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The Nervous System

The nervous system controls and coordinates the functions of other systems of the body so they work harmoniously and efficiently. The nervous system is composed of the brain, spinal cord, and peripheral nerves. The primary function of the nervous system is to collect a multitude of sensory information, process, interpret, and integrate that information, and initiate appropriate responses throughout the body. The functions of the nervous system are: 1. 2. 3. 4. To rule the body by controlling all visible and invisible activities To control human thought and conduct To govern all internal and external movements of the body To give the power to see, hear, move, talk, feel, think, and remember

Despite the complexity of the nervous system, it consists of only two principal kinds of cells: neurons and neuroglia. Neurons are responsible for most special functions attributed to the nervous system: sensing, thinking, remembering, controlling muscle activity, and regulating glandular secretions. Neuroglia support, nurture, and protect the neurons and maintain homeostasis of the fluid that bathes neurons.

Neurons and Nerves


A neuron consists of a cell body and its outgrowth of projections called neuronal fibers. There are two types of neuronal fibers: numerous multibranched dendrites that connect with other neurons to receive information and a single axon that conducts impulses away from the cell body. The cell body stores energy and nutrients that are used by the cellular projections to receive and conduct nerve impulses throughout the body. The ability of a neuron to receive a stimulus is known as irritability. The ability of a neuron to conduct an impulse is known as conductability. Impulses are passed from one neuron to another at a junction called a synapse. When an impulse reaches the end of an axon, a chemical neurotransmitter is released at the synapse that acts on the membrane of the receptive neuron to pass the impulse along. There are three types of neurons classified according to the direction in which they transmit nerve impulses and the type of information carried. Sensory neurons originate in the periphery of the body and carry impulses or messages from sense organs to the brain where sensations of touch, cold, heat, sight, hearing, taste, or pain are interpreted and experienced. Motor neurons carry nerve impulses from the brain to the muscles or glands that they control. Interneurons are located in the brain and spinal cord and carry impulses from one neuron to another. Sensory neurons are also called afferent neurons. Motor neurons are also called efferent neurons. Interneurons are also called central or connecting neurons. Almost all the nerve cell bodies are contained in the brain and spinal cord, while their fibers extend outward to make up the nerves. A nerve is a group of neuronal fibers (axons) found in the peripheral portions of the nervous system bundled together by connective tissue like the strands of a cable. The axons found within a nerve are also individually wrapped by a fatty insulating material called myelin.

Divisions of the Nervous System


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The two principle divisions of the nervous system are the central nervous system and the peripheral nervous system. Central Nervous System The central nervous system (CNS) consists of the brain and spinal cord. Within the CNS, many different kinds of incoming sensory information are integrated and correlated, thoughts and emotions are generated, and memories are formed and stored. Most nerve impulses that stimulate muscles to contract and glands to secrete originate in the CNS. The CNS communicates with the rest of the body through the peripheral nervous system. The brain, the principle nerve center, is the bodys largest and most complex nerve tissue containing in excess of ten billion neurons and innumerable nerve fibers. It is located in and protected by the cranium. It controls sensations, muscles, glandular activity, and the power to think and feel (emotions). The brain includes three major portions:
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The cerebrum, the largest portion making up the front and top of the brain, presides over such mental activities as speech, sensation, communication, memory, reasoning, and emotions. The cerebellum, the smaller part of the brain, located below the cerebrum and at the back of the cranium, helps maintain body balance, coordinates voluntary muscles, and makes muscular movement smooth and graceful. The brain stem has three parts: the midbrain, pons, and the medulla oblongata. These contain intricate masses of nerve fibers that relay and transmit impulses from one portion of the brain to another.

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The midbrain contains the main nerve pathways connecting the cerebrum and the lower nervous system as well as certain visual and auditory reflexes that coordinate head and eye movement with things seen and heard. The pons, located between the midbrain and the medulla oblongata, relays nerve impulses between the cerebrum and the medulla oblongata and from the cerebrum to the cerebellum. The medulla oblongata is an enlarged continuation of the spinal cord that extends from the foramen magnum to the pons and connects the brain with the spinal cord. Control centers within the medulla oblongata regulate heart rate, rate and depth of respiration, and tonicity of the blood vessels. The spinal cord extends downward from the brain and is housed in and protected by the vertebral column. It extends down from the medulla oblongata to the level of the first lumbar vertebra. The spinal cord consists of thirty-one segments, each segment being the site of attachment of a pair of spinal nerves. The spinal cord functions as a conduction pathway for nerve impulses traveling to and from the brain as well as a reflex center between incoming and outgoing peripheral nerve fibers. Several types of connective tissue surround and protect the delicate nervous tissue of the brain and spinal cord including cranial bones, vertebrae, meninges, and a layer of cerebrospinal fluid. The meninges are three connective tissue coverings that encircle the brain and spinal cord. The most superficial and durable of the three meninges is called the dura mater, which is composed of a very thick and strong connective tissue. The middle meninge is an avascular covering called the arachnoid layer because of its spider web arrangement of delicate
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collagen fibers. The innermost meninge is the pia mater, a thin transparent connective tissue layer that adheres to the surface of the spinal cord and brain. It contains many blood vessels that supply nutrients and oxygen to the brain and spinal cord. The brain and spinal cord are also nourished and protected against chemical or physical injury by cerebrospinal fluid (CSF). This fluid continuously circulates around the brain and spinal cord inside the subarachnoid space found between the arachnoid layer and the pia mater. Although cerebrospinal fluid carries nutrients to the nerve tissue and carries wastes away, its main function is to protect the CNS by acting as a shock absorber for the delicate nervous tissue. Peripheral Nervous System The peripheral nervous system consists of all the nerves that connect the central nervous system to the rest of the body. It includes the spinal nerves, the cranial nerves, and all of their branches. Peripheral nerves send sensory impulses to the brain and spinal cord and transmit motor impulses from the brain and spinal cord to the muscles, glands, and visceral organs. There are twelve pairs of cranial nerves that connect directly to some part of the brain surface and pass through openings on the sides and base of the cranium. They are classified as motor, sensory, and mixed nerves. Mixed nerves contain both motor and sensory fibers. The following is a brief discussion of the twelve cranial nerves: Cranial Nerve 1. Olfactory nerve 2. Optic nerve 3. Oculomotor nerve 4. Trochlear nerve 5. Trigeminal nerve 6. Abducent nerve 7. Facial nerve 8. Auditory nerve 9. Glossopharyngeal nerve 10. Vagus nerve 11. Spinal accessory nerve 12. Hypoglossal nerve Function Sense of smell Sense of sight Controls eye movements Controls eye movements Controls sensations of the face and movements of the jaw Controls eye movements Controls facial muscles of expression and some muscles of the neck Sense of hearing Sense of taste Controls sensations and muscular movements relating to talking, heart action, and digestion Controls movement of the neck muscles including the trapezius and sternocleidomastoid Controls movement of the tongue

Thirty-one pairs of spinal nerves emerge from the spinal cord. All spinal nerves are mixed nerves that contain both sensory and motor nerve fibers to provide two-way communication between the CNS and the body. They emerge from the spinal cord in the following order: eight pairs are attached to the cervical segments, twelve pairs are attached to the thoracic segments, five pairs are attached to the lumbar segments, five pairs are attached to the sacrospinal segments, and one pair is attached to the coccygeal segment. After spinal nerves exit from their spinal cord segments, they branch to form the many peripheral nerves of the trunk and limbs. Sometimes, neuronal fibers from several spinal nerves are reorganized to

form a single peripheral nerve. This reorganization can be seen as a network of intersecting or braided branches called a plexus. The four upper cervical nerves form the cervical plexus, which supplies sensation for the skin and motor control for the muscles of the head, neck, and shoulders. The four lower cervical nerves and the first pair of thoracic nerves form the brachial plexus, which controls the movement of the arms by way of the musculocutaneous, radial, median, and ulnar nerves. The remaining thoracic nerves provide sensory and motor control for the muscles, skin, and organs of the thorax. The first four lumbar nerves form the lumbar plexus, whose nerves supply sensory and motor control for the skin, abdominal organs, hip, thigh, knee, and leg. The femoral and obturator nerves are branches of the lumbar plexus. Portions of the forth and fifth lumbar nerves, the first, second, third, and fourth sacral nerves form the sacral plexus. The spinal nerves that form the sacral plexus divide and merge to form several other nerves and one main branch, the sciatic nerve. The sciatic nerve is the largest and longest nerve in the body. The sciatic nerve consists of two nerves in the same nerve sheath: the common peroneal nerve and the tibial nerve. The sciatic nerve serves the hamstrings and the lower leg and foot. Another portion of the fourth and fifth sacral nerves along with the coccygeal nerve forms the coccygeal plexus. The coccygeal nerves supply the skin and muscles around the coccyx. The following is a brief discussion of some important spinal nerves: Spinal Nerve 1. Phrenic nerve Location Thoracic cavity Function

Controls muscles of respiration (diaphragm) 2. Musculocutaneous nerve Upper extremity Controls arm and forearm flexion (biceps brachii) 3. Radial nerve Upper extremity Controls arm and forearm extension (triceps brachii) 4. Median nerve Upper extremity Controls forearm and wrist flexors (carpal tunnel effects this nerve) 5. Ulnar nerve Upper extremity Controls muscles of the forearm and hand (also known as the funny bone) 6. Femoral nerve Lower extremity Controls hip flexion and knee extension (iliopsoas and quadriceps) 7. Obturator nerve Lower extremity Controls adduction of the thigh (Adductor magnus, longus, and brevis) 8. Sciatic nerve Lower extremity Controls hip extension and knee *largest nerve in the body* flexion (hamstrings) The peripheral nervous system can be further divided into the autonomic nervous system and the somatic nervous system. Basically, the somatic nervous system involves those nerves connecting the CNS to the voluntary muscles and skin, while the autonomic nervous system connects the CNS to the visceral organs such as the heart, blood vessels, glands, and intestines. The word autonomic means self-governing. The autonomic nervous system regulates the actions of glands, smooth muscles, and the heart. It consists of motor neurons that originate in the central nervous system. The ANS is further subdivided into the sympathetic and parasympathetic nervous systems.

The nerves of the sympathetic nervous system originate in the thoracic and lumbar portions of the spinal cord between T1 and L2 and enter a double chain of small masses of neurons known as ganglia that extend along the spinal column from the base of the brain to the coccyx. Within these ganglia, neurons synapse with other neurons before continuing to their target organs. These ganglia are connected with each other and with the central nervous system by nerve fibers. The sympathetic nervous system supplies the glands, involuntary muscles of internal organs, and walls of blood vessels and nerves. The activity of the sympathetic nervous system is primarily to prepare the body for energy expending, stressful, or emergency situations. Stimulation of the sympathetic nerves can bring about rapid responses, such as increased respiration, dilated pupils, and increased heart rate and cardiac output. Blood vessels dilate, and the liver increases its production of glucose for more energy. There is increased mental activity and production of adrenal hormones. All of these activities prepare us to meet emergencies. The parasympathetic nervous system balances the action of the sympathetic system. The general function of the parasympathetic division is to conserve energy and reverse the action of the sympathetic division. Parasympathetic nerve fibers that serve the organs and glands of the thorax and abdomen are part of the vagus nerve. Pelvic portions of the parasympathetic system arise from the second, third, and fourth sacral spinal nerves. Parasympathetic nerve fibers associated with parts of the head are included in the III, VII, and IX cranial nerves.

Reflexes and Reflex Arcs


A neurological pathway is the route that a nerve impulse travels through the nervous system. The usual nerve path consists of a stimulus that initiates an impulse along a sensory nerve fiber to the spinal cord to communicate with a large number of interneurons and finally a response impulse along motor nerves to the associated effectors, resulting in an action. The simplest form of nervous activity that includes a sensory and motor nerve is called a reflex. Reflexes are automatic, unconscious, involuntary responses to a stimulus and are responsible for many of the bodys activities such as sneezing, coughing, and swallowing as well as many involuntary activities such as heart rate, breathing rate, and blood pressure. The nerve pathway of a reflex is called a reflex arc. A simple reflex, such as a knee jerk, involves just two neurons (sensory and motor) that pass into and out of the spinal cord without influencing any other nerve centers. Another type of reflex called the withdrawal reflex (flexor reflex) occurs when a person touches something sharp or hot and immediately pulls away, thereby preventing excessive injury. The areas of the body that are particularly sensitive to reflex influences are: 1. 2. 3. 4. 5. The skin of the back between the shoulders The side of the chest between the fourth and sixth ribs The skin at the upper and inner portion of the thigh The skin overlying the gluteal muscles The sole of the foot

Proprioception
Proprioception is a system of sensory and motor nerve activity that provides information as to the position and rate of movement of different body parts to the central nervous system. Proprioception provides information as to the state of contraction and position of the muscles and
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in so doing helps to prevent injury to the joints and muscles from excessive stretches or contractions. It also makes possible the coordination of smooth and accurate motion. Proprioceptors sense tissue distortion. Each time the tissue is compressed, decompressed, twisted, or distorted in a specific way or there is a pressure on or movement in the body, these nerves record that change with the central nervous system. These messages feed the integrative areas of the brain with richer and more detailed information about every body part. The information is continually assembled into an overall body image that is the brains way of knowing what the body is doing. Peripheral nerves are classified as either motor nerves or sensory nerves. Sensory nerves can be further classified as exteroceptors and proprioceptors according to their location and the sensations they record. Exteroceptors are located throughout the body and record conscious sensations such as heat, cold, pain, and pressure. Proprioceptors respond to the unconscious inner sense of position and movement of the body known as kinesthesia. They sense where the body is and how it moves. Proprioceptors are specialized nerve endings located in the muscles, tendons, joints, or fascia. Two major categories of proprioceptors are the muscle spindle cells and the golgi tendon organs. Spindle cells are sensors located in the belly of the muscle that detect movement and the amount of stretch placed upon a muscle. Golgi tendon organs are sensors found within the musculotendinous intersection that also monitor the amount of force pulling on the bone to which the tendon attaches.

Neurological Disorders
Diseases of the nervous system have many causes. They may result from birth defects, trauma, or degenerative disease. They may be caused by infection, blood clots, tumors, or hemorrhage. Some diseases manifest as abnormal muscular activity, while other affect functional and mental activities. Degenerative nerve diseases such as multiple sclerosis (MS) and Parkinsons disease affect the ability to control the muscles. Multiple sclerosis usually occurs in young adults between the ages of twenty and forty and is the result of the breakdown of the myelin sheath, which inhibits nerve conduction. Symptoms include muscle weakness and loss of coordination and balance. Speaking becomes difficult and vision is affected. The progress of the disease varies with periods of remission and progression. There is no cure, but massage, physical therapy, and psychological counseling are useful in counteracting the effects of the disease. Parkinsons disease occurs as a result of the degeneration of certain nerve tissues responsible for the regulation of certain body movements. It generally develops late in life and is characterized by tremors and shaking, especially in the hands. Muscles stiffen as movement slows and becomes more deliberate as many of the postural reflexes are lost. Massage is useful to relieve tension and relax muscles, especially in the shoulders, neck, and legs. Trauma may result in a variety of dysfunctions depending on the severity and location of the injury. Head injuries may cause a loss of reasoning, speech, coordination, and often partial paralysis or mental retardation. A spinal cord injury usually results in paralysis of the parts of the body controlled by the spinal nerves that exit the spinal cord at or below the site of the injury. If only the legs are affected, the condition is called paraplegia. If the arms and legs are affected, the condition is known as quadriplegia. Stroke, which is also known as a cerebrovascular accident, is the result of a blood clot or ruptured blood vessel in or around the brain with subsequent destruction of nerve tissue. The effect of the stroke will depend on the location and extent of the damage. The condition of unilateral paralysis commonly caused by a stroke is called hemiplegia.
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Epilepsy is a neurological condition that is caused by abnormal electrical activity in the central nervous system without apparent tissue abnormalities. Epilepsy is characterized by seizures, some of which are so mild that they are barely noticeable while others may be so extreme that the person loses consciousness and is thrown into uncontrollable convulsions. People can live normal, productive lives with the use of appropriate medication. Poliomyelitis or polio, is a crippling or even deadly disease that affects the motor neurons of the medulla oblongata and spinal cord, resulting in paralysis of the related muscle tissues. Symptoms of polio include fever, gastrointestinal discomfort, stiff neck, and headache. If detected early, its devastating effects can be minimized. The development of the Salk and Sabin vaccines has nearly eradicated this terrible disease. Meningitis is an acute inflammation of the pia and arachnoid mater around the brain and spinal cord. This is often a secondary infection due to bacteria traveling from the middle ear, upper respiratory tract, lungs, sinuses, or due to polio or mumps viruses. Symptoms include severe headache, stiff neck, high fever, chills, delirium, and often convulsions or even coma. Antibiotic treatment is usually effective. If untreated, permanent brain damage usually results with possible blindness, deafness, retardation, or paralysis. Diagnosis of meningitis is made with a spinal tap or lumbar puncture, in which a hollow needle is inserted into the spinal canal in the lumbar area to determine the constituents and pressure of the cerebrospinal fluid. Shingles is an acute inflammation of a nerve trunk by the herpes zoster virus. The symptoms include a band of pain around the torso and a rash with water blisters that erupt in a confined area on one side of the trunk. Seldom does the rash cross the midline of the body. Shingles may develop from an exposure to herpes or chicken pox, a reaction to a medication, or trauma. Massage is contraindicated due to the risk of infection and because it would be very painful. Immediate medical attention is recommended. Neuritis literally means inflammation of a nerve. Neuritis affects the nerves of the peripheral nervous system. Sense most peripheral nerves are both sensory and motor, neuritis may cause weakness or paralysis and be painful. The pain associated with neuritis is known as neuralgia. Generalized neuritis may be due to nutritional deficiency, alcoholism, chemical poisoning, allergies, and viral or bacterial infections. Rest, a diet rich in B vitamins, and therapy such as massage are helpful. Sometimes neuritis will affect a specific nerve. A common form of neuralgia is the result of injury or pressure on the sciatic nerve known as sciatica. The sciatic nerve is exposed to many sites of possible injury in the back, through the pelvis, and along its course down the leg. The pain may radiate down the leg and into foot and may be accompanied by muscle weakness or paralysis.

Questions for Discussion and Review: The Nervous System


1. 2. 3. 4. 5. 6. 7. 8. What structures compose the nervous system? What is the primary function of the nervous system? What are some of the other functions of the nervous system? What are the two principle types of cells that form the nervous system structures? What are the functions of neurons? What are the functions of neuroglia? What is a dendrite? What is an axon?
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9. What is the function of a neuron cell body? 10. What is irritability? 11. What is conductability? 12. What is a synapse? 13. What is a neurotransmitter? 14. What are sensory neurons? 15. What are motor neurons? 16. What are interneurons? 17. What is another name for sensory neurons? 18. What is another name for motor neurons? 19. What are some other names for interneurons? 20. Where are all nerve cell bodies found? 21. What is a nerve? 22. What is myelin? 23. What are the two principle divisions of the nervous system? 24. What organs compose the central nervous system? 25. What are the functions of the central nervous system? 26. What is the brain? 27. What are some of the functions of the brain? 28. What are the three major portions of the brain? 29. Describe the structure and function of the cerebrum. 30. Describe the structure and function of the cerebellum. 31. What are the three parts of the brainstem? 32. What is the function of the midbrain? 33. What is the function of the pons? 34. What is the function of the medulla oblongata? 35. How long is the spinal cord? 36. Describe the structure and function of the spinal cord. 37. What are the meninges? 38. What is the dura mater? 39. What is the arachnoid layer? 40. What is the pia mater? 41. What is the function of cerebrospinal fluid and where is it found? 42. What organs compose the peripheral nervous system? 43. What are the functions of the peripheral nervous system? 44. How many cranial nerves are there? 45. Describe the functions of the cranial nerves. 46. How many spinal nerves are there? 47. What is a plexus? 48. What is the cervical plexus? 49. What is the brachial plexus? 50. Which nerves are derived from the brachial plexus? 51. What is the lumbar plexus? 52. Which nerves are derived from the lumbar plexus? 53. What is the sacral plexus? 54. What is the largest and longest nerve in the body? 55. What are the two branches of the sciatic nerve? 56. What is the function of the phrenic nerve and where is it found? 57. What is the function of the musculocutaneous nerve and where is it found? 58. What is the function of the radial nerve and where is it found? 59. What is the function of the median nerve and where is it found? 60. What is the function of the ulnar nerve and where is it found? 61. What is the function of the femoral nerve and where is it found?
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62. 63. 64. 65. 66. 67. 68. 69. 70. 71. 72. 73. 74. 75. 76. 77. 78. 79. 80. 81. 82. 83. 84. 85. 86. 87. 88. 89. 90. 91. 92. 93. 94. 95. 96.

What is the function of the obturator nerve and where is it found? What is the function of the sciatic nerve and where is it found? Which nerve is affected in carpal tunnel syndrome? Describe the somatic nervous system. Describe the autonomic nervous system. What does the word autonomic mean? What is a ganglia? What is the function of the sympathetic nervous system? What is the function of the parasympathetic nervous system? Which cranial nerves are associated with the parasympathetic nervous system? What is a neurological pathway? What is a reflex? What is the nerve pathway of a reflex known as? How many neurons compose the simplest type of reflex arc? What is a withdrawal reflex? Name some areas of the body that are particularly sensitive to reflex influences. What is an exteroreceptor? What is a proprioceptor? What is a spindle cell? What is a golgi tendon organ? What is proprioception? What is multiple sclerosis (MS)? What is Parkinsons disease? What is paraplegia? What is quadriplegia? What is a stroke? What is hemiplegia? What is epilepsy? What is poliomyelitis or polio? What is meningitis? What is shingles? What is neuritis? What is neuralgia? What are some of the causes of neuritis? What is sciatica?