Autonomic Nervous System

• Sympathetic Nervous System


  • Thoracolumbar (T1-L3)
  • “FIGHT or FLIGHT” response
  • Emergency situation
  • Adrenergic response – “Epinephrine” predominant neurotransmitter
  • “Adrenaline rush”
  • Excitement – “Exam”
  • Exercise – increase Blood pressure, Tachycardia
  • Stress
• Parasympathetic Nervous System


  • Craniosacral division
  • Cranial Nerve (10,9,7,3)
  • CN10 – Dorsal Nerve Nucleus - innervates the Heart, Lungs, GIT (Gastrointestinal Tract)
  • Longest Cranial Nerve
  • “Rest and Digest” – sleepy and ptosis
  • CN9 – Inferior Salivatory Nucleus - Parotid Glands, Salivary Glands
  • Parotiditis – inflammations of parotid gland
  • MUMPS “BEKE”
  • CN7 – Superior Salivatory Nucleus - Sublingual Gland, Submandibular Gland
  • CN3 – Edinger Westphal Nucleus - PERRLA – Pupil Equally Round Reactive to Light Accommodation, Pupillary Light Reflex
• Sympathetic Nervous System


  • Heart Rate increase
  • Cardia Output increase
  • Stroke Volume increase
  • Force increase
  • Blood pressure increase
• Parasympathetic Nervous System


  • Heart Rate decrease
  • Peristalsis decrease
  • GIT decrease
  • ConStipation
  • GIT increase
  • Peristalsis increase
  • Digestion, gastric juice secretion
  • Pancreatic Activity
  • Salivation
• Erection is controlled by Parasympathetic Nervous System in Psychogenic situations
• iSip is controlled by the Sympathetic Nervous System
• Reflexogenic erections are controlled by Parasympathetic Nervous System
• Shoot (Ejaculation) is controlled by the Sympathetic Nervous System
• Horner’s Syndrome is associated with T1 affected root of the sympathetic fiber
• Klumpke’s palsy affects C8-T1 spinal nerves
• Triad of Horner’s Syndrome includes Ptosis, Myosis, Anhydrosis, Enophthalmos
• Spinal Nerves


  • 31 pairs
  • Cervical Spinal Nerve - 8 pairs
  • Thoracic Spinal Nerve - 12 pairs
  • Lumbar Spinal Nerve - 5 pairs
  • Sacral Spinal Nerve - 5 pairs
  • Coccygeal Spinal Nerve - 1 pair
• Male Sexual Responses are influenced by the Autonomic Nervous System
• Myotome


  A muscle or group of muscles innervated by a single root
• Upper Extremity Myotomes


  • C5 - Shoulder Abduction (deltoid, Supraspinatus, infraspinatus, teres minor), Elbow Flexion (biceps)
  • C6 - Wrist Extension (Extensor carpi radialis Longus and ECR Brevis)
• Upper Extremity


  • C5 = Shoulder Abduction (deltoid, Supraspinatus, infraspinatus, teres minor)
  • Elbow Flexion (biceps)
  • C6 = Wrist Extension (Extensor carpi radialis Longus and ECR Brevis), (Brachioradialis, Pronator teres)
  • C7 = Elbow extension (triceps), Wrist Flexion (Flexor Carpi radialis and FC Brevis), Finger Extension (Extensor digitorum communis)
  • C8 = Finger Flexion (Flexor digitorum superficialis, Flexor digiturom profundus), (Flexor pollicis longus, adductor pollicis)
  • T1 = Little Finger abduction (abductor digiti minimi) or finger interossei
• Lower Extremity


  • L2 = Hip Flexion (Iliopsoas), Hip Adduction
  • L3 = Knee extension (Quads)
  • L4 = Ankle Dorsiflexion (Tibialis Anterior)
  • L5 = Big Toe extension (Extensor hallucis Longus)
  • S1 = Toe Flexion, Ankle Plantarflexion (gastrocnemius/soleus) + Foot Eversion (Peroneus Longus and Peroneus Brevis), Knee Flexion (Hamstrings), Hip Extension (Gluteus Maximus)
• Dermatome


  • C2 = Occiput
  • C3 = Supraclavicular Fossa
  • C4 = Top of Acromioclavicular joint
  • C5 = Lateral antecubital Fossa
  • C6 = Thumb/index
  • C7 = Middle finger
  • C8 = Little finger or ring finger
  • T1 = Medial antecubital Fossa
  • T2 = Apex of axilla
  • T4 = Nipple line
  • T6 = Xiphoid process
  • T10 = Umbilicus
  • T12 = Inguinal ligaments
  • L1 = Below inguinal ligament (Groin)
  • L2 = Mid Anterior thigh
  • L3 = Medial Femoral Epicondyle
• fight and flight response

  Symphathetic