REVIEW OF THE AUTONOMIC

NERVOUS SYSTEM
 JOG YOUR MEMORY
WITH “FAMILIAR AUTONOMIC ANIMALS”
• Daily autonomics: Explain the sympathetic or parasympathetic process.
• You wake up at 3 am in your dark room. What happens to your pupils?
• You turn on your study lamp to cram for that exam in 10 hours. Your eyes adjust to the
sudden brightness. How?
• You set up your bookstand and notes. You then go to the bathroom to pee. What helps
relax your urethral sphincters?
• You then get a notification that the exam is actually 3 hours earlier. Your heart starts
beating fast. Do you fight (cram faster) or do you take flight (maybe give up and sleep)?
What ANS receptors would mediate this reaction?
• You decide to cram as best as you can. You are confident about the basic concepts of the
ANS. You went through the details of ANS receptors. Your GI tract begins to get
hyperperistalsis. Which specific type of ANS receptor would be activated?
ANATOMIC ASPECTS OF THE ANS
• Motor (efferent) = CNS  involuntary effector tissues (smooth
muscle, cardiac muscle, and exocrine glands
1. Parasympathetic (PANS)
2. Sympathetic (SANS)
3. Enteric (ENS) – semiautonomous; neuron cell bodies are 2 way (sensory
input, motor output)
• Myenteric plexus (Auerbach)
• Submucous plexus (Meissner)
• Many drugs for ANS motor functions; few for sensory (afferent)
ANATOMIC ASPECTS OF THE ANS
Parasympathetic (craniosacral)
• preganglionic motor fibers originate in cranial nerve nuclei III, VII, IX,
and X and in sacral segments (usually S2–S4) of the spinal cord
• Most of the parasympathetic ganglia are located in the organs
innervated and more distant from the spinal cord.
• preganglionic fibers are longer and postganglionic fibers are short
ANATOMIC ASPECTS OF THE ANS
Sympathetic (thoracolumbar)
• Preganglionic fibers originate in the thoracic (T1–T12) and lumbar
(L1–L5) segments of the cord
• ganglia are located in 2 paravertebral chains that lie along the sides of
the spinal column in the thorax and abdomen. A few (the prevertebral
ganglia) are located on the anterior aspect of the abdominal aorta
• preganglionic sympathetic fibers are short and the postganglionic
fibers are long (pre short, post long)
ANATOMIC ASPECTS OF THE ANS
Some receptors that respond to autonomic transmitters and drugs
receive no innervation.
• muscarinic receptors on the endothelium of blood vessels
• some presynaptic receptors on nerve endings, and,
• in some species, the adrenoceptors on apocrine sweat glands and α2
and β adrenoceptors in blood vessels.
 ANS NEUROTRANSMITTERS
• The synthesis, storage, release, receptor interactions, and termination of action of
the neurotransmitters all contribute to the action of autonomic drugs (Fig 6–2).
A. Cholinergic Transmission
1. Synthesis and storage – Ach = acetyl-CoA (mito) + choline (from CM transport)
- enzyme: choline acetyltransferase (ChAT)
- Rate-limiting step: transport of choline into nerve terminal (hemicholinium)
2. Release of Ach – SNARE proteins interact  vesicle dock to TM  Ca influx
3. Termination of action of Ach – acetylcholinesterase in synaptic cleft
4. Drugs – block synthesis (hemicholinium), block storage (vesamicol), block release
(botulinum toxin)
B. Adrenergic transmission
1. Synthesis and storage
2. Release and termination of action
3. Drug effects -
Skill Keeper Boxes
C. Cotransmitters
ANS RECEPTORS
• Cholinoreceptors – respond to Ach and analogs (cholinergic)
• Muscarinic receptors – mainly on effector cells
• Nicotinic receptors – mainly on ganglia and skeletal muscle end plates
• Adrenoreceptors
• Alpha receptors
• Beta receptors
• Dopamine receptors
• Renal and splanchnic vessels, brain
EFFECTS OF ACTIVITATIN AUTONOMIC NERVES
• Table 6-3
• Dually innervated organs ex:
• Iris of the eye
• Sinoatrial node of the heart
• Both have dominant PANS effect  blockade of both SANS and PANS
 mydriasis and tachycardia
Non-adrenergic, non-cholinergic transmission
(NANC)
• Motor fibers that realeas ATP and other purines
• Bronchi, GI tract, urinary tract
• Peptidergic – release pepetides as primary transmitters
• Nitric oxide – synthesized on demand, in blood vessels aka EDRF
• Subtance P
SITES OF AUTONOMIC DRUG ACTION
• Table 6-4
• CNS centers; the ganglia; the postganglionic nerve terminals; the
effector cell receptors; and the mechanisms responsible for
transmitter synthesis, storage, release, and termination of action.
• The most selective effect is achieved by drugs acting at receptors that
mediate very selective actions
 INTEGRATION OF AUTONOMIC FUNCTION
• Negative feedback mechanisms
• Local integration
• Modulatory pre and post synaptic receptors (autoreceptors, heteroreceptors)
• norepinephrine upon its own release from adrenergic nerve terminals (alpha-2
receptors)
• Systemic integration
• Homeostatic reflexes at the system level
• control of blood pressure—by the baroreceptor neural reflex and the renin-
angiotensin-aldosterone hormonal response
• Ex: hemorrhage  dec BP  inc SANS discharge and renin release
• Chronic HPN  only hydralazine to vasodilate  compensatory tachycardia
(baroreceptor reflex) and salt and water retention (renin system response)  need
other drugs to regulate these compensatory mechanisms
Thank you.