BASIC CONCEPTS IN NEURO-PHYSIOLOGY

1. Autonomic nervous system

2. Sensory system
3. Motor system
4. Important brain areas
Genera] overview of nervous system
NERVOUS
SYSTEM

1
/—
CENTRAL
NERVOUS
SYSTEM
------ -- Jk

MOTOR
Brain Spinal cord
PNS
L
. ........ -■ ■
Autonomic i.e. involuntary
---- -- -A . .. m
Somatic
senses
 Viscera!
Eg skin senses
locomotio Like dull
n pain
c.
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Further dissection of central nervous sytem

*
TRACTS
Association Fibers

Concepts in Autonomic Nervous System

1. Origin:
• Sympathetic: Thoraco-Luminar outflow i.e T1-L2
• Parasympathetic: 3, 7, 9,10 and S2, S3, S4
cranial nerve 3, 7, 9, and 10 and S2, S3, S4 ->So called cranio-sacral outflow
2. Neurons:-
• Preganglionic neuron will secret Ach and its receptor must be nicotinic receptor
• Same rule applies to the neuron supplying skeletal muscle i.e Ach - Nicotinic receptor
• POst ganglionic neuron will have its own neurotransmitter and receptor according to
Autonomic nervous system subtype of symp and parasymp
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Brain
3,7,9,40
Long Pregang of PANS

Short Post Gang «Ach

Nicotinic receptor Muscarinic receptor
Spinal
Card
T1-T2
Symphthtic Short Pregang_
Ach
Nicotinic
Long Post Gang
Nor-Epineephrine
reaptc
Symph Adrenal medulla Adrenal secretes Epinephrine > N.epi
Ach
Nicotinic receptor
V

Motor neuron
* Ach Nicotinic
Skeletal Muscle
Receptors:
Parasympathetic

v
M
2
• Heart

1
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Sympathetic Receptors
al a2 (Inhibitory] (31 P2 (Inhibitory)
• Blood vessels -» • Pre- Synaptic • Heart - inc its • Lung - dilation of
Constriction neuron terminals • activity • Kidney - airways
Platelet inc • Gl-Muscles and
• Eye ... Radial •pancreas renin bladder - relaxation •
muscle, iris • Fats - inc lipid Blood vessel in
contraction break down skeletal
muscle - dilation
0
3 Main Action of Para-Svm
1
l #Dec heart Activity
' ♦ increases smooth muscle Contraction e.g G-I Muscle, urinarybladder etc ♦ inc every
single secretions e.g lacrimation, salivation, urination etc
i
Note that... the actions of sympathetic nervous system are just opposite to these
i
Important Autonomic Centers
Mid Brain - Pons - Medulla - vasomotor
For micturition Pnemotaxic centers centers e.g swallowing
apneustic Centers sneezing resp centers
etc.

Sensory System
we will discuss sensory system with following main areas
Sensory Receptors Sensory Fibers Pathways (ascending
pathways
f "
!
i
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Sensory Receptors
• Pacinian -» vibration (rapidly adopting)
• Meisner -> soft touch, 2-point discrimination velocity
• Merckle -> Deep static touch & position sense
• Raffini-> Pressure
• Krause -> Cold
• Free nerve endings -> Pain (Slowly adapting)
Important fibers in peripheral nervous system Fibers
A - Fibers B- Fibers C- Fibers
A- A- A-Y A-6(Delta) Autonomic Slow Pain
(gamma) (un-
a(alpha) (3 (beta) ♦ Motor ♦ Fast pain nervous myelinated)
♦ motor ♦ neuron to and system
 temperatur
neurons Touch muscle e
(extra- and spindles
fusal) Pressur (intrafusal)
♦ fastest e
fiber Esp on
tips ie
fingerti
__
__

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■
Fibers in central nervous system

Commissural fibers Structures that connects hemisphere

for example
♦ .corpus callosum ♦ Anterior commissure ♦ .posterior commissures Note that... cpsp
frequently asks about corpus callosum
Association fibers these are mainly horizontal fibers, association fibers -» connects
different parts of the same hemisphere for example
♦ Fornex connects the parts of limbic association area
♦ Cingulum &
♦ Short association fibers connect regains of gray matter in same hemisphere
Projection fibers, these are mainly vertical fibers, & these -> connect the cerebral cortex
to the lower brain region
For example ♦ Internal capsule.
In these examples internal capsule is cpsp favorite
! Ascending Pathways and important concepts. *
1. Concepts of 1st, 2nd and 3rd order neuron
I
2. Concept of spinothalamic and dorsal column pathway
While descending pathways only have 2 number i.ei. UMH & LMN
Neurons:
• First order neuron lies in sensory ganglion also called dorsal not ganglion, that
carries sensations from sensory receptors and then enters into spinal cord.
• Second order neuron - in spinal cord or brainstem,, it crosses midline, while
for spinothalamic, it crosses in spinal cord.
• 3rd order neuron - lies in thalamus and carries sensations to cerebral cortex.
\P

.... "

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)
Receptors
Note That: thalamus contains
• Ventral posterior-lateral nucleus - that receives fibers from spinothalamic and dorsal
column systems.
• Ventral-posterio-medial nucleus - that receive, fibers from face via ventral tegmental
tract
Mnemonic is:
o M for medial i.e. V-P medial o M for makeup i.e. appeared to face.
Sensations:
• Pain and temperature. Note that anterior spinothalamic carries crude pressure
sensations.
Spinothalamic tract is also called anterio-lateral system, as the fibers are ascending
up in anterior and lateral parts of spinal cord.
I
!
Lesions:
♦ Any lesion of this pathway results in loss of contra-lateral pain and temp 1-2 segments
below the point of lesion
For example: If the lesion is at right T3 then loss will be at left T5 (opposite and 2
segments below)
Dorsal Column Medial Luminiscal System
Sensations:
Dorsal column carries fine sensation like vibration, proprioception etc.
Neuronal Pathway:
♦ First order neuron: lies in dorsal root ganglion, and after entering into spinal cord, it
ascend up ipsilaterally and ends-up in nucleus gracillus and cuneatus of brainstem
♦ Second order neuron: crosses midline in brainstem and form internal arcuate fibers,
and ascends up to thalamus as medial lemniscus.
♦ Third order neuron: ascends up to cerebral cortex
Note that dorsal column has 2 pathways in it:
1. Fasciculus Gracilis - fibers from lower limb and memorized as "Legs are graceful)
2. Fasciculus cuneatus - fibers from upper limb
Lesions: any lesion of this pathway results in loss of ipsilateral vibration
/position/proprioception at the level of lesion.
For example: lesion of dorsal column system at right T3 means loss of sensations, at right
T3 level on same side.
Motor System
Three important concepts in motor system ?
Types of muscle sensors
Type of muscle fibers
Descending pathways
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Muscle Sensors

Muscle spindles Golgi Tendon Organs

©Detects change in muscle length e.g. ©Think about its action as opposite to
stretch muscle spindle i.e. muscle contraction
on muscle increase
® If there is stretching of rr ide .1 j g ft G golg: ten den organ, and as a
activate result
muscle spindles, and m ., r o.1 >ii muscle has to relax
contract to dec its leng’ h While :n case of spindles, stretch would
cause the spindle to fire more and result is
-—-
contraction

MUSCLE SPINDLES;
IN nutshell
♦ Stretch on muscle Inc firing from muscle spindles $ On other hand contraction . fmnsc!
dec firing from muccle spindle
Summary: Stretch spindles slin Ration contraction ie
stretch on muscle Inc firing from sjfrnfres Result in muscle contraction EXAMPLE ... KNEE
JERK
GOLGI TENDON ORGANS;
GTO wants the muscles in relaxed r&ste i.e. it relives it tension
$ Muscle in tension - inc firing of GTO $ Muscle relaxation ~ dec its firing

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Muscle Fibers
 Sxtra Fusal Fibers © Make bulk
Intra-Fusal Fibers j ©Smaller than extrafusal fibers
of muscle
© Unite to form muscle j © Su spindle
lied by a-motor neurons
• Innervated by Gamma motor neurons; which
are at its ends. »
©These fibers has 2 j
i
i
Subtypes
a
Nuclear Chain Fibers Nuclear bag fibers j
# Detects static ^Detects dynanr : fast change in
chain muscle length. j
in muscle length i

'
!

s'
•«rw?

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Functions of Alpha and Gamma motor Neuron
♦ Alpha motor neuron, innervate, extrafusal fibers, - resulting in force generation during
contraction.
♦ Gamma motor neurons innervate the end, of intrafusal fibers (muscle spindles)
Note That: Both alpha and gamma motor neurons are co-activated alpha-motor
neurons, are for contraction while gamma motor neurons adjust the sensitivity of muscle
spindles in response to contraction.
\
l mil
Descending Pathways
Neurons: Motor system consist of 2 types of neurons
1. Upper motoneuron
2. Lower motoneurons
UMN - neuron from higher centers
&
Lesion of UMN - everything goes up i.g up going planters exaggerated reflexes spastic
paralysis etc.
Lmn
LMN - neuron from anterior horn of spinal cord
&
lesions of LMN: everything go down e.g. down going planters, down reflexes flaccid
paralysis etc.
Descending Pathways:
1. Cortico-Spinal Tract:
• Upper neuron from cortex
• Lower neuron from anterior horn of spinal cord
• UMN cross midline in medulla i.e. Decussation
Lesion of UMN->contra-lateral problem
Lesion of LMN^IPSi-Lateral problem
2. Cortico-Nuclear/Bulbar:- •Upper neuron from cortex
• Lower neuron in brainstem (e.g CN nuclei) and cranial nerves are lower motoneurons
Lesion of UMN - supra balder palsy Lesion of LMN - bulbar palsy
3. Rubro-Spinal:
• From red nucleus to spinal cord supplies flexor muscles i.e. helps in sitting
4. Vestibulo-Spinal:
• Supplies extensors and Helps in standing
Muscle Reflexes
Muslce Stretch Reflex
Golgi Tendon Reflex
Flexor Withdrawl

1. Muscle Stretch:
♦ Stimulus: stretching muscle
♦ Number of = one i.e. Mono-synaptic .... Afferent fibers - II (sensory)
♦ Response: Contraction
♦ Pathway
c^Motor
2. Golgi Tendon Reflex:
(Inverse of the muscle-stretch reflex i.e. a contracted muscle is relaxed)
♦ Stimulus = muscle contraction
j
♦ Num of synapsis= 2 i.e. Bi-synaptic
♦ Afferent fiber = lb (remember for Bi-Synaptic its lb and for minoscymaptic la)
(sensory)
♦ Response: Relaxation of muscle
♦ Pathway:

3. Flexor Withdrawal Reflex:

♦ Stimulus: Pain
♦ Num of snapsis: Polysynaptic
♦ Afferent: II, III, IV, (2, 3, 4) as 12 and lb are already used by stretch and golgi tendon
reflexes
♦ Response: Ipsilateral flexion & contralateral extension
♦ Pathway:
<11
ft ■ «

Thalamic Nuclei (Relay Station)

Only impotant one are discussed
1. VPL: sensations from limbs
2. VPM: Sensations from Face
3. Lateral Geniculate body: Visual reflexes i.e. L for Light
4. Medial geniculate body: Auditory reflexes, i.e M for music
Note That: Lesion of thalamus produces thalamic pain syndrome i.e. Normal stimulus i.e.
soft touch provokes pain.
Hypothalamic Nuclei
1. Anterior Nuclei: parasympathetic center -dor cooling of the body [AC= Ant Cooling]
2. Posterior Nuclei: sympathetic center -» for healing the body up
3. Arcuate nucleus: produces GnRh and its lesion causes (kalman syndrome]
4. Supra-optic nucleus: ADH Production
5. Supra-Chaismatic: for circadian Rhythms

Basal Ganglia
• Lentiform nucleus -»putamen + Globu palldus •Neostriatum also called striatum ->
putamen+ caudate
• Corpus striatum -> putamen + globus pallidus + caudate
Pathways
i
V
*
l
Indirect pathway (Inhibitory) D2-receptors
♦ pathway -> cortical inputs stimulate the striatum, releasing GABA that disinhibits Sub
thalamic nuclei via GP-Externa inhibition, and STN stimulates GP-interna to inhibit the
thalamus
i.e. end result on thalamus is inhibitory
Direct Pathway (Excitatory)
Dl- Receptor
♦ Pathway -^cortical inputs stimulate the striatum, stimulating the release of * GABA,
which
Inhibits GABA release from the Globus pallidus interna, disinhibiting the thalamus, ie the
end result is excitatory on thalamus
♦ Lesion -> Site •Chorea -» Caudate •Athetosis -» Globus Pallidus •Hemi ballismas -»
Sub Thalamus
•Parkinson -> substantic niagra (Damage, to direct pathway) •Huntingtool ->
neostriatum (Damage to Gaba neuron)
Heat exhaustion vs heat stroke
Heat Stroke Heat Exhaustion
♦ Core temp is inc ♦ Core temp will not be high
♦ Less sweating ♦ Excessive sweating - lead to
fluid loss - fall in BP fainting
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Some important Patterns of Stroke
■

Note: if only motor function is lost prefer internal capsule over cerberal cortex.
Artery involved =MCA
3. Cerbello-pontine angle
Persentation is similar to lesion seen in pons, but patient will be having ATAXIA as well.
4. Medial medullary syndrome:
Lesion side
5. Lateral Medullary syndrome
Lesion side
Artery = post inf cerebellar artery