Medical Physiology, 3rd Edition

CHAPTER 14. The Autonomic Nervous System

George B. Richerson

When we are awake, we are constantly aware of sensory input from our external environment, and we consciously plan how to react to it. When we are asleep, the nervous system has a variety of mechanisms to dissociate cortical function from sensory input and somatic motor output. Among these mechanisms are closing the eyes, blocking the transmission of sensory impulses to the cortex as they pass through the thalamus, and effecting a nearly complete paralysis of skeletal muscles during rapid eye movement (REM) sleep to keep us from physically acting out our dreams.

The conscious and discontinuous nature of cortical brain function stands in sharp contrast to that of those parts of the nervous system responsible for control of our internal environment. These “autonomic” processes never stop attending to the wide range of metabolic, cardiopulmonary, and other visceral requirements of our body. Autonomic control continues whether we are awake and attentive, preoccupied with other activities, or asleep. While we are awake, we are unaware of most visceral sensory input, and we avoid any conscious effort to act on it unless it induces distress. In most cases, we have no awareness of motor commands to the viscera, and most individuals can exert voluntary control over visceral motor output in only minor ways. Consciousness and memory are frequently considered the most important functions of the human nervous system, but it is the visceral control system—including the autonomic nervous system (ANS)—that makes life and higher cortical function possible.

We have a greater understanding of the physiology of the ANS than of many other parts of the nervous system, largely because it is reasonably easy to isolate peripheral neurons and to study them. As a result of its accessibility, the ANS has served as a key model system for the elucidation of many principles of neuronal and synaptic function.

Organization of the Visceral Control System

Synaptic Physiology of the Autonomic Nervous System

Central Nervous System Control of the Viscera