Anatomy

NERVOUS SYSTEM
Date | Dr. Fe J. Fernandez, US.R.N., M.D., F.P.S.A. LE #1

NERVOUS SYSTEM
• Complex organ system
• Enables the body to react to continuous changes to its internal and external environment
• Controls and integrates various activities of the body → circulation, respiration
• Structurally divided into
o Central nervous system
▪ Brain
▪ Spinal cord
o Peripheral nervous system
▪ Cranial nerves – 12 pairs
▪ Spinal nerves – 31 pairs

CENTRAL NERVOUS SYSTEM (CNS)

• Integrate and coordinate incoming and outgoing neural signals
• Carry out higher mental functions → thinking and learning

PERIPHERAL NERVOUS SYSTEM (PNS)

• Conduct impulses to or away from CNS
• Organized into nerves that connect CNS with peripheral structures
• Functionally divided into:
1) Somatic NS
a. Somatic sensory → touch
b. Somatic motor → response to touching hot iron
2) Autonomic NS – consist of motor fibers that stimulate smooth muscles, cardiac mammary glands (effector organs)
a. Sympathetic
o Thoracolumbar
o Norepinephrine – NTs
b. Parasympathetic
o Craniosacral
o Acetylcholine

[ANA] Editor: NNDR 1 of 6

NE
CENTRAL NERVOUS SYSTEM
NERVOUS TISSUE
1. Neuron
→ Nerve cell
→ Structural and functional unit of nervous system
→ Specialized for rapid communication
2. Neuroglia (glial cells)
→ 5 times as abundant as neurons
→ Nonneuronal, non-excitable cells that form a major component in
nervous tissue
→ Support, Insulate, Nourish the neurons
→ In CNS
▪ Oligodendroglia
▪ Ependymal cells
▪ Microglia – small glial cells
▪ Astrocytes
→ In PNS
▪ Satellite cells – around neurons in spinal (posterior root)
▪ Schwann cells – neurolemma
▪ Autonomic ganglia

Parts of a Neuron
1) Cell body
2) Dendrites
▪ Processes (extensions)
▪ carry impulses towards cell body
3) Axon
▪ Myelinated forming the myelin sheath or non-myelinated → increase velocity of impulse conduction
▪ carry impulses away from cell body

2 Types of Neurons
• Multipolar motor neurons
→ 2 or more dendrites and 1 axon
→ Most common
→ All motor neurons that control skeletal muscle and those compromising ANS
• Pseudounipolar sensory neurons
→ Short, apparently single (but actually double) process extending from the cell body
→ Common process – separates into peripheral process
o Conduct impulses from receptor organ (touch, pain, temperature sensors in skin) toward cell body
→ Central process – continuous from Cell body into CNS
→ Cell bodies
o Outside CNS → in sensory ganglia, thus part of PNS
→ Neurons communicate with each other at Synapses
o Synapse – points of contact between neurons
o communication occurs by means of neurotransmitters, chemical agents released or secreted by one neuron, which may
excite or inhibit another neuron, continuing or terminating the relay of impulses or the response to them.

BRAIN
• integrate , coordinate incoming and outgoing neural signals
• carry out higher mental functions → thinking, learning
• Location: Cranial Cavity, Convoluted gyri and sulci; average human brain weighs 1,400 g
• Divided into:
1) Cerebrum – frontal, parietal, occipital, temporal lobe
2) Diencephalon – thalamus, hypothalamus
3) Cerebellum
4) Brainstem – pons, medulla oblongata, midbrain
5) Nucleus – collection of nerve cell bodies in CNS
6) Tract – bundle of nerve fibers or axons within CNS
7) Gray matter – made up of nerve cell bodies
▪ Outer gray matter
▪ Inner gray matter
→ H-shaped area
→ Outer White mater in Spinal cord – in Cross section
→ Anterior horn (rounded) and Posterior horn, Lateral horn
8) White matter – made up of fiber tracts

[ANA] Editor: NNDR 2 of 6

 SPINAL CORD
• Location: vertebral canal, spina; cavity
• Cylindrical, tube-like found in the Upper 2/3 of Vertebral canal → a continuation of the brainstem about 17 inches (43 cm) long,
extends from foramen magnum to level of L1 vertebra
• Lumbar puncture site: between L3 and L4 at subarachnoid space to avoid hitting subcutaneous with the needle
• Gray matter (inside) White matter (Outside
• Attached to Spinal cord → Spinal nerves
• 3 major functions:
o Sensory pathway
o Motor pathway
o Reflex center
• Reflex arc – involuntary response to a stimulus ; e.g. touching a hot object, patellar tendon, knee jerk
• Dermatome – area of the skin innervated by each spinal nerve, purely sensory
MENINGES OF BRAIN AND SPINAL CORD
1. Dura mater
• Outermost covering
• Thick, tough, intimately related to the bone neurocranium
• Epidural space
2. Arachnoid mater
• Cobweb-like covering
• Beneath this is the CSF at the subarachnoid space of Brain and Spinal Cord
• Surround and Protect
3. Pia mater
• Innermost layer
• Delicate, transparent
NERVO
PERIPHERAL NERVOUS SYSTEM
• Consists of nerve cell bodies and nerve fibers outside CNS that conduct nerve impulses to and away fromcns
• Nerve fiber
→ Consist of an axon, neurolemma
→ Neurolemma
▪ Cell membrane of Schwann cell that immediately surrounds the axon separating it from other axons
▪ Myelinated or Unmyelinated
• Nerve
→ Bundles of nerve fibers outside CNS
• Vasa vasorum
→ Blood vessels that nourish nerve fibers and their coverings
• Ganglion
→ Collection of neuron cell bodies outside CNS
→ Both motor and sensory

Connective tissue coverings of Nerve Fiber

1. Endoneurium – delicate connective tissue
▪ immediately surrounding the neurilemma cells and axons.
2. Perineurium – dense connective tissue layer
▪ encloses a fascicle of nerve fibers
▪ providing an effective barrier against penetration of the nerve fibers by foreign substances.
3. Epineurium – thick connective tissue sheath
▪ surrounds and encloses a bundle of fascicles, forming the outermost covering of the nerve
▪ includes fatty tissue, blood vessels, and lymphatics.

Nerves – organized much like a telephone cable

Axons – like individual wires insulated by the neurolemma and endoneurium;
Perineurium – bundles the insulated wires
Epineurium – surround bundles forming cable’s outer wrapping
Endoneurium – insulate axons
Ganglion – collection of neuron cell bodies outside the CNS; There are both motor (autonomic) and sensory ganglia.

[ANA] Editor: NNDR 3 of 6

TYPES OF NERVES
• Sensory (Afferent) fibers
o Carry neural impulses to the CNS
▪ From sense organs – eyes
▪ From sensory receptors – skin
• Motor (Efferent) fibers
o Convery neural impulses
▪ From CNS to Effector organs – muscle and glands
1) Cranial nerves – 12 pairs
→ Exit thru foramina
→ Skull = purely sensory, motor, mixed
→ In Roman Numeral
o CNI, CNII, III, IV, V, VI, to XII
→ Corresponding names
o Purely sensory: CN I, II,VIII
o Motor: CN III, IV, XI
o Mixed: CN V, VII, IX, X
2) Spinal nerves – 31 pairs
→ Exit thru intervertebral foramina
→ C8, T12, L5, S5, Coccygeal 1
→ Arise from spinal cord as rootlets – converge to 2 nerve roots

Spinal nerve formation

1. Anterior (ventral) nerve root
• Motor fibers from nerve cell bodies in the anterior horn of gray matter of spinal cord
2. Posterior (dorsal) nerve root
• Sensory fibers from nerve cell bodies in the posterior root ganglion and centrally to posterior horn of spinal cord of gray
matter
Anterior and Posterior nerve roots unite to form Spinal nerve, a Mixed nerve, Motor and Sensory at the Intervertebral foramen and
divides into:
o Posterior ramus
o Anterior ramus

Somite period
o the tissue that will give rise to muscle, bones, and other connective tissue—including the dermis of skin
Somites
o takes on the appearance of a bilateral row of biscuit-like formations flanking our primitive spinal cord (neural tube)
Sclerotomes
o Medial sides of somites
o Exit somite and migrate medially
Bodies of Vertebrae
o Ventrally migrating sclerotomal cells surround the notochord
Neural arch of the Vertebrae
o Dorsally migrating sclerotomal cells surround the neural tube
Dermatomyotomes
o The lateral aspect of the somites
o gives rise to the skeletal muscles and dermis of the skin.
o Cells of the dermatomyotome that migrate posteriorly give rise to the intrinsic or epaxial (deep) muscles of the back and overlying
dermis
o Cells that migrate anteriorly give rise to the hypaxial muscles of the anterolateral trunk and limbs and associated dermis.

The relationship between the nerves and the tissue derived from the dermatomyotome remains throughout life:
o Dermatome – unilateral area of skin supplied by a single (right or left member of
o pair of) spinal nerves
o Myotome - unilateral mass of muscle supplied by a single spinal nerve

[ANA] Editor: NNDR 4 of 6

SYMPATHETIC SYSTEM
• Thoracolumbar
• Presynaptic neurons arise from intermediolateral column of gray mater, Spinal cord of T1-T12 and L1 to L3 segments

Postsynaptic neurons found in 2 locations

1. Paravertebral ganglia
o Cervical ganglia (superior middle, inferior)
o Thoracic, sympathetic, ganglia T1-T12
o Lumbar ganglia, Sacral ganglia, the 2 trunks unite to form ganglian impar
2. Prevertebral ganglia
o In the plexuses that surround main branches of abdominal aorta (celiac gangliam sup. Mesenteric ganglia, aorticorenal
ganglia, inferior mesenteric ganglion)
o Primarily regulates blood vessels, facilitates emergency response

PARASYMPATHETIC SYSTEM
1. Cranial nerves
▪ CN III – Oculomotor
▪ CN VII – Facial
▪ CN IX – Glossopharyngeal
▪ CN X – Vagus
2. Sacral nerves
▪ Distributed to the viscera of the head, neck, cavities pf trunk and erectile tissues of the genitalia
▪ Decreases heart rate, increases GI motility, and Secretory activity
▪

SYMPATHETIC PARASYMPATHETIC
Arousing/ Flight or Fight Calming/ Rest and Digest
Dilate EYES Contract
Decreases SALIVATION Increases
Perspires SKIN Dries
Increases RESPIRATION Decreases
Accelerated HEART Slows
Inhibits DIGESTION Activates
Secretes stress hormones ADRENAL GLANDS Decrease secretion of stress hormones
Reduced IMMUNE SYSTEM FUNCTIONING Enhanced

Splanchnic nerves
1. Cardiopulmonary splanchnic nerves
• To heart, lungs, esophagus
2. Abdominopelvic splanchnic nerves
• Greater, lesser, least thoracic, lumbar splanchnic
• To stomach, intestines

Nerve degeneration
• Neurons do not proliferate in adult nervous system except those related to sense of smell in the olfactory epithelium therefore when
destroyed thru disease or trauma are not replaced
• When nerves are cut, their axons degenerate distal to the lesion because they depend on their nerve cell bodies for survival
• If axons are damaged but cell bodies are intact, regeneration and return of function may occur

[ANA] Editor: NNDR 5 of 6

Clinical Box
Damage to the CNS
• When the brain or spinal cord is damaged, the injured axons do not recover in most circumstances. Their proximal stumps begin to
regenerate, sending sprouts into the area of the lesion; however, this growth is blocked by astrocyte proliferation at the injury site, and
the axonal sprouts are soon retracted.
• As a result, permanent disability follows destruction of a tract in the CNS.

Rhizotomy
• Done to relief of intractable pain site at sensory roots or spinal nerve or to relieve spastic paralysis (rhizotomy).at motor root of spinal
nerve

Nerve Degeneration and Ischemia of Nerves

• Neurons do not proliferate in the adult nervous system, except those related to the sense of smell in the olfactory epithelium.
Therefore, neurons destroyed through disease or trauma are not replaced
• When nerves are stretched, crushed, or severed, their axons degenerate mainly distal to the lesion because they depend on their
nerve cell bodies for survival.
• If the axons are damaged but the cell bodies are intact, regeneration and return of function may occur.
• The chance of survival is best when a nerve is compressed.
Paresthesia
• Pressure on a nerve
• the pins-and-needles sensation that occurs when one sits too long with the legs crossed
• transient paresthesia after injection of anesthetic in dental repairs

A cutting nerve injury

• requires surgical intervention because regeneration of the axon requires apposition of the cut ends by sutures through the epineurium.
• The individual nerve bundles are realigned as accurately as possible.
• Anterograde (wallerian) degeneration
o degeneration of axons detached from their cell bodies.
o The degenerative process involves the axon and its myelin sheath, even though this sheath is not part o the injured neuron.

Prolonged ischemia (inadequate blood supply) of a nerve

• may result in damage no less severe than that produced by crushing or even cutting the nerve.
• Compromising a nerve’s blood supply for a long period by compression of the vasa nervorum

The Saturday night syndrome

• intoxicated individual who “passes out” with a limb dangling across the arm of a chair or the edge of a bed,
• example of a more serious, often permanent, paresthesia.
• can also result from the sustained use of a tourniquet during a surgical procedure.
• If the ischemia is not too prolonged, temporary numbness or paresthesia results.

Transient paresthesias
• are familiar to anyone who has had an injection of anesthetic for dental repairs.

How to describe a nerve

1. origin
2. course
3. branches
4. area of body innervated

Example: Sciatic nerve

1. Origin: sacral plexus, L4 to S3 spinal nerves
2. Course: enter gluteal region via greater sciatic foramen below piriformis m., descend post thigh
3. Branches: divides at apex of popliteal fossa into → tibial and common peroneal
4. Areas of body innervated: all muscles of post cot. Of thigh

[ANA] Editor: NNDR 6 of 6