THE NERVOUS SYSTEM: AUTONOMIC DIVISION

Jakarta, April 13th 2005 By Mila Citrawati

Autonomic Nervous System

There is always a synapse interposed between the CNS and peripheral effector Visceral motor neuron in the CNS [preganglionic or first order]

synapse on second order or ganglionic neurons located in autonomic ganglia outside CNS

divergen [single myelinated preganglionic fiber may activate over 2 dozen ganglionic neuron]
axon leaving the autonomic ganglia [smaller & unmyelinated postganglionic fibers]

innervate peripheral organs [cardiac muscle, smooth muscle, glands, adipose tissue]

SUBDIVISION OF THE ANS

Preganglionic fibers from the thoracic and lumbar spinal segments synapse in ganglia near the spinal cord sympathetic division of the ANS Fight or Flight [stimulates tissue metabolism, increases alertness,and generally prepares the body to deal with emergencies]

Preganglionic fibers originating in the brain and the sacral spinal segments synapse on neurons of intramural ganglia located inside the tissues of visceral organs parasympathetic division of ANS rest and repose [conserves energy and promote sedentary activities such as digestion]

Symp & parasymp affect target organs through the controlled release of spesific NT by postganglionic fiber The result depends on the response of the membrane receptor to the presence of the NT All preganglionic autonomic fibers are cholinergic, they release ACh at their synaptic terminal [always excitatory] Postganglionic parasymp fibers are also cholinergic [excitatory or inhibitory] Most postganglionic symp terminals are adrenergic release NE usually excitatory

SYMPATHETIC DIVISION

Preganglion neurons [1st order] located between T1-L2 of the spinal cord, their axon enter the ventral roots of these segments Ganglionic neuron [2nd order] located in ganglia near the vertebrae column. There are 2 types of symp ganglia :
Symp chain ganglia [paravert ganglia] This ganglia contain 2nd order neuron that control effector in the body wall and inside the thoracic cavity

1.

2. Collateral ganglia [prevert ganglia] Contain 2nd order neuron that innervate tissues and organs in the abdominopelvic cavity

Specialized 2nd order neurons in the interior of the adrenal gland [adrenal medulla contains a modified symp ganglion] - very short axon - when stimulated they release NT into general circulation

Functions Of The Sympathetic Chain

Stimulation of secretion by sweat glands Stimulation of errector pili muscle Constriction of cutaneous blood vessels Acceleration of blood flow to skeletal muscle Stimulation of energy production & use by skeletal muscle tissue Release of stored lipids from subcutan adipose tissue

Midriasis, focusing eyes for viewing distant objects Accelerating heart rate Increasing force of cardiac contraction Dilating respiratory passageways

Help prepare for crisis

Heart work harder moving blood faster muscles receive more blood utilization of stored & absorbed nutrients increase lipid release lungs deliver more oxygen, prepare to eliminate carbondioxyde produced by contracting muscle sweat glands become active anticipating the need to lose the heat the eyes look for approaching danger

Function Of Collateral Ganglia

Vasoconstriction small arteries reducing the flow of blood to visceral organs Decrease activity of digestive glands & organs [stomach, intestine, pancreas and gallbladder] Stimulation the release of glucose from glycogen reserve in the liver Stimulation the release of lipids from adipose tissue

Relaxing the smooth muscle in the wall of urinary bladder Controlling some aspects of sexual function [ eq. ejaculation in male] General pattern: -reduction of blood flow & energy used by visceral organs that are not important to short term survival [digestive tract] -the release of stored energy reserves

The Adrenal Medulla

Preganglionic fibers entering adrenal medulla synapse on modified neuron that preform endocrine function The cells of the adrenal medulla are neurons with short axon that end on an extensive network of capillaries in the center of the adrenal gland

When stimulated cells release NT [NE +E] into surrounding capillaries diffuse into peripheral tissues changes in the metabolic activities of many different cells the effect resembles those produced by stimulation of symp postganglionic fibers Note : + cells not innervated by symp are affected as well + last longer than those produced by direct symp innervation

Central Effects Of Sympathetic Stimulation

Increase allertness via stimulation of RAS A feeling of energy and euphoria, often associated with disregard for danger & temporary insensitivity to painful stimuli Increase activity in the cardiovascular & resp centers of the pons & medulla increase blood pressure, heart rate, breathing rate, depth of resp.

General elevation in muscle tone via stimulation of extrapyramidal system [look tense, begin to shiver]

Preparation to cope with stressful and dangerous situation

Sympathetic Activation & NT Release

On stimulation, symp preganglionic fibers ACh at synapses with ganglionic neuron cholinergic [the effect always excitatory] Symp postganglionic fibers release NE at neuro effector junction adrenergic synapse Terminal axon branches form a network / chain of enlarge terminal knobs NT release entering interstitial fluid affect the postsynaptic membrane [50-80% NE reabsorbed by terminal knob, the rest diffuses or broken down by enzyme]

ACh release at the adrenal gland stimulate the neuron to release E & NE into bloodstream, rather than into local tissues E ~ adrenalin [75-80% of secretory output; the rest is NE] The release of NE at spesific location The secretion of E into general circulation The effects of symp stimulation result primarily from interaction with membrane receptors sensitive to NE or E [ and ] These receptors activate/inactivate intracellular enzyme the result can be stimulatory / inhibitory

Alpha Receptor [1]

Two types of receptors [1, 2] Stimulation of most common receptor triggers a depolarization excitatory effect The surface of smooth muscle+gland cells contain abundant 1receptor stimulate vasoconstriction + closure of sphincters along digestive tract

Emergency increase blood pressure, reduce blood flow to digestive organs, & reduce oxygen demands of organ that cannot help the individual fight or flee In addition to elevating intracellular [Ca], stimulation of 1 speed up cellular metabolism by activating enzymes that regulate important metabolism pathway [glycolysis]

 2 Receptor

Much more limited distribution Stimulation of these receptor leads to a decrease in the intracellular [cAMP] inhibitory effect Found on presynaptic surfaces at autonomic neuroeffector junction

Provides a negative feedback mechanism that control the amount of NE released at the synapse 2 receptors are also present at parasymp neuroeffector junction, release of E / NE inhibit parasymp activity widespread inhibitory effect of symp stimulation on the digestive system

 Receptor [1]

Two classes of receptors [1, 2] Act by increasing intracellular [cAMP] 1 receptor are equally sensitive to E & NE their stimulation has an excitatory effect Found in the heart, when stimulated they produce an increase in HR & force of cardiac contraction These responses accelerate blood flow to active tissues & help maintain adequate blood pressure & flow in the event of a severe injury and blood loss

2 Receptor

Found in the smooth muscle surrounding blood vessels in the heart, skeletal muscle, lungs, and smooth muscle of resp passageway walls Symp stimulation of 2 receptor generalized inhibition & relaxation of smooth muscle fibers vasodilatation, bronchodilatation making it easier to breath quickly & deeply Symp postganglionic >> adrenergic releasing NE, << cholinergic Symp activation occurs during exercise stimulates sweat gland secretion & dilates the blood vessels

SUMMARY

2 segmentally arrange symp chain one on each side of the spinal column, 3 collateral ganglia in front of the spinal column, 2 adrenal medullae Preganglionic fibers are relatively short, close to the spinal cord. Postganglionic fibers are relatively long & extend Extensive divergence, single preganglionic fiber may innervate as many as 32 2nd order neurons in different ganglia Preganglionic neuron release ACh, most postganglionic fiber release NE, few ACh Effector response depends on the nature of enzyme activated when NE/E bind to /receptor

Parasympathetic Division

1st order [preganglionic neuron] in brain-stem [mesenchepalon & pons] & sacral segments of spinal cord [S2-S4]

2nd order [ganglionic neurons] located within / adjacent to the target organ the effects of parasymp stimulation are more spesific & localized than those of symp division

General Function Of Parasympathetic Division

Myosis, focusing on near by object Secretion by digestive glands [salivary, gastric, duodenal, intestinal,pancreas, liver] Secretion of hormones that promote nutrient absorption by peripheral cells Increase smooth muscle activity along digestive tract Stimulation and coordination of defecation

Contraction of urinary bladder Contraction resp passageways Reduction in heart rate and force of cardiac contraction Relaxation,food processing, energy absorption anabolic system All pre & postganglionic fibers release ACh at synapse & neuroeffector junction The effect of stimulation are short lived for most of the ACh released is inactivated by ACh esterase the effects localized & last few second

Receptors

Two types of ACh receptors on postsynaptic membrane [Nicotinic & Muscarinic receptors] Nicotinic receptor molecules are chemically regulated sodium ion channels, exposure to ACh always cause excitation to ganglionic / muscle fiber Muscarinic receptor produce a longer lasting effect than nicotinic. Activate enzyme that may open K ion channels hyperpolarization+inhibition, close K channel producing depol+excitation

Inhibitory Muscarinic Receptor Are Found At Cholinergic Neuroeffector Junction

At sphingter muscle along digestive tract relax + promote movement of material On surface of cardiac muscle decrease of heart rate and force of cardiac contraction At smooth muscle in the walls of small arteries along digestive tract & skeletal muscle [vasodilatation]

Excitatory Muscarinic Receptor are found at Cholinergic Neuroreceptor Junction

In the pancreas, salivary gland and other glands of digestive tract accelerate secretion On smooth muscle surrounding resp passageways muscle contraction + airways obstruction In the wall of urinary bladder contraction

Summary

Includes visceral motor nuclei associated with 4 cranial nerves [III,VII, IX, X] & in S2-S4 2nd order neuron situated in ganglion closely associated with target organ Innervate areas serviced by cranial nerves & organ in the thoracic & abdominopelvic cavities Cholinergic neuron. Nicotinic receptor excited by Ach. Muscarinic receptor [excitation / inhibition] The effect are usually brief & restricted to spesific organs & sites

Autonomic Patterns of Activity

Parasymp division responsible for the state rest and repose body relaxes, energy demands are minimal & both heart rate + blood pressure relatively low. Organs of digestive tract are highly stimulated [secretory glands are active, stomachs contracting, peristaltik, defecation, urination]

-metabolism rate decrease -heart rate+blood pressure decrease -secretion of salivary & digestive glands -digestive tract activity increase -urination and defecation

Symp division responsible for fight or flight response -increase level of allertness -metabolism rate increase [2xrest] -suspension of digestive & urinary tract function -activation of energy reserve -resp rate & efficiency increase -blood pressure and heart rate increase -activation of sweat glands

Visceral Reflexes [parasymp]

Reflexes that coordinated the digestive activities [N.X] Defecation & urination reflexes Light & consensual light reflexes Swallowing, coughing, gagging, sneezing, vomiting [N.IX , N.X] Baroreceptor reflexes [N.X] Reflex pattern of sexual arousal in response to erotic stimuli

Visceral Reflexes [symp]

Baroreceptor reflexes heart rate +cardiac contraction force increase Vasomotor reflexes Pupillary dilatation reflexes Sexual reflexes [eq, ejaculation]

DRUG

Mimetic drug [mimic the activity one of the normal autonomic transmitter] Sympatomimetic drug may survive oral adm [whereas NE/E dont] topically, spray, inhalation, injection. Phenylephrine receptor Ephedrine, pseudoephedrine receptor Dobutamin 1 receptor HR & BP increase Albuteral/tarbutalin2 receptor

Symp blocking agent bind to the the receptor site & prevent a normal response to the presence of NT / sympatomimetic drug : - prazosin 1 blocker [decrease BP] - propanolol 1 + 2 - metoprolol 1 [save for astma]

Parasympatomimetic drug [increase activity of digestive tract] : -physostigmine / neostigmine [blocking ACh esterase] counteract paralytic effect of d-tubocurarine Parasymp blocking agent : -atropin muscarinic receptor control diarrhea, cramps [food poisoning] -scopolamine promoting drowsiiness, reducing nausea, relieve anxiety [pre-op]

BELAJAR GITU LOCH !!!!!