The autonomic

nervous system
Mohamed Elsadig
• Body functions are regulated by two major system:
1. Nervous system.
2. Endocrine system (hormones).
Nervous system

Nervous
system

Peripheral Central

Spinal Cranial Brain &

nerves nerves spinal cord
 • The nervous system can be classified
functionally into two physiological divisions:
1. The somatic nervous system (SNS).
2. The autonomic nervous system (ANS).
Differences between ANS and SNS
ANS SNS
1. Controls smooth 1. Controls the skeletal
and cardiac muscle muscle
2. Controls involuntary 2. Controls voluntary
function function
3. Two neurons 3. One neuron connect
connect the CNS the CNS with the
with target organ. target organ.
Peripheral neurons of the SNS & ANS
• The autonomic nervous system is the portion of the
nervous system that controls most visceral functions
of the body.
• This system helps to control arterial pressure,
gastrointestinal motility and secretion, urinary
bladder emptying, sweating, body temperature, and
many other activities.
• The autonomic nervous system is activated mainly
by centers located in the:
1. Spinal cord.
2. Brain stem.
3. Hypothalamus.
4. Cerebral cortex, especially the limbic cortex.
Divisions of the autonomic nervous
system
• The autonomic nervous system (ANS) is divided
into:
• Sympathetic division
• Parasympathetic division
Differences between the sympathetic
and the parasympathetic divisions
I. Output from the CNS:
• The central parts of the sympathetic and
parasympathetic nervous systems:
• They originate from certain autonomic centers at the
brain e.g. the hypothalamus or the brain stem and
then descend through the spinal cord.
• The peripheral part of the sympathetic
• It passes out through the spinal nerves that originate
from the thoracic and some lumbar segments (from
T1 to L2).
• The peripheral part of the parasympathetic:
• It passes out through some cranial nerves (number
10, 9, 7 and 3) and some sacral spinal nerves S2,
S3 and S4.
• In general the outflow of the sympathetic is
described as thoraco-lumbar and that of the
parasympathetic as cranio-sacral.
 Division of the ANS

SYMPATHETIC PARASYMPATHETIC

arises from the 2nd-3rd&4th

this arises from the lateral horn cells of the sacral segments of the spinal
thoracic and upper two or three lumber cord as well as from the
segment of the spinal cord (thoracolumber
outflow).
nuclei of some cranial nerves
which are the following
a) Oculomotor nerve (3rd)
b) Facial nerve (7th)
c) Glossopharyngeal (9th )
d) Vagus (10th)
called craniosacral outflow
II. Activators:
• For the sympathetic: stressful stimuli e.g. fear, pain
and exercise.
• For the parasympathetic: complete physical and
mental rest e.g. sleep.
III. Metabolism:
• The sympathetic nervous system: causes
catabolism for immediate release of energy that’s used
for fight or flight.
• The parasympathetic: causes anabolic reactions that
store energy until needed by the body.
IV. Anatomical points:
• The peripheral parts of the ANS are made up of
preganglionic type B and postganglionic type C
neurons.
• The cell bodies of the preganglionic neurons are
located in the lateral horn of the spinal cord or the
motor nuclei of the cranial nerves 10, 9, 7 and 3.
• The axons of preganglionic neurons that come from
spinal cord, pass through the ventral horns to the
spinal nerves and then they have many courses.
• Physiologic anatomy of the sympathetic
nervous system:
• Sympathetic ganglia:
• Ganglia of sympathetic division are classified into
three groups:
1. Paravertebral or sympathetic chain ganglia.
2. Prevertebral or collateral ganglia.
3. Terminal or peripheral ganglia.
1. Paravertebral or Sympathetic Chain Ganglia:
• Arranged in a segmental fashion along the
anterolateral surface of vertebral column.
• Ganglia on both sides of the spinal cord are
connected with each other to form the sympathetic
chains that extend from skull to coccyx.
• The sympathetic chains serves as a distribution
system enabling preganglionic neurons which are
limited to thoracic and upper lumbar segments, to
activate postganglionic neurons that innervate all
body segments.
• Ganglia of the sympathetic chain (trunk) on each
side are divided into four groups:
a. Cervical ganglia : 8 in number and arrange in three
ganglia as follow: 4 superior, 2 middle and 2
inferior cervical ganglia.
b. Thoracic ganglia : 12 in number.
c. Lumbar ganglia : 5 in number.
d. Sacral ganglia : 5 in number.
2. Prevertebral or Collateral Ganglia:
• Prevertebral ganglia are situated in thorax,
abdomen and pelvis.
• Prevertebral ganglia are:
a. Celiac ganglion.
b. Superior mesenteric ganglion.
c. Inferior mesenteric ganglion.
3. Terminal or Peripheral Ganglia:
• Terminal ganglia are situated within or close to
structures innervated by them.
• Heart, bronchi, pancreas and urinary bladder are
innervated by the terminal ganglia.
• The preganglionic neurons of the sympathetic are
short.
• The preganglionic sympathetic fibers leave the spinal
nerve and pass through a white ramus into one of
the ganglia of the sympathetic chain.
• The course of the fibers can be one of the following
three:
1. It can synapse with postganglionic sympathetic
neurons in the ganglion that it enters.
2. It can pass upward or downward in the chain and
synapse in one of the other ganglia of the chain.
3. It can pass for variable distances through the chain
and then finally synapsing in a peripheral
sympathetic ganglion.
Sympathetic ganglia
• Physiologic anatomy of the parasympathetic
nervous system:
• The preganglionic parasympathetic neurons are
longer than the postganglionic.
• The ganglia are found near or within the wall of the
target organs.
V. Effects:
• The ratio of a preganglionic neuron to
postganglionic neurons is about 1:20 for the
sympathetic neurons and 1:1 for the
parasympathetic neurons, this indicates that the
effects of the sympathetic are generalized (because
of divergence of its preganglionic neurons) while
those of the parasympathetic are localized.
 Generalize

Ganglia is a collection of cell bodies outside the CNS

Figure 15.4a
localized

Figure 15.4b
VI. The neurotransmitters released by the
neurons:
• All preganglionic neurons whether sympathetic or
parasympathetic, and all postganglionic
parasympathetic neurons release acetylcholine
whereas most postganglionic sympathetic neurons
release noradrenaline, but others release
acetylcholine.
• Postganglionic sympathetic neurons that release
acetylcholine supply the sweat glands, arterioles of
skeletal muscles and piloerectror muscles.
 Differences between sympathetic and
parasympathetic.
difference sympathetic parasympathetic
Activator during emergency or stress Rest
“fight-or-flight”
effects Generalized Localized
neurotransmitter Preganglionic (Acetylcholine) Preganglionic
postganglionic (norepinephrine ) (Acetylcholine)
postganglionic
(acetylcholine)

Preganglionic Short Long

neuron
Postganglionic Long short
neuron

Metabolism Catabolic that release high Anabolic that store

amount energy energy
Origin (output) thoracolumbar craniosacral
The autonomic
neurotransmtters
• The principal neurotransmitters (NT) in the autonomic
nervous system are acetylcholine and noradrenaline.
• Acetylcholine:
• Synthesized from acetyl co A and choline in the cell
body of cholinergic neurons.
• Synthesis is catalyzed by the enzyme choline acetyl
transferase.
• Acetylcholine action is terminated by the acetylcholine
esterase enzyme in the synaptic cleft.
 • Acetylcholine is released by:
1. All preganglionic parasympathetic neurons
2. All postganglionic parasympathetic neurons
3. All preganglionic sympathetic neurons
4. Some postganglionic sympathetic neurons (those
supplying sweat glands, arterioles of skeletal
muscles and piloerector muscles).
5. Mast cell.
6. Gastric mucosa.
7. Many regions of brain.
• Action of acetylcholine:
1. Produces excitatory function of synapse by
opening the sodium channels.
2. Activates smooth muscles in GIT, urinary tract and
skeletal muscles to cause contraction.
3. Inhibits cardiac function.
4. Causes vasodilatation.
• Noradrenaline (norepinephrine):
• Synthesized from the amino acid tyrosine in
noradrenergic neurons.
• Noradrenaline is also synthesized in the adrenal
medulla which is an endocrine gland regarded as a
modified sympathetic ganglion that lost its
postganglionic axons.
• In the adrenal medulla gland, most of the
synthesized noradrenaline (norepinephrine) is
converted to adrenaline (epinephrine) by the
enzyme phenylethanolamine-N-methyltransferase
(PNMT).
 • Adrenaline, noradrenaline and dopamine are called
catecholamines.
• In summary, noradrenaline is released by:
• Most postganglionic sympathetic neurons (excluding
those which release acetylcholine).
• The adrenal medulla releases mainly adrenaline
plus some noradrenaline.
• Action of noradrenaline is terminated in the plasma
by two enzyme:
1. Monoamine oxidase (MAO).
2. Catechol-O-methyl-transferase (COMT).
• Other neurotransmitters:
• Dopamine: Released by some interneurons in
sympathetic ganglia.
• Co-transmitters:
• VIP and No : May be found with acetylcholine in
some cholinergic neurons.
• ATP, Neuropeptide Y and somatostatin: may be
found with noradrenaline in some adrenergic
neurons.
Thank you