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[Special feature] Talk from the otolaryngology ear No. 5 For relaxation and dieting? Ears must be damaged!

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Disturbances in the autonomic nerves can cause headaches, insomnia, and malaise.

When the function of the autonomic nerves, which is the control tower, is disturbed due to stress or irregular life, physical problems occur. → Continue reading

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fatigue(Hirou,British: Tiredness ) Is(English edition)It is a different subjective sensation and begins gradually. Unlike helplessness, fatigue休息It can be alleviated by (sleep).


Fatigue has physical and mental causes.

Physical fatigue is for maintaining optimal physical ability筋肉Is a temporary decline in ability and is strongPhysical exerciseGets worse by[1][2][3].. Mental fatigue is a temporary decline in maximum cognitive ability due to long-term cognitive activity. Mental fatigue(English edition)(sleepiness),Lethargy,(English edition)Can appear as[4].

Medically, fatigueNonspecific symptoms(English edition)Is. This means that there are many possible causes, with many different states. FatigueSignsRather thansymptomIs considered. This is because fatigue is not an objective observable by others, but a subjective sensation reported by the patient. Fatigue and "feeling of fatigue" are often confused[5].

Fatiguepain,FeverIt is also said to be the three major danger signals of the living body, and is one of the important signals for the body to maintain life and health. Physiological fatigue in a healthy person can be defined as a state in which work efficiency (performance) is temporarily reduced when a load is applied to the mind or body. It is usually accompanied by a desire for rest and discomfort (so-called malaise). Fatigue in the sick (pathological fatigue),Malignant tumor,Diabetes mellitus,Chronic fatigue syndrome,Multiple sclerosisAs in the above, even when the load is low, a chronic decrease in work efficiency or fatigue may be recognized.

Physiology of fatigue

Classification of fatigue

Fatigue isPeripheral fatigueとCentral fatigueare categorized. Peripheral fatigue is a state in which a sensation of fatigue originates in the body (periphery) other than the brain, that is, muscles. Central fatigue is a state in which the brain is the main subject and feels fatigue.

Also, if classified according to whether it is morbid,Physiological fatigueとPathological fatigueTo be distinguished. What is physiological fatigue?diseaseIt is absent and appears when the amount of activity exceeds the level of rest within the range where recovery is possible in the natural state. What is morbid fatigue?cancer,AIDSPhysical diseases such asdepression,schizophrenia,Sleeping disorderIf there is a mental illness such asChronic fatigue syndrome,FibromyalgiaIt is fatigue due to a disease characterized by constant fatigue. Fever for morbid fatigue,Lymph nodeIt may be accompanied by objective symptoms such as swelling and memory loss. Iron deficiencyanemiaHowever, they exhibit shortness of breath and tiredness.

Objective fatigue and subjective fatigue

In many cases, the degree of fatigue evaluated by an objective index such as the amount of exercise of the muscles (travel time, etc.) and the sensation of fatigue (feeling of fatigue) that is consciously felt are different from each other. It is greatly influenced by mental factors, and individual differences are also large. For example, if you are uplifted, you may not feel tired even with the workload that normally makes you tired. This also makes it difficult to make objective criteria for fatigue. In addition, because of mental exhaustion, we may not be able to keep our ego (following frustration), and our relationships may collapse.

Fatigue mechanism

The following are possible mechanisms of fatigue.

  • Lack of energy source (meal): If dietary intake of sufficient energy is not enough, fatigue tends to occur.
  • Even with sufficient energy supply, fatigue is caused by strength or long-term load. When skeletal muscle cells and nerve cells are loaded, excess free radicalsOxidative stressExposure to the condition causes a decrease in cell function and a decrease in mitochondrial ATP-producing ability. In Japan, where nutritional supply is sufficient, physical fatigue due to exercise and mental work fatigue due to desk work and driving are rather caused by damage to muscle cells or nerve cells due to this oxidative stress.
  • Maladjustment of the brain's coordinating ability: The brain's coordinating ability decreases due to continuous thinking and memory, and fatigue occurs due to the inability to process information smoothly.
  • SerotoninCentral fatigue due to

Relationship with muscle fatigue

frog's筋肉Since it was proposed by Hill et al. in 1929 based on research using[6]Lactic acid has been considered as a causative agent of muscle fatigue. this is,Lactic acidDue to the accumulation ofacidosisIt was understood that the function of contractile protein was inhibited by[7].. However, in a later study, rebuttal evidence against the theory that acidosis causes muscle fatigue has been reported.[7].. Then, in 2001, it was accumulated extracellularly by Nielsen et al.potassiumion K+ Was reported to be a key substance in muscle fatigue. In Nielsen's system, K+ When an acid such as lactic acid was added to a muscle specimen weakened by the addition of sucrose, recovery was observed contrary to the conventional theory.[8].. A 2004 report by Pedersen et al. also showed that chloride ion cell permeability decreased at low pH, suggesting that acidosis has a protective effect on muscle fatigue.[9].. Also, in high-intensity exerciseATP,CreatineBy the decomposition of phosphoric acidphosphoric acidAccumulates. This phosphoric acidcalciumWhen calcium binds to phosphoric acid, the function of calcium essential for muscle contraction deteriorates. This is considered to be one of the causes of fatigue. Calcium is originally muscleEndoplasmic reticulumStored in the muscle, the muscle contracts by leaving the sarcoplasmic reticulum, and relaxes when returning to the sarcoplasmic reticulum[10].

Recovery and prevention of fatigue


The following methods are considered to be effective for relieving fatigue.

There are various other methods,Alternative medicineAs seen in some of the above, it is hard to say that the effect of fatigue recovery is scientifically recognized.

Super recovery period

When your body function declines due to fatigue due to work or exercise, you can recover your body function by resting. After resting, the body's functions may be temporarily increased, which is called the super recovery period. However, when rest is insufficient, the body's function gradually declines.


On a daily basismotionBy strengthening your physical strength by doing, the accumulation of fatigue substances slows down, and the metabolic efficiency improves, so you can reduce fatigue. However, exercising will temporarily exhaust physical strength and accumulate fatigue. However, as the physical strength is increased by continuing the exercise, the tolerance and the allowable amount against fatigue increase, so that it becomes harder to get tired gradually, which leads to the prevention of fatigue in the long term.

Other than that, the following methods are generally effective. However, fatigue cannot be completely prevented.

  1. If the calorie intake is insufficient, take a sufficient amount of food such as sugar as an energy source.
    A balanced intake of nutrients is important. EspeciallyproteinPlays an important role in the restoration of physical functions that are reduced by fatigue.
  2. Supplement with antioxidants such as imidazole dipeptide to prevent exposure to strong oxidative stress during excessive exercise and mental work.
  3. Replenish water and minerals appropriately.
  4. Take a good rest and maintain central coordination. Also, try to live a regular life.

Fatigue and society

Fatigue is said to be felt by most modern people on a daily basis, causing economic problems such as a decrease in labor force.

Also excessiveThe laborCaused by morbid fatigue andDeath from overwork-Overworked suicideIf occurs,Industrial accidentMay be recognized as.

In addition, in the state of fatigueAutomobileTheoperationToFatigue driving(Hirou Unten) orOverwork(Karou Unten) is a serious accident (Traffic accident), which can causeRoad Traffic LawInViolation scoreIs "25 points".


  1. ^ Gandevia SC (1992). “Some central and peripheral factors affecting human motoneuronal output in neuromuscular fatigue”. Sports Medicine 13 (2): 93–8. two:10.2165 / 00007256-199213020-00004. PMID 1561512. 
  2. ^ Hagberg M (1981). “Muscular endurance and surface electromyogram in isometric and dynamic exercise”. Journal of Applied Physiology 51 (1): 1–7. PMID 7263402. 
  3. ^ “Fatigue revisited”. Journal of sports sciences 15 (3): 245–6. (1997). two:10.1080/026404197367245. PMID 9232549. 
  4. ^ “Mental fatigue impairs physical performance in humans”. Journal of Applied Physiology 106 (3): 857–864. (January 2009). two:10.1152 / japplphysiol.91324.2008. PMID 19131473. 
  5. ^ Berrios GE (1990). “Feelings of fatigue and psychopathology: a conceptual history”. Buy Psychiatry 31 (2): 140–51. two:10.1016 / 0010-440X (90) 90018-N. PMID 2178863. http://linkinghub.elsevier.com/retrieve/pii/0010-440X(90)90018-N. 
  6. ^ Hill, AV; Kupalov, P. Proc. R. Soc. London Ser. B, 1929, 105, 313.
  7. ^ a b Perspective: Allen, D .; Westerblad, H. Science, 2004, 305, 1112-1113. IT HURTS: 10.1126 / science.1103078
  8. ^ Nielsen, OB; de Paoli, F.; Overgaard, K. J. Physiol. 2001, 536, 161-166. two:10.1111 / j.1469-7793.2001.t01-1-00161.x
  9. ^ Pedersen, TH; Nielsen, OB; Lamb, GD; Stephenson, DG Science 2004, 305, 1144-1147. two:10.1126 / science.1101141
  10. ^ A new perspective on lactic acid, Hatta Hideo, Academic Trends, Vol. 11 (2006) No. 10
  11. ^ "[Doctor supervision] Explains methods and measures for recovery from fatigue!”. Harumeku Beauty and Health (November 2020, 11). 2020/11/16Browse.

Related item

外部 リンク

Autonomic nervous system

Autonomic nervous system(Jiitsu Shinkei,British: Autonomic nervous system) IsPeripheral nervous systemOut ofVegetativeIt is a nervous system that plays a role and plays a role in animal functions.Somatic nervous systemContrasted with. The autonomic nervous system consists of two systems: an efferent mechanism that regulates the functions of internal organs and an afferent mechanism that transmits information from the internal organs to the central nervous system.

Sympathetic nervous systemとParasympathetic nervous systemTwo ofNervous systemIt is composed of. There is also a nervous system called the intramural enteric nervous system as a nervous system that controls the intestinal tract. Embryologically faster than the brain. The intramural enteric nervous system is also called the second brain.

Nerve function

In contrast to the somatic nervous system, which is the involuntary nervous system, the involuntary "autonomic nervous system"digestion, Sweating and thermoregulation, endocrine function, reproductive function, andmetabolismControl involuntary functions like. The autonomic nervous system regulates various physiological parameters in cooperation with the endocrine system, which is a hormonal regulatory mechanism.HomeostasisContribute to the maintenance of. In recent years, the immune system has been added to the autonomic nervous system and endocrine system, and it is sometimes treated as a "homeostasis triangle". Not only classical physiology and autonomic neurology as neurology, but also neuroimmunity, which is one of the interdisciplinary fields Studies in psychology and neuroimmunology are also being conducted.

Sympathetic nerveとParasympathetic nerveIt consists of two nervous systems, both of which often control one organ (double dominance), and the actions of both on one organ generally act antagonistically (reciprocal dominance). The function of the sympathetic nervous system is broadly defined as physical activity, noxious stimuli, and fear, which are collectively referred to as fight or flight.stressIs important in many situations.

The function of the sympathetic nervous system will be described below by taking biological reactions during exercise as an example.

The blood vessels contract due to the enhancement of the sympathetic nervous system,Heart rateWill increase. As a resultblood pressureIs increased and the amount of perfusion of peripheral tissues is increased. The result of such actionDigestive tract,皮膚Blood volume toSkeletal muscleIncrease blood supply to. This is partly due to the abundance of β receptors involved in vasodilation in muscle blood vessels, in addition to the influence of local factors associated with skeletal muscle movement.BronchiSmooth muscles relax, which results in an increase in tracheal diameter, which results in an increase in tidal volume and thus gas exchange efficiency.

On the other hand, shift the viewpoint to the metabolic system.

Maintaining blood glucose is important because a large amount of energy substrate (glucose) is consumed in skeletal muscle during exercise. Glucose release from the liver is important. The sympathetic nerveliverAtglycogenDisassembly andAdipose tissueAtfatIt promotes decomposition and gives the blood the necessary energy. In addition, it has been reported that sympathetic nerves directly promote skeletal muscle glucose uptake. The sympathetic nerve also acts on endocrine organs, stimulates secretion of adrenal medullary hormones and glucagon, and also acts to promote energy supply to peripheral tissues. As a result, abundant oxygen and glucose are supplied to tissues centered on skeletal muscle, while supply to the skin and digestive tract becomes poor. In this way, the autonomic nervous system regulates the functions of each organ in an integrated manner, resulting in the purpose of the internal environment of the individual.

Hyperactivity of the heart,BronchiDialysis, hepatic glycogenolysis, lipolysis, etc. are under the control of the sympathetic nervous system, while the gastrointestinal function (gastrointestinal motility, gastric secretion) and urinary function, which are important during rest, are increased by the parasympathetic nervous system. Is under the control of. It reduces heart rate, lowers blood pressure, restores blood to the skin and gastrointestinal tract, constricts pupils and bronchioles, salivary glandssecretionStimulate the peristalsis. The parasympathetic nervous system has an anabolic tendency in metabolism.

Sympathetic nervous system,as well asParasympathetic nervous systemPlease refer to each item for each organ and its effect on each organ.

Autonomic reflex

ReflectionIs a certain stimulusStereotypeIt is the response that occurs in. Reflexes integrate receptors, receptors that receive stimuli, afferent nerves that convey the excitement of receptors,Central nervous systemIt is composed of the (reflex center), the efferent nerve that transmits the signal emitted to the peripheral organs as a result of integration in the central nervous system, and the effector that responds. Many of the reflexes existing in the living body involve the autonomic nervous system, including (1) visceral-visceral reflex, (2) somatic-visceral reflex, and (3) visceral-somatic reflex. These are the autonomic reflexes in a broad sense, but when they are called autonomic reflexes, they usually refer to (1) and (2). Since there are many reflexes involving the autonomic nervous system, it is not possible to enumerate all of them here. Therefore, only representative groups of reflexes and the reflex mechanisms that belong to them are described below.

  1. Viscera-visceral reflex Is a reflex mechanism in which both afferent and efferent tracts are composed of autonomic nerve fibers, and many visceral functions are autonomously performed by this mechanism. A typical example of this reflex is the arterial baroreceptor reflex. A pressure sensor called a baroreceptor exists in the arterial system of the neck. This baroreceptor constantly monitors arterial pressure and this information is transmitted to the central nerve via afferent autonomic nerves. Based on this information, the central nerve regulates blood pressure by changing the flow of the sympathetic nerve and the vagus nerve. The baroreceptor reflex is the most basic and important reflex circulatory regulatory mechanism and is also an example of the visceral-visceral reflex.
  2. Somatic-visceral reflex Is a reflex mechanism in which the afferents are somatosensory and the efferents are composed of the autonomic nervous system. The somatic-sympathetic nerve reflex has long been known as an example of this reflex. This is a noxious stimulus (so-calledpainStimulation) is a reflex in which the function of the sympathetic nervous system is enhanced to increase the heart rate and blood pressure. In addition, when a thermal stimulus is applied to the skin, sweating occurs, which is a result of the thermal stimulus exciting the sympathetic nerves innervating the sweat glands through the somatosensory nerves, which can be called the somatic-visceral reflex. right. In addition, since ancient times, as physical therapy, there have been medical treatments for improving and maintaining physical functions by applying various stimuli (mechanical stimulus, temperature stimulus, chemical stimulus, scent, etc.) to the body surface. This somatic-autonomic reflex may explain some of the physiological mechanisms of. Up to now, acupuncture stimulation has increased endorphins, dynorphins, etc., which are endogenous morphines in the central nervous system, and various sensory stimulations have been carried out via the autonomic nervous system to the peripheral organs (digestive tract function, urinary system, cardiovascular system, endocrine system). It has been studied in basic medicine and clinical medicine to act on organs.
  3. Viscera-somatic reflex Is a reflex mechanism in which the afferents are afferent autonomic nerves and the efferents are somatic motor nerves. Muscular defense is famous among the members of this group. This is a phenomenon in which disorders of the abdominal organs and peritoneum (inflammation, mechanical changes) cause the abdominal muscles to contract via the afferents. Clinically found in many digestive disorders, especiallyappendicitisIt is famous for its physical findings. Muscular defense is a phenomenon based on the physiological reflex arc as described above.

Pharmacological basis of the autonomic nervous system

Sympathetic and parasympathetic nerve fibers are single cells orNeuronThere are both "preganglionic" and "postganglionic" neurons, as opposed to spontaneous motor nerves that consist solely of them. They associate in ganglia and are synaptic chemical transmittersacetylcholine(ACh)NerveImpulses in ganglia細胞から細胞Transmitted to. acetylcholineIs the firstNeuronReleased from (pre-ganglionic neuron), the secondNeuron(Postganglionic neuron)nicotine型ReceptorBinds to, opens ligand-gated Na channels, causes depolarization to generate impulses, and releases a second neurotransmitter at neuronal terminals, thereby transmitting information to the postsynaptic membrane. The second transmitter of the parasympathetic nervous system is alsoacetylcholineBut the second transmitter in the sympathetic nervous system isNoradrenalineWill be responsible. The nerves that control the adrenal medulla terminate in preganglionic fibers. Normally, noradrenaline is released from the postganglionic fibers of the sympathetic nerve. From a functional perspective, instead of releasing transmitters, from the adrenal medullaア ド レ ナ リ ンAnd noradrenaline are secreted. In other words, the adrenal medulla itself acts as a huge postganglionic fiber. The cell bodies of preganglionic autonomic neurons arecentral nervous systemThe sympathetic nervous system cell bodies are located in the thoracic and lumbar regions of the spinal cord, while the parasympathetic nervous system cell bodies areBrainstemIt is located in the cranial parasympathetic nerve (part of the cranial nerve such as the vagus nerve) and the sacrum (sacral parasympathetic nerve).

Main functions responsible for autonomic nervous systemNeurotransmitter TheacetylcholineとNoradrenalineIs. As mentioned above, acetylcholine is released from the preganglionic fiber ends of the sympathetic and parasympathetic nerves, whereReceptorIs the nicotinic acetylcholine receptor. It is known that there are other muscarinic acetylcholine receptors, dopamine receptors, etc. in the autonomic ganglia. These are called neuromodulators rather than neurotransmitters and are involved in the transmission of excitement. It is believed that Block nicotine receptors in autonomic gangliaAntagonistTrimetaphan and hexamethounium are known as the drug, and although they are less used today, they are the earliest introduced antihypertensive drugs. In addition to the nicotinic acetylcholine receptors, there are other muscarinic receptors that are present in parasympathetic innervated effectors. Today, muscarinic receptors are known to have subtypes of M1 to M5 receptors, and future development of better drugs based on the difference between these subtypes in individual organs is expected. The localization of muscarinic receptors includes sympathetic nerve endings under the control of sweat glands in addition to parasympathetic nerve endings. The sweat glands are in principle controlled by the central control of the sympathetic nerves, while the transmitter is acetylcholine and the receptor is a muscarinic acetylcholine receptor, which is characteristic. Muscarinic receptorAntagonistIs famous for atropine, which is known as a cardiovascular and digestive medicine. In recent years, nicotine receptors are present on the cell surface of macrophages, and it has been revealed that they exert a suppressive effect on the production and release of inflammatory cytokines (TNF-α, IL-1, etc.) in macrophages. This nicotine receptor was found to be an α7 nicotine receptor in subsequent analysis, and is expected as a target for new drug treatments for various pathological conditions involving inflammation, such as sepsis, rheumatoid arthritis, and ulcerative colitis. ..

Noradrenaline is released from the sympathetic nerve endings,Adrenal medullaSecreted by adrenaline from. Like acetylcholine, subtypes are known to exist in (nor)adrenergic receptors, and they are roughly classified into α receptors and β receptors. Among the actions of sympathetic nerves on various organs, vasoconstriction is mediated by α receptors and heart rate increase is mediated by β receptors. In consideration of such differences in receptors, α/β agonists or blockers that selectively reproduce or block the action of the sympathetic nerve are clinically applied. Today, it is known that α has further subtypes of α1, α2, and β, β1, β2, and β3. β1 adrenergic receptors are mainly localized in the heart and increase cardiac output through increased heart rate and contractile force. Based on this, β-receptor antagonists are used in patients with hypertension for the purpose of suppressing cardiac function. Conversely, in the case of heart failure, β receptor stimulants are used for the purpose of assisting cardiac function. β2 is present in many smooth muscles, but is clinically important as a bronchodilator. The β3 adrenergic receptor is the latest reported receptor, but it is known to be localized in adipose tissue, bladder, digestive tract, etc., and a drug that selectively stimulates the β3 receptor has been developed. By doing so, it is expected that fat can be efficiently reduced without affecting the heart or bronchi.

One of the recent topics is bone as a target organ of the sympathetic nervous system. In animal models, it has been reported from inside and outside that the sympathetic nervous system is involved in osteogenesis via the β 2 receptor in an inhibitory manner, and that β-blockers act to promote osteogenesis. It has been suggested that leptin secreted from adipose tissue is involved in this mechanism, and is attracting attention as a nerve-bone connection.

The sympathetic axons are so-calledSympathetic nerveAs the trunk,spineOn each side of, make a chain of 22 ganglia. The visceral nerves from these are largearteryLeading to the prevertebral ganglion, which is in the area of ​​the anterior splanchnic artery bifurcation. The left and right nerve trunks of the sympathetic nerve meet in the pelvic region to form an unpaired ganglion. Organs controlled by autonomic nerve fibers心 臓,lung,esophagus,stomach,Small intestine,colon,liver,gall bladder,andGenitalIs included. In addition to the ventricles, these organs are also controlled by the parasympathetic nervous system.colonThe end of the digestive system to the posterior part is regulated through the pelvic ganglia and through the sacral parasympathetic nerve fibers. The digestive tract before thatVagusGet ruled.

Autonomic nervous system anatomy

Figure 1: Right sympathetic nerve chain and plexus of the chest, abdomen, and pelvis and their connections. (After correction by Schwalbe)

The peripheral part of the sympathetic nervous system is characterized by the presence of numerous ganglia and a complex plexus. These ganglia are connected to the central nervous system by three groups: the efferent or preganglionic sympathetic nerves, the skull, thoracolumbar, and sacrum. These outputs of the autonomic nerves are separated by intervals where there are no connections.

John Newport Langley is grayAnatomyTerms used inPharmacologyI used a term that was somewhat different from the term in. This has caused considerable confusion, as indicated by the arrangement of terms in the table below. Walter Holbrook Gaskell also used the term involuntary nervous system.

GrayLangleyMeyer and Gottlieb
Sympathetic nervous system(Sympathetic nervous system)Autonomic nervous system(Autonomic nervous system)Plant nervous system(Vegetative nervous system)
Craniosacral sympathetic nerve(Cranio-sacral sympathetics)Parasympathetic nerve(Parasympathetics)Autonomic nerves(Autonomic)
Oculomotor sympathetic nerve(Oculomotor sympathetics)Tectal autonomic nerve(Tectal autonomics)Head autonomic nerve(Cranial autonomics)
Facial sympathetic nerve(Facial sympathetics)Medulla oblongata(Bulbar autonomics)
Glossopharyngeal sympathetic nerve(Glossopharyngeal sympathetics)
Vagus(Vagal sympathetics)
Sacral sympathetic nerve(Sacral sympathetics)Sacral autonomic nerve(Sacral autonomics)Sacral autonomic nerve(Sacral autonomics.)
Thoracolumbar sympathetic nerve(Thoracolumbar sympathetics)Sympathetic nerve(Sympathetic)Sympathetic nerve(Sympathetic.)
Thoracic nerve(Thoracic autonomic)
Enteric nerve(Enteric)Enteric nerve(Enteric)Enteric nerve(Enteric.)

Fibers derived from the brain stem of the autonomic nervous system (ocular nerve, facial nerve, glossopharyngeal nerve, vagus nerve)

It deals with the moving eye, face, glossopharyngeal nerve, and vagus nerve. Of these nerves, all the fibers of the autonomic nervesParasympathetic nerveIs. The last three include afferent fibers. By the way, the sympathetic nerves that antagonize these parasympathetic nerves change neurons in the superior cervical ganglion,Internal carotid arteryDistribute to each organ along the (carotid nerve plexus).

Figure 2: Output sympathetic nervous system list. Blue: Output of the skull and sacral cord. Red: chest and upper arm output. -Postganglionic fibers of motor nerves to the nerves of the spinal cord and cerebrospinal cord that control vasomotor movements of the head, trunk, limbs, smooth muscles of skin and sweat glands. (After modification of Meyer and Gottlieb)

Oculomotor nerve

Oculomotor nerveEfferent fibers of the mouse probably arise from cells in the anterior part of the oculomotor nucleus located in the cortex of the midbrain. These preganglionic fibers extend and enter the orbit with the third nerve. Here, the postganglionic fibers of the parasympathetic nerve pass through the eye as short ciliary nerves and end up forming synapses with motor neurons. Where they areCiliary muscle,Pupil sphincterDominates.

Figure 3: Sympathetic connections of the ciliary body and superior cervical ganglion

Facial nerve

The efferent fibers of the facial nerve are thought to arise from small cells of the facial nucleus. According to one theory, the cells that make up the special nucleus, the superior salivary nucleus, in which nerve fibers to the salivary glands occur, are scattered in the reticular formation and consist of cells dorsomedial to the facial nucleus. Some of these preganglionic fibers enter via the lingual nerve and change neurons in the submandibular ganglion. The postganglionic fibers are distributed in the submandibular and sublingual glands, ending in the cell body of neurons that conduct salivary secretion and vasodilator impulses. The other preganglionic fibers of the facial nerve are viaWing palatine ganglionIt enters the (butterfly-shaped palate ganglion), where it forms postganglionic fibers and synapses. Postganglionic fibersMaxillary nerveWith the fibers ofnose, The soft palate,tonsil, Uvula,palate, Upper lip, gums,Parotid gland, And orbitalGland OfMucosaAnd is responsible for vasodilation and secretion. (However, the maxillary nerve has only afferent fibers.) Some afferent fibers are said to be connected to the facial nerve, and their cell bodiesKnee ganglionIt's in, but little known.

Figure 4: Autonomic connections to the butterfly-shaped palate and superior cervical ganglion.
Figure 5: Autonomic connection of the submandibular and superior cervical ganglia

Glossopharyngeal nerve

Glossopharyngeal nerveThe afferent fibers of are believed to originate from both the dorsal nucleus or another, inferior salivary nucleus located near the dorsal nucleus. These preganglionic fibers pass through the tympanic branches of the glossopharyngeal nerve and through the small superficial pyramidal nerves to transfer neurons at the otoganglia. Postganglionic fibers, vasodilators and secretory nerves pass through the auricular temporal nerveParotid gland,MucosaとtongueIts gland on,mouthDistributed at the bottom of the

Figure 6: Connection of sympathetic nerves to the ear and maxillary ganglia

The source of the afferent fibers of the autonomic nerves originates from the ganglia above and below the main nerve, and appears to end in the dorsal nucleus. It is not known what happens to the ends of this nerve. The efferent fibers of the vagus nerve are thought to originate from the dorsal nucleus (nucleus ala cinerea). These preganglionic fibers are thought to terminate in ganglia located at or near the organ with the vagus nerve. The inhibitory fibers to the heart probably end in small ganglia located in the heart wall, especiallyAtriumThe postganglionic fibers from the muscle are distributed in the muscular system, and the preganglionic motor fibers to most of the esophagus, stomach, small intestine and large intestine areSmooth muscleDistributed inAuerbach's plexusIs believed to end with. The other fibers are the bronchial treegall bladderAnd across the smooth muscle of its drain. The vagus nervestomachとpancreasIs said to be a secretory fiber. It probably contains many other efferent fibers than those listed above. The source of cells for the vagal sympathetic afferents lies in the jugular or supraganglional ganglia, probably ending in the dorsal nerve of the medulla oblongata, or, according to many authors, the arcuate nucleus. Peripherally, the fibers appear to be distributed in various organs with efferent fibers.

Fibers derived from the spinal cord of the autonomic nervous system (sympathetic nervous system originating in the lumbar spinal cord and thoracic cord and pelvic splanchnic nerve)

Sympathetic nerve-thoracic-lumbar sympathetic fibers of the thoracolumbar and lumbar spinal cord originate from the dorsolateral region of the spinal cord in the anterior gray column and pass through the entire thoracic cord and a few of the anterior lumbar cord roots. These preganglionic fibers enter the white rami communicantes to the sympathetic trunk, with many ending in their ganglia and the rest passing through the anterior spinal ganglia plexus to their accessory ganglia. The postganglionic fibers are widely distributed. The vasoconstrictor fibers of the nerve trunk and the skin of the extremities leave the spinal cord, for example, all thoracic cords and the preganglionic fibers of the lumbar spinal cord from the top two to three and directly to the branches of the sympathetic trunk or the ganglia of the proximal ring. It ends in the connecting ganglion. Postganglionic fibers originating from these ganglia pass through the gray communication branch to all spinal nerves, and are divided into cutaneous plexus and finally connected to small arteries. The postganglionic fiber does not necessarily have to return to the same spinal nerve to which it corresponds. Vasoconstrictor nerves to the head exit the thoracic spinal nerve, whose preganglionic fibers terminate in the superior cervical ganglion. The postganglionic fibers pass through the internal carotid nerve and its branches to various cerebrospinal nerves, especiallyTrigeminal nerveJoin the sense branch of. Deep structure andSalivary glandsOther fibers to the are probably associated with the arteries.

Postganglionic vasoconstrictor fibers of the abdominal viscera grow in the anterior spine or accessory ganglia, where many preganglionic fibers terminate. Vasoconstrictor fibers to the pelvic viscera grow from the inferior mesenteric ganglion. Apparently, raised fibers to the hair and motor fibers to the sweat glands have a distribution similar to that of the vasoconstrictor fibers of the skin.

The center of vasoconstrictionPhysiologyHave been identified by others as near the facial nucleus. The axons from the cells appear to descend in the spinal cord ending around the cell body of preganglionic fibers on the dorsal part of the anterior column of the thorax and lumbar region.

OcularDilated pupilThe sympathetic nerves to come from preganglionic sympathetic fibers that leave the spinal cord at the anterior root of the upper thoracic nerve. These nerves pass through the white communication branch to the sympathetic trunk and terminate in the superior cervical ganglion. Postganglionic fibers pass through the internal carotid nerve and the visual area of ​​the trigeminal nerve to the tract muscle of the long ciliary nerve that guides impulses to the eye and dilated pupil muscles. The cell bodies of these preganglionic fibers connect with the fibers descending from the midbrain.

Other postganglionic fibers from the superior cervical ganglion distribute as secretory nerves to the salivary glands, lacrimal glands, and small glands of the mucous membranes of the nose, mouth, and pharynx. The thoracic sympathetic nerve, also called the cardiac nerve, acts to promote new functions. That is, it increases the heart rate, enhances the contractile force, and consequently increases the stroke volume. They emerge from the upper 4 or 5 anterior branches of the thoracic nerve of the spinal cord, pass through in the white rami to the first thoracic ganglion, some terminate there, and others in the lower cervical nerve to the subclavian loop It seems to pass the knot. The postganglionic nerve partially passes through the subclavian loop to the heart. Along the way, it mixes with the sympathetic fibers from the vagus nerve to form the cardiac plexus.

Inhibitory fibers of the smooth muscle system of the stomach, small intestine, and most of the large intestine appear to emerge from the anterior roots of the lower thoracic nerve and upper lumbar nerve. These fibers are white ramiSympathetic trunkThrough theLarge internal organsThrough internal organs such asCeliac plexus・It ends in "etc."

The postganglionic fibers (suppression) from the abdominal cavity and superior mesenteric ganglia are distributed in the stomach, small intestine, and most of the large intestine. The inhibitory fibers to the descending colon, rectum, and internal anal sphincter are probably postganglionic fibers from the inferior mesenteric ganglion.

The thoracolumbar sympathetic nerve is characterized by the presence of numerous ganglia that can be divided into two groups, central and accessory.

The central ganglia are arranged in two vertical rows, one on one side of the midline located partially anterior and partially lateral to the spinal column. Each ganglion is connected by a nerve cord to an adjacent ganglion, and thus two chains of the sympathetic trunk are formed. Accessory ganglia are found in the three large anterior vertebral plexusesrib cage,abdomen,pelvisLocated in each.

The sympathetic trunk extends from the skull to the coccyx (bite kotsu). The end of the head goes back through the carotid canal into the skull,Internal carotid arteryTo form the plexus. The tail ends converge to terminate in a ganglion impar located anterior to the coccyx. Each stem ganglion is classified into a cervix, a chest, a lumbar region, and a sacrum, and they closely correspond to the vertebrae except for the neck. The sequence is as follows.

  • Cervical 3 ganglia
  • Chest 12 ganglia
  • Lumbar 4 ganglia
  • Sacral 4-5 ganglia

In the neck, the ganglia are in front of the transverse processes of the vertebrae, in the chest in front of the head of the ribs, in the lumbar region on the side of the vertebral body and in the sacral region in front of the sacrum.

Efferent fibers originating from the sacrum exit the spinal cord from the anterior roots of the second, third, and fourth sacral nerves. These small premyelinated fibers are collected in the pelvis, the erectile or pelvic nerves, where the postganglionic fibers go to the plexus of the lower abdomen or pelvis, which is distributed in the internal organs of the pelvis. Motor nerve descendingcolon,Rectum,anus,bladderPass through the smooth muscle of. Vasodilators are distributed in these organs and the vulva, and inhibitory fibers probably pass through the smooth muscles of the vulva. The afferent autonomic nerve guides impulses from the pelvic viscera to the second, third, and fourth sacral nerves. The source of the cells is in the dorsal root ganglion.

Connection with spinal nerves

The sympathetic nerve and the spinal nerve are connected through the gray and white traffic branches. The gray communication branch carries the sympathetic fibers to the spinal nerve, and the white communication branch transfers the spinal fibers to the sympathetic nerve. Each spinal nerve receives a gray communication branch from the sympathetic trunk, but the white communication branch does not extend from all spinal nerves. The white communication branch branches from the first cervical to the first lumbar nerve, while the visceral branch that goes directly from the second, third, and fourth sacral nerves to the pelvic plexus falls into this category. The fibers that reach the sympathetic nerve through the white communication branch are myelinated, and those originating from the cells of the sympathetic ganglion are almost completely unmyelinated. The sympathetic nerve is composed of efferent and afferent fibers. Three large nodular plexuses (collateral plexuses) were located in front of the spine of the chest, abdomen, and pelvis, and were named the cardiac plexus, solar plexus, and hypogastric plexus, respectively. They constitute a collection of nerves and plexuses, which belong to the nerves diverging from the sympathetic trunk and the cerebrospinal nerves. They have branches extending to the internal organs.


Sympathetic ganglion cells derive from the neural crest. These neural crests move forward on the side of the neural tube, segment into spinal ganglia, and their ventral cells separate and move to the side of the aorta, where some of them are grouped into ganglia of the sympathetic trunk. And the rest migrate further to form the anterior spine and visceral plexus.

Trigeminal nerveYou can see the branches ofWing palate, And are formed by groups of cells that have migrated from the portion of the neural crest that becomes the meniscus ganglion. Some cells of the ciliary ganglion are said to migrate from the neural tube along the oculomotor nerve.


Autonomic nervesAs a typical symptom of failure (neurogenic autonomic dysfunction / failure), the blood pressure drops by 50-100 mmHg and faints (orthostatic hypotension) when standing from the lying position, and urine reaches the bladder. However, it cannot be excreted from the body (urinary retention), the peristaltic movement of the intestinal tract is stopped and the abdomen becomes tense, or it cannot be excreted from the body due to rectal and anal abnormalities (ireus). Since these are not abnormal in cystoscopy and gastrointestinal endoscopy, they are sometimes referred to as "functional" in each organ department. Diabetic peripheral neuropathy and spinal cord injury as causative diseases of autonomic nerve failure傷, Multiple system atrophy, an intractable neurological diseasediseaseEtc. are well known. These are neurosurgery / neurosurgery / orthopedic disordersAutonomic nervesInsufficiency (visceral symptoms) is often accompanied by motor and sensory symptoms, but autonomic nervous system insufficiency (visceral symptoms) may be the only symptom. That is,Autonomic nervesIt can be said that cooperation between each organ department and the department of neurology is necessary for the diagnosis and treatment of insufficiency.

(Commentary) As a cause of visceral symptoms, when diseases of each organ department are sufficiently excluded and diseases of neurosurgery / neurosurgery / orthopedics are sufficiently excluded, there is a case of psychiatric disease (autonomia). ).

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