Autonomic nervous system Autonomic nervous system 1. 1. Autonomic nervous system (ANS) Autonomic nervous system (ANS) – – nomenclature nomenclature 2. 2. Topographic organization and structural features of ANS Topographic organization and structural features of ANS 3. 3. Main subdivisions of the ANS: Main subdivisions of the ANS: sympathetic nervous system sympathetic nervous system parasympathetic parasympathetic nervous system enteric nervous system enteric nervous system 4. 4. Sympathetic (thoracolumbar) nervous system Sympathetic (thoracolumbar) nervous system 5. 5. Parasympathetic (craniosacral) nervous system Parasympathetic (craniosacral) nervous system 6. 6. Enteric (intrinsic) nervous system Enteric (intrinsic) nervous system 7. 7. Neurotransmitters, receptors and some ANS drugs Neurotransmitters, receptors and some ANS drugs 8. 8. Autonomic innervation of the eye and salivary glands Autonomic innervation of the eye and salivary glands 9. 9. Autonomic plexuses in the thoracic cavity: Autonomic plexuses in the thoracic cavity: cardiac plexus cardiac plexus pulmonary plexus pulmonary plexus thoracic aortic plexus thoracic aortic plexus 10. 10. Autonomic plexuses in the abdomen Autonomic plexuses in the abdomen – – primary and secondary primary and secondary abdominal aortic plexus abdominal aortic plexus coeliac (solar) plexus coeliac (solar) plexus 11. 11. Autonomic plexuses in the pelvis Autonomic plexuses in the pelvis – – primary and secondary primary and secondary inferior hypogastric plexus inferior hypogastric plexus
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Autonomic nervous systemAutonomic nervous system1.1. Autonomic nervous system (ANS) Autonomic nervous system (ANS) –– nomenclaturenomenclature2.2. Topographic organization and structural features of ANSTopographic organization and structural features of ANS3.3. Main subdivisions of the ANS:Main subdivisions of the ANS:
4.4. Sympathetic (thoracolumbar) nervous systemSympathetic (thoracolumbar) nervous system5.5. Parasympathetic (craniosacral) nervous systemParasympathetic (craniosacral) nervous system6.6. Enteric (intrinsic) nervous systemEnteric (intrinsic) nervous system7.7. Neurotransmitters, receptors and some ANS drugsNeurotransmitters, receptors and some ANS drugs8.8. Autonomic innervation of the eye and salivary glandsAutonomic innervation of the eye and salivary glands9.9. Autonomic plexuses in the thoracic cavity:Autonomic plexuses in the thoracic cavity:
10.10. Autonomic plexuses in the abdomen Autonomic plexuses in the abdomen –– primary and secondaryprimary and secondary�� abdominal aortic plexusabdominal aortic plexus�� coeliac (solar) plexuscoeliac (solar) plexus
11.11. Autonomic plexuses in the pelvis Autonomic plexuses in the pelvis –– primary and secondaryprimary and secondary�� inferior hypogastric plexusinferior hypogastric plexus
Prof. Dr. Nikolai LazarovProf. Dr. Nikolai Lazarov 2
�� Autonomic Nervous System (ANS):Autonomic Nervous System (ANS):
� part of the peripheral nervous system
�� autonomicautonomic = auto (self) + nomos, = auto (self) + nomos, GrGr. . νόµοςνόµος (law)(law)
� reflex, involuntary actions
� automatic, independent, unconscious system
�� innervation of:innervation of:
�� visceraviscera
�� glandsglands
�� blood vesselsblood vessels
�� nonstriated (smooth and cardiac) musclesnonstriated (smooth and cardiac) muscles
�� synonyms:synonyms: visceral visceral (vegetative) (vegetative) nervous systemnervous system
� main function – control system to maintain life:
� regulation and control of visceral functions
� reproduction
� vital body processes – circulation, digestion, secretion and excretion etc.
Definition and nomenclatureDefinition and nomenclatureAutonomic nervous systemAutonomic nervous system
John Newport Langley John Newport Langley (1852(1852––1925)1925)
Prof. Dr. Nikolai LazarovProf. Dr. Nikolai Lazarov 3
Structural organizationStructural organizationAutonomic nervous systemAutonomic nervous system
�� twotwo --neuron efferent system neuron efferent system (visceral(visceral efferentefferent neurons):neurons):� first (preganglionicpreganglionic ) ) neuronneuron – inside the CNS� second ((postganglionicpostganglionic ) ) neuronneuron – in ganglion
or plexus of neurons�� perikarya of visceralperikarya of visceral afferent neurons:afferent neurons:
� in dorsal root (spinal) ganglia
Prof. Dr. Nikolai LazarovProf. Dr. Nikolai Lazarov 4
Structural and neurochemical differencesStructural and neurochemical differencesAutonomic nervous systemAutonomic nervous system
Prof. Dr. Nikolai LazarovProf. Dr. Nikolai Lazarov 6
�� parasympathetic reactions:parasympathetic reactions:� generally localized and anabolicanabolic – day-to-day internal processes and behavior� conservation of body energies during rest, preparing us to go to sleep and digestsleep and digest
�� sympathetic reactionssympathetic reactions ::� mass responses – cataboliccatabolic� mobilize body energies
in stressful situations, preparing us for fight, flight or frightfight, flight or fright
Functional considerationsFunctional considerationsAutonomic nervous systemAutonomic nervous system
NB: antagonistic actions of both componentsantagonistic actions of both components
to maintain homeostasis!to maintain homeostasis!
Prof. Dr. Nikolai LazarovProf. Dr. Nikolai Lazarov 7
�� terminal terminal ganglion imparganglion impar – anterior to the coccyx
Sympathetic trunkSympathetic trunkAutonomic nervous systemAutonomic nervous system
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�� celiac ganglionceliac ganglion ((semilunar semilunar or or solar gangliasolar ganglia ): ): �� largest largest ganglionganglion in the ANSin the ANS� postganglionic sympathetic neurons� paired, with variable position:
� upper part joined with greater splanchnic nerve� lower part receives lesser splanchnic nerve � renal plexus
�� aorticorenal ganglionaorticorenal ganglion�� lower part of celiac ganglion lower part of celiac ganglion � kidney, ureters
�� phrenic ganglionphrenic ganglion� small ganglion on the diaphragm� located at the junction of the right phrenic nerve
�� superior mesenteric ganglionsuperior mesenteric ganglion� close to the origin of the superior mesenteric artery� unpaired, innervates part of the large intestine
�� inferior mesenteric ganglioninferior mesenteric ganglion� several small bodies� close to the origin of the inferior mesenteric artery� innervate part of the large intestine
Prevertebral sympathetic gangliaPrevertebral sympathetic gangliaAutonomic nervous systemAutonomic nervous system
Prof. Dr. Nikolai LazarovProf. Dr. Nikolai Lazarov 13
� embedded in the walls of the:� esophagus� stomach� small intestine� colon
� triggered to act when the walls of the hollow organs are stretched by food.
� This local nervous system, referred to as intrinsicintrinsic or enteric nervous systementeric nervous system (ENS), functions independently of the CNS and is influenced by the ANS in a limited way.
� It controls the motility, exocrine and endocrine motility, exocrine and endocrine secretions, local blood flowsecretions, local blood flow, and also modulates immune and inflammatory processesimmune and inflammatory processes of GI tract.
Autonomic nervous systemAutonomic nervous system
Enteric nervous systemEnteric nervous system
NB: NB: neither sympathetic nor parasympathetic!neither sympathetic nor parasympathetic!
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�� The myenteric plexus (of The myenteric plexus (of AuerbachAuerbach) ) primarily controls digestive tract motility [strength & frequency]
�� The submucous plexus (of The submucous plexus (of MeissnerMeissner)) regulates mucosal movements and epithelial cell function [mucosal gland secretion]�� internal submucosal plexus (the true plexus of internal submucosal plexus (the true plexus of MeissnerMeissner))�� external submucosal plexus (the plexus of external submucosal plexus (the plexus of SchabadaschSchabadasch))
Autonomic nervous systemAutonomic nervous system
Enteric nervous systemEnteric nervous system
Prof. Dr. Nikolai LazarovProf. Dr. Nikolai Lazarov 15
Plexus myentericus
Plexus submucosus externus
Plexus submucosus internus
Autonomic nervous systemAutonomic nervous system
Enteric nervous systemEnteric nervous systemProf. Dr. HeinzProf. Dr. Heinz--Juergen Krammer, Juergen Krammer, University Hospital of Heidelberg at Mannheim, GermanyUniversity Hospital of Heidelberg at Mannheim, Germany
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Autonomic nervous systemAutonomic nervous system
Autonomic transmitters and receptors Autonomic transmitters and receptors
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““The fate of a nation has often depended on food The fate of a nation has often depended on food or bad digestion of a prime ministeror bad digestion of a prime minister””
Is really there a brain in the gut?�� here are some reasons...here are some reasons...
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Is really there a brain in the gut?Two brains are better than one, Two brains are better than one, especially if you are hungryespecially if you are hungry!!
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�� aggregations (a network) of autonomic nerves and ga nglia:aggregations (a network) of autonomic nerves and ga nglia:� situated in the thoracic, abdominal and pelvic cavities
� innervate the thoracic, abdominal and pelvic viscera
� pass along branches of the arterial blood vessels� composed of sympathetic, parasympathetic, and
Primary plexuses in the pelvisPrimary plexuses in the pelvisAutonomic plexusesAutonomic plexuses
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�� common (male&female) plexuses:common (male&female) plexuses:�� middle and inferior rectal plexusesmiddle and inferior rectal plexuses�� vesical plexusvesical plexus
�� autonomic plexuses in the male:autonomic plexuses in the male:�� prostatic plexusprostatic plexus�� plexus of the deferent ductplexus of the deferent duct
�� autonomic plexuses in the female:autonomic plexuses in the female:�� uterovaginal plexusuterovaginal plexus�� vaginal nerves vaginal nerves –– parasympatheticparasympathetic
Secondary plexuses in the pelvisSecondary plexuses in the pelvisAutonomic plexusesAutonomic plexuses
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Autonomic plexusesAutonomic plexuses
Autonomic innervation of male genitalsAutonomic innervation of male genitals�� innervated by both somatic and autonomic nerve fibersinnervated by both somatic and autonomic nerve fibers
�� somatic innervationsomatic innervation :
� pudendal nerve
�� autonomic innervation autonomic innervation – parasympathetic and
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Autonomic plexusesAutonomic plexuses
Autonomic innervation of female genitalsAutonomic innervation of female genitals
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Clinical notesClinical notes
� the overall functional status of the body:� vital body processes are autonomic reflex
responses;� many somatic-visceral and visceral
somatic reflexes;� metabolic and mechanical irritations of
autonomic nerve fibers cause different pathologic conditions;
� an appreciation of the nuclei, fiber pathways and resulting reflex deficits from injuries are useful as a diagnostic aid in exploring the diffuse distribution of the autonomic system;
� changes in cutaneous sudomotor and vasomotor reflexes, changes in skin temperature, and increased skin resistance to passage of a minute electric current indicate the involvement of sympathetic nerve fibers;
� a knowledge of dermatomal and peripheral nerve distributions often can provide additional evidence to substantiate both the location and level of a nerve injury.
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