Autonomic Nerv System

Autonomic Nervous System
Dr. Jayanta Sarkar

1
st
Year PGT
Department of Anatomy
Autonomic Nervous system is visceral
component of the nervous system.
It consists of neurons located both in
CNS and PNS.
It controls the internal environment of
human body.
This faculty is known as the milieu
interior of Claude Bernard
Or homeostasis of Canon.
Introduction
Innervation in:
Cardiac muscle,
Smooth muscle
Secretory Glands
Functions closely integrated with somatic nervous system.
This system has both Motor and Sensory Components.
The Motor component presents two sets of neurons:
Preganglionic
Postganglionic
They work mostly at Unconscious level.
Introduction
Somatic Efferents Autonomic Efferents
Consists single set of neuron Consists two sets of neurons: pre &
post ganglionic
Target cells are Striated muscle only Target cells are Cardiac muscle,
Smooth muscle & Secretory glands.
Stimulation produces excitatory
response
Stimulation produces both excitatory
and inhibitory response
Activity of effector cells completely
dependent on intact supply.
Effector cells are not completely
dependent.
Form plexus close to the CNS Forms plexus close to effector cells
Somatic vs. Autonomic Nervous System
Somatic vs. Autonomic Nervous System
Sympathetic
Parasympathetic
Enteric
They differ in organization and structure; but functionally integrated.
Most structures innervated by the ANS receive both sympathetic and
parasympathetic fibres except
Follicular cells of Thyroid gland
Juxta-glomerular cells of nephron
Pineal gland by nervi conarii
Chromaffin cells of suprarenal medulla
Enteric division is a network of neurons intrinsic to the wall of GI system.
Divisions
Sympathetic: mobilization & increased metabolism
fight, flight or fright or fight, flight or freeze
Parasysmpathetic: routine maintenance
rest & digest
Mechanism of Function
Origin
CRANIO-SACRAL
OUTFLOW
THORACO-LUMBAR
OUTFLOW
Sympathetic Nervous System
Also called THORACOLUMBAR system:
all its neurons are in lateral horn of Spinal cord from T1-L2
Lead to every part of the body
Have definite anatomical entity.
Norepinephrine (noradrenaline) is neurotransmitter released by
most postganglionic fibers (acetylcholine in preganglionic):
adrenergic
Regardless of target, all begin same
Preganglionic axons exit spinal cord through ventral root and
enter spinal nerve
Exit spinal nerve via communicating ramus
Enter sympathetic trunk/chain where most postganglionic
neurons are
Peripheral autonomic activity is integrated
at higher levels in the:
Brain stem
Cerebrum,
Thalamus,
Hypothalamus
Limbic lobe
Prefrontal neocortex
Integration
Neurotransmitters
Preganglionic sympathetic fibres- Cholinergic
Preganglionic parasympathetic fibres- Cholinergic
Postganglionic sympathetic fibres- Noradrenergic
Postganglionic parasympathetic fibres- Cholinergic
Co-transmitters in sympathetic fibres- ATP, Neuropeptide Y
Co-transmitters in parasympathetic fibres- VIP
Co-transmitters in enteric fibres- ATP, VIP and Substance P
Sympathetic Nervous System
Two ganglionated nerve cords
extending from base of the skull to coccyx
Located on both sides of the vertebral column
At coccyx both trunk unite to form unpaired ganglion impar
Joined to spinal nerves by white and grey rami communicantes
Preganglionic axons join the trunk through White rami communicantes
Postganglionic axons leave the trunk in the grey rami communicantes
Sympathetic Trunk
Sympathetic Trunk
Relation:
In the neck:
Posterior to the carotid sheath &
anterior to the transverse process of cervical vertebrae
In the thorax:
Anterior to the heads of the ribs
In the abdomen:
Anterolateral to the bodies of lumbar vertebrae
In the pelvis:
Anterior to the sacrum &
medial to the anterior sacral foramina
Sympathetic Trunk
Ganglia:
Cervical: 3
Thoracic: 10-12 (usually 11)
Lumbar: 4
Sacral: 4-5
Initially sympathetic ganglia corresponds with spinal nerves.
Sympathetic Trunk
Cervical sympathetic ganglia are reduced to 3 by fusion.
1
st
to 4
th
cervical ganglia fuse to form Superior cervical ganglion
5
th
& 6
th
fuse to form Middle cervical ganglion
7
th
& 8
th
fuse to form Inferior cervical ganglion
Sometimes, Inferior cervical ganglion fuse with
1
st
Thoracic ganglion to form Stellate ganglion
Internal Carotid nerve, continuation of sympathetic trunk
from superior cervical Ganglion accompanies the
Internal Carotid artery to the cranium.
Cervical part:
Sympathetic Trunk
Thoraco lumbar outflow:
Preganglionic neurones located in Lateral horn
of Spinal cord.
Axons are myelinated with diameter of 1.5-4 m
Nerve fibres leave the cord through
corresponding ventral root in the spinal nerves.
Sympathetic preganglionic fibres join the
sympathetic trunk by white rami communicantes.
Preganglionic part:
Sympathetic System
Preganglionic fibres:
Options of preganglionic axons in sympathetic trunk:
Synapse on postganglionic neuron in
chain ganglion then return to spinal
nerve and follow its branch to the
skin
Ascend or descend within
sympathetic trunk, synapse with a
posganglionic neuron within a chain
ganglion, and return to spinal nerve
at that level and follow branches to
skin
Thoraco Lumbar Outflow
Preganglionic fibres:
May enter sympathetic chain,
pass through without synapsing,
form a splanchnic nerve,
that passes toward thoracic
or abdominal organs
These synapse in prevertebral
ganglion in front of aorta
Postganglionic axons follow arteries to
organs
Options of preganglionic axons
in sympathetic trunk:
Postganglionic part:
Postganglionic neurons may be:
Lateral ganglia - in the sympathetic trunk.
Collateral ganglia Coeliac, superior mesenteric,
inferior mesenteric,
aortico renal,
superior hypogastric
Terminal ganglia Chromaffin cells at
Suprarenal medulla
LATERAL GANGLIA COLLATERAL GANGLIA TERMINAL GANGLIA
Axons are longer than preganglionic
except the postganglionic fibres that innervate the pelvic viscera.
Axons are unmyelinated.
Each lateral sympathetic ganglion contains multipolar
postganglionic neurons, interneurons
(including chromaffin cells of paraganglia).
Cells of paraganglia are SIF cells and secretes Dopamine.
Postganglionic fibres:
Distribution to the target organs in various way:
Some Postganglionic fibres return to spinal nerve through
grey rami communicantes just proximal to white ramus.
They are distributed through dorsal and ventral rami to-
Blood vessels
Sweat glands
Hair follicles
Segmental areas overlap.
Some fibres pass in a medial branch of ganglion
to supply particular viscera or adjacent Blood vessels.
Some fibres may ascend or descend to join
Brachial and lumbosacral plexus by grey rami.
(Vasomotor, pilomotor, sudomotor).
On rare occasions, Skoogs ganglia formed in ventral root.
Postganglionic sympathetic fibres those return to spinal nerves:
Vasoconstrictor to blood vessels
Secretomotor to sweat glands
Motor to the Arrector pili muscles
Postganglionic fibres accompany motor nerves are mostly Dilatatory.
Postganglionic fibres from collateral ganglia reaches target organ
via peri arterial plexus.
Neurotransmitters:
Preganglionic fibres liberate acetylcholine- cholinergic
Postganglionic fibres mostly liberate nor adrenaline- adrenergic
Postganglionic fibres to the eccrine sweat glands of hairy skin
and to the arteries of Limb muscles are cholinergic.
Head & Neck:
Preganglionic fibres arise from T
1
- T
3
.
Relays to Superior, Middle and Inferior Cervical ganglia
Postganglionic fibres from Superior Cervical ganglion accompany
Internal carotid artery (Internal Carotid Nerve)- supply
Vasomotor
Sudomotor
Pilomotor
Pupillary Dilator fibres
Mullers muscle of the eye
Involuntary component of
Levator palpabrae superioris
Postganglionic fibres from Inferior Cervical ganglion accompany
Vertebral artery and enters cranial cavity
Sympathetic Innervations
Head & Neck:
Upper Limb:
2
- T
7
.
Vasomotor fibres from T
2
& T
3
.
Postganglionic fibres join the brachial plexus.
Lower Limb:
10
- L
2
.
Postganglionic fibres join the lumbosacral plexus.
Heart:
Preganglionic fibres arise
from T
1
- T
5
.
Postganglionic fibres
emerge from three cervical
and upper four or five
thoracic ganglia and form
cardiac plexus.
They act as
cardioaccelerator and
vasodilator of coronary
arteries.
Lungs:
Preganglionic fibres
arise from T
2
- T
4
.
Postganglionic fibres
form Pulmonary
plexus.
They act as
bronchodilator and
vasoconstrictor.
Alimentary & Uro-Genital System:
Preganglionic fibres from T
5
- L
2
forms:
Greater splanchnic nerve- T
5
- T
9
Lesser splanchnic nerve- T
10
- L
11
Least splanchnic nerve- T
12
Postganglionic neurons are at collateral ganglia:
Coeliac
Superior mesenteric
Inferior mesenteric
Aortico-renal
Superior hypogastric
Alimentary & Uro-Genital System:
Alimentary System:
Oesophagus: T
5
- T
6
Oesophagus frequently receives few fibres from cardiac plexus
Stomach: T
6
- T
9
Supply vasomotor fibres;
Stimulate pyloric sphincter
Inhibit rest of the gastric musculature.
Small gut: T
9
- T
10
Supply vasomotor fibres;
Stimulate ileocolic sphincter
Inhibit peristalsis.
Large gut: T
11
- L
1
Upto proximal 2/3
rd
of transverse colon
L
1
- L
2
supply rest of the large gut
Liver, Gallbladder,
Pancreas, Spleen: T
6
- T
9
Uro-Genital System:
Kidney & Ureters: T
10
- L
1
Urinary Bladder & Proximal Urethra: T
11
- L
2
Postganglionic fibres arise from hypogastric plexus.
Primarily vasomotor.
Stimulate trigonal muscle of ureters-
prevent retrograde ejaculation
Testis or Ovary: T
10
- T
11
Prostate, Seminal vesicle, Vas deferens: T
12
- L
1
Seminal ejaculation
Uterus: T
12
- L
1
Vasoconstrictors and Contractors of uterine muscles
Uro-Genital System:
To be continued
Autonomic Nervous System-II
Dr. Jayanta Sarkar
1
st
Year PGT
Sympathetic System
Afferent Path:
Afferent sympathetic fibres essentially convey
Visceral Pain Sensations.
Three types of pain may be encountered:
True Visceral Pain
Sharp Pain
Referred Pain
Pain may be due to:
Stretching of solid viscera
Distension of hollow viscera
Irregular spasm of smooth muscles
Ischaemia
Sympathetic System
Afferent Path:
Cell bodies lie in:
Dorsal Root Ganglia of T
1
- L
2
Afferent fibres arising from viscera:
Enter the Lateral ganglia along medial branches
Passes along White rami communicantes
Through Dorsal Nerve Root
To Dorsal Root Ganglia
Sympathetic Ganglia
Cervical: 3
Thoracic: 10-12 (usually 11)
Lumbar: 4
Sacral: 4-5
Cervical Sympathetic Ganglia
3 in no.:
Superior
Middle
Inferior
Receive preganglionic fibres from T
1
- T
4
Post ganglionic fibres emerge as:
Lateral- Grey rami communicantes and join
corresponding cervical spinal nerves
Medial- Vascular
Splanchnic
Superior Cervical Ganglia:
Lateral Branches: 4 grey rami communicantes to join C
1
- C
4
Medial Branches:
Internal carotid nerve: form internal carotid plexus:
branch to dilator pupillae
Deep Petrosal nerve
Sympathetic fibres to Ciliary ganglion
Branches along External Carotid Artery:
Sympathetic fibres to Otic ganglion
Sympathetic fibres to Submandibular ganglion
Vasoconstrictor fibres to Facial artery.
Pharyngeal branch: form pharyngeal plexus with
IXth & Xth Cranial nerves
Cardiac Branch:
Left: Superficial Cardiac Plexus
Right: Deep Cardiac Plexus
Superior Cervical Ganglia:
Middle Cervical Ganglia:
5
- C
6
Medial Branches:
Tracheal Branches: Vasomotor
Oesophageal Branches: Vasomotor
Thyroid Branches: Along Inferior Thyroid Artery
Cardiac Branch: Deep Cardiac Plexus
Inferior Cervical Ganglia:
7
- C
8
Medial Branches:
Ansa Subclavia: Forms plexus around Subclavian artery
Vertebral Nerve: Forms plexus around Vertebral artery
Cardiac Branch: Deep Cardiac Plexus
Thoracic Sympathetic Ganglia
12 in no.
Receive preganglionic fibres from T
1
- T
12
Post ganglionic fibres emerge as:
Lateral- Grey rami communicantes and join
corresponding Thoacic spinal nerves
Medial-
T
1
- T
5
: Supply Thoracic viscera
T
5
- T
12
: Supply Upper abdominal viscera
Medial Branches from T
1
- T
5
:
Before reaching the target organ these fibres form plexus with
Parasympathetic fibres of Xth Cranial nerve
Plexuses are:
Cardiac Plexus
Pulmonary Plexus
Oesophageal Plexus
Aortic Plexus
Cardiac Plexus
Divided into :
Superficial
Deep
It may also be described as:
Coronary
Pulmonary
Atrial
Aortic
These plexus contain Ganglion cells.
Ganglion cells distributed mainly in atrial tissue
with preponderance near Sinu-atrial node.
Cholinergic & adrenergic fibres distributed most profusely
in SA and AV node
Supply to myocardium is less dense.
Cardiac Plexus
Superficial Cardiac Plexus
Location:
Below the aortic arch and anterior to right pulmonary artery
Formation:
Formed by Left superior cervical sympathetic ganglion &
2 cervical cardiac branches of Left Vagus.
Small cardiac ganglion present in the plexus below aortic arch &
Right to Ligamentumarteriosum.
Connects with right coronary plexus & anterior pulmonary plexus
Deep Cardiac Plexus
Posterior to the aortic arch and anterior to tracheal bifurcation
and above the division of Pulmonary trunk.
Formed by Middle and Inferior cervical & T
1
- T
5
sympathetic ganglion, & cardiac branches of Vagus
& recurrent Laryngeal nerve.
Location:
Formation:
The cardiac nerves that join the superficial plexus
do not join the deep plexus.
Divided into:
Left Coronary Plexus Supply Lt. Atrium and Lt. Ventricle;
accompany LCA
Right Coronary Plexus- formed by both
superficial & deep plexus;
Supply Rt. Atrium and Rt. Ventricle;
accompany RCA
Atrial Plexuses- distributed to the atria
Deep Cardiac Plexus
Pulmonary Plexus
Formation:
Sympathetic fibres from T
2
- T
5
sympathetic ganglion, &
Parasympathetic fibres of Vagus related to root of lung.
Sympathetic fibres cause Bronchodilatation,
Vasoconstriction & decreased mucous secretion
Parasympathetic fibres have opposite action
on tracheobronchial tree.
Oesophageal Plexus
1
- T
4
sympathetic ganglion, &
Parasympathetic fibres from Vagus nerve.
Sympathetic fibres are Vasomotor in nature.
Parasympathetic fibres are motor, secretomotor and sensory.
Formation:
Aortic Plexus
1
- T
5
sympathetic ganglion.
Runs along the wall of the arteries.
They are Vasodilators.
Formation:
Medial Branches from T
5
- T
12
:
These are preganglionic fibres
They relay in ganglia which are in relation to the arteries close to
midline of body
They leave posterior thoracic wall to reach posterior abdominal wall.
Postganglionic fibres are distributed to upper abdominal viscera &
the blood vessels supplying them.
Preganglionic fibres form:
Greater splanchnic nerve- T
5
- T
9
Lesser splanchnic nerve- T
10
- T
11
Least splanchnic nerve- T
12
Splanchnic Nerves
Greater Splanchnic Nerve
Formation:
By preganglionic fibres of T
5
- T
9
ganglia
Entry into abdomen:
By piercing respective crus of the Diaphragm
Distribution:
Preganglionic fibres terminate into:
Coeliac Ganglia: Placed on both side of Coeliac trunk
Aorticorenal Ganglia: Placed near origin of Renal artery
Terminal Ganglia to Suprarenal medulla.
Lesser Splanchnic Nerve
10
- T
11
ganglia
By piercing respective crus of the Diaphragm
Preganglionic fibres terminate into: Coeliac Ganglia
Formation:
Entry into abdomen:
Distribution:
Least Splanchnic Nerve
12
ganglia
By passing deep to medial arcuate ligament.
Preganglionic fibres terminate into: Aorticorenal Ganglia
Formation:
Distribution:
Entry into abdomen:
Autonomic Plexuses of Abdomen
Sympathetic ganglia alongwith
parasympathetic branches from Vagus nerve forms :
Coeliac Plexus
Phrenic Plexus
Superior Mesenteric Plexus
Intermesenteric Plexus
Inferior Mesenteric Plexus
Superior Hypogastric Plexus
Coeliac Plexus
Largest autonomic plexus
Sited at the level of T
12
& L
1
Vertebra
Dense network uniting two coeliac ganglia
Surrounds Coeliac trunk and root of Superior mesenteric artery.
Relation:
Posterior to Stomach & lesser sac
Anterior to crura of the Diaphragm
At beginning of Abdominal Aorta
Between two Suprarenal glands
Formed by Greater & Lesser Splanchnic nerves,
Vagus nerve and Phrenic nerve.
Secondary Plexuses are: Phrenic, Splenic, Hepatic,
Superior Mesenteric, Suprarenal, Renal, Gonadal
Coeliac Plexus
Phrenic Plexus
Lies around Inferior Phrenic arteries in the crura of the Diaphragm.
Superior extension of Coeliac Ganglia &
Receive sensory branch from Phrenic nerve
Left one is larger than right one.
Left phrenic plexus supply-
Cardiac orifice of Stomach
Left Suprarenal gland
Right Phrenic plexus join phrenic nerve to form Phrenic Ganglion.
Phrenic ganglion distributes to IVC, Suprarenal gland, Hepatic plexus.
Superior Mesenteric Plexus
Located-
in the Preaortic connective tissue
Posterior to the Pancreas
Around origin of Superior mesenteric artery.
Inferior continuation of Coeliac plexus
Receives branches from Coeliac plexus & Vagus nerve.
Branches distributed along the artery.
Superior mesenteric ganglion lies superior to the plexus.
Inter Mesenteric Plexus
Also known as Abdominal Aortic Plexus
Situated in the side and in front of Abdominal Aorta
Between the origin of SMA & IMA.
Consists of 4-12 intermesenteric nerves.
Continuous above with Superior Mesenteric Plexus
& below with Superior Hypogastric Plexus.
Formed by Sympathetic and Parasympathetic fibres from Coeliac plexus.
Receives rami from 1
st
& 2
nd
Lumbar Splanchnic nerves.
Inferior Mesenteric Plexus
Situated around the origin of Inferior Mesenteric artery.
Formed by Aortic plexus, 1
st
& 2
nd
Lumbar Splanchnic nerves,
and branches from Superior Hypogastric plexus.
Superior Hypogastric Plexus
Situated anterior to
Aortic bifurcation
Left Common iliac vein
Median Sacral vessels
Body of L5 vertebra
Sacral promontory
&
Between the common iliac arteries.
Formed by branches from Aortic Plexus,
3
rd
& 4
th
Lumbar Splanchnic nerves &
Parasympathetic fibres from Pelvic Splanchnic nerve.
To be continued
Autonomic Nervous System-III
Dr. Jayanta Sarkar
1
st
Year PGT
Parasympathetic Nervous System
Parasysmpathetic: routine maintenance
rest & digest
It has no definite Anatomical entity
Parasympathetic nerve fibres pass through
Certain cranial nerves and Sacral spinal nerves.
Hence it is called Cranio Sacral outflow.
Location:
Preganglionic neurons are located in :
Brainstem in connection with
Oculomotor (III
rd
), Facial (VII
th
),
Glossopharyngeal (IX
th
) and Vagus (X
th
) nerve nuclei.
Lateral horn cells of S2- S4 segment of Spinal cord.
Postganglionic neurons consist of Collateral and Terminal ganglia.
Collateral ganglia:
Ciliary ganglia
Pterygopalatine ganglia
Submandibular ganglia
Otic ganglia
Terminal ganglia:
Located in the walls of target organ
Actions:
Localized and accurate.
Anabolic in function.
Conserve energy for future.
Essential for our life.
On stimulation:
Decrease HR
Reduce BP
Constrict Pupils
Increase Peristalsis
Increase Glandular secretion
Evacuates Bowel & Bladder
Cranial component keep in well sustained tranquil state
Sacral component facilitates Micturation & Defaecation.
Parasympathetic Efferent Pathway
Cranial Outflow:
Oculomotor Nerve:
Preganglionic fibres arise from
Edinger Westphal nucleus.
Relay in Ciliary ganglion
Postganglionic fibres form Short ciliary nerve.
They pierce the sclera and supply-
Sphincter pupillae & ciliaris
Cranial Outflow:
Facial Nerve:
Superior Salivatory nucleus.
Synapses with 2 collateral ganglia:
Pterygopalatine ganglion- via Greater Petrosal nv.
Postganglionic fibres are Secretomotor to
Lacrimal gland
Nasal gland
Palatine gland
Submandibular ganglion- via Chorda Tympani nv.
Postganglionic fibres are Secretomotor &
Vasodilator to
Submandibular glands
Sublingual glands
Facial Nerve:
Glossopharyngeal Nerve:
Cranial Outflow:
Inferior Salivatory nucleus.
Relayed to collateral ganglia:
Otic ganglion- via Lesser Petrosal Nerves
&
Tympanic branch of Glossopharyngeal Nv.
Postganglionic fibres are Secretomotor and
Vasodilator to
Parotid glands
(through Auriculotemporal nerve)
Cranial Outflow:
Vagus Nerve:
Dorsal nucleus of Vagus nerve.
Relayed to Terminal ganglia close to
the target organ:
Heart
Lungs
Stomach
Small gut
Large gut upto
proximal 2/3
rd
of Transverse colon
Cranial Outflow:
Vagus Nerve:
Heart:
Few preganglionic fibres from nucleus Ambiguus.
Post ganglionic neurons are around SA node & AV node
Cardioinhibitor & Vasoconstrictor
Lungs:
Bronchoconstrictor & Secretomotor to Bronchial glands
Stomach:
Secretomotor to Gastric glands
Motor to musculature
Inhibitor to pyloric sphincter
Small & Large Gut:
Secretomotor to glands
Stimulates peristalsis
Inhibitor to Ileo-colic sphincter
Sacral Outflow:
Lateral Horn Cells of S2, S3, S4.
They form:
Pelvic Splanchnic Nerve (Nervi Erigentes)
Inferior Hypogastric Plexus
(Close to the Pelvic Viscera)
Sacral Outflow:
Postganglionic fibres from Sacral outflow Supply:
Distal Part of Colon & Rectum
Secretomotor to glands
Stimulates peristalsis
Inhibits Sphincters
Urinary Bladder
Stimulates Detrusor muscle
Muscles of Proximal Urethra
Testes / Ovaries Vasodilator
Penis/ Clitoris Vasodilator- Erection
Uterine Tubes & Uterus
Inhibit Uterine musculature
Vasodilator
Pelvic Splanchnic Nerve
Formation:
By anterior rami of S
2
- S
4
Spinal Nerves
They unite with branches of sympathetic plexus
Distribution:
They relay into:
Inferior Hypogastric plexus & supply
Motor to muscle of Rectum & Bladder wall
Inhibitory to Vesical Sphincter
Vasodilator to Penis/ Clitoris
Vasodilator to Testes/ Ovary; Uterus & Uterine tube.
Inferior Hypogastric Plexus
Situated in extra peritoneal connective tissue:
Lateral to
Rectum
Seminal Vesicle/Cervix
Prostate/ Vaginal fornix
Posterior to
Urinary Bladder
The plexus contains numerous small ganglia
Each ganglia is formed by:
Sympathetic fibres from Hypogastric Nerve
Parasympathetic fibres from Pelvic Splanchnic Nerve
Parasympathetic Afferent Pathway
Afferent fibres convey :
General Visceral Sensations-
Hunger, Thirst, Nausea, Sexual sensations
Sensations for normal Visceral Reflexes-
Hering Breuers Reflex, Cardiac Reflex, Micturation reflex
Visceral pain sensations-
from Pelvic viscera
Cells of origin:
Glossopharyngeal nerve:
Sensory neurons are pseudo unipolar
Located in Superior & Inferior Ganglia of the nerve
Central processes of these neurons synapse with
Dorsal nucleus of Vagus nerve
Nucleus Tractus Solitarius (Probably)
Peripheral processes distributed in
Posterior 1/3
rd
of Tongue
Oropharynx
Carotid Sinus
Carotid Body
Cells of origin:
Vagus nerve:
Located in Inferior Ganglion (Ganglion Nodosum) of the nerve
Central processes of these neurons synapse with
Dorsal nucleus of Vagus nerve
(Complete the Reflex Arc)
Vagus nerve:
Pharynx & Oesophagus- Swallowing reflex
Heart- Reflex inhibition
Aortic Body- Baroreceptor
Adventitia of Pulmonary Artery- Baroreceptor
Intima of Pulmonary Vein- Chemoreceptor
Lungs- Cough reflex & Hering Breuer reflex
Stomach- Hunger & nausea
Cells of origin:
Pelvic Splanchnic nerve:
Located in Dorsal Root Ganglia of S2- S4
Central processes of these neurons terminate into
Lateral Horn Cells of corresponding spinal segment
Urinary Bladder- Sense of Distension & Visceral Pain
Rectum- Sense degree of distension
Cervix Uteri- Visceral Pain

Autonomic Nerv System

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Autonomic Nervous System

Dr. Jayanta Sarkar

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