Autonomic Nervous System

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Lecture: Autonomic Nervous System
I. Overview of the Autonomic Nervous System (ANS)
A. Major Functions: maintain optimal performance of visceral organs, glands, smooth muscle, and cardiac muscle in order to maintain homeostatic state within body
1. involuntary nervous system - not under conscious control: regulates heart rate, blood pressure, respiratory rate, body temperature, smooth muscle contraction, glandular function, and secretions
2. General visceral motor system - most “effectors” (organs & tissues regulated) are visceral (as opposed to somatic - skeletal muscle & joints)
B. Somatic vs. Autonomic Nervous Systems
1. Effectors (Target of Motor Neuron)
a. SOMATIC - skeletal muscle
b. AUTONOMIC - organs, glands, smooth & cardiac muscle
2. Efferent (Motor Neuron) Pathway
a. SOMATIC - one motor neuron from CNS to skeletal muscle
b. AUTONOMIC - two neurons in the motor pathway
i. preganglionic neuron - located in the CNS, sends its axon to an autonomic ganglion located outside the CNS; lightly myelinated, thin axons
ii. postganglionic neuron - located in the autonomic ganglion, sends it axon to the effector (tissue to be effected); unmyelinated, very thin axons
3. Action of Neurotransmitters
a. SOMATIC - acetylcholine (ACh); stimulatory
b. AUTONOMIC - post ganglionic neurons may release either ACh or Norepinephrine (NE); whether response is stimulatory or inhibitory depends on the effector
4. Coordination of Somatic and Autonomic Systems
a. Both systems send their motor neurons to effectors via the 31 pairs of spinal nerves and 12 pairs of cranial nerves
b. When skeletal muscle is active, autonomic must regulate other body activities for sufficient blood, oxygen, waste removal
C. Divisions of the Autonomic Nervous System - the sympathetic and parasympathetic divisions work in contrasting fashion to stimulate and inhibit effectors
1. Sympathetic Division - classic "flight-or-fight" response in scary situations
a. increased heart rate

b. rapid, deep breathing pattern

c. cold, sweaty skin

d. dilated eye pupils

e. large burst of energy available (glucose)

f. constriction of blood vessels

g. increased blood pressure

h. dilation of bronchioles (more air)

2. Parasympathetic Division - the "resting and digesting" system, keeps body calm, stimulates digestion, urination, and defecation
II. Physiology of Autonomic Nervous System
A. Autonomic Neurotransimitters and Their Receptors
1. Acetylcholine (ACh) - the same neurotransmitter at the neuromuscular junction is used by autonomic fibers in two places (cholinergic fibers):
a. secreted by ALL preganglionic neurons of the ANS
b. secreted by MOST postganglionic neurons of PARASYMPATHETIC onto target cells
2. Acetylcholine (cholinergic) receptors
a. nicotinic receptors - ACh receptors that can also be activated by nicotine - STIMULATE
i. at neuromuscular junction of skeletal muscle

ii. located on ALL postganglionic nerve cell bodies of ANS

iii. hormone-producing cells of adrenal medulla
b. muscarinic receptors - ACh receptors which are activated by mushroom toxin muscarine STIMULATE or INHIBIT depending of target cell
i. located on the target cells of the body receiving ACh from the parasympathetic division
cardiac muscle -> INHIBITORY

smooth muscle of GI tract -> STIMULATORY
3. Norepinephrine (noradrenaline) - released by most postganglionic neurons of the SYMPATHETIC system (adrenergic fibers)

exceptions: postganglionic sympathetic fibers to some sweat glands of skin, some blood vessels to skeletal muscle and external genitalia

4. norepinephrine (noradrenergic) receptors
a. alpha adrenergic receptors - generally STIMULATE the effector organ/tissue
b. beta adrenergic receptors - generally INHIBIT the effector organ/tissue
B. Drug Effects on the Autonomic NS
1. synaptic cleft enzyme inhibitors
a. neostigmine - blocks acetylcholinesterase for accumulation of ACh (myasthenia gravis)
2. tricyclic antidepressants - prolong the binding of norepinephrine to postsynaptic receptors
3. beta-blockers - block binding of norepinephrine to beta-I receptors; reduce heart rate
C. Antagonistic Control with Sympathetics & Parasympathetics

Target Parasympathetic Sympathetic

eye pupil constricts dilates

heart decreases heart rate increases heart rate

lung constricts bronchioles dilates bronchioles

GI Tract increases digestion decreases digestion

urinary promotes urination inhibits urination

most glands stimulate secretion inhibits secretion
D. Sympathetic Tone and Parasympathetic Tone

1. Sympathetic Tone - constriction of blood vessels almost exclusively controlled by sympathetic

  1. blood pressure - sympathetic stimulation causes vasoconstriction of blood vessels and increase in blood pressure; when stimulation decreases, blood pressure likewise decreases

b. phentolamine - blocks NE, used to treat with high blood pressure

2. Parasympathetic Tone - primary control of heart rate (decrease), GI tract (stimulate), and urinary function (stimulate)
a. anticholinergic drugs - block ACh causing increased heart rate, decreased defecation and urination
b. anticholinergic side effects - drugs that partially block ACh causing problems of symptoms of anticholingeric drugs (many pschotropic drugs like anti-depressants)
E. Other Roles of the Autonomic Nervous System
1. Cooperative Effects - parasympathetic causes vasodilation of penis and clitoris; sympathetic causes ejaculation and peristalsis of vagina
2. Sympathetic ONLY -
a. stimulation of adrenal medulla to secrete hormones norepinephrine and epinephrine

b. stimulates sweat glands to secrete

c. arrector pili hair to stand up on arm/neck

d. blood vessels - causes to constrict

e. thermoregulation - vasodilation of capillaries in skin and sweat gland stimulation

f. release of renin from kidney - release of hormone causes increased blood pressure

g. metabolic effects - increases general alertness

i. increased metabolic rate

ii. increased glucose release to blood

iii. mobilization of fat for fuel use

iv. activate reticular formation of brain
III. Central Nervous System Regulation of the Autonomic NS
A. Control by Brain Stem and Spinal Cord
1. medulla - can regulate heart rate (cardiac center), blood vessel constriction (vasomotor center), respiration, and some gastrointestinal activity
2. pons - can regulate respiration (respiratory center), and the pupils (ocularmotor nuclei)
3. spinal cord - can regulate defecation/urination
B. Hypothalamus - Overall Integration of Autonomics
1. hypothalamus - can coordinate the regulation of heart rate, blood pressure, body temperature, water/electrolyte balance, hormonal activity, pleasure, rage, thirst, hunger, and sex drive
a. sympathetic - lateral & posterior hypothalamus
b. parasympathetic - medial & anterior hypothalamus
hypothalamus ----> reticular formation ----> preganglionic autonomics
C. Cerebral Cortex and Biofeedback - making patient aware of autonomically controlled functions (heart rate, blood pressure) can allow them to learn how to better control them

IV. Abnormalities of Autonomic Control Mechanisms

A. hypertension - increased blood pressure due to overstimulation of sympathetics that results from stress; NE blockers to treat
B. Raynaud’s disease - abnormal vasoconstriction of vessels in the extremities; surgery to sever sympathetic fibers used to treat this problem
C. autonomic hyperflexia - massive reflex activation of all autonomics that occurs in response to spinal injury; can cause death due to loss of control of visceral function

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