THE CENTRAL NERVOUS SYSTEM

Dr. Nuryani Sidarta, Sp.KFR

CONTENT
ANATOMI
FUNCTION
CONNECTION & INTERACTION
CENTRAL NERVOUS SYSTEM
CENTRAL NERVOUS SYSTEM
BRAIN
SPINAL CORD
HUMAN BRAIN
HUMAN BRAIN
 BRAINPERFORMS OUR MOST COMPLEX
NEURAL FUNCTION
 CONTROL OUR BODY AND MIND
 ASSOCIATED WITH INTELLIGENCE,
CONSCIOUSNESS AND INSTINCT
 INVOLVE WITH SENSORY AND MOTOR
INNERVATION
HUMAN BRAIN
 SIZE : APPROXIMATELY TWO LARGE
HANDFULS OF PINKISH GRAY TISSUE
 CONSISTENCY OF COLD OATMEAL
 THE AVERAGE WEIGH ABOUT 1500 g OR
3.3 POUNDS
BRAIN PROTECTOR
 CRANIAL MENINGES
 CEREBROSPINAL FLUID
 THE BLOOD BRAIN BARRIER
CEREBRAL MENINGES
CSF
 A CLEAR, COLORLESS BODY FLUID IN THE
BRAIN AND SPINAL CORD
 PRODUCED FROM ARTERIAL BLOOD BY
THE CHOROID PLEXUSES IN LATERAL AND
FOURTH VENTRICLES
 ACTS AS A CUSHION
THE BLOOD SUPPLY TO THE
BRAIN

 NEURON HAVE A HIGH DEMAND FOR

ENERGY
 BUT THEY HAVE NEITHER ENERGY RESERVES
IN THE FORM OF CARBOHYDRATES OR
LIPID, NOR OXYGEN RESERVES
 BRAIN, IS AN EXTREMELY ACTIVE ORGAN
WITH CONTINUOUS DEMAND FOR
NUTRIENTS AND OXYGEN
THE BLOOD SUPPLY TO THE
BRAIN
 EXTENSIVE CIRCULATORY SUPPLY
 RECEIVES 15% OF THE BLOOD (750 mL/min)
 CONSUMES 20% OF THE OXYGEN AND
GLUCOSE
 ANTERIOR AND POSTERIOR SUPPLY
BLOOD BRAIN BARRIER SYSTEM
 TIGHT JUNCTION AND THE BASEMENT
MEMBRANE
 HIGLY PERMEABLE TO WATER, GLUCOSE, LIPID-
SOLUBLE SUBTANCES (OXYGEN AND CARBON
DIOXIDE) AND DRUGS SUCH AS ALCOHOL,
CAFFEINE, NICOTINE AND ANESTHETICS
 OBSTACLES TO ANTIBIOTICS AND CANCER
DRUG
 ABSENT FROM PATCHES CALLED
CIRCUMVENTRICULAR ORGAN (CVOs) ON THE
WALL OF THIRD AND FOURTH VENTRICLES
BASIC PART OF THE BRAIN
 CEREBRAL HEMISPHERES
 DIENCEPHALON (THALAMUS, HYPOTHALAMUS
AND EPITHALAMUS)
 BRAIN STEM (MIDBRAIN, PONS AND MEDULLA
OBLANGATA)
 CEREBELLUM
CEREBRUM
 LARGEST REGION OF THE BRAIN
 THE CEREBRAL CORTEX
 THE WHITE MATTER
CEREBRAL HEMISPHERES
 EACH CEREBRAL HEMISHPERES RECIEVES
SENSORY INFORMATION FROM THE OPPOSITES
SIDE OF THE BODY
 EACH CEREBRAL HEMISPHERES SENDS MOTOR
COMMANDS TO THE OPPOSITE SIDE OF THE
BODY
 THE TWO HEMISPHERS HAVE DIFFERENT
FUNCTION
 THE CORRESPONDENCE BETWEEN A SPECIFICT
FUNCTIONS AND A SPECIFIC REGIOS OF THE
CEREBRAL CORTEX IS IMPRECISE
CEREBRAL CORTEX
A BLANKET OF NEURAL CORTEX
 COVER THE SUPERIOR AND LATRAL
SURFACES OF THE CEREBRUM
 THE GYRUS INCREASE THE SURFACE AREA
OF THE CEREBRAL (2200 CM2)
 2 HEMISPHERES
 5 LOBES
THE WHITE MATTER
 ASSOCIATION FIBERS : ARCUATE FIBERS
AND LONGITUDINAL FASCICULI
 COMMISURAL FIBERS : CORPUS CALLOSUM
 PROJECTION FIBERS : INTERNAL CAPSULE
ANATOMY OF THE BASAL
NUCLEI
 ARE MASSES OF GRAY MATTER
 LIE WITHIN EACH HEMISPHERES DEEP TO
THE FLOOR OF THE LATERAL VENTRICLE
 HISTORICALLY KNOWN AS THE BASAL
GANGLIA
 CONSIST OF THE CAUDATE NUCLEUS,
LENTIFORM NUCLEUS, GLOBUS PALLIDUS
AND PUTAMEN
THE BASAL NUCLEI
 INVOLVED WITH THE SUBCONSCIOUS
CONTROL OF SKELETAL MUSCLE TONE
 INVOLVED WITH THE COORDINATION OF
LEARNED MOVEMENT PATTERN
FUNCTIONAL REGIONS OF THE
CEREBRAL CORTEX
 MOTOR AREAS
 SENSORY AREAS
 ASSOCIATON AREAS
HOMONCULUS MOTORIS DAN
SENSORIS
MOTOR AREA
 PRIMARY MOTOR CORTEX
 PREMOTOR CORTEX
 FRONTAL EYE FIELD
 BROCA’S AREA
Note decussation area.
SENSORY AREAS
 PRIMARY SOMATOSENSORY CORTEX
 SOMATOSENSORY ASSOCIATION AREA
 VISUAL AREA
 AUDITORY AREA
 GUSTATORY AREA
 VESTIBULAR CORTEX
 OLFACTORY CORTEX
Fig. 11.18
ASSOCIATION AREA
 PREFRONTAL CORTEX
 GENERAL INTERPRETATION AREA
 LANGUAGE AREA
 INSULA
DIENCEPHALON
 THALAMUS
 HYPOTHALAMUS
 EPITHALAMUS
THALAMUS
 MAKES UP 80% OF THE DIENCEPHALON
 MEANING : INNER ROOM (GREEK WORD) WHICH
DESCRIBES THIS DEEP BRAIN REGION
 RIGH AND LEFT THALAMUS JOINED BY
INTERTHALAMIC ADHESION
 RELAY STATION FOR THE SENSORY INFORMATION
ASCENDING TO THE PRIMARY SENSORY AREAS OF
THE CORTEX
THALAMUS
 EVERY PART OF THE BRAIN THAT COMMUNICATES
WITH THE CEREBRAL CORTES MUST RELAY ITS
SIGNAL THROUGH A NUCLEUS OF THE THALAMUS
 GATEWAY TO THE CEREBRAL CORTEX
 THALAMUS : RECEIVES AND EDIT INFORMATION
BEFORE SENDING IT ALONG
TALAMUS
 ISTHE FINAL RELAY POINT FOR ASCENDING
SENSORY INFORMATION THAT WILL
PROJECTED TO THE PRIMARY SENSORY
CORTEX
 ACTS AS A FILTER
 COORDINATES THE ACTIVITIES OF THE
BASAL NUCLEI AND THE CEREBRAL CORTEX
BY RELAYING INFORMATION BETWEEN
THEM
HYPOTHALAMUS
 BELOW THE THALAMUS
 FORMS THE INFEROLATERAL WALLS OF THE THIRD
VENTRICLES
 LIES BETWEEN THE OPTIC CHIASMA AND THE
MAMMILLARY BODIES
 PROJECTIONG INFERIORLY FROM THE
HYPOTHALAMUS IS THE PITUITARY GLANDS
HYPOTHALAMUS/FUNCTIONAL
CENTER
• CONTROL OF THE AUTONOMIC NERVOUS
SYSTEM
• CONTROLOF EMOTIONAL RESPONSES
• REGULATION OF THE BODY TEMPERATURE
• REGULATION OF THE HUNGER AND THIRST
SENSATION
• CONTROL OF BEHAVIOR
• REGULATION OF SLEEP-WAKE CYCLES
• CONTROL OF ENDOCRINE SYSTEM
• FORMATION OF MEMORY
HYPOTALAMUS
 CONTAINS IMPORTANT CONTROL AND
INTEGRATIVE CENTERS, IN ADDITION TO THOSE
ASSOCIATED WITH THE LIMBIC SYSTEM
 STIMULATED BY SENSORY INFORMATION FROM
THE CEREBRUM, BRAIN STEM, AND SPINAL
CORD
 STIMULATED BY CHANGES IN THE
COMPOSITION OF THE CSF AND INTERSTITIAL
FLUID
 STIMULATED BY CHEMICAL STIMULI IN THE
CIRCULATING BLOOD
HYPOTALAMUS FUNCTION
 THE SUBCONSCIOUS CONTROL OF THE SKELETAL
MUSCLE CONTRACTIONS
 THE CONTROL OF AUTONOMIC FNCTIONS
 THE COORDINATION OF ACTIVITIES OF NERVOUS AND
ENDOCRINE SYSTEMS
 THE SECRETION OF ADH AND OXYTOCIN HORMONE
 THE PRODUCTION OF EMOTION AND BEHAVIORAL
DRIVES
 COORDINATION BETWEEN VOLUNTARY AND
AUTONOMIC FUNCTION
 THE REGULATION OF BODY TEMPERATURE
 THE CONTROL OF CIRCADIAN RHYTMS
EPITHALAMUS
• MOST DORSAL PART OF THE DIENCEPHALON
• PINEAL BODY/PINEAL GLAND
• IS A HORMON SECRETING ORGAN
• UNDER THE INFLUENCE OF THE
HYPOTHALAMUS, THE PINEAL GLANDS
SECRETES THE HORMONE OF MELATONIN
(SIGNALS THE BODY TO PREPARE FOR THE
NIGHTTIME STAGE OF THE SLEEP-WAKE CYCLES)
LYMBIC SYSTEM
= LIMBUS/BORDER
 INCLUDES NUCLEI AND TRACT ALONG THE
BORDER BETWEEN THE CEREBRUM AND
DIENCEPHALON
 IS A FUNCTIONAL GROUPING
 KNOWN AS THE MOTIVATIONAL SYSTEM
LYMBIC SYSTEM
 ESTABLISHING EMOTIONAL STATES
 LINKING THE CONSCIOUS, INTELLECTUAL
FUNCTIONS OF THE CEREBRAL CORTEX
WITH THE UNCONSCIOUS AND
AUTONOMIC FUNCTIONS OF THE BRAIN
STEM
 FACILITATING MEMORY STORAGE AND
RETRIEVAL
LYMBIC SYSTEM
 CEREBRALCOMPONENT
 DIENCEPHALIC COMPONENT
 OTHE COMPONENT : RAS
LYMBIC – CEREBRAL
COMPONENTS
 CORTICAL AREAS : LIMBIC LOBE
(CINGULATE GYRUS, DENTATE GYRUS,
PARAHIPPOCAMPAL GYRUS)
 NUCLEI : HIPPOCAMPUS, AMYGDALOID
BODY
 TRACT : FORNIX
LIMBIC SYSTEM
DIENCEPHALIC COMPONENTS
 THALAMUS : ANTERIOR NUCLEAR GROUP
 HYPOTALAMUS : CENTERS CONCERNED
WITH EMOTION, APPETITES, AND RELATED
BEHAVIOR
RAS
 The RAS refers to a network of nerves and
connections that originate in the superior
portion of the brainstem which together serve
the purpose of modulating attention and
arousal
 The superior portion of the RAS, which is
based in the upper pons and extends into the
midbrain, regulates arousal level and
consciousness [1]. In contrast, the inferior
portion of the RAS, which lies in the lower pons
and medulla, tends to be primarily involved in
motor and autonomic function
RAS
BRAIN STEM
 MESENCEPHALON
 PONS
 MEDULLA OBLONGATA
MESENCEPHALON
 MID BRAIN
 CONSISTS OF :
SUPERIOR COLLICULI
INFERIOR COLLICULI
RED NUCLEI
SUBSTANSIA NIGRA
RETICULAR FORMATION
NUCLEI III AND IV
CEREBRAL PEDUNCLES
PONS
 LINKS THE CEREBELLUM WITH THE MESENCEPHALON,
DIENCEPHALON, CEREBRUM AND SPINAL CORD
 CONTAINS OF FOUR GROUP OF COMPONENT:
SENSORY AND MOTOR NUCLEI OF CN V,VI,VII AND
VIII
NUCLEI INVOLVED WITH THE CONTROL OF
RESPIRATION
NUCLEI AND TRACTS THAT PROCESS AND RELAY
INFORMATION FROM AND TO THE CEREBELLUM
ASCENDING, DESCENDING AND TRANSVERSE
TRACTS
MEDULLA OBLONGATA
 THE MOST INFERIOR OF THE BRAIN REGIONS
 CONTAINS THREE GROUP OF NUCLEI:
1. AUTONOMIC NUCLEI CONTROLLING
VISCERAL ACTIVITIES
2. SENSORY AND MOTOR NUCLEI OF CN VIII,
IX, X,XI AND XII
3. RELAY STATIONS ALONG SENSORY AND
MOTOR PATHWAYS
 DECUSSATION PYRAMIDUM (CROSS TO THE
OPPOSITE SIDE OF THE BRAIN)
CEREBELLUM
 ANTERIOR AND POSTERIOR LOBE
SEPARATED BY PRIMARY FISSURE
 VERMIS , A NARROW BAND OF
CEREBELLAR CORTEX
 FLOCCULONODULAR LOBES
 TWO CEREBELLAR HEMISPHERES
 THREE PENDUCULUS (SUPERIOR MEDIA
INFERIOR)
CEREBELLUM
 IS AN AUTOMATIC PROCESSING CENTER
 TWO PRIMARY FUNCTIONS:
1. ADJUSTING THE POSTURAL MUSCLES OF
THE BODY
2. PROGRAMMING AND FINE-TUNING
MOVEMENTS CONTROLLED AT THE
CONSCIOUS AND SUBCONSCIOUS LEVEL
SPINAL CORD
 PATHWAY BETWEEN THE PERIPHERAL
NERVOUS SYSTEM WITH CENTRAL NERVOUS
SYSTEM
 ASCENDING AND DESCENDING TRACTS
SUMMARY
ENJOY YOUR CNS