Autonomic Nervous System: Difference between revisions

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Autonomic Dysregulation
 
 
=== Dysautonomia ===
* Dysautonomia is an umbrella which contains different entities depending on which part of ANS is affected
 
==== Clinical Types ====
 
* Afferent Baroreflex Failure
* Familial Dysautonomia
 
* Hereditary sensory and autonomic neuropathies (HSAN)
 
* Holmes-Adie syndrome (HAS)
* [[Autonomic Neuropathy entities|Autonomic neuropathy]]
 
=== Causes ===
{| class="wikitable"
!Dynamic
!
!
!
!
!
|-
!Sympathetic nervous system
!Paraympathetic nervous system
!Visceral / Sensory neurons
![[Enteric nervous system]]
!
!
|-
|
* [[POTS, Postural orthostatic tachycardia syndrome entities|POTS]]
* [[Generalized anxiety disorder|GAD]]
* [[Pure Autonomic Failure]] = Neurogenic syncope Neurocardiogenic syncope (NCS)
|[[Syncope|Vasovagal Syncope]]
|
|
* [[Irritable bowel syndrome (IBS)|IBS]]
* [[Gastroparesis miasms|Gastroparesis]] / [[GERD, Gastroesophageal Reflux Disease|GERD]]
|
|
|}
 
==== Related diseases ====
{| class="wikitable"
!Disease
!Pathology
!Entities
!Miasms
|-
|[[POTS, Postural orthostatic tachycardia syndrome entities|POTS]]
|General Sympathetic
Hyperactivity
|
* Hypotention (Orthostatic)
 
* Tachicardia
* Disorientation
|RBS
|-
|[[Syncope|Vasovagal Syncope]]
|General Parasympathetic
Hyperactivity
|
* Hypotention
* Coma
 
*
* Dizziness
|SAHF
|-
|[[Irritable bowel syndrome (IBS)|IBS-C]]
|Local Symp/ Parasympathetic
Dysregulations
|
* Ileus
* Constipation
|EBV
|-
|IBS-D
|Local Symp / Parasympathetic
Dysregulations
|
* Ileus
* Gastroenteritis / Diarrhea
|CMV
|-
|IBS-M
|Local Symp / Parasympathetic
Dysregulations
|
* Ileus
* Constipation
|EBV
|-
|Gasteroparesis / GERD
|Local symp / Parasympathetic
Dysregulations
|Gastric Dilation
|PLV
|-
|[[Generalized anxiety disorder|GAD]]
|
|[[Anxiety]]
Anhydrosis
|
|-
|[[Pure Autonomic Failure]] = Neurogenic syncope
Neurocardiogenic syncope (NCS)
|
|
|
|-
|
|
|
|
|}
My research
 
I determine [[Syncope]] and Anxiety as entities for Autonomic dysfunction
{| class="wikitable"
|+
!
!General Sympathetic Hyperactivity
!General Parasympathetic Hyperactivity
!Local symp / Parasympathetic dysregulations
|-
|
|[[Anxiety miasms|Anxiety]]
|Depression
|Constipation
|-
|
|Anhydrosis
|Dizziness / Brain fog
|Dysphagia
|-
|
|Insomnia
|Exercise intolerance / Weakness
|Bowel incontinence
|-
|
|Tachycardia
|Syncope/ Orthostatic hypotension
|Urinary incontinence or
|-
|
|Tunnel vision
|Vertigo
|Urinary retention
|-
|
|
|Blurry or double vision
|
|-
|Miasms
|RBS
|HSV-1, CMV
|
|}
 
=== Other related disease ===
* HIV/AIDS
* Alcoholism
* Amyloidosis
* Autoimmune disease such as
** [[Sjogren's syndrome entities|Sjögren's syndrome]]
** SLE
** Autoimmune autonomic ganglionopathy
* Craniocervical instability
* Diabetes
* Eaton-Lambert syndrome
* Ehlers-Danlos syndrome
* Guillain-Barré syndrome
* Long COVID
* [[MS, Multiple Sclerosis remedies|Multiple sclerosis]]
* Paraneoplastic syndrome
* Spinal cord injury or traumatic brain injury
* Synucleinopathy, a group of neurodegenerative diseases including [[Dementia entities|dementia]] with Lewy bodies, multiple system atrophy, and [[Parkinson disease entitieis|Parkinson's disease]]
* Surgery or injury involving the nerves
* Toxicity (vincristine)
* Parkinson’s disease
* [[Fibromyalgia entities|Fibromyalgia]]
* Chronic fatigue syndrome
* [[IBS, irritable bowel syndrome entities|Irritable bowel syndrome]]
* Interstitial cystitis
*Multiple system atrophy (MSA)
 
=== Causes ===
 
* Inherited or degenerative neurologic diseases (primary dysautonomia)
* Injury of the autonomic nervous system from an acquired disorder (secondary dysautonomia).
 
=== Anxiety vs autonomic dysfunction ===
Anxiety can sometimes physically manifest symptoms resembling autonomic dysfunction. A thorough investigation ruling out physiological causes is crucial, but in cases where relevant tests are performed and no causes are found or symptoms do not match any known disorders, a primary anxiety disorder is possible, but should not be presumed. For such patients, the anxiety sensitivity index may have better predictivity for anxiety disorders, while the Beck anxiety inventory may misleadingly suggest anxiety for patients with dysautonomia.
 
 
Entity / Miasm
[[Anxiety]]
 
[[Syncope]]
 
[[Male Impotency remedies|Impotence]]
 
Incontinence
 
[[Gastroparesis miasms|Gastroparesis]]
 
[[GERD, Gastroesophageal Reflux Disease|GERD]]
 
[[Achalasia]]
 
[[Thermoregulatory disorder]]

Revision as of 11:52, 28 July 2023

Physiology

  • ANS is a division of the peripheral nervous system that supplies internal organs, smooth muscle and glands.
  • It is a control system that acts unconsciously and regulates bodily functions such as:
    • Heart rate and its force of contraction
    • Digestion
    • Respiratory rate
    • Pupillary response
    • Urination
    • Sexual arousal
    • Fight-or-flight response
    • Vasomotor activity (the vasomotor center)
    • Certain reflex actions such as coughing, sneezing, swallowing and vomiting.
  • ANS is regulated by integrated reflexes through the brain-stem to the spinal cord and organs.
  • Hypothalamus acts as an integrator for autonomic functions, receiving autonomic regulatory input from the limbic system.


ANS branches

  1. Sympathetic nervous system
  2. Parasympathetic nervous system
  3. Visceral / Sensory nervous system
  4. Enteric nervous system


Sympathetic division

  • It consists of cells with bodies in the lateral grey column from T1 to L2/3.
  • These cell bodies are preganglionic neurons
  • These all contain Afferent (sensory) nerves as well, known as General Visceral Afferent neurons.


Parasympathetic division

  • It consists of cells with bodies in one of two locations:
    1. Brainstem (Cranial Nerves III, VII, IX, X)
    2. Sacral spinal cord (S2, S3, S4). These are the preganglionic neurons, which synapse with postganglionic neurons in these locations:
  • These ganglia provide the postganglionic neurons from which innervations of target organs follows. Examples are:
    • Postganglionic parasympathetic splanchnic (visceral) nerves
    • Vagus nerve which innervates heart, lungs, liver and stomach


Visceral / Sensory neurons

  • It is composed of primary visceral sensory neurons found in the peripheral nervous system (PNS) in cranial sensory ganglia
  • Visceral sensory information constantly and unconsciously modulates the activity of the motor neurons of ANS.
  • They monitor the
    • Levels of carbon dioxide, oxygen and sugar in the blood
    • Arterial pressure
    • Chemical composition of the stomach and gut content.
    • Sense of taste and smell, which, unlike most functions of the ANS, is a conscious perception.
    • Input from a nearby chemosensory center: The memory that ensures that an animal that has been poisoned by a food never touches it again
    • All this
    • Pain in any internal organ is perceived as referred pain, more specifically as pain from the dermatome corresponding to the spinal segment.
Target organ/system Parasympathetic Sympathetic
Digestive system
  • Increase peristalsis
  • Increase secretion of digestive glands
 Decrease activity of digestive system
Liver No effect Releasing glucose to blood
Lungs Constricts bronchioles Dilates bronchioles
Urinary bladder/ Urethra Relaxes sphincter Constricts sphincter
Kidneys No effects Decrease urine output
Heart Decreases rate Increase rate
Blood vessels No effect Constricts blood vessels in viscera; increase BP
Salivary and Lacrimal glands Increases saliva and tears Dry mouth /eyes
Eye (iris) Constrict pupils Dilates pupils
Eye (ciliary muscles) Increase bulging of lens for close vision Decrease bulging of lens; prepares for distant vision
Adrenal Medulla No effect Increase secretion epinephrine / norepinephrine
Sweat gland of skin No effect Increase perspiration
Sexual organs
  • Erection of genital tissues
  • Stimulating sexual arousal.

Autonomic Dysregulation

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