The Autonomic Nervous System Overview • Primary Function
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The Baseline Structure of the Enteric Nervous System and Its Role in Parkinson’S Disease
life Review The Baseline Structure of the Enteric Nervous System and Its Role in Parkinson’s Disease Gianfranco Natale 1,2,* , Larisa Ryskalin 1 , Gabriele Morucci 1 , Gloria Lazzeri 1, Alessandro Frati 3,4 and Francesco Fornai 1,4 1 Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, 56126 Pisa, Italy; [email protected] (L.R.); [email protected] (G.M.); [email protected] (G.L.); [email protected] (F.F.) 2 Museum of Human Anatomy “Filippo Civinini”, University of Pisa, 56126 Pisa, Italy 3 Neurosurgery Division, Human Neurosciences Department, Sapienza University of Rome, 00135 Rome, Italy; [email protected] 4 Istituto di Ricovero e Cura a Carattere Scientifico (I.R.C.C.S.) Neuromed, 86077 Pozzilli, Italy * Correspondence: [email protected] Abstract: The gastrointestinal (GI) tract is provided with a peculiar nervous network, known as the enteric nervous system (ENS), which is dedicated to the fine control of digestive functions. This forms a complex network, which includes several types of neurons, as well as glial cells. Despite extensive studies, a comprehensive classification of these neurons is still lacking. The complexity of ENS is magnified by a multiple control of the central nervous system, and bidirectional communication between various central nervous areas and the gut occurs. This lends substance to the complexity of the microbiota–gut–brain axis, which represents the network governing homeostasis through nervous, endocrine, immune, and metabolic pathways. The present manuscript is dedicated to Citation: Natale, G.; Ryskalin, L.; identifying various neuronal cytotypes belonging to ENS in baseline conditions. -
What Is the Autonomic Nervous System?
J Neurol Neurosurg Psychiatry: first published as 10.1136/jnnp.74.suppl_3.iii31 on 21 August 2003. Downloaded from AUTONOMIC DISEASES: CLINICAL FEATURES AND LABORATORY EVALUATION *iii31 Christopher J Mathias J Neurol Neurosurg Psychiatry 2003;74(Suppl III):iii31–iii41 he autonomic nervous system has a craniosacral parasympathetic and a thoracolumbar sym- pathetic pathway (fig 1) and supplies every organ in the body. It influences localised organ Tfunction and also integrated processes that control vital functions such as arterial blood pres- sure and body temperature. There are specific neurotransmitters in each system that influence ganglionic and post-ganglionic function (fig 2). The symptoms and signs of autonomic disease cover a wide spectrum (table 1) that vary depending upon the aetiology (tables 2 and 3). In some they are localised (table 4). Autonomic dis- ease can result in underactivity or overactivity. Sympathetic adrenergic failure causes orthostatic (postural) hypotension and in the male ejaculatory failure, while sympathetic cholinergic failure results in anhidrosis; parasympathetic failure causes dilated pupils, a fixed heart rate, a sluggish urinary bladder, an atonic large bowel and, in the male, erectile failure. With autonomic hyperac- tivity, the reverse occurs. In some disorders, particularly in neurally mediated syncope, there may be a combination of effects, with bradycardia caused by parasympathetic activity and hypotension resulting from withdrawal of sympathetic activity. The history is of particular importance in the consideration and recognition of autonomic disease, and in separating dysfunction that may result from non-autonomic disorders. CLINICAL FEATURES c copyright. General aspects Autonomic disease may present at any age group; at birth in familial dysautonomia (Riley-Day syndrome), in teenage years in vasovagal syncope, and between the ages of 30–50 years in familial amyloid polyneuropathy (FAP). -
The Neuroanatomy of Female Pelvic Pain
Chapter 2 The Neuroanatomy of Female Pelvic Pain Frank H. Willard and Mark D. Schuenke Introduction The female pelvis is innervated through primary afferent fi bers that course in nerves related to both the somatic and autonomic nervous systems. The somatic pelvis includes the bony pelvis, its ligaments, and its surrounding skeletal muscle of the urogenital and anal triangles, whereas the visceral pelvis includes the endopelvic fascial lining of the levator ani and the organ systems that it surrounds such as the rectum, reproductive organs, and urinary bladder. Uncovering the origin of pelvic pain patterns created by the convergence of these two separate primary afferent fi ber systems – somatic and visceral – on common neuronal circuitry in the sacral and thoracolumbar spinal cord can be a very dif fi cult process. Diagnosing these blended somatovisceral pelvic pain patterns in the female is further complicated by the strong descending signals from the cerebrum and brainstem to the dorsal horn neurons that can signi fi cantly modulate the perception of pain. These descending systems are themselves signi fi cantly in fl uenced by both the physiological (such as hormonal) and psychological (such as emotional) states of the individual further distorting the intensity, quality, and localization of pain from the pelvis. The interpretation of pelvic pain patterns requires a sound knowledge of the innervation of somatic and visceral pelvic structures coupled with an understand- ing of the interactions occurring in the dorsal horn of the lower spinal cord as well as in the brainstem and forebrain. This review will examine the somatic and vis- ceral innervation of the major structures and organ systems in and around the female pelvis. -
Brainstem Dysfunction in Critically Ill Patients
Benghanem et al. Critical Care (2020) 24:5 https://doi.org/10.1186/s13054-019-2718-9 REVIEW Open Access Brainstem dysfunction in critically ill patients Sarah Benghanem1,2 , Aurélien Mazeraud3,4, Eric Azabou5, Vibol Chhor6, Cassia Righy Shinotsuka7,8, Jan Claassen9, Benjamin Rohaut1,9,10† and Tarek Sharshar3,4*† Abstract The brainstem conveys sensory and motor inputs between the spinal cord and the brain, and contains nuclei of the cranial nerves. It controls the sleep-wake cycle and vital functions via the ascending reticular activating system and the autonomic nuclei, respectively. Brainstem dysfunction may lead to sensory and motor deficits, cranial nerve palsies, impairment of consciousness, dysautonomia, and respiratory failure. The brainstem is prone to various primary and secondary insults, resulting in acute or chronic dysfunction. Of particular importance for characterizing brainstem dysfunction and identifying the underlying etiology are a detailed clinical examination, MRI, neurophysiologic tests such as brainstem auditory evoked potentials, and an analysis of the cerebrospinal fluid. Detection of brainstem dysfunction is challenging but of utmost importance in comatose and deeply sedated patients both to guide therapy and to support outcome prediction. In the present review, we summarize the neuroanatomy, clinical syndromes, and diagnostic techniques of critical illness-associated brainstem dysfunction for the critical care setting. Keywords: Brainstem dysfunction, Brain injured patients, Intensive care unit, Sedation, Brainstem -
The Autonomic Nervous System and Gastrointestinal Tract Disorders
NEUROMODULATION THE AUTONOMIC NERVOUS SYSTEM AND GASTROINTESTINALTRACT DISORDERS TERRY L. POWLEY, PH.D. PURDUE UNIVERSITY • MULTIPLE REFRACTORY GI DISORDERS EXIST. • VISCERAL ATLASES OF THE GI TRACT ARE AVAILABLE. • REMEDIATION WITH ELECTROMODULATION MAY BE PRACTICAL. TERRY l. POWLEY, PH.D. PURDUE NEUROMODUlATION: THE AUTONOMIC NERVOUS SYSTEM AND GASTP.OINTESTINAL TRACT DISORDERS UNIVERSITY 50 INTERNATIONAL I:"' NEUROMODULATION SOCIETY 0 40 ·IS 12TH WORLD CONGRESS -I: -• 30 !"' A. -..0 20 ..a• E 10 z::::t TERRY l. POWLEY, PH.D. PURDUE NEUROMODUlATION: THE AUTONOMIC NERVOUS SYSTEM AND GASTP.OINTESTINAL TRACT DISORDERS UNIVERSITY DISORDERS TO TREAT WITH NEUROMODULATION ACHALASIA DYSPHAGIA GASTROPARESIS GERD GUT DYSMOTILITY MEGA ESOPHAGUS DYSPEPSIA ,, VISCERAL PAIN l1 ' I NAUSEA, EMESIS OBESITY ,, ' 11 I PYLORIC STENOSIS ==..:.= --- "" .:.= --- .. _ _, DUMPING REFLUX COLITIS I:' . - IBS -·-- - CROHN'S DISEASE HIRSCHSPRUNG DISEASE CHAGAS DISUSE Gastrointestinal Tract Awodesk@ Ma;·a@ TERRY l. POWLEY, PH.D. PURDUE NEUROMODUlATION: THE AUTONOMIC NERVOUS SYSTEM AND GASTP.OINTESTINAL TRACT DISORDERS UNIVERSITY TIME The Obesity Epidemic in America ·. TERRY l. POWLEY, PH.D. PURDUE NEU ROMODUlATION : THE AUTO N OMIC NERVOUS SYSTEM A N D G A STP.OINTESTINAL TRACT DISORDERS UNI V E R SI TY ROUX-EN-Y BYPASS Bypassed portion of stomach Gastric -"'~ pouch Bypassed - Jejunum duodenum -1" food -___----_,,.,. digestivejuice TERRY l. POWLEY, PH.D. PURDUE NEU ROMODUlATION: THE AUTONOMIC NERVOUS SYSTEM A N D GASTP.OINTESTINAL TRACT DISORDERS UNIVERSITY 8y~s~ portionof i t()(l\3Ch • TERRYl. POWLEY, PH.D. PURDUE NEUROMOOUlATION: THE AUTONOMIC NERVOUS SYSTEM ANO 0.-STP.OINTESTINAL TRACT DISORDERS UHIVlflSITY • DESPERATE PATIENTS • ABSENCE OF SATISFACTORY PHARMACOLOGICAL TREATMENTS • POPULAR MEDIA HYPE • ABSENCE OF A SOLID MECHANISTIC UNDERSTANDING • UNCRITICAL ACCEPTANCE OF PROPONENT'S CLAIMS • MYOPIA REGARDING SIDE EFFECTS TERRY l. -
Biology 251 Fall 2015 1 TOPIC 6: CENTRAL NERVOUS SYSTEM I
Biology 251 Fall 2015 TOPIC 6: CENTRAL NERVOUS SYSTEM I. Introduction to the Nervous System A. Objective: We’ve discussed mechanisms of how electrical signals are transmitted within a neuron (Topic 4), and how they are transmitted from neuron to neuron (Topic 5). For the next 3 Topics, we will discuss how neurons are organized into functioning units that allow you to think, walk, smell, feel pain, etc. B. Organization of nervous system. Note that this is a subdivision of a single integrated system, based on differences in structure, function and location (Fig 7.1). Such a subdivision allows easier analysis and understanding than trying to comprehend the system as a whole. 1. Central Nervous System (integrates and issues information) a) brain b) spinal cord 2. Peripheral Nervous System a) Afferent Division (sends information to CNS) b) Efferent Division (receives information from CNS) (1) Somatic nervous system (2) Autonomic nervous system (a) Sympathetic nervous system (b) Parasympathetic nervous system C. Three classes of neurons (Fig 7.4) 1. afferent neurons a) have sensory receptors b) axon terminals in CNS c) send information to CNS from body 2. efferent neurons a) cell body in CNS b) axon terminals in effector organ c) send information from CNS to body 3. interneurons a) lie within CNS b) some connect afferent neurons and efferent neurons (1) integrate peripheral responses and peripheral information c) some connect other interneurons (1) responsible for activity of the “mind”, i.e., thoughts, emotions, motivation, etc. d) 99% of all neurons are interneurons II. The Brain: Gross Structure and Associated Functions (Fig 9.11) A. -
Autonomic Nervous System
Editing file Lecture 4: AUTONOMIC NERVOUS SYSTEM • Red : important • Pink : in girls slides only • Blue : in male slides only • Green : notes, Extra Objectives At the end of the lecture, students should be able to: ❖ Define the autonomic nervous system. ❖ Describe the structure of autonomic nervous system ❖ Trace the preganglionic & postganglionic neurons in both sympathetic & parasympathetic nervous system. ❖ Enumerate in brief the main effects of sympathetic & parasympathetic system Autonomic Nervous System The autonomic nervous system is concerned with the Autonomic nervous system: Nerve cells innervation and control of Involuntary structures such as located in both central & visceral organs, smooth muscles, cardiac muscles and glands. peripheral nervous system Skeletal muscles are controlled by somatic motor Difference between somatic and visceral motor: ● Somatic motor ● Function: Maintaining the homeostasis Fibers from Anterior horn cell —-> to target of the internal environment along with ● Visceral motor Regulation: (Controlled) the endocrine system. 1-Brain: from nuclei by the Hypothalamus 2- spinal cord: lateral horn cell Note: Hypothalamus controls ﺗﻌدي ﻋﻠﻰ . Ganglion ﻗﺑل ﺗوﺻل ﻟﻠـ Location: Central nervous system and Target ● both of Autonomic system + peripheral nervous system Endocrine system. Autonomic Nervous System Unlike the somatic nervous system, the Efferent pathway of the autonomic nervous system is made up of Preganglionic Neuron two neurons called as: Preganglionic Postganglionic The cell bodies are The cell bodies are Postganglionic Neuron located in the brain located in the and spinal cord autonomic ganglia (inside CNS ). (outside CNS). Preganglionic axons synapse with the postganglionic neurons Note: before the fibers reach the target, it should first pass by the autonomic ganglion and synapse ( interconnection). -
Review of Sympathetic Blocks Anatomy, Sonoanatomy, Evidence, and Techniques
CHRONIC AND INTERVENTIONAL PAIN REVIEW ARTICLE Review of Sympathetic Blocks Anatomy, Sonoanatomy, Evidence, and Techniques Samir Baig, MD,* Jee Youn Moon, MD, PhD,† and Hariharan Shankar, MBBS*‡ Search Strategy Abstract: The autonomic nervous system is composed of the sympa- thetic and parasympathetic nervous systems. The sympathetic nervous sys- We performed a PubMed and MEDLINE search of all arti- tem is implicated in situations involving emergent action by the body and cles published in English from the years 1916 to 2015 using the “ ”“ ”“ additionally plays a role in mediating pain states and pathologies in the key words ultrasound, ultrasound guided, sympathetic block- ”“ ”“ body. Painful conditions thought to have a sympathetically mediated com- ade, sympathetically mediated pain, stellate ganglion block- ”“ ” “ ” ponent may respond to blockade of the corresponding sympathetic fibers. ade, celiac plexus blockade, , lumbar sympathetic blockade, “ ” “ ” The paravertebral sympathetic chain has been targeted for various painful hypogastric plexus blockade, and ganglion impar blockade. conditions. Although initially injected using landmark-based techniques, In order to capture the breadth of available evidence, because there fluoroscopy and more recently ultrasound imaging have allowed greater were only a few controlled trials, case reports were also included. visualization and facilitated injections of these structures. In addition to There were an insufficient number of reports to perform a system- treating painful conditions, sympathetic blockade has been used to improve atic review. Hence, we elected to perform a narrative review. perfusion, treat angina, and even suppress posttraumatic stress disorder symptoms. This review explores the anatomy, sonoanatomy, and evidence DISCUSSION supporting these injections and focuses on ultrasound-guided/assisted tech- nique for the performance of these blocks. -
Sympathetic Tales: Subdivisons of the Autonomic Nervous System and the Impact of Developmental Studies Uwe Ernsberger* and Hermann Rohrer
Ernsberger and Rohrer Neural Development (2018) 13:20 https://doi.org/10.1186/s13064-018-0117-6 REVIEW Open Access Sympathetic tales: subdivisons of the autonomic nervous system and the impact of developmental studies Uwe Ernsberger* and Hermann Rohrer Abstract Remarkable progress in a range of biomedical disciplines has promoted the understanding of the cellular components of the autonomic nervous system and their differentiation during development to a critical level. Characterization of the gene expression fingerprints of individual neurons and identification of the key regulators of autonomic neuron differentiation enables us to comprehend the development of different sets of autonomic neurons. Their individual functional properties emerge as a consequence of differential gene expression initiated by the action of specific developmental regulators. In this review, we delineate the anatomical and physiological observations that led to the subdivision into sympathetic and parasympathetic domains and analyze how the recent molecular insights melt into and challenge the classical description of the autonomic nervous system. Keywords: Sympathetic, Parasympathetic, Transcription factor, Preganglionic, Postganglionic, Autonomic nervous system, Sacral, Pelvic ganglion, Heart Background interplay of nervous and hormonal control in particular The “great sympathetic”... “was the principal means of mediated by the sympathetic nervous system and the ad- bringing about the sympathies of the body”. With these renal gland in adapting the internal -
Neuron-Satellite Glial Cell Interactions in Sympathetic Nervous System Development
NEURON-SATELLITE GLIAL CELL INTERACTIONS IN SYMPATHETIC NERVOUS SYSTEM DEVELOPMENT by Erica D. Boehm A dissertation submitted to the Johns Hopkins University in conformity with the requirements for the degree of Doctor of Philosophy Baltimore, Maryland July 2020 © 2020 Erica Boehm All rights reserved. ABSTRACT Glial cells play crucial roles in maintaining the stability and structure of the nervous system. Satellite glial cells are a loosely defined population of glial cells that ensheathe neuronal cell bodies, dendrites, and synapses of the peripheral nervous system (Elfvin and Forsman 1978; Pannese 1981). Satellite glial cells are closely juxtaposed to peripheral neurons with only 20nm of space between their membranes (Dixon 1969). This close association suggests a tight coupling between the cells to allow for possible exchange of important nutrients, yet very little is known about satellite glial cell function and development. How neurons and glial cells co-develop to create this tightly knit unit remains undefined, as well as the functional consequences of disrupting these contacts. Satellite glial cells are derived from the same population of cells that give rise to peripheral neurons, but do not begin differentiation and proliferation until neurogenesis has been completed (Hall and Landis 1992). A key signaling pathway involved in glial specification is the Delta/Notch signaling pathway (Tsarovina et al. 2008). However, recent studies also implicate Notch signaling in the maturation of glia through non- canonical Notch ligands such as Delta/Notch-like EGF-related Receptor (DNER) (Eiraku et al. 2005). Interestingly, it has been reported that levels of DNER in sympathetic neurons may be dependent on the target-derived growth factor, nerve growth factor (NGF), and this signal is prominent in sympathetic neurons at the time in which satellite glial cells are developing (Deppmann et al. -
Anatomy Review: Digestive System
THE DIGESTIVE SYSTEM Topic 2: Control of the Digestive System Graphics are used with permission of: Pearson Education Inc., publishing as Benjamin Cummings (http://www.aw-bc.com) Page 1: Title Page • The autonomic nervous system, hormones, and other chemicals control motility and secretion of the digestive system. The Autonomic Nervous System Parasympathetic Sympathetic Page 2: Goals • To list the phases of GI control • To describe the interaction between the enteric and autonomic nervous systems • To discuss short and long reflexes. • To list the hormones that control digestion and describe the function of each hormone. Page 3: Control of the GI tract depends on the location of food • The sight, smell, taste, and mental images of food trigger the cephalic phase of digestion via the vagus nerve (N X) which includes: o salivation o gastric juice production o gastric contractions • Increased volume of food in the stomach and subsequent stimulation of stomach stretch receptors triggers the gastric phase of digestion which includes: o gastric juice production o increased gastric motility • As food moves into the small intestine (duodenum), the chemical composition and volume of that food triggers specific reflexes during the intestinal phase of digestion which may include: o pancreatic secretion of bicarbonate into the duodenum o pancreatic secretion of digestive enzymes into the duodenum o gall bladder release of bile into the duodenum o segmentation contractions of the small intestine • The small intestine reflexively slows gastric emptying to allow for neutralizing, enzymatic digestion, and absorption of its contents Page 4: Parasympathetic and sympathetic nerves innervate the GI tract • Both parasympathetic and sympathetic divisions of the autonomic nervous system control digestion by contacting the enteric nervous system in the wall of the digestive tract • The parasympathetic division typically stimulates digestion while the sympathetic division typically inhibits it. -
The Intrinsic Cardiac Nervous System and Its Role in Cardiac Pacemaking and Conduction
Journal of Cardiovascular Development and Disease Review The Intrinsic Cardiac Nervous System and Its Role in Cardiac Pacemaking and Conduction Laura Fedele * and Thomas Brand * Developmental Dynamics, National Heart and Lung Institute (NHLI), Imperial College, London W12 0NN, UK * Correspondence: [email protected] (L.F.); [email protected] (T.B.); Tel.: +44-(0)-207-594-6531 (L.F.); +44-(0)-207-594-8744 (T.B.) Received: 17 August 2020; Accepted: 20 November 2020; Published: 24 November 2020 Abstract: The cardiac autonomic nervous system (CANS) plays a key role for the regulation of cardiac activity with its dysregulation being involved in various heart diseases, such as cardiac arrhythmias. The CANS comprises the extrinsic and intrinsic innervation of the heart. The intrinsic cardiac nervous system (ICNS) includes the network of the intracardiac ganglia and interconnecting neurons. The cardiac ganglia contribute to the tight modulation of cardiac electrophysiology, working as a local hub integrating the inputs of the extrinsic innervation and the ICNS. A better understanding of the role of the ICNS for the modulation of the cardiac conduction system will be crucial for targeted therapies of various arrhythmias. We describe the embryonic development, anatomy, and physiology of the ICNS. By correlating the topography of the intracardiac neurons with what is known regarding their biophysical and neurochemical properties, we outline their physiological role in the control of pacemaker activity of the sinoatrial and atrioventricular nodes. We conclude by highlighting cardiac disorders with a putative involvement of the ICNS and outline open questions that need to be addressed in order to better understand the physiology and pathophysiology of the ICNS.