C 60 The Autonomic Nervous System

By Prof. Dr. Abdul Majid MBBS, M.Phil, FCPS

Autonomic Nervous System

Visceral functions of the body. Arterial blood pressure. GI motility. GI secretion. Urinary bladder emptying. Sweating. Body temperature and many other activities. Rapidity & intensity.

General Organization of ANS

Control centers are located in: Spinal cord. Brain stem. Hypothalamus. CC, limbic cortex.

Cont:
ANS operations by means of visceral reflexes: Subconscious sensory signals from the visceral organs enter into autonomic ganglia, brain stem or hypothalamus and subconscious reflex responses pass directly back to effecter organs.

Subdivision of ANS
Sympathetic nervous system. (Thoracolumber out flow that is from T1 to L2). Para sympathetic nervous system. (craniosacral out flow that is 3rd, 7th, 9th and 10th cranial nerves and 2nd and 3rd sacral nerves)

Physiologic Anatomy of Sympathetic NS

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Sympathetic Nerve Fibers in the Skeletal Nerves

Postganglionic sympathetic nerve fibers enter spinal or skeletal nerve fibers through gray rami from sympathetic chain. All are C nerve fibers. 8% of the total skeletal nerve fibers. To all parts of the body to provide cholinergic sympathetic nerve supply to sweat glands, piloerector muscles of the hair, blood vessels.

Segmental Distribution of Sympathetic NF

Special nature of sympathetic NE in the adrenal medullae

Physiologic Anatomy of Para sympathetic NS

Pre-Ganglionic & Post Ganglionic Para sympathetic Neurons

Cholinergic & Adrenergic NF

Synthesis of Acetyeholine, its Destruction After secretion, and its Duration of Action

Synthesis of Norepinephrine, its Removal, and its Duration of Action

Mechanism of Action of Neuro Transmitters

When neuro transmitters like acetylcholine, nor-epinephrine, epinephrine combine with prosthetic group of a receptor, it brings conformational change in its protein part. It can result in; Change in the membrane permeability for ions e.g if there is increase permeability for sodium ions or calcium ions then there will be depolarization resulting in excitation.

Cont:
If there is increased permeability for potassium ions it will result in hyperpolarization & inhibition. Altering intracellular second messenger enzymes e.g stimulation of adenyl cyclase enzyme results in increased formation of cyclic AMP.

Two Types of Acetylcholine Receptors

1. Nicotinic receptors are present in the autonomic ganglia where pre-ganglionic nerve fibers synapse on post ganglionic neurons & in the neuro muscular junctions. 2. Muscarinic receptors are present in the post ganglionic nerve endings whether sympathetic or parasympathetic.

Cont:
Muscarine, a poison from toad stools stimulates only muscarinic receptors. Nicotine stimulates nicotinic receptors only. Acetylcholine stimulates both muscarinic & nicotinic receptors equally.

Adrenergic Receptors
Adrenergic receptors are two types Alpha & beta. Alpha receptors are further subdivided into alpha1 & alpha 2. Beta receptors are further subdivided into beta1, beta2 & beta3 receptors. Norepinephrine mainly excites alpha receptors & to a lesser extent - beta receptors.

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Epinephrine excites both receptors equally. So the effect on an organ depends upon relative number of receptors. A sympathetic hormone isopropyl norepinephrine has extremely strong action on beta receptors & no action on alpha receptors.

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Alpha receptors Inhibits neurotransmitter release ( 2 ) Beta receptors Thermo genesis ( 3)

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Alarm or Stress Response of Sympathetic Nervous System

Physical or mental stress or emotional states such as rage causes generalized sympathetic stimulation called mass sympathetic discharge to increase ability of the person to perform vigorous muscle activity through following ways: 1. Increased arterial blood pressure. 2. Increased blood flow to active muscles.

Cont:
3. Increased rate of cellular metabolism throughout the body. 4. Increased blood glucose concentration. 5. Increased glycolysis in the lever & muscle. 6. Increased muscle strength. 7. Increased mental activity. 8. Increased rate of blood coagulation.

Autonomic Control Areas in the Brain Stem & Hypothalamus