Autonomic Nervous System - IntroductionThe organs of our body (viscera), such as the heart, intestines and stomach, are regulated by a branch of the nervous system known as the autonomic nervous system. The autonomic nervous system is part of the peripheral nervous system and controls the function of many muscles, glands and organs within the body. We are usually quite unaware of the functioning of our autonomic system because it functions in a reflexive and involuntary manner. For example, we are not aware when our blood vessels change size, and we are (usually) unaware when our hearts speed up or slow down. Show
What is the Autonomic Nervous System?The Autonomic Nervous System (ANS) is the involuntary division of the nervous system. It consists of autonomic neurons that conduct impulses from the central nervous system (brain and/or spinal cord) to glands, smooth muscle and cardiac muscle. ANS neurons are responsible for regulating the secretions of certain glands (i.e., salivary glands) and the regulation of heart rate and peristalsis (contraction of smooth muscle in the digestive tract), among other functions Role of the ANSThe role of the ANS is to constantly fine-tune the functioning of organs and organ systems according to both internal and external stimuli. The ANS helps to maintain homeostasis (internal stability and balance) through the coordination of various activities such as hormone secretion, circulation, respiration, digestion and excretion. The ANS is always "on" and functioning unconsciously, so we are unaware of the important tasks it is performing every waking (and sleeping) minute of every day. The ANS is divided into two subsystems, the SNS (the sympathetic nervous system) and the PNS (parasympathetic nervous system). Sympathetic nervous system (SNS) - the SNS triggers what is commonly known as the "fight or flight" response:
The following effects are seen as a result of activation of adrenergic receptors:
Parasympathetic nervous system (PNS) - the PNS is sometimes referred to as the "rest and digest" system. In general, the PNS acts in the opposite way to the SNS, reversing the effects of the fight-or-flight response. However, it may be more correct to say that the SNS and the PNS have a complementary relationship, rather than one of opposition.
The following effects are seen as a result of activation of the PNS:
The Messengers of the SNS and PNSThe autonomic nervous system releases chemical messengers to influence its target organs. The most common are norepinephrine (NE) and acetylcholine (Ach). All presynaptic neurons use Ach as a neurotransmitter. Ach is also released by some sympathetic postsynaptic neurons and all parasympathetic postsynaptic neurons. The SNS uses NE as its principle postsynaptic chemical messenger. NE and Ach are the best-known neurotransmitters of the ANS. In addition to neurotransmitters, certain vasoactive substances are released by postsynaptic automatic neurons, which bind to receptors on target cells and influence the target organ. How does the SNS mediate its action?In the sympathetic nervous system, catecholamines (norephinephrine, epinephrine) act on specific receptors located on the cell surface of the target organs. These receptors are called adrenergic receptors.
How does the PNS mediate its action?As mentioned, acetylcholine is the primary neurotransmitter of the PNS. Acetylcholine acts on cholinergic receptors known as muscarinic and nicotinic receptors. Muscarinic receptors exert their effect on the heart. There are two main muscarinic receptors: M2 receptors- acted on by acetylcholine, M2 receptors are located in the heart; stimulation of these receptors causes the heart to slow (decreased heart rate and contractility and an increase in refractoriness). M3 receptors- located throughout the body; activation causes increased synthesis of nitric oxide, which results in relaxation of cardiac smooth muscle cells. How is the autonomic nervous system organized?As previously discussed, the autonomic nervous system is subdivided into two separate divisions: the sympathetic nervous system and the parasympathetic nervous system. It is important to understand how these two systems function in order to determine how they each affect the body, keeping in mind that both systems work in synergy to maintain homeostasis within the body. Both the sympathetic and parasympathetic nerves release neurotransmitters, primarily norepinephrine and epinephrine for the sympathetic nervous system, and acetylcholine for the parasympathetic nervous system. These neurotransmitters (also called catecholamines) relay the nerve signals across the gaps (synapses) created when the nerve connects to other nerves, cells or organs. The neurotransmitters then attach to either sympathetic receptor sites or parasympathetic receptor sites on the target organ to exert their effect. This is a simplified version of how the autonomic nervous system functions. How is the autonomic nervous system controlled?The ANS is not under conscious control. There are several centers which play a role in control of the ANS:
What are some receptors of the autonomic nervous system?Sensory neuron dendrites are sensory receptors that are highly specialized, receiving specific types of stimuli. We do not consciously sense impulses from these receptors (except perhaps pain). There are numerous sensory receptors:
Autonomic (visceral) motor neurons synapse onto neurons located in the ganglia of the sympathetic and parasympathetic nervous system, which in turn directly innervate muscles and some glands. In this way, visceral motor neurons can be said to indirectly innervate smooth muscles of arteries and cardiac muscle. Autonomic motor neurons work by increasing (in the SNS) or decreasing (in the PNS) activities of their target tissues. In addition, autonomic motor neurons can continue to function even if their nerve supply is damaged, albeit to a lesser extent. Where are the autonomic nervous system neurons located?The ANS is essentially comprised of two types of neurons connected in a series. The nucleus of the first neuron is located in the central nervous system. (SNS neurons begin at the thoracic and lumbar areas of the spinal cord, PNS neurons begin at the cranial nerves and sacral spinal cord). The first neuron's axons are located in the autonomic ganglia. In terms of the second neuron, its nucleus is located in the autonomic ganglia, while the axons of the second neuron are located in the target tissue. The two types of giant neurons communicate using acetylcholine. However, the second neuron communicates with target tissue using acetylcholine (PNS) or norepinephrine (SNS). Both the PNS and SNS are connected to the hypothalamus.
The autonomic nervous system functions to sustain life by exerting control over the following functions/systems:
The ANS, through its two branches (sympathetic and parasympathetic), controls energy expenditure. The sympathetic branch mediates this expenditure while the parasympathetic branch serves a restorative function. In general:
Health can be adversely affected when the effects on one of these systems is unchecked by the other, resulting in a disturbance of homeostasis. The ANS affects changes in the body that are meant to be temporary; in other words, the body should return to its baseline state. It is natural that there should be brief excursions from the homeostatic baseline, but the return to baseline should occur in a timely manner. When one system is persistently activated (increased tone), health may be adversely affected. The branches of the autonomic system are designed to oppose (and thus balance) each other. For example, as the sympathetic nervous system begins to work, the parasympathetic nervous system goes into action to return the sympathetic nervous system back to its baseline. Therefore, it is not difficult to understand that persistent action by one branch may cause a persistently decreased tone in the other, which can lead to ill health. A balance between the two is both necessary and healthy. The parasympathetic nervous system has a quicker ability to respond to change than the sympathetic nervous system. Why are we designed this way? Imagine if we weren't: exposure to a stressor causes tachycardia; if the parasympathetic system did not immediately begin to counter the increased heart rate, the heart rate could continue to increase until a dangerous rhythm, such as ventricular fibrillation, developed. Because the parasympathetics are able to respond so quickly, dangerous situations like the one described cannot occur. The parasympathetic nervous system is the first to indicate a change in health condition in the body. The parasympathetics are the main influencing factor on respiratory activity. As for the heart, parasympathetic nerve fibers synapse deep within the heart muscle, while sympathetic nerve fibers synapse on the surface of the heart. Thus, parasympathetics are more sensitive to heart damage. Transmission of Autonomic StimuliNeurons generate and propagate action potentials along their axons. They then transmit signals across a synapse through the release of chemicals called neurotransmitters, which stimulate a reaction in another effector cell or neuron. This process may cause either stimulation or inhibition of the receiving cell, depending which neurotransmitters and receptors are involved. Propagation- along the axon, axon potential propagation is electrical and occurs through the exchange of N+ and K+ ions across the membrane of the axon. Individual neurons generate the same potential after receiving each stimulus and conduct the axon potential at a fixed rate of velocity along the axon. Velocity is dependent upon the diameter of the axon and how heavily it is myelinated- speed is faster in myelinated fibers because the axon is exposed at regular intervals (nodes of Ranvier). The impulse "jumps" from one node to the next, skipping myelinated sections. Transmission- transmission is chemical, resulting from the release of specific neurotransmitters from the terminal (nerve ending). These neurotransmitters diffuse across the cleft of the synapse and bind to specific receptors attached to the effector cell or adjoining neuron. Response may be excitatory or inhibitory depending on the receptor. Neurotransmitter-receptor interaction must occur and terminate quickly. This allows for repeated and rapid activation of the receptors. Neurotransmitters can be "reused" in one of three ways:
Receptors- receptors are protein complexes that cover the membrane of the cell. Most interact primarily with postsynaptic receptors; some are located on presynaptic neurons, which allows for finer control of the release of the neurotransmitter. There are two major neurotransmitters in the autonomic nervous system:
Functions of the Autonomic Nervous SystemThe Parasympathetic System"Rest and digest" response:
In order to understand the functioning of the parasympathetic nervous system, it is helpful to use a real example: The male sexual response is under direct control of the CNS. Erections are controlled by the parasympathetic system through excitatory pathways. Excitatory signals originate in the brain, through thought, sight or direct stimulation. Regardless of the origin of the excitatory signal, penile nerves respond by releasing acetylcholine and nitric oxide, which in turn signal the smooth muscles of the arteries of the penis to relax and fill with blood. This cascade of events results in erection. The Sympathetic System"Fight or Flight" response:
As with the parasympathetic system, it is helpful to look at a real example to understand how the sympathetic nervous system functions: Extreme heat is a stressor that many of us have experienced. When we are exposed to excessive heat, our bodies respond in the following manner: thermal receptors convey stimuli to sympathetic control centers located in the brain. Inhibitory messages are sent along the sympathetic nerves to the blood vessels in the skin, which dilate in response. This dilation of the blood vessels increases the flow of blood to the body's surface so that heat can be lost through radiation from the body surface. In addition to the dilation of blood vessels in the skin, the body also reacts to excessive heat by sweating. This occurs through the rise in body temperature, which is sensed by the hypothalamus, which sends a signal via the sympathetic nerves to the sweat glands, which increase the amount of sweat produced. Heat is lost by evaporation of the sweat produced. Autonomic NeuronsNeurons that conduct impulses away from the central nervous system are known as efferent (motor) neurons. They differ from somatic motor neurons in that Efferent neurons are not under conscious control. Somatic neurons send axons to skeletal muscle, which is usually under conscious control.
Where preganglionic fibers originate and autonomic ganglia are found helps in differentiating between the sympathetic nervous system and the parasympathetic nervous system. Divisions of the Autonomic Nervous SystemA summary of the ANS divisions:
Adrenal GlandsThe adrenal glands are located above each kidney (also referred to as the suprarenal glands). They are located at approximately the level of the 12th thoracic vertebrae. The adrenal gland has two parts, an outer cortex and an inner medulla. Both parts produce hormones: the outer cortex produces aldosterone, androgens and cortisol, while the medulla mainly produces epinephrine and norepinephrine. The medulla releases epinephrine and norepinephrine when the body responds to a stressor (i.e., the SNS is activated) directly into the bloodstream. The cells of the adrenal medulla are derived from the same embryonic tissue as sympathetic postganglionic neurons; therefore the medulla is akin to a modified sympathetic ganglion. The cells of the medulla are innervated by sympathetic preganglionic fibers. In response to neural stimulation, the medulla secretes epinephrine into the bloodstream. Epinephrine effects are similar to norepinephrine. The hormones produced by the adrenal glands are crucial to normal healthy functioning of the body. Cortisol released as a response to chronic stress (or increased sympathetic tone) can be damaging to the body (i.e., hypertension, altered immune function). If the body is stressed for a prolonged period of time, cortisol levels may be insufficient (adrenal fatigue), causing low blood sugar, excessive tiredness and muscle pain. Parasympathetic (Craniosacral) DivisionThe parasympathetic division of the autonomic nervous system is often referred to as the craniosacral division. This is due to the fact that cell bodies of preganglionic neurons are located in the brain stem nuclei, and also in the lateral grey horns of the 2nd through the 4th sacral segments of the spinal cord; hence, the term craniosacral is often used to refer to the parasympathetic division. Parasympathetic cranial outflow:
Parasympathetic sacral outflow:
Functions of the Autonomic Nervous SystemThe "3F's" mnemonic (fear, fight, or flight) makes it easy to predict the workings of the sympathetic nervous system. When faced with situations of intense fear, anxiety or stress, the body reacts by speeding up the heart rate, increasing blood flow to vital organs and muscles, slowing digestion, making changes to our vision to allow us to see better and numerous other changes that allow us to react quickly in dangerous or stressful situations. These reactions have allowed us to survive as a species for thousands of years. As is often the case with the human body, the sympathetic system is perfectly balanced by the parasympathetic division, which returns our system to normal following activation of the sympathetic division. The parasympathetic system not only restores balance, but also performs other important functions in reproduction, rest and sleep, and digestion. Each division uses different neurotransmitters to perform their actions- for the sympathetic nervous system, norepinephrine and epinephrine are the neurotransmitters of choice, while the parasympathetic division uses acetylcholine to perform its duties. Neurotransmitters of the Autonomic Nervous System
The above chart describes the major neurotransmitters of the sympathetic and parasympathetic divisions.
Receptors of the ANSThe following chart depicts the receptors of the ANS, including their location:
Agonist and AntagonistIn order to understand how certain drugs affect the autonomic nervous system, it is necessary to define certain terms:
(One way to keep the terms straight is to think of the suffix -mimetic as meaning "mimic"; in other words, it mimics the action. "Lytic"generally means destruction, so you can think of the suffix -lytic as inhibiting or destroying the action of the system in question). Responses to Adrenergic StimulationAdrenergic responses in the body are stimulated by compounds that are chemically similar to adrenalin. Norepinephrine, which is released from sympathetic nerve endings, and epinephrine (adrenalin) in the bloodstream are the most important adrenergic transmitters. Adrenergic stimulation can have both excitatory and inhibitory effects, depending on the type of receptor on the effector (target) organ:
Understanding the 3 F's (fear, fight or flight) can help you to imagine the response that can be expected. For example, when faced with a threatening situation, it makes sense that your heart rate and blood pressure will increase, breakdown of glycogen will occur (to provide needed energy) and your rate of respiration will increase. All of these are stimulatory effects. On the other hand, if you are faced with a threatening situation, digestion will not be a priority, thus this function is suppressed (inhibited). Responses to Cholinergic StimulationIt is helpful to remember that parasympathetic stimulation is, in general, opposite to the effects of sympathetic stimulation (at least on organs that have dual innervations- there are always exceptions to every rule). An example of an exception is the parasympathetic fibers that innervate the heart- inhibition causes slowing of the heart rate.
Complementary Effects of Both DivisionsThe salivary gland is acted upon by both the sympathetic and parasympathetic divisions of the ANS. Sympathetic nerves stimulate constriction of blood vessels throughout the alimentary tract, resulting in decreased blood flow to the salivary glands, which in turn causes thicker saliva. Parasympathetic nerves stimulate the secretion of watery saliva. Thus, the two divisions act differently, but in a complementary fashion. Cooperative Effects of Both DivisionsCooperation between the sympathetic and parasympathetic divisions of the ANS can best be seen in the urinary and reproductive systems:
Organs Without Dual Innervation Most organs of the body are innervated by nerve fibers from both the sympathetic and parasympathetic nervous system.
These organs/tissues are only innervated by sympathetic fibers. How does the body regulate their action? The body achieves control through increasing or decreasing of the tone of the sympathetic fibers (firing rate). By controlling the stimulation of sympathetic fibers, the action of these organs can be regulated. Stress and ANSWhen a person is placed in a threatening situation, messages from the sensory nerves are carried to the cerebral cortex and limbic system (the "emotional" brain) and also to the hypothalamus. The anterior portion of the hypothalamus excites the sympathetic nervous system. The medulla oblongata contains centers that control many functions of the digestive, cardiovascular, pulmonary, reproductive and urinary systems. The vagus nerve (which has both sensory and motor fibers) supplies sensory input to these centers through its afferent fibers. The medulla oblongata is itself regulated by the hypothalamus, the cerebral cortex and the limbic system. Thus there are several areas involved in the body's response to stress. When a person is exposed to extreme stress (picture a terrifying situation that occurs without warning, such as a wild animal poised to attack you), the sympathetic nervous system may become completely paralyzed so that its functions cease completely. The person may be frozen in place, unable to move. They may lose control of their bladder. This is due to an overwhelming number of signals that the brain must "sort" and a corresponding tremendous surge of adrenalin. Thankfully, most of the time we are not exposed to stress of this magnitutude and our autonomic nervous system functions as it should! Disturbances Clearly Related to Autonomic InvolvementThere are numerous diseases/conditions which result from automatic nervous system dysfunction:
Autonomic NeuropathyAutonomic neuropathies are a collection of conditions or diseases that affect sympathetic or parasympathetic neurons (or sometimes both). They may be hereditary (present from birth and passed down from an affected parent) or acquired later in life. The autonomic nervous system controls many body functions, therefore autonomic neuropathies may cause any number of symptoms and signs that may be elicited through exam or laboratory studies. Sometimes only a single nerve of the ANS is affected; however, physicians must watch for development of symptoms stemming from involvement of other areas of the ANS. Autonomic neuropathies can cause a wide variety of clinical symptoms. These symptoms are dependent upon which nerves of the ANS are affected. Symptoms may be widely variable and can affect almost all body systems:
Causes of autonomic neuropathy may be related to numerous diseases/conditions, medications used to treat other diseases or procedures (such as surgery):
The following are some examples:
Obviously, some individuals cannot control their risk factors for autonomic neuropathy (i.e., hereditary causes of AN). Diabetes is by far the largest contributing factor to AN and puts individuals with the disease at high risk for AN. Diabetics can reduce their risk of AN by controlling their blood sugars carefully to prevent damage to their nerves. Smoking, consuming alcohol regularly, hypertension, hypercholesteremia (high blood cholesterol) and obesity may also increase the risk of developing AN, so these factors should be controlled as much as possible to reduce the risk of developing AN. Treatment of autonomic dysfunction is largely dependent on the cause of AN. When treatment of the underlying cause is not possible, physicians will attempt various therapies to mitigate symptoms of AN:
KEY_Web_Disclaimer Where are specialized ganglionic sympathetic neurons that release hormones into the bloodstream found?The adrenal medulla is a modified sympathetic prevertebral ganglion that releases epinephrine and norepinephrine into the blood (about 4:1) in response to sympathetic stimulation.
Where are specialized ganglionic sympathetic neurons found?Sympathetic neuron cell bodies are located in sympathetic ganglia. Parasympathetic neuron cell bodies are located in the brainstem and sacral spinal cord.
What type of neurons are in sympathetic ganglia?2 Sympathetic Models
Sympathetic ganglia in mouse, rat, and cat are composed primarily of two neuronal elements: the presynaptic cholinergic nerve terminals and postsynaptic noradrenergic neurons (Giacobini, 1970; Giacobini et al., 1970).
What neurotransmitter is released at sympathetic ganglia?Norepinephrine gets released by postganglionic neurons of the sympathetic nervous system, which binds to and activates adrenergic receptors.
|