DR. Hanan A. Mubarak, BM.Bch, MSc., M.

D
Professor of Physiology, Faculty of Medicine,
Cairo University
1
 Autonomic nervous system

• The autonomic nervous system is responsible

for the control of involuntary actions.

• One of the most characteristics of autonomic

N.S. is the rapidity and intensity with which it can
change visceral function.

• The main processes regulated by the autonomic

nervous system are:
-- Contraction and relaxation of smooth muscle
-- The rate and force of the heart beat
-- All exocrine and some endocrine secretions
2
 Autonomic nervous system
• It is divided into : sympathetic & parasympathetic
nervous system.
• Autonomic fibers arise from limited areas of CNS:
Sympathetic fibers arise from lateral horn cells of all
thoracic & upper three lumbar segments.
Parasvmpathetic fibers arise from : cranial nuclei: III,
VII, IX, X & Sacral segments 2,3,4.

• Both sympathetic and parasympathetic are two efferent

neuron system: preganglionic & postganglionic
neurons.

• The two neurons synapse at a ganglion. Fibers before

the ganglion are PRE-GANGLIONIC, fibers after the
ganglion are POST-GANGLIONIC.
• The neurotransmitter at the synapse is acetylcholine 3
4
 Autonomic ganglia

• A ganglion is a collection of neurons

outside the CNS.

• An autonomic ganglion contains the cell

bodies of postganglionic neurons, where
each preganglionic fiber synapse with 8-9
postganglionic neurons. In this way, the
autonomic output is diffused.

• It acts as distributing centers (multiplicity)5

6
 Autonomic ganglia
Types of ganglia:

1- Paravertebral (sympathetic chain)

2- Collateral ganglia ( sympathetic,

parasympathetic )

3- Terminal ganglia ( parasympathetic)

4- Adrenal medulla (sympathetic)

7
Sympathetic ganglia

8
Autonomic ganglia

9
 Chemical transmitters in autonomic
nervous system

• Acetylcholine

• Noradrenaline

10 10
 Chemical transmitters in autonomic
nervous system
Sites of release of acetylcholine
• All preganglionic autonomic fibers (sympathetic &
para sympathetic )
• All postganglionic parasympathetic fibers
• Preganglionic sympathetic fibers to adrenal
medulla
• Postganglionic sympathetic fibers to sweet
glands and blood vessels of skeletal muscle.
Sites of release of noradrenaline
Most postganglionic sympathetic fibers 11
11
12
Autonomic ganglia

13
Autonomic ganglia & receptors

14
 Cholinergic receptors

Nicotinic receptors
- All autonomic ganglia
- Skeletal muscles
- Adrenal medulla

Muscarinic receptors
- Viscera supplied by postganglionic para
sympathetic fibers
- Sweet glands and blood vessels of skeletal
muscle ( sympathetic cholinergic fibers)

15
 Adrenergic receptors

• Alpha receptors: Alpha 1 and alpha 2

Alpha 1: Excitatory
Vasoconstriction, Contraction of sphincter of GIT,
dilator pupillea , splenic capsule, seminal vesicles and
vas deferens
Alpha 2: inhibitory to intestinal wall

• Beta receptors: Beta 1 and Beta 2

Beta 1: Excitatory; heart & metabolic action
Bate 2: Inhibitory; smooth muscles of bronchi, urinary
bladder, intestine, B.V. of skeletal muscle.
16
Sympathetic nervous system
- Arises from thoracic and lumbar segments of
spinal cord
- Catabolic (energy consuming)
- Activated during stress ( fear, fight and flight)

Parasympathetic nervous
- Arises from the brain stem and sacral part of
the spinal cord
- Anabolic
- Activated at rest
17
 Sympathetic division (thoraco lumbar)
• The preganglionic neurons arise from lateral
horn cells of all thoracic and upper 2 (3)
lumbar segments of the spinal cord

• The post ganglionic neurons from Paravertebral

sympathetic chain or collateral ganglia

• Postganglionic sympathetic fibers release nor

adrenaline (nor epinephrine).

• Adrenal medulla secretes adrenaline

(epinephrine) and nor adrenaline (nor
epinephrine) into the blood.
18 18
Parasympathetic Nervous System
• Parasympathetic is the cranio-sacral outflow of
autonomic nervous system

• The cranial outflow includes:

→ Occulomotor III, Facial VII, Glossopharyngeal

IX nerves which supply the head & neck.

→ Vagus X nerve which supply thorax &
abdomen.

• The sacral outflow includes: pelvic branches of S2,

S3, S4 which supply pelvic viscera. 19
Cranial nerves

20
21
Effects of parasympathetic N.S.

22
 Sympathetic nervous system
(1) Head & Neck:
o Eye:
1) Pupil dilatation (mydriasis) due to contraction of dilator pupillae
muscle
2) Elevation of upper eye lid.
3) Decrease power of lens to see far objects
4) Vasoconstriction of conjunctival vessels
5) Decrease tear secretion of lacrimal glands.
6) Exophthalmos due to contraction of Muller’s muscles (in animals).
o Skin:
1) Increase sweat gland secretion
2) vasoconstriction of blood vessels

o SaIivary gIands:
1) Stimulate little viscid secretion
23
2) Vasoconstriction of blood vessel
 Sympathetic nervous system
(2) Thorax:
• Heart : Stimulation
(1) Increase force of contraction
(2) Increase heart rate
(3) vasodilatation of coronary vessels
(4) Increase 02 consumption

• Lung: → Bronchodilatation by relaxation

of bronchial muscles.
24
 Sympathetic nervous system

3) Abdomen:
1) Liver → Glycogenolysis → hyperglycemia & increase
metabolic rate.
→ increase fibrinogen synthesis which limits
bleeding.
2) Spleen: Contraction of its capsule → increase RBC into
circulation
3) Adrenal medulla: Secretion of 80% adrenaline & 20%
noradrenaline.
4) Gastrointestinal tract: Inhibition of smooth muscle of
stomach, small intestine & proximal part of large intestine

but motor to the sphincters e.g. Pyloric sphincter

5) Blood vessels: Mainly vasoconstriction of arterioles 25
 Sympathetic nervous system

(4) Pelvis:

1) GIT (distal colon & rectum): Retention of

feces

2) Urinary bladder: Retention of urine

3) Male genitalia: Ejaculation

26
27
 Parasympathetic Nervous System
1) Head & Neck:
• Occulomotor Nerve (3rd cranial nerve):
A. Pupil constriction (miosis)
B. Increase power of lens necessary for near vision

• Facial nerve (7th cranial nerve):

A- Secretomotor & vasodilator to the salivary glands
B- Vasodilatation of anterior 2/3 of tongue.

• Glossopharynqeal nerve (9th cranial nerve):

A- Secretomotor & vasodilator to parotid gland.
B- Vasodilatation of posterior 1/3 of tongue.

28
 Parasympathetic Nervous System
• (2) Thorax & (3) Abdomen : Vaqus nerve (10th cranial
nerve)

(2) Thorax:

• Heart: → Inhibition of all atrial properties (NO

vagal supply to ventricles)
→ Decrease coronary flow & 02
consumption

• Lungs: → Bronchial constriction

→ Dilatation of pulmonary blood vessels
→ Increase bronchial secretion.
29
 Parasympathetic Nervous System
(3) Abdomen:
• GIT: → Motor to the wall of esophagus, stomach,
small intestine, proximal part of large
intestine
→ Inhibitory to sphincters
→ Secretory to glands of stomach, small
intestine, liver, pancreas

• Gall bladder: → Motor to wall

→ Inhibitory to sphincter
i.e. Evacuation of gall bladder.
30
 Parasympathetic Nervous System

(4) Pelvis: sacral outflow

1) Defecation: Stimulation

2) Micturition: Stimulation

3) MaIe genitalia:
→ Erection
→ Secretory to seminal vesicle &
prostate 31
32
33