The Autonomic

Nervous System

Neuroanatomy and Organ System Anatomy

Basic Sciences Team
AY 2018-2019
Prepared by: Arisa Takagi, PTRP,PT
References used for this Lecture

Arisa Takagi, PTRP, PT

Arisa Takagi, PTRP, PT
 AUTONOMIC NERVOUS SYSTEM
•  controls visceral functions
•  a regulatory structure that
helps people adapt to
changes in their environment
•  For homeostasis
•  functions in an involuntary,
reflexive manner
(subconscious)
Arisa Takagi, PTRP, PT
 ANS
•  control of target tissues:
the cardiac muscle, the
smooth muscle in blood
vessels and viscera/organs,
and the exocrine glands.
•  Modulated by: brainstem,
hypothalamus and spinal
cord
•  Divided into; sympathetic
and parasympathetic
Arisa Takagi, PTRP, PT
Arisa Takagi, PTRP, PT
Arisa Takagi, PTRP, PT
 SOMATIC VS AUTONOMIC SYSTEMS
FEATURES SOMATIC AUTONOMIC
Target Tissues Skeletal mm Smooth mm, cardiac mm,
exocrine glands
Regulation Conscious & Unconscious, some
unconscious influence by conscious
movement mental fxn (ie sphincters)
(reflexes)
Reaction to Contraction Stimulation / inhibition
stimulation
Arisa Takagi, PTRP, PT
 SOMATIC VS AUTONOMIC SYSTEMS

FEATURES SOMATIC AUTONOMIC

# of Neuron 1 neuron 2 neurons

Axon sheaths Myelinated Pre: myelinated; Post:

unmyelinated
Neurotransmitter Ach Pre: Ach;
Post: Ach or NE
Arisa Takagi, PTRP, PT
 ANS
•  Unlike the somatic nervous system, this reaches its
effector organs by a two-neuron chain

Preganglionic Postganglionic

1. Brainstem (CN III, VII, IX, X) At the outlying ganglion

2. Spinal Cord: connecting with the
(intermediolateral gray RL VII) effector organ
Arisa Takagi, PTRP, PT
 Autonomic Outflow
Preganglionic postganglionic target organ

Arisa Takagi, PTRP, PT

Visceral/Autonomic Pathway

AFFERENT

EFFERENT

Arisa Takagi, PTRP, PT

ANS VS. ENDOCRINE SYSTEM

ANS Endocrine

Autonomic Nerves Hormones

Smooth Muscles, Cardiac Muscles, Glands

Arisa Takagi, PTRP, PT
 AUTONOMIC MOTOR NEURONS:
TWO NEURON PATHWAY
PRE-GANGLIONIC POST-GANGLIONIC

CELL BODY CNS Autonomic Ganglia

MYELINATION + -
SYNAPSE Post-ganglionic (N) Visceral Effector

Arisa Takagi, PTRP, PT

 PRE-GANGLIONIC NEURON VS. POST-GANGLIONIC
NEURON

PRE-GANGLIONIC POST-GANGLIONIC

NUMBER Few Many

NEUROTRANS Sympa & Para: Ach Sympa: NE

-MITTER Para: Ach

Arisa Takagi, PTRP, PT

 SYMPATHETIC DIVISION
•  Prepares the body for
emergency
•  Redistribution of blood from
the skin and GIT to the
brain, muscles and heart
•  Consits of:
–  Efferent outflow from spinal
cord
–  Sympathetic trunk
–  Regional ganglia
–  Plexuses
Arisa Takagi, PTRP, PT
 SYMPATHETIC GANGLIA
•  Paravertebral
ganglia (sympathetic
trunk)
•  Pre-vertebral
(collateral) ganglia

Arisa Takagi, PTRP, PT

 SYMPATHETIC OUTFLOW
1. Preganglionic efferents are
in the lateral gray of the
thoracic and lumbar segments

2. Short, myelinated
preganglionic axons connect to
paravertebral ganglia
(sympathetic chain or trunk )
à white communicating rami
Arisa Takagi, PTRP, PT
Arisa Takagi, PTRP, PT
 SYMPATHETIC
OUTFLOW
3. Once in the sympathetic trunk,
the outflow can go through
different pathways:
3a: Travels up in the sympathetic
trunk and out to synapse with
cervical ganglia
3b: synapse with a ganglion in the
sympathetic trunk and will exit as
the gray communicating rami
Arisa Takagi, PTRP, PT
 SYMPATHETIC OUTFLOW
3c. Pass through the sympathetic ABDOMINOPELVIC SPLANCHNICS
trunk and synapse with pre-
vertebral ganglia via the 3 Celiac
splanchnic nerves: Ganglion
•  Greater splanchnic (from T5-T9)
•  Lesser splanchnic (T9-T11)
Superior
•  Least splanchnic (T12) Mesenteric

Inferior
Mesenteric

Arisa Takagi, PTRP, PT

Arisa Takagi, PTRP, PT
Arisa Takagi, PTRP, PT
 Sympathetic: Cervical Division
•  Superior, middle and inferior
cervical ganglion
•  Superior cervical ganglion gives
rise to the carotid plexus.
•  All these supply the blood
vessels, sweat glands of the head
and face, lacrimal and salivary
glands.
•  Innervates the dilator pupillae
and levator palpebrae superioris

Arisa Takagi, PTRP, PT

 Sympathetic:
Cardiopulmonary
•  Upper thoracic fibers of
the sympathetic trunk
becomes the cardiac
plexus at the base of the
heart and distribute
cardioaccelerator fibers to
the myocardium
•  T1-T5 branches also forms
the pulmonary plexus
through which dilator
fibers of the bronchi arise.
Arisa Takagi, PTRP, PT
Arisa Takagi, PTRP, PT
 Horner’s Syndrome
Clinical Pearl
•  Injury to the sympathetic
innervation of the orbit
•  Results from lesions that interrupt
the central or peripheral
sympathetic pathways to the face
•  Can occur in a spinal cord lesion
that damages the preganglionic
neurons in the upper thoracic or
axons in the cervical trunk

Arisa Takagi, PTRP, PT

 PARASYMPATHETIC
DIVISION
•  Craniosacral outflow
•  Preganglionic cells arise from CN nuclei
(CN III, VII, IX, X) or lateral gray fibers in
the S2-S4
•  Preganglionic axons synapse at terminal
(intramural) ganglia with short
postganglionic neurons going to target
organs Arisa Takagi, PTRP, PT
 PARASYMPATHETIC
DIVISION
•  CN III: Edinger Westphal
•  CN VII: Superior salivatory nucleus and
lacrimatory nucleus
•  CN IX: Inferior salivatory nucleus
•  CN X: Dorsal nucleus of Vagus (X)

•  S2-S4 à fibers form the pelvic

splanchnic nerves (nervus erigentes) à
eventually becomes the hypogastric
plexus
Arisa Takagi, PTRP, PT
 PARASYMPATHETIC
DIVISION
GANGLIA

•  CN III à Ciliary ganglion

•  CN VII à Pterygopalatine,
submandibular
•  CN IX à Otic

Arisa Takagi, PTRP, PT

 Parasympathetic Ganglia Innervate Single
Organs

•  Parasympathetic ganglia innervate single end-organs and

lie near to or within the end-organs they regulate.

•  The caudal parasympathetic outflow supplies the large

intestine, rectum, bladder and reproductive organs.

Arisa Takagi, PTRP, PT

Arisa Takagi, PTRP, PT
 AUTONOMIC PLEXUSES
•  They are slender bundles of preganglionic or
postganglionic fibers arranged in a branching network.
•  Found in the thorax, abdomen, and pelvis

Cardiac Celiac/solar
Pulmonary Superior mesenteric Hypogastric
Esophageal Inferior mesenteric

Arisa Takagi, PTRP, PT

Arisa Takagi, PTRP, PT
 Sympathetic vs
Parasympathetic

Arisa Takagi, PTRP, PT

 SYMPATHETIC PARASYMPATHETIC
Prepares body for emergency, For rest and digest
Fight and flight response

noradrenergic cholinergic
Catabolic nervous system Anabolic nervous system
Thoracolumbar division Craniosacral division
- T1-L3 -  CN: X IX VII III
-  S2-S4
Long postganglionic fibers Short postganglionic fibers

Arisa Takagi, PTRP, PT

Arisa Takagi, PTRP, PT
 postganglionic

preganglionic

Arisa Takagi, PTRP, PT

ORGAN   SYMPATHETIC PARASYMPATHETIC

EYE Pupil and Ciliary Dilates, Relaxes Constricts, Contracts

muscle
GLANDS Lacrimal, salivary, Vasoconstrictionà Increased secretion
nasal reduced secretion

Sweat Increased secretion Reduced Secretion

Arisa Takagi, PTRP, PT

ORGAN   SYMPATHETIC PARASYMPATHETIC

HEART Myocardium Increased force of Decreased force of

contraction contraction
Coronary arteries Dilates (Beta)

LUNG Bronchial muscles Relaxesà bronchodilation Contractsà

bronchoconstriction
Bronchial Decreased secretion Increased
secretion
Bronchial arteries Constricts Dilates

Arisa Takagi, PTRP, PT

ORGAN   SYMPATHETIC PARASYMPATHETIC

GASTRO Liver Glycogenolysis  

INTESTINAL Gallbladder Relaxes Contracts
Pancreas Decreased pancreatic Increased pancreatic
enzymes, insulin, glucagon enzymes, insulin,
glucagon
Stomach Motility: decreased Motility: increased
Sphincters: contraction Sphincters: relaxation
Secretion: inhibition Secretion: stimulation

Intestines Motility: decreased Motility: increased

Sphincters: contracts Sphincters: relaxes
Secretion: inhibition Secretion: stimulation

Arisa Takagi, PTRP, PT

GENITO Sympathetic  Parasympathetic
URINARY
Adrenal glands Liberates catecholamines

Kidneys Renal arteries Increased output
constriction à decreased
output
Urinary bladder Detrusor muscle: relaxes Detrusor muscle:
Trigon and sphincter: contracts
contracts Trigon and sphincter:
relaxes

Male sex organ Ejaculation Erection

Arisa Takagi, PTRP, PT

ORGAN   SYMPATHETIC PARASYMPATHETIC

SYSTEMIC ARTERIES Skin All systemic

Abdominal viscera arteries will
Muscle constrict except
for muscles

Arisa Takagi, PTRP, PT

 NEUROTRANSMITTERS
OF THE ANS
•  Cholinergic Neurons
– Secrete Ach
– Bind to cholinergic receptors (Nicotinic & Muscarinic)
•  Adrenergic Neurons
– Secrete Adrenalin (E)
– Binds to adrenergic receptors (a or b)

Arisa Takagi, PTRP, PT

Arisa Takagi, PTRP, PT
Arisa Takagi, PTRP, PT
 PRINCIPAL TRANSMITTER AGENTS

•  ACETYLCHOLINE
-  Released at all preganglionic endings
-  Released by parasympathetic post ganglionic neurons and
sympathetic post ganglionic neurons that project to sweat
glands or mediate vasodilation.

Arisa Takagi, PTRP, PT

 PRINCIPAL TRANSMITTER AGENTS

•  NOREPINEPHRINE
-  Found at most sympathetic postganglionic endings
-  Secreted by adrenal medulla

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 NEUROTRANSMITTERS
OF THE ANS
NEURON SYMPATHETIC PARASYMPATHETIC

Pre-Ganglionic Nicotinic Ach Nicotinic Ach

Post-Ganglionic Alpha/Beta Muscarinic Ach

Adrenergic

Arisa Takagi, PTRP, PT

Arisa Takagi, PTRP, PT
Hypothalamus
•  Extends from optic chiasma
to mammillary bodies
•  Floor of the 3rd ventricle
•  Center of the limbic system
•  Controls & Integrates
functions of the ANS &
Endocrine system
– Vital role in homeostasis

Arisa Takagi, PTRP, PT

 HYPOTHALAMIC NUCLEI
Medial Zone Lateral Zone
•  Preoptic •  Preoptic
•  Anterior •  Suprachiasmatic
•  Posterior •  Supraoptic
•  Suprachiasmatic •  Lateral
•  Paraventricular •  Tuberomammillary
•  Dorsomedial •  Lateral Tuberal
•  Ventromedial Arisa Takagi, PTRP, PT
Arisa Takagi, PTRP, PT
Autonomic Centers in the Brain

Arisa Takagi, PTRP, PT

 FUNCTIONS OF
HYPOTHALAMIC NUCLEI
• Supraoptic: ADH production
• Paraventricular: Oxytocin production
• Preoptic & Anterior: Parasympathetic
Regulation
• Posterior & Lateral: Sympathetic
Regulation Arisa Takagi, PTRP, PT
 FUNCTIONS OF
HYPOTHALAMIC NUCLEI
• Posterior: Response to Cold
• Anterior: Response to Heat
• Lateral: Hunger & thirst
• Medial: Satiety
• Suprachiasmatic: Circadian Rhythm
Arisa Takagi, PTRP, PT
Hypothalamus – Greatest Concentration
of Autonomic Centers
•  Temperature Regulation
•  Regulation of Food Intake (Feeding and Satiety)
•  Regulation of Water Intake

Arisa Takagi, PTRP, PT

 Other Autonomic Centers in the Brain aside
from the Hypothalamus
•  Micturation Center – Pons
•  Vasomotor and Vasodilator Centers – Medulla
•  Respiratory Center – Medulla and Pons

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Baroreceptor Reflex

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Arisa Takagi, PTRP, PT
Arisa Takagi, PTRP, PT
 SYMPATHETIC PARASYMPATHETIC
ACTION Prepares for Conserves and
emergency restores energy
OUTFLOW T1-L2 CN III, VII, IX, X
and S2-24
PREGANGLIONIC Myelinated Myelinated

GANGLIA Paravertebral, Small ganglia close

prevertebral to viscera
NEURO ACh Ach
TRANSMITTER
Receptor Nicotinic Nicotinic
Arisa Takagi, PTRP, PT
 SYMPATHETIC PARASYMPATHETIC
Postganglionic Long, non Short, non
myelinated myelinated
Characteristic Widespread (many Discrete action
Activity postgang) (few popstgang)
Neuro NE Ach
Transmitter
Receptors Adrenergic Muscarinic
Higher Control Hypothalamus Hypothalamus

Arisa Takagi, PTRP, PT

Arisa Takagi, PTRP, PT
Arisa Takagi, PTRP, PT