OUTLINE

I. Word Roots and Combining Forms

II. Overview of the Nervous System
a. Functions of the Nervous System
b. Nervous System Divisions
III. Cells of a Nervous System
a. Nerve Cells (Neurons)
b. Neuroglia (Glial Cells/Glia)
IV. Collections of Nervous Tissue
a. Myelin Sheath
V. Anatomy of the Central Nervous System 2.a Functions of the Nervous System
a. Meninges
b. Cerebrospinal Fluid ● The nervous system is involved in some way in nearly
c. Brain every function in the human body
d. Spinal Cord
VI. Anatomy of the Peripheral Nervous System 1. Sensory function
a. Anatomy of a Nerve ○ For receiving sensory input
b. Cranial Nerves ○ Sensory receptors monitor numerous
c. Spinal Nerves external and internal stimuli
VII. Physiology of the Nervous System ○ We are aware of sensations of some stimuli
a. Nerve Impulses (e.g. vision, hearing, taste, smell, touch,
b. Reflexes pain, body position, temperature)
c. Memory ○ Other stimuli such as blood pH, blood
d. Language gasses, blood pressure are processed at the
e. Functions of the Nervous System subconscious level
f. Nutritional Requirements
VIII. Effects of Aging on the Nervous System 2. Integrative function
IX. Diagnostic Tests for the Nervous System Disorders ○ They integrate information
X. Nervous System Disorders ○ The brain is the spinal cord are the major
organs responsible for initiating responses
and sensory input
I. WORD ROOTS AND COMBINING FORMS ➢ Sensory input may produce an
immediate response, be stored as
memory, or be ignored
cephal/o head cerebell/o cerebellum
3. Motor function
cerebr/o cerebrum dur/o tough ○ Controlling muscles and glands
○ Skeletal muscles normally contract only
encephal/o brain gangli/o ganglia when stimulated by nervous system
➢ By controlling skeletal muscle, the
gli/o glue medulla/o medulla NS controls the major movement of
the body
mening/o meninges myel/o spinal cord ➢ NS also participates in controlling
cardiac and smooth muscles and
neur/o nerve poli/o gray matter many glands

4.
II. OVERVIEW OF THE NERVOUS SYSTEM
● Has 2 main divisions––​central nervous (CNS)​,
composed of the brain and spinal cord as central
processing center and ​peripheral nervous (PNS)​, a
network of all the nerves in the body that sends
messages to and from the central processing center
Homeostasis
○ NS plays an important role for maintaining
homeostasis
○ This function depends on the N’s ability to
detect, interpret, and respond to changes in
internal and external conditions
○ NS can stimulate or inhibit the activities of
other systems to help maintain a constant
internal environment

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 5. Mental activity
○ The brain is the center of mental activity
including consciousness memory and
thinking

2.b Nervous System Divisions

● Central Nervous System (CNS)

○ Brain
○ Spinal Cord

● Peripheral Nervous System (PNS) ● Afferent (Sensory)

○ Consists of all the nervous tissue outside the ○ Sensory receptors to CNS
CNS ○ Sensory neurons are the neurons that
➢ Cranial nerves transmit action potential from periphery to
➢ Spinal nerves CNS
➢ Ganglia ○ Conducts action potentials from sensory
receptors to CNS

● Efferent (Motor)
○ CNS to effector organs
○ Motor neurons transmit action potential to
the CNS toward the periphery
○ Conducts action potential from CNS to the
effector organs ​(e.g. muscles and glands)
○ Somatic
➢ Transmits action potential from
CNS to skeletal muscles
○ Autonomic
Subdivisions of the Central Nervous System ➢ Transmits action potential from
CNS to cardiac and smooth
muscles, and glands

III. CELLS OF A NERVOUS SYSTEM

3.a Nerve Cells (Neurons)

● Receives stimuli, conduct action potential, and

transmit signal to other neurons or effector organs

Parts

● Sympathetic
○ Sends electrical messages to prepare body
for physical activities
○ Fight or flight division

● Parasympathetic
○ Sends electrical messages to carry out
functions for vegetative activities ​(e.g.
digestion, defecation, urination)

Subdivisions of the Peripheral Nervous System

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 ➢ Axon hillock​ is the area where
axon leaves the neuron cell body
(trigger zone)
➢ Axoplasm​ - cytoplasm
➢ Axolemma​ - membrane
➢ Each axon has a uniform diameter
and may vary in length from a few
mm to more than a meter
➢ May remain unbranched or
branched to form​ lateral axons
(axon collaterals)
➢ Axon terminal​ are the tips where
you can find synaptic vesicles
➢ Synaptic vesicles​ contains
neurotransmitter involved in
transmission of action potential
from one cell to another
➢ Myelin sheath​ is a highly
specialized insulating layer of cells
1. Cell Body (Soma/Perikaryon)
surrounding the axons
○ Single nucleus
➢ Node of Ranvier​ are the gaps
➢ Source of information for gene
between myelin sheaths
expression
➢ They transmit infr away from
➢ Extensive rough ER, golgi
neuron cell body
apparatus, and mitochondria
○ Dendrite​ - absent or present
surrounds this
➢ Up to 1,000
○ Nissl bodies/Chromatophilic Substance
➢ Short, unmyelinated, tapering, and
(RER)
highly branching (tree-shaped
○ Golgi apparatus
array)
○ Mitochondria
➢ Extensions of neuron cell body
○ Large number of neurofilaments and
➢ Receiving information or input
microtubules
portion from other neurons or
➢ Organize the cytoplasm into distinct
sensory receptors that transmit the
areas
information toward the neuron cell
2. Process
body
➢ Transmit impulse toward cell body
➢ Tapered from their bases at the
neuron cell body to their tips
➢ Dendrite-like structures also project
from peripheral ends of some
sensory axons

Structural Types
1. Multipolar
○ 1 axon and several dendrites
○ Location is on the brain and spinal cord
○ Motor and efferent (if they are motor
neurons)
○ Most of their neurons within the CNS and
nearly all motor neurons are multipolar
2. Bipolar
○ 1 axon and 1 dendrite
○ Axon​ - 1 in every neuron ○ Location is on the nasal cavity, retina of the
➢ Single long cell extending from eye, and inner ear
neuron cell body ○ Sensory and afferent

3. Unipolar

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 ○ 1 axon and no dendrite
○ Found on skin, organs, etc
○ Sensory and afferent
○ Most other sensory neurons are
pseudounipolar
➢ Have a single process extending
from the cell body
➢ Divides into 2 process, short
distance from the cell body––1
process extends from the periphery
while the other extends from the
CNS
➢ The 2 extensions function as a
single axon with small dendrite-like
sensory receptors at periphery
➢ Axon receives sensory info at the
periphery and transmits info in the
form of action potentials to the CNS
MULTIPOLAR BIPOLAR UNIPOLAR
Functional Types
1. Sensory or afferent
○ Transmits sensory nerve impulse from
receptors towards the CNS
2. Motor or efferent
○ Conveys motor nerve impulse from CNS to
effectors
3. Association or interneuron
○ Not specifically sensory or motor
○ Transmit nerve impulses between these 2
other types of neurons
○ 90% of nerve cells
3.b Neuroglia (Glial Cells/Glia)
● Cells smaller but much more numerous than neurons
● Can multiply and divide and fill in brain areas
● Non-neuronal cells of CNS and PNS
● Usually retain the ability to divide
● Gliomas​: brain tumors derived from neuroglia
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● Its primary function is not conduct nerve impulses but
rather to support, nourish and protect neurons
CNS
1. Astrocytes
○ Major supporting cells of CNS
○ Star-shape appearance
○ Participate in blood vessel endothelium to
form blood brain barrier (permeability barrier)
between blood and CNS
○ Regulate the contents of CSF ​(e.g. excess
neurotransmitters and K ions)
○ Stimulate or inhibit signalling activity of
nearby neurons
○ Help limit damage to neural tissue but repair
process can form a scar that locks
regeneration of damaged axons
Scar tissue (sclerosis - process of development of
tissue due to damaged nerve cells)
2. Ependymal cells
○ Lines the fluid filled cavities called the
ventricles​ within CNS
○ Form ​cerebrospinal fluid ​(CSF)
○ Cilia of ependymal cells help in the
flow of CSF through the CNS
3. Microglia
○ Protect CNS cells from diseases
○ Act as immune cells of CNS
○ Macrophages in the CNS
➢ Phagocytic cells that serve as
protective cells in different areas of
the body
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 ○ Surround the cell body of neuron in the PNS
○ Regulate the chemical environment

4. Oligodendrocytes
○ Responsible of the production of myelin in
CNS
○ Phospholipids in cell membrane wrapped
around axons forming myelin sheath on
several axons at one time

IV. COLLECTION OF NERVOUS TISSUE

● Clusters of neuron cell bodies

○ Ganglion​: cluster of cell bodies in PNS
○ Nucleus​: cluster of cell bodies in CNS
● Bundles of axons
○ Nerve​: bundle of axons in PNS
○ Tract​: bundle to axons in CNS

4.a Myelin Sheath

PNS
1. Schwann cells
➢ Form myelin sheath in the PNS
➢ Several cells myelinate a single axon
➢ If the oligodendrocytes in the CNS can
myelinate several axons, here a single axon
is myelinated by several schwann cells
which are involved in axon regeneration
● Lipid and protein
➢ The myelin sheaths formed in the
● Insulates axon
oligodendrocytes and schwann are insulating
● Produced by oligodendrocytes and Schwann cells
materials that surround the axons
● Increases speed of nerve impulse
● In between the myelin sheaths are gaps called the
Node of Ranvier
○ Increases the speed of nerve impulses
because in the transmission of nerve
impulses, it jumps from one node to another

Myelination by Schwann Cells

● Spiral around and several times
○ Repeatedly wrapped around a segment of
axon to form a series of tightly wrapped cell
membrane
● Remember that a single axon in PNS is myelinated by
several schwann cells
● 1 mm. of axon
2. Satellite cells ● 500 in a single atom
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 ● Outermost layer: ​Neurolemma​ or ​sheath of ○ Consists of 2 layers which functions as a
Schwann single layer but are physically separated by
● Inner: ​100 layers several regions to form ​dural folds​ and
dural venous sinuses
Myelination of Oligodendrocytes ➢ Folds of dura mater extends into
● Similar to Schwann cell myelination but they are fewer longitudinal fissure between 2
nodes of Ranvier produced cerebral hemisphere and cerebrum
● 15 broad, flat processes and cerebellum
● Single oligodendrocytes can myelinate several axons ➢ Folds help hold brain in place within
● No neurolemma skull
○ Dural venous sinuses
➢ Collect blood from small veins in
brain and empty to internal jugular
veins that exits the skull
○ Within the skull, the dura mater adheres
V. ANATOMY OF THE CENTRAL NERVOUS
tightly to the cranial bones
SYSTEM
○ Epidural space (spinal cord)
➢ Within the vertebral canal and
● The brain and spinal cord are very delicate organs so between the dura mater and
there is a need to be protected vertebrae
➢ Clinically important as injection site
​Protection of the Brain and Spinal Cord for epidural anesthesia of spinal
● Cranium​ (brain) and ​vertebrae​ (spinal cord) nerves which is often given to
● Meninges women during childbirth
○ Made up of CT ● Arachnoid mater
● Cerebrospinal fluid​ (CSF) ○ Very thin
○ Subdural space
5.a Meninges ➢ Space between dura mater and
arachnoid mater
➢ Normally only a potential space
containing small amount of serous
fluid
○ The spinal cord extends only approx. to the
level of the second lumbar vertebra
○ Spinal nerves surrounded by meninges
extend to end of vertebral column because
there is no spinal cord on the inferior portion
of vertebral canal
➢ A needle can be introduced at
subarachnoid space​ at that level
without damaging the spinal cord
○ Healthcare professionals use such needles
to inject anesthetic to the area as a spinal
block or to take a sample of CSF in a spinal
tap
➢ CSF can be examined for infectious
agents or for presence of blood
● Pia mater
○ Very tightly bound to surface of brain and
spinal cord
○ Subarachnoid space
➢ Found in between Arachnoid mater
and Pia mater
● Three CT membranes surround and protect brain and ➢ Filled with CSF and contains blood
spinal cord vessels
● Dura mater
○ Most superficial and thickest Ventricles of the Brain

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 ● Normally clear, colorless liquid containing glucose,
proteins, lactic acid, urea, Na, K, Ca, Mg, Cl, HCO​3
and WBC
● Functions
○ Provides protection
○ Provides buoyancy
➢ The floor of cranial cavity is a bone
with various regions which allow the
brain to float in the cranial cavity
➢ Without CSF, nervous tissues will
be damaged by shear weight of the
brain against bony floor
○ Facilitates chemical stability
➢ CSF rinses metabolic wastes from
brain and spinal cord and help
regulate chemical environment
○ Provide nutrients
➢ CSF is a source of nutrient ​(e.g.
glucose)

Flow of CSF

● CNS contains fluid filled cavities called ​ventricles

which are small in some areas and large in others
● Each cerebral hemisphere contains large cavities
called ​lateral ventricles
● Lateral ventricles (2)
○ Cerebral hemispheres
● Third ventricle
○ Center of diencephalon between two halves
of thalamus connected by foreman to the
lateral ventricles
○ Small midline cavity
● Fourth ventricle
○ Base of cerebellum connected to third
ventricle by a narrow canal called ​cerebral
aqueduct
○ Continuous with central canal of spinal cord
○ Opens to central canal and subarachnoid
space through foramina through its walls and
roof

5.b Cerebrospinal Fluid

● Bathes the brain and spinal cord provide a protective

cushion around CNS
● Produced by choroid plexuses (specialized structures
made of ependymal cells) located in the ventricles
● Fills up the ventricles, central canal, and
subarachnoid space
● Approx. 100-160 ml are produced daily which are
absorbed in arachnoid villi back in the bloodstream
everyday at any one time
● Lateral ventricles

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 ○ CSF flows from lateral to third ventricles
through the ​Interventricular foramina​ or
foramina of Monro
● Third ventricle
○ CSF flows from third ventricles to the fourth
ventricle via ​Cerebral aqueduct​ or
aqueduct of Sylvius
● Fourth ventricle
○ From fourth ventricle, CSF flows into central
canal of the spinal cord and the
subarachnoid space passing through three
openings:
➢ Single​ Median aperture​ or
aperture of Magendie
➢ Paired ​Lateral aperture​ or
aperture of Luschka
● Central canal and subarachnoid space
5.c Brain
Major Parts
● Brain stem
○ Continuous with spinal cord
○ Consists of medulla oblongata, pons,
midbrain, reticular formation
● Cerebellum
○ Posterior and most inferior part of brain
○ Means ​“little brain”
● Diencephalon
○ Superior to brain stem
○ Consists of thalamus, hypothalamus,
epithalamus, and pineal gland
● Cerebrum
○ Largest part and most superior area of the
brain
○ Surface covered with gray matter is the
cortex
○ Deep to cortex is ​cerebral white matter
5.d Spinal Cord
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● The brain stem is continuous to the spinal cord
● Cylindrical but slightly flattened in its anterior-posterior
dimension
● It extends from the foramen magnum (base of the
skull) to the 2nd lumbar region (adults – 42 to 45 cm.)
● Stops elongation at age 4-5
● Two enlargements
○ Superior portion: Cervical enlargement
○ Inferior portion: Lumbar enlargement
● Depression at the center of the anterior portion of
spinal cord is the ​Anterior median fissure​ while that
of posterior portion is the ​Posterior median sulcus
● Conus medullaris
○ Conus terminalis
○ Tapered lower end of the spinal cord
○ Occurs near the 1sr lumbar and 2nd lumbar
vertebrae
● Cauda equina
○ Bundle of spinal nerves and spinal nerve
rootlets consisting of 2nd to 5th lumbar nerve
pairs of coccygeal nerve
○ All of which arise for lumbar enlargement
and conus medullaris of spinal cord
● Filum terminale
○ Extension of the Pia mater that is attached to
coccygeal segment to suspend the cord in
CSF
Cross Section of Spinal Cord
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 ● Peripheral white matter
○ Superficial
○ Myelinated axons
○ Organized into 3 columns in each half of the
spinal cord
➢ Dorsal (posterior), ventral (anterior),
● The spinal cord and brainstem contain a number of
and lateral
ascending tracts/pathways
○ Each column of the spinal column contains
● They transmit action potentials from periphery to brain
ascending and descending tracts/pathways
parts
○ Nerve tracts
● Each tract is involved with a limited type of sensory
➢ Ascending​ consists of axon that
input ​(e.g. pain, temperature, touch, position,
conducts action potential to the
pressure)​ because each tract contains axons from
brain
specific sensory receptors specialized to detect a
➢ Descending​ consists of axons that
particular type of stimulus
conduct action potential away from
● Usually given composite names (indicate their origin
the brain
and termination)
● Central gray matter
○ Spinothalamic tract
○ Deep
➢ Begins at spinal cord and
○ Mainly a collection of neuron cell bodies,
terminates at thalamus
dendrites, and unmyelinated axons
➢ Transmit action potential dealing
○ H shaped
with pain, temp, light touch,
○ Horns
pressure, tickle, and each sensation
➢ Posterior, anterior, and lateral
to thalamus and on cerebral cortex
➢ Small lateral horns exists in levels
○ Dorsal column
of cord associated with autonomic
➢ Transmits action potential dealing
nervous system
with touch, position, and pressure
○ Central canal
○ Spinocerebellar tract
➢ Fluid filled space at the center of
● Most ascending tracts consists of 2-3 neurons in the
the cord
sequence from the periphery to the brain
● The spinal nerves arise from numerous rootlets along
○ Almost all neuron relays information to the
the dorsal and ventral surfaces of spinal cord
cerebrum from SC to thalamus
● Ventral root
○ Another neuron relays information from
○ Combination of ventral rootlets on the
thalamus to cerebral cortex
ventral/anterior side of spinal
● Typically cross from one side of the body in the spinal
● Dorsal root
cord or brainstem to the other
○ Combination of dorsal rootlets on the dorsal
○ The left side of the brain receives sensory
side of the cord in each segment
from right side of the body and vice versa
● Ventral and dorsal roots unite lateral to the spinal cord
● Terminates in the brainstem or cerebellum
to form a spinal nerve
● Dorsal root ganglion
e.g. The anterior/posterior spinocerebellar tract transmits info
○ Cell bodies of unipolar sensory neurons
about body position to the cerebellum.
Ascending Tracts
Descending Tracts

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 ○ Rubrospinal
○ Reticulospinal
○ Vestibulospinal
○ Tectospinal
● Control different types of movement
○ Lateral column are most important in
controlling goal directed limb movement ​(e.g.
reaching and manipulation)
○ Ventral column​ (e.g. reticulospinal)​ are most
important for maintaining posture, balance,
and position through control of neck, trunk,
and proximal limb muscles

VI. ANATOMY OF THE PERIPHERAL NERVOUS

● Transmit action potentials from brain parts to the SYSTEM
periphery
● The names of the descending tracts are based also
on their origin and termination 6.a Anatomy of a Nerve

e.g. The corticospinal tracts are so named because they begin

in the cerebral cortex and terminate in the spinal cord.

● Other tracts are named after the part of the brain stem
from which they originate
○ Though they originate in the brainstem,
these tracts are indirectly controlled by
cerebral cortex, basal nuclei, and cerebellum
● Direct
○ Extend directly from upper motor neuron in
cerebral cortex to the lower motor in spinal
cord
○ Lateral corticospinal
➢ Specially important in controlling
speed and precision of skilled
movement of hands
➢ Shows how the descending
pathways function as it begins in
the cerebral cortex and descends in
brainstem
○ Anterior corticospinal
● At the inferior ends of the pyramids of the medulla
oblongata, axons cross over to opposite side of body
and continue in spinal cord
● Crossover of axon in the brainstem or spinal cord to
the opposite side is typical of descending pathways
○ Left side of the brain controls skeletal
muscles on the right side of the body and
vice versa
● Indirect
○ No direct connection exists bet cortical and
spinal neurons
● The microscopic anatomy of a nerve is similar to the
muscle
● Specialized CT enclose the nerves
○ Endoneurium
➢ Encloses axon of individual neuron
○ Perineurium
➢ Encloses fascicles of axons
○ Epineurium
➢ Encloses the entire nerve
6.b Cranial Nerves
● There are 12 pairs of CN which are designated by
roman numerals (1-12)
● There are two general categories of these
function––sensory and motor
○ Sensory can be divided into special sense
(e.g. vision, touch, pain)
○ Motor are subdivided into somatic and
parasympathetic

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 ➢ Somatic innervates skeletal ● Sensory
muscles in head and neck ● Origin
➢ Parasympathetic innervate glands, ○ Olfactory mucosa, olfactory foramina in
smooth muscle, and cardiac muscle cribriform plate of ethmoid bone
● Termination
○ Olfactory bulb, olfactory area of temporal
CRANIAL NERVE Mnemonic Function Mnemonic
lobe
I Olfactory Oh Sensory Some ● Function
○ Smell
II Optic Oh Sensory Say ● Clinical application (damage to the nerve)
○ Anosmia​: loss of sense of smell
III Oculomotor Oh Motor (P) Money

IV Trochlear To Motor Matters

V Trigeminal Touch Both But

VI Abducens And Motor My

Optic Nerve (II)
VII Facial Feel Both (P) Brother

VIII Auditory A Sensory Says

vestibular/
Vestibulocochlear

IX Glossopharyngeal Girl’s Both (P) Big

X Vagus Vagina Both (P) Boobs

XI Accessory Ah Motor Matter

● Sensory
XII Hypoglossal Heavenly Motor More ● Origin
○ Retina, optic foramen, optic chiasm, optic
tract
● Termination
○ Thalamus
● Function
○ Vision
● Clinical application
○ Loss of visual acuity
○ Anopsia​: loss of sense of sight

Oculomotor Nerve (III)

Olfactory Nerve (I)

● Motor, parasympathetic
● Origin
○ Midbrain

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 ● Termination ● Termination
○ Levator palpebrae superioris, superior, ○ Muscles of mastication
medial, and inferior rectus, inferior oblique, ● Function
ciliary muscle, sphincter muscle of iris ○ Chewing
● Motor function ● Clinical application
○ Movement of eyeball and eyelid, ○ Paralysis of muscles of mastication
accommodation for near visions
● Parasympathetic function ● Sensory
○ Constriction of pupils, thickens lens ● Origin
● Clinical application ○ Ophthalmic
○ Strabismus​: abnormal alignment of the eyes ➢ Skin over eyelid, eyeball, lacrimal
○ Diplopia​: simultaneous perception of 2 glands, nasal cavity, side of nose,
images of a single object forehead, anterior half of scalp
○ Ptosis​: drooping of upper eyelid due to ○ Maxillary
paralysis ➢ Mucosa of nose, palate, parts of
○ Pupil dilation​: pharynx, upper lip, upper teeth,
○ Loss of accommodation lower eyelid
○ Mandibular
Trochlear Nerve (IV) ➢ Anterior two-thirds of tongue, lower
teeth, skin over mandible, cheek,
side of head in front of ear
● Termination
○ Pons
● Function
○ Sensation for pain, touch, and temperature
○ Muscle sense
● Clinical application
○ Loss of sensation of touch and temperature
○ Trigeminal neuralgia​: chronic pain condi
● Motor that affects trigeminal nerve and even in mild
● Origin stimulation of face, it ac cause excruciating
○ Midbrain pain
● Termination ● Said to be the most anesthetized nerve because it is
○ Superior oblique the one that is anesthetized during dental procedures
● Function
○ Eyeball movement Abducens (VI)
● Clinical application
○ Strabismus, diplopia

Trigeminal Nerve (V)

● Motor
● Origin
○ Pons
● Termination
● Motor ○ Lateral rectus
○ Mandibular branch ● Function
● Origin ○ Movement of eyeball
○ Pons ● Clinical application

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 ○ No lateral eyeball movement
● Sensory
Facial (VII) ● Cochlear branch
● Origin
○ Organ of Corti
● Termination
○ Thalamus
○ Auditory areas in temporal lobe
● Function
○ Hearing
● Clinical application
○ Tinnitus​: perception of noise or ringing in
the ears

● Motor, parasympathetic
● Origin
○ Pons
● Termination
○ Facial, scalp, and neck muscles
○ Lacrimal, sublingual, submandibular, nasal,
and palatine glands
● Motor function
○ Facial expression
● Parasympathetic function
○ Production of saliva and tears ● Vestibular branch
● Clinical application ● Origin
○ Bell’s palsy​: condition that is a paralysis of ○ Semicircular canal, saccule, utricle to form
half of the face resulting from the swelling or vestibular ganglion
inflammation of facial nerve––cause is ● Termination
unknown ○ Pons and cerebellum
● Function
● Sensory ○ Equilibrium
● Origin ● Clinical application
○ Taste buds ○ Vertigo​: perception that the environment
○ Stylomastoid foramen around you is moving or spinning
○ Proprioceptors in muscles of face and scalp ○ Ataxia​: loss of full of control of body
● Termination movement
● Pons ○ Nystagmus​: repetitive and uncontrollable
○ Thalamus movement of eyes
○ Gustatory area in parietal lobe
● Function Glossopharyngeal (IX)
○ Muscle sense and taste
● Clinical application
○ Loss of taste

Vestibulocochlear (VIII)

● Motor, parasympathetic
● Origin
○ Medulla oblongata
● Termination

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 ○ Parotid gland ○ Sensations from visceral organs supplied
● Motor function ○ Muscle sense
○ Salivation ● Clinical application
● Parasympathetic function ○ Interrupts sensation from organs supplied
○ Salivary glands
● Clinical application Accessory (XI)
○ Difficulty in swallowing ● Motor
○ Reduced saliva secretion ● Cranial portion
● Origin
● Sensory ○ Medulla oblongata
● Origin ● Termination
○ Taste buds ○ Voluntary muscles of pharynx, larynx, and
○ Jugular foramen soft palate
○ Sensory receptors of tongue ● Function
○ Proprioceptors of swallowing muscles ○ Mediates swallowing
● Termination ● Clinical application
○ Medulla oblongata ○ Difficulty in swallowing
● Function
○ Taste, regulation of blood pressure, muscle ● Spinal portion
sense ● Origin
● Clinical application ○ Anterior gray horn of C1 – C5
○ Loss of sensation in throat ● Termination
○ Loss of taste ○ Sternocleidomastoid and trapezius
● Function
Vagus (X) ○ Mediates head movement
● Clinical application
○ Paralysis of sternocleidomastoid and
trapezius
○ Inability to raise the shoulders
○ Difficulty in turning the head

Heavenly (XII)

● Motor, parasympathetic
● Origin
○ Medulla oblongata
● Termination
○ Muscles of airways, lungs, esophagus, small
intestine, large intestine, bladder
○ Involuntary muscles and glands of GI tract
● Motor function ● Motor
○ Smooth muscle contraction and relaxation ● Origin
○ Secretion of digestive fluids ○ Medulla
● Parasympathetic function ● Termination
○ Viscera of thorax and abdomen ○ Muscles of tongue
● Clinical application ● Function
○ Interference of swallowing ○ Movement of tongue during speech and
○ Paralyzes vocal cords swallowing
● Clinical application
● Sensory ○ Difficulty in chewing, speaking, swallowing
● Origin
○ Areas supplied by motor portion 6.c Spinal Nerves
● Termination
○ Medulla and pons ● There are 31 pairs of spinal nerves
● Function

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 ● The thoracic spinal nerves do not form a plexus
Femoral Anterior thigh Anterior thigh,
because they directly innervate the areas in between (extensors) medial leg, foot
the ribs
Ischiadic or sciatic Posterior thigh Posterior leg, sole of
Regions tibia (flexors), posterior foot
● Cervical​: C1 to C8 (8 pairs) leg, foot
● Thoracic​: T1 to T12 (12 pairs)
Common fibular Lateral thigh and Anterior and lateral
● Lumbar​: L1 to L5 (5 pairs) leg, foot leg, dorsal part of
● Sacral​:S1 to S5 (5 pairs) foot
● Coccygeal​: Co (1 pair)
○ Lumbar​: L1 to L4
Plexuses
○ Sacral​: L4 to S4
● Networks of nerves in the body
● Cervical​: C1 to C4
VII. PHYSIOLOGY OF THE NERVOUS SYSTEM

7.a Nerve Impulses

● A ​resting​ ​membrane​ ​potential​ is the basis for a

nerve impulse and therefore must be maintained
● Polarized​ ​membrane​ is when the outside is positive,
and the inside is negative
○ Sodium​ flows into the cell = ​de​polarization
(cell becomes more positive)
○ Potassium​ flows out of the cell =
re​polarization (cell becomes more negative)
○ Major nerve ● Concentration gradients of ions result mainly from
➢ Phrenic ○ TheNa​+ ​- K​+ pump
​

○ Muscles innervated ➢ Moves ions by active transport

➢ Neck muscles, diaphragm ➢ Potassium ions are moved into the
○ Skin innervated cell, and Na+ are moved out of it
➢ Neck, posterior head ○ Permeability characteristics ​of the plasma
membrane are determined by
● Brachial​: C5 to T1 ➢ Leak channels (always open)
● Potassium ion leak
channels are more
Major Nerves Muscles Skin Innervated
Innervated
numerous than Na+ leak
channels; thus, the plasma
Axillary Shouler (2) Part of shoulder membrane is more
permeable to K+ than to
Radial Posterior arm, Posterior arm, Na+ when at rest
forearm (extensors) forearm, hand ➢ Gated ion channels
● Include ligand-gated ion
Musculocutaneous Anterior arm Radial surface of
(flexors) forearm
channels, voltage-gated
ion channels, and other
Ulnar Anterior forearm (2 Ulnar side of arm gated ion channels
flexors), intrinsic ● Local potentials start at a dendrite and travel toward
Median hand Radial side of arm the trigger zone
● Local potential has the following characteristics:
● Lumbosacral​: L1 to S4, T12 ○ Graded​ - strength determined by the amount
of ion flow
○ Decremental​ - effects decrease with
Major Nerves Muscles Skin Innervated distance
Innervated ○ Reversible​ - returns to normal after
stimulation
Obturator Medial thigh Medial thigh
(adductors)

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 ○ Excitatory​ or ​inhibitory​ - can result in
depolarization or hyperpolarization
● Action potentials travel from the trigger zone to the
synaptic knob
● They require a threshold stimulus and have an
all-or-nothing effect
○ They are not graded, decremental, or
reversible
● Myelination​ allows for the speed of an action
potential
3. Neurotransmitters diffuse from the presynaptic
terminal across the synaptic cleft
4. Neurotransmitters combine with their receptor sites
and cause ligand-gated ion channels to open. Ions
diffuse into the cell or out of the cell and cause a
change in membrane potential

Action Potential Frequency

● The number of action potentials produced per unit of
time in response to stimuli
● It is directly proportional to stimulus strength and to
the size of the graded potential
○ Subthreshold​ ​stimulus​: graded potential
○ Threshold​ ​stimulus​: a single action
potential
○ Submaximal​ ​stimulus​: action potential
frequency increases as the strength of the
stimulus increases
○ Maximal​ or a ​supramaximal​ ​stimulus​:
produces a maximum frequency of action
potentials

Propagation of Action Potentials

● An action potential generates ionic currents
○ Currents stimulate voltage-gated Na​+
channels in adjacent regions of the plasma
membrane to open
○ Producing new action potentials
● Occurs most rapidly in myelinated, large-diameter
axons
● In an unmyelinated axon, action potentials are
generated immediately adjacent to previous action
potentials
● In a myelinated axon, action potentials are generated
at successive Nodes of Ranvier

Electrical Synapses
● Gap junctions in which tubular proteins called Neurotransmitters
connexons allow ionic currents to move between cells ● Acetylcholine (ACh)
● An action potential in one cell generates an ionic ○ Site of Release
current that causes an action potential in an adjacent ➢ CNS/ANS synapses and
cell neuromuscular junctions
● Action potentials are conducted rapidly between cells ○ Effect
allowing for synchronized activity ➢ Excitatory or inhibitory
● Common in cardiac muscle and in many types of ○ Clinical Example
smooth muscle where coordinated contractions are ➢ Alzheimer disease​ (a type of a
essential sneile dementia) is associated with
a decrease in ACh-secreting
Chemical Synapses neurons
1. Action potentials arriving at the presynaptic terminal ➢ Myasthenia gravis​ (weakness of
cause voltage-gated Ca2+ channels to open skeletal muscles) results from a
2. Calcium ions diffuse into the cell and cause synaptic reduction in ACh receptors
vesicles to release neurotransmitters

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● Norepinephrine (NE) ➢ Glycine receptors are inhibited by
○ Site of Release the poison strychnine
➢ Selected CNS synapses and some ➢ Strychnine​ increases the excitatory
ANS synapses of certain neurons by blocking their
○ Effect inhibition
➢ Excitatory ➢ Strychnine​ poisoning results in
○ Clinical Example powerful muscle contractions and
➢ Cocaine​ and ​amphetamines convulsions
increase the release and block the ➢ Tetanus​ of respiratory muscles can
reuptake of NE resulting in cause deaths
overstimulation of postsynaptic
neurons ● Endorphins
○ Site of Release
● Serotonin ➢ Descending pain pathways
○ Site of Release ○ Effect
➢ CNS synapses ➢ Inhibitory
○ Effect ○ Clinical Example
➢ Generally inhibitory ➢ The ​opiates​ ​morphine​ and ​heroin
○ Clinical Example bind to endorphin receptors on
➢ It is involved with mood, anxiety, presynaptic neurons and reduce
and sleep induction pain by blocking the release of a
➢ Levels of serotonin are elevated in neurotransmitter
schizophrenia​ (delusions,
hallucinations, and withdrawal) Neuronal Pathways and Circuits
➢ Drugs that block serotonin ● Convergent pathways​ have many neurons
transporters (proplax) are used to synapsing with a few neurons
treat depression and anxiety ● Divergent pathways​ have a few neurons synapsing
disorders with many neurons
● Oscillating circuits​ have collateral branches of
● Dopamine postsynaptic neurons synapsing with presynaptic
○ Site of Release neurons
➢ Selected CNS synapses and some
ANS synapses Refractory Periods
○ Effect ● Absolute refractory period
➢ Excitatory and inhibitory ○ Time during an action potential when a
○ Clinical Example second stimulus (no matter how strong)
➢ Parkinson’s disease ​(depression cannot initiate another action potential
of voluntary motor control) results ● Relative refractory period
from destruction of ○ Time during which a stronger-than-threshold
dopamine-secreting neurons stimulus can evoke another action potential

● Gaming-aminobutyric acid (GABA) 7.b Reflexes

○ Site of Release
➢ CNS synapses ● Stereotypic, unconscious, involuntary responses to
○ Effect stimuli
➢ Inhibitory ● Maintain homeostasis
○ Clinical Example ● Somatic reflexes
➢ Drugs that increase GABA function ○ Mediated through the somatic motor nervous
have been used to treat epilepsy system and includes responses that:
(excessive discharge of neuron) ➢ Remove the body from painful
stimuli
● Glycine ➢ Keep the body from suddenly falling
○ Site of Release ➢ Cause movement because of
➢ CNS synapses external forces
○ Effect
➢ Inhibitory
○ Clinical Example

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 ● Autonomic reflexes
○ Mediated through the ANS and are
responsible for maintaining variables within
their normal ranges
➢ Blood pressure
➢ Blood carbon dioxide levels
➢ Water intake
● Receptor
1. Dendrite of a neuron receiving the stimulus
2. Afferent neuron (sensory): a neuron that has
an action potential carrying the signal to the
CNS
3. Integrating center: either the brain or spinal
cord
4. Efferent neuron (motor): a neuron that has
an action potential carrying a signal away
from the CNS
5. Effector: the structure causing the effect
➢ Skeletal muscle = somatic reflex
➢ Gland, smooth or cardiac muscle =
autonomic reflex
7.c Memory
● Immediate memory​ lasts a few seconds
● Short-term memory​ lasts a few seconds to a few
hours; forgetting results if there is a distraction
● Long-term memory​ results from chemical changes in
the neuron
○ Results in cellular changes, including the
growth of dendrites and the formation of new
connections
7.d Language
● Wernicke’s area​ is located in the ​temporal​ lobe and
is used to interpret incoming language.
● Broca’s area​ is located in the ​frontal​ lobe and is
used to find the words for outgoing language
7.e Functions of the Nervous System
Main Function of the Nervous System
● Fast, efficient communication of one part of the body
with another part, using action potentials
● The master controlling and communicating system of
the body
● The function can be demonstrated through identifying
pathways
Specific Functions
● Sensory input: detects external and internal stimuli
● Integration: processes and responds to sensory input
● Control of muscles and glands
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● Homeostasis is maintained by regulating other
systems
● Center for mental activities
7.f Nutritional Requirements
● Sodium and potassium are needed throughout life to
maintain resting membrane potentials
● Fat is necessary in the diet (especially for children) to
ensure the proper myelination of developing neurons
VIII. EFFECTS OF AGING ON THE NERVOUS
SYSTEM
● Cognitive ability increases in the young, remains
stable in adulthood, and declines in old age
● The definition of old age differs for each individual
● Short-term memory is affected early
● Verbal skills decline around age 70
● Intellectual performance may remain high until around
age 80
● Reaction times slow as neurons become less efficient
● The number of neurons in the brain decreases with
age
IX. DIAGNOSTIC TESTS FOR NERVOUS SYSTEM
DISORDERS
● Lumbar Puncture​ is a procedure used to collect and
analyze cerebrospinal fluid (CSF) surrounding the
brain and spinal cord
● Nerve Conduction Study​ is a procedure that
assesses the conduction of nerve impulses along
peripheral nerves by using electrodes to stimulate the
nerve while reading the conduction of the impulse as
it reaches its end point
X. NERVOUS SYSTEM DISORDERS
● Cerebrovascular Accident (CVA)
○ Commonly called stroke
○ When part of the brain dies due to a lack of
blood supply
○ Result of a blocked artery, but can also
result from the rupture of an artery feeding
part of the brain
➢ Part of the brain past the rupture
doesn’t receive blood due to the
bleed
○ Symptoms occur suddenly and may include
muscle weakness, paralysis. loss in
sensation on one side of the body,
confusion, vision problems, and difficulty with
speech
18
 ○ Important to know the cause before treating
○ Medications to dissolve clot is desirable if the
cause is a blockage but can be very harmful
if the cause is a ruptured vessel in the brain

● Alzheimer’s Disease
○ Progressive, irreversible disease of the brain
characterized by dementia
➢ Dementia is the loss of cognitive
function ​(e.g. thinking,
remembering, and reasoning)
○ Symptoms usually appear after the age of 60
but the process may start 10-20 years earlier
○ Cause is yet to be known
○ Results in tangles of insoluble proteins within
nerve cells and clumps of dead nerve cells
called ​plaques
○ Parts of the brain degenerate causing the
death of neurons and reducing the
responsiveness of other neurons to
neurotransmitters
○ Diagnosis is not possible until an autopsy is
completed upon death
○ An alternative explanation for the dementia
is always considered first before an
Alzheimer’s disease diagnosis is made
○ There is currently no definitive treatment for
this but medications to increase neuron
sensitivity to neurotransmitters can help
alleviate the severity of the symptoms
● Huntington Disease
● Parkinson’s Disease
● Multiple Sclerosis
● Paralysis
● Epilepsy
● Hydrocephalus
● Cerebral Palsy

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