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OVERVIEW
➢ Nervous system
o Provides swift, brief responses to
stimuli
➢ Endocrine system
o Adjusts metabolic operations and
directs long term changes
➢ Nervous system includes
o All the neural tissue of the body
o Basic unit = neuron
FUNCTION CLASSIFICATION (PNS only)
FUNCTIONS OF THE NERVOUS SYSTEM
➢ Afferent division (SAD)
➢ Sensory input – gathering information
o Brings sensory information from
o To monitor changes occurring inside
receptors to the CNS
and outside the body
o Somatic – skin, skeletal muscles,
o Changes = stimuli
joints
➢ Integration
o Visceral – visceral organs
o To process and interpret sensory
➢ Efferent division (MED)
input and decide if action is needed
o Carries motor commands from the
➢ Motor output
CNS to effectors
o A response to integrated stimuli
o Somatic nervous system = voluntary
o The response activates muscles or
▪ Consciously controls skeletal
glands
muscles
o Autonomic Nervous system =
involuntary
▪ Automatically controls
smooth and cardiac muscles
and glands
▪ Further divided into the
sympathetic and
parasympathetic nervous
STRUCTURAL CLASSIFICATION
systems
➢ CNS (Central Nervous System)
o Brain and spinal cord
o Functions:
▪ Integration; command center
▪ Interpret incoming sensory
information
▪ Issues outgoing instructions
➢ PNS (Peripheral Nervous System)
o Neural tissue outside CNS (nerves)
o Spinal nerves
▪ Carry impulse to and from
the spinal cord
o Cranial nerves
▪ Carry impulse to and from
the brain
o Functions
▪ Serve as communication
lines among sensory organs,
the brain and spinal cord,
and glands or muscles
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ASTROCYTRES
➢ Abundant, star-shaped cells
TWO GROUPS OF CELLS
➢ Provide structural support
➢ NEURONS ➢ From barrier between capillaries and
o Receive stimuli, conduct action neurons (blood-brain barrier)
potentials, and transmit signals to ➢ Control the chemical
other neurons or effector organs. environment of the
➢ NEUROGLIA brain
o AKA Glial cells ➢ Forms scar tissue
o Support and protect neurons and after injury
perform other functions
o Account for over half of the brain’s
weight
o 10 to 50 times more glial cells than
neurons in various parts of the MICROGLIA
brain.
➢ Spiderlike
(Supporting Nervous Tissues) phagocytes
➢ Remove cell debris,
➢ Also known as glial cells pathogens and wastes
➢ Support cells in the CNS
➢ Unable to transmit impulses
➢ Never lose their capability to divide EPENDYMAL CELLS
➢ General functions:
o Support ➢ Line cavities of the brain (ventricles) and
o Insulate spinal cord (central
o Protect neurons canal)
➢ Assist in producing,
circulating and
monitoring of
cerebrospinal fluid

OLIGODENDROCYTES
➢ Provide structural
support
➢ Wrap around nerve
fibers in the central
nervous system
➢ Produce myelin
sheaths
PNS NEUROGLIA
➢ Satellite cells
o Cushions neuron cells bodies in the
PNS
o Regulate gas, nutrients, and
neurotransmitter levels
➢ Schwann cells
o Form myelin sheath
around the axons in
the peripheral nervous
system
o Helps in repairs after
injury
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MYELIN SHEATH
➢ Whitish fatty material with a waxy
CELL BODY appearance covering the nerve fibers
➢ Metabolic center of the neuron o Schwann cells – PNS
➢ Nucleus with large nucleolus o Oligodendrocytes – CNS
➢ Does not contain centrioles ➢ Protects and
➢ Nissl bodies insulates
o Specialized rough ➢ Increases
endoplasmic reticulum transmission rate of
➢ Neurofibrils nerve impulses
o Intermediate ➢ Nodes of Ranvier –
cytoskeleton gaps or indentions
o Maintains cell shape between myelin
sheaths
➢ Neurilemma –
important in PNS nerve
DENDRITES
fiber regeneration
➢ Processes that convey impulses toward the
cell body
➢ May be present in numerous amounts
AXON
➢ Only one axon arises from a conelike region
of the cell body called the axon hillock
➢ Transmits impulses away from the cell body
➢ Trigger zone: where the action potential is
generated
AXONS
➢ Branch profusely at the terminal end (axon
UNMYELINATED AXONS
terminals) that contain vesicles containing
neurotransmitters ➢ The axons rest in invaginations of the
➢ Axon terminals are separated from the next Schwann cells or oligodendrocytes
neuron by a gap
o Synaptic cleft – gap between
adjacent neurons
o Synapse – junction between nerves
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DISORDER OF THE MYELIN SHEATH ➢ Bipolar – only 2 processes, one axon, one
dendrite; found in special sense organs
➢ MULTIPLE SCLEROSIS
such as nose and eye
o Autoimmune disease o Rare in adults
o Destruction of myelin sheaths
o Short-circuited electrical impulses
o Signs and symptoms
• Visual and speech
disturbance
• Muscle incoordination
TERMINOLOGIES

➢ WHITE MATTER – dense collections of ➢ Unipolar – with a single process emerging

myelinated fibers (tracts) from the cell body which divides into
o TRACTS – bundles of nerve fibers central and peripheral processes; found in
running through the CNS PNS ganglia
o NERVES - bundles of nerve fibers o Well-suited for rapid sensory
running through the PNS transmission and reflex responses
➢ GRAY MATTER – unmyelinated fibers and
cell bodies
o CORTEX – surface of the brain
o NUCLEI – clusters of cell bodies
found in the CNS
o GANGLIA – small collections of cell
bodies in the PNS

FUNCTIONAL CLASSIFICATION OF NEURONS

➢ Sensory (afferent) neurons
o Carry impulses from the sensory
receptors to the CNS
• Cutaneous sense organs
(skin)
• Proprioceptors – detect
stretch or tension (muscle
CLASSIFICATION OF NEURONS and tendon)
➢ Based on structure (number of processes)
o Unipolar
o Bipolar
o Multipolar
➢ Based on function
o Sensory or afferent neurons
o Motor or efferent neurons
o Interneurons
STRUCTURAL CLASSIFICATION OF NEURONS
➢ Multipolar – several processes; most
common structure
o All motor and interneurons are
multipolar
o Many extensions from the cell body
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➢ Motor (efferent) neurons o Require the opening of voltage-
o Carry impulses from the central gated channels
nervous system to viscera, muscles, o Occur along axons
or glands
RESTING NEURON
➢ Interneurons (association neurons)
o Located entirely within the CNS ➢ Plasma membrane
o Distribute sensory input and of a resting neuron
coordinate motor input is polarized (fewer
o Connect sensory and motor neurons positive ions are
inside the cell than
outside the cell)
➢ Depolarization occurs when the neuron is
excited by neurotransmitters or any type of
stimuli
LOCAL DEPOLARIZATION
➢ A stimulus depolarizes
a patch of the neuron’s
membrane
➢ The membrane is now
permeable to sodium as sodium channels
open
➢ A depolarized membrane allows sodium
(Na+) to flow inside the membrane
ACTION POTENTIAL
FUNCTIONAL PROPERTIES OF NEURONS ➢ If the stimulus is strong
enough, depolarization
➢ Irritability
causes membrane
o Ability to respond to stimuli
polarity to be completely reversed, and an
➢ Conductivity
action potential is initiated
o Ability to transmit an impulse
➢ ALL OR NON RESPONSE – the impulse is
➢ Action potential – electrical signals
either propagated over the entire axon or it
produced by specialized cells
doesn’t happen at all
RESTING MEMBRANE POTENTIAL
PROPAGATION OF THE ACTION POTENTIAL
➢ Interior of the plasma membrane is
➢ If enough sodium
negatively charged and the exterior is
enters the cell, the
positively charged
action potential
➢ “polarized”
(nerve impulse)
➢ Depolarization
starts and is propagated over the entire
o Occurs when the neuron is excited
axon
by neurotransmitters or any type of
➢ Impulses travel faster when fibers have a
stimuli
myelin sheath
ELECTRICAL SIGNALS
REPOLARIZATION
➢ Graded Potentials
➢ Potassium ions
o Used for short distance
rush out of the
communication
neuron after
o Result from the opening of
sodium ions
chemically gated channels
rush in, which
o Occur along dendrites
repolarizes the membrane
➢ Action Potentials
➢ Repolarization involves restoring the inside
o Allow communication over long
of the membrane to a negative charge and
distances within the body
the outer surface to a positive charge

REPOLARIZATION
➢ Initial ionic condition are restored using the
sodium-potassium pump.
➢ This pump, using ATP, restores the original
configuration
➢ Three sodium ions are ejected from the cell
while two potassium ions are returned to
the cell
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2. Calcium, in turn, causes the tiny vesicles
containing the neurotransmitter chemical to
fuse with the axonal membrane.
3. The tiny vesicles upon fusing with the
axonal membrane will form pore-like
openings thereby releasing the transmitter
into the synaptic cleft.
4. The neurotransmitter molecules diffuse
across the synapse and bind to receptors
on the membrane of the next neuron.

NERVE CONDUCTION
➢ Myelinated fibers conduct impulses faster
than unmyelinated ones because the nerve
impulses jump from node to node
➢ SALTATORY CONDUCTION
o Faster type of electrical impulse
propagation 5. If enough neurotransmitter is released,
graded potential will be generated.
SYNAPSE
Eventually an action potential (nerve
➢ Site of intercellular communication impulse) will occur in the neuron beyond
➢ Neurotransmitters released from synaptic the synapse.
knob (presynaptic membrane) of
presynaptic neuron bind to receptors on the 6. The electrical changes prompted by
membrane of the next neuron neurotransmitter binding are brief. The
neurotransmitter is quickly removed from
TRANSMISSION OF A SIGNAL AT SYNAPSES the synapse.
1. When the action potential reaches the axon
terminal, the electrical charge opens calcium
channels

NOTE: TRANSMISSION OF AN IMPULSE IS AN

ELECTROCHEMICAL EVENT.
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Clinical Connection
➢ Factors that can impair conduction of
impulses
o Anesthetics
o Sedatives
o Prolonged pressure
o Cold temperature
THE REFLEX ARC
➢ Reflex – rapid, predictable, and involuntary TWO-NEURON REFLEX ARC
response to a stimulus
o Occurs over pathways called reflex ➢ Simplest type
arcs ➢ Example: Patellar (knee-jerk) reflex
➢ Reflex arc – direct route from a sensory
neuron, to an interneuron, to an effector
o The basic function unit of the
nervous system because it is the
smallest, simplest portion capable
of receiving a stimulus and
producing a response
➢ Somatic reflexes
o Reflexes that stimulate the skeletal
Patellar (Knee-jerk) Reflex
muscles; still involuntary
o Example: pull your hand away from ➢ When the patellar ligament is tapped, the
a hot object tendons and muscles of the quadriceps
➢ Autonomic reflexes femoris muscle group stretch.
o Regulate the activity of smooth ➢ Sensory receptors within the muscles
muscles, the heart, and glands stretch, which activates the stretch reflex,
o Example: regulation of smooth leading to the characteristic knee-jerk
muscles, heart and blood pressure, response.
glands, digestive system (secretion
of saliva, pupillary reflex) THREE-NEURON REFLEX ARC

FIVE ELEMENTS OF A REFLEX ➢ Three-neuron reflex arcs

o Consists of five elements: receptor,
1. Sensory receptor sensory neuron, interneuron, motor
o Reacts to a stimulus neuron, and effector
2. Sensory neuron o Example: Flexor (withdrawal) reflex
o Carries message to the integration
center
3. Integration center (CNS)
o Processes information and directs
motor output
4. Motor neuron
o Carries message to an effector
5. Effector organ
o The muscle or gland to be
Flexor (Withdrawal) Reflex
stimulated
➢ The limb is withdrawn from a painful
stimulus
➢ There is an interneuron in the three-neuron
reflex arc, allowing for more complex
processing and integration of sensory
information within the central nervous
system before transmitting the motor
command to the effector organ.
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➢ The brain is the CONTROL CENTER for

registering sensations, correlating them
with one another and with stored
information, making decisions, and taking
actions.
➢ It also is the center for the intellect,
emotions, behavior and memory.
➢ It directs our behavior toward others.
CENTRAL NERVOUS SYSTEM (CNS)
CEREBRUM
➢ CNS develops from the
➢ AKA Cerebral Hemispheres
embryonic neural tube
➢ Paired (left and right) superior parts of the
➢ The neural tube becomes the
brain
brain and spinal cord
➢ Includes more than half of the brain mass
➢ The opening of the neural
which is 1400g in males, 1200g in females
tube becomes the ventricles
o Four chambers BASIC REGIONS OF THE CEREBRUM
within the brain
o Filled with cerebrospinal fluid ➢ Gray matter (Cerebral cortex)
o Superficial region (Cortex)
o 2-4 mm thick
o Responsible for speech, memory,
logical and emotional responses,
consciousness, the interpretation
sensation, and voluntary movement
➢ White matter (Cerebral medulla)
o Internal region
o Consists of tracts that connect areas
of the cerebral cortex to each other
or to other parts of the CNS.
➢ Basal nuclei
o Islands of gray matter situated deep
within the white matter
CHARACTERISTICS OF THE BRAIN o Involved in controlling motor
1. Pinkish gray functions
2. Walnut-like appearance
3. Oatmeal-like in texture
4. Average weight – 3lbs
MAJOR PARTS OF THE BRAIN
➢ Cerebrum – largest part of the brain
➢ Diencephalon
o Composed of:
• Thalamus
• Epithalamus
• Hypothalamus
➢ Cerebellum – posterior to the midbrain
➢ Brainstem – continuous with the spinal cord
o Composed of: Medulla oblongata,
Pons, and Midbrain

CEREBRUM
➢ The “seat of intelligence”.
➢ During embryonic development, when brain
size increases rapidly, the gray matter of
the cortex enlarges much
faster than the deeper
white matter causing the
cortical region to roll and
fold on itself.
➢ The cerebral hemisphere
are connected internally
by the corpus callosum
THE CEREBRAL CORTEX
➢ Gyrus (Gyri) – elevated ridges of tissues
➢ Sulcus (Sulci) – shallow groove separating
gyri and divides the hemispheres into lobes
o Central sulcus – separates the
frontal and parietal lobes
➢ Fissures – deeper grooves
o Longitudinal fissure – divides the
cerebral hemisphere into right and
left
o Lateral fissure - separates the
temporal lobe from other lobes
➢ Lobes – divisions of the cerebrum
corresponding with the names of bones
that house them
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LOBES OF THE BRAIN
➢ Precentral gyrus – located immediately
anterior to the central sulcus
o Contains the primary motor area of
the cerebral cortex
➢ Postcentral gyrus – located immediately
posterior to the central sulcus
o Contains the primary somatosensory
area of the cerebral cortex
➢ INSULA – the fifth lobe
o Gustatory function
o Regulation of the ANS
➢ FRONTAL LOBE
o Voluntary motor function
o Motivation
o Aggression
o Sense of smell
o Mood
o Prefrontal cortex (anterior region) –
personality and decision making
➢ PARIETAL LOBE
o The major center for receiving and
evaluating most sensory
information, except for smell,
hearing, taste, and vision.
➢ OCCIPITAL LOBE
o Functions in receiving and
integrating visual input
o Not distinctly separate from the
other lobes
➢ TEMPORAL LOBE
o Center for smell and hearing
o Involved in memory abstract
thought and judgment
o Separated from the other lobes by
the lateral fissure
o Insula (AKA fifth lobe)
o – center for taste

FUNCTIONAL ORGANIZATION OF THE CEREBRAL
CORTEX
➢ SENSORY AREAS
o Receive sensory information
o Involved in perception, the
conscious awareness of a sensation
➢ MOTOR AREAS
o Control the execution of voluntary
movements
➢ ASSOCIATION AREAS
o Deal with more complex integrative
functions (memory, emotions,
reasoning, will, judgement,
personality traits, intelligence).
➢ Brodmann’s Area
o Way of mapping the cortex and its
functions
o Pioneered by a German neurologist
Korbinian Brodmann
o Cortex is divided into 52 areas
which are numbered sequentially
o Each area is distinguished by
microscopic anatomy through the
shapes and types of cells and their
connections
IMPORTANT BRODMANN SENSORY AREAS
➢ Primary somatosensory area (areas 1, 2, 3)
– parietal lobe
o Postcentral gyrus
o Receives nerve impulses for touch,
pressure, vibration, itch, tickle,
temperature, pain, and
proprioception
o Control body areas having the finest
motor control (face, mouth, and
hands)
➢ Primary visual area (area 17) – occipital
lobe
o Receives visual information and is
involved in visual perception
➢ Primary auditory area (areas 41 and 42) –
temporal lobe
o Receives information for sound and
is involved in auditory perception
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➢ Primary gustatory area (area 43) – insula
o Involved in gustatory perception
and taste discrimination
➢ Primary olfactory area (area 28) – temporal
lobe
o Receives impulses for smell and is
involved in olfactory perception
➢ Primary motor area (area 4) – frontal lobe
o Precentral gyrus
o Controls voluntary contractions of
specific or groups of muscles
➢ Broca’s speech area (areas 44 and 45) –
frontal lobe
o Usually located in the left
hemisphere (97%)
o Involved in planning and production
of speech
o Damage to the Broca’s area may
cause inability to speak despite
having clear thoughts (nonfluent
aphasia)
➢ Somatosensory association area (areas 5
and 7) – parietal lobe
o Permits you to determine the exact
shape and texture of an object by
feeling it, to determine the
orientation of one object with
respect to another as they are felt,
and to sense the relationship of one
body part to another
o Storage of memories of past
somatic sensory experiences
➢ Visual association area (areas 18 and 19) –
occipital lobe
o Relates present and past visual
experiences and is essential for
recognizing and evaluating what is
seen
➢ Facial recognition area (areas 20, 21, and
37) – temporal lobe
o Stores information about faces
o More dominant in right hemisphere
➢ Orbitofrontal cortex (area 11) – frontal lobe
o Involved in identifying odors and
odor discrimination
o More dominant in right hemisphere
➢ Common integrative area (areas 5, 7, 39,
and 40)
o Bordered by somatosensory, visual,
and auditory association areas.
o Integrates sensory interpretations
from the association areas and
impulses from other areas.
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➢ Prefrontal cortex (areas 9, 10, 11, 12) – THE CEREBRAL WHITE MATTER
frontal lobe
➢ Composed of fiber tracts carrying impulses
o Frontal association area
o Has numerous connections with to, from and within the cortex
other areas of the cerebral cortex,
thalamus, hypothalamus, limbic
system, and cerebellum
o Concerned with the makeup of a
person’s personality, intellect,
complex learning abilities, recall of
information, initiative, judgment,
foresight, reasoning, conscience,
intuition, mood, planning for the
future, and development of abstract THREE TYPES OF TRACTS (Cerebral White Matter)
ideas.
➢ Premotor area (area 6) – frontal lobe 1. Association tracts – contain axons that
o Deals with learned motor activities conduct nerve impulses between gyri in the
of a complex and sequential nature. same hemisphere
➢ Frontal eyefield area (area 8) 2. Commissural tracts – contain axons that
o Controls voluntary scanning conduct nerve impulses from gyri in one
movements of the eyes cerebral hemisphere to corresponding gyri
➢ Wernicke’s area (area 22, and possibly in the other cerebral hemisphere
areas 39 and 40) o Corpus callosum (the largest fiber
o Posterior language area bundle in the brain – 300 million
o Left temporal and parietal lobes fibers)
o Interprets the meaning of speech by o Anterior commissure
recognizing spoken words o Posterior commissure
o Damage to this area results in fluent 3. Projection tracts
aphasia (word salad) o Contain axons that conduct nerve
impulses between the cerebrum and
IMPORTANT AREAS OF THE BRAIN lower parts of the CNS
1. Primary somatosensory area – parietal lobe
2. Visual area – occipital lobe
3. Auditory area – temporal lobe
4. Olfactory area - temporal lobe
5. Gustatory area – insula (AKA fifth lobe)
6. Primary motor area – frontal lobe
7. Prefrontal cortex - frontal lobe
8. Broca’s area (production of speech) – left
frontal lobe
9. Wernicke’s area (comprehension of speech)
– left temporal and parietal lobes

THE BASAL NUCLEI

➢ AKA basal ganglia
➢ Help regulate voluntary motor activities by
modifying instructions (particularly in
relation to starting or stopping movement)
sent to the skeletal muscles by the primary
motor cortex
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Disorders in the Basal Nuclei ➢ Delta waves – normal during deep sleep in
adults and awake infants
➢ Parkinson’s Disease
o Due to degeneration of neurons in
the substantia nigra
o Bradykinesia, pill rolling, shuffling
movement, gait and postural
disturbances
➢ Huntington’s disease
o A rare, genetic disease that causes
the progressive breakdown
(degeneration) of nerve cells in the
basal nuclei
o Hallmark symptoms:
• Uncontrolled movement of
the arms, legs, head, face
and upper body,
• Also causes a decline in PROTECTIVE COVERINGS OF THE BRAIN
thinking and reasoning
skills, including memory, ➢ Scalp
concentration, judgment, ➢ Cranial bones
and ability to plan and ➢ Cranial meninges – connective tissue
organize membranes
o Pia mater (inner)
HEMISPHERIC LATERALIZATION/FUNCTIONAL o Arachnoid mater (middle)
ASSYMETRY o Dura mater (outer – periosteal layer
and meningeal layer)
➢ LEFT HEMISPHERE typically contains
➢ Cerebrospinal fluid
general interpretative and speech centers
and is responsible for language-based skills MENINGES
➢ RIGHT HEMISPHERE is typically responsible
for spatial relationships and analyses ➢ Dura mater
o Dense irregular tissue with two
layers
1. Periosteal layer 0 adherent to
the cranium
2. Meningeal layer – continuous
with the dura of the SC
➢ Arachnoid mater
o Very thin, wispy membrane
(cobweb-like)
o Subdural space – between dura and
arachnoid mater
➢ Pia mater
o Bound very tightly to the brain
o Subarachnoid space – between
arachnoid and pia mater
ELECTROENCEPHALOGRAPHY
• Filled with CSF
➢ Useful in studying electrical activity of the • Contains web-like strands of
brain arachnoid mater and blood
➢ Also utilized to confirm brain death vessels
BRAIN WAVES
➢ Alpha waves – healthy resting adult
➢ Beta waves – concentrating adult
➢ Theta waves – normal children and adults
under stress
➢
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SUBDURAL SPACE
➢ Location: between the dura mater and the
arachnoid mater
➢ Significance:
o Potential site of pathology: subdural
hematomas (collection of blood in
the subdural space)
• These hematomas may
result from head injuries,
ruptures blood vessels, or
bleeding disorders.
• They can exert pressure on
the brain, leading to
neurological symptoms.
SUBARACHNOID SPACE
➢ It is filled with cerebrospinal fluid (CSF)
➢ Location: between the arachnoid mater and
the pia mater
➢ Significance:
o Serves as reservoir for cerebrospinal
fluid
o Lumbar punctures or spinal taps are
Disorder of the Meninges – Meningistis
often performed by accessing the
subarachnoid space in the lower ➢ Inflammation of the meninges
lumbar region. ➢ May be bacterial or viral etiology
➢ May lead to encephalitis (inflammation of
DURAL FOLDS
the brain tissues)
➢ Tough connective tissue partitions that ➢ Usually diagnosed by lumbar tap
extend into the major brain fissures
BRAIN BLOOD FLOW
➢ Falx cerebri – largest
o Lies in the longitudinal fissure that ➢ Blood supply:
separates the left and right o Internal carotid arteries
hemispheres o Vertebral arteries
o Anchored anteriorly to the crista ➢ Venous drainage:
galli of the ethmoid o Dural venous sinuses drain into the
➢ Tentorium cerebelli internal jugular veins
o Lies between the cerebrum and the ➢ Brain is 2% of the total body weight but
cerebellum consumes 20% of the O2 and glucose used
➢ Falc cerebelli by the body
o Lies between the two cerebellar ➢ Total O2 deprivation of 4 mins =
hemispheres irreversible brain damage
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o Connected with the lateral ventricles
by the two interventricular foramina
BLOOD-BRAIN BARRIER
➢ Fourth ventricle
➢ The specialized system of brain o Cavity situated within the brainstem
microvascular endothelial cells (BMVEC) (superior portion of the medulla and
that: inferior portion of the pons)
o Shields the brain from toxic o Connected to the 3rd ventricle via
substances in the blood the cerebral aqueduct
o Supplies brain tissues with o Continuous with the central canal of
nutrients, and the spinal cord
o Filters harmful compounds from the
brain back to the bloodstream
➢ Allowed substances:
o O2, Co2, water, glucose, essential
amino acids, steroid hormones,
alcohol, barbiturates, nicotine,
caffeine, water
➢ Not allowed:
o Urea, proteins, nonessential amino
acids, potassium and most
antibiotics
CEREBROSPINAL FLUID (CSF)
➢ Clear, colorless liquid composed primarily
of water that protects the brain and spinal
cord from chemical and physical injuries
➢ Components are similar to blood plasma,
from which it but with less protein and
more vitamin C
➢ Formed by the CHOROID PLEXUS
➢ Total volume: 80-150ml in an adult
FUNCTIONS OF THE CSF
➢ Mechanical protection
o Shock-absorber
GAPS IN BLOOD BRAIN BARRIER
➢ Chemical protection
➢ Parts of the diencephalon, called o Prevents changes in ionic
circumventricular organs (CVOs) because compositions
they lie in the wall of the third ventricle, can o Provides an optimal chemical
monitor chemical changes in the blood environment for accurate neuronal
because they lack a blood-brain barrier. signaling
➢ Areas with incomplete blood-brain barrier: ➢ Circulation
o Parts of the hypothalamus o Medium for nutrients and waste
o Pituitary gland products exchange
o Pineal gland
o Choroid plexus
VENTRICLES
➢ Lateral ventricles
o Cavity within each cerebral
hemisphere
o Separated by a thin membrane
called septum pellucidum
➢ Third ventricle
o Smaller cavity that lies at the
midline of the thalamus (midbrain)
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CFS Imbalances – Hydrocephalus
➢ “Water on the brain”
➢ CFS accumulates and exerts pressure on the
brain if not allowed to drain
➢ Possible in an infant because the skull
bones have not yet fused
➢ In adults, this situation results in brain
damage
TRAUMATIC BRAIN INJURIES
THE THALAMUS
➢ Concussion – slight brain injury; no
permanent brain damage ➢ Principal relay station for sensory impulses
➢ Contusion – nervous tissue destruction that reach the cerebral cortex from other
occurs; nervous tissue does not regenerate parts of the brain and the spinal cord.
➢ Cerebral edema – swelling from the ➢ Separates conscious from unconscious
inflammatory response; may compress and activity.
kill brain tissue ➢ Coordinates the activities of the cerebral
cortex, cerebellum and basal nuclei
CEREBROVASCULAR ACCIDENT (subconscious control of skeletal muscle)
➢ Commonly called strokes
➢ Occur when blood circulation to a brain
area is blocked, as by a blood clot or a
ruptured blood vessel
➢ Hemiplegia – one sided paralysis
➢ Paraplegia – lower paralysis
➢ Quadriplegia – below the neck paralysis
➢ Aphasia – inability to speak (Broca’s) or
inability to understand written or spoken
language (Wernicke’s)
➢ Transient Ischemic Attack (TIA) – temporary THE HYPOTHALAMUS
brain ischemia (restriction of blood flow)
1. Controls vital functions (ANS)
o Warning signs for more serious
2. Production of hormones
CVAs
o Regulates the pituitary gland
ALZHEIMER’S DISEASE o Produces ADH and oxytocin
3. Produces emotions and behavioral drives
➢ Progressive degenerative brain disease associated with survival (together with the
➢ Mostly seen in the elderly, but may begin in limbic system)
middle age 4. Regulation of eating and drinking
➢ Structural changes in the brain include o Thirst center
abnormal protein deposits and twisted o Satiety center
fibers within neurons 5. Regulates body temperature (body’s
➢ Victims experience memory loss, irritability, thermostat)
confusion, and ultimately, hallucinations and
death

THE DIENCEPHALON (Interbrain)

➢ Sits atop the brainstem and is covered by
the cerebral hemispheres
➢ Surrounds the third ventricle
➢ Parts:
o Epithalamus
o Hypothalamus
o Thalamus

THE EPITHALAMUS
➢ Forms the roof of the 3rd ventricle
➢ PINEAL GLAND – produces hormone
melatonin which controls circadian rhythm,
promotes sleep and inhibits reproductive
functions in certain animals
➢ HABENULAR NUCLEI – involved in olfaction,
especially emotional responses to odors
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The Limbic System
➢ AKA “emotional brain”
➢ Plays a primary role in a range of emotions,
(pain, pleasure, docility, affection, anger)
➢ Also involved in olfaction and memory
➢ Together with parts of the cerebrum, the
limbic system also function in memory;
damage to the limbic system causes
memory impairment.
➢ Hippocampus – has cells reported to be
capable of mitosis.

THE LIMBIC SYSTEM

➢ Also known as the motivational system
➢ Deep portions of the cerebrum that form a THE BRAINSTEM
ring around the diencephalon
➢ Plays a central role in emotions and basic ➢ Between the spinal cord and the
survival functions, such as memory, diencephalon
reproduction, and nutrition. ➢ Three structures:
o Medulla oblongata
o Pons
o Midbrain
➢ Reticular formation – netlike region of gray
and white matter
MEDULLA OBLONGATA
➢ The most inferior part of the brain
➢ Merges into the spinal cord below without
any obvious change in structure
➢ The area where the important pyramidal
tract (motor fibers) cross over to the
opposite side.
➢ Contains centers that control:
STRUCTURES OF THE LIMBIC SYSTEM o Heart rate
o Blood pressure
1. Cingulate gyrus
o Breathing
2. Parahippocampal
o Swallowing
gyrus
o Vomiting
3. Thalamus and
o Sneezing
epithalamus
o Coughing
4. Hippocampus
o Hiccupping
5. Amygdala
6. Hypothalamus
7. Olfactory cortex

Clinical Connection (Medulla Oblongata Injury)
➢ May be due to hard blow on the back of the
head or falling
➢ Damage to respiratory center may result to:
o Death
o Cranial nerve malfunction on the
same side of the body
o Paralysis and loss of sensation of
the opposite side of the body
o Irregular heart and respiratory
rhythm
➢ Alcohol may also suppress medullary
rhythmicity center leading to death
THE PONS
➢ The building center part of the brain stem
(2.5cm)
➢ Mostly composed of fiber tracts
➢ PONTINE SLEEP CENTER
o Initiates rapid eye movement (REM)
sleep
➢ PONTIME RESPIRATORY CENTER
o Works with the respiratory centers
in the medulla oblongata to help
control respiratory movements
MIDBRAIN (MESENCEPHALON)
➢ Smallest region of the brainstem
➢ Mostly composed of tracts of nerve fibers
➢ Important parts:
o Corpora quadrigemina – visual and
auditory information and reflex
response
• Superior
colliculi – visual,
tactile, and
auditory sensory
systems
• Inferior
colliculi –
auditory input
that stimulates
visual reflexes
o Tegmentum
• Red nuclei – unconscious
regulation and coordination
of motor activities
• Cerebral penducles – carry
motor information from the
cerebrum to the brainstem
and spinal cord
• Substantia nigra – maintains
muscle tone and coordinates
movements
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RETICULAR FORMATION
➢ A net like arrangement of gray and white
matter extending the entire length of the
brain stem
➢ Plays a role in consciousness and awake
and sleep cycles
➢ Prevents sensory overload
➢ Damaged to this area can result in coma
THE CEREBELLUM
➢ Cauliflower-like structure projecting dorsally
from under the occipital lobe of the
cerebrum
➢ Coordinates skilled movements and
regulates posture and balance
➢ Damage to cerebellum can result in a loss
ability to coordinate muscular movements
(ATAXIA)
➢ Alcohol inhibits activity if the cerebellum
Clinical Correlation – Damage to Cerebellum
➢ Ataxia (loss of ability to coordinate
muscular movements)
➢ Change in speech pattern
➢ Abnormal walking movements (staggering)
➢ Alcohol inhibits the activity of the
cerebellum
THE SPINAL CORD
➢ Oval in shape
➢ Length – 42-45 cm (16-18in)
➢ Extends until the superior border of L2
➢ Maximum diameter: 1.5cm (cervical region)
➢ A glistening white continuation of the brain
stem approximately 17 inches long
➢ Extends from the foramen magnum to the
first and second lumbar vertebra
➢ Cushioned and protected by meninges
➢ Meninges do not end at the L2 but extend
well beyond the end of the spinal cord
➢ 31 spinal nerves arise from the cord
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➢ CAUDA EQUINA – collection of spinal
nerves at the inferior end of the vertebral
canal
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CROSS SECTION OF THE SPINAL CORD ➢ The anterior gray horns = cell bodies of
somatic motor neurons
➢ Internal gray matter is mostly cell bodies
o Dorsal (posterior) horns
o Anterior (ventral) horns
o Gray matter surrounds the central
canal
• Central canal is filled with
cerebrospinal fluid
➢ Exterior white matter – conduction tracts
o Dorsal, lateral, ventral columns

THE PNS
➢ Consists of nerves and scattered groups of
ganglia found outside the CNS
➢ 12 pairs of cranial nerves
➢ 31 pairs of spinal nerves
NERVE STRUCTURE
➢ A nerve is bundle of
WHITE MATTER OF THE SC neuron fibers outside
the CNS
➢ Composed of myelinated fiber tracts ➢ Coverings:
➢ Divided into dorsal, lateral, and ventral o Endoneurium
columns o Perineurium
o Epineurium

GRAY MATTER OF THE SPINAL CORD

➢ Divided into dorsal, lateral, and ventral
horns
➢ The posterior gray horn = axons of sensory
neurons and cell bodies of interneurons
➢ The lateral gray horn = cell bodies of
autonomic motor neurons
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TYPES OF NERVES
➢ Sensory of afferent nerves
o Carry impulses towards the CNS
➢ Motor or efferent nerves
o Carry impulses from the CNS
➢ Mixed nerves
o Carry both sensory and motor fibers
o NOTED: ALL SPINAL NERVES ARE
MIXED NERVES

CRANIAL NERVES
➢ Primarily serve the head and neck
➢ Only one pair (vagus) extends to the OLFACOTRY NERVES (I)
abdominal and thoracic cavities ➢ Carry sensory
➢ Each attaches to the ventrolateral surface of information
the brainstem near the associated sensory responsible for
or motor nuclei the sense of
smell
➢ Sensory
OPTIC NERVES (II)
➢ Carry visual
information from
special sensory
receptors in the
eyes
➢ Purely sensory

OCULOMOTOR NERVES (III)

➢ Primary source of
innervation for 4 of
the extraocular
muscles (superior,
inferior and medial
rectus, inferior
oblique)
➢ Supply motor fibers to the eyelid, and the
internal eye muscles that control lens shape
and pupil size
TROCHLEAR NERVES (IV)
➢ Supplies motor fibers for one external eye
CRANIAL NERVE FUNCTIONS muscle (superior oblique)
Some(1) Say(2) Marry(3) Money(4), But(5) My(6)
Brother(7) Says(8), “Big(9) Brains(10) Matter(11)
Most(12).”
S=Sensory
M=Motor
B=Both
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TRIGEMINAL NERVES (V) ➢ Cochlear branch monitors hearing
➢ Conducts sensory impulses from the skin of
the face and mucosa of the nose and mouth
➢ Also contains motor fibers that activate
chewing muscles
➢ With ophthalmic, maxillary and mandibular
branches

GLOSSOPHARYNGEAL NERVES (IX)

➢ Supply motor fibers that innervate the
tongue and pharynx
➢ Control the action of swallowing

ABDUCENS NERVE (VI)

➢ Innervates the
lateral rectus
muscle which
rolls the eye
laterally VAGUS NERVES (X)
➢ Mixed nerves
➢ Carry sensory impulses from and motor
FACIAL NERVES (VII) impulses to the pharynx, larynx, and the
abdominal and thoracic viscera
➢ Mixed nerves
➢ Carry motor fibers that promote digestive
➢ Activate muscles of facial expression and
activity and help regulate heart activity
the lacrimal and salivary glands
➢ Carry sensory impulses from the taste buds
of the anterior tongue

ACCESSORY NERVES (XI)

➢ Motor fibers activate sternocleidomastoid
and trapezius
muscles
VESTIBULOCOCHLEAR NERVES (VIII)
➢ Purely sensory
➢ Vestibular branch monitors balance,
position and movement

HYPOGLOSSAL NERVES (XII)
➢ Provide voluntary motor control over
tongue movement
➢ Carry sensory fibers from the tongue
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DERMATONE
➢ Refers to the area of the skin that provides
sensory input to the CNS via one pair of
spinal nerves or the trigeminal (V) nerve
➢ Nerve supply in adjacent dermatomes
overlaps
➢ SIGNIFICANCE: Knowing which spinal cord
segments supply each dermatome makes it
possible to locate damaged regions of the
spinal cord.

CRANIAL REFLEXES
➢ Involve sensory and motor fibers of cranial
nerves
➢ Pupillary reflex
➢ Consensual reflex
➢ Gag reflex
➢ Corneal reflex

SPINAL NERVES
THE SPINAL NERVES
➢ Each is divided into a dorsal and ventral
➢ 31 pairs are formed by the combination of rami
dorsal and ventral roots of the spinal cord ➢ Dorsal ramus
➢ Named from the region of the spinal cord o Sensory and motor innervation to
where they arise the skin and muscles of the back –
➢ NOTE: Not all spinal cord segments are DERMATOME
aligned with their corresponding verterbrae. ➢ Ventral ramus
o Supplying ventrolateral body
surface, body wall and limbs
➢ Meningeal branch
o Supplies the vertebrae, vertebral
ligaments, blood vessels and
meninges
➢ Rami communicantes
o Components of the autonomic
nervous system
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INTERCOSTAL NERVES (T2-T12)
➢ Formed by the 2nd thoracic nerve until the
12th thoracic nerve
➢ Anterior Rami Innervated Areas
o T2 – 2nd ICS muscles, skin of axilla
and posteromedial aspect of the
arm
o T3-T6 – intercostal muscles and skin
of the anterior and lateral chest wall
o T7-T12 - intercostal muscles and
abdominal muscles, along with the
overlying skin
➢ Posterior rami
o Deep back muscles and skin of the
posterior aspect of the thorax
PLEXUSES
➢ A bundle of intersecting nerves typically
originating from the same anatomical area
and serve specific areas of the body.
o Cervical plexus – ventral rami from
C1-C4
o Brachial plexus - ventral rami from
C5-T1
o Lumbar plexus – ventral rami from
L1-L4
o Sacral plexus - ventral rami from L4-
S4
o Coccygeal plexus - ventral rami from
S5 and the coccygeal nerve (Co)

BRACHIAL PLEXUS
CERVICAL PLEXUS
➢ C5 to C8 and T1
➢ C1-C5 ➢ Branches:
➢ Important nerve: o Axillary – deltoid muscle and skin of
Phrenic nerve – supplies the diaphragm shoulder; muscles and skin of
(C3-C5) superior thorax
o Radial – triceps and extensor muscle
and muscles of the forearm; skin of
posterior upper limb (wristdrop)
o Median – flexor muscles and skin of
forearm

o Musculocutaneous - flexor muscles
of forearm; skin of lateral forearm
o Ulnar – flexor muscles of forearm,
wrist, hand muscles; skin of hand
(clawhand)
INJURIES TO NERVES EMERGING FROM THE
BRACHIAL PLEXUS
➢ Erb-Duchenne palsy
o Injury to the superior roots of the
brachial plexus (C5-C6)
o Waiter’s tip position – shoulder is
adducted, the arm is medially
rotated, the elbow is extended, the
forearm is pronated, and the wrist is
flexed
➢ Radial Nerve Injury
o Injury to the radial (and axillary)
nerve
o Inability to extend the wrist and
fingers (wristdrops)
➢ Median nerve palsy
o Injury to the median nerve
o inability to pronate the forearm and
flex the proximal interphalangeal
joints of all digits and the distal
interphalangeal joints of the second
and third digits (ape hands)
➢ Ulnar Nerve Palsy
o Injury to the ulnar nerve
o Inability to abduct or adduct the
fingers, atrophy of the interosseous
muscles of the hand, hyperextension
of the metacarpophalangeal joints,
and flexion of the interphalangeal
joints (clawhand)
➢ Long thoracic nerve injury
o Medial border of the scapula
protrudes (winged scapula)
➢ Thoracic outlet syndrome
o Compression of the brachial plexus
on one or more of its nerves
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o Causes:
• Physical trauma from a car
accident
• Repetitive injuries from job-
or sports-related activities
• Presence of a cervical rib
• Misaligned ribs
• Pregnancy
o Pain, numbness, weakness, or
tingling in the upper limb, across
the upper thoracic area, and over
the scapula on the affected side
LUMBAR PLEXUS
➢ L1 to L4
➢ Femoral nerve – lower abdomen, anterior
and medial thigh muscles (hip flexors and
knee extensors) skin of anteromedial leg
and thigh
➢ Obturator nerve – adductor muscles of the
thigh and small hip muscles; skin of medial
hip thigh and hip joint
INJURY TO THE LUMBAR PLEXUS
➢ Injuries to the femoral nerve
o Stab or gunshot wounds
o Inability to extend the leg
o Loss of sensation in the skin over
the anteromedial aspect of the thigh
➢ Injuries to the obturator nerve
o Pressure on the nerve by the fetal
head
o Paralysis of the adductor muscles of
the thigh
o Loss of sensation over the medial
aspect of the thigh
SACRAL PLEXUS
➢ L4-L5 and S1-S4
➢ SCIATIC NERVE - largest nerve in the body;
splits into common fibular and tibial nerves
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o Supplies lower trunk and posterior ➢ Injury to the Tibial Portion of the Sciatic
surface of the thigh (hip extensors Nerve
and knee flexors) o May be due to:
o Common fibular – lateral aspect of • Direct trauma
leg and foot (foot drop) • Pressure on the nerve for a
o Tibial (sural and plantar) – posterior long period
aspect of leg and foot • Pressure on the nerve from
➢ Superior and inferior gluteal – gluteal nearby body structures
muscles o Calcaneovalgus – dorsiflexion plus
eversion of the foot

SYMPATHETIC NERVOUS SYSTEM AND

PARASYMPHATHETIC NERVOUS SYSTEM
The ANS
➢ The motor subdivision of the PNS that
controls body activities automatically
➢ Composed of a specialized group of
neurons that regulate cardiac muscle,
smooth muscles, and glands
INJURIES TO THE NERVES OF THE SACRAL PLEXUS ➢ Also known as the involuntary nervous
➢ Injury to the Sciatic Nerve system
o Sciatica – pain that may extend from ➢ Has a chain of two motor neurons
the buttock down the posterior and o PREGANGGLIONIC NEURON (in the
lateral aspect of the leg and the CNS – brainstem or the lateral horn
lateral aspect of the foot. of the spinal cord)
o May be due to: • Axon leaves the CNS to form
• Herniated (slipped) disc a synapse with the
postganglionic neuron
• Dislocated hip
• Axons are myelinated
• Osteoarthritis of the
o POSTGANGGLIONIC NEURON
lumbosacral spine
(outside CNS in the autonomic
• Pathological shortening of
ganglion)
the lateral rotator muscles of
• Axon extends to the target
the thigh (especially
tissues
piriformis)
• Axons are unmyelinated
• Pressure from the uterus
during pregnancy
• Inflammation and irritation
• Improper administration of
gluteal intramuscular
injection
➢ Injury to the Common Fibular Portion of the
Sciatic Nerve
o Commonly affected
o May be due to:
• Fractures of the fibula
• By pressure from casts or
splints over the thigh or leg
o Equinovarus – plantarflexion
(footdrop) and inversion of foot
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SYMPATHETIC vs. PARASYMPATHETIC ACTIVITY
➢ Dual innervations:
o GIT – influenced more by PNS
o Heart
o Reproductive organs
o Urinary bladder
➢ Most blood vessels and most structures of
the skin, some glands, and the adrenal
medulla are innervated by sympathetic
neurons
➢ Note: Even if the PNS is responsible for the
“rest and digest activities” the SNS remains
active so as to maintain normal BP and
temperature.
THE SNS
➢ Thoracolumbar outflow (T1-L3)
➢ Activity is evident when a person is excited
or in a threatening or emergency condition
➢ Fight or flight system
➢ E (exercise, excitement, emergency, and
embarrassment)
THE PNS
➢ Craniosacral outflow (nuclei of four cranial
nerves; III, VII, IX, and X) and S2-S4
➢ Most active when the body is at rest and
not threatened in any way
➢ Sometimes called the “resting and
digesting” system
➢ Chiefly concerned with promoting normal
digestion, elimination of feces and urine,
and with conserving body energy
➢ D (digestion, defecation, diuresis)
➢ Housekeeping system of the body

NOTE:
A DYNAMIC BALANCE EXISTS BETWEEN THE TWO
DIVISIONS, AND BOTH ARE CONTINUOUSLY
MAKING FINE ADJUSTMENTS.