Parasympathetic (craniosacral) outflow

Outflow · III, VII, IX, X S2–S4 N_N at ganglion ACh on M1–M3

Preganglionic neurones lie in the brainstem nuclei of cranial nerves III, VII, IX and X and in the sacral cord at S2–S4. Long cholinergic preganglionic fibres synapse in ganglia in or beside the target, so postganglionic fibres are short and responses are discrete rather than mass.

Detail

Cranial component
Edinger–Westphal (III), superior salivatory (VII), inferior salivatory (IX), dorsal motor nucleus of vagus and nucleus ambiguus (X)
Sacral component
S2–S4 lateral grey → pelvic splanchnic nerves
Postganglionic transmitter
Acetylcholine on muscarinic receptors: M2 heart, M3 smooth muscle and glands
Share of outflow
The vagus carries roughly three-quarters of all parasympathetic fibres

When it goes wrong

Organophosphate (pesticide, nerve agent) inhibits acetylcholinesterase at every muscarinic synapse

Cholinergic crisis — salivation, lacrimation, urination, diarrhoea, bronchorrhoea with bronchospasm, bradycardia and miosis (DUMBELS); treat with atropine to effect and pralidoxime

Practise this structure

1 question in the bank tagged Autonomic.