U N I T XI

Textbook of Medical Physiology, 11th edition

GUYTON & HALL
Chapter 60: lecture 1
The Autonomic Nervous System (ANS);
The Adrenal Medulla

By
Dr. Mudassar Ali Roomi (MBBS, M.Phil)
Assistant Professor Physiology
Autonomic Nervous System (ANS)
It is motor system for visceral organs, blood vessels and
secretory glands
This system helps to control:
arterial pressure,
gastrointestinal motility,
gastrointestinal secretion,
urinary bladder emptying,
sweating,
body temperature,
and many other activities,
One of the most striking characteristics of the autonomic
nervous system is the rapidity and intensity with which it
can change visceral functions.

Why is ANS called so?
The name was given as it was thought that this system is independent
of CNS.
But it is controlled by many parts of CNS and these centers are present
in the :
medulla oblangata,
pons
mid brain,
hypothalamus,
portion of limbic system
cerebral cortex.
Spinal cord

CNS centres for control
of ANS
General Organization of the Autonomic Nervous
System
And Limbic cortex
General Organization of the Autonomic
Nervous System
General Organization of the
Autonomic Nervous System
Sympathetic
Nervous System

It consists of the thoraco
lumbar outflow.
The lateral horns of spinal
segments T1-L2 contain cell
bodies of the pre-ganglionic
sympathetic neuron.
Sympathetic ganglia can be
divided into 2 groups.
1)Paravertebral ganglia (which
make the sympathetic chain)
2)Pre-vertebral ganglia which
include celiac ganglion,
superior mesenteric ganglion,
inferior mesenteric ganglion.



visceral motor neuron located in the intermediolateral horn
of the spinal cord from T-1 to L-2 (thoracolumbar outflow)
Axons can take 1 of 3 paths
1. enter the sympathetic
chain via the white ramus
and terminate there
2. enter the sympathetic chain
via the white ramus and ascend
or descend a few segments
before terminating
3. enter via the white ramus
and exit via a splanchnic
nerve and terminate in a
prevertebral ganglia
Figure 60-2; Guyton & Hall
Physiologic Anatomy of the
sympathetic Nervous System
Segmental Distribution of the
Sympathetic Nerve Fibers

the sympathetic fibers from cord
segment T-1 generally pass up the
sympathetic chain to terminate in
the head;
from T-2 to terminate in the neck;
from T-3, T-4, T-5, and T-6 into
the thorax;
from T-7, T-8, T-9, T-10, and T-11
into the abdomen;
and from T-12, L-1, and L-2 into
the legs.
Segmental Distribution of the Sympathetic Nerve Fibers
Special Nature of the Sympathetic Nerve
Endings in the Adrenal Medullae
Adrenal medulla is a part of
the sympathetic nervous
system
Adrenal medulla cells are
embryologicaly post-
ganglionic sympathetic
neuron lost their N.fibers
to become secretory.
Instead of giving post
ganglionic symp N.fiber
these secrete catacholamines
(adrenaline & nor-
adrenaline).

Physiologic Anatomy of the
Parasympathetic Nervous System
Visceral motor neurons are located in
discrete brain stem nuclei and in sacral
segments (S2-4). It is also called as
craniosaccral outflow.
Parasympathetic nerves originate from
cranial nerves III, VII, IX, and X and the
sacral spinal cord.
occulomotor nerve - fibers to the
pupillary sphincters and ciliary muscle
facial nerve - fibers to nasal, lacrimal
and submandibular gland
glossopharyngeal nerve - fibers to
parotid gland
vagus nerve - motor inputs to visceral
organs
sacral segments - fibers to descending
colon, rectum, bladder and genitalia

Neurotransmitters in ANS
sympathetic nerves release norepinephrine at
their nerve endings
these nerves are call adrenergic nerves
parasympathetic nerves release acetylcholine
at their nerve endings
these nerves are called cholinergic
nerves
All preganglionic sympathetic and
parasympathetic nerves release acetylcholine.
All postganglionic parasympathetic nerves
release acetylcholine.
almost all postganglionic sympathetic nerves
release norepinephrine
except for sweat glands, piloerector
muscles and select blood vessels which
release Ach ******

Mechanisms of Transmitter Secretion and
Subsequent Removal of the Transmitter
at cholinergic neuro-effector junction
Mechanisms of Transmitter Secretion and
Subsequent Removal of the Transmitter
at the adrenergic neuro-effector junction
Receptors of the Autonomic Nervous
System
Cholinergic receptors
1. Muscarinic receptors
(M1, M2, M3)
2. Nicotinic receptors
a. Nn
b. Nm
Adrenergic receptors
1. Alpha 1,2
2. Beta 1,2

Adrenergic receptors
May 26, 2014 20
Cellular mechanism of action of
neurotransmitters in ANS
May 26, 2014 21
cAMP second messenger system
May 26, 2014 22
cAMP second messenger system
May 26, 2014 23
Phospholipid second messenger
system
May 26, 2014 24
Phospholipid second messenger system
May 26, 2014 25
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