The Nervous System (Ⅰ)

蔡怡汝 老師

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 Introduction of Nervous System
Nervous system (神經系統)

Central nervous system Peripheral nervous system

(CNS；中樞神經系統) (PNS；周邊神經系統)

Brain (腦) Spinal cord Afferent system Efferent system

(脊髓) (傳入系統) (傳出系統)

Somatic nervous system Autonomic nervous system

(體神經系統) (ANS；自主神經系統)

Sympathetic nervous system Parasympathetic

(交感神經系統) nervous system
(副交感神經系統)
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 Central nervous system (CNS) Peripheral nervous system (PNS)
Brain and spinal cord Cranial nerves and spinal nerves
Integrative and control centers Communication lines between the CNS
and the rest of the body

Sensory (afferent) division Motor (efferent) division

Somatic and visceral sensory Motor nerve fibers
nerve fibers
Conducts impulses from the CNS
Conducts impulses from to effectors (muscles and glands)
receptors to the CNS

Somatic sensory Somatic nervous Autonomic nervous

fiber Skin system system (ANS)
Somatic motor Visceral motor
(voluntary) (involuntary)
Conducts impulses Conducts impulses
from the CNS to from the CNS to
skeletal muscles cardiac muscles,
Visceral sensory smooth muscles,
fiber and glands
Stomach
Skeletal
muscle
Motor fiber of somatic nervous system

Sympathetic division Parasympathetic

division
Mobilizes body systems
during activity Conserves energy
Promotes house-
keeping functions
during rest

Sympathetic motor fiber

of ANS Heart
Structure
Function
Sensory (afferent) Bladder
division of PNS Parasympathetic motor fiber of ANS
Motor (efferent)
division of PNS 4
 Nervous Tissue (神經組織)

Two main cell types:

■ Neuron (神經元)
- Basic structural units of the nervous system
- Many billions (十億) of neurons
- Live and function over 100 years
- Do not divide
■ Supporting cell (支持細胞；neuroglial cell，神經膠細胞)
- Four types in the CNS
- Two types in the PNS

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Structure of a Typical Neuron
• Dendrites (樹突): 數目很多，將訊息傳至細胞體
• Cell body, Soma, Perikaryon (細胞體):
 Nucleus (細胞核)
 Nucleolus (核仁)
 Nissl body (尼氏體): 由顆粒性內質網 (granular endoplasmic
reticulum, rER)組成，功能為合成蛋白質
 Neurofilament (神經細絲): 擔任支持及傳送營養的功能
 Axon hillock (軸丘): 發出軸突的部位，為軸突起源之處
• Axon (軸突): 只有一條 ，將訊息由細胞體傳至另一神經元
 Myelin sheath (髓鞘): 富含白色磷脂質，功能是增加神經衝動傳導的速率，並做為軸
突的絕緣作用
 Node of Ranvier (朗氏結): 位於髓鞘間的空隙
 Terminal branches (終末分支)
 Axonal terminal (軸突終末)
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樹突 細胞體

細胞核

核仁
軸突
朗氏結
軸突終末
尼氏體
軸丘
終末分支

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Two Neurons Communicating at a
Synapse (突觸)
突觸前神經元 樹突 突觸後神經元

軸突

突觸

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突觸前緻密 突觸小泡

突觸裂

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突觸後緻密
 Classification of Neurons
(神經元的分類)
Structural classification (構造分類)
 Multipolar neuron (多極神經元): have more than two processes,
numerous dendrites (樹突) and one axon (軸突)
- Motor neuron (運動神經元), Interneuron (中間型神經元)
 Bipolar neuron (雙極神經元): have two processes
- Special sensory organs (inner ear, nose, retina of the eye)
 Pseudounipolar neuron (偽單極神經元): have a short, single process
that emerges from the cell body, and divides two long processes
- Sensory neuron (感覺神經元)

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 中間型神經元
運動神經元

(多極神經元)

(雙極神經元)
感覺神經元

Pseudounipolar neuron (偽單極神經元) 11

 Classification of Neurons
(神經元的分類)
Functional Classification (功能分類)
 Sensory (afferent) neuron (感覺(傳入)神經元):
- Transmit impulses toward the CNS
- Virtually all are Pseudounipolar neurons (偽單極神經元)
- Cell bodies (細胞體) in ganglion outside the CNS
- Sensory neuron have a short, single process divides into:
■ Peripheral process (周邊分支): extends peripherally to the receptors

■ Central process (中央分支): runs centrally into the CNS

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 Classification of Neurons
(神經元的分類)
 Motor (efferent) neuron (運動(傳出)神經元)
- Carry impulses away from the CNS to effector organs
- Most motor neurons are Multipolar neurons (多極神經元)
- Cell bodies are within the CNS

 Interneuron (中間型神經元) (association neuron, 聯絡神經元)

- Lie between motor and sensory neurons
- Most interneuron are Multipolar neurons (多極神經元)
- Cell bodies are within the CNS

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 Neurons Classified by
Function
(感覺)神經節
(Sensory) 中央分支

感覺(傳入)神經元

周邊分支

中間型神經元

運動(傳出)神經元

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Supporting Cells (支持細胞; Neuroglia
Cells, 神經膠細胞)

 Six types of supporting cells

Four types in the CNS
Two types in the PNS
 Provide supportive functions for neurons
(提供神經元一個支持的功能)

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 Supporting Cells in the CNS
•位於中樞神經系統的支持細胞有四種:
- 星形神經膠細胞(Astrocyte): 此細胞的突起會包圍腦部的血管，使
血管變得極度地不通透性，故對於血管和腦的物質擴散而言，其作
用有如障壁，特稱此構造為血腦障壁(blood-brain barrier (BBB))。
- 微小神經膠細胞(Microglial cell): 來自單核球(monocytes)，細胞最
小，可移至受傷的神經組織區域，行巨噬細胞的功能，故亦稱為腦
的巨噬細胞。
- 室管膜細胞(Ependymal cell): 形狀由扁平到柱狀，很多皆具有纖毛
(cilia)，在腦室內形成單層的上皮細胞，協助腦脊髓液(cerebrospinal
fluid, CSF)的循環 。
- 寡樹突神經膠細胞(Oligodendrocyte): 環繞中樞神經系統的神經元
軸突，形成髓鞘(myelin sheath)。
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 (星形神經膠細胞)
(室管膜細胞)

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(寡樹突神經膠細胞)
(微小神經膠細胞)
 Supporting Cells in the PNS

 Satellite cell (衛星細胞): surround neuron cell body within ganglia

 Schwann cell (許旺氏細胞): surround axons in the PNS
Form myelin sheath (髓鞘)

許旺氏細胞 衛星細胞

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 Nerve (神經)
 Endoneurium (神經內膜): layer of delicate connective tissue surrounding the axon
 Fascicle (神經纖維束): groups of axons bound into bundles
 Perineurium (神經束膜): connective tissue wrapping surrounding a fascicle
 Epineurium (神經外膜): whole nerve is surrounded by tough fibrous sheath

神經系統名詞:
Neuron (神經元)
Nerve fiber (神經纖維)
Nerve (神經): PNS
Tract (神經徑): CNS
Ganglion (神經節): PNS
Nucleus (神經核): CNS

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 Introduction of Nervous System
Nervous system (神經系統)

Central nervous system Peripheral nervous system

(CNS；中樞神經系統) (PNS；周邊神經系統)

Brain (腦) Spinal cord Afferent system Efferent system

(脊髓) (傳入系統) (傳出系統)

Somatic nervous system Autonomic nervous system

(體神經系統) (ANS；自主神經系統)

Sympathetic nervous system Parasympathetic

(交感神經系統) nervous system
(副交感神經系統)
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Central Nervous System (中樞神經系統)

Brain (腦)
■ Cerebral hemispheres (大腦半球)
■ Diencephalon (間腦)

■ Brainstem (腦幹)

- midbrain (中腦)
- pons (橋腦)
- medulla oblongata (延腦)
■ Cerebellum (小腦)

Spinal cord (脊髓)

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 大腦半球

視丘
間腦

下視丘
小腦
中腦

橋腦

腦幹

延腦
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Fissure (裂) (deep sulcus，深溝): separate major regions of the brain
• Longitudinal fissure (縱裂): separates cerebral hemispheres (大腦半球)
• Transverse fissure (橫裂): separates cerebrum (大腦) and cerebellum (小腦)
Gyrus (腦回): twisted ridges between sulci (溝)

Anterior

縱裂

橫裂

Posterior
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• Sulcus (溝): Central sulcus (中央溝), Parieto-occipital sulcus (頂枕溝), lateral sulcus
(外側溝) (insula (腦島): deep within the lateral sulcus)
• Frontal lobe (額葉) (precentral gyrus,前中央腦回), Parietal lobe (頂葉) (postcentral
gyrus, 後中央腦回), Occipital lobe (枕葉), Temporal lobe (顳葉)

Cerebrum

Parietal lobe
頂葉
前 後
中 中
央 央 Occipital lobe
腦 腦 枕葉
Frontal lobe
回 回
額葉

Temporal lobe
顳葉

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 Location of the insula (腦島)
後中央腦回 中央溝
前中央腦回
頂葉
額葉
頂枕溝 腦島
枕葉
外側溝
橫裂
小腦 顳葉

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 前中央腦回 中央溝
後中央腦回
頂葉
額葉
頂枕溝

外側溝
枕葉
顳葉

Cerebral cortex
腦回
大腦皮質

灰質 contain cell body of neuron

溝
白質 contain axon of neuron
裂 26
 Functional Areas of the Cerebral Cortex
(大腦皮質的功能區)
中央溝 主要運動區(前中央腦回)
主要體感覺區(後中央腦回)
運動前區
體感覺
聯絡區
頂葉
額葉

視覺聯絡區 波卡氏語言區
枕葉 顳葉
主要視
覺區
主要聽覺區

韋尼克氏區 聽覺聯絡區
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 Functional Areas of the Cerebral Cortex
(大腦皮質的功能區)

主要運動區 (primary motor area): 控制身體(肌肉)的活動。

運動前區 (premotor area): 安排一連串動作的先後次序。
主要體感覺區 (primary somatosensory area): 接受身體傳來的感覺訊息。
體感覺聯絡區 (somatosensory association area): 與以前的感覺經驗做連結。
主要視覺區 (primary visual area): 接受視覺訊息。
視覺聯絡區 (visual association area): 與以前的視覺影像做連結。
主要聽覺區 (primary auditory area): 接受聽覺訊息。
聽覺聯絡區 (auditory association area): 與以前的聲音做連結。
Wernick’s area (韋尼克氏區; sensory language area): 認識和理解文字的意思。
Broca’s area (波卡氏區; motor speech area): 協調說話所需要用到的肌肉，使
其收縮。
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 主要運動皮質
運動前皮質

波卡氏區

Left cerebral hemisphere (左大腦半球): language-dominant cerebral hemisphere (語言優勢的

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大腦半球)
禽距溝

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主要運動皮質
主要體感覺皮質
(前中央腦回) 31
(後中央腦回)
 Cerebral white matter (大腦白質)

Fibers are usually myelinated and bundled into tracts.

Types of tracts:
-- Commissural fibers (連合纖維): interconnect of the right and left cerebral
hemispheres. Example: corpus callosum (胼胝體).
-- Association fibers (聯絡纖維): connect different parts of the same hemisphere
● short association fibers (短聯絡纖維): connect neighboring cortical area

● long association fibers (長聯絡纖維): connect widely cortical area

-- Projection fibers (投射纖維):

● Descend fibers: from cerebral cortex to caudal part of the CNS

● Ascend fibers: from caudal part of the CNS to cerebral cortex

● Example: internal capsule (內囊), corona radiata (放射冠)

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聯絡纖維

連合纖維

投射纖維

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 連合纖維(胼胝體)

放射冠

內囊

投射纖維

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 Cerebral gray matter (大腦灰質)
基底神經節 (Basal ganglion)又稱 基底神經核 (Basal nucleus): motor control
= 紋狀體 (corpus striatum) + 黑質 (substantia nigra) + 丘腦下核 (subthalamic nucleus)
紋狀體(Corpus striatum)
= 尾狀核 (caudate nucleus) + 豆狀核 (lentiform nucleus) + 帶狀核 (claustrum) + 杏仁體 (amygdaloid body)
豆狀核 (Lentiform nucleus)
= 蒼白球 (globus pallidus，位於內側) + 殼核 (putamen，位於外側)

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尾狀核
殼核
蒼白球

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 Diencephalon (間腦)

*Thalamus (視丘)
*Hypothalamus (下視丘)
*Epithalamus (上視丘): pineal
gland (松果腺)

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 Thalamus (視丘)

- Interthalamic adhesion (視丘間接合): connect right and left thalamus

- Function: act as relay station for the sensory information ascending to the primary
sensory area of the cortex (扮演將感覺訊息傳到大腦主要感覺皮質的轉播站).
- Ventral posterolateral nucleus (腹後外側神經核) (VPL nucleus): receive general
somatic sensory information (接受一般體感覺的訊息)
- Lateral geniculate nucleus (外側膝狀核): receive visual information (接受視覺訊息)
- Medial geniculate nucleus (內側膝狀核): receive auditory information (接受聽覺訊
息)

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 內側膝狀核

外側膝狀核

腹後外
側神經
核

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Hypothalamus (下視丘)

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 Hypothalamus (下視丘)

-- Functions include the following:

Control of the autonomic nervous system (調控自主神經系統)
Control of emotional responses (調控情緒反應)
Regulation of body temperature (調節體溫)
Regulation of hunger and thirst sensations (調節饑餓與飽食的感覺)
Control of behavior (調控行為)
Regulation of sleep-wake cycles (調節睡眠與甦醒週期)
Control of the endocrine system (調控內分泌系統)
Formation of memory (記憶形成)

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 Epithalamus (上視丘)
•Pineal gland (松果腺) (pineal body, 松果體) - Secretes the hormone
melatonin (褪黑激素), prepare sleep-wake cycle

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Brainstem (腦幹):
Lateral view (1)
視丘

松果腺
間腦

中腦

下視丘
小腦
橋腦

延腦

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 Brainstem:
Ventral view (2)

中腦

橋腦

延腦

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 Brainstem:
Dorsal view (3)

中腦

橋腦

延腦

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 Midbrain (中腦)
• Lies between the diencephalon (間腦) and the pons (橋腦)
• Cerebral peduncles (大腦腳): located on the ventral surface of the midbrain,
contain pyramidal tract (錐體神經徑) (corticospinal tract, 皮質脊髓徑)
• Superior cerebellar peduncle (上小腦腳): connect the midbrain to the
cerebellum (連接中腦與小腦)
• Corpora quadrigemina (四疊體) (largest nuclei):
- Superior colliculus (上丘): visual reflexes (視覺反射)
- Inferior colliculus (下丘): reflexive response to sound (對聲音產生反射反應)
• Two pigmented nuclei (色素神經核):
- Substantia nigra (黑質): neuronal cell bodies contain melanin (黑色素)
- Red nucleus (紅核): lies deep to the substantia nigra

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 上丘
大腦腳 下丘 四疊體
上小
腦腳

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Substantia nigra (黑質): 黑質內的細胞會分泌一種神經傳導物質稱為多巴胺 (dopamine)，多巴胺的正常
分泌與運作，對動作的品質有決定性的影響。多巴胺的分泌量若是減少到某個關鍵量(一般是正常量
的百分之二十以下)，就會開始發生顫抖、肌肉僵硬、動作緩慢等動作障礙，多巴胺的量減得越低症
狀就越厲害。巴金森氏病(Parkinson's Disease)就是黑質細胞退化死亡，引起多巴胺的量減少而導致的
疾病。
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 Brainstem

Pons (橋腦)
• Located between the midbrain (中腦) and medulla oblongata (延腦)
• Middle cerebellar peduncle (中小腦腳): connect the pons to the cerebellum
(連接橋腦與小腦)

Medulla oblongata (延腦)

• Most caudal level of the brainstem
• Continuous with the spinal cord (脊髓)
• Pyramids (錐體): lie on the ventral surface of medulla oblongata, pyramidal
tract (錐體神經徑) (corticospinal tract, 皮質脊髓徑)
• Inferior cerebellar peduncle (下小腦腳): connect the medulla oblongata to
the cerebellum (連接延腦與小腦)
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錐體

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 The most important visceral center in
medulla oblongata

• Cardiac center (心臟中樞): adjusts the force and rate of the heartbeat (調節
心跳速率及心臟收縮強度)
• Vasomotor center (血管運動中樞): regulates blood pressure (調節血壓)
• The medullary respiratory center (呼吸中樞): controls the basic rhythm and
rate of breathing (調節呼吸的基本節律及速率)
• Centers for hiccupping, sneezing, swallowing, and coughing (打嗝、打噴涕、
吞嚥、咳嗽中樞)

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 Cerebellum (小腦)
前葉

橋腦 後葉

延腦
小葉結狀葉

• Located dorsal to the pons and medulla (橋腦與延腦的後方)

• Consists of two cerebellar hemispheres (小腦半球)
• Hemispheres each subdivided into:
- Anterior lobe (前葉): coordinate body movements (協調身體運動)
- Posterior lobe (後葉): coordinate body movements (協調身體運動)
- Flocculonodular lobe (小葉結狀葉): maintain equilibrium (維持平衡) 54
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Thick tracts connecting the cerebellum to the brainstem:
• Superior cerebellar peduncles (上小腦腳)
• Middle cerebellar peduncles (中小腦腳)
• Inferior cerebellar peduncles (下小腦腳)

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 Unlike the contralateral distribution of fibers
to and from the cerebral cortex, virtually all
fibers that enter and leave the cerebellum are
ipsilateral. (大腦發出及接受對側來的神經纖
維, 而小腦是發出及接受同側來的神經纖維)

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• Limbic system (邊緣系統) (emotional brain, 情緒腦): spread widely
in the forebrain, septal nuclei (中隔核), cingulate gyrus (扣帶回), hippocampus
(海馬回), parahippocampal gyrus (海馬旁回), and amygdala (杏仁核).

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• Reticular formation (網狀結構) (Reticular activating system
(RAS) 網狀活化系統): spans the brainstem, maintains consciousness and
alertness (維持意識及警覺) (arousal from sleep, 從睡眠中驚醒過來).

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•The brain is protected by (腦的保護構造): Skull (顱骨), Meninges (腦膜),
Cerebrospinal fluid (腦脊髓液), Blood-brain barrier (血腦障壁)

額骨
蝶骨
頂骨 篩骨

顳骨

枕骨

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Meninges (腦膜):
Dura mater (硬腦膜): Periosteal layer (骨外膜層), Meningeal layer (腦膜層) 
Subdural space (硬腦膜下腔)  Arachnoid mater (蜘蛛膜)  Subarachnoid space (蜘
蛛膜下腔) (cerebrospinal fluid (CSF), 腦脊髓液)  Pia mater (軟腦膜)

硬腦膜

蜘蛛膜
硬腦膜 軟腦膜
下腔

蜘蛛膜下腔

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Dura mater (硬腦膜):
- Falx cerebri (大腦鐮): in the longitudinal fissure (縱裂) between the cerebral
hemispheres (大腦半球)
- Falx cerebelli (小腦鐮): between the cerebellum hemispheres (小腦半球)
- Tentorium cerebelli (小腦天幕): in the transverse fissure (橫裂) between the
cerebrum (大腦) and cerebellum (小腦)

大腦鐮

小腦天幕

小腦鐮 62
 側腦室

室間孔

正
中
孔
外側孔

lateral ventricle (側腦室，位於大腦) (choroid plexus (脈絡叢): 製造腦脊髓液) 

interventricular foramen (室間孔)  third ventricle (第三腦室，位於間腦) 
cerebral aqueduct (大腦導水管，位於中腦)  fourth ventricle (第四腦室，位於橋
腦與小腦之間)  lateral aperture (外側孔，2個), median aperture (正中孔，1個)
 subarachnoid space (蜘蛛膜下腔)  arachnoid villus (蜘蛛膜絨毛)  venous
sinus (靜脈竇)
63
上矢狀竇(靜脈竇)
蜘蛛膜絨毛

蜘蛛膜下腔
脈絡叢

室間孔
側腦室
第三腦室

大腦導水管

第四腦室

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 The Spinal Cord (脊髓)

Runs through the vertebral canal (椎管)

Extends from the foramen magnum (枕骨大孔) to the level of the vertebra
L1 or L2 (第一或第二腰椎)
Protected by bone, spinal meninges, and CSF
Conus medullaris (脊髓圓錐): the inferior end of the spinal cord
Filum terminale (終絲): long filament of connective tissue, attaches to the
coccyx inferiorly
Cervical and lumbar enlargements (頸膨大，腰膨大): where nerves for
upper and lower limbs arise
Cauda equina (馬尾)

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Interventricular foramen
(室間孔)

65
Spinal cord
(脊髓)

67
 脊髓

椎孔

68
 脊髓膜

軟腦膜

蜘蛛膜

硬腦膜

蜘蛛膜下腔

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 頸膨大

腰膨大

脊髓圓錐
馬尾

終絲

70
 (髂骨嵴)

腰椎穿刺
71
72
 硬腦膜上腔
脊髓膜
硬腦膜下腔

蜘蛛膜下腔

Outer to inner: Epidural space (硬腦膜上腔)  Dura mater (硬腦膜) (spinal

dural sheath, only one layer)  Subdural space (硬腦膜下腔)  Arachnoid mater (蜘
蛛膜)  Subarachnoid space(蜘蛛膜下腔)  Pia mater (軟腦膜)
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 灰質聯合
後索
後角
前索 前角
外側角 灰質
白質 外側索

Two deep grooves run the length of the cord

• Posterior (Dorsal) median sulcus (後正中溝)
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• Anterior (Ventral) median fissure (前正中裂)
 灰質

白質

脊髓
腦

75
 Gray matter of Spinal cord (脊髓灰質)

Shaped like the letter H

Gray commissure (灰質聯合): contains the central canal (中央管)
Anterior horns (前角): contain cell bodies of motor neurons (運動神經元的細胞體)
Posterior horns (後角): consist of interneurons (中間型神經元)

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 White matter of Spinal cord (脊髓白質)

Three types of tracts:

• Ascending tract (上升徑): carry sensation information (感覺訊息)
• Descending tract (下降徑): carry motor information (運動訊息)
• Commissural tract (聯絡徑): some fibers cross from one side of the spinal cord77to
the other
 大腦皮質的主要體感覺區

視丘
三級神經元

中腦
二級神經元

延腦
一級神經元

脊髓
傳遞痛覺、
溫覺。
前外側(脊髓丘腦)路徑
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Pyramidal tract (錐體神經徑) 大腦皮質的主要運動區
(Corticospinal tract, 皮質脊
髓徑): 與運動有關

中腦
上運動神經元 大腦腳

橋腦

延腦

下運動神經元

脊髓
79