Chapter 8: Nervous System

- Master controlling and communicating center of the body

- Includes Brain, Cranial Nerves (12 Pairs) and its branches, Spinal Cord, Spinal Nerves
(31 Pairs) and its branches, Ganglia, Enteric Plexus, and Sensory Receptors

Structure:
1. Brain ​- enclosed by skull; contains around 10B neurons
2. Cranial Nerves​ - 12 pairs; numbered I-XII
I. Olfactory
II. Optic
III. Oculomotor
IV. Trochlear
V. Trigeminal
VI. Abducens
VII. Facial
VIII. Vestibulocochlear
IX. Glossopharyngeal
X. Vagus
XI. Spinal Accessory
XII. Hypoglossal
3. Spinal Cord​ - connects the brain via foramen magnum and protected by vertebral
column
4. Spinal Nerves​ - 31 pairs; emerges from spinal cord
5. Ganglia ​- small masses of nerve tissue consisting primarily of neuronal cell bodies
6. Enteric Plexuses​ - network of neurons regulating digestive system
7. Sensory Receptors
- Dendrites of sensory neurons
- Specialized cells that monitor in the internal and external environment

Functions:
1. Receiving sensory input
2. Integrating information
3. Motor function
4. Maintains homeostasis
5. Mental activity
Subdivision:
1. Central Nervous System (CNS)
- Consists of brain and spinal cord
2. Peripheral Nervous System (PNS)
- Outside CNS; consists mainly of the nerves that extends from the brain to spinal
cord; all nerves

Neurons
- Transmits messages from one part of the body to another
- Parts:
a. Cell Body​ - contains nucleus; metabolic center of cell
b. Processes of Fibers:
➔ Dendrites ​- toward cell body
➔ Axons ​- away cell body
➔ Axon Hillock​ - area where axon leaves cell body

Classification of Neurons:
1. Structural​:
a. Multipolar
- Have many dendrites and one axon
- Most motor neurons and most CNS neurons
b. Bipolar
- Have one dendrites and one axon
- Special sense organs such as eyes and nose
c. Unipolar
- Single process coming from the cell body
- Most sensory neurons (afferent neurons)

2. Functional:
a. Sensory or Afferent
- Conveys action potential towards CNS
- Mostly unipolar
b. Motor or Efferent
- Away CNS to effector organs
- Mostly multipolar
c. Interneurons or Association
- Found in between sensory and motor neurons
Neuroglia
- Non-excitable, support cells (no action potential passing through)
- Generally small and outnumber the neurons by 5-50 times
- Comprises about half the total volume of brain and spinal cord
- Five Types:
1. Astrocytes
- Star shaped; supporting framework for nerve cells and fibers
- Serves as electrical insulators; prevents axon terminals to influence
- Serves as phagocytes by taking up degenerating synaptic terminalis
2. Oligodendrocytes
- Cells with process that can surround several axons
- Frequently found in rows along myelinated (to make it faster) nerve fibers
3. Microglia
- Smallest neuroglial cells; spider like
- Functions as phagocytes that protects CNS from infection
4. Ependyma
- Squamous epithelia like; ciliated
- Lines the cavities of brain and central canal of the spinal cord
- Lines the ventricles of the brain and central canal of the spinal cord and
are in contact with the cerebrospinal fluid (provides nutrients, protection
against trauma), the third ventricles and choroid plexuses
- Assists in the circulation of CSF; produces CSF - protein in nature
(glucose component)
5. Schwann Cells
- A.k.a. Neurolemmocytes or Neurilemma Cells
- Single cells surrounding axons
- Forms the myelin sheath in the PNS

Myelin Sheaths
- Whitish, fatty material that protects, insulates the fibers and increases the speed of nerve
impulses
- Oligodendrocytes ​- forms the myelin sheath in CNS
- Schwann ​- forms the myelin sheaths in PNS
- Nodes of Ranvier​ - gaps in myelin sheaths, where current flows
Organization of Nervous Tissue
● Nuclei ​- clusters of cell bodies in CNS
● Ganglia ​- collection of cell bodies in PNS
● Tracts ​- bundles of nerve fibers in CNS
● Nerves ​- bundles of nerve fibers in PNS
● Gray Matter
- Dense collection of unmyelinated fibers
- Parts:
a. Cortex ​- gray matter on surface of brain
b. Nuclei ​- gray matter deeper within brain
● White Matter
- Dense collection of myelinated fibers

Conduction of Action Potentials

1. Unmyelinated Axon​ - conducted slowly because potentials travel along the surface of
axon
2. Myelinated Axon​ - conducts rapidly by saltatory conduction

Saltatory Conduction​ - action potential that jumps from one node of ranvier to next

Synapse​ - junction where axon of one neuron interacts with another neuron
● Presynaptic Terminal​ - formed by axonal terminals
● Synaptic Cleft ​- space separating presynaptic and postsynaptic membranes
● Postsynaptic​ - membrane of effector cell
● Neurotransmitters ​- substances stored in synaptic vesicles found in presynaptic
terminal

Reflex
- Involuntary reactions in response to stimulus applied to periphery transmitted to the CNS
- Protective in nature
- Components:
a. Sensory Receptor
b. Sensory Neuron
c. Interneuron
d. Motor Neuron
e. Effector Organ
CNS ​- interprets incoming sensory information

PNS
- Spinal and Cranial Nerves
- 2 Division:
a. Sensory (Afferent) ​- sensory nerves
b. Motor (Efferent)​ - motor nerves

Sensory
a. Somatic Sensory Fibers
- Stimuli from skin, skeletal muscle, and joints
b. Visceral Sensory Fibers
- Transmits impulses coming from visceral organs

Motor
a. Somatic Motor Nervous System
- From CNS to Skeletal Muscles
- “Voluntary” Nervous System
b. Autonomic Motor Nervous System
- From CSN to Cardiac Muscles, Smooth Muscles, Glands
- “Involuntary” Nervous System

Autonomic Motor Nervous System

a. Sympathetic NS
- “Fight or Flight” system
- Increase HR, BP, RR, BT, dilate respiratory passages, perspiration, dry mouth
b. Parasympathetic NS
- “Resting and Digesting” system
- Decrease VS, constrict respiratory passages
c. Enteric NS
- Control of Digestive System
Central Nervous System
1. Brain
- Most complex mass of nervous tissue in the body
- About 2 good fistfuls, pinkish gray tissue, wrinkled like a walnut
- 3 lbs.; texture of cold oatmeal
- Four Major Regions:
a. Brainstem ​- midbrain, pons, medulla oblongata
b. Diencephalon ​- thalamus, epithalamus, hypothalamus
c. Cerebellum
d. Cerebrum

A. Brainstem
- About the size of a thumb; approximately 3in long
- Nuclei forms all cranial nerves except CNI and CNII, responsible for breathing,
maintenance of vital signs
- Reticular Formation​ - involved in regulating cyclical motor functions such as
respiration, walking, and chewing
- Reticular Activating System​ - regulates consciousness and awake/sleep cycles
1. Midbrain
- Smallest part; superior portion
- Substantia Nigra​ - part of basal nuclei involved in regulation of
general body movements
- 4 Bulging Fiber Tracts (colliculi)
● 2 Superior​ - visual reflexes
● 2 Inferior​ - auditory reflexes
2. Pons
- “Bridge”; bridges cerebrum and cerebellum
- Works with medulla oblongata - regulates breathing
- Other nuclei - chewing and salivation
3. Medulla Oblongata
- Most inferior
- Maintains nuclei that regulate vital visceral activities
- Regulates vital signs, swallowing, coughing, sneezing, vomiting
B. Diencephalon
- Central portion of brain between brainstem and cerebrum
- “Interbrain”
1. Thalamus
- Largest part; shaped like yoyo
- Two large, lateral parts connected by Interthalamic Adhesion
- Relay station for sensory impulses passing upward to the sensory
cortex
- Influenced mood and registers an unlocalized, uncomfortable
perception of pain
 2. Epithalamus
- Superior and Posterior of Thalamus
- Emotional and visceral response to odors
- Contains pineal body - endocrine gland that influence the onset of
puberty
3. Hypothalamus
- Inferior to Thalamus
- Control body temperature, hunger, thirst, sexual pressure, emotion
- Emotions are an important part of so-called Limbic System
- Limbic System
➔ Seethe emotions
➔ Regulates secretions of:
● Pituitary Gland
● Mammillary Bodies​ - emotional responses to odor
and memory
- Infundibulum
➔ Funnel shaped stalk
➔ Extends from floor of Hypothalamus to Pituitary Gland

C. Cerebellum
- “Little brain”; 2 Hemispheres
- Large cauliflower like that projects dorsally from under occipital lobe of cerebrum
- 2 hemispheres and convoluted surface
- Precise timing for skeletal muscle activity, controls balance and equilibrium,
maintains muscle tone and coordination of motor movements (involves only
hands)
- Cerebellar Peduncles​ - attach cerebellum to brainstem
- Comparator​ - compares information about intended movement from motor
cortex with sensory information
- Proprioceptive Neurons​ - innervate joints, tendons, muscles, provides info
about the position of body parts
- Involved in learning motor skills
 D. Cerebrum
- Largest part of brain
- Most superior; 2 hemispheres by a longitudinal fissure
- Exhibits elevated ridges of tissue called ​Gyri
- Gyri is separated by Sulci (shallow)
- Fissures​ - deeper grooves; between gyri
- 4 Lobes named after Cranial Bones:
1. Frontal
- Control the voluntary motor functions, motivation, aggression,
mood, and olfactory
- Contains primary motor area that allows to consciously move
skeletal muscle
- Axons of these motor major voluntary tract - the Pyramidal or
Corticospinal Tract (descending)
- Broca’s Area (Aphasia)
➔ Primary motor speech center
➔ If damaged - inability to say words properly

2. Parietal
- Primary sensory area
- Recognize pain, light, touch, temperature, balance, taste
- Body regions with the most sensory receptors are Lips and
Fingertips
- Sensory pathways are crossed pathways
- Wernicke’s Area​ - primary sensory speech area
*Mixed Aphasia/Global Aphasia

3. Occipital
- Reception and visual input and are not distinctly separated from
other lobes
- Contains primary visual area

4. Temporal
- Lateral Fissure ​- separated from the rest of the cerebrum
- Olfactory and auditory sensations and in memory
- Psychic Cortex​ - functions of abstract thought and judgement
Other brain functions:
● Right and Left Hemispheres
- Connected by commissures
- Corpus Callosum​ - largest commissure
- Right Hemisphere
➔ Receives sensory input and controls muscular activity in the left half of the
body
➔ Three dimensional or Spatial perception and Musical ability
- Left Hemisphere
➔ Receives sensory input and controls muscular activity in the right half of
the body
➔ Analytical hemisphere emphasizing in skills like Mathematics and Speech
● Speech
- Wernicke’s Area​ - sensory speech area in the parietal lobe
- Broca’s Area​ - motor speech area in the frontal lobe
- Aphasia​ - absent or defective speech or language comprehension as a result of
the damage in speech areas
● Memory
- Sensory
➔ Temporal
➔ Lasts for less than a second
- Short term
➔ Info retained in few seconds to a few minutes
➔ Limited to number of bits of information (about seven) that can be stored
at any time
- Long term
➔ Lasts for few minutes and some may become permanent
➔ Memory Engrams/Memorytraces - involved in long term retention of a
given piece of information, thought, or idea

● Limbic System
- Responds to olfactory stimulation
- Responses for survival such as thirst and hunger
- Influences memory, emotions, visceral responses to emotions, motivation, and
mood
- Lesions in LS - voracious appetite; increased sexual activity and docility (loss of
normal fear responses)
 2. Spinal Cord
- Long, glistening white continuation of brainstem
- Two-way conduction pathway to and from the brain
- Extends from the foramen magnum to L2
- 31 pairs of spinal nerves; terminates inferiorly known as Cauda Equinal
- Cauda (tail); Equinal (horse)

White Matter
- Myelinated fiber tracts
- 3 regions:
1. Posterior Columns
2. Lateral Columns
3. Anterior Columns (cut)
- Made up of tracts with axons with the same destination and function:
a. Ascending Tracts​ - from periphery to brain
b. Descending Tracts​ - from brain to periphery

Gray Matter
- Central portion of spinal cord; Shaped like “H”
- 3 regions:
1. Posterior Horns
2. Lateral Horns
3. Anterior Horns
- Ventral Root
- Dorsal Root
- Dorsal Root Ganglion
- Spinal Nerve​ - Ventral Root + Dorsal Root

Spinal Cord Reflexes

● Knee-jerk Reflex/Patellar Reflex
- Stretch reflex when patellar ligament is tapped causing leg extension
● Withdrawal Reflex/ Flexor Reflex
- To remove a limb from painful stimulus
Ascending Tracts
- Pathway from the periphery to various parts of the brain
- Parts:
1. Spinothalamic Tract
- Transmits pain, light, touch, deep pressure
2. Dorsal Column
- Transmission of proprioception (position sense), touch, deep pressure,
and vibration
3. Spinocerebellar
- Proprioception to cerebellum

*Decotiates - crossed pathways

Descending Tracts
- Pathway from the brain to periphery
- Parts:
1. Lateral Corticospinal
- Muscle tone and skilled movements especially the hand
2. Anterior Corticospinal
- Muscle tone and movement of trunk muscles
3. Rubrospinal
- Movement coordination
4. Reticulospinal
- Posture adjustment
5. Vestibulospinal
- Posture and balance
6. Tectospinal
- Movement in response to visual reflexes

Protection of CNS
- 3 layers of connective tissue and protects structures are meninges:
- Parts:
1. Dura Mater ​- outermost layer
2. Arachnoid Mater​ - middle portion; “Spider like”
3. Pia Mater​ - innermost layer; cling tightly to the surface of the brain and spinal
cord
Spaces Between Meninges:
a. Epidural Space
- Between the dura mater and periosteum of vertebrae
- Site for epidural anesthesia injection
b. Subdural Space
- Between the dura mater and arachnoid mater
c. Subarachnoid Space
- Between arachnoid mater and pia mater
- Filled with CSF and blood vessels

PNS
- Nerve​ - bundle of neuron fibers
a. Endoneurium
- Delicate connective tissue that surrounds a neuron fiber
b. Perineurium
- A coarser connective sheath that covers group of fibers (fascicles)
c. Epineurium
- A tough fibrous sheath that bounds together the fascicles
- Superficial
Cranial Nerves
- 12 pairs; primary supplies action potentials to head and neck
- Only CN X - extends from thoracic and abdominal cavities
- Located at the inferior view portion

I. Olfactory
- Sensory; smell
- Asked to sniff aromatic substances
II. Optic
- Sensory; sense of vision
- Snellen Chart
III. Oculomotor
- Motor; pupil constriction
- Penlight, eye convergence
IV. Trochlear
- Motor; supplies superior oblique
- Same test for CN III
V. Trigeminal
- Both;​ 3 Branches:
a. Ophthalmic ​(Sensory) - cotton wisp
b. Maxillary​ (Sensory) - safety pin and hot or cold objects
c. Mandibular​ (Motor) - open and close jaw w/ resistance
VI. Abducens
- Motor; supplies the lateral rectus muscle of the eye
- Ability of each eye to move laterally
VII. Facial
- Both; Facial Expression, Lacrimal, and Salivary Glands
- Sensation of the anterior ⅔ of the tongue
- Facial Expression ​- close eyes, smile, whistle
- Lacrimal Glands​ - tested with ammonia fumes
- Tongue​ - tested for different tastes
VIII. Vestibulocochlear
- Sensory;​ 2 Branches:
a. Vestibular​ - Romberg’s Test; Stand erect, foot together
b. Cochlear ​- Watch Tick’s Test; Hearing
IX. Glossopharyngeal
- Both; sensory to posterior ⅓ of tongue
- Motor to swallowing
- Test posterior tongue for different taste and ask client to swallow
X. Vagus
- Sensory; sensation of the pharynx, larynx
- Same test with CN IX
XI. Accessory
- Motor; innervates sternocleidomastoid and trapezius muscle
- Ask client to flex his/her neck and shrug shoulders w/ resistance
XII. Hypoglossal
- Motor; tongue movements
- Ask client to move tongue

CN I Sensory

CN II Sensory

CN III Motor

CN IV Motor

CN V Both

CN VI Motor

CN VII Both

CN VIII Sensory

CN IX Both

CN X Sensory

CN XI Motor

CN XII Motor

Spinal Nerves
- Arises along the spinal cord upon the union of the dorsal and ventral roots
- 31 pairs:
● Cervical ​- 8
● Thoracic ​- 12
● Lumbra ​- 5
● Sacral ​- 5
● Coccyx ​- 1
- Organized into 3 plexus
 A. Cervical Plexus
- Originates from C1-C4
- Innervates the diaphragm via the phrenic nerve

B. Brachial Plexus
- Originates from C3-T1
- Comprises of 5 Nerves:
1. Axillary Nerve
- Innervates shoulder muscle
2. Median Nerve
- Innervates the anterior forearm and intrinsic muscle
3. Musculocutaneous Nerve
- Innervates the anterior muscles of the arm and skin on radial side
of forearm
4. Radial Nerve
- Innervates the posterior arm and forearm
5. Ulnar Nerve
- Innervates the two anterior forearm muscles and most of the
intrinsic hand muscles
C. Lumbosacral Plexus
- Originates from L1-S4
- With four major nerves to innervate the lower limb:
1. Obturator Nerve
- Innervates the muscles of the medial thigh and the skin over the
same region
2. Femoral Nerve
- Innervates the anterior thigh muscles and the skin over the
anterior thigh and medial side of the leg
Sciatic Nerve​ - largest nerve in the body and innervates posterior surface of the thigh; divides
into:

3. Tibial Nerve
- Innervates the posterior leg muscles, intrinsic foot muscles, and
skin over the sole of the foot
4. Common Peroneal Nerve
- Innervates the muscles of the lateral thigh and leg, and some
intrinsic foot muscles
- Innervates the skin over the anterior and lateral leg, and dorsal
surface of the foot