CLINICAL I Human body

Anatomy and physiology, 4.

The brain
Ian Peate, Head of School, School of Health Studies, Gibraltar

The brain is protected from damage by

Abstract
several layers of defences. Outermost are
The brain is the largest and most complex single organ in the body. This article introduces the the bones of the skull. Beneath the skull
healthcare assistant and assistant practitioner (HCA and AP) to basic aspects associated with the are the meninges, a series of membranes
anatomy of the brain. The brain, along with the spinal cord, comprises the body’s central nervous that surround the brain and spinal cord
system and is the major control network for the body’s functions and abilities, enabling conscious (see Figure 3). Inside the meninges, the
communication with the body and automatic operation of vital organs, such as the heart. brain is cushioned by fluid.
In this article, the specific functions of the brain are addressed. The four lobes of the brain are The brain’s central physiological
discussed, as well as the three meningeal coverings. The need for the HCA and AP to develop activity is involved in receiving
an understanding of the various functions in illness and health is emphasised. Understanding information from the rest of the body;
how the brain functions can help the HCA and AP to offer people care that is based on a sound it interprets that information and then
knowledge base. A glossary of terms is offered, assisting in further developing understanding. directs the body’s response to it. There
A short quiz has also been provided. are several types of input that the brain
Keywords interprets and these include:
Brain Nervous system Odours
Communication Coordination Light
Sounds
Pain

T
he brain is the centre of all thought
and life and is part of the nervous
system that, besides the brain,
includes the nervous tissue contained
within the skull (cranium), and the spinal
cord, the extension of nervous tissue
within the vertebral column. The brain
is located in the cranium and weighs
between 1450g and 1600g. It receives
15% of the cardiac output and has a
system of autoregulation that ensures that
blood supply is constant, regardless of
positional changes.
The brain is made up of more than
100 billion nerves that communicate via
trillions of connections that are called
synapses. The brain is made up of many
specialised areas and regions that work
together for many different and separate
functions (see Figure 1).
The sections of the brain
The brain is divided into sections (see
Figure 1). Each section has responsibility
for certain portions of the brain’s overall
Migliozzi, 2017). The cerebrum is the
largest part of the brain and is responsible
for memory, speech, the senses,
emotional response and more. It is
divided into several sections called lobes.
The cerebellum is below and behind
the cerebrum attached to the brain stem;
it controls motor function, the ability to
balance and the body’s ability to interpret
information sent to the brain via the eyes,
ears and other sensory organs (Waugh
and Grant, 2014).
The functions the brain stem controls
include respiration, blood pressure, some
reflexes and the changes occurring in the
body during what is called the ‘fight or
flight’ response.
The brain stem is also divided into
several distinct sections:
Midbrain
Pons
Medulla oblongata
“The brain’s central physiological activity is involved
The brain also assists in performing
vital actions, for example:
Breathing
Maintaining blood pressure
Releasing hormones
The lobes of the brain
Frontal lobe
This lobe is the part of the brain that
controls important cognitive skills,
such as emotional expression, problem-
solving, memory, language, judgement
and sexual behaviour. It is seen as the
‘control panel’ of personality and the
person’s ability to communicate.
This lobe is also responsible for
primary motor function, or our ability
to move our muscles consciously and
the two key areas related to speech; this
includes the part called Broca’s area.
In humans, the frontal lobe is larger
and more developed than in any other
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job (see Figure 2). The larger parts are

divided into smaller areas that manage
smaller portions of the work. Often,
different areas will share responsibility
for the same task (McErlean and
538
in receiving information from the rest of the body; it
interprets that information and then directs the body’s
response to it”
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 Human body I CLINICAL

organism. As the name suggests, it is

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located at the front of the brain. The
right hemisphere of the frontal lobe
controls the left side of the body and the
left hemisphere controls the right side of
the body.

Parietal lobe
The parietal lobe is located near the
centre of the brain, behind the frontal
lobe, in front of the occipital lobe and
above the temporal lobe. The parietal
lobe contains an area known as the
primary sensory area, where sensations
are managed and impulses from the skin,
such as warmth, cold, pain, and touch
are translated.
The parietal lobe is also important
with regards to spatial information,
providing us with the ability to judge size,
distance and shapes. A specific area in Figure 1. The four lobes of the brain.
the parietal lobe provides the ability to

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understand written language and to solve
mathematical problems.

Temporal lobe
This lobe folds underneath each
hemisphere of the brain on either side
and below the frontal and parietal lobes.
It houses the ability to receive and
interpret auditory information from
the ear. In addition, it also collects and
interprets information from the nose.
The parietal lobe is the key area of the
brain for dealing with sensory input.
Within this lobe is an important area
known as Wernicke’s area, providing the
ability to recognise speech and interpret
the meaning of words. The temporal
lobe is also thought to be associated with
long-term memory, such as remembering
autobiographical information, dates
and places. Figure 2. Functions of different areas of the brain.

Occipital lobe
The occipital lobe is located at the rear
aspect of the skull, behind the parietal
and temporal lobes. The primary visual
cortex is one of the most important
parts of this lobe, a region of the brain
receiving input from the retina. It is here
where the mind interprets colour and
other important aspects of vision.
The occipital lobe contains different
© 2017 MA Healthcare Ltd
It is critically important for reading and
reading comprehension.
The meninges
The nervous tissue is protected by
layers of defence: the hair on the head,
the skin covering the scalp and the
bone of the skull offer an outer layer of
protection. The meninges are membranes
surrounding the central nervous system,
provides a cushion to the brain and
spinal cord, protecting them from shocks
that might lead to harm. Approximately
150ml of CSF circulates around the brain,
in the ventricles and around the spinal
cord. Every 8 hours, the CSF is replaced.
CSF also acts as a transport system
delivering nutrients to the central
nervous system. It also removes waste
products. There are three layers to the

areas relating to visual communication.
One area is where visual images of
language are received (the visual
receiving area) and another is where it
is interpreted (visual association area).
adding an additional layer of protection
beneath the bones of the skull and
spine. Circulating within the meninges
is a fluid substance that is known as the
cerebrospinal fluid (CSF). This fluid
meninges—see Table 1 and Figure 3.
The nerves
The nerves of the peripheral nervous
system connect the brain to the rest of

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 CLINICAL I Human body

the body, providing communication and

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response to stimuli. These nerves are

named after the areas that they service.
The sciatic and femoral nerves, named
for the hip and femur, respectively, serve
aspects of the lower body. The ulnar
nerve is one that serves part of the arm
and the hand.

Cerebral circulation
The blood supply to the brain is
important for healthy brain function.
Circulating blood supplies the brain with
the oxygen and nutrients it requires to
function properly. Blood delivers oxygen
and glucose to the brain (Herlihy, 2014).
There are four main arteries supplying
blood to the brain:
The left and right internal carotid
arteries
The left and right vertebral arteries
These arteries attach, creating a circle at
the base of the brain. This is known as the
Figure 3. The meninges illustrated. Circle of Willis (see Figure 3). There are
smaller blood vessels that branch off from
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these arteries to sustain other parts of the

brain (McErlean and Migliozzi, 2017).
The brain also has venous sinuses
(types of veins) carrying blood containing
carbon dioxide and other waste products
away from the cranium. Some of these
connect with the veins of the scalp and
face. Nutrient and waste exchange occurs
across the blood-brain barrier. The
blood-brain barrier protects the brain.
When cerebral circulation is impaired,
there will be less oxygen and glucose
reaching the brain. This can result in
brain damage and neurological problems.
These are some conditions that are

“The nervous tissue is

protected by layers of
defence: the hair on the
head, the skin covering the
scalp and the bone of the
skull offer an outer layer of
protection. The meninges
add an additional layer
© 2017 MA Healthcare Ltd

of protection beneath
the bones of the skull
Figure 4. The circle of Willis. and spine”
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 Human body I CLINICAL

related to impaired cerebral circulation Table 1. The three layers of the meninges
and include:
Dura mater This is the outermost membrane and is the thickest of the three layers:
Stroke
it has both an outer and inner layer. It is one of the few structures of the
Cerebral haemorrhage skull capable of feeling pain. The brain cannot feel pain.
Cerebral hypoxia
Cerebral oedema Arachnoid mater This middle layer includes a network of fibres and collagen that are part
of the suspension system helping to protect the brain and spinal cord
from sudden impact. They also form a gap between the arachnoid and
Conclusion the pia mater called the subarachnoid space. It is in this space that the
The brain is one of the most complex cerebrospinal fluid is found.
organs in the body. Then brain
Pia mater The innermost layer, the pia mater enfolds the spinal cord and brain. It has
provides awareness of ourselves and
blood vessels that deliver oxygen and nutrients to the spinal cord.
of the environment and it processes
Source: adapted Boore et al, 2017.
a continuous stream of sensory data.
The brain controls muscle movements,
glandular secretions, breathing and Glossary of terms
internal temperature. ‘Fight or Physiological response triggered when a strong emotion such as fear
Each creative thought and feeling is flight’ response is experienced
developed by the brain. Anatomically, the
Hemisphere Half of the brain.
brain can be divided into regions. The
largest part of the brain is the cerebrum, Homeostasis Maintenance of a constant internal environment
which is divided into two hemispheres. Hypoxaemia Low oxygen in the blood stream
BJHCA
Membrane Selective barrier allowing some things to pass through, but which
stops others
Acknowledgement
Stimulus Thing or event that evokes a specific functional reaction in an organ
I would like to thank Mrs Frances Cohen or tissue (plural is stimuli)
for her help and support.
Synapse Junction between two nerve cells, consisting of a minute gap, across
which impulses pass
References Ventricles There are four ventricles in the brain. They are hollow spaces that
Boore, J., Cook, N. and Shepherd, A. (2017) house the cerebrospinal fluid (CSF)
“Essentials of Anatomy and Physiology for Visual cortex Part of the brain that processes visual information located in the
Nursing Practice” Sage London occipital lobe
Herlihy, B. (2014) (5th edn) “The Human Body in
Health and illness” Elsevier. St Louis 3. How many meningeal layers Test answers below
McErlean, L. and Migliozzi, J. (2017) The nervous are there?
system. In: Peate, I, Nair, M. (eds) (2nd edn) a. 1
Fundamentals of Anatomy and Physiology b. 2
for Nursing and Healthcare Students. Wiley, c. 3
Oxford, Ch 13 pp 403–38 d. 4 Answers to quiz
Waugh, A. and Grant, A. (2014) (12th Ed) Ross Answer: 1A, Answer: 2D, Answer: 3C,
and Wilson Anatomy and Physiology. Churchill 4. The arteries creating a circle at the Answer: 4A, Answer: 5D
Livingstone, Edinburgh base of the brain are known as:
a. Circle of Willis Key points
b. Circle of William In order to provide people with safe and
c. Circle of Wise effective care, the HCA and AP must have an
d. Circle of Broca understanding of the brain and its functions
Test The brain is the centre of all thought and life
1. What is another name for the skull? 5. The brain controls: The cerebrum is the largest part of the brain
a. Cavity a. Muscle movements There are four lobes in the brain
b. Ventricle b. Glandular secretions The meninges act as yet another protective
c. Cranium c. Breathing mechanism for the brain
d. None of the above d. All of the above

2. How many lobes in the brain

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are there? Reflective questions for your continuing professional development (CPD)
a. 1 Name 6 components of blood and three of the functions of blood
b. 2 How does an understanding ofblood help you as an HCA or AP to care for people better?
c. 3 Prepare with a colleague a talk for fellow support staff on the importance of blood
d. 4

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