Elsevier items and derived items © 2007, 2003, 2000 by Saunders, an imprint of Elsevier Inc. Slide 1
Chapter 12Autonomic Nervous System
Slide 2
Autonomic or Visceral Reflexes• What They Do: Autonomic reflexes regulate
organ function• Pathway: The sequence is receptor activation,
sensory input ( CNS), motor neuron response, and effector response
Slide 3
Organization and Function of the Autonomic Nervous System
• Divisions of the ANS: There are two divisions.– Sympathetic nervous system, called “Fight or Flight.”– Parasympathetic Nervous System, called “Feed and Breed.”
• Autonomic Terminology and Autonomic Pharmacology– Drugs that affect the sympathetic nervous system are called
sympathomimetic and sympatholytic.– Drugs that affect the parasympathetic nervous system are
called parasympathomimetic and parasympatholytic.
Slide 4
Organization and Function of the Autonomic Nervous System - cont’d
• Autonomic Tone and Vasomotor Tone– Background firing of the ANS causes autonomic
tone.– Background sympathetic stimulation of the blood
vessels causes vasomotor tone.
Slide 5
ANS: Neurons• Numbers and Ganglia– Preganglionic fibers are fibers that extend from
the CNS to the ganglia.– Postganglionic fibers are fibers that extend from
the ganglia to the effector organ.
Slide 6
ANS: Neurons - cont’d
• Neurons of the Sympathetic Nervous System– The SNS is called the thoracolumbar outflow.– The sympathetic ganglia are located in a chain
close to the spinal cord; the chain is called paravertebral ganglia.
– The adrenal medulla secretes hormones that mimic the SNS.
Slide 7
ANS: Neurons - cont’d
• Neurons of the Parasympathetic Nervous System– The parasympathetic nervous system is called the
craniosacral outflow.– Parasympathetic fibers travel with cranial nerves;
most parasympathetics run with the vagus nerve CN X.
• Naming Fibers and Neurotransmitters– Cholinergic fibers secrete acetylcholine (ACh).– Adrenergic fibers secrete norepinephrine (NE).
Slide 8
ANS: Neurons - cont’d
• Neurotransmitters: Termination of Activity– ACh is degraded immediately by
acetylcholinesterase.– NE activity is ended primarily by reuptake of the
NE into the nerve terminal and by MAO activity within the nerve terminal.
Slide 9
Receptors of the Autonomic Nervous System
• Cholinergic Receptors– These are activated by ACh.– There are two types: muscarinic and nicotinic
(with subtypes). • Adrenergic Receptors– Activated by NE– There are two types: alpha and beta
(with subtypes).
Slide 10
Receptors of the Autonomic Nervous System - cont’d
• Receptor activation and blockade can be determined by examining Tables 12-1, 12-3, and 12-4.
• Autonomic Receptors: “Doing Autonomic Pharmacology”– Clinical examples where drugs target autonomic
receptors
Slide 11
Introduction• The brain, spinal cord, and peripheral nervous
system act as a vast communication system. The spinal cord transmits information to and from the brain. The peripheral nervous system brings information to the CNS (its sensory role) and delivers information from the CNS to the periphery (its motor role).
Slide 12
What the Spinal Cord Is• The spinal cord is a tubelike structure located
in the spinal cavity, extending from the foramen magnum (occipital bone) to L1
• Arrangement of Nervous Tissue– The gray matter is a centrally located, butterfly-
shaped area.– The white matter is composed of myelinated
fibers arranged in tracts. Ascending tracts are sensory tracts. Descending tracts are motor tracts.
Slide 13
What the Spinal Cord Is - cont’d
• Arrangement of Nervous Tissue—cont’d– Spinal nerves are attached to the spinal cord. All
spinal nerves are mixed (they contain sensory and motor fibers).
– Sensory nerve fibers travel to the cord through the dorsal root. Motor nerve fibers travel in the ventral root.
Slide 14
What the Spinal Cord Does: Functions • The spinal cord relays both sensory and motor
information. • The spinal cord acts as a major reflex center.
Slide 15
Reflexes• A reflex is an involuntary response to a
stimulus.• The four components to a reflex are a sensory
receptor; an afferent (sensory) neuron; an efferent (motor) neuron; and an effector organ.
Slide 16
Peripheral Nervous System• Nerve– A nerve is a group of neurons, blood vessels,
and connective tissue.– There are sensory nerves, motor nerves, and
mixed nerves.
Slide 17
Peripheral Nervous System - cont’d
• Structural Classification of Nerves– A classification of nerves on the basis of structure divides
nerves into cranial nerves and spinal nerves. There are 12 pairs of cranial nerves (Table 11-3) and 31 pairs of spinal nerves (Table 11-5).
– Spinal nerves are sorted out at nerve plexuses. The three major plexuses are the cervical plexus, the brachial plexus, and the lumbosacral plexus.
– A dermatome is the area of skin innervated by each spinal nerve.
Slide 18
Peripheral Nervous System - cont’d
• Functional Classification of Nerves– Somatic afferent nerves carry sensory information
to the CNS.– Somatic efferent nerves carry motor information
to skeletal muscles.– Autonomic nerves carry motor information to the
organs (viscera).
Slide 19
Introduction• The purpose of the nervous system is to bring
information to the central nervous system, interpret the information, and enable the body to respond to the information.
Slide 20
The Nervous System: Overview• Divisions of the Nervous System– The central nervous system (CNS) includes the
brain and the spinal cord.– The peripheral nervous system includes the nerves
that connect the CNS with the rest of the body.
Slide 21
The Nervous System: Overview - cont’d
• Cells That Make Up the Nervous System– Neuroglia (glia) support, protect, and nourish the
neurons.– Neurons conduct the nerve impulse. – The three parts of a neuron are the dendrites,
cell body, and axon.
Slide 22
The Nervous System: Overview - cont’d
• Types of Neurons– Sensory, or afferent, neurons carry information
toward the CNS.– Interneurons are located in the CNS
(make connections).– Motor, or efferent, neurons carry information
away from the CNS toward the periphery.
Slide 23
The Nervous System: Overview - cont’d
• White Matter and Gray Matter– White matter is due to myelinated fibers.– Gray matter is composed primarily of cell bodies,
interneurons, and unmyelinated fibers.– Clusters of cell bodies (gray matter) are called
nuclei and ganglia.
Slide 24
The Neuron Carrying Information• Nerve Impulse– The electrical signal is called the action potential or
nerve impulse.– The nerve impulse is due to the following changes in
the neuron: polarization, depolarization, and repolarization.
– The nerve impulse is due to flow of ions: polarization (outward flux of K+), depolarization (influx of Na+), and repolarization (outward flux of K+).
Slide 25
The Neuron Carrying Information - cont’d
• Nerve Impulse—cont’d– The refractory period is the unresponsive period
of the neuron.– The nerve impulse jumps from node to node as it
travels along a myelinated fiber. Myelination increases the speed of the nerve impulse.
– The nerve impulse causes the release of a neurotransmitter.
Slide 26
The Neuron Carrying Information - cont’d
• Synapse– The synapse is a space between two neurons.– The nerve impulse of the first (presynaptic)
neuron causes the release of neurotransmitter into the synaptic cleft. The neurotransmitter diffuses across the synaptic cleft and binds to the receptors on the second (postsynaptic) membrane. The activation of the receptors stimulates a nerve impulse in the second neuron.
Slide 27
Brain: Structure and Function• Cerebrum– The right and left hemispheres are joined by the
corpus callosum.– The four main cerebral lobes are the frontal,
parietal, temporal, and occipital lobes. Functions of each lobe are summarized in Table 10-2.
– Large areas of the cerebrum, called association areas, are concerned with interpreting, integrating, and analyzing information.
Slide 28
Brain: Structure and Function - cont’d
• Diencephalon– The thalamus is a relay station for most sensory
tracts traveling to the cerebrum.– The hypothalamus controls many body functions
such as water balance, temperature, and the secretion of hormones from the pituitary gland; it exerts an effect on the autonomic nervous system.
Slide 29
Brain: Structure and Function - cont’d
• Brain Stem– Brain stem: midbrain, pons, and medulla
oblongata.– The medulla oblongata is called the vital center
because it controls the heart rate, blood pressure, and respirations (the vital functions).
– The vomiting center is located in the medulla oblongata; it receives input directly and indirectly from activation of the chemoreceptor trigger zone (CTZ).
Slide 30
Brain: Structure and Function - cont’d
• Cerebellum– The cerebellum is sometimes called the little
brain.– The cerebellum is concerned primarily with the
coordination of voluntary muscle activity.
Slide 31
Brain: Structure and Function - cont’d
• Structures Involving More than One Lobe– The limbic system is sometimes called the
emotional brain.– The reticular formation is concerned with the
sleep/wake cycle. It keeps us conscious and prevents us from slipping into a coma state.
– The “memory areas” handle short-term and long-term memory.
Slide 32
Protection of the CNS• Bone: cranium and vertebral column• Meninges: pia mater, arachnoid, and dura
mater• Cerebrospinal fluid (CSF) that circulates within
the subarachnoid space• Blood-brain barrier
Slide 33
Introduction• The purpose of muscle is to contract and to
cause movement.
Slide 34
Muscle Function: Overview• Types and Functions of Muscles– Skeletal muscle is striated and voluntary; its
primary function is to produce movement.– Smooth (visceral) muscle is nonstriated and
involuntary; it helps the organs perform their functions.
– Cardiac muscle is striated and involuntary; it is found only in the heart and allows the heart to function as a pump.
Slide 35
Muscle Function: Overview - cont’d
• Structure of the Whole Muscle– A large muscle consists of thousands of single
muscle fibers (muscle cells).– Connective tissue binds the muscle fibers (cells)
together (forming compartments in the limbs) and attaches muscle to bone and other tissue (by tendons and aponeuroses).
Slide 36
Muscle Function: Overview - cont’d
• Structure and Function of a Single Muscle Fiber– The muscle fiber (cell) is surrounded by a cell
membrane (sarcolemma). The cell membrane penetrates to the interior of the muscle as the transverse tubule (T tubule).
– An extensive sarcoplasmic reticulum (SR) stores calcium.
– Each muscle fiber consists of a series of sarcomeres. Each sarcomere contains the contractile proteins actin and myosin.
Slide 37
Muscle Function: Overview - cont’d
• How Muscles Contract– Muscles shorten or contract as the actin and myosin
(in the presence of calcium and ATP) interact through crossbridge formation, according to the sliding filament theory.
– For skeletal muscle to contract, it must be stimulated by a motor nerve. The nerve impulse releases acetycholine (ACh) from the nerve terminal. ACh diffuses across the neuromuscular junction (NMJ), binds to the muscle membrane and causes an electrical signal to form in the muscle membrane.
Slide 38
Muscle Function: Overview - cont’d
• How Muscles Contract—cont’d– The electrical signal enters the T-tubular system
and stimulates the SR to release calcium.– Actin, myosin, and ATP interact to form
crossbridges, which cause sliding or shortening.– Calcium is pumped back into the SR and the
muscles relax.
Slide 39
Muscle Function: Overview - cont’d
• Responses of a Whole Muscle– A single muscle fiber contracts in an all-or-nothing response; a whole
muscle can contract partially (i.e., not all-or-nothing).
– A whole muscle increases its force of contraction by recruitment of additional muscle fibers.
– Two terms describe the contractile activity of a whole muscle: twitch and tetanus. Tetanus refers to a sustained muscle contraction.
– Energy for muscle contraction can be obtained from three sources: burning fuel aerobically, burning fuel anaerobically, and metabolizing creatine phosphate.
Slide 40
Muscle Function: Overview - cont’d
• Terms That Describe Muscle Movement– Origin and Insertion: The attachments of the
muscles.– Prime mover: The muscle most responsible for the
movement achieved by the muscle group – Synergist and Antagonist: Works with, or has an
opposing action.
Slide 41
Muscles from Head to Toe• Skeletal muscles are named according to size,
shape, direction of fibers, location, number of origins, place of origin and insertion, and muscle action.
• See Table 9-1 for a list of the body’s muscles.
Slide 42
Introduction• The skeletal system supports the weight of the
body, supports and protects body organs, enables the body to move, acts as storage site for minerals, and produces blood cells.
Slide 43
Bones: An Overview• Sizes and Shapes
– Bones are classified as long, short, flat, and irregular.– Bone markings function as sites of muscle attachments and passages
for nerves and blood vessels.– A long bone has a diaphysis (shaft) and two epiphyses (ends). Articular
cartilage is found on the outer surface of the epiphyses. – The diaphysis is composed of compact or hard bone. The epiphysis
consists of spongy or soft bone; red marrow is found in the holes of spongy bone.
Slide 44
Bones: An Overview - cont’d
• Bone Formation and Growth– Bones ossify in two ways. In the skull, osteoblasts replace
thin connective tissue membrane, forming flat bones. Other bones form on hyaline cartilage models as osteoblasts replace cartilage with bone.
– Bones grow longitudinally at the epiphyseal disc, to determine height; bones also grow thicker and wider to support the weight of the body.
– Bone growth and reshaping occur throughout life and depend on many factors, including diet, exercise, and hormones.
Slide 45
Divisions of the Skeletal System• The names of the 206 bones of the skeleton
are listed in Table 8-2.
Slide 46
Divisions of the Skeletal System - cont’d
• Axial Skeleton– The axial skeleton includes the bones of the skull
(cranium and face), hyoid bone, bones of the middle ear, bones of the vertebral column, and the thoracic cage.
– The skull of a newborn contains fontanels, which are membranous areas that allow brain growth.
– The skull contains air-filled cavities called sinuses.
Slide 47
Divisions of the Skeletal System - cont’d
• Axial Skeleton—cont’d– The vertebral column is formed from 26 vertebrae,
one sacrum, and one coccyx. The vertebrae are separated by cartilaginous discs. The vertebral column of the adult has four curvatures: cervical, thoracic, lumbar, and sacral.
– The thoracic cage is a bony, cone-shaped cage formed by the sternum, 12 pairs of ribs, and thoracic vertebrae.
Slide 48
Divisions of the Skeletal System - cont’d
• Appendicular Skeleton– The appendicular skeleton includes the bones of
the extremities (arms and legs), and the bones of the hip and shoulder girdles.
– The shoulder girdle consists of the scapula and the clavicle.
– The pelvic girdle is formed by the two coxal bones and is secured to the axial skeleton at the sacrum.
Slide 49
Joints• A joint or articulation is the site where two
bones meet.
Slide 50
Joints - cont’d
• Types of Joints (based on the degree of movement)– Immovable joints. – Slightly movable joints.– Freely movable joints or synovial joints. Structures
within a synovial joint (knee): articular cartilage, the joint capsule, synovial membrane, synovial fluid, bursae, and supporting ligaments.
– The types of freely movable joints include hinge, ball and socket, pivot, gliding, saddle, and condyloid.
Slide 51
Joints - cont’d
• Joint Movement– Freely movable joints are capable of different
types of movement.– Types of movements at freely movable joints
include flexion and extension, abduction and adduction, inversion and eversion, supination and pronation, and circumduction.
Slide 52
Introduction• The integumentary system includes the skin,
which covers the body, protects the internal organs, and plays an important role in the regulation of body temperature.
Slide 53
Structures: Organs of the Integumentary System
• The integumentary system includes the skin, accessory structures, and subcutaneous tissue beneath the skin.
Slide 54
Structures: Organs of the Integumentary System - cont’d
• Skin– The skin is called the cutaneous membrane.– The skin has two layers, an outer layer called the
epidermis and an inner layer called the dermis.– The epidermis has five layers. The stratum
germinativum is the layer in which cell division takes place. The new cells produce keratin (waterproofing) and die as they are pushed toward the surface. The outer layer is the stratum corneum and consists of flattened, dead, keratinized cells.
Slide 55
Structures: Organs of the Integumentary System - cont’d
• Skin—cont’d– The dermis lies on the subcutaneous tissue.– Skin color is determined by many factors: some
genetic, some physiologic, and some due to disease. Melanin causes skin to darken. Carotene causes skin to appear yellow. The amount of blood in the skin affects skin color (e.g., flushing) as does the appearance of abnormal substances such as bilirubin (jaundice) and a low blood oxygen content (cyanosis).
Slide 56
Structures: Organs of the Integumentary System - cont’d
• Accessory Structures of the Skin– Hair is unevenly distributed over the skin. The location of the
hair determines its function. Eyebrows and eyelashes protect the eyes from dust and perspiration.
– The main parts of a hair are the shaft and root.– Hair color is determined by the amount and type of melanin.– Nails are thin plates of stratified squamous epithelial cells
that contain a hard form of keratin.– There are two major exocrine glands in the skin: sebaceous
glands and sweat glands.
Slide 57
Structures: Organs of the Integumentary System - cont’d
• Accessory Structures of the Skin—cont’d– The sebaceous glands (oil glands) secrete sebum. The
sebum lubricates hair and skin. In the fetus, these glands secrete vernix caseosa, a cheeselike substance that coats the skin of a newborn.
– The two types of sweat glands (sudoriferous glands) are the apocrine glands and the eccrine glands. The eccrine sweat glands play a crucial role in temperature regulation.
– The mammary glands (which secrete milk) and the ceruminous glands (which secrete ear wax) are modified sweat glands.
Slide 58
Structures: Organs of the Integumentary System - cont’d
• Subcutaneous Tissue– Subcutaneous tissue anchors the dermis to
underlying structures.– Subcutaneous tissue acts as an insulator; it
prevents heat loss.
Slide 59
Regulation of Body Temperature• Heat Production– Heat produced by metabolizing cells constitutes
the body temperature.– Most of the heat is produced by the muscles and
the liver.• Heat Loss– Most of the heat (80%) is lost through the skin.– Heat loss occurs through radiation, conduction,
convection, and evaporation.
Slide 60
Regulation of Body Temperature - cont’d
• Heat Loss—cont’d– Normal body temperature is set by the body’s
thermostat in the hypothalamus. – Heat is lost through sweating and vasodilation.
Heat is conserved by vasoconstriction and produced by shivering.
Slide 61
When Skin Is Burned• Physiological Effects – Short-term effects: fluid and electrolyte losses,
shock, inability to regulate body temperature, infection
– Long-term effects: scarring, loss of function, and cosmetic and emotional problems
• Classification of Burns– Classified according to the thickness of the burn
(partial, full); also first, second, and third degree.– The rule of nines is a way to evaluate burns.
Slide 62
Introduction• Tissues are groups of cells similar to each
other in structure and function. • Membranes are thin sheets of tissue that
cover surfaces, line body cavities, and surround organs.
Slide 63
Types of Tissue • Epithelial Tissue Types – Epithelial tissue covers surfaces, lines cavities, and
engages in secretion/absorption and protective functions.
– Epithelial tissue is classified according to cell shape (squamous, cuboidal, and columnar) and layers (simple and stratified).
– The types and functions are summarized in Table 6-1.
Slide 64
Types of Tissue - cont’d
• Connective Tissue– The primary function of connective tissue is to bind
together the parts of the body. Other functions include support, protection, fat storage, and transport of substances.
– Connective tissue has an abundant intercellular matrix that fills spaces between cells. The intercellular matrix may be liquid, gel-like, or hard. The matrix often contains protein fibers that are secreted by the cells.
– There are three types of loose connective tissue: areolar, adipose, and reticular.
Slide 65
Types of Tissue - cont’d
• Connective Tissue—cont’d– Dense fibrous connective tissue forms tendons, ligaments,
capsules, and fascia, and is found in the skin (dermis).– Types of cartilage include: hyaline, elastic, and
fibrocartilage.– Bone (osseous tissue) is connective tissue formed by
osteocytes. Bone cells have a hard intercellular matrix that includes collagen, calcium salts, and other minerals.
– Blood and lymph are types of connective tissue that have a watery intercellular matrix.
Slide 66
Types of Tissue - cont’d
• Nervous Tissue– Nervous tissue is found in the peripheral nerves, brain,
and spinal cord.– The two types of nervous tissue are neurons, which
transmit electrical signals, and neuroglia, which support and take care of the neurons.
• Muscle Tissue– Muscle cells contract, thereby causing movement.– The three kinds of muscle are skeletal, smooth, and
cardiac.
Slide 67
Tissue Repair• Tissue Repair by Regeneration – Replacement of tissue by cells that undergo
mitosis• Tissue Repair by Fibrosis – Formation of scar tissue
Slide 68
Membranes• Epithelial Membranes
– The cutaneous membrane is the skin.– Mucous membranes are epithelial membranes that line all body
cavities that open to the exterior of the body.– Serous membranes are epithelial membranes that line the ventral
body cavities, which are not open to the exterior of the body.– Serous membranes form two layers: a parietal layer that lines the
wall of the cavity and a visceral layer that covers the outside of an organ.
– The three serous membranes are the pleura, the pericardium, and the peritoneum.
Slide 69
Membranes - cont’d
• Connective Tissue Membranes– Synovial membranes are connective tissue
membranes.– Other connective tissue membranes are listed in
Table 6-3.