ANATOMY AND PHYSIOLOGY

Your nervous system is made up of two main parts: the brain and the spinal cord, which combine
to form the central nervous system; and the sensory and motor nerves, which form the peripheral
nervous system. The names make it easy to picture: the brain and spinal cord are the hubs, while
the sensory and motor nerves stretch out to provide access to all areas of the body.

Put simply, sensory nerves send impulses about what is happening in our environment to the
brain via the spinal cord. The brain sends information back to the motor nerves, which help us
perform actions. It’s like having a very complicated inbox and outbox for everything.

The central nervous system (CNS) is made up of the brain and spinal cord. The brain controls
most body functions, including awareness, movements, sensations, thoughts, speech and
memory. The spinal cord is connected to the brain at the brainstem and is covered by the
vertebrae of the spine. Nerves exit the spinal cord to both sides of the body. The spinal cord
carries signals back and forth between the brain and the nerves in the rest of the body.
The brain is the center of our thoughts, the interpreter of our external environment, and the
origin of control over body movement. Like a central computer, it interprets information from
our eyes (sight), ears (sound), nose (smell), tongue (taste), and skin (touch), as well as from
internal organs such as the stomach. The brain has three main parts: the cerebrum, cerebellum
and brainstem.

Cerebrum: is the largest part of the brain and is composed of right and left hemispheres. It
performs higher functions like interpreting touch, vision and hearing, as well as speech,
reasoning, emotions, learning, and fine control of movement.

Cerebellum: is located under the cerebrum. Its function is to coordinate muscle movements,
maintain posture, and balance.

Brainstem: acts as a relay center connecting the cerebrum and cerebellum to the spinal cord. It
performs many automatic functions such as breathing, heart rate, body temperature, wake and
sleep cycles, digestion, sneezing, coughing, vomiting, and swallowing.
The spinal cord is an elongated cylinder of neuron cell bodies, bundles of axons and other cells,
protected by connective tissue and bone. It connects to the brain at the medulla oblongata and
runs down the vertebral column, the hollow tunnel enclosed within the vertebrae of the spine.
The spinal cord is part of the central nervous system and serves as a kind of superhighway.
Sensory information and motor commands travel up and down, heading to and from the brain.
These signals speed in and out of the spinal cord via spinal nerves—the “on-ramps and off-
ramps” that branch out to supply the limbs, torso, and pelvis. Some incoming signals demand a
simple, immediate response. The spinal cord can shoot out a reflex command without bothering
the brain. The spinal cord is the highway for communication between the body and the brain.
When the spinal cord is injured, the exchange of information between the brain and other parts of
the body is disrupted.

The peripheral nervous system (PNS) is the part of the nervous system outside of the CNS.
The peripheral nervous system (PNS) is the division of the nervous system containing all the
nerves that lie outside of the central nervous system (CNS). The primary role of the PNS is to
connect the CNS to the organs, limbs, and skin. These nerves extend from the central nervous
system to the outermost areas of the body. The peripheral system allows the brain and spinal
cord to receive and send information to other areas of the body, which allows us to react to
stimuli in our environment. The PNS is divided into the somatic nervous system and the
autonomic nervous system. The somatic nervous system controls body movements that are under
our control such as walking. The autonomic nervous system controls involuntary functions that
the body does on its own such as breathing and digestion.
How does nervous system process pain?

When noxious stimuli impinge upon the body from external or internal sources, information
regarding the damaging impact of these stimuli on bodily tissues is transduced through neural
pathways and transmitted through the peripheral nervous system to the central and autonomic
nervous systems. This form of information processing is known as nociception. Nociception is
the process by which information about actual tissue damage (or the potential for such damage,
should the noxious stimulus continue to be applied) is relayed to the brain. Nociception is
mediated by specialized receptors known as nociceptors that are attached to thin myelinated Aδ
and unmyelinated C fibers, which terminate in the dorsal horn of the spine. Sufficiently intense
mechanical stimulation (such as stretching, cutting, or pinching), intense warming of the skin, or
exposure to noxious chemicals can activate nociceptors.2 In turn, activation of nociceptors is
modulated by inflammatory and bio-molecular influences in the local extracellular
environment. Although under most circumstances transmission of nociceptive information
results in pain perception, many physicians and patients are unaware that nociception is
dissociable from the experience of pain. In other words, nociception can occur in the absence of
awareness of pain, and pain can occur in the absence of measurably noxious stimuli. This
phenomenon is observable in instances of massive trauma (such as that which might be incurred
by a motor vehicle accident) when victims exhibit a stoic painless state despite severe injury, and
conversely, when individuals with functional pain syndromes report considerable anguish in
spite of having no observable tissue damage.

Activation of nociceptors is transduced along the axons of peripheral nerves which terminate in
the dorsal horn of the spine. There, messages are relayed up the spinal cord and through the
spinothalamic tract to output on the thalamus. In turn, the thalamus serves as the major “relay
station” for sensory information to the cerebral cortex.5 Nociceptive pathways terminate in
discrete subdivisions of thalamic nuclei known as the ventral posterior lateral nucleus and the
ventromedial nucleus.6 From these nuclei, nociceptive information is relayed to various cortical
and subcortical regions, including the amygdala, hypothalamus, periaqueductal grey, basal
ganglia, and regions of cerebral cortex. Most notably, the insula and anterior cingulate cortex are
consistently activated when nociceptors are stimulated by noxious stimuli, and activation in these
brain regions is associated with the subjective experience of pain.7 In turn, these integrated
thalamocortical and corticolimbic structures, which collectively have been termed the pain
“neuromatrix,” process somatosensory input and output neural impulses which influence
nociception and pain perception.

REFERENCE:
Jacques, E. (2020, January 08). How Your Nervous System Works to Detect and Interpret Pain
Signals. Retrieved June 16, 2020, from https://www.verywellhealth.com/how-we-feel-
pain-2564638

Anatomy and physiology of the nervous system - Canadian Cancer Society. (n.d.). Retrieved
June 16, 2020, from https://www.cancer.ca/en/cancer-information/cancer-
type/neuroblastoma/neuroblastoma/the-nervous-system/?region=qc

Brain Anatomy, Anatomy of the Human Brain. (n.d.). Retrieved June 16, 2020, from
https://mayfieldclinic.com/pe-anatbrain.htm

How the spinal cord works. (n.d.). Retrieved June 16, 2020, from
https://www.christopherreeve.org/living-with-paralysis/health/how-the-spinal-cord-work

Cherry, K. (2020, June 04). What You Should Know About the Peripheral Nervous System.
Retrieved June 16, 2020, from https://www.verywellmind.com/what-is-the-peripheral-
nervous-system-2795465

Body, V. (n.d.). Nervous System Overview. Retrieved June 16, 2020, from
https://www.visiblebody.com/learn/nervous/system-overview

Garland, E. (2012, September). Pain processing in the human nervous system: A selective review
of nociceptive and biobehavioral pathways. Retrieved June 16, 2020, from
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3438523/