NCM 116 — PERCEPTION AND COORDINATION
OVERVIEW OF THE NERVOUS SYSTEM
(2nd Term, 3rd Year)
NERVOUS SYSTEM
Nervous System has 2 main parts:
1. CENTRAL NERVOUS SYSTEM
a. Brain
b. Spinal Cord
2. PERIPHERAL NERVOUS SYSTEM
a. Somatic
• Voluntary – movement
• Involuntary — reflexes
b. Autonomic
• Sympathetic
— Fight and Flight
• Parasympathetic
— Read, Digest, Rest
PARTS OF THE BRAIN
1. CEREBRUM
— Divided into two hemispheres; center for
coordination and integration of all information needed
to interpret and respond to the environment
• Pineal Body – an endocrine gland that influences
the activities of the pituitary gland, islet of
langerhans, parathyroids, adrenals and gonads.
• Corpus Callosum – a pathway conneting the two
hemispheres and coordinating their function.
• Left Hemisphere – controls the right side of the
body and is the center for logical reasoning and
analytical functioning such as reading, writing and
mathematical task.
• Right Hemisphere – controls the left side of the
body and is the center for creative thinking,
intuition, and artistic abilities
2. CEREBRAL CORTEX
4 LOBES
a. Frontal Lobes
— Control the organization of thought, body
movement, memories, emotions and moral
behavior.
— The integration of all these information helps
regulate arousal, focuses attention and enables
problem solving and decision making.
— Abnormalities are associated with schizophrenia,
attention deficit, hyperactivity disorder (ADHD)
and dementia
b. Parietal Lobes
— interprets sensations of taste and touch and assist
in spatial orientation.
c. Temporal Lobes
— centers for the senses of smell and hearing,
memory and emotional expressions.
d. Occipital Lobes
— assist in coordinating language generation and
visual interpretation such as depth perception
3. BASAL GANGLIA
— A group of structures near the center of your brain
that form important connections.
— These connections allow different areas of your
brain to work together.
— The basal ganglia manage the signals your brain
sends that help you move your muscles.
4. DIENCAPHALON
— The diencephalon acts as a primary relay and
processing center for sensory information and
autonomic control.
— The plethora of communicating pathways
between these structures and other parts of the
body makes the diencephalon a functionally
diverse area.
5. BRAIN STEM
— Includes the mid brain, Pons, and medulla
oblongata, and the nuclei for the cranial nerves 3-
12.
— Contains centers that control cardiovascular and
respiratory functions, sleep, consciousness, and
impulses
• Medulla Oblongata – located at the top of the
spinal cord, contains vital centers for respiration
and cardiovascular functions .
• Pons – above the medulla and in front of the
cerebrum , bridges the gap both structurally and
functionally serving as a primary motor pathway.
• Mid Brain
— connects the Pons and cerebellum with the
cerebrum.
 — Measures 0.8 inch (2 centimeters) and includes
most of the reticular activating system and the
extrapyramidal system
• Reticular Activating System – influences motor
activity, sleep, consciousness and awareness.
• Extrapyramidal System – relays information
about movement and coordination from the brain
to the spinal nerves .
• Locus Ceruleus – a small group of
norephinephrine-producing neurons in the brain
stem, is associated with stress, anxiety and
impulsive behavior
6. CEREBELLUM
— Located below the cerebrum and is the center for
coordination of movements and postural
adjustments.
— Receives and integrates information from all areas
of the body such as the muscle, joints, organs, and
other components of the CNS.
— Inhibited transmission of dopamine in this area is
associated with the lack of smooth, coordinated
movements in diseases such as Parkinson’s and
dementia
7. SPINAL CORD
— Cylindrical structure that runs through the center
of your spine, from your brainstem to your low
back.
— It’s a delicate structure that contains nerve bundles
and cells that carry messages from your brain to
the rest of your body.
8. LIMBIC SYSTEM
— regulates body temperature, appetite, sensations,
memory and emotional arousal; located above the
brain stem, includes:
• Thalamus – regulates activity, sensation and
emotion.
• Hypothalamus – involved in temperature
regulation, appetite control, endocrine function,
sexual drive and impulsive behavior associated
with feelings of anger, rage, or excitement .
• Hippocampus and Amygdala – involved in
emotional arousal and memory
— Disturbances in limbic system has been
implicated with memory loss that accompanies
dementia.
— And poorly controlled emotions and impulses
seen with psychotic or manic behavior
NEURONS
— basic sub unit of the nervous system and there are
100 billion of them in the brain.
— Composed of a cell body with a large nucleus.
— It is the cell body and dendrites of the neuron that
makes up the gray matter of the cortex and the
brain nuclei.
— Transmit information by sending action
potentials, or waves of electrical depolarization,
down there processes to other neurons
• Dendrites – receive impulses from other neurons
and transmit to the cell body
• Axons – carry impulses away from the cell body
to another neuron, muscle or gland
3 Types of Neurons
1. Sensory Neurons (Afferent Neurons) – send
messages to the CNS.
2. Motor Neurons (Efferent Neurons) – send
messages from the CNS to the periphery.
3. Association Neurons (Interneurons) – lie
between sensory and motor neurons
NEUROTRANSMISSION
— a process wherein neurons communicate
information with one another by sending
electrochemical messages from neuron to neuron
Process:
• Electrochemical messages pass from the dendrites
through the soma or cell body down the axon and
across the synapse (gaps between cells) to the
dendrites of the next neuron.
• In the nervous system, the electrochemical
messages cross the synapses between neural cells
by way of special chemical messengers called
neurotransmitters.
NEUROTRANSMITTERS – chemical substances
manufactured in the neuron that aid in the transmission
of information throughout the body
• Excitatory – stimulate an action in the cells
• Inhibitory – stop an action
— Neurotransmitters fit into specific receptor cells
embedded in the membrane of the dendrite, just
like a key shape fits into a lock.
— After neurotransmitters are released into the
synapse and relay the message to the receptor
cells:
• Reuptake – transported back from the synapse to
the axon to be stored for later use.
• Metabolized and inactivated by enzymes
(monoamine oxidase)
— Abnormal neurotransmission causing some
mental disorders because of excess transmission
or excess responsiveness of receptors
• Deficient neurotransmitter
• Deficient receptor
• Excess neurotransmitter
• Excess receptors
MAJOR NEUROTRANSMITTERS
ASSOCIATED WITH MENTAL DISORDERS
• DOPAMINE
— A neurotransmitter located primarily in the brain
stem.
— Involved in the control of complex movements,
motivation, cognition and regulation of emotional
responses.
— Generally excitatory and is synthesized from
tyrosine, a dietary amino acid.
— Is implicated in Schizophrenia and Parkinson’s
disease.
— Antipsychotic drugs work by blocking dopamine
receptors and reducing dopamine activity
• NOREPINEPHRINE/ NORADRENALINE
— The most prevalent neurotransmitter in the
nervous system, located primarily in the brain
stem
— Plays a role in changes in attention, learning and
memory, sleep and wakefulness, and mood
regulation
— Excitatory
— Excess has been implicated in several anxiety
disorders.
— Deficits contribute to memory loss, social
withdrawal, and depression.
— Some Antidepressants blocks the reuptake, others
inhibit MAO from metabolizing it
• EPINEPHRINE / ADRENALINE
— Limited distribution in the brain
— Excitatory
— Controls the fight-or-flight response in the
peripheral nervous system
• SEROTONIN
— A neurotransmitter found only in the brain,
derived from tryptophan, a dietary amino acid.
— Mostly inhibitory, involved in the control of food
intake, sleep and wakefulness, temperature
regulation, pain control, sexual behavior, and
regulation of emotions.
— Plays an important role in anxiety and mood
disorders and schizophrenia.
— Contribute to the delusions, hallucinations, and
withdrawn behavior seen in schizophrenia.
— Some antidepressants block serotonin reuptake,
leaving it available for longer in the synapse,
which results in improved mood
• HISTAMINE
— Involved in peripheral allergic responses, control
of gastric secretions, cardiac stimulation, and
alertness.
— Neuromodulator.
— Some psychotic drugs block histamine, resulting
in weight gain, sedation, and hypotension
• ACETYLCHOLINE
— Neurotransmitter found in the brain, spinal cord,
peripheral nervous system particularly at the
neuromuscular junction of skeletal muscle.
— Excitatory or inhibitory.
— Synthesized from dietary choline found in red
meat and vegetables
— Affect the sleep/wake cycle and signal muscles to
become active
— Studies have shown that people with Alzheimer’s
disease have decreased acetylcholine-secreting
neurons.
— People with Myasthenia gravis (a muscular
disorder in which impulses fail to pass the
myoneural junction, which causes muscle
weakness) have reduced acetylcholine receptors
• GLUTAMATE
— An excitatory amino acid that, at high levels, can
have a major neurotoxic effects.
— Implicated in the brain damage caused by stroke,
hypoglycemia, sustained hypoxia or ischemia, and
some degenerative diseases such as Huntington’s
or Alzheimer’s.
• GAMMA-AMINOBUTYRIC ACID (GABA)
— An amino acid, is the major inhibitory
neurotransmitter in the brain and has been found
to modulate other neurotransmitter systems rather
than to provide a direct stimulus.
— Drugs that increase GABA function such as
benzodiazepines are used to treat anxiety and
induce sleep.
• NEOROPEPTIDES
— Neuromodulators
— Enhance, prolong, inhibit, or limit the effects of
principal neurotransmitters
DIAGNOSTIC PROCEDURES
1. Lumbar Puncture
2. X-Ray
3. CT Scan
4. MRI Scan
5. Cerebral Angiography
ASSESSMENT
1. MENTAL STATUS EXAM
a. Assessment of Mental Status
 b. Level of Consciousness Confused —4
c. Posture Inappropriate Words. —3
Incomprehensible Words — 2
2. SYSTEM ASSESSMENT No Response —1
a. Medical History
- Medications • Motor Response
- Pregnancy History Obeys Command —6
- Pain Moves to localized pain —5
b. Family History Flexion withdrawal from pain —4
c. Physical History Abnormal Flexion (Decorticate) — 3
d. History and symptoms of present problem Abnormal Extension (Decerebrate) — 2
No Response —1
3. PHYSICAL ASSESSMENT
a. General Observation Total:
Best Response — 15
— Posture and Gait
Comatose Client — 8 or less
— Position of rest of infants and children
Totally Unresponsive — 3
— Personal Hygiene and Grooming

b. Mental Status
— Culture
— Educational Background
— General Appearance
— Level of Consciousness

c. Assessment of Pupillary Movement

— Reaction to light
— Pupil size should be equal
— Accommodation
— Consensual Movement
— Ability of eyes to move together

d. Evaluate the motor function

— Extension and hyperextending

e. Evaluation of Reflexes
— Gag reflex
— Swallowing reflex
— Babinski reflex
— Deep tendon reflex

f. Assess the vital signs and correlate with other

datas.

4. NEURO CHECK
— parameters for neurologic symptoms.

a. GLASGOW COMA SCALE (GCS)

• Eye Movement
Spontaneously — 4
To Speech —3
To Pain —2
No Response — 1

• Verbal Response
Oriented. —5