1. INTRODUCTION TO ANS Dr.B.M.PUROHIT Assistant Professor (Pharmacology) P.D.U.MEDICAL COLLEGE, Rajkot (GUJARAT). 360001 [email_address] 13/07/2010

2. 13/07/2010

3. Central nervous system (brain & spinal cord) Peripheral nervous system (Cranial & spinal nerves) Afferent nerves (from peripheral tissues to CNS) Efferent nerves (from CNS to peripheral tissues) Somatic or Voluntary Autonomic or Involuntary Sympathetic system Parasympathetic system 13/07/2010

5. 13/07/2010

6. Necessary for maintaining normal/house keeping function during minimal activity….. Necessary for coping with the stress, 13/07/2010

10. CENTRE AFFERENT EFFERENT NUTS AND BOLTS OF ANS !!!! 13/07/2010

11. VISCERAL AFFERENT FIBRES Mechano ceptor & chemoceptor stimuli Temperature stimuli Mechanical, chemical and thermal stimulie 13/07/2010

12. Internal face & head Tongue (taste) Trigeminal V VII Hard palate & upper part of oropharynx IX Carotid body, lower part or oropharynx, larynx, trachea, esophagus, thoracic and abdominal viscera EXCEPT PELVIC ORGANS X Pelvic viscera S2-S4 Nucleus Tractus Solitarus (NTS) Parabrachial nucleus Brain stem Hypothalamus Basal forebrain Thalamus Cerebral cortex Other structures 13/07/2010

14. Internal face & head Tongue (taste) Trigeminal V VII Hard palate & upper part of oropharynx IX Carotid body, lower part or oropharynx, larynx, trachea, esophagus, thoracic and abdominal viscera EXCEPT PELVIC ORGANS X Pelvic viscera S2-S4 Nucleus Tractus Solitarus (NTS) Parabrachial nucleus Brain stem Hypothalamus Basal forebrain Thalamus Cerebral cortex Other structures 13/07/2010

15. Others ascend via dorsal column At every level, spinal and cranial nerves converge with each other … 13/07/2010

17. Think of any thing that is happening AUTOMATICALLY in the body…!!! Cardiovascular function, respiration, metabolism, temp. regulation, hormonal secretion etc. etc…!!!!! 13/07/2010

18. Distribution of hypothalamic nuclei Remember MAP We have studied AFFERENT division & CENTRE…Now we will study EFFERENT division.. 13/07/2010

20. NEED A REVISION ? 13/07/2010 SYMPATHETIC PARASYMPATHETIC Thoracolumber output Craniosacral output Wide distrubution Limited distribution to head,neck & trunk Ganglia are away from organs Ganglia are near to organs Long postganglionic fibres Short postganglionic fibres NT is NA, Ach NT is Ach Necessary in the hour of crisis Necessary in maintaining normal functions

21. 13/07/2010 SYMPATHETIC PARASYMPATHETIC Thoracolumber output Craniosacral output Wide distrubution Limited distribution to head,neck & trunk Ganglia are away from organs Ganglia are near to organs Long postganglionic fibres Short postganglionic fibres NT is NA, Ach NT is Ach Necessary in the hour of crisis Necessary in maintaining normal functions

23. Medulla oblongata III Ciliary ganglion Ciliary muscle, circular muscles of iris VII Lacrimal gland Sphenopalatine ganglion Submaxillary and sublingual gland Submaxillary ganglion IX Parotid gland Otic ganglion X Heart,lung, intestine Nervi irrigantis Kidney, bladder, colon and genitals Pelvic ganglion Cervical Lumber Sacral Thoracic So..read like this.. from MEDULA 3 rd nerve arises , ends in CILIARY GANGLION and supplies CILIARY MUSCLES AND CIRCULAR MUSCLES of iris.. Do it for all the nerves REMEMBER…PARASYMPATHETIC O.P. IS…. CRANIO SACRAL 13/07/2010

25. Medulla oblongata III Ciliary ganglion Ciliary muscle, circular muscles of iris VII Lacrimal gland Sphenopalatine ganglion Submaxillary and sublingual gland Submaxillary ganglion IX Parotid gland Otic ganglion X Heart,lung, intestine Nervi irrigantis Kidney, bladder, colon and genitals Pelvic ganglion Cervical Lumber Sacral Thoracic So..read like this.. from MEDULA 3 rd nerve arises , ends in CILIARY GANGLION and supplies CILIARY MUSCLES AND CIRCULAR MUSCLES of iris.. Do it for all the nerves REMEMBER…PARASYMPATHETIC O.P. IS…. CRANIO SACRAL 13/07/2010

27. Medulla oblongata Cervical T1 T2 T3 T4 T5 T6 T7 T8 T9 T10 T11 T12 L1 L2 L3 respiratory tract, thorax Radial muscle fibres of iris,blood vessels of head & neck, salivary glands ICG MCG SCG CG GIT,hepatic and renal Blood vessels and sweat glands Adrenal medula SMG Colon, rectum,kidney IMG Genitals Blood vessels of lower extremity Sacral SG Sex organs,bladder REMEMBER…SYMPATHETIC O.P. IS…. THORACO LUMBER Heart, 13/07/2010

29. Medulla oblongata Cervical T1 T2 T3 T4 T5 T6 T7 T8 T9 T10 T11 T12 L1 L2 L3 respiratory tract, thorax Radial muscle fibres of iris,blood vessels of head & neck, salivary glands ICG MCG SCG CG GIT,hepatic and renal Blood vessels and sweat glands Adrenal medula SMG Colon, rectum,kidney IMG Genitals Blood vessels of lower extremity Sacral SG Sex organs,bladder REMEMBER…SYMPATHETIC O.P. IS…. THORACO LUMBER Heart, 13/07/2010

31. HOW SYMPATHETIC NERVOUS SYSTEM(SNS), BENEFICIALLY REACTS IN STRESS… 13/07/2010

34. BASIC STEPS IN NEUROHUMORAL TRANSMISSION…….. Remember this cascade. There are so many sites of pharmacological intervention . 13/07/2010

35. SYNTHESIS OF NT IN NEURONS…. STORAGE OF NT IN VESICLES…. ……… DOWNWARD MOVEMENT OF VESICLE IN RESPONSE TO NERVE STIMULATION FUSION OF VESICLES WITH NERVE TERMINAL MEMBRANES & RELEASE OF NT IN RESPONSE TO NERVE STIMULATION ……… ACTION ON POST JUNCTIONAL MEMBRANE (Generation of EPSP or IPSP).. TERMINATION OF NEUROTRANSMITTER ACTION BY EITHER DIFFUSION, METABOLISM OR REUPTAKE POST JUNCTIONAL ACTIVITY ( Secretion or contraction ) 13/07/2010

36. NEED A REVISION ? 13/07/2010

37. SYNTHESIS OF NT IN NEURONS…. STORAGE OF NT IN VESICLES…. ……… DOWNWARD MOVEMENT OF VESICLE IN RESPONSE TO NERVE STIMULATION FUSION OF VESICLES WITH NERVE TERMINAL MEMBRANES & RELEASE OF NT IN RESPONSE TO NERVE STIMULATION ……… ACTION ON POST JUNCTIONAL MEMBRANE (Generation of EPSP or IPSP).. TERMINATION OF NEUROTRANSMITTER ACTION BY EITHER DIFFUSION, METABOLISM OR REUPTAKE POST JUNCTIONAL ACTIVITY ( Secretion or contraction ) 13/07/2010

39. PATTERN OF NEUROTRANSMITTER RELEASE IN PERIPHERAL NERVOUS SYSTEM 13/07/2010

40. ANS SYMPATHETIC PARASYMPATHETIC SOMATIC NERVOUS SYSTEM ACh NA & A in adrenal medula NA & A in blood circulation ACh DA D1 & D2 on Renal vasculature ACh ACh M3 sweat glands ACh NA LOT MANY ORGANS !! ACh ACh ACh Nm skeletal muscles Now get ready for interpretation of the diagram, observe a few SALIENT points !! N N N N N N N N N N All ganglia contains Nn receptor Somatic NS does not contain ganglia In the entire peripheral nervous system ADRENALINE is released only IN ADRENAL MEDULA nowhere else. In symp.sys DA is also released !! In symp.sys also ACh is released (at sweat glands)!! All preganglionice fibres(symp. & parasympathetic) releases Ach. 13/07/2010

42. ANS SYMPATHETIC PARASYMPATHETIC SOMATIC NERVOUS SYSTEM ACh NA & A in adrenal medula NA & A in blood circulation ACh DA D1 & D2 on Renal vasculature ACh ACh M3 sweat glands ACh NA LOT MANY ORGANS !! ACh ACh ACh Nm skeletal muscles Now get ready for interpretation of the diagram, observe a few SALIENT points !! N N N N N N N N N N All ganglia contains Nn receptor Somatic NS does not contain ganglia In the entire peripheral nervous system ADRENALINE is released only IN ADRENAL MEDULA nowhere else. In symp.sys DA is also released !! In symp.sys also ACh is released (at sweat glands)!! All preganglionice fibres(symp. & parasympathetic) releases Ach. 13/07/2010

45. SEROSA LongitudinalMuscle AUERBACH’S PLEXUS (ACh,CGRP,NPY) Myenteric Plexus Circular Muscle MEISSNER’S PLEXUS (Substance P, 5-HT, ACh, NE) Submucous Plexus LUMEN 13/07/2010