# Introduction to Autonomic Nervous System | Symptoms, Causes, Tests and Treatment | OSANG

> The autonomic nervous system is a nervous system that regulates body functions that operate automatically without conscious awareness, such as heart rate, blood pressure…

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- Organization: OSANG Neurosurgery

## Page content

Autonomic Medicine

## Introduction to Autonomic Nervous System

Autonomic Nervous System

The autonomic nervous system (ANS) is a branch of the peripheral nervous system that regulates involuntary body functions such as cardiovascular, breathing, digestion, and temperature regulation. It maintains homeostasis in the internal environment through the antagonistic actions of the sympathetic and parasympathetic nervous systems.

## At a glance

The autonomic nervous system is a nervous system that regulates body functions that operate automatically without conscious awareness, such as heart rate, blood pressure, breathing, digestion, and body temperature. It consists of the sympathetic nerve, which activates the body in a state of tension, and the parasympathetic nerve, which helps recovery in a resting state. These two nerves must be balanced to maintain health, and when the balance is broken, various symptoms such as palpitations, dizziness, indigestion, and chronic fatigue appear. Autonomic function can be checked through heart rate variability (HRV) testing.

- 01Definition and Overview

- 02structure

- 03function

- 04Symptoms of autonomic nervous system abnormalities

- 05Inspection method

- 06life management

## Definition and Overview

The autonomic nervous system (ANS) is a nervous system that automatically regulates the functions of internal organs. Almost all organs, including the heart, lungs, gastrointestinal tract, bladder, and blood vessels, are under the control of the autonomic nervous system and play a role in maintaining the balance of the body's internal environment without conscious effort.

The name autonomic nervous system was first used by British physiologist Langley in 1898. Langley divided the autonomic nervous system into three branches, the sympathetic nervous system, parasympathetic nervous system, and enteric nervous system, according to the location of the nerves, and this classification is still used to this day.

The autonomic nervous system includes both sensory pathways that send information from organs to the brain and motor pathways that send commands from the brain to organs. Sensory pathways convey information about the state of organs to the brain, allowing autonomic reflexes to occur.

## structure

### sympathetic nervous system

The sympathetic nervous system is often called the ‘battle mode nerve’. Nerves originate from the thoracic to lumbar areas of the spinal cord (1st thoracic to 2nd lumbar vertebrae). This nerve passes through a nerve relay station (ganglion) located next to or in front of the spine before reaching each organ.

In the front section of the sympathetic nervous system, a signaling substance called acetylcholine is used, and in the back section of the relay center, a signaling substance called norepinephrine is used. However, the sympathetic nerves that control the sweat glands use acetylcholine as an exception.

### parasympathetic nervous system

The parasympathetic nervous system corresponds to the ‘recovery mode nerve’. Nerves originate from the brain stem and the sacral region of the spinal cord (sacral vertebrae 2 to 4). The parasympathetic nerve coming out of the brain stem travels along several cranial nerves, of which the vagus nerve transmits about 75% of parasympathetic nerve signals.

The parasympathetic nerve uses acetylcholine as a signaling substance in both the anterior and posterior segments of the relay station.

### intestinal nervous system

The enteric nervous system is an independent neural network made up of more than 100 million nerve cells located in the walls of the digestive tract. It is called the ‘second brain’ because it can control the movement of the digestive tract, secretion of digestive juices, and blood flow on its own without commands from the brain.

## function

### cardiovascular regulation

The autonomic nervous system maintains appropriate blood pressure and blood flow by regulating heart rate, cardiac contraction force, and degree of blood vessel constriction. When the sympathetic nervous system is activated, the heart beats faster and harder and blood vessels narrow. Conversely, the parasympathetic nerve (vagus nerve) slows the heart rate.

When at rest, the heart is under constant inhibition from the vagus nerve, which is called vagal tone. Vagal tone can be measured indirectly by testing heart rate variability (HRV).

### breathing control

The parasympathetic nerves narrow the bronchi, and the sympathetic nerves widen the bronchi. In airway hypersensitivity diseases such as asthma, excessive activity of the parasympathetic nervous system is involved.

### digestive function

The parasympathetic nerve (vagus nerve) promotes gastric acid secretion, digestive enzyme secretion, and intestinal movement. Conversely, the sympathetic nerve suppresses digestive function and tightens the sphincter. The enteric nervous system coordinates the digestive process through its own reflexes, separate from these external nerve signals.

### body temperature regulation

Sweat secretion, changes in skin blood flow, and contraction of the erector pilonidal muscle are key mechanisms for regulating body temperature. In a hot environment, the sympathetic nerve stimulates sweat glands to release sweat and expands skin blood vessels to dissipate heat.

## Symptoms of autonomic nervous system abnormalities

When the balance of the autonomic nervous system is broken, various symptoms appear across multiple organs. This condition is called autonomic dysfunction.

Typical symptoms are as follows:

- Cardiovascular system: palpitations, dizziness when standing up (orthostatic hypotension), sudden fainting (syncope)

- Digestive system: heartburn, indigestion, constipation or diarrhea

- Temperature/sweating: Cold hands and feet, excessive sweating, abnormal body temperature regulation

- Urinary system: frequent urination, feeling of residual urination

- Systemic symptoms: chronic fatigue, sleep disturbance, difficulty concentrating.

Postural orthostatic tachycardia syndrome (POTS) is a representative autonomic disease in which the heart rate rapidly increases to more than 30 beats per minute when standing up.

## Inspection method

Representative tests to evaluate autonomic function are as follows.

- Heart rate variability (HRV) analysis: This is a non-invasive test that determines the state of autonomic nervous system balance by analyzing minute changes in heartbeat intervals. According to the 1996 European Society of Cardiology standards, an SDNN of less than 100ms suggests a decline in autonomic function.

- Standing tilt table test: The patient is fixed to the bed and tilted to observe changes in blood pressure and heart rate.

- Valsalva maneuver: Analyze blood pressure and heart rate responses after holding your breath and exerting force.

- Deep breathing test: Measures heart rate changes due to deep breathing.

- Perspiration function test: Evaluates sweat secretion ability to check for autonomic nervous system abnormalities.

## life management

Daily management rules to maintain autonomic balance are as follows.

- Regular aerobic exercise: Walking, swimming, or cycling for more than 30 minutes, 3 to 5 times a week, helps improve parasympathetic nerve function.

- Sufficient sleep: Regular sleep of 7 to 8 hours a day is essential for autonomic recovery.

- Stress management: Overactivation of the sympathetic nervous system can be suppressed through abdominal breathing, meditation, and relaxation training.

- Balanced diet: Reduce excessive caffeine and alcohol intake and drink plenty of fluids.

- Be careful of sudden changes in posture: If you have orthostatic symptoms, stand up slowly and avoid standing for long periods of time.

If chronic stress, lack of sleep, and irregular lifestyle continue, overactivation of the sympathetic nervous system may become established and various symptoms of autonomic abnormalities may appear. If symptoms persist, it is recommended to consult a specialist.

## Frequently asked questions

### Q01What is the autonomic nervous system?

The autonomic nervous system is a nervous system that regulates body functions that occur automatically without conscious effort, such as heart rate, blood pressure, breathing, digestion, and body temperature. It consists of the sympathetic nervous system and the parasympathetic nervous system, and these two systems must be well balanced to maintain a healthy state.

### Q02What is the difference between the sympathetic and parasympathetic nervous systems?

To put it simply, the sympathetic nervous system is a ‘battle mode’ nerve that activates the body by raising the heart rate and blood pressure when you are nervous or in an emergency. Conversely, the parasympathetic nerve can be understood as a 'recovery mode' nerve that lowers the heart rate and promotes digestion in a stable state.

### Q03What symptoms appear when there is an abnormality in the autonomic nervous system?

A variety of symptoms may occur, including palpitations, dizziness when standing up, abnormal or no sweating, indigestion, chronic fatigue, sleep disorders, and abnormal body temperature regulation. If you experience several of these symptoms at the same time, we recommend that you undergo an autonomic nerve function test.

### Q04How is autonomic nervous system function tested?

Heart rate variability (HRV) analysis is the most widely used noninvasive testing method. It checks the balance of the autonomic nervous system by analyzing minute changes in heartbeat without pain. In addition, the tilt-table test, Valsalva maneuver, and deep breathing test are also performed for a comprehensive evaluation.

### Q05How can I keep my autonomic nervous system healthy?

Regular aerobic exercise, sufficient sleep (7 to 8 hours), stress management, and balanced diet help maintain autonomic balance. In particular, chronic stress and lack of sleep are the main causes of excessive stimulation of the sympathetic nervous system, so it is recommended to maintain a consistent daily rhythm.

### Q06What is the relationship between the autonomic nervous system and stress?

When you experience acute stress, your sympathetic nervous system is activated, causing your heart to beat faster and you become tense. This is a normal response, but if stress becomes chronic, hyperactivity of the sympathetic nervous system and inhibition of the parasympathetic nervous system may become entrenched, resulting in autonomic imbalance. If this condition persists, it increases the risk of cardiovascular disease, decreased immune function, and mental health problems, so early management is important.

## Related articles

- Irritable Bowel Syndrome

- sympathetic nervous system

- Aging and autonomic nervous system

- Autonomic dysfunction after stroke

This article provides general medical information and does not replace an individual diagnosis or treatment plan. Please seek a medical assessment if symptoms persist.

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