Sympathetic nervous system

The sympathetic nervous system is one of the two main 1.1

divisions of the autonomic nervous system, the other being the parasympathetic nervous system.[1][2] The autonomic nervous system functions to regulate the bodys unconscious actions. The sympathetic nervous systems primary process is to stimulate the bodys ght-or-ight response. It is, however, constantly active at a basic level to
maintain homeostasis.[3] The sympathetic nervous system
is described as being complementary to the parasympathetic nervous system which stimulates the body to restand-digest or feed and breed

Organization

The name of this system can be traced to the concept of

sympathy, in the sense of connection between parts,
rst used medically by Galen.[4] In the 18th century,
Winslow applied the term specically to nerves.[5]

Structure

There are two kinds of neurons involved in the transmission of any signal through the sympathetic system: pre-ganglionic and post-ganglionic. The shorter
preganglionic neurons originate from the thoracolumbar
region of the spinal cord (levels T1L2, specically)
and travel to a ganglion, often one of the paravertebral
ganglia, where they synapse with a postganglionic neuron. From there, the long postganglionic neurons extend
across most of the body.[6]
At the synapses within the ganglia, preganglionic neurons release acetylcholine, a neurotransmitter that activates nicotinic acetylcholine receptors on postganglionic neurons. In response to this stimulus postganglionic neuronswith two important exceptions
release norepinephrine, which activates adrenergic receptors on the peripheral target tissues. The activation of target tissue receptors causes the eects associated with the
sympathetic system.[7]

The sympathetic nervous system extends from the thoracic to lumbar vertebrae and has connections with the thoracic, abdominal,
and pelvic plexuses.

Sympathetic nerves arise from near the middle of the

spinal cord in the intermediolateral nucleus of the lateral
grey column, beginning at the rst thoracic vertebra of
the vertebral column and are thought to extend to the
second or third lumbar vertebra. Because its cells begin in the thoracic and lumbar regions of the spinal cord,
the sympathetic nervous system is said to have a thoracolumbar outow. Axons of these nerves leave the spinal
cord through the anterior root. They pass near the spinal
(sensory) ganglion, where they enter the anterior rami of
the spinal nerves. However, unlike somatic innervation,
they quickly separate out through white rami connectors
(so called from the shiny white sheaths of myelin around
each axon) that connect to either the paravertebral (which
lie near the vertebral column) or prevertebral (which lie

The two exceptions mentioned above are postganglionic

neurons of sweat glands and chroman cells of the
adrenal medulla. Postganglionic neurons of sweat glands
release acetylcholine for the activation of muscarinic receptors. Chroman cells of the adrenal medulla are analogous to post-ganglionic neurons; the adrenal medulla
develops in tandem with the sympathetic nervous system and acts as a modied sympathetic ganglion. Within
this endocrine gland, pre-ganglionic neurons synapse with
chroman cells, stimulating the chroman to release
norepinephrine and epinephrine directly into the blood.[8]
1

FUNCTION

near the aortic bifurcation) ganglia extending alongside 1.2 Information transmission
the spinal column.
To reach target organs and glands, the axons must Messages travel through the sympathetic nervous systravel long distances in the body, and, to accomplish tem in a bidirectional ow. Eerent messages can trigthis, many axons relay their message to a second cell ger changes in dierent parts of the body simultanethrough synaptic transmission. The ends of the axons ously. For example, the sympathetic nervous system
link across a space, the synapse, to the dendrites of the can accelerate heart rate; widen bronchial passages; desecond cell. The rst cell (the presynaptic cell) sends a crease motility (movement) of the large intestine; conneurotransmitter across the synaptic cleft where it acti- strict blood vessels; increase peristalsis in the esophagus;
vates the second cell (the postsynaptic cell). The message cause pupillary dilation, piloerection (goose bumps) and
perspiration (sweating); and raise blood pressure.
is then carried to the nal destination.
The rst synapse (preganglionic neuron to postganglionic
neuron) is mediated by nicotinic receptors activated by
acetylcholine (a neurotransmitter). The target synapse
of the postganglionic neuron is mediated by adrenergic
receptors and is activated by either noradrenaline (norepinephrine) or adrenaline (epinephrine). An exception is
with sweat glands, which receive sympathetic innervation
but have muscarinic acetylcholine receptors, which are
normally characteristic of the parasympathetic nervous
system. Another exception is with certain deep muscle
blood vessels, which dilate (rather than constrict) with an
The postsynaptic cell then goes on to innervate the tar- increase in sympathetic tone, this is because of the presgeted end eector (i.e. gland, smooth muscle, etc.). Be- ence of more beta2 receptors, rather than alpha1, which
cause paravertebral and prevertebral ganglia are relatively are more frequently found on other vessels.
close to the spinal cord, presynaptic neurons are generally
much shorter than their postsynaptic counterparts, which
must extend throughout the body to reach their destinations.
2 Function
Presynaptic nerves axons terminate in either the
paravertebral ganglia or prevertebral ganglia. There are
four dierent ways an axon can take before reaching its
terminal. In all cases, the axon enters the paravertebral
ganglion at the level of its originating spinal nerve. After
this, it can then either synapse in this ganglion, ascend to a
more superior or descend to a more inferior paravertebral
ganglion and synapse there, or it can descend to a prevertebral ganglion and synapse there with the postsynaptic
cell.

A notable exception to the routes mentioned above is

the sympathetic innervation of the suprarenal (adrenal)
medulla. In this case, presynaptic neurons pass through
paraverterbral ganglia, on through prevertebral ganglia
and then synapse directly with suprarenal tissue. This tissue consists of cells that have pseudo-neuron like qualities
in that when activated by the presynaptic neuron, they will
release their neurotransmitter (epinephrine) directly into
the blood stream.
In the sympathetic nervous system and other components of the peripheral nervous system, these synapses
are made at sites called ganglia. The cell that sends its
ber is called a preganglionic cell, while the cell whose
ber leaves the ganglion is called a postganglionic cell.
As mentioned previously, the preganglionic cells of the
sympathetic nervous system are located between the rst
thoracic segment and third lumbar segments of the spinal
cord. Postganglionic cells have their cell bodies in the
ganglia and send their axons to target organs or glands.
The ganglia include not just the sympathetic trunks but
also the cervical ganglia (superior, middle and inferior),
which sends sympathetic nerve bers to the head and thorax organs, and the celiac and mesenteric ganglia (which
send sympathetic bers to the gut).

The sympathetic nervous system is responsible for upand down-regulating in many homeostatic mechanisms in
living organisms. Fibers from the SN innervate tissues in
almost every organ system, providing at least some regulatory function to things as diverse as pupil diameter, gut
motility, and urinary system output and function.[12] It is
perhaps best known for mediating the neuronal and hormonal stress response commonly known as the ght-oright response. This response is also known as sympathoadrenal response of the body, as the preganglionic sympathetic bers that end in the adrenal medulla (but also all
other sympathetic bers) secrete acetylcholine, which activates the great secretion of adrenaline (epinephrine) and
to a lesser extent noradrenaline (norepinephrine) from
it. Therefore, this response that acts primarily on the
cardiovascular system is mediated directly via impulses
transmitted through the sympathetic nervous system and
indirectly via catecholamines secreted from the adrenal
medulla.
Some evolutionary theorists suggest that the sympathetic
nervous system operated in early organisms to maintain
survival as the sympathetic nervous system is responsible
for priming the body for action.[13] One example of this
priming is in the moments before waking, in which sympathetic outow spontaneously increases in preparation
for action.
Sympathetic nervous system stimulation causes vasocon-

3
striction of most blood vessels, including many of those
in the skin, the digestive tract, and the kidneys. This occurs as a result of activation of alpha-1 adrenergic receptors by norepinephrine released by post-ganglionic sympathetic neurons. These receptors exist throughout the
vasculature of the body but are inhibited and counterbalanced by beta-2 adrenergic receptors (stimulated by
epinephrine release from the adrenal glands) in the skeletal muscles, the heart, the lungs, and the brain during a
sympatho-adrenal response. The net eect of this is a
shunting of blood away from the organs not necessary to
the immediate survival of the organism and an increase
in blood ow to those organs involved in intense physical
activity.

2.1

Sensation

The aerent bers of the autonomic nervous system,

which transmit sensory information from the internal organs of the body back to the central nervous system (or
CNS), are not divided into parasympathetic and sympathetic bers as the eerent bers are.[14] Instead, autonomic sensory information is conducted by general visceral aerent bers.
General visceral aerent sensations are mostly unconscious visceral motor reex sensations from hollow organs and glands that are transmitted to the CNS. While
the unconscious reex arcs normally are undetectable, in
certain instances they may send pain sensations to the
CNS masked as referred pain. If the peritoneal cavity becomes inamed or if the bowel is suddenly distended, the
body will interpret the aerent pain stimulus as somatic
in origin. This pain is usually non-localized. The pain is
also usually referred to dermatomes that are at the same
spinal nerve level as the visceral aerent synapse.

2.2

Relationship with the parasympathetic

nervous system

4 See also
Epinephrine
History of catecholamine research
Norepinephrine
Sympathetic ganglia
Sympathetic trunk

5 References
[1] Dorlands (2012). Dorlands Illustrated Medical Dictionary (32nd ed.). Elsevier Saunders. p. 1862. ISBN 9781-4160-6257-8.
[2] Pocock, G and Richards, C (2006). Human Physiology
The Basis of Medicine (Third ed.). Oxford University
Press. p. 63. ISBN 978-0-19-856878-0.
[3] Brodal, Per (2004). The Central Nervous System: Structure
and Function (3 ed.). Oxford University Press US. pp.
369396. ISBN 0-19-516560-8.
[4] Sympathy, Sympathetic. Evolution of a Concept and Relevance to Current Understanding of Autonomic Disorders
(2013)
[5] Olry, R. (1996). Winslows contribution to our understanding of the cervical portion of the sympathetic
nervous system.
J Hist Neurosci 5 (2): 1906.
doi:10.1080/09647049609525666. PMID 11619046.
[6] Drake, Richard L.; Vogl, Wayne; Mitchell, Adam W.M.,
eds. (2005). Grays Anatomy for Students (1 ed.). Elsevier. pp. 7684. ISBN 0-443-06612-4.
[7] Rang, H.P.; Dale, M.M.; Ritter, J.M.; Flower, R.J.
(2007). Rang and Dales Pharmacology (6 ed.). Elsevier.
p. 135. ISBN 0-443-06911-5.
[8] Silverthorn, Dee Unglaub (2009). Human Physiology:
An Integrated Approach (4 ed.). Pearson/Benjamin Cummings. pp. 379386. ISBN 0-321-54130-8.

Together with the other component of the autonomic nervous system, the parasympathetic nervous system, the
sympathetic nervous system aids in the control of most [9] Unless specied otherwise in the boxes, the source is:
of the bodys internal organs. Reaction to stress as
Moore, Keith L.; Agur, A. M. R. (2002). Essential Clinin the ight-or-ght response is thought to counterical Anatomy (2nd ed.). Lippincott Williams & Wilkins.
act the parasympathetic system, which generally works to
p. 199. ISBN 978-0-7817-5940-3.
promote maintenance of the body at rest. The comprehensive functions of both the parasympathetic and sym- [10] Berger, Michael P. Hlastala; Albert J. (2001). Physiology
of respiration (2. ed. ed.). Oxford [u.a.]: Oxford Univ.
pathetic nervous systems are not so straightforward, but
Press. p. 177. ISBN 0195138465.
[3][15]
this is a useful rule of thumb.

Clinical signicance

Sympathicotonia is a stimulated[16] condition of the sympathetic nervous system, marked by vascular spasm,[17]
elevated blood pressure,[17] and goose bumps.[17]

[11] Jnig, Wilfrid (2006). The integrative action of the autonomic nervous system : neurobiology of homeostasis.
Cambridge: UK. pp. 132135. ISBN 9780521845182.
[12] Moro, C; Tajouri, L; Chess-Williams, R (January 2013).
Adrenoceptor function and expression in bladder urothelium and lamina propria. Urology. 81 (1): 211.e17.
doi:10.1016/j.urology.2012.09.011. PMID 23200975.

[13] Robert Ornstein (1992). The Evolution of Consciousness:

of Darwin, Freud, and Cranial Fire: The Origins of the
Way We Think. New York: Simon & Schuster. ISBN
0-671-79224-5.
[14] Moore, K.L., & Agur, A.M. (2007). Essential Clinical
Anatomy: Third Edition. Baltimore: Lippincott Williams
& Wilkins. 34-35. ISBN 978-0-7817-6274-8
[15] Sherwood, Lauralee (2008). Human Physiology: From
Cells to Systems (7 ed.). Cengage Learning. p. 240. ISBN
0-495-39184-0.
[16] thefreedictionary.com Citing: Dorlands Medical Dictionary for Health Consumers. 2007
[17] thefreedictionary.com Citing: The American Heritage
Medical Dictionary Copyright 2007

REFERENCES

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