Anatomy and physiology

Lesson 3/ finals
NERVOUS SYSTEM Nerve cell fibers
Anatomy • Dendrites
• Central Nervous System (CNS) – branching process that receives stimuli; thinner, shorter and
– comprising the brain and the spinal cord; enclosed in a bone and more plentiful than axons
wrapped in protective coverings (meninges) and fluid-filled • Axon
spaces. – generates or propagates action potential away from the cell
• Peripheral Nervous System (PNS) body
– formed by the 12 cranial and 31 spinal nerves • Axon Hillock
Physiology – junction of axon and cell body
• Somatic Nervous System Classification of Neurons
– voluntary control; this innervates the structures of the body • Multipolar
wall (skin, muscles and mucus membranes). – usually has one axon and multiple dendrites
• Autonomic Nervous System – most common type of neuron found in the CNS such as the brain
– involuntary control; it controls the activities of smooth muscles, and the spinal cord.
glands, internal organs and blood vessels. • Bipolar
Autonomic Nervous System – possesses one axon and one dendrite
These 2 components are important in modulating many vital functions – Relatively rare, and are a sensory neurons that are typically found
including respiration and cardiac contractility. in the olfactory epithelium, the retina of the eye, and gangs of
For example, the activities of both sympathetic and parasympathetic vestibulocochlear.
maintains the adequate blood pressure, as well as the vagal tone and the • Unipolar
heartbeat. – a neuron with a single axon that bifurcates or divides after a short
• Sympathetic (“Fight and flight response”) distance from the cell body
– prepares the body for emergency – Typically a sensory neurons, with receptors that are located within
– Actions that requires quick responses. the skin, joint, muscles and other internal organs.
• Parasympathetic (“rest and digest”) – The axons of this neurons terminates in the spinal cord.
– aims to conserve and restore energy.
– Do not require immediate reaction.
Neurons
• the primary functional and anatomic unit of the nervous system
• composed of nerve cell body and nerve cell fibers.
• They are excitable, meaning, they respond to stimuli by generating
electrical impulses

Impulse
• Message generated by neurons
• The neurons are excitable, they are generated by the messages
called as impulse.
• Neurons receives messages that called impulse.
TYPES
1. Afferent Impulse
Nerve cell body
– from sensory neurons to the higher centers of the brain
• Also known as soma or perikaryon
2. Efferent impulse
• For protein synthesis
– initiated from the higher centers of the brain to the effector
– Nucleus – responsible for storing the gene elements.
organs via motor neurons
– Nucleolus – concerned with the RNA synthesis or the
– INTERNEURONS – connection with motor neurons and sensory
ribonucleic acid. Its main function is protein systhesis as to
neurons. In between the higher centers of the brain into the spinal
maintain the protein level of the cytoplasm.
cord.
– Nuclear pores – passage way of the newly formed
• Comprises 99.9% of the nervous system.
ribosomes from the nucleus going to the cytoplasm.
• Plays a vital role in reflexes.
– Nissyl (Nissl) bodies – composed of the nissyl substances that
is located in the rough endoplasmic reticulum and it consist of
ribosomes. It is responsible in synthesizing the protein which
flows along the axons and the dendrites. This nissyl bodies
replaces the proteins that are broken down during the
cellular activity.
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o Axoaxonic – a synapse that composed of axon terminal that is
contacting with another axon terminal.
o Axospinous – a synapse that composed of presynaptic terminal
that is in contact with small protuberances on the dendrites
that is called the dendritic spine, that is why it is called as
axospinous.
Types of Synapse
THE PICTURE ABOVE SHOWS A STIMULI WHICH IS THE FIRE, THIS FIRE WILL BE PERCEIVED 1. Chemical
BY THE RECEPTORS OF THE SKIN. THE RECEPTORS OF THE SKIN CAN THEN DETECT IF
– uses a chemical, a neurotransmitter, passes across the narrow
THERE IS A THERMAL OR PAIN SENSATION. HOWEVER, THE FIRST INFORMATION ABOUT space between the cells and becomes attached to a protein
THE RECEPTORS IS THAT IT CANNOT REALLY INTERPRET WHAT DOES IT FEEL. THE ONLY molecule called receptor.
CENTER OR THE STRUCTURE OF THE BODY THAT CAN INTERPRET IS THE BRAIN. THUS, – Unidirectional
THERE IS WHAT WE CALL AS IMPULSE, THE FIRE OR THE TEMPERATURE OF THE FIRE Neurotransmitters
CANNOT BE DETERMINED BY THE RECEPTORS ALONE BUT THESE RECEPTORS CAN ONLY • chemicals used by neurons to communicate with other neurons or
PERCEIVE IF THERE IS SOMETHING IN THE SKIN. THESE SENSATION THAT WE FEEL BY THIS other cells
RECEPTORS WILL NOW BECOME AN IMPULSE. HENCE, THIS RECEPTORS WILL PROVIDE EXCITATORY – promotes the generation of electrical signals called action
IMPULSE AND THESE IMPULSE WILL BE CARRIED ON TOWARDS THE HIGHER CENTERS OF potential in the receiving neuron.
THE BRAIN VIA SENSORY NEURON OR THE AFFERENT NEURON. ONCE THE IMPULSE a. Glutamate
COMING FROM THE SENSORY NEURON OR THE AFFERENT NEURON GO TO THE HIGHER – produced by cortex and thalamus; main excitatory
BRAIN CENTERS, THE BRAIN WILL NOW INTERPRET THE IMPULSE IF THE STIMULI neurotransmitter of the cortex or CNS in general.
PARTICULARLY SHOWS THAT THERE IS A FIRE WHICH SHOWS THAT THERE IS AN b. Acetylcholine (Ach)
INCREASE IN TEMPERATURE IN THE SKIN. – found in both Peripheral Nervous System and Central Nervous
System.
ONCE PERCEIVED BY THE HIGHER BRAIN CENTERS, SUCH AS THE BRAIN, ONCE THE BRAIN INHIBITORY – they are the one that prevents the action potential.
PERCEIVED THAT THERE IS AN INCREASE IN TEMPERATURE IT WILL NOW PROVIDE A c. Dopamine
COMMAND WHICH WILL TRY TO PROVIDE AN INFORMATION TO THE EFFECTOR ORGAN – main inhibitory neurotransmitter of the striatum/substantia
WITH THE USE OF ANOTHER IMPULSE GOING TO THE EFFECTOR ORGANS WHICH WILL BE nigra
CARRIED BY THE MOTOR NEURON, OR THE EFFERENT NEURONS. WHEN THE IMPULSE GO d. GABA
TO THE EFFECTOR ORGANS SUCH AS THE MUSCLE, WILL NOW MOVE THE ARM – main inhibitory neurotransmitter of the cortex or CNS
VOLUNTARILY SO THAT THE ARM WILL BE RELEASED ON TO THE STIMULI. Types of Synapse
2. Electrical
SUMMARY: – uses gap junctions that extend from the cytoplasm of
AFFERENT NEURONS OR THE SENSORY NEURONS CARRY THE IMPULSES FROM SENSORY presynaptic neuron the cytoplasm of the postsynaptic neuron
STIMULI TOWARDS THE CENTRAL NERVOUS SYSTEM TO THE BRAIN. WHILE THE – there are no neurotransmitters or any form of chemicals.
EFFERENT NEURONS ARE THE MOTOR NEURONS THAT CARRY THE IMPULSES AWAY – ionic current flow from one neuron to the other with a
FROM THE CENTRAL NERVOUS SYSTEM, AND TO THE MUSCLES TO CAUSE MOVEMENT. minimum delay.
Synapse – Bidirectional, it means that a post synaptic cells can actually
• communication between two neurons or between a neuron and a send messages to presynaptic cell.
target structure THE DIFFERENCE OF THESE 2 TYPES OF SYNAPSE:
• It is also called as the neuronal junction. This junction is the site of IS THAT IN THE ELECTRICAL, THEY ARE VERY RAPID WHILE THE CHEMICAL, THEY ARE
transmission of SLOW IN PROPAGATING ACTION POTENTIAL. WHILE IN ELECTRICAL, THEY TYPICALLY
electric nerve USES A PASSIVE PROCESSES WHILE FOR CHEMICAL, IT USES ACTIVE PROCESS WHICH
impulses between 2 REQUIRES ION GATED CHANNELS. AGAIN, ELECTRICAL USES BIDIRECTIOINAL WHILE
nerve cells or CHEMICAL USES UNIDIRECTIONAL.
neurons. (It can also Neuroglia
be between a • aka Satellite cells/ glue cells.
neuron and a gland • Nonexcitable cells that surround
or a muscle cell, or neurons.
an effector.)
• Synapse may be:
o Axodendritic – a synapse that composed presynaptic terminal
that is in contact with a dendrite.
o Axosomatic – a synapse that composed of presynaptic terminal
that is in contact with the cell body or soma.
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Types of Neuroglia Cerebrum
• Schwann cells and Oligodendrocytes • largest subdivision of the human brain
– produces myelin sheath. (Myelin, meaning insulating layer; they • memory, interpretation and processing of information (generally
are forms around the nerves, including the brain and spinal for consciousness or conscious behavior)
cord nerves.) • initiates correct response to a situation
– found in the myolinated nerve fibers, it is the nerve fibers • contains gray and white maters
that have a myelin sheath. Gray Matter
– Primarily the Schwann Cells, they are the one produces the • aka cortex
myelin sheath of the peripheral nervous system. While the • contain the nerve cell bodies of neurons
Oligodendrocytes, produces the myelin sheath of the central White Matter
nervous system. • aka medulla
• Ependymal cells • contains the nerve cell fibers
– lining of cavities of the brain and spinal cord • white due to myelination
– They form a single layer of cells that are cuboidal or columnar Classification of White Matter
and the pusesusmicrodelaienselia. a. Commissural
• Microglia • Connects corresponding regions of the 2 hemisphere
– active during inflammations and are phagocytic (it is the • Corpus callosum is the largest commissural fiber
absorb of the infection such as virus, bacteria, and etc. and b. Association
even the debree of inflammation) activity. • Connect various cortical regions with the SAME hemisphere
– smallest neuroglia, dervied from macrophages (e.g. Arcuate fasciculus)
• Astrocytes c. Projection
– star-shaped, most abundant and they brace neurons or • Connects the cerebral cortex with the lower portions of the
provide supporting framework. brain or spinal cord (e.g. ascending and descending tracts)
Central Nervous System Protective Coverings
Brain 1. Skull
–
bony rigid structure; protects the brain and sense organs. It also
serves as attachment for muscles and ligaments.
2. Meninges and spaces
– 2nd protective layer and coverings; 3 layers of connective
tissues.
– They are continuous with the meninges of the spinal cord
Meninges and Spaces
a. Dura mater (1)
– outermost layer/pachymeninx
– contains the venous dural sinuses which drains deoxygenated
blood from the brain.
– It also covers the cranial nerves
b. Subdural space
– a protective space between the dura and arachnoid maters
c. Arachnoid mater (2)
– it's a Greek word which means “spider”
– thin, transparent and avascular.
– It closely covers the brain but does NOT follow the
convolutions/folds of the brain
d. Subarachnoid space
– protective space between the arachnoid and pia
– contains the CSF and the main blood vessels/arteries
e. Pia mater (3)
– innermost layer
– highly vascular connective tissue
– follows the convolutions of the gyri, sulci and fissures
– no potential or actual space in between the pia and brain
– The pia mater together with the ependymal cells forms the
choroid plexus which produces Cerebral Spinal Fluid.

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- Non-communicating – there is an obstruction of cerebrous
spinal fluid inside the ventricle, primarily, in the aqueduct of
Slyvius.
Protective Coverings
4. Blood-brain Barrier
– helps maintain the normal function of the brain as it keeps
harmful substances from entering the brain.
Protective Coverings
3. Cerebrospinal Fluid
– produced by the choroid plexus
– clear, colorless, odorless solution
– also contains small amounts of protein, glucose and ions such as
sodium, potassium and chloride.
– usual volume is 100-150mL with a rate of production of
500mL/day
Functions of CSF
External Features of the brain
• shock absorber 1. Fissure
• conveys nutrients to the – deep grooves
CNS • Medial Longitudinal Fissure - sagittal fissure that separates
• removes by-product of the two cerebral hemispheres
metabolism (as there are 2. Gyrus
no lymphatic system in – folds that increase the surface area of the brain
CNS) 3. Sulcus
– gaps/lines that separates gyri.
• Central Rolandic -
separates frontal and
parietal lobes
THE CSF IS PRODUCED IN THE CHOROID PLEXUS, IT RETAINS IN THE LATERAL VENTRICLE, • Lateral Sylvian -
THE LATERAL VENTRICLE IS LOCATED IN THE TELENCEPHALON OF AN ADULT BRAIN. separates parietal
THUS, THE FLUID WILL NOW GO TO THE 3RD VENTRICLE VIA THE FORAMEN OF MONRO, and temporal lobes
ONCE THE FLUID CLOSED ON TO THE 3RD VENTRICLE, THE 3RD VENTRICLE IS LOCATED IN " Si Sylvia nakahiga, si
THE DIENCEPHALON, IT WILL NOW MOVE AND FLOW TO THE 4TH VENTRICLE (LOCATED IN Rolando nakatayo"
THE RHOMBENCEPHALON) VIA THE CEREBRAL AQUEDUCT OF SLYVIUS. ONCE THE FLUID
FLOWS TO THE 4TH VENTRICLE, IT WILL NOW PROCEED TO THE SUBARACHNOID SPACE,
BUT BEFORE IT GOES THERE, THE FLUID WILL EITHER GO TO THE FORAMEN OF MAGENDIE
(MEDIALLY) OR FORAMEN OF LUSCHKA (LATERAL). ONCE THE FLUID GOES TO THE
SUBARACHNOID SPACE, IT WILL NOW PROCEED TO THE ARACNOID VILLI (THE ONE THAT
BRINGS THE CSF BACK TO THE BLOOD).
Pathway of Cerebral Spinal Fluid
• Choroid plexus > Lateral ventricle > Foramen of Monro > Third
Ventricle > Cerebral aqueduct of Slyvius > Fourth ventricle >
Foramen of Magendie and Luschka > Subarachnoid space > CENTRAL SULCUS – LOCATED IN THE LATERAL SURFACE OF THE CEREBRUM. FROM
Arachnoid villi. SUPERIOR TO INFERIOR, TO SEPARATE THE FRONTAL AND PARIETAL LOBES.
• “come let’s meet together Sylvia, 4 months later, (naghiwalay na), PRECENTRAL GYRUS – LOCATED ANTERIOR TO THE CENTRAL SULCUS, AND IT IS THE
sobrang aray!” PRIMARY MOTOR CORTEX.
Hydrocephalus POSTCENTRAL GYRUS – WHICH IS THE PRIMARY SOMATIC SENSORY CORTEX.
• accumulation of excessive Cerebral spinal fluid in the brain
Lobes of Cerebrum
• It has 2 processes: 1. Frontal – important in voluntary motor function, motivation,
- Communicating – there is an obstruction of the cerebrous aggression, sense of smell and mood.
spinal fluid outside of the ventricle, primarily, outside of the – Prefrontal Cortex – it is involve in the personality and decision
subarachnoid space. making.

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2. Parietal – major center of the receiving and evaluating most – emotional side of the brain
sensory information except for sense of smell, hearing, taste and – processes abstract concepts and non-verbal ideas
vision. – appreciation of arts and music
3. Temporal – primarily it receives and evaluates input for smell and – concerned with personal space, intuition and emotion
hearing, and it plays an important role in memory. Brodmann’s Area
– Anterior and Inferior Portion – associate with the function of • Refers to the 52 regions of the cerebral cortex that were
abstract thought and judgement. identified in the year 1909, by a German Neurologist, Dr. Brodmann.
– The temporal lobe is separated from the rest of cerebrum by • Dr. Brodmann, based the Brodmann’s area according to its
the lateral fissure and deep within the fissure is what we cytoarchitectonic differences (cell size, spacing, density, as well as
called the insula. It receives and evaluates the taste the lamination of the cerebral cortex.)
information, and it is also refered to as the 5th lobe. • A system that is used to divide the cerebral cortex according to its
4. Occipital – receives and integrates visual inputs and its not distincly cytoarchitectural organization and it is used as a standardized
separated to the other lobes. nomenclature which is superimposed on somewhat variable gharial
Insular Lobe and sugal anatomy.
– no distinct function; aka
Island of Reil, lie deep
within the lateral sulcus
and can only be seen by
spreading the lips of
the lateral sulcus
Limbic Lobe
– concerned with emotions
and memory; oldest lobe
phylogenetically Basal Ganglia
– PARTS: parahippocampal gyrus, uncus, cingulate gyrus, • Also known as Basal Nuclei
hippocampus, amygdaloid nucleus • Group of functionally related nuclei, that is located beneath the
Limbic Lobe cortex. It is also known as subcortical.
• Uncus • related to the cognition and fine tuning of movement (amplitude,
– interpretation of olfactory sensation; lesion will result to either speed and direction)
anosmia (inability to sense smell) or hyposmia (decrease ability to • Largest nuclei of the brain; located laterally in the interior cerebrum
sense smell) diencepahlone
• Hippocampus • mass of gray mater deep within the cerebral hemispheres
– short term memory; lesion will result in anterograde amnesia • The term is debatable because these masses are nuclei (CNS)
(decrease ability to retain new information) rather than ganglia (PNS).
• Amygdaloid nucleus Parts of Basal Ganglia
– emotion and sexual drive; lesion will result to Kluver Bucy 1. Caudate nucleus
Syndrome or hypersexual behavior – afferent limb of basal ganglia
Generalized Functions 2. Putamen
1. Motor – one of the main entrance of impulses to the basal ganglia
– voluntary movements – lesion on this area results in dystonia (movement disorder where
2. Sensory your muscles contract, involuntarily.)
– provides conscious awareness of a sensation 3. Globus Pallidus
3. Association – one of the efferent limb of the basal ganglia together with
– act mainly to integrate diverse information to come up with subthalamic nucleus
purposeful actions – lesion of the globus pallidus 2° to deposition of bilirubin results in
Functions of Hemispheres athetosis (movement disfunction, involuntary, and the movement
1. Dominant may be contiuous, slow and lobing)
– usually the left hemisphere (90%)
– right cerebral dominant people are usually males
– concerned with analytical (math concepts) and logical thinking
– language and speech
– more intellectual hemisphere
– production of skilled movements
2. Non-dominant

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ANTERIOR LOBE FLOCCULONODULAR LOBE POSTERIOR LOBE

PALEO CEREBELLUM Archi (QUI) Cerebellum Neo Cerebellum
Associated Structures SPINO CEREBELLUM Vestibular Fine Movements
4. Subthalamus POSTURE Equilibrium CoordiNEOtion.
– located in the diencephalon Diencephalon
– lesion on this area results in hemiballismus (movement disorder COMPONENTS:
and it is characterized by an unilateral, non-rhythmic, rapid, 1. Thalamus
non-suppresible, wide restraining movement of the proximal – major relay center of all sensory stimulus EXCEPT olfaction
arm or leg.) – contains the geniculate bodies on the posterior portion of the
5. Substantia nigra thalamus
– located in midbrain – lesion on thalamus results in contralateral (the right
Collective terms diencephalon is damage, then there is a part of the left side
1. Neostriatum/Striatum – caudate nucleus + putamen of the body that is lost in sensation) sensory loss
2. Paleostriatum – Globus pallidus Cochlear nuclei → Medial Geniculate Body → Brodmann's area 41
3. Lentiform nucleus – Putamen + globus pallidus (primary auditory area)
4. Corpus striatum – caudate + putamen + globus pallidus; lesion of – lesion on medial geniculate body leads to deafness
corpus striatum results in chorea. Optic tract → Lateral Geniculate Body → Brodmann's area 17
– Chorea-rapid, jerky, bizarre, and discrete movements (Corpus- (primary visual area)
Chorea) – lesion on lateral geniculate body leads to blindness
Cerebellum 2. Hypothalamus
• synchronizes/coordinates motor function in order to execute a – controls body's homeostasis
smooth sequence of movements necessary for skilled actions – also controls emotion, behavior, endocrine function (oxytocin
• it maintains/controls muscle tone, proper posture and equilibrium. and vasopressin) and circadian rhythm (sleep/wake cycle)
• has no direct pathway or connections to the lower motor neurons THERMOREGULATION
but it exerts control via the cerebrum, brainstem and spinal cord. – Anterior hypothalamic center: regulates loss of heat
• controls movements on the SAME side of the body. (sweating, vasodilation, panting)
RIGHT HEMISPHERE OF THE CERERBUM WILL CONTROL THE LEFT SIDE OF THE BODY, – Posterior hypothalamic center: regulates conservation of heat
WHILE THE LEFT HEMISPHERE WILL CONTROL THE RIGHT SIDE OF THE BODY. (vasoconstriction, shivering, piloerection)
HOWEVER, FOR THE CEREBELLUM, IT CONTROL ON THE SAME SIDE OF THE BODY. REGULATION OF FOOD AND WATER INTAKE
Lobes of Cerebellum • Lateral - Hunger and Thirst center; lesion to this area results
1. Anterior Lobe (paleocerebellum/spinocerebellum) in anorexia (afraid to gain weight, do not eat alot.)
– involved with maintenance of posture • Ventromedial - Satiety center; inhibits food and water intake;
2. Flocculonodular Lobe (archicerebellum) lesion to this area results in bulimia/hyperphagia (do not want
– involved with balance or equilibrium to eat alot but gain weight; they tend to purge and force
3. Posterior Lobe (neocerebellum) themselves to vomit)
– involved with fine movements and coordination 3. Epithalamus
– contains the pineal gland which secretes melatonin (rise at
darkness and falls at day)
– Melatonin - regulates sleep/wake cycle
4. Subthalamus
– controls muscular/motor activities through its connection
with the basal ganglia

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Brainstem
• Consist of the midbrain, pons, and medulla oblongata.
• Connects the spinal cord to the base of the brain and it is also
responsible for many essential functions.
• Any damage to this area will often causes death, because many
reflexes essential for survival are integrated in the brainstem.
1. Channel for tracts from spinal cord to higher centers in the brain
2. Contains important reflex centers
3. Contains important nuclei of cranial nerves III through XII.
Cranial Nerve Nuclei
The Cranial nuclei of the following is located in the:
• Cranial Nerve I – located in the telencephalon.
• Cranial Nerve II – located in the diencephalon.
• Cranial Nerve III to X11 – located in the brainstem
o Cranial Nerve III and IV – located in the midbrain.
o Cranial Nerve V to VIII – located in the Pons.
o Cranial Nerve IX to XII – located in the medulla.
Three Main Structures
• MIDBRAIN
• PONS
• MEDULLA
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Midbrain
• region between the pons and diencephalon
• contains the corpora quadrigemina (superior colliculi and inferior
colliculi)
Corpora Quadrigemina
• Superior Colliculi – contains neurons that receive visual input and
serve ocular reflexes.
• Inferior Colliculi – received input from both ears; involved in auditory
reflexed and in determining the side on which a sound originates.
Pons
• anterior to the cerebellum
• connects the medulla oblongata to the midbrain
• LARGEST portion of the brainstem.
Medulla Oblongata
• connects with the pons superiorly and spinal cord inferiorly
• junction of medulla and spinal cord corresponds approximately to the
level of the foramen magnum
Control of Breathing
• Pons - controls the rate and rhythm of breathing
• Medulla
o Dorsal - rhythm generator of breathing
o Ventral - force expiration or coughing
Reticular Formation
• Resources of introversion and extroversion character traits.
Beccause it has been found that Introverted people have more
easily stimulated reticular formation resulting to a diminished desire
to seek out stimulus. While extroverted people have a less easily
stimulated reticular formation, resulting in the need to seek out
simulus to maintain the brain activity.
• The reticular activating system is the name given to part of the
brain believed to be the CENTER OF AROUSAL AND MOTIVATION.
• The activity of this system is crucial for maintaining the state of
consciousness.
• It is involved with the CIRCADIAN RHYTHM (24-hour cycle in the
physiological processes of living beings; biological clock)
Substantia Nigra
• Plays a key role in motor control
• Degeneration of substantia nigra occurs in Parkinson’s disease.
Periaqueductal Gray Mater
• Contains Endorphin - producing cells that suppress pain
• NOTE: Endorphin: “natural pain killer”
Blood Supply
Also known as the Circle of Willis.
Major part of the Circle of Willis is the: Internal Carotid Artery, Middle
Cerebral Artery, and the Basilar Artery.
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Spinal Cord
• The major connection link between the brain and the PNS inferior
to the head.
• It integrates incoming information and produces responses through
reflex mechanisms.
• occupies the upper 2/3 of the vertebral canal
• Shorter the vertebral column (From brain at the level of foramen
magnum to the 2nd Lumbar vertebra)
• composed of segments corresponding to the segments of the
vertebral column (Cervical, thoracic, Lumbar and Sacral segments)
• Gives rise to 31 spinal nerves
• It has central gray mater composed of neurons, surrounded by
white mater made up of ascending and descending tracts
• The cord is normally 42-45cm long and ends at the L1-L2
vertebral level
• In children, the conus medullaris ends at the level of L2 or L3

Segments
• Cervical (8)
• Thoracic (12)
• Lumbar (5)
• Sacral (5)
• Coccygeal (1)

Parts of spinal cord

• Conus Medullaris
– tapered distal end of the spinal cord (L1/L2)
• Cauda Equina
– collection of nerve roots below the conus medullaris
• Filum Terminale
– extends from the tip of the conus to the distal dural sac of
the first coccygeal vertebra
• Cervical Enlargement
– Inferior cervical region

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– Where nerve fibers that supply the upper limbs enter and – 5 pairs (lumbar)
leave the spinal cord – 5 pairs (sacral)
• Lumbosacral Enlargement – 1 pair (coccygeal)
– Inferior thoracic, lumbar, and superior sacral regions.
– Where the nerve fibers supplying the lower lims enter or
leave the spinal cord

BELL MAGENDIE LAW
All the nerves found on the posterior portion are sensory, while all the
nerves found on the inferior portion of the spinal cord are said to be
motor.
Spinal Nerves
• DORSAL ROOT – has axons of sensory neurons
– Dorsal root (spinal) ganglion – sensory neuron cell bodies
• VENTRAL ROOT – has axons of motor neurons
– Cell bodies: Located in the Spinal cord gray matter
primarily located in the Anterior Horn
o Lateral Horn: Autonomic motor neuron cell bodies

Spinal nerves
• Exit the vertebral column (bone that surrounds the spinal cord) Reflex Arc
through intervertebral and sacral foramina • The smallest, simplest portion capable of receiving a stimulus and
• Each spinal nerve is a bundle of axons, scwann cells, and connective producing a response
tissue sheaths 5 BASIC COMPONENTS:
• Arise from numerous rootlets along the dorsal and ventral surfaces (1) a sensory receptor
of the spinal cord. (2) a sensory neuron
• 6-8 rootlets combine to form a ventral root on the ventral (3) an interneuron
(anterior) side of the spinal cord, and another 6-8 to form a dorsal (4) a motor neuron
root on the dorsal (posterior) side of the cord at each segment (5) an effector organ
• The ventral and dorsal roots extend laterally from the spinal cord, Reflex
passing through the subarachnoid space, piercing the arachnoid – Is an automatic response to a stimulus produced by a reflex arc.
mater and dura mater, and joining one another to form a spinal – Unconsciously
nerve. 1. Monosynaptic reflexes
• Spinal Nerves (31) – involve simple neuronal pathways in which sensory neurons
– 8 pairs (cervical) synapse directly with motor neurons.
– 12 pairs (thoracic)
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– Example: Patelar Reflex/ Achilles Reflex, that is typically seen when
performing beat tendon reflex examination.
2. Polysynaptic reflexes
– involve more complex pathways involving multiple synapses with
interneurons between the sensory and motor neurons.
– Example: Reciprocal Inhibition
Process of reflex arc

Cranial Nerves
1. A sensory receptor (Skin) detects an outside stimulus Cranial Nerves
2. A sensory neuron conducts action potentials through the nerve and • There are 12 pairs of cranial nerves included in the peripheral
dorsal root to the spinal cord. nervous system (PNS)
3. In the spinal cord, the sensory neuron synapses with an • CN III to XII originate in the brainstem
interneuron. (An interneuron is not involved in a monosynaptic reflex • Cranial nerves are nerves that emerge directly from the brain in
arc) contrast to spinal nerves which emerge from segments of the
4. The interneuron synapses with a motor neuron. spinal cord.
5. A motor neuron axon conducts action potentials through the ventral • In terms of function, cranial nerves could be grouped as sensory,
root and spinal nerve to an effector organ. motor or mixed
Dermatome o Sensory: CN I, II, VIII
• Is the area of skin supplied with sensory innervation by pair of o Mixed: CN X, IX, VII, V - (1975)
spinal nerves. Each of the spinal nerves except C1 has a specific o Motor: III, IV, VI, XI, XII
cutaneous sensory distribution. o With parasympathetic function: CN X, IX, VII, III (1973)

CN I- Olfactory (Sensory)
CN II- Optic (Sensory)
CN III- Oculomotor (Motor)
CN IV- Trochlear (Motor)
CN V- Trigeminal (Mixed)
CN VI- Abducens (Motor)
CN VII- Facial (Mixed)
CN VIII- Auditory (Sensory)
CN IX- Glossopharyngeal (Mixed)
CN X- Vagus (Mixed)
CN XI- Spinal Accessory (Motor)
CN XII- Hypoglossal (Motor)
Myotome
• A myotome is a group of muscles which are innervated by a single CN I: Olfactory Nerve
spinal nerve which has derived from the same embryological • reaches the cerebral cortex without synapsing on the thalamus.
segment. The olfactory cortex sends nerve fibers to many other centers
within the brain to establish connections for emotional and
autonomic responses to olfactory sensation
CN II: Optic Nerve
• Enters the undersurface of the medial (middle) frontal part of the
cerebral hemispheres
• It carries visual impulses from the retina to the brain.
• TESTS:
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 Anatomy and physiology
Lesson 3/ finals
– Visual Acuity test – Motor nucleus- motor aspects
– Visual Field test – Mesencephalic nucleus- proprioception
CN III: Oculomotor Nerve – Semilunar or Trigeminal nucleus- pain and temperature sense
• innervates levator palpebrae superioris (opening of eye for 80%); CN VII: Facial Nerve
Mueller's muscle opens the eye 20% (C7-T1) • SENSORY: anterior 2/3 of the tongue
• lesion on CN III leads to ptosis or drooping of the eyelids. • MOTOR: facial muscles (muscles of expression)
CN III: Oculomotor Nerve CN VIII: Auditory Nerve
• innervates all the extraocular muscle except the superior oblique • Enters the side of the pons and consists of two parts: the cochlear
and the lateral rectus nerve which carries hearing and the vestibular nerve which
• when there's lesion on CN III, the eyes cannot be moved upward, transmits impulses from the semicircular canals which affect
downward and inward and at rest the eyes look laterally and balance.
downward (external strabismus). The patient also has double vision CN VIII: Auditory Nerve
(diplopia). • Lesion in outer and middle ear - conductive
• also innervates the pupillary muscles namely the sphicter pupillae • Lesion in inner ear or nerve – sensorineural
and the ciliary muscles necessary for pupillary constriction/dilation Cn IX and X
• TEST: Pupillary light reflex: CN II (sensory part) and CN III (motor
part)
o direct: the eye lighted should constrict
o consensual: the eye opposite to the side lighted should
constrict
CN IV: Trochlear Nerve
• the most slender nerve and the only nerve exiting at the dorsal
brainstem and immediately decussates with the nerve at the
opposite side
• This nerve innervates superior oblique and assists in turning the FOR CN 9, THESE 2 NERVES HAVE A PARASYMPATHETIC FUNCTION: AUTONOMIC. THEIR
eyeball downward and medially FUNCTION IS TO PRODUCE PARASYMPATHETIC AND SYMPATHETIC SUPPLY ON THE
• If there is lesion, it could result to diplopia (vertical); It is corrected PAROTID GLAND.
with the use of head tilting. CN XI: Accessory Nerve
CN VI: Abducens Nerve • innervates trapezius and SCM
• arises from the anterior (front portion) pons and supplies one • contains cranial and spinal roots; they join together as they pass
muscle that moves the eye (lateral rectus) the jugular foramen
• responsible for turning the eyes laterally. The longest nerve • C2-C3 - SCM
intracranially. • C3-C4 – trapezius
• If there is an lesion in CN 6, it could also result to diplopia (horizontal). • Shoulder shrugging
It is corrected with the use of head rotation. CN XII: Hypoglossal Nerve
• Another lesion is strabismus, but intenal. The eye will be projected • innervates all the intrinsic muscles of the tongue and in addition, the
inward. (Inward Strabismus) styloglossus, hyoglossus and genioglossus
• palatoglossus is innervated by the pharyngeal plexus.

CN V: Trigeminal Nerve
• the largest cranial nerve
• SENSORY: carries sensation from the inside of the mouth, teeth,
and skin of the face
• MOTOR: supplies the muscles of the jaw /chewing muscles
• NUCLEI:
– Main sensory nucleus and spinal nucleus - light touch and
pressure
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