An enormous number of neurons are specifically associated with the gastrointestinal tract to control its many functions; indeed, more neurons are said to reside in the human gut than in the entire spinal cord. As already noted, the activity of the gut is modulated by both the sympathetic and the parasympathetic divisions of the visceral motor system. However, the gut also has an extensive system of nerve cells in its wall [as do its accessory organs such as the pancreas and gallbladder] that do not fit neatly into the sympathetic or parasympathetic divisions of the visceral motor system [Figure 21.4A]. To a surprising degree, these neurons and the complex enteric plexuses in which they are found [plexus means “network”] operate more or less independently according to their own reflex rules; as a result, many gut functions continue perfectly well without sympathetic or parasympathetic supervision [peristalsis, for example, occurs in isolated gut segments in vitro]. Thus, most investigators prefer to classify the enteric nervous system as a separate component of the visceral motor system.
Figure 21.4
Organization of the enteric component of the visceral motor system. [A] Sympathetic and parasympathetic innervation of the enteric nervous system, and the intrinsic neurons of the gut. [B] Detailed organization of nerve cell plexuses in the gut wall. [more...]
The neurons in the gut wall include local and centrally projecting sensory neurons that monitor mechanical and chemical conditions in the gut, local circuit neurons that integrate this information, and motor neurons that influence the activity of the smooth muscles in the wall of the gut and glandular secretions [e.g., of digestive enzymes, mucus, stomach acid, and bile]. This complex arrangement of nerve cells intrinsic to the gut is organized into: [1] the myenteric [or Auerbach's] plexus, which is specifically concerned with regulating the musculature of the gut; and [2] the submucus [or Meissner's] plexus, which is located, as the name implies, just beneath the mucus membranes of the gut and is concerned with chemical monitoring and glandular secretion [Figure 21.4B].
As already mentioned, the preganglionic parasympathetic neurons that influence the gut are primarily in the dorsal motor nucleus of vagus nerve in the brainstem and the intermediate gray zone in the sacral spinal cord segments. The preganglionic sympathetic innervation that modulates the action of the gut plexuses derives from the thoraco-lumbar cord, primarily by way of the celiac, superior, and inferior mesenteric ganglia.
Review
doi: 10.1002/ddrr.15.
Affiliations
- PMID: 18646012
- DOI: 10.1002/ddrr.15
Review
The nervous system and gastrointestinal function
Muhammad A Altaf et al. Dev Disabil Res Rev. 2008.
Abstract
The enteric nervous system is an integrative brain with collection of neurons in the gastrointestinal tract which is capable of functioning independently of the central nervous system [CNS]. The enteric nervous system modulates motility, secretions, microcirculation, immune and inflammatory responses of the gastrointestinal tract. Dysphagia, feeding intolerance, gastroesophageal reflux, abdominal pain, and constipation are few of the medical problems frequently encountered in children with developmental disabilities. Alteration in bowel motility have been described in most of these disorders and can results from a primary defect in the enteric neurons or central modulation. The development and physiology of the enteric nervous system is discussed along with the basic mechanisms involved in controlling various functions of the gastrointestinal tract. The intestinal motility, neurogastric reflexes, and brain perception of visceral hyperalgesia are also discussed. This will help better understand the pathophysiology of these disorders in children with developmental disabilities.
[c] 2008 Wiley-Liss, Inc.
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