1. Chapter 15 APR Enhanced Lecture PowerPoint 15-1 Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.

2. 15-2 Autonomic Nervous System and Visceral Reflexes Autonomic Nervous System (ANS) –general properties –anatomy Autonomic Effects on Target Organs Central Control of Autonomic Function

3. 15-3 Autonomic Nervous System portion of the nervous system that operates in comparative secrecy it manages a multitude of unconscious processes responsible for the body’s homeostasis Walter Cannon –coined the expressions as ‘homeostasis’ and ‘fight-or- flight’ –dedicated his career to studying the ANS homeostasis cannot be maintained without the ANS

4. 15-4 General Properties of ANS autonomic nervous system (ANS) – a motor nervous system that controls glands, cardiac muscle, and smooth muscle –also called visceral motor system –primary organs of the ANS viscera of thoracic and abdominal cavities some structures of the body wall –cutaneous blood vessels –sweat glands –piloerector muscles –carries out actions involuntarily – without our conscious intent or awareness –visceral effectors do not depend on the ANS to function only to adjust their activity to the body’s changing needs –denervation hypersensitivity – exaggerated response of cardiac and smooth muscle if autonomic nerves are severed

5. 15-5 Visceral Reflexes visceral reflexes - unconscious, automatic, stereotyped responses to stimulation involving visceral receptors and effectors and somewhat slower responses visceral reflex arc –receptors – nerve endings that detect stretch, tissue damage, blood chemicals, body temperature, and other internal stimuli –afferent neurons – leading to the CNS –interneurons – in the CNS –efferent neurons – carry motor signals away from the CNS –effectors – that make adjustments ANS modifies effector activity

6. 15-6 Visceral Reflex to High BP high blood pressure detected by arterial stretch receptors (1), afferent neuron (2) carries signal to CNS, efferent (3) signals travel to the heart (4), heart slows reducing blood pressure example of homeostatic negative feedback loop Figure 15.1 Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. 2 3 4 1 Glossopharyngeal nerve transmits signals to medulla oblongata Baroreceptors sense increased blood pressure Common carotid artery Vagus nerve transmits inhibitory signals to cardiac pacemaker Terminal ganglion Heart rate decreases

7. 15-7 Divisions of ANS two divisions innervate same target organs –may have cooperative or contrasting effects sympathetic division –prepares body for physical activity – exercise, trauma, arousal, competition, anger, or fear increases heart rate, BP, airflow, blood glucose levels, etc reduces blood flow to the skin and digestive tract parasympathetic division –calms many body functions reducing energy expenditure and assists in bodily maintenance digestion and waste elimination “resting and digesting” state

8. Sympathetics & Parasympathetics 15-8

9. 15-9 Divisions of ANS autonomic tone - normal background rate of activity that represents the balance of the two systems according to the body’s changing needs –parasympathetic tone maintains smooth muscle tone in intestines holds resting heart rate down to about 70 – 80 beats per minute –sympathetic tone keeps most blood vessels partially constricted and maintains blood pressure sympathetic division excites the hearts but inhibits digestive and urinary function, while parasympathetic has the opposite effect

10. 15-10 Neural Pathways ANS has components in both the central and peripheral nervous systems –control nucleus in the hypothalamus and other brainstem regions –motor neurons in the spinal cord and peripheral ganglia –nerve fibers that travel through the cranial and spinal nerves somatic motor pathway –a motor neuron from the brainstem or spinal cord issues a myelinated axon that reaches all the way to the skeletal muscle autonomic pathway –signal must travel across two neurons to get to the target organ –must cross a synapse where these two neurons meet in an autonomic ganglion –presynaptic neuron – the first neuron has a soma in the brainstem or spinal cord –synapses with a postganglionic neuron whose axon extends the rest of the way to the target cell

11. Control of Autonomic Function HYPOTHALAMUS 15-11

12. 15-12 Somatic versus Autonomic Pathways ANS – two neurons from CNS to effectors presynaptic neuron whose cell body is in CNS postsynaptic neuron cell body in peripheral ganglion Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Somatic efferent innervation Autonomic efferent innervation ACh ACh or NE Myelinated fiber Somatic effectors (skeletal muscles) Myelinated preganglionic fiber Unmyelinated postganglionic fiber Autonomic ganglion Visceral effectors (cardiac muscle, smooth muscle, glands) Figure 15.2

13. 15-13 also called the thoracolumbar division because it arises from the thoracic and lumbar regions of the spinal cord relatively short preganglionic and long postganglionic fibers preganglionic neurosomas in lateral horns and nearby regions of the gray matter of spinal cord –fibers exit spinal cord by way of spinal nerves T1 to L2 –lead to nearby sympathetic chain of ganglia (paravertebral ganglia) series of longitudinal ganglia adjacent to both sides of the vertebral column from cervical to coccygeal levels usually 3 cervical, 11 thoracic, 4 lumbar, 4 sacral, and 1 coccygeal ganglion sympathetic nerve fibers are distributed to every level of the body Sympathetic Nervous System

14. Sympathetic Division 15-14

15. 15-15 –each paravertebral ganglion is connected to a spinal nerve by two branches – communicating rami –preganglionic fibers are small myelinated fibers that travel form spinal nerve to the ganglion by way of the white communicating ramus (myelinated) –postganglionic fibers leave the ganglion by way of the gray communicating ramus (unmyelinated) forms a bridge back to the spinal nerve –postganglionic fibers extend the rest of the way to the target organ Sympathetic Nervous System

16. 15-16 Sympathetic Chain Ganglia Figure 15.3 Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Cardiac n. Splanchnic n. Heart Rib Bronchi Diaphragm Phrenic n. Superior vena cava Vagus n. Sympathetic chain Communicating ramus Thoracic ganglion © From A Stereoscopic Atlas of Anatomy by David L. Basett. Courtesy of Dr. Robert A. Chase, MD

17. 15-17 after entering the sympathetic chain, the postganglionic fibers may follow any of three courses –some end in ganglia which they enter and synapse immediately with a postganglionic neuron –some travel up or down the chain and synapse in ganglia at other levels these fibers link the paravertebral ganglia into a chain only route by which ganglia at the cervical, sacral, and coccygeal levels receive input –some pass through the chain without synapsing and continue as splanchnic nerves Sympathetic Nervous System

18. 15-18 nerve fibers leave the sympathetic chain by spinal, sympathetic, and splanchnic nerves –spinal nerve route some postganglionic fibers exit a ganglion by way of the gray ramus returns to the spinal nerve and travels the rest of the way to the target organ most sweat glands, piloerector muscles, and blood vessels of the skin and skeletal muscles –sympathetic nerve route other nerves leave by way of sympathetic nerves that extend to the heart, lungs, esophagus and thoracic blood vessels these nerves form carotid plexus around each carotid artery of the neck issue fibers from there to the effectors in the head –sweat, salivary, nasal glands, piloerector muscles, blood vessels, dilators of iris some fibers of superior and middle cervical ganglia form cardiac nerves to the heart –splanchnic nerve route some fibers that arise from spinal nerves T5 to T12 pass through the sympathetic ganglia without synapsing –continue on as the splanchnic nerves –lead to second set of ganglia – collateral (prevertebral) ganglia and synapse there Sympathetic Nervous System

19. 15-19 collateral ganglia contribute to a network called the abdominal aortic plexus –wraps around abdominal aorta –three major collateral ganglia in this plexus celiac, superior mesenteric, and inferior mesenteric postganglionic fibers accompany these arteries and their branches to their target organs –solar plexus – collective name for the celiac and superior mesenteric ganglia nerves radiate from ganglia like rays of the sun neuronal divergence predominates –each preganglionic cell branches and synapses on 10 to 20 postganglionic cells –one preganglionic neuron can excite multiple postganglionic fibers leading to different target organs –have relatively widespread effects Sympathetic Nervous System

20. 15-20 Efferent Pathways Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Salivary glands Heart Lung Stomach Spleen Pancreas Small intestine Large intestine Rectum Kidney Bladder Penis Scrotum Uterus Ovary Pons Regions of spinal cord Thoracic Cervical Lumbar Sacral Eye Adrenal medulla Preganglionic neurons Postganglionic neurons Postganglionic fibers to skin, blood vessels, adipose tissue Sympathetic chain ganglia Liver and gallbladder Inferior mesenteric ganglion Superior mesenteric ganglion Celiac ganglion Cardiac and pulmonary plexuses Figure 15.4

21. 15-21 Preganglionic Pathways Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Collateral ganglion Spinal nerve White ramus Gray ramus Sympathetic nerve Splanchnic nerve 2 2 3 1 Postganglionic neuron Preganglionic neuron Somatic neuron Somatic motor fiber To somatic effector (skeletal muscle) Soma of somatic motor neuron Postganglionic sympathetic fibers To liver, spleen, adrenal glands, stomach, intestines, kidneys, urinary bladder, reproductive organs Sympathetic ganglion Sympathetic trunk Soma of postganglionic neuron Communicating rami Postganglionic sympathetic fiber Preganglionic sympathetic fiber Soma of preganglionic neuron To sweat glands, piloerector muscles, and blood vessels of skin and skeletal muscles To iris, salivary glands, lungs, heart, thoracic blood vessels, esophagus Figure 15.5

22. 15-22 Ganglia and Abdominal Aortic Plexus Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Celiac ganglia (a) (b) Aortic plexus Renal plexus Esophagus Diaphragm Kidney Superior mesenteric artery Inferior mesenteric artery Aorta Celiac trunk Adrenal gland Adrenal cortex Adrenal medulla First lumbar sympathetic ganglion Pelvic sympathetic chain Inferior mesenteric ganglion Superior mesenteric ganglion Figure 15.6

23. 15-23 Summary of Sympathetic Innervation effectors in body wall are innervated by sympathetic fibers in spinal nerves effectors in head and thoracic cavity are innervated by fibers in sympathetic nerves effectors in abdominal cavity are innervated by sympathetic fibers in splanchnic nerves

24. 15-24 Adrenal Glands paired adrenal (suprarenal) glands on superior poles of the kidneys each is two glands with different functions –adrenal cortex (outer layer) secretes steroid hormones –adrenal medulla (inner core) essentially a sympathetic ganglion consists of modified postganglionic neurons without dendrites or axons –stimulated by preganglionic sympathetic neurons that terminate on these cells secretes a mixture of hormones into bloodstream –catecholamines - 85% epinephrine (adrenaline) and 15% norepinephrine (noradrenaline) –also function as neurotransmitters sympathoadrenal system is the closely related functioning adrenal medulla and sympathetic nervous system

25. Adrenal Glands 15-25

26. Adrenal Gland capsule cortex medulla 15-26

27. 15-27 Parasympathetic Division parasympathetic division is also called the craniosacral division –arises from the brain and sacral regions of the spinal cord –fibers travel in certain cranial and sacral nerves origin of long preganglionic neurons –midbrain, pons, and medulla –sacral spinal cord segments S 2 -S 4 pathways of long preganglionic fibers –fibers in cranial nerves III, VII, IX and X –fibers arising from sacral spinal cord pelvic splanchnic nerves and inferior hypogastric plexus terminal ganglia in or near target organs –long preganglionic, short postganglionic fibers neuronal divergence less than sympathetic division –one preganglionic fiber reaches the target organ and then stimulates fewer than 5 postganglionic cells

28. Parasympathetic Division 15-28

29. 15-29 Parasympathetic Cranial Nerves Oculomotor nerve (III) –narrows pupil and focuses lens Facial nerve (VII) –tear, nasal and salivary glands Glossopharyngeal nerve (IX) –parotid salivary gland Vagus nerve (X) –viscera as far as proximal half of colon –cardiac, pulmonary, and esophageal plexus Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Lacrimal gland Heart Lung Stomach Pancreas Small intestine Rectum Bladder Penis Scrotum Uterus Ovary Ciliary ganglion Spleen Descending colon Otic ganglion Cardiac plexus Eye Thoracic Cervical Lumbar Sacral Preganglionic neurons Postganglionic neurons Pterygopalatine ganglion Oculomotor n. (CN III) Submandibular ganglion Facial n. (CN VII) Submandibular salivary gland Parotid salivary gland Glossopharynge al n. (CN IX) Vagus n. (CN X) Pulmonary plexus Esophageal plexus Abdominal aortic plexus Pelvic splanchnic nerves Inferior hypogastric plexus Liver and gallbladder Kidney and ureter Transverse colon Pelvic nerves Regions of spinal cord Celiac ganglion Figure 15.7

30. Efferent Pathways remaining parasympathetic fibers arise from levels S 2 to S 4 of the spinal cord form pelvic splanchnic nerves that lead to the inferior hypogastric plexus most form pelvic nerves to their terminal ganglion on the target organs –distal half of colon, rectum, urinary bladder, and reproductive organs Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Lacrimal gland Heart Lung Stomach Pancreas Small intestine Rectum Bladder Penis Scrotum Uterus Ovary Ciliary ganglion Spleen Descending colon Otic ganglion Cardiac plexus Eye Thoracic Cervical Lumbar Sacral Preganglionic neurons Postganglionic neurons Pterygopalatine ganglion Oculomotor n. (CN III) Submandibular ganglion Facial n. (CN VII) Submandibular salivary gland Parotid salivary gland Glossopharyngeal n. (CN IX) Vagus n. (CN X) Pulmonary plexus Esophageal plexus Celiac ganglion Abdominal aortic plexus Pelvic splanchnic nerves Inferior hypogastric plexus Liver and gallbladder Kidney and ureter Transverse colon Pelvic nerves Regions of spinal cord Figure 15.7 15-30

31. 15-31 Enteric Nervous System enteric nervous system – the nervous system of the digestive tract –does not arise from the brainstem or spinal cord –does innervate smooth muscle and glands composed of 100 million neurons found in the walls of the digestive tract no components in CNS has its own reflex arcs regulates motility of esophagus, stomach, and intestines and secretion of digestive enzymes and acid normal digestive function also requires regulation by sympathetic and parasympathetic systems

32. 15-32 Megacolon Hirschsprung disease – hereditary defect causing absence of enteric nervous system –no innervation in sigmoid colon and rectum –constricts permanently and will not allow passage of feces –feces becomes impacted above constriction –megacolon – massive dilation of bowel accompanied by abdominal distension and chronic constipation –maybe colonic gangrene, perforation of bowel, and peritonitis –usually evident in newborns who fail to have their first bowel movement

33. 15-33 Neurotransmitters and Receptors how can different autonomic neurons have different effects? constricting some vessels but dilating others –effects determined by types of neurotransmitters released and types of receptors found on target cells 2 fundamental reasons: –sympathetic and parasympathetic fibers secrete different neurotransmitters –target cells respond to the same neurotransmitter differently depending upon the type of receptor they have for it all autonomic fibers secrete either acetylcholine or norepinephrine there are 2 classes of receptors for each of these neurotransmitters

34. 15-34 Acetylcholine (ACh) ACh is secreted by all preganglionic neurons in both divisions and the postganglionic parasympathetic neurons –called cholinergic fibers –any receptor that binds it is called cholinergic receptor 2 types of cholinergic receptors –muscarinic receptors all cardiac muscle, smooth muscle, and gland cells have muscarinic receptors excitatory or inhibitory due to subclasses of muscarinic receptors – nicotinic receptors on all ANS postganglionic neurons, in the adrenal medulla, and at neuromuscular junctions of skeletal muscle excitatory when ACh binding occurs

35. 15-35 Norepinephrine (NE) NE is secreted by nearly all sympathetic postganglionic neurons –called adrenergic fibers –receptors for it called adrenergic receptors alpha-adrenergic receptors –usually excitatory –2 subclasses use different second messengers (α 1 & α 2 ) beta-adrenergic receptors –usually inhibitory –2 subclasses with different effects, but both act through cAMP as a second messenger (β 1 & β 2 )

36. 15-36 Overview autonomic effects on glandular secretion are often an indirect result of their effect on blood vessels –vasodilation – increased blood flow – increased secretion –vasoconstriction – decreased blood flow – decreased secretion sympathetic effects tend to last longer than parasympathetic effects –ACh released by parasympathetics is broken down quickly at synapse –NE by sympathetics is reabsorbed by nerve, diffuses to adjacent tissues, and much passes into bloodstream many substances released as neurotransmitters that modulate ACh and NE function –sympathetic fibers also secrete enkephalin, substance P, neuropeptide Y, somatostatin, neurotensin, or gonadotropin-releasing hormone –parasympathetic fibers stimulate endothelial cells to release the gas, nitric oxide – causes vasodilation by inhibiting smooth muscle tone function is crucial to penile erection - means of action of Viagra

37. 15-37 Neurotransmitters and Receptors Figure 15.8 Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. (b) Sympathetic adrenergic fiber (c) Sympathetic cholinergic fiber (a) Parasympathetic fiber NE ACh Adrenergic receptor ACh Muscarinic receptor ACh Nicotinic receptor Preganglionic neuron Nicotinic receptor Preganglionic neuron Postganglionic neuron Nicotinic receptor Preganglionic neuron Postganglionic neuron Target cell Postganglionic neuron Target cell Target cell Muscarinic receptor

38. 15-38 Dual Innervation dual innervation - most viscera receive nerve fibers from both parasympathetic and sympathetic divisions –antagonistic effect – oppose each other –cooperative effects – two divisions act on different effectors to produce a unified overall effect both divisions do not normally innervate an organ equally digestion, heart rate

39. Sympathetics & Parasympathetics 15-39

40. 15-40 Dual Innervation antagonistic effects - oppose each other –exerted through dual innervation of same effector cells heart rate decreases (parasympathetic) heart rate increases (sympathetic) –exerted because each division innervates different cells pupillary dilator muscle (sympathetic) dilates pupil constrictor pupillae (parasympathetic) constricts pupil

41. 15-41 Dual Innervation cooperative effects - when two divisions act on different effectors to produce a unified effect –parasympathetics increase salivary serous cell secretion –sympathetics increase salivary mucous cell secretion

42. 15-42 Dual Innervation of the Iris Figure 15.9 Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Brain Spinal cord Iris Pupil Pupil dilatedPupil constricted Parasympathetic fibers of oculomotor nerve (III) Sympathetic fibers Ciliary ganglion Superior cervical ganglion Parasympathetic (cholinergic) effect Sympathetic (adrenergic) effect Adrenergic stimulation of pupillary dilator Cholinergic stimulation of pupillary constrictor

43. 15-43 Without Dual Innervation some effectors receive only sympathetic fibers –adrenal medulla, arrector pili muscles, sweat glands and many blood vessels control of blood pressure and routes of blood flow sympathetic vasomotor tone - a baseline firing frequency of sympathetics keeps vessels in state of partial constriction increase in firing frequency - vasoconstriction decrease in firing frequency - vasodilation can shift blood flow from one organ to another as needed sympathetic division acting alone can exert opposite effects on the target organ through control of blood vessels –during stress blood vessels to muscles and heart dilate blood vessels to skin constrict

44. 15-44 Sympathetic and Vasomotor Tone sympathetic division prioritizes blood vessels to skeletal muscles and heart in times of emergency blood vessels to skin vasoconstrict to minimize bleeding if injury occurs during stress or exercise Figure 15.10 Artery 1 1 2 3 3 1 2 3 2 2 3 1 Strong sympathetic tone Smooth muscle contraction Vasoconstriction Weaker sympathetic tone Smooth muscle relaxation Vasodilation Sympathetic nerve fiber Vasomotor tone (a) Vasoconstriction (b) Vasodilation Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.

45. 15-45 Control of Autonomic Function ANS regulated by several levels of CNS –cerebral cortex has an influence – anger, fear, anxiety powerful emotions influence the ANS because of the connections between our limbic system and the hypothalamus –hypothalamus - major visceral motor control center nuclei for primitive functions – hunger, thirst, sex –midbrain, pons, and medulla oblongata contain: nuclei for cardiac and vasomotor control, salivation, swallowing, sweating, bladder control, and pupillary changes –spinal cord reflexes defecation and micturition reflexes are integrated in spinal cord we control these functions because of our control over skeletal muscle sphincters…if the spinal cord is damaged, the smooth muscle of bowel and bladder is controlled by autonomic reflexes built into the spinal cord

46. Control of Autonomic Function HYPOTHALAMUS Controls ANS using 2 tools! Link between Nervous and Endocrine Systems Activates ‘Fight-or- Flight’ response 15-46

47. Control of Autonomic Function Cerebral Cortex Influences ANS control Anger raises BP Fear raises heart rate Sexual thoughts increase blood flow to genitals Anxiety inhibits sexual function 15-47

48. 15-48 Drugs and the Nervous System neuropharmacology – study of effects of drugs on the nervous system sympathomimetics enhance sympathetic activity –stimulate receptors or increase norepinephrine release cold medicines that dilate the bronchioles or constrict nasal blood vessels sympatholytics suppress sympathetic activity –block receptors or inhibit norepinephrine release beta blockers reduce high BP interfering with effects of epinephrine/norepinephrine on heart and blood vessels parasympathomimetics enhance activity while parasympatholytics suppress activity many drugs also act on neurotransmitters in CNS –Prozac blocks reuptake of serotonin to prolong its mood-elevating effect caffeine competes with adenosine (the presence of which causes sleepiness) by binding to its receptors

49. 15-49 Adenosine and Caffeine Figure 15.11 Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. CaffeineAdenosine O O H3CH3C N N N N CH 3 NN N NH 2 O OH N