The autonomic nervous system

The autonomic nervous system (ANS) is the part of the nervous system that is responsible for
homeostasis. The term homeostasis is used by physiologists to mean maintenance of nearly
constant conditions in the internal environment. The autonomic nervous system helps to control
arterial pressure, gastrointestinal motility, gastrointestinal secretion, urinary bladder emptying,
sweating, body temperature, and many other activities. The autonomic nervous system has two
major divisions: the sympathetic and parasympathetic nervous system. In addition, the autonomic
nervous system includes the enteric nervous system within the gastrointestinal tract.

Sympathetic→ “ Fight or flight”, E” division →Exercise, excitement, emergency, and

embarrassment

Parasympathetic →Rest and digest ” D” division →Digestion, defecation, and diuresis

Physiologic Anatomy of the autonomic nervous system

The autonomic nervous system is made up of two neurons: preganglionic and postganglionic
neurons. preganglionic axons are small-diameter, myelinated B fibers. The axons of the
postganglionic neurons are mostly unmyelinated C fibers and terminate on the visceral effectors.

A. Physiologic Anatomy of the Parasympathetic Nervous System

The parasympathetic nerve fibers leave the central nervous system through

1. Cranial outflow: cranial nerves III, VII, IX, and X.

Parasympathetic fibers in the third cranial nerve go to the pupillary sphincter and ciliary
muscle of the eye. Fibers from the seventh cranial nerve pass to the lacrimal, nasal, and
submandibular glands and fibers from the ninth cranial nerve go to the parotid gland.

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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.

2. Sacral outflow: Supplies the pelvic viscera

via the pelvic branches of the S2- S4 sacral
N. The parasympathetic nervous system is
sometimes called the craniosacral division of
the ANS

Generally speaking, the ganglia of the

parasympathetic system are located close to,
or sometimes within the structures controlled
by the systems. Pre-ganglionic fibers
therefore tend to be long and post-ganglionic
fibers short

Physiologic Anatomy of the Sympathetic Nervous System

The sympathetic nerve fibers originate

in the spinal cord along with spinal
nerves between cord segments T-1 and
L-2. This is why the sympathetic
nervous system is sometimes called the
thoracolumbar division of the ANS. The
cell body of each preganglionic neuron
lies in the intermediolateral horn of the
spinal cord; the axons of the
sympathetic preganglionic neurons
leave the spinal cord and exit via the
ventral root. They then separate from
the ventral root and project to the
adjacent sympathetic paravertebral
ganglion, where some of them end on
the cell bodies of the postganglionic
neurons. Paravertebral ganglia are
located adjacent to each thoracic and
upper lumbar spinal segments. These
ganglia form the sympathetic chain bilaterally. Some preganglionic neurons pass through the
paravertebral ganglion chain and end on postganglionic neurons located in prevertebral
ganglia close to the viscera, including the celiac, superior mesenteric, and inferior mesenteric

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ganglia. Postganglionic fibers from prevertebral ganglia also terminate in visceral targets.
There are also preganglionic neurons whose axons terminate directly on the adrenal gland.

▪ Synapses between pre - and post-ganglionic neurons are mostly located in ganglia
close to the spinal cord (the 'sympathetic or paravertebral chain'), so pre-ganglionic
fibers are short and post- ganglionic fibers are long.

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Chemical transmission at autonomic junctions
The sympathetic and parasympathetic nerve fibers secrete either acetylcholine or norepinephrine.

• Those fibers that secrete acetylcholine are said to be cholinergic.

• Those fibers that secrete norepinephrine are said to be adrenergic.

✓ All preganglionic neurons are cholinergic (ie, release acetylcholine) in both the
sympathetic and the parasympathetic nervous systems.
✓ The postganglionic neurons of the parasympathetic system are also cholinergic .
✓ Most of the postganglionic sympathetic neurons are adrenergic.
✓ However, the postganglionic sympathetic nerve fibers to the sweat glands, to the
piloerector muscles of the hairs, and to blood vessels in skeletal muscles are cholinergic.

Types of acetylcholine receptors

Acetylcholine activates mainly two types of receptors. They are called muscarinic and nicotinic
receptors

1. Muscarinic receptors are found on all effector cells that are stimulated by the
postganglionic cholinergic neurons of either the parasympathetic nervous system or the
sympathetic cholinergic fibers.

2. Nicotinic receptors are found in the autonomic ganglia at the synapses between the
preganglionic and postganglionic neurons of both the sympathetic and parasympathetic

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 systems. Nicotinic receptors are also present in the brain and at the neuromuscular
junctions in skeletal muscle

Types of adrenergic receptors

There are also two major types of adrenergic receptors, alpha receptors and beta receptors.

The beta receptors in turn are divided into beta1 and beta2 receptors. Also, there is a division of
alpha receptors into alpha1 and alpha2 receptors.

The actions of the autonomic nervous systems

Most organs in the body are innervated by the sympathetic nervous system, rather fewer by the
parasympathetic. Some organs have both sympathetic and parasympathetic innervation which
generally, but not invariably, have opposing actions.

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The effect of ANS on blood vessels
The smooth muscle in the walls of arteries, arterioles and veins is innervated by the sympathetic
branch of the autonomic nervous system. sympathetic activity causes vasoconstriction (mediated
via α1 adrenoreceptors) except in specialized vessels. There is constant activity in the
sympathetic nervous system (sympathetic vasomotor tone) tending to make arteriolar smooth
muscle contract. Sympathetic outflow to blood vessels is controlled via the vasomotor center in
the medulla oblongata.

The tone varies from organ to organ.

• In skin, for example, vasomotor tone is high, so arterioles, pre-capillary sphincters and
arterio-venous anastomoses are generally shut down. Variation in sympathetic outflow
produces large changes in skin blood flow, usually for purposes of thermoregulation.

• In skeletal muscles vasomotor tone is high at rest, but in exercise is antagonized mostly
by local release of vasodilator metabolites but also to a smaller extent by specialized
vasodilator response to circulating levels of adrenaline (mediated through ß2
adrenoreceptors).

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 • In the gut vasomotor activity is high until a meal is consumed, when it is antagonized by
various vasodilator substances produced in gut tissue.

• The circulation to the brain on the other hand is virtually unaffected by sympathetic
activity

The effect of ANS on blood the heart

Heart rate
It is affected by both the parasympathetic and sympathetic branches of the ANS
which innervate both the SA and AV nodes. Parasympathetic activity slows heart rate and
sympathetic activity speeds it up. There is a certain basal activity of both the
parasympathetic and sympathetic systems at rest, but if all autonomic inputs are
pharmacologically blocked the intrinsic heart rate is about 100 beats per minute (100bpm).
The normal resting heart rate of about 60bpm is produced because the parasympathetic
system dominates at rest. Increases in heart rate are brought about by a reduction in
parasympathetic and an increase in sympathetic outflow. Both parasympathetic and
sympathetic outflow to the heart is controlled by centers in the medulla oblongata
Contractility
Sympathetic nerve fibers also innervate ventricular cardiac myocytes. Sympathetic activity
increases the force of contraction of the ventricle. Changes in heart rate and force of contraction
alter cardiac output