Ronald Allan Cruz, MD

Department of Physiology
FEU-NRMF Institute of Medicine

Discuss the organization of the nervous

system
Review anatomic overview of the peripheral
nervous system
Discuss cholinergic and adrenergic
transmission
Discuss neurotransmitter-receptor
interaction
Discuss physiologic differences between
sympathetic and parasympathetic nervous
system

Central
nervous
system
Brain

Spina
l cord

Sympathetic
nervous
system

Nervou
s
System

Peripheral
nervous
system

Somatic
nervous
system

Autonomi
c nervous
system

Enteric
nervous
system

Parasympathet
ic nervous
system

Cranial nerves
12 pairs

Somatic afferent
Somatic efferent
Autonomic afferent
Autonomic efferent

Spinal nerves
31 pairs

Cervical: C1-8
Thoracic: T1-12
Lumbar: L1-5
Sacral: S1-5
Coccygeal: C1

Somatic afferent
Somatic efferent
Autonomic afferent
Autonomic efferent

Somatic nervous
system

Autonomic nervous
system

CNS
Hypothalamus
Limbic system
Somatic afferent
Somatic efferent

Visceral afferent
Visceral efferent

Somatic afferent

Autonomic afferent

CNS

Cutaneous
receptors
Muscle spindle
GTO

Receptor
s

+ -

Baroreceptors
Chemoreceptors
Stretch
receptors

Receptor
s

Somatic efferent

CNS

Skeletal
muscle

Autonomic efferent
Cardiac muscle
Smooth muscle
Glands
+ Effector

+
Effector

+
Adrenal
gland

Parasympathetic
division
CN 3, 7, 9, 10, S2-3
Long pre-ganglionic

fiber
1:1 branching

Sympathetic
division
T1-L2
Long post-ganglionic

fiber
Except for the adrenal
medulla

Paravertebral

ganglia
Prevertebral ganglia
1:20 branching

CNS

CNS

CNS

CNS

Acetylcholine
Acetyl-CoA + choline ACh

Norepinephrine, epinephrine
Tyr dopa dopamine NE Epi

Adrenal medulla
Epinephrine,

norepinephrine

Interneurons
Dopamine
GnRH
VIP
NPY, somatostatin
ATP
Enkephalin
Substance P
LH releasing

hormone
Neurotensin

Synthesis and storage of neurotransmitters

Release of neurotransmitters
Interaction of neurotransmitters with the
receptor of the post-synaptic element
Deactivation of the neurotransmitter
Diffusion
Enzymatic destruction
AchE
COMT, MAO

Reuptake by the post-ganglionic fiber

ACh ACh receptor

Acetylcholine

Nicotinic

Excitation of post-ganglionic neuron

Muscarinic M1 Presynaptic sites, CNS, cholinergic-adrenergic

neurons
Muscarinic M2 Cardiac effects of ACh
Muscarinic M3 ACh-induced secretion from glands
Muscarinic M4 Modulates synaptic transmission
Muscarinic M5 Pupil sphincter, esophagus, parotid gland,
cerebral blood vessels

Epi, NE adrenergic receptor

Norepinephrine

Contractile effects of NE on smooth muscles (blood

vessels, urogenital, sphincter muscles)

release of NE, ATP, ACh

Stimulates cardiac activity

Relaxes smooth muscles in GIT, GUT, airways

fatty acid release

Conformational change in receptor CHON

Change in cell membrane permeability to ions
Na, Ca permeability
K, Cl permeability

Activate or inactivate enzymes associated to

receptors
adenylyl cyclase cAMP
inositol P3-diacylglycerol Ca, DAG

Parasympathetic Division
Rest and digest
cardiac activity
GIT motility, sphincter tone
Short duration, localized effects

Sympathetic division
Fight or flight
Mass discharge
cardiac activity,

airway diameter
Vasoconstriction:
skin, viscera
Vasodilation: muscle
alertness
GI motility,
sphincter tone

Pilomotor muscle
Sweat glands
M receptors:
sympathetic cholinergic

Blood vessels
, receptors
M receptors:
sympathetic cholinergic

Sustained, wide-

spread effects

People come into our lives for a reason

Bringing something we must learn.
And we are lead to those who help us most to
grow
If we let them
-Wicked