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Purves D, Augustine GJ, Fitzpatrick D, et al., editors. Neuroscience. 2nd edition. Sunderland (MA): Sinauer Associates; 2001.

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The visceral motor system is regulated in part by circuitry in the cerebral cortex:Involuntary visceral reactions such as blushing in response to consciouslyembarrassing stimuli, vasoconstriction and pallor in response to fear, and autonomicresponses to sexual situations make this plain. Indeed, autonomic function isintimately related to emotional experience and expression, as described in Chapter 29. In addition, thehippocampus, thalamus, basal ganglia, cerebellum, and reticular formation allinfluence the visceral motor system. The major center in the control of the visceralmotor system, however, is the hypothalamus (Box A). The hypothalamic nuclei relevant to visceral motor functionproject to the nuclei in the brainstem that organize many visceral reflexes (e.g.,respiration, vomiting, urination), to the cranial nerve nuclei that containparasympathetic preganglionic neurons, and to the sympathetic and parasympatheticpreganglionic neurons in the spinal cord. The general organization of this centralautonomic control is summarized in Figure21.6, and some important clinical manifestations of damage to thisdescending system are illustrated in BoxB.


Figure 21.6

Summary of the central control of the visceral motor system. The majororganizing center for visceral motor functions is the hypothalamus (seeBox A).

Although the hypothalamus is the key structure in the overall organization ofvisceral function, and in homeostasis generally, the visceral motor system continuesto function independently if disease or injury impedes the influence of thiscontrolling center. The major subcortical centers for the ongoing regulation of theautonomic function in the absence of hypothalamic control are a series of poorlyunderstood nuclei in the brainstem tegmentum that organize specific visceralfunctions such as cardiac reflexes, reflexes that control the bladder, and reflexesrelated to sexual function, as well as other critical autonomic reflexes such asrespiration and vomiting.

The afferent information from the viscera that drives these brainstem centers is, asnoted already, received by neurons in the nucleus of the solitary tract, whichrelays these signals to the hypothalamus and to the various autonomic centers in thebrainstem tegmentum.

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