOUS SYSTEM
Neural control of GIT:
1. AUTONOMIC NS*
2. ENTERIC NS*
MYENTERIC/AUERBACH’S
SUBMUCOSAL/MEISSNER’s
•Control the GIT motor & secretory
activity
3. SENSORY fibers
SOMATIC VS AUTONOMIC NS
SOMATIC NS ANS
• Fibers do not synapse • Synapse in ganglia
once they leave the after leaving the CNS
CNS • A two neuron pathway
• A one neuron pathway • Innervates cardiac,
• it innervates skeletal smooth muscles, and
muscles glands
• Always leads to muscle • Can lead to either
contraction excitation or inhibition
AUTONOMIC NERVOUS SYSTEM
• In ANS, the motor output is transmitted
from the CNS
Pre-ganglionic fiber
Peripheral ganglion
Post-ganglionic fiber
Effector organ
Since, all glands are controlled by the ANS
– receive impulses from the CNS through a 2 neuron
pathway, with the exception of the adrenal medulla which
is anatomically, embryonically and functionally similar to a
post ganglionic fiber
Hence, adrenal medulla is not a typical gland. It is
considered a component of the ANS
DIVISIONS OF THE ANS
1. SYMPATHETIC
2. PARASYMPATHETIC
They are
– Anatomically
– Functionally
– Biochemically
– Pharmacologically different from one
another
ANATOMICAL DIFFERENCES
SYMPA PARA
• Origin of pre- T1 – L2 CN III, VII, IX,
ganglionic fibers X & S2-S4
T1 – head
T2 – neck
T-3 - T-6 – thorax;
T-7 - T-11 - abdomen;
T-12, L-1, L-2 - legs.
• Location of ganglia para or pre- In (CN 10, sacral)
vertebral or near the
effector organ
(CN 3, 7, 9)
• Branching of Extensive Limited
Preganglionic fibers 1:20 1:1
SYMPATHETIC NERVOUS SYSTEM
PHYSIOLOGICAL DIFFERENCES
Stimulation of:
• Sympa - Fight or flight
• Para - Conservative or restoratove
processes
• Most organs are innervated by both
para and sympa EXCEPT for:
• Sweat glands
• Pilimotor muscles exclusively innervated by
• Most blood vessels the sympa
SYMPA DIV. PARA DIV
1. General description Propagation for Conservative &
of effector organ emergency or restoration of
responses stress situation body’s
“Fight or flight” resources.
What happens is….. Are often highly
- Inc aBP, Inc blood flow to specific.
active muscles, Inc. cellular
metab, inc bld glucose,
inc glycolysis in the liver
and muscle, inc. muscle
strength,inc mental activity,
inc rate of blood coag.
2. Localization of Widespread Localized effect
responses region of the body
3. Duration of Sustained Short lived
responses
BIOCHEMICAL DIFFERENCES
• Impulse transmission
– along a nerve – electrical
– across a synapse and neuroeffector
junction is chemical
• Chemical transmission in ANS could be
– Cholinergic
– Adrenergic
CHOLINERGIC & ADRENERGIC
TRANSMISSION
ANS SOMATIC
Sympa Para
Ganglia Ach-n Ach-n Ach-n
NE- a, B Ach-m Ach-m Ach-n

NEURO NEURO NEURO SKELETAL
EFFECTOR EFFECTOR EFFECTOR MUSCLE
ORGAN ORGAN ORGAN
(sweat glands, most b.v.)
RECEPTORS
1. Adrenergic receptors
•Alpha receptors stimulation – excitatory
Ex. Vasoconstriction in skin and mucosa
Contraction of GI sphincters piloerection,
pupillodilation, increase glycogenlysis
EXCEPTION: GI motility and tone
insulin secretion
• Beta receptors stimulation – inhibitory
Ex. B2 vasodilation in skeletal muscle
Relaxation of bronchial muscle
insulin secretion
EXCEPTION: B1 – HR, cardiac contractility,
conduction velocity,
lipolysis
RECEPTORS
2. Cholinergic receptors
• Muscarinic receptors
– All parasympathetic neuroeffector junction
– Sympathetic cholinergic neuroeffector jxn
– M1: Brain
– M2: Heart
– M3 and M4: Visceral smooth muscle & glands
– M5: unclear
• Nicotinic receptors
– All autonomic ganglia
– All somatic neuromuscular junction
NEUROHUMORAL TRANSMISSION
STEPS
1. Synthesis and storage
2. Release
3. Interaction of the NT with
the post junctional cell and
initiates post junctional activity
4. Destruction or dissipation of
neurohumor
Synthesis
• Ach
Acetyl-CoA + choline choline acetyltransferase ACh
• NE
Tyrosine hydroxylation Dopa
Dopa decarboxylation Dopamine
Transport of dopamine into the vesicles
Dopamine hydroxylation NE methylation Epi
(dopamine B hydroxylase)
Table 11-1. Responses of Effector
Organs to Autonomic Nerve Impulses
Effector Organs Receptor Type Adrenergic Cholinergic

Impulses,1 Responses2 Impulses,1Responses2
•Eye - Radial muscle, A Contraction (mydriasis) ++
iris
• Sphincter muscle, α Contraction (miosis) +++
iris
• Ciliary muscle β Relaxatn for far vision + Contractn for near vision +++
•Heart
• Sinoatrial node β1 Inc. HR - ++ Dec. HR ; vagal arrest +++
• Atria
β1 Inc contractility & conductn velocity ++
•Decrease in contractility and (usually) increase in conduction velocity ++
• Atrioventricular node
•β1
•Increase in automaticity and conduction velocity ++
Clearing of Ach & NE from the cleft
1. Reuptake
(50 to 80% for NE)
2. Diffuse out of the

synaptic cleft
3. Enzymatic degradation by
tissue enzymes
Ach – Acetylcholineesterase, major
NE - MAO, COMT
GENERAL CONTROL OF ANS
• Spinal cord
• Medulla oblongata
• Midbrain
• Hypothalamus
• Limbic
• Cerebral Cortex
AUTONOMIC CONTROL AREAS IN THE
BRAINSTEM AND HYPOTHALAMUS
• Neuronal areas in
the brain stem
reticular substance
and along the
course of the
tractus solitarius
of the medulla,
pons and
mesencephalon
•
Control of Brainstem Autonomic
Centers by Higher Centers
• Hypothalamus and cerebrum
• Many of our behavioral responses are
mediated through:
– Hypothalamus
– Reticular areas of the brain stem
– ANS
• Higher brain areas alter function of the
ANS, be it as a whole or partial inducing
diseases like:
– PUD
– Constipation
– Heart palpitation or heart attack
PHARMACOLOGY OF ANS
• Sympathomimetic
• Parasympamimetic
• Sympatholytic
• Parasympatholytic
Sympathomimetic Drugs
• NE
• E
• Methoxamine
Receptor specific
• Phenylephrine – alpha receptors
• Isoproterenol – beta receptors
• Albuterol – alpha2 receptors
•
Sympathomimetic Drugs
• Drugs that cause release of NE from

nerve endings
– Ephedrine
– Tyramine
– Amphetamine
Sympatholytic Drugs
DRUG MOA
• Reserpine - blocks synthesis
and storage of NE
• Guanethidine - blocks NE release
• Phenoxybenzamine - blocks a receptors
Phentolamine
• Metoprolol - blocks b receptors
Propranolol
• Hexamathonium - blocks impulse
transmission through
the ganglia
Parasympathomimetic
DRUG MOA
• Pilocarpine - Acts directly on
Methacholine muscarinic receptors
Parasympathetic potentiating effect

• Neostigmine - Anti-cholinesterase
Pyridostigmine drug
Ambenonium
Parasympatholytic
DRUG MOA
• Atropine - blocks muscarinic
Homotropine receptors
Scopolamine
Drugs that stimulate or block sympa or
parasympa post-ganglionic neurons
A. Stimulate autonomic post ganglionic neurons

• Nicotine – stimulates nicotinic receptors
• Methacholine - stimulates nicotinic and
muscarinic receptors
• Pilocarpine - stimulates muscarinic
receptors
NICOTINE – excites both sympa and parasympa neurons but
(+) strong sympathetic – vasoconstriction of abdominal organs and limbs
(+) parasympathetic effects – Increase GI activity and sometimes slows the
heart
Drugs that stimulate or block sympa or
parasympa post-ganglionic neurons
B. Ganglionic blocking agents

- Blocks impulse transmission from the
pre to post ganglionic neurons
• Tetraethyl ammonium ion
• Hexamethonium ion
• Pentolinum
* Commonly used for blocking sympathetic but seldom for blocking
parasympathetic activity because the sympathetic blocking effect
overshadows that of parasympathetic effect
EFFECTS OF DRUGS IN ANS
THANK YOU!!!
CHOLINERGIC TRANSMISSION
1. All neuroeffector junctions in the PS
division
2. Some neuroeffector junctions in the
sympathetic division, specifically –
sweat glands, some blood vessels
3. All peripheral ganglia – at synaptic
junction between pre- and post
ganglionic fiber
4. All neuromuscular junctions in somatic
nervous system
ADRINERGIC TRANSMISSION
• Some neuroeffector junction of

the sympathetic division

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AUTONOMIC NERVOUS

Rodina Rivera-Gorospe, M.D.

Ganglia Ach-n Ach-n Ach-n

NE- a, B Ach-m Ach-m Ach-n

Effector Organs Receptor Type Adrenergic Cholinergic

2. Diffuse out of the

• Drugs that cause release of NE from

Parasympathetic potentiating effect

A. Stimulate autonomic post ganglionic neurons

B. Ganglionic blocking agents

• Some neuroeffector junction of

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