Anatomy, Autonomic Nervous System

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In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan.
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Excerpt

The autonomic nervous system is a component of the peripheral nervous system that regulates involuntary physiologic processes including heart rate, blood pressure, respiration, digestion, and sexual arousal. It contains three anatomically distinct divisions: sympathetic, parasympathetic, and enteric.

The sympathetic nervous system (SNS) and the parasympathetic nervous system (PNS) contain both afferent and efferent fibers that provide sensory input and motor output, respectively, to the central nervous system (CNS). Generally, the SNS and PNS motor pathways consist of a two-neuron series: a preganglionic neuron with a cell body in the CNS and a postganglionic neuron with a cell body in the periphery that innervates target tissues. The enteric nervous system (ENS) is an extensive, web-like structure that is capable of function independently of the remainder of the nervous system. It contains over 100 million neurons of over 15 morphologies, greater than the sum of all other peripheral ganglia, and is chiefly responsible for the regulation of digestive processes.

Activation of the SNS leads to a state of overall elevated activity and attention: the “fight or flight” response. In this process, blood pressure and heart rate increase, glycogenolysis ensues, gastrointestinal peristalsis ceases, etc. The SNS innervates nearly every living tissue in the body. The PNS promotes the “rest and digest” processes; heart rate and blood pressure lower, gastrointestinal peristalsis/digestion restarts, etc. The PNS innervates only the head, viscera, and external genitalia, notably vacant in much of the musculoskeletal system and skin, making it significantly smaller than the SNS. The ENS is composed of reflex pathways that control the digestive functions of muscle contraction/relaxation, secretion/absorption, and blood flow.

Presynaptic neurons of both the SNS and PNS utilize acetylcholine (ACh) as their neurotransmitter. Postsynaptic sympathetic neurons generally produce norepinephrine (NE) as their effector transmitter to act upon target tissues, while postsynaptic parasympathetic neurons use ACh throughout. Enteric neurons have been known to use several major neurotransmitters such as ACh, nitrous oxide, and serotonin, to name a few.

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