Chapter 11 Autonomic Nervous System (ANS) Copyright 2010, John Wiley & Sons, Inc. Introduction to the ANS Somatic nervous system (SNS) + ANS peripheral nervous system (PNS) ANS Not under conscious control Is regulated by hypothalamus, brainstem The ANS supplies nerves to viscera Smooth muscle (stomach, blood vessels) Cardiac muscle (heart) Glands (sweat and digestive glands) Copyright 2010, John Wiley & Sons, Inc. Comparison: SNS vs ANS SNS Controls skeletal muscle Conscious, voluntary control Motor pathway: one neuron from CNS to effector Does include sensory neurons (from skin, skeletal muscles, and special sense organs) All release the neurotransmitter ACh ANS Controls viscera: smooth and cardiac muscle, and glands Unconscious, involuntary Motor pathway: series of two neurons from CNS to effector Does include sensory neurons (monitors viscera) Two divisions: sympathetic, parasympathetic Release either ACh or NE Copyright 2010, John Wiley & Sons, Inc. Somatic Nervous System Copyright 2010, John Wiley & Sons, Inc. ANS Motor Pathways Autonomic motor pathway includes two motor neurons Preganglionic neuron from CNS to neuron in autonomic ganglion Postganglionic neuron from cell body in ganglion to effector Copyright 2010, John Wiley & Sons, Inc. ANS Motor Pathways Copyright 2010, John Wiley & Sons, Inc. Divisions of the ANS Sympathetic (S) division + parasympathetic (P) division Most viscera supplied with nerves of both S and P divisions: dual innervation S and P have opposite (antagonistic) effects Heart rate: S stimulates, P inhibits Digestive organs: S inhibit, P stimulate S: “flight or flight” P: “rest and digest” Some viscera receive only S (not P) nerves: Sweat glands, many blood vessels, hair muscles Copyright 2010, John Wiley & Sons, Inc. Sympathetic (S) Division Sympathetic preganglionic neurons Have cell bodies located in lateral gray of spinal cord segments T1-T12 + L1-L2 So S division is called “thoracolumbar” Axons pass through ventral roots of spinal nerves May branch many times May ascend or descend to many levels of S trunk ganglia (from cervical to sacral) Can synapse with 20 or more postganglionic neuron cell bodies Results: widespread S effects (viscera respond “in sympathy with one another”) Copyright 2010, John Wiley & Sons, Inc. Sympathetic (S) Division Sympathetic postganglionic neurons S postganglionic neurons cell bodies located In S “trunk ganglia” (2 long chains lateral to vertebrae) From cervical to sacral regions widespread S effects Many axons from these cell bodies pass back into spinal nerves to reach viscera in skin (sweat glands, hair muscles, blood vessels) In S “prevertebral ganglia” anterior to 3 large abdominal arteries Named celiac, superior and inferior mesenteric ganglia Supply abdominal viscera: stomach, intestine, kidneys, liver, spleen Axons pass from ganglia to viscera in S nerves Copyright 2010, John Wiley & Sons, Inc. Sympathetic (S) Division Copyright 2010, John Wiley & Sons, Inc. Parasympathetic (P) Division P preganglionic neurons Cell bodies located in brainstem + in spinal cord segments S2-S4 Therefore P division is called “craniosacral” Axons in cranial nerves III, VII, IX and X and in pelvic nerves from S2-S4 Vagus nerves (cranial nerves X) carry 80% of all P nerve impulses. Vagus nerves carry both motor and sensory neurons to/from viscera within the thorax and most of the abdominal cavity. P preganglionic axons do not branch or pass though S trunk ganglia but pass directly almost to viscera Copyright 2010, John Wiley & Sons, Inc. Parasympathetic (P) Division P postganglionic neurons Cell bodies lie in terminal ganglia Located within or near the innervated organ So P nerves cause precise, localized (not widespread) effects Because of anatomical arrangement, S nerves supply all viscera but P nerves do not reach some viscera. These include sweat glands, arrector pili muscles of hairs in skin, kidneys, spleen, adrenal medullae, and the walls of most blood vessels. Axons pass from ganglia to viscera in P nerves Copyright 2010, John Wiley & Sons, Inc. Parasympathetic (P) Division Copyright 2010, John Wiley & Sons, Inc. ANS Neurotransmitters: Comparison Acetylcholine (ACh) ACh more common; released by: All S and P preganglionic axons All P postganglionic axons Some S postganglionic axons (to sweat glands) ACh destroyed by enzyme ACh-ase so short-lived response Norepinephrine (NE) NE less common; released by: Almost all S postganglionic axons NE has longer lasting effects enhanced by epinephrine + NE from adrenal medullae Copyright 2010, John Wiley & Sons, Inc. Sympathetic Effects “Fight-or-flight” activities Increase heart rate and contraction, and blood pressure (BP) Dilate pupils Dilate airways Dilate vessels to skeletal muscles, heart, liver and adipose tissue Constrict blood vessels to nonessential organs: skin, GI tract, kidneys Mobilize nutrients for energy: glucose and fats Copyright 2010, John Wiley & Sons, Inc. Activities of the sympathetic division of the ANS (Generally: "Fight-or-flight responses") Organ/Tissue Activity Effect Eye Heart Blood Lungs increased increased increased increased decreased contracted increased Skin Pancreas Pupil dilation Heart rate & force Pressure Airway dilation Blood vessel diameter; urine production Blood vessel diameter Sphincter Blood vessel diameter Blood vessel diameter Breakdown of TGs and FAs Blood vessel diameter Release of bile acids sweat gland activity Glucagon secretion Pancreas Insulin/Digestive enzyme secretion decreased Pituitary gland (post.) ADH hormone secretion increased Urinary bladder Muscle wall & diameter of sphincter relaxation & decrease Skin Smooth muscles of hair follicles contract ("goose bumps") Uterus Smooth muscles of uterine wall contract (pregnant) relax (non-pregnant) Sex organs Muscles for ejaculation of semen (man) contract Mouth Salivary gland secretion decreased Kidney GI tract Skeletal muscle Adipose tissue Liver decreased increased increased increased increased Parasympathetic Effects Rest-and-digest activities SLUDD Salivation Lacrimation Urination Digestion Defecation Decrease heart rate, airway diameter, pupil diameter Copyright 2010, John Wiley & Sons, Inc. Activities of the parasympathetic division of the ANS (Generally: "SLUDD responses") Organ/Tissue Activity Effect Eye Radial muscle/Pupil dilation n.e. Heart Heart rate & force decreased Blood Pressure decreased Lungs Airway narrowing (bronchoconstriction) increased Kidney Blood vessel diameter; urine production n.e. GI tract Blood vessel diameter, motility Sphincter increased relaxed Skeletal muscle Blood vessel diameter n.e. Adipose tissue Blood vessel diameter TG, FA build-up n.e. Liver Blood vessel diameter Storage of bile decreased increased Skin sweat gland activity n.e. Pancreas Secretion of digestive enzymes & insulin increased Pituitary gland (post.) ADH hormone secretion n.e. Urinary bladder Muscle wall & diameter of sphincter contraction & increase Skin Smooth muscles of hair follicles n.e. Uterus Smooth muscles of uterine wall minimal effect Sex organs Erection of penis and clitoris increased Mouth Salivary gland secretion increased ANS & Human Health Understand the important aspect of mind-body harmony and control means, such as music, yoga, tai-chi, forms of meditation (e.g. prayers), hiking, gardening to sustain human health These activities are able to stimulate/activate the parasympathetic division of the ANS to restore PNS homeostasis and feelings of relaxation and “happiness” Copyright 2010, John Wiley & Sons, Inc. Pathology – Disease & disorders connected with ANS Horner's syndrome Loss of sympathetic stimulation of muscles of one side of the face due to inherited mutation, an injury or a disease that affects the sympathetic outflow through the cervical ganglion. Symptoms include drooping of the upper eyelid, constricted pupil and loss of sweating. Autonomic dysreflexia Exaggerated sympathetic ANS response which occurs in 85% of individuals with spinal cord injury above the T6 level. Mass stimulation of sympathetic nerves below the level of injury due to ascending sensory nerve impulses from the lower body. Symptoms include: pounding head ache, severe high blood pressure, pale cold skin below injury level; warm, flushed sweating skin above injury level; Can lead to stroke, seizures and heart attacks if untreated! Copyright 2010, John Wiley & Sons, Inc. Raynaud's syndrome (RS) Human skin microcirculation disorder caused by hyperactivation of the sympathetic system causing extreme vasoconstriction of peripheral blood vessel & episodic skin ischemia. Disorder is manifested by pallor, cyanosis and erythema of the fingers in response to different forms of stress, e.g. cold or emotional. Exact pathophysiology of RS is currently not known, but it has been hypothetized that it may be caused by an autonomic alteration in the sympathetic innervation of the blood vessels of the skin. RS can progress into a systemic autoimmune disease mainly due to progressive systemic sclerosis (= hardening) of the blood vessels. Copyright 2010, John Wiley & Sons, Inc. Parasympathicomimetics (Part-1) Generally drugs which elicit the same effects as the post-synaptic nerves of the parasympathetic division of the ANS. Have acetyl choline-like effects on the effectors; many are used for treatment of high blood pressure. Prominent examples are: 1. Acetyl choline - very short-lived within the body therefore not very useful for therapy or treatment 2. Carbachol - stimulates smooth muscles of intestines and bladder; Copyright 2010, John Wiley & Sons, Inc. Parasympathicomimetics (Part 2) 3. Muscarin - molecule of the poisonous mushroom Amanita muscaria; - leads to very strong Vagus nerve stimulation with typical intoxication syndromes, which include: - increased salivation, excessive sweat production, diarrhea, vomiting, cardiovascular collapse 4. Pilocarpin - toxic component of the South American plant Pilocarpus jaborandi; toxic effects on the human include: - excessive sweat production, strong bronchial mucus secretion, increased motility of GI tract; vomiting, - often used in low doses to treat Glaucoma; Copyright 2010, John Wiley & Sons, Inc.