nerves

Sympathetic vs Parasympathetic Nervous System

Sympathetic Nervous System vs Parasympathetic Nervous System

The autonomic nervous system has two divisions with opposing effects: the sympathetic "fight or flight" system and the parasympathetic "rest and digest" system. Understanding their anatomical differences (thoracolumbar vs craniosacral outflow) and physiological effects is essential for pharmacology and clinical medicine.

Comparison Table

Feature
Sympathetic Nervous System
Parasympathetic Nervous System
Common name
Fight or flight
Rest and digest
Spinal outflow
Thoracolumbar (T1-L2)
Craniosacral (CN III, VII, IX, X + S2-S4)
Preganglionic fiber length
Short (synapse in paravertebral or prevertebral ganglia)
Long (synapse near or in target organ)
Postganglionic fiber length
Long
Short
Preganglionic neurotransmitter
Acetylcholine (nicotinic receptors)
Acetylcholine (nicotinic receptors)
Postganglionic neurotransmitter
Norepinephrine (adrenergic receptors)
Acetylcholine (muscarinic receptors)
Heart rate
Increases (β1 receptors)
Decreases (M2 receptors)
Bronchi
Dilates (β2 receptors)
Constricts (M3 receptors)
Pupils
Dilates (mydriasis, α1 receptors)
Constricts (miosis, M3 receptors)
GI motility
Decreases
Increases
Bladder
Relaxes detrusor, contracts sphincter (retention)
Contracts detrusor, relaxes sphincter (voiding)
Blood vessels
Generally constricts (α1), dilates in muscle (β2)
Little direct effect on most vessels

Key Differences

  • Outflow: Thoracolumbar (sympathetic) vs Craniosacral (parasympathetic)
  • Fiber lengths: Short pre/long post (sympathetic) vs Long pre/short post (parasympathetic)
  • Postganglionic neurotransmitter: Norepinephrine (sympathetic) vs Acetylcholine (parasympathetic)
  • General effect: Mobilizes energy vs Conserves energy

Clinical Relevance

  • Beta-blockers (β1): Decrease heart rate and blood pressure (block sympathetic)
  • Atropine (muscarinic antagonist): Increases heart rate, dilates pupils (blocks parasympathetic)
  • Horner's syndrome: Sympathetic lesion causing miosis, ptosis, anhidrosis
  • Anticholinergics side effects: "Dry as a bone, red as a beet, blind as a bat, mad as a hatter"

Study Tips

  • Sympathetic: "Fight or Flight" - dilated pupils, fast heart, bronchodilation, blood to muscles
  • Parasympathetic: "Rest and Digest" - constricted pupils, slow heart, increased GI activity
  • "Craniosacral" for parasympathetic: Cranial nerves + Sacral spinal nerves
  • Remember SLUDGE for parasympathetic excess: Salivation, Lacrimation, Urination, Defecation, GI upset, Emesis

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FAQs

Common questions about this comparison

Sympathetic preganglionic neurons exit the spinal cord and synapse quickly in the paravertebral (sympathetic chain) or prevertebral ganglia, which are close to the spinal cord. This creates a short preganglionic fiber. The postganglionic fiber then travels a longer distance to reach the target organ.

Sweat glands are embryologically derived from ectoderm and retain acetylcholine receptors. While they are innervated by sympathetic postganglionic fibers (anatomically sympathetic), these particular fibers release acetylcholine instead of norepinephrine - they are "sympathetic cholinergic" fibers. This is an exception to the rule.

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