HUMAN SYSTEM ANATOMY &

PHYSIOLOGY I

NERVOUS SYSTEM 2

PERIPHERAL NERVOUS SYSTEM

DR WAN SAFWANI WAN KAMARUL ZAMAN

 Peripheral Nervous System
ways to categorize:
• Motor or sensory
• General (widespread) or specialized (local)
• Somatic (outer tube) or visceral (inner tube)
SENSORY RECEPTORS – BY STIMULUS TYPE

• Mechanoreceptors
• Thermoreceptors
• Photoreceptors
• Chemoreceptors
• Nociceptors
 SENSORY RECEPTORS – BY LOCATION

By location:
• Exteroceptors
– Sensitive to stimuli arising from outside body
• Interoceptors
– Or visceroreceptors, from internal viscera
• Proprioceptors
– Monitor degree of stretch in skeletal muscles,
tendons, joints and ligaments
 Sensory Receptors
• Free nerve endings (pain and
temp)
• Merkel discs (light touch)
• Root hair plexuses – entwine
hair follicles (light touch)
• Encapsulated Meissner’s
corpuscles (light touch in
hairless skin)
• Ruffini’s corpusucles (deep
pressure and stretch)
• Pacinian corpuscles (deep
pressure, vibration, visceral:
pain, nausea, hunger, fullness)
 Proprioceptors

• Skeletal muscles, joints, tendons, ligaments

• Degree of stretch, therefore information on body
movement:
– to cerebrum,
– cerebellum and
– spinal reflex arcs
• Include: -Muscle spindles
-Golgi tendon organs
-Joint kinesthetic receptors
 Proprioceptors

Muscle spindles:
Intrafusal fibers – rate &
degree of stretch
Golgi tendon organs
Near muscle-tendon
junction: monitor tension
within tendons
Joint kinesthetic receptors
Monitor stretch in
synovial joints
Send info to cerebellum
and spinal reflex arcs
OVERVIEW OF PNS – from sensation to perception

3 Perceptual level

2 Circuit level

1st order neuron

2nd order neuron
1 Receptor level 3rd order neuron
 RECEPTOR LEVEL

1. Stimulus – specificity & within receptor’s receptive field.

2. Stimulus energy – converted into receptor potential during transduction.

- summation of receptor potential leads to action potential – generator
potentials.

3. Stimulus may exhibit:

a) Adaptation – change in sensitivity/nerve impulse generation in the presence of
constant stimuli.
b) Phasic - fast adapting burst of impulses at beginning & end of stimulus
c) Tonic – sustained response with little or no adaptation.
 PERCEPTUAL LEVEL

• Interpretation of sensory input in cerebral cortex.

• Sensory perception:
1) Perceptual detection
2) Magnitude estimation
3) Spatial discrimination
4) Feature abstraction
5) Quality discrimination
6) Pattern recognition
 PERIPHERAL MOTOR NERVE ENDINGS

• Innervation of skeletal muscle

• Innervation of visceral muscles and glands

• Motor axons innervate skeletal muscle fibers at
neuromuscular junctions = motor end plates
Resemble nerve synapses between neurons, except for
acetylcholinesterase:
breaks down acetylcholine so one twitch only
All muscles in motor unit contract together when neuron fires
Stimulation of single motor unit causes weak contraction of entire
muscle (spread out)
Those with fine control – fewer fibers per motor neuron (avg. 150:
range is 4-100s)
Motor unit: motor neuron & all the muscle fibers it
innervates
 Innervation of visceral muscles & glands
• Near end organ visceral motor axon swells = presynaptic
terminals (vesicles with neurotransmitters): action slow (NT
diffuses)
CRANIAL NERVES
FORAMINA
Many cranial nerves have their nuclei
in the brain stem
 CRANIAL NERVES CONTINUES….

• 12 pairs, Roman numerals I-XII

• Serve mainly head and neck
– Vagus – into thoracic and abdominal cavities
• All but first 2 arise from brain stem and pass
through foramina in base of skull
• Most are mixed (motor and sensory)
– 3 are purely sensory:
• Optic
• Olfactory
• Vestibulocochlear
 Cranial Nerves
CN # Name Attached to Foramen Function

I Olfactory Forebrain Cribriform plate Sense of smell

II Optic Forebrain Optic canal Sense of vision (sight) from retina

III Oculomotor Midbrain Superior orbital Motor to 4 of the 6 muscles of eye

(brainstem) fissure movement (up & in); eyelid;
constriction of pupil

IV Trochlear Midbrain Superior orbital Motor to superior oblique muscle of

(brainstem) fissure eye (down & out)

V Trigeminal Pons V1: superior All three divisions: facial sensation

V1 ophthalmic (brainstem) orbital fissure
V2 maxillary V2: foramen
V3 mandibular rotundum V3 (mandibular division): chewing
V3: foramen ovale also
 VI Abducens Pons Superior orbital Motor to lateral rectus muscle of
(brainstem) fissure eye (abducts outwards)
VII Facial Pons Internal auditory Facial expression (motor)
(brainstem) canal Taste anterior 2/3 tongue
Salivary & lacrimal glands (saliva
and tears)

VIII Vestibulocochlear Pons Internal auditory Equilibrium (vestibular)

(brainstem) canal Hearing (cochlear)

IX Glossopharyngeal Medulla Jugular foramen Taste & touch from posterior 1/3
(brainstem) tongue (sour, bitter); pharynx
(throat) muscles of swallowing;
parotid gland (saliva); senses
carotid BP
X Vagus Medulla Jugular foramen Senses aortic BP, slows heart rate,
(brainstem) stimulates digestive organs; larynx
(vocal cords), taste, swallowing

XI Accessory Medulla Jugular foramen Sternocleidomastoid, trapezius,

(brainstem) swallowing; part joins Vagus

XII Hypoglossal Medulla Hypoglossal canal Innervation of tongue muscles

(brainstem)

For more details read chapter 13 pg 502 – 508 Human Anatomy & Physiology by Marieb & Hoehn
Tests questions may also come from here….
 Demonstration of testing of cranial nerves
• I Olfactory: usually only done by neurologists: sniff
e.g. coffee grounds, vanilla
• II Optic: vision (eye chart), visual fields (grossly or
formally), fundoscopy
• III Oculomotor: pupilary reflexes (constriction to
light); test with IV and VI for EOMs (extraocular
movements) – follow finger
• IV Trochlear: motor to superior oblique (test with
EOMs – problem if eye can’t go down and out)
V trigeminal: largest cranial nerve; sensory info
from face, 3 divisions (“tri”):
– V1 ophthalmic
– V2 maxillary
– V3 mandibular

– Light touch in cursory exam

– Plus corneal reflex (neurologists usually)
– Motor (V3): clench teeth, open mouth against
resistance, move jaw side to side
• VI Abducens: motor to lateral rectus of eye
(abducts eye outward)
• VII Facial: (mixed) – facial expression
– Symmetry (droop of eyelid, corner of mouth, etc.);
wrinkle forehead, close eyes, smile, pucker etc.;
– Taste anterior 2/3 tongue & tearing (neurologist)
• VIII Vestibulocohclear (old: auditory): hearing by
air and bone conduction (tuning fork)
• IX Glossopharyngeal (mixed): uvula, gag reflex,
cough, +taste posterior 1/3 tongue (neurologist)
• X Vagus (mixed):
as IX (muscles of
tongue and throat
with IX)

26
• XI Accessory (old: “spinal accessory”):
sternocleidomastoid and trapezius (rotate head
and shrug shoulders against resistance)
• XII Hypoglossal: stick tongue out straight

• Learn them; mneumonic helps, e.g.:

“Oh, oh, oh, to touch and feel very good velvet, ah!”
“On occasion, our trusty truck acts funny – very
good vehicle anyhow”
 SPINAL NERVES
 Part of the peripheral nervous system
 31 pairs attach through dorsal and ventral nerve roots
 Lie in intervertebral foramina
• Spinal cord segments are
superior to where their
corresponding spinal nerves
emerge through
intervetebral foramina

• Spinal nerves are named

according to the spinal cord
segment from which they
originate
– 8 cervical
– 12 thoracic
– 5 lumbar
– 5 sacral
– 1 coccygeal

• Cauda equina (“horse’s

tail”): collection of nerve
roots at inferior end of
vertebral canal
 SPINAL NERVES
Dorsal roots – sensory fibers arising from cell bodies in dorsal root ganglia
Ventral roots – motor fibers arising from anterior gray column of spinal cord
 SPINAL NERVES
• Note: cervical spinal nerves exit from above the
respective vertebra
– Spinal nerve root 1 from above C1
– Spinal nerve root 2 from between C1 and C2, etc.

• The remaining spinal nerve pairs emerge from the

spinal cord below the same-numbered vertebra

• Clinically, for example when referring to disc

impingement, both levels of vertebra mentioned, e.g.
C6-7 disc impinging on root 7

• Symptoms usually indicate which level

Cross section of thorax showing main roots and
branches of a spinal nerve
– Note dorsal and ventral roots and rami, and rami
communicantes
– In the thorax, each ventral ramus continues as an
intercostal nerve
 Nerve plexuses
• Networks of successive
ventral rami that exchange
fibers (crisscross &
redistribute)
– Why would this be
protective?
• Mainly innervate the limbs
• Thoracic ventral rami do
not form nerve plexuses

33
 Plexuses

• Cervical
• Brachial
• Lumbar
• Sacral

34
 Nerve plexuses

• Cervical plexus (C1-C4)

innervates the muscles and
skin of the neck and shoulder

most important:
Its phrenic nerve* (C3-C5) is
the sole motor supply of
diaphragm: one reason why
neck injuries are so dangerous
– can be lethal (respiratory *
arrest = stop breathing)

35
CUTANEOUS BRANCHES

*
*
*

36
 MOTOR BRANCHES

Ansa Cervicalis C1-C3

Infrahyoid muscles of the neck –
omohyoid, sternohyoid & sternothyroid
*
Segmental branches C1-C5
Deep muscles of neck (geniohyoid &
thyrohyoid) & portions of scalenes,
levator scapulae, trapezius &
sternocleidomastoid.

Phrenic nerve C3-C5

*
Diaphragm

*
 REFLEX ACTIVITY
• Reflexes are automatic, unconscious to changes,
either inside or outside the body.
a. Reflexes maintain homeotasis (autonomic
reflexes) – heart rate, breathing rate, bp,
digestion.
b. Reflexes also carry out the automatic actions of
swallowing, sneezing, coughing, vomiting.
c. Reflexes maintain balance and posture; e.g.,
spinal reflexes control trunk and limb muscles.
d. Brain reflexes involve reflex center in brainstem;
e.g., reflexes for eye movement.
 Reflex Arc
• The reflex arc governs the operation of reflexes. Nerve
impulses follow nerve pathways as they travel through the
nervous system. The simplest of these pathways, which
include only a few neurons, is called the reflex arc. Reflexes
whose arc passes through the spinal cord are called spinal
reflexes.
 Parts of the Reflex Arc

1. Receptor – detects the stimulus. a) Description: the

receptor end of a particular dendrite or a
specialized receptor cell in a sensory organ. b)
Function: sensitive to a specific type of internal or
external change.
2. Sensory neuron – conveys the sensory info. to brain
or spinal cord. a. Description: Dendrite, cell body,
and axon of a sensory neuron. b. Function: transmit
nerve impulses from the receptor into the brain or
spinal cord.
 Parts of the Reflex Arc

3. Interneuron: relay neurons. a. Description: dendrite,

cell body, and axon of a neuron within the brain or
spinal cord. b. Function: serves as processing center,
conducts nerve impulses from the sensory neuron
to a motor neuron.
4. Motor neuron: conduct motor output to the
periphery. a. Description: Dendrite, cell body, and
axon of a motor neuron. b. Function: transmits
nerve impulse from the brain or spinal cord out to
an effecter.
 Parts of the Reflex Arc
5. Effector: a. Description: a muscle or gland. b.
Function: Response to stimulation by the motor
neuron and produces the reflex or behavioral action.
 Spinal Reflexes

Sensory feedback from muscle

 FUNCTIONAL ANATOMY OF MUSCLE SPINDLES
• Intrafusal muscle fibers
Enclosed in connective tissue capsule.
Central region – receptive surfaces, noncontractile, lack myofilaments.
- wrap by 2 types of afferent endings:
1) Ia fibers – primary sensory endings innervate spindle center &
stimulated only by rate & degree of stretch.
2) II fibers – secondary sensory endings innervate spindle ends &
stimulated by only by degree of stretch.
Contractile region is only in the end region – contain actin & myosin myofilaments &
innervated by:
1) gamma (γ) efferent fibers (ventral horn of spinal cord) - maintain spindle sensitivity.
2) alpha (α) efferent fibers (large alpha motor neurons) – stimulate contraction of
extrafusal fibers.

• Extrafusal muscle fibers

Effector fibers of muscles spindles
 MUSCLE SPINDLES

• Stretching/excite in one of 2 ways:

1) Applying external force that lengthens the entire muscles.

2) Activating the γ motor neurons that stimulate distal end of

intrafusal fibers to contract – stretch middle of spindle
(internal stretch)
 Spinal Reflexes

The Myotatic Reflex

• Stretch reflex: Muscle pulled tendency to
pull back
• Feedback loop
• Discharge rate of sensory axons: Related to
muscle length
• Monosynaptic
• Example: knee-jerk reflex
 Spinal Reflexes
The Myotatic Reflex
 Spinal Reflexes
Gamma Motor Neurons
• Muscle spindle
• Intrafusal fibers: gamma
• Extrafusal fibers: alpha
• Gamma feedback loop provides
more control
 Spinal Reflexes

Reverse myotatic reflex

•Regulate muscle tension
•Golgi tendon organs
 Spinal Reflexes
Reciprocal inhibition Flexor reflex: Complex reflex
Contraction of one muscle set accompanied by arc used to withdraw limb from
relaxation of antagonist muscle aversive stimulus

Crossed-extensor reflex:
Activation of extensor muscles
and inhibition of flexors on
opposite side
Spinal Motor Programs
 Stretch and Deep Tendon Reflexes
For skeletal muscles to perform normally:
The Golgi tendon organs (proprioceptors) must
constantly inform the brain as to the state of
of the muscle.
Stretch reflexes initiated by muscle spindles
must maintain healthy muscle tone.
 Muscle Spindles
• Are composed of a few intrafusal muscle fibers that lack
actin and myosin in their central regions, are
noncontractile, and serve as receptive surfaces.
• Muscle spindles are wrapped with two types of afferent
endings: primary sensory endings of type Ia fibers and
secondary sensory endings of type II fibers and secondary
sensory endings of type II fibers.
• These regions are innervated by gamma (γ) efferent fibers.
• Note: contractile muscle fibers are extrafusal fibers and
are innervated by alpha (α) efferent fibers.
Muscle Spindles
 Operation of the Muscle Spindles
• Stretching the muscles activates the muscle
spindle.
There is an increased rate of action
potential in Ia fibers.
• Contracting the muscle reduces tension on the
muscle spindle.
There is a decreased rate of action
potential on Ia fibers
Operation of the
Muscle Spindles
 Stretch Reflex
• Stretching the muscle activates the muscle spindle.
• Excited motor neurons of the spindle cause the
stretched muscle to contract.
• Afferent impulses from the spindle result in inhibition of
the antagonist inhibition of the antagonist.
• Example: patellar reflex.
Tapping the patellar tendon stretches the quadriceps
and starts the reflex action.
The quadriceps contract and the antagonistic hamstrings
relax.
Stretch Reflex
 Golgi Tendon Reflex
• The opposite of the stretch reflex.
• Contracting the muscle activates the Golgi
tendon organs.
• Afferent Golgi tendon neurons are stimulated,
neurons inhibit the contracting muscle, and
the antagonistic muscle is activated.
• As a result, the contracting muscle relaxes and
the antagonist muscle contracts.
Golgi Tendon Reflex
Monosynaptic Stretch
Reflex
•Simplest reflex
because it has only 1
synapse in the path of
its arc.
• Muscle spindles
contain the sensory
receptors for the
stretch reflex.
• Each spindle contains
modified muscle fibers
called spindle or
intrafusal fibers (inside
spindle), innervated
by γ efferent fibers.
Monosynaptic Stretch
Reflex
•The middle segment
of each spindle fiber
acts as a mechanical
stretch receptor that is
connected to a
sensory afferent nerve
to the spinal cord.
• Stretching of the
muscle stretches the
spindle fibers
activating the muscle
spindle stretch
receptors and the
associated sensory
fibers.
• The terminals of the spindle sensory fibers make direct excitatory
synaptic contact with alpha motor neurons serving the ordinary
muscle fiber (extrafusal fibers).
• Contraction of these fibers shorten the muscle and relaxes the
spindle fibers terminating the stretch reflex and muscle contraction.
 Events in the Monosynaptic Stretch Reflex -
Summary
• 1. Passive stretch of a muscle (produced by tapping its
tendon) stretches the spindle (intrafusal) fibers.
• 2. Stretching of a spindle distorts its central (chain) region,
which stimulates dendritic endings of sensory nerves.
• 3. Action potentials are conducted by afferent (sensory) fibers
into the spinal cord on the dorsal roots of spinal nerves.
• 4. Axons of sensory neurons synapse with dendrites and cell
bodies of somatic motor neurons located in the ventral horn
gray matter of the spinal cord.
• 5. Efferent impulses in the axons of somatic motor neurons
(which form the ventral roots of the spinal nerves) are
conducted to the ordinary (extrafusal) muscle fibers. These
neurons are (alpha) motor neurons.
 Events in the Monosynaptic Stretch Reflex -
Summary
• 6. Release of Ach from the endings of alpha motor neuron
stimulates the contraction of extrafusal fibers, and thus the
whole muscle.
• 7. Contraction of the muscle relieves the stretch of its
spindles, thus decreasing electrical activity in the afferent
nerve fibers, and relaxes the spindle fiber and terminates
the stretch reflex and muscle contraction. the stretch reflex
and muscle contraction.
• Note: By sending command to the motor neurons, the
brain set a muscle’s length. The stretch reflex makes sure
the muscle stay at that length. The stretch reflex is
therefore important for maintaining muscle tone and
upright posture.
 The Deep Tendon Reflex
- If you tap on the tendon of a muscle, it contracts. Its synergists
contract and its antagonists are inhibited. - polysynaptic reflex.
- A tap on the patellar tendon stretches the extensor muscle
and its spindles.
• The spindle discharges and excites the associated sensory fibers that
excite the motor neurons to the extensor muscle.
• - Contraction of the extensor muscle extends the lower leg (knee - jerk).
• - Ipsilateral flexor muscle relax for extensors to function.
• - Branches of the sensory fibers from muscle spindle activate inhibitory
interneuron, which in turn, inhibit the motor neuron to the flexor
muscle.
 The Withdrawal Reflex (Flexor Reflex)
• The automatic withdrawal of an extremity from a
painful stimulus.
• A polysynaptic reflex.
• Sensory pain signals excite motor neurons to the
flexor muscles, eliciting flexion and withdrawal of
the leg.
• Motor neurons to the extensor muscles are
inhibited via inhibitory interneurons.
• This would relax the extensors of the same leg.
The Withdrawal Reflex
 The Crossed Extensor Reflex
• A polysynaptic reflex.
• E.g., Painful stimulation of one foot causes
flexion (withdrawal) of the ipsilateral leg as
well as the extension of the contralateral leg,
to stabilize the posture; thus the ipsilateral leg
flexors are activated and the extensors are
inhibited and vice versa in the contralateral
leg.
 Superficial Reflexes
• Biceps jerk reflex: the examiner places finger on the
inside of the extended elbow over the tendon of the
biceps muscle and the finger is tapped. The biceps
contracts in response, and the forearm flexes at the
elbow.
• Triceps jerk reflex: tapping the short tendon of the
triceps muscle close to its insertion near the tip of the
elbow elicit this reflex. The muscle contracts in
response, and the forearm extends, slightly.
• Abdominal reflex: the examiner strokes the skin of the
abdomen with a dull pin from the side of abdomen
upward towards the midline and above the umbilicus.
The umbilicus moves towards the stimulated region.
 Superficial Reflexes
• Ankle – jerk reflex (plantar reflex): tapping the
Achilles tendon just above its insertion on the
Calcaneous elicits this reflex. The response is
plantar flexion, produced by contraction of the
gastrocnemius and the solues muscles.
• Cremastric reflex: this reflex is elicited in males
by stroking the upper inside of the thigh. In
response, the testis on the same side is
elevated by contracting muscles.