autonomic nervous system autonomic nervous system the autonomic nervous system (ans), formerly referred to as the vegetative nervous system, is a division of the nervous system that supplies internal organs, smooth muscle and glands. the autonomic nervous system is a control system that acts largely unconsciously and regulates bodily functions, such as the heart rate, its force of contraction, digestion, respiratory rate, pupillary response, urination, and sexual arousal. this system is the primary mechanism in control of the fight-or-flight response. autonomic nervous systemautonomic nervous system innervationdetailsidentifierslatinautonomici systematis nervosimeshd001341ta98a14.3.00.001ta26600fma9905anatomical terminology the autonomic nervous system is regulated by integrated reflexes through the brainstem to the spinal cord and organs. autonomic functions include control of respiration, cardiac regulation (the cardiac control center), vasomotor activity (the vasomotor center), and certain reflex actions such as coughing, sneezing, swallowing and vomiting. those are then subdivided into other areas and are also linked to autonomic subsystems and the peripheral nervous system. the hypothalamus, just above the brain stem, acts as an integrator for autonomic functions, receiving autonomic regulatory input from the limbic system. although conflicting reports about its subdivisions exist in the literature, the autonomic nervous system has four branches: the sympathetic nervous system, the parasympathetic nervous system, the visceral sensory nervous system and the enteric nervous system. some textbooks do not include the enteric nervous system as part of this system. the sympathetic nervous system is often considered the "fight or flight" system, while the parasympathetic nervous system is often considered the "rest and digest" or "feed and breed" system. in many cases, both of these systems have "opposite" actions where one system activates a physiological response and the other inhibits it. an older simplification of the sympathetic and parasympathetic nervous systems as "excitatory" and "inhibitory" was overturned due to the many exceptions found. a more modern characterization is that the sympathetic nervous system is a "quick response mobilizing system" and the parasympathetic is a "more slowly activated dampening system", but even this has exceptions, such as in sexual arousal and orgasm, wherein both play a role. there are inhibitory and excitatory synapses between neurons. a third subsystem of neurons has been named as non-noradrenergic, non-cholinergic transmitters (because they use nitric oxide as a neurotransmitter) and are integral in autonomic function, in particular in the gut and the lungs. although the ans is also known as the visceral nervous system and although most of its fibers carry non-somatic information to the cns, many authors still consider it only connected with the motor side. most autonomous functions are involuntary but they can often work in conjunction with the somatic nervous system which provides voluntary control. structure autonomic nervous system, showing splanchnic nerves in middle, and the vagus nerve as "x" in blue. the heart and organs below in list to right are regarded as viscera. the autonomic nervous system has been classically divided into the sympathetic nervous system and parasympathetic nervous system only (i.e. exclusively motor). the sympathetic division emerges from the spinal cord in the thoracic and lumbar areas, terminating around l2-3. the parasympathetic division has craniosacral "outflow", meaning that the neurons begin at the cranial nerves (specifically the oculomotor nerve, facial nerve, glossopharyngeal nerve and vagus nerve) and sacral (s2-s4) spinal cord. the autonomic nervous system is unique in that it requires a sequential two-neuron efferent pathway; the preganglionic neuron must first synapse onto a postganglionic neuron before innervating the target organ. the preganglionic, or first, neuron will begin at the "outflow" and will synapse at the postganglionic, or second, neuron's cell body. the postganglionic neuron will then synapse at the target organ. sympathetic division main article: sympathetic nervous system the sympathetic nervous system consists of cells with bodies in the lateral grey column from t1 to l2/3. these cell bodies are "gve" (general visceral efferent) neurons and are the preganglionic neurons. there are several locations upon which preganglionic neurons can synapse for their postganglionic neurons: paravertebral ganglia (3) of the sympathetic chain (these run on either side of the vertebral bodies) cervical ganglia (3) thoracic ganglia (12) and rostral lumbar ganglia (2 or 3) caudal lumbar ganglia and sacral ganglia prevertebral ganglia (celiac ganglion, aorticorenal ganglion, superior mesenteric ganglion, inferior mesenteric ganglion) chromaffin cells of the adrenal medulla (this is the one exception to the two-neuron pathway rule: the synapse is directly efferent onto the target cell bodies) these ganglia provide the postganglionic neurons from which innervation of target organs follows. examples of splanchnic (visceral) nerves are: cervical cardiac nerves and thoracic visceral nerves, which synapse in the sympathetic chain thoracic splanchnic nerves (greater, lesser, least), which synapse in the prevertebral ganglia lumbar splanchnic nerves, which synapse in the prevertebral ganglia sacral splanchnic nerves, which synapse in the inferior hypogastric plexus these all contain afferent (sensory) nerves as well, known as gva (general visceral afferent) neurons. parasympathetic division main article: parasympathetic nervous system the parasympathetic nervous system consists of cells with bodies in one of two locations: the brainstem (cranial nerves iii, vii, ix, x) or the sacral spinal cord (s2, s3, s4). these are the preganglionic neurons, which synapse with postganglionic neurons in these locations: parasympathetic ganglia of the head: ciliary (cranial nerve iii), submandibular (cranial nerve vii), pterygopalatine (cranial nerve vii), and otic (cranial nerve ix) in or near the wall of an organ innervated by the vagus (cranial nerve x) or sacral nerves (s2, s3, s4) these ganglia provide the postganglionic neurons from which innervations of target organs follows. examples are: the postganglionic parasympathetic splanchnic (visceral) nerves the vagus nerve, which passes through the thorax and abdominal regions innervating, among other organs, the heart, lungs, liver and stomach sensory neurons main article: sensory neuron the sensory arm is composed of primary visceral sensory neurons found in the peripheral nervous system (pns), in cranial sensory ganglia: the geniculate, petrosal and nodose ganglia, appended respectively to cranial nerves vii, ix and x. these sensory neurons monitor the levels of carbon dioxide, oxygen and sugar in the blood, arterial pressure and the chemical composition of the stomach and gut content. they also convey the sense of taste and smell, which, unlike most functions of the ans, is a conscious perception. blood oxygen and carbon dioxide are in fact directly sensed by the carotid body, a small collection of chemosensors at the bifurcation of the carotid artery, innervated by the petrosal (ixth) ganglion. primary sensory neurons project (synapse) onto "second order" visceral sensory neurons located in the medulla oblongata, forming the nucleus of the solitary tract (nts), that integrates all visceral information. the nts also receives input from a nearby chemosensory center, the area postrema, that detects toxins in the blood and the cerebrospinal fluid and is essential for chemically induced vomiting or conditional taste aversion (the memory that ensures that an animal that has been poisoned by a food never touches it again). all this visceral sensory information constantly and unconsciously modulates the activity of the motor neurons of the ans. innervation autonomic nerves travel to organs throughout the body. most organs receive parasympathetic supply by the vagus nerve and sympathetic supply by splanchnic nerves. the sensory part of the latter reaches the spinal column at certain spinal segments. pain in any internal organ is perceived as referred pain, more specifically as pain from the dermatome corresponding to the spinal segment. autonomic nervous supply to organs in the human body organnervesspinal column origin stomach ps: anterior and posterior vagal trunks s: greater splanchnic nerves t5, t6, t7, t8, t9, sometimes t10 duodenum ps: vagus nerves s: greater splanchnic nerves t5, t6, t7, t8, t9, sometimes t10 jejunum and ileum ps: posterior vagal trunks s: greater splanchnic nerves t5, t6, t7, t8, t9 spleen s: greater splanchnic nerves t6, t7, t8 gallbladder and liver ps: vagus nerve s: celiac plexus right phrenic nerve t6, t7, t8, t9 colon ps: vagus nerves and pelvic splanchnic nerves s: lesser and least splanchnic nerves t10, t11, t12 (proximal colon) l1, l2, l3, (distal colon) pancreatic head ps: vagus nerves s: thoracic splanchnic nerves t8, t9 appendix nerves to superior mesenteric plexus t10 bladder ps: pelvic splanchnic nerves to detrusor muscles s: inferior hypogastric nerves s2-s4 kidneys and ureters ps: vagus nerve s: thoracic and lumbar splanchnic nerves t11, t12 motor neurons main article: motor neuron motor neurons of the autonomic nervous system are found in "autonomic ganglia". those of the parasympathetic branch are located close to the target organ whilst the ganglia of the sympathetic branch are located close to the spinal cord. the sympathetic ganglia here, are found in two chains: the pre-vertebral and pre-aortic chains. the activity of autonomic ganglionic neurons is modulated by "preganglionic neurons" located in the central nervous system. preganglionic sympathetic neurons are located in the spinal cord, at the thorax and upper lumbar levels. preganglionic parasympathetic neurons are found in the medulla oblongata where they form visceral motor nuclei; the dorsal motor nucleus of the vagus nerve; the nucleus ambiguus, the salivatory nuclei, and in the sacral region of the spinal cord. function function of the autonomic nervous system sympathetic and parasympathetic divisions typically function in opposition to each other. but this opposition is better termed complementary in nature rather than antagonistic. for an analogy, one may think of the sympathetic division as the accelerator and the parasympathetic division as the brake. the sympathetic division typically functions in actions requiring quick responses. the parasympathetic division functions with actions that do not require immediate reaction. the sympathetic system is often considered the "fight or flight" system, while the parasympathetic system is often considered the "rest and digest" or "feed and breed" system. however, many instances of sympathetic and parasympathetic activity cannot be ascribed to "fight" or "rest" situations. for example, standing up from a reclining or sitting position would entail an unsustainable drop in blood pressure if not for a compensatory increase in the arterial sympathetic tonus. another example is the constant, second-to-second, modulation of heart rate by sympathetic and parasympathetic influences, as a function of the respiratory cycles. in general, these two systems should be seen as permanently modulating vital functions, in a usually antagonistic fashion, to achieve homeostasis. higher organisms maintain their integrity via homeostasis which relies on negative feedback regulation which, in turn, typically depends on the autonomic nervous system. some typical actions of the sympathetic and parasympathetic nervous systems are listed below. target organ/system parasympathetic sympathetic digestive system increase peristalsis and amount of secretion by digestive glands decrease activity of digestive system liver no effect causes glucose to be released to blood lungs constricts bronchioles dilates bronchioles urinary bladder/ urethra relaxes sphincter constricts sphincter kidneys no effects decrease urine output heart decreases rate increase rate blood vessels no effect on most blood vessels constricts blood vessels in viscera; increase bp salivary and lacrimal glands stimulates; increases production of saliva and tears inhibits; result in dry mouth and dry eyes eye (iris) stimulates constrictor muscles; constrict pupils stimulate dilator muscle; dilates pupils eye (ciliary muscles) stimulates to increase bulging of lens for close vision inhibits; decrease bulging of lens; prepares for distant vision adrenal medulla no effect stimulate medulla cells to secrete epinephrine and norepinephrine sweat gland of skin no effect stimulate sudomotor function to produce perspiration sympathetic nervous system main article: sympathetic nervous system promotes a fight-or-flight response, corresponds with arousal and energy generation, and inhibits digestion diverts blood flow away from the gastro-intestinal (gi) tract and skin via vasoconstriction blood flow to skeletal muscles and the lungs is enhanced (by as much as 1200% in the case of skeletal muscles) dilates bronchioles of the lung through circulating epinephrine, which allows for greater alveolar oxygen exchange increases heart rate and the contractility of cardiac cells (myocytes), thereby providing a mechanism for enhanced blood flow to skeletal muscles dilates pupils and relaxes the ciliary muscle to the lens, allowing more light to enter the eye and enhances far vision provides vasodilation for the coronary vessels of the heart constricts all the intestinal sphincters and the urinary sphincter inhibits peristalsis stimulates orgasm the pattern of innervation of the sweat gland—namely, the postganglionic sympathetic nerve fibers—allows clinicians and researchers to use sudomotor function testing to assess dysfunction of the autonomic nervous systems, through electrochemical skin conductance. parasympathetic nervous system main article: parasympathetic nervous system the parasympathetic nervous system has been