ANESTHESIOLOGY

Nervous System LAYERS OF THE SCALP

Two Parts:
1. Central Nervous System
a. Brain
b. Spinal Cord
2. Peripheral Nervous System
a. Network of Nerves
Function: send signal/impulses between the brain and
the body
Medulla: connects brain and spinal cord
Foramen magnum: biggest hole in the skull
Cerebrospinal Fluid (CSF): 1. Skin: hair follicles with sebaceous glands
• Provides main nutrients of the brain 2. Dense Connective Tissue: vascularized
• Protects brain from trauma 3. Epicranial Aponeurosis: connects occipitalis
and frontalis
4. Loose Areolar CT: has numerous BV
Choroid Plexus:
5. Periosteum: outer layer of skull bone
• produce CSF
• location: subarachnoid spaces PARTS OF MENINGES OF THE BRAIN

Neurons:
• basic unit of nervous system
• function: send impulses
• incapable of mitosis (cannot reproduce)

Supporting cells/Neuroglia/Glial cells:

• NS cells capable of mitosis
• Examples
o Ependymal cells: produce CSF
o Schwann cells: produce myelin sheath in
PNS
o Oligodendrocytes: produce myelin
sheath in CNS
o Astrocytes: homeostasis 1. Dura Mater: Outer layer
o Satellite cells: regeneration of muscle 2. Arachnoid: contains BV; filled with CSF
tissue 3. Pia mater: covers brain

PARTS OF NEURON
Myelin Sheath:
• Some neurons are covered with myelin sheath
(particularly in axon area)
• Help in transmitting impulses faster

Nodes of Ranvier:
• Gaps/tiny breaks in between myelin sheath

Saltatory Conduction:
• Impulses skips from one node to another

Function: electrically excitable cell that communicates

with other cells via specialize connection called synapses
ANESTHESIOLOGY
Synapses: space between neurons; has reactions Different Stages of Action Potential Propagation
triggered by neurotransmitter *neuron→ neuron
*firing of neuron
Multipolar neuron: PNS *ATP: opens Na K Pump
1. Resting State
Two Kinds of Neurons Based on Function
1. Sensory/Afferent: carries information from
sensory receptors toward brain
2. Motor/Efferent: action

Types of Neuron Based on Extension of Processes

1. Multipolar/Motor Neuron
o Most abundant in number
o Distributed in PNS
2. Unipolar
o Distributed in CNS Inside cell: -70 mV → -90 mV
3. Bipolar
o More on sensory • All voltage gated sodium and potassium
o Can be found on sense of sight transporter pumps are close
• More K inside the cell (kulong inside)
• For every 3 Na going out: 2 K going in →
Pain: maintain -70mV inside.
• unpleasant sensation brought by noxious stimuli • Inside of cell is -70mV less positive than outside
• common symptom in dentistry • Anions number inside and outside: equal
• body in protective mode • Na K Pump: maintains resting potential to -70 mV

2. Depolarization State:
Fire of neuron= send of action potential/impulses
• if sobra sa -70 Na K pump tries to achieve
electromechanically equilibrium
• reversal of polarity or charge
Cell Membrane: • Na channels open→ More Na inside
cells→membrane starts depolarized→ charged
• separate cell from outer surroundings
across membrane lessens→ threshold of
• has different charges excitation reach →More sodium channel opens
• has transport channels → inside more positive than outside (0 mV)
• semi permeable • Saltatory conduction:
o jumping of impulse of one node of ranvier
to another
o usually in large myelinated fibers
• Threshold potential/ion: has to reach certain
mV to go into next phase (-55 mV)
• One node of ran view

-70 mv of resting → -55 mV (depolarization)→ 0 mV

Composed of lipid bilayer:

1. Phospholipid (head): hydrophilic
2. Fatty acid (tail): hydrophobic

Na, K, Cl: change charge of cell to effectively send

impulses; transmission of nerve signals depends on
charge particles
ANESTHESIOLOGY

3. Hyperpolarization
• potassium influx sodium reflux
• Occurs in 3-4 millisecond (absolute refractory
period)
o Absolute Refractory Period: opening of
Na gate until closing or inactivation of the
gate; membrane can’t be stimulated
o Relative Refractory Period: membrane
can be stimulated by greater than normal
stimulus; certain minimum stimulus is
necessary to promote sufficient ionic
exchange

DIFFERENT THEORIES OF PAIN

1. Speficity theory:
• By Von Frey
• One receptor for each sensation
• Has specific cutaneous receptors for mediation of
touch receptors, heat, cold, pain
• Nociceptor: receptor for pain

2. Intensity theory:
• To feel pain it should be intense enough to
acknowledge pain.
• No distinct pathway