ANATOMY AND PHYSIOLOGY

The Central Nervous System

ANATOMY OF THE BRAIN


The brain is divided into three major areas: the cerebrum, the brain stem, and the cerebellum.
o The cerebrum is composed of two hemispheres: the thalamus and the
hypothalamus, and the basal ganglia.
 Additionally, connections for the olfactory (cranial nerve I) and optic
(cranial nerve III) nerves are found in the cerebrum.
o The brain stem includes the midbrain, pons, medulla, and connections for cranial
nerves II and IV through XII.
o The cerebellum is located under the cerebrum and behind the brain stem.
 The brain accounts for approximately 2% of the total body weight; it weighs
approximately 1,400g in an average young adult.
 In the elderly, the average brain weighs approximately 1,200 g.
Cerebrum
 The cerebrum consists of two hemispheres that are incompletely separated by the great
longitudinal fissure. This sulcus separates the cerebrum into the right and left
hemispheres.
 The two hemispheres are joined at the lower portion of the fissure by the corpus
callosum.
 The outside surface of the hemispheres has a wrinkled appearance that is the result of
many folded layers or convolutions called gyri, which increase the surface area of the
brain, accounting for the high level of activity carried out by such a small-appearing
organ.
 The external or outer portion of the cerebrum (the cerebral cortex) is made up of gray
matter approximately 2 to 5 mm in depth; it contains billions of neurons/cell bodies,
giving it a gray appearance.
 White matter makes up the innermost layer and is composed of nerve fibers and
neuroglia (support tissue) that form tracts or pathways connecting various parts of the
brain with one another (transverse and association pathways) and the cortex to lower
portions of the brain and spinal cord (projection fibers).
The cerebral hemispheres are divided into pairs of frontal, parietal, temporal, and occipital lobes.
 Frontal—the largest lobe. The major functions of this lobe are concentration, abstract
thought, information storage or memory, and motor function. It also contains Broca’s
area, critical for motor control of speech. The frontal lobe is also responsible in large part
for an individual’s affect, judgment, personality, and inhibitions.
 Parietal—a predominantly sensory lobe. The primary sensory cortex, which analyzes
sensory information and relays the interpretation of this information to the thalamus and
other cortical areas, is located in the parietal lobe. It is also essential to an individual’s
awareness of the body in space, as well as orientation in space and spatial relations.
 Temporal—contains the auditory receptive areas. Contains a vital area called the
interpretive area that provides integration of somatization, visual, and auditory areas and
plays the most dominant role of any area of the cortex in cerebration.
 Occipital—the posterior lobe of the cerebral hemisphere is responsible for visual
interpretation.
Corpus callosum.
 A thick collection of nerve fibers that connects the two hemispheres of the brain and is
responsible for the transmission of information from one side of the brain to the other.
 Information transferred includes sensation, memory, and learned discrimination.
 Right-handed people and some left-handed people have cerebral dominance on the left
side of the brain for verbal, linguistic, arithmetical, calculating, and analytic functions.
 The non-dominant hemisphere is responsible for geometric, spatial, visual, pattern, and
musical functions.
Basal ganglia. Masses of nuclei located deep in the cerebral hemispheres that are responsible
for control of fine motor movements, including those of the hands and lower extremities.
Thalamus. lies on either side of the third ventricle and acts primarily as a relay station for all
sensation except smell. All memory, sensation, and pain impulses also pass through this section
of the brain.
Hypothalamus. located anterior and inferior to the thalamus.
 The hypothalamus lies immediately beneath and lateral to the lower portion of the wall of
the third ventricle.
 It includes the optic chiasm (the point at which the two optic tracts cross) and the
mamillary bodies (involved in olfactory reflexes and emotional response to odors).
 Plays an important role in the endocrine system because it regulates the pituitary
secretion of hormones that influence metabolism, reproduction, stress response, and urine
production.
 It works with the pituitary to maintain fluid balance and maintains temperature regulation
by promoting vasoconstriction or vasodilatation.
 Site of the hunger center and is involved in appetite control.
 It contains centers that regulate the sleep–wake cycle, blood pressure, aggressive and
sexual behavior, and emotional responses (ie, blushing, rage, depression, panic, and fear).
 The hypothalamus also controls and regulates the autonomic nervous system.
Pituitary gland. located in the sella turcica at the base of the brain and is connected to the
hypothalamus.
  Common site for brain tumors in adults; frequently they are detected by physical signs
and symptoms that can be traced to the pituitary, such as hormonal imbalance or visual
disturbances secondary to pressure on the optic chiasm.
Brain Stem.
 The brain stem consists of the midbrain, pons, and medulla oblongata.
 The midbrain connects the pons and the cerebellum with the cerebral hemispheres; it
contains sensory and motor pathways and serves as the center for auditory and visual
reflexes.
 Cranial nerves III and IV originate in the midbrain.
 The pons is situated in front of the cerebellum between the midbrain and the medulla and
is a bridge between the two halves of the cerebellum, and between the medulla and the
cerebrum
o Cranial nerves V through VIII connect to the brain in the pons.
o The pons contains motor and sensory pathways. Portions of the pons also control
the heart, respiration, and blood pressure.
 The medulla oblongata contains motor fibers from the brain to the spinal cord and
sensory fibers from the spinal cord to the brain.
o Most of these fibers cross, or decussate, at this level.

o Cranial nerves IX through XII connect to the brain in the medulla.

Cerebellum.
 The cerebellum is separated from the cerebral hemispheres by a fold of dura mater, the
tentorium cerebelli.
 The cerebellum has both excitatory and inhibitory actions and is largely responsible for
coordination of movement. It also controls fine movement, balance, position sense
(awareness of where each part of the body is), and integration of sensory input.
Strucures Protecting the Brain
 The brain is contained in the rigid skull,
which protects it from injury.
 The major bones of the skull are the frontal,
temporal, parietal, and occipital bones.
The meninges (fibrous connective tissues that cover the brain and spinal cord) provide
protection, support, and nourishment to the brain and spinal cord.
 Dura mater—the outermost layer; covers the brain and the spinal cord. It is tough, thick,
inelastic, fibrous, and gray.
 Arachnoid—the middle membrane; an extremely thin, delicate membrane that closely
resembles a spider web (hence the name arachnoid).
o It appears white because it has no blood supply.

o The arachnoid layer contains the choroid plexus, which is responsible for the
production of cerebrospinal fluid (CSF).
o The subdural space is between the dura and the arachnoid layer, and the
subarachnoid space is located between the arachnoid and pia layers and contains
the CSF.
 Pia mater—the innermost membrane; a thin, transparent layer that hugs the brain closely
and extends into every fold of the brain’s surface.
Cerebral Circulation
Major Blood Vessels

 Blood is supplied to the brain, face, and scalp via two major sets of vessels: the right and
left common carotid arteries and the right and left vertebral arteries.
 The external carotid arteries supply the face and scalp with blood.
 The internal carotid arteries supply blood to most of the anterior portion of the cerebrum.
 The vertebrobasilar arteries supply the posterior two-fifths of the cerebrum, part of the
cerebellum, and the brain stem.
 Any decrease in the flow of blood through one of the internal carotid arteries brings about
some impairment in the function of the frontal lobes. This impairment may result in
numbness, weakness, or paralysis on the side of the body opposite to the obstruction of
the artery.
 Occlusion of one of the vertebral arteries can cause many serious consequences, ranging
from blindness to paralysis.
Circle of Willis
 At the base of the brain, the carotid and vertebrobasilar arteries form a circle of
communicating arteries.
 From this circle, other arteries—the anterior cerebral artery (ACA), the middle cerebral
artery (MCA), the posterior cerebral artery (PCA)—arise and travel to all parts of the
brain. Posterior Inferior Cerebellar Arteries (PICA), which branch from the vertebral
arteries, are not shown.
 Because the carotid and vertebrobasilar arteries form a circle, if one of the main arteries
is occluded, the distal smaller arteries that it supplies can receive blood from the other
arteries (collateral circulation).

Middle Cerebral Artery

 The middle cerebral artery is the largest branch of the internal carotid.
 The artery supplies a portion of the frontal lobe and the lateral surface of the temporal
and parietal lobes, including the primary motor and sensory areas of the face, throat, hand
and arm, and in the dominant hemisphere, the areas for speech.
 The middle cerebral artery is the artery most often occluded in stroke.

Posterior Cerebral Artery

 The posterior arteries supply the temporal and occipital lobes of the left cerebral
hemisphere and the right hemisphere.
 When infarction occurs in the territory of the posterior cerebral artery, it is usually
secondary to embolism from lower segments of the vertebral basilar system or heart.

Veins

 Venous drainage for the brain does not follow the arterial circulation as in other body
structures.
 The veins reach the brain’s surface, join larger veins, then cross the subarachnoid space
and empty into the dural sinuses, which are the vascular channels lying within the tough
dura mater.
 The network of the sinuses carries venous outflow from the brain and empties into the
internal jugular vein, returning the blood to the heart.
  Cerebral veins and sinuses are unique because, unlike other veins in the body, they do not
have valves to prevent blood from flowing backward and depend on both gravity and
blood pressure.

The Peripheral Nervous System

Cranial Nerves

There are 12 pairs of cranial nerves

that emerge from the lower surface of
the brain and pass through the foramina
in the skull.
I. Olfactory nerve
 Transmits information to the
brain regarding a person's sense
of smell.
II. Optic nerve
 Transmits information to the
brain regarding a person's
vision.
III. Oculomotor nerve
 Helps control muscle movements of the eyes.
IV. Trochlear nerve
 Also involved in eye movement.
 It powers the contralateral superior oblique muscle that allows the eye to point downward
and inward.
V. Trigeminal nerve
 The largest cranial nerve and has both motor and sensory functions.
 Its motor functions help a person to chew and clench the teeth and gives sensation to
muscles in the tympanic membrane of the ear.
 The ophthalmic part gives sensation to parts of the eyes, including the cornea, mucosa in
the nose, and skin on the nose, the eyelid, and the forehead.
  The maxillary part gives sensation to the middle third of the face, side of the nose, upper
teeth, and lower eyelid.

 The mandibular part gives sensation to the lower third of the face, the tongue, mucosa in
the mouth, and lower teeth.

VI. Abducens nerve

 Also helps control eye movements.
 It helps the lateral rectus muscle, which is one of the extraocular muscles, to turn the gaze
outward.
VII. Facial Nerve
 Has both motor and sensory functions.
 The facial nerve is made up of four nuclei that serve different functions:
o movement of muscles that produce facial expression
o movement of the lacrimal, submaxillary, and submandibular glands
o the sensation of the external ear
o the sensation of taste
VIII. Vestibulocochlear nerve
 Involved with a person's hearing and balance.
 The vestibulocochlear nerve contains two components:
o The vestibular nerve helps the body sense changes in the position of the head with
regard to gravity. The body uses this information to maintain balance.
o The cochlear nerve helps with hearing. Specialized inner hair cells and the basilar
membrane vibrate in response to sounds and determine the frequency and
magnitude of the sound.
IX. Glossopharyngeal nerve
 Possesses both motor and sensory functions.
o The sensory function receives information from the throat, tonsils, middle ear, and
back of the tongue. It is also involved with the sensation of taste for the back of
the tongue.
 o The motor division provides movement to the stylopharyngeus, which is a muscle
that allows the throat to shorten and widen.
X. Vagus nerve
 Has a range of functions, providing motor, sensory, and parasympathetic functions.
o The sensory part provides sensation to the outer part of the ear, the throat, the
heart, abdominal organs. It also plays a role in taste sensation.
o The motor part provides movement to the throat and soft palate.
o The parasympathetic function regulates heart rhythm and innervates the smooth
muscles in the airway, lungs, and gastrointestinal tract.
 The vagus nerve is the longest cranial nerve as it starts in the medulla and extends to the
abdomen.
XI. Accessory nerve
 Provides motor function to some muscles in the neck:
 It controls the sternocleidomastoid and trapezius muscles that allow a person to
rotate, extend, and flex the neck and shoulders.
 The accessory nerve separates into spinal and cranial parts.
XII. Hypoglossal nerve
 A motor nerve that supplies the tongue muscles.

Spinal Nerves

 The spinal cord is composed of 31 pairs of

spinal nerves: 8 cervical, 12 thoracic, 5
lumbar, 5 sacral, and 1 coccygeal. Each spinal
nerve has a ventral root and a dorsal root.
o The dorsal roots are sensory and
transmit sensory impulses from
specific areas of the body known as
dermatomes to the dorsal ganglia.
The sensory fiber may be somatic, carrying information about pain, temperature,
 touch, and position sense (proprioception) from the tendons, joints, and body
surfaces; or visceral, carrying information from the internal organs.
o The ventral roots are motor and transmit impulses from the spinal cord to the
body. These fibers are also either somatic or visceral. The visceral fibers include
autonomic fibers that control the cardiac muscles and glandular secretions.
Autonomic Nervous System
 Regulates the activities of internal organs such as the heart, lungs, blood vessels, digestive
organs, and glands.
o There are two major divisions: the sympathetic nervous system, with
predominantly excitatory responses, most notably the “fight or flight” response
o The parasympathetic nervous system, which controls mostly visceral
functions.
 The autonomic nervous system has two neurons in a series extending between the centers
in the CNS and the organs innervated.
o The first neuron, the preganglionic neuron, is located in the brain or spinal cord,
and its axon extends to the autonomic ganglia.
o There, it synapses with the second neuron, the postganglionic neuron, located in
the autonomic ganglia, and its axon synapses with the target tissue and
innervates the effector organ. Its regulatory effects are exerted not on individual
cells but on large expanses of tissue and on entire organs.
Motor (efferent) division
 The motor (also known as efferent) division of the nervous system contains motor nerves. 
 These nerves conduct impulses from the CNS and PNS to the muscles, organs and glands’
effecting what happens in those tissues.

The Role of the Basal Ganglia in Movement

The basal ganglia are responsible for voluntary motor control, procedural learning, and eye
movement, as well as cognitive and emotional functions

Location
  The basal ganglia (or basal nuclei) are a group of nuclei of varied origin in the brains of
vertebrates that act as a cohesive functional unit. They are situated at the base of the
forebrain and are strongly connected with the cerebral cortex, thalamus, and other brain
areas.

 The basal ganglia are associated with a variety of functions, including voluntary motor
control, procedural learning relating to routine behaviors or habits such as bruxism and
eye movements, as well as cognitive and emotional functions

Action Selection

 Currently popular theories hold that the basal ganglia play a primary role in action
selection. Action selection is the decision of which of several possible behaviors to
execute at a given time.

 Experimental studies show that the basal ganglia exert an inhibitory influence on a
number of motor systems, and that a release of this inhibition permits a motor system to
become active. The behavior switching that takes place within the basal ganglia is
influenced by signals from many parts of the brain, including the prefrontal cortex, which
plays a key role in executive functions.

Function in Eye Movement

 One of the most intensively studied functions of the basal ganglia is their role in
controlling eye movements. Eye movement is influenced by an extensive network of
brain regions that converge on a midbrain area called the superior colliculus (SC).

o The SC is a layered structure whose layers form two-dimensional retinotopic

maps of visual space. A bump of neural activity in the deep layers of the SC
drives eye movement toward the corresponding point in space.
Neurotransmitters

 In most regions of the brain, the predominant classes of neurons use glutamate as the
neurotransmitter and have excitatory effects on their targets. In the basal ganglia,
however, the great majority of neurons uses gamma-aminobutyric acid (GABA) as the
neurotransmitter and have inhibitory effects on their targets.

 The inputs from the cortex and thalamus to the striatum and subthalamic nucleus are
glutamatergic, but the outputs from the striatum, pallidum, and substantia nigra pars
reticulata all use GABA. Thus, following the initial excitation of the striatum, the internal
dynamics of the basal ganglia are dominated by inhibition and disinhibition.

 Other neurotransmitters have important modulatory effects. Dopamine is used by the

projection from the substantia nigra pars compacta to the dorsal striatum and also in the
analogous projection from the ventral tegmental area to the ventral striatum (nucleus
accumbens).

 Acetylcholine also plays an important role, as it is used both by several external inputs to
the striatum and by a group of striatal interneurons. Although cholinergic cells make up
only a small fraction of the total population, the striatum has one of the highest
acetylcholine concentrations of any brain structure.

Modulation of Movement by the Cerebellum

 The cerebellum is important for motor control—specifically coordination, precision, and

timing—as well as some forms of motor learning.

 The cerebellum is a region of the brain that plays an important role in motor control. It
may also be involved in some cognitive functions such as attention and language, and in
regulating fear and pleasure responses, but its movement-related functions are the most
solidly established. The cerebellum does not initiate movement, but it contributes to
coordination, precision, and accurate timing.
  It receives input from sensory systems of the spinal cord and from other parts of the
brain, including the cerebral cortex, and integrates these inputs to fine-tune motor
activity. Because of this fine-tuning function, damage to the cerebellum does not cause
paralysis, but instead produces disorders in fine movement, equilibrium, posture, and
motor learning.
 The cerebellum differs from most other parts of the brain, especially the cerebral cortex,
in regards to the ability of signals to move unidirectionally from input to output. This
feedforward mode of operation means that the cerebellum cannot generate self-sustaining
patterns of neural activity, in contrast to the cerebral cortex. However, the cerebellum can
receive information from the cerebral cortex and processes this information to send motor
impulses to the skeletal muscle.

Sensory (afferent) division

 The sensory (also known as afferent) division of the nervous system contains nerves that
come from the viscera (internal organs) and the somatic areas (muscles, tendons,
ligaments, ears, eyes and skin). 
 These nerves conduct impulses to the PNS/CNS providing information on what is
happening within and outside the body.  The senses include; hearing, sight, touch, and
proprioception (the awareness of where you are in space and what position you’re in).