Neuromuscular control of motion
J. Gordon Betts; James A. Wise; Kelly A. Young; Eddie Johnson; Brandon Poe; Dean H. Kruse; Oksana Korol; Jody E. Johnson; Mark Womble; and Peter DeSaix
Learning Objectives
By the end of this section, you will be able to:
- Describe the structures found in the PNS
- Distinguish between somatic and autonomic structures, including the special peripheral structures of the enteric nervous system
- Name the twelve cranial nerves and explain the functions associated with each
- Describe the sensory and motor components of spinal nerves and the plexuses that they pass through
The peripheral nervous system (PNS) is defined as nervous tissue that is outside the CNS. In describing the anatomy of the PNS, it is necessary to describe the common structures, the nerves and the ganglia, as they are found in various parts of the body. Many of the neural structures in the periphery are features of the digestive system; these structures are known as the enteric nervous system and are a special subset of the PNS.
Ganglia
A ganglion is a group of neuron cell bodies in the periphery. Remember the clusters of neuron cell bodies in the CNS called nuclei that we learned about previously? These are similar, but when they are found outside the CNS they are referred to as ganglia. Ganglia can be categorized, for the most part, as either sensory ganglia or autonomic ganglia, referring to their primary functions. The most common type of sensory ganglion is a dorsal (posterior) root ganglion. These ganglia are the cell bodies of neurons within the dorsal root of a spinal nerve. They function as specialized sensors in the periphery, such as in the skin, and that extend into the CNS through the dorsal nerve root. Under microscopic inspection, it can be seen to include the cell bodies of the neurons, as well as bundles of fibers that are the posterior nerve root (Figure 12.28). Also, the small round nuclei of satellite cells can be seen surrounding—as if they were orbiting—the neuron cell bodies.
Another type of sensory ganglion is a cranial nerve ganglion. This is analogous to the dorsal root ganglion, except that it is associated with a cranial nerve instead of a spinal nerve. The roots of cranial nerves are within the cranium, whereas the ganglia are outside the skull. For example, the trigeminal ganglion contains the cell bodies of neurons attached to the mid-pons region of the brain stem. We’ll learn more about cranial nerves later on in this chapter.
The other major category of ganglia are those of the autonomic nervous system, which is divided into the sympathetic and parasympathetic nervous systems. The autonomic nervous system controls many different bodily processes and aims to maintain homeostasis, which is a state of relative internal stability despite changing environments. For example, the autonomic nervous system controls and regulates blood pressure, heart rate, pupil size, and bladder function. It does this involuntarily, meaning that we have very little to no awareness or control over these functions*. The two divisions of the autonomic nervous system, the sympathetic and parasympathetic systems, generally have opposing functions. The sympathetic system is known as our “fight or flight” response and controls the body’s response to stressful situations. For example, if you are giving a speech in front of a crowd, your sympathetic nervous system may cause your blood pressure and heart rate to rise. On the other hand, the parasympathetic nervous system controls our “rest and digest” functions, for example aiding in digestion while we are resting.
The conduction system of the ANS consists of two neurons which synapse at a ganglion. The preganglionic neuron begins at the lateral horn of the gray matter within the spinal cord or in various nuclei within brainstem. It projects to a ganglion where it synapses with the postganglionic neuron, which then innervates the target tissue. The sympathetic ganglia form a chain that is located on either side of the vertebral column in the the thoracic and upper lumbar spinal cord regions.
The parasympathetic ganglia receive input from cranial nerves in the brainstem or sacral spinal nerves. Unlike sympathetic ganglia, which are located near the spinal cord, parasympathetic ganglia are usually located within or in very close proximity to the tissues they innervate. This means that their preganglionic neurons are generally much longer than those in the sympathetic nervous system. These two sets of ganglia, sympathetic and parasympathetic, often project to the same organs to regulate the overall function in an opposing fashion. For example, the heart receives two inputs such as these; one increases heart rate (sympathetic nervous system), and the other decreases it (parasympathetic nervous system). See Figure 12.30 for an overview of the structure and function of the autonomic nervous system.
Figure 12.30 Used under creative commons license. Original author Nursing Pharmacology by Open Resources for Nursing (Open RN)
Nerves
Bundles of axons in the PNS are referred to as nerves. These structures in the periphery are different than the central counterpart, called a tract. Nerves are composed of more than just nervous tissue. They have connective tissues invested in their structure, as well as blood vessels supplying the tissues with nourishment. The outer surface of a nerve is a surrounding layer of fibrous connective tissue called the epineurium. Within the nerve, axons are further bundled into fascicles, which are each surrounded by their own layer of fibrous connective tissue called perineurium. Finally, individual axons are surrounded by loose connective tissue called the endoneurium (Figure 12.31). These three layers are similar to the connective tissue sheaths for muscles. Nerves are associated with the region of the CNS to which they are connected, either as cranial nerves connected to the brain or spinal nerves connected to the spinal cord.
Cranial Nerves
The nerves attached to the brain are the cranial nerves, which are primarily responsible for the sensory and motor functions of the head and neck (one of these nerves targets organs in the thoracic and abdominal cavities as part of the parasympathetic nervous system). There are twelve cranial nerves, which are designated CNI through CNXII for “Cranial Nerve,” using Roman numerals for 1 through 12. They can be classified as sensory nerves, motor nerves, or a combination of both, meaning that the axons in these nerves originate out of sensory ganglia external to the cranium or motor nuclei within the brain stem. Sensory axons enter the brain to synapse in a nucleus. Motor axons connect to skeletal muscles of the head or neck. Three of the nerves are solely composed of sensory fibers; five are strictly motor; and the remaining four are mixed nerves.
Learning the cranial nerves is a tradition in anatomy courses, and students have always used mnemonic devices to remember the nerve names. A traditional mnemonic is the rhyming couplet, “On Old Olympus’ Towering Tops/A Finn And German Viewed Some Hops,” in which the initial letter of each word corresponds to the initial letter in the name of each nerve. The names of the nerves have changed over the years to reflect current usage and more accurate naming. An exercise to help learn this sort of information is to generate a mnemonic using words that have personal significance. The names of the cranial nerves are listed in Table 12.3 along with a brief description of their function, their source (sensory ganglion or motor nucleus), and their target (sensory nucleus or skeletal muscle).
The olfactory nerve and optic nerve are responsible for the sense of smell and vision, respectively. The oculomotor nerve is responsible for eye movements by controlling four of the extraocular muscles. It is also responsible for lifting the upper eyelid when the eyes point up, and for pupillary constriction. The trochlear nerve and the abducens nerve are both responsible for eye movement, but do so by controlling different extraocular muscles. The trigeminal nerve is responsible for cutaneous sensations of the face and controlling the muscles of mastication. The facial nerve is responsible for the muscles involved in facial expressions, as well as part of the sense of taste and the production of saliva. The vestibulocochlear nerve is responsible for the senses of hearing and balance. The glossopharyngeal nerve is responsible for controlling muscles in the oral cavity and upper throat, as well as part of the sense of taste and the production of saliva. The vagus nerve is responsible for contributing to homeostatic control of the organs of the thoracic and upper abdominal cavities. The spinal accessory nerve is responsible for controlling the muscles of the neck, along with cervical spinal nerves. The hypoglossal nerve is responsible for controlling the muscles of the lower throat and tongue.
Three of the cranial nerves also contain autonomic fibers, and a fourth is almost purely a component of the autonomic system. The oculomotor, facial, and glossopharyngeal nerves contain fibers that contact autonomic ganglia. The oculomotor fibers initiate pupillary constriction, whereas the facial and glossopharyngeal fibers both initiate salivation. The vagus nerve primarily targets autonomic ganglia in the thoracic and upper abdominal cavities.
Another important aspect of the cranial nerves that lends itself to a mnemonic is the functional role each nerve plays. The nerves fall into one of three basic groups. They are sensory, motor, or both (see Table 12.3). The sentence, “Some Say Marry Money But My Brother Says Brains Beauty Matter More,” corresponds to the basic function of each nerve. The first, second, and eighth nerves are purely sensory: the olfactory (CNI), optic (CNII), and vestibulocochlear (CNVIII) nerves. The three eye-movement nerves are all motor: the oculomotor (CNIII), trochlear (CNIV), and abducens (CNVI). The spinal accessory (CNXI) and hypoglossal (CNXII) nerves are also strictly motor. The remainder of the nerves contain both sensory and motor fibers. They are the trigeminal (CNV), facial (CNVII), glossopharyngeal (CNIX), and vagus (CNX) nerves. The nerves that convey both are often related to each other. The trigeminal and facial nerves both concern the face; one concerns the sensations and the other concerns the muscle movements. The facial and glossopharyngeal nerves are both responsible for conveying gustatory, or taste, sensations as well as controlling salivary glands. The vagus nerve is involved in visceral responses to taste, namely the gag reflex. This is not an exhaustive list of what these combination nerves do, but there is a thread of relation between them.
| Mnemonic | # | Name | Function (S/M/B) | Central connection (nuclei) | Peripheral connection (ganglion or muscle) |
|---|---|---|---|---|---|
| On | I | Olfactory | Smell (S) | Olfactory bulb | Olfactory epithelium |
| Old | II | Optic | Vision (S) | Hypothalamus/thalamus/midbrain | Retina (retinal ganglion cells) |
| Olympus’ | III | Oculomotor | Eye movements (M) | Oculomotor nucleus | Extraocular muscles (other 4), levator palpebrae superioris, ciliary ganglion (autonomic) |
| Towering | IV | Trochlear | Eye movements (M) | Trochlear nucleus | Superior oblique muscle |
| Tops | V | Trigeminal | Sensory/motor – face (B) | Trigeminal nuclei in the midbrain, pons, and medulla | Trigeminal |
| A | VI | Abducens | Eye movements (M) | Abducens nucleus | Lateral rectus muscle |
| Finn | VII | Facial | Motor – face, Taste (B) | Facial nucleus, solitary nucleus, superior salivatory nucleus | Facial muscles, Geniculate ganglion, Pterygopalatine ganglion (autonomic) |
| And | VIII | Auditory (Vestibulocochlear) | Hearing/balance (S) | Cochlear nucleus, Vestibular nucleus/cerebellum | Spiral ganglion (hearing), Vestibular ganglion (balance) |
| German | IX | Glossopharyngeal | Motor – throat Taste (B) | Solitary nucleus, inferior salivatory nucleus, nucleus ambiguus | Pharyngeal muscles, Geniculate ganglion, Otic ganglion (autonomic) |
| Viewed | X | Vagus | Motor/sensory – viscera (autonomic) (B) | Medulla | Terminal ganglia serving thoracic and upper abdominal organs (heart and small intestines) |
| Some | XI | Spinal Accessory | Motor – head and neck (M) | Spinal accessory nucleus | Neck muscles |
| Hops | XII | Hypoglossal | Motor – lower throat (M) | Hypoglossal nucleus | Muscles of the larynx and lower pharynx |
Spinal Nerves
The nerves connected to the spinal cord are the spinal nerves. The arrangement of these nerves is much more regular than that of the cranial nerves. All of the spinal nerves are combined sensory and motor axons that separate into two nerve roots. The sensory axons enter the spinal cord as the dorsal nerve root. The motor fibers, both somatic and autonomic, emerge as the ventral nerve root. The dorsal root ganglion for each nerve is an enlargement of the spinal nerve.
There are 31 spinal nerves, named for the level of the spinal cord at which each one emerges. The arrangement of the spinal nerves is outlined in Figure 12.34. There are eight pairs of cervical nerves designated C1 to C8, twelve thoracic nerves designated T1 to T12, five pairs of lumbar nerves designated L1 to L5, five pairs of sacral nerves designated S1 to S5, and one pair of coccygeal nerves. The nerves are numbered from the superior to inferior positions, and each emerges from the vertebral column through the intervertebral foramen, the space between two adjacent vertebrae, at its level. The first nerve, C1, emerges between the first cervical vertebra and the occipital bone at the base of the skull. The second nerve, C2, emerges between the first and second cervical vertebrae. The same occurs for C3 to C7, but C8 emerges between the seventh cervical vertebra and the first thoracic vertebra. For the thoracic and lumbar nerves, each one emerges below the vertebra that has the same designation. The sacral nerves emerge from foramina along the length of the sacrum, which are five sacral vertebrae fused into a single bone. Below the sacrum is the coccyx, a bone formed from the fusion of a variable number of coccygeal vertebrae, usually four.
Spinal nerves extend outward from the vertebral column to innervate the periphery. The nerves in the periphery are not straight continuations of the spinal nerves, but rather the reorganization of the axons in those nerves to follow different courses. Axons from different spinal nerves will come together into a systemic nerve. This occurs at four places along the length of the vertebral column, nerve fibres form branching networks called a nerve plexus. Of the four nerve plexuses, two are found at the cervical level, one at the lumbar level, and one at the sacral level (Figure 12.35).
The cervical plexus is composed of axons from spinal nerves C1 through C5 and branches into nerves in the posterior neck and head, as well as the phrenic nerve, which connects to the diaphragm at the base of the thoracic cavity. The other plexus from the cervical level is the brachial plexus. Spinal nerves C4 through T1 reorganize through this plexus to give rise to the nerves of the arms, as the name brachial suggests. The lumbar plexus arises from all the lumbar spinal nerves and gives rise to nerves enervating the pelvic region and the anterior leg. The sacral plexus comes from the lower lumbar nerves L4 and L5 and the sacral nerves S1 to S4. The most significant systemic nerve to come from this plexus is the sciatic nerve, which is a combination of the tibial nerve and the fibular nerve. The sciatic nerve extends across the hip joint and is most commonly associated with the condition sciatica, which is the result of compression or irritation of the nerve or any of the spinal nerves giving rise to it.
These plexuses are described as arising from spinal nerves and giving rise to certain systemic nerves, but they contain fibers that serve sensory functions or fibers that serve motor functions. This means that some fibers extend from cutaneous or other peripheral sensory surfaces and send action potentials into the CNS. Those are axons of sensory neurons in the dorsal root ganglia that enter the spinal cord through the dorsal nerve root. Other fibers are the axons of motor neurons of the anterior horn of the spinal cord, which emerge in the ventral nerve root and send action potentials to cause skeletal muscles to contract in their target regions. For example, the radial nerve within the brachial plexus contains fibers of cutaneous sensation in the arm, as well as motor fibers that move muscles in the arm.
Spinal nerves of the thoracic region, T2 through T11, are not part of the plexuses but rather emerge and give rise to the intercostal nerves found between the ribs, which articulate with the vertebrae surrounding the spinal nerve.
Aging and the Nervous System
Anosmia is the loss of the sense of smell. It is often the result of the olfactory nerve being severed, usually because of blunt force trauma to the head. The sensory neurons of the olfactory epithelium have a limited lifespan of approximately one to four months, and new ones are made on a regular basis. The new neurons extend their axons into the CNS by growing along the existing fibers of the olfactory nerve. The ability of these neurons to be replaced is lost with age. Age-related anosmia is not the result of impact trauma to the head, but rather a slow loss of the sensory neurons with no new neurons born to replace them.
Smell is an important sense, especially for the enjoyment of food. There are only five tastes sensed by the tongue, and two of them are generally thought of as unpleasant tastes (sour and bitter). The rich sensory experience of food is the result of odor molecules associated with the food, both as food is moved into the mouth, and therefore passes under the nose, and when it is chewed and molecules are released to move up the pharynx into the posterior nasal cavity. Anosmia results in a loss of the enjoyment of food.
As the replacement of olfactory neurons declines with age, anosmia can set in. Without the sense of smell, many sufferers complain of food tasting bland. Often, the only way to enjoy food is to add seasoning that can be sensed on the tongue, which usually means adding table salt. The problem with this solution, however, is that this increases sodium intake, which can lead to cardiovascular problems through water retention and the associated increase in blood pressure.
Adaptation
This chapter was adapted by Valerie Swanston from the following texts:
The Peripheral Nervous System in Anatomy and Physiology by OSCRiceUniversity is licensed under a Creative Commons Attribution 4.0 International License
McCorry LK. Physiology of the autonomic nervous system. Am J Pharm Educ. 2007 Aug 15;71(4):78. doi: 10.5688/aj710478.
