29-1

The Nervous System

PowerPoint® presentation to accompany:

Medical Assisting
Third Edition

Booth, Whicker, Wyman, Pugh, Thompson

© 2009 The McGraw-Hill Companies, Inc. All rights reserved

 29-2

Learning Outcomes
29.1 Explain the difference between the central
nervous system and the peripheral nervous
system.
29.2 Describe the functions of the nervous system.
29.3 Describe the structure of a neuron.
29.4 Describe the function of a nerve impulse and how
a nerve impulse is created.

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Learning Outcomes (cont.)

29.5 Describe the structure and function of a synapse.

29.6 Describe the function of the blood-brain barrier.

29.7 Describe the structure and functions of meninges.

29.8 Describe the structure and functions of the spinal

cord.

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Learning Outcomes (cont.)

29.9 Describe the location and function of
cerebrospinal fluid.

29.10 Define reflex and list the parts of a reflex arc.

29.11 List the major divisions of the brain and give the
general functions of each.

29.12 Explain the functions of the cranial and spinal

nerves.

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Learning Outcomes (cont.)

29.13 Describe the differences between the somatic
nervous system and autonomic nervous system.

29.14 Explain the two divisions of the autonomic

nervous system.

29.15 Describe the causes, signs and symptoms, and

treatments of various diseases and disorders of
the nervous system.

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Introduction
 Highly complex system  Controls all other
of two parts organ systems and is
 Central nervous important for
system (CNS) maintaining balance
within those systems
 Peripheral nervous
system (PNS)

Disorders are numerous and often

difficult to diagnose and treat

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General Functions of the NS

 CNS  PNS
 Brain  Peripheral nerves
 Spinal cord  Two sections
 Somatic nervous system
(SNS)
 Skeletal or voluntary
muscles
 Autonomic nervous system
(ANS)
 Automatic functions

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General Functions (cont.)

 Three types of neurons
 Afferent or sensory nerves
 Sensory information from environment or inside body
to CNS for interpretation
 Efferent or motor nerves
 Impulses from CNS to PNS to allow for movement or
action
 Interneruons
 Interpretive neurons between afferent and efferent
nerves in the CNS

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Apply Your Knowledge

Match the following: ANSWER:
B Somatic nervous system
___ A. Motor nerves
C Autonomic nervous system
___ B. Governs skeletal or voluntary muscles
A Afferent nerves
___ C. Governs respiratory and GI systems
E Efferent nerves
___ D. Go-betweens or interpreters
D Interneurons
___ E. Sensory nerves

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Neuron Structure
 Functional cells of NS

 Transmit
electrochemical
messages called nerve
impulses to
 Other neurons
 Effectors (muscles or
glands)
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Neuron Structure (cont.)

 Neurons lose their ability to divide
 If destroyed, not replaced
 Neuralgia
 Support cells for neurons that can divide
 Astrocytes – anchor blood vessels to nerves
 Microglia – act as phagocytes
 Oligodendrocytes – assist with production of
myelin sheath

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Neuron Structure (cont.)

 Dendrites – short
 Receive nerve impulses
Neurons have cell for the neuron
body processes called
nerve fibers that  Axons – long
extend from the cell  Send nerve impulses
body. away from the cell body

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Neuron Structure (cont.)

 White matter – axons with myelin
sheath
Dendrites  Schwann cells – neurological cells
 Wrap around some axons
 Cell membranes contain myelin
 Myelin insulates axons and enables
Schwann axons to send nerve impulses more
cells quickly

Axon  Gray matter – axons without

myelin sheath

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Apply Your Knowledge

True or False: ANSWER:
___
F Effectors are neurons. They are the muscles or glands.
___
F Neurons can reproduce. Neurons cannot reproduce.
___
T Astrocytes anchor blood vessels to nerve cells.

T Microglia act as phagocytes.

___
They take part in
F Oligodendrocytes are reproductive cells.
___ myelin production.
T Repolarization is the return to the resting state.
___
GOOD JOB!
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Nerve Impulse
 Membrane potential
 Neuron cell membrane at rest is in a polarized state
 Inside of cell membrane is negative
 Outside of cell membrane is positive due to more Na+ and K+
 As Na+ and K+ move into the cell, the membrane becomes
depolarized
 Inside becomes more positive
 Action potential (nerve impulse) is created
 Repolarization occurs when K+ and later Na+ move to the
outside of the cell membrane
 Return of the cell to polarized (resting) state

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Nerve Impulse (cont.)

 Impulse travels down axon to synaptic knob
 Vesicles or small sacs in synaptic knob
 Produce chemicals called neurotransmitters

 Neurotransmitters are released by synaptic knob

 Allow impulse transmission to postsynaptic structures
 Dendrites
 Cell bodies
 Axons of other neurons

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Nerve Impulse (cont.)

 Functions of neurotransmitters
 Cause muscles to contract or relax

 Cause glands to secrete products

 Activate or inhibit neurons

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Apply Your Knowledge

What is the function of neurotransmitters?
ANSWER: Neurotransmitters cause muscles to
contract or relax, cause glands to secret products,
activate neurons to send nerve impulses, or inhibit
neurons from sending them.

Right!
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Central Nervous System

 Includes the spinal cord and brain
 Blood-brain barrier
 Protects layers of the membranes of the CNS
 Formed by tight capillaries
 Prevents unwanted substances from entering the CNS
tissues
 Inflammation can make more permeable

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CNS (cont.)
 Meninges –protect brain and spinal cord
 Dura mater
 Tough outer layer
 Arachnoid mater
 Middle layer (web-like)
 Pia mater
 Innermost and most
delicate
 Directly on top of brain
and spinal cord
 Holds blood vessels on the
surface of these structures

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CNS (cont.)
 Epidural space
 Above dura mater

 Subdural space
 Below dura mater

 Subarachnoid space
 Between arachnoid mater and pia mater
 Contains cerebrospinal fluid (CSF)
 Cushions CNS

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CNS: Spinal Cord

 Slender structure continuous with the
brain
 Descends into the vertebral canal and
ends around the level of the first or
second lumbar vertebra
 31 spinal segments:
 8 cervical segments
 12 thoracic segments
 5 lumbar segments
 5 sacral segments
 1 coccygeal segment  

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CNS: Spinal Cord (cont.)

 Cervical enlargement
 Motor neurons that control
muscles of the arms

 Lumbar enlargement
 Motor neurons that control
muscles of the legs

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CNS: Spinal Cord (cont.)

 Gray matter
 Inner tissue with darker color
 Contains neuron cell bodies and their dendrites
 Divisions are called horns
 Central canal runs down the entire length of the
spinal cord through the center of the gray
matter Spinal
Cord/Nerve

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CNS: Spinal Cord (cont.)

 White matter
 Outer tissue
 Contains myelinated axons
 Divisions are called columns (funiculi)
 Columns contain groups of axons called nerve
tracts
Spinal
Cord/Nerve

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CNS: Spinal Cord (cont.)

 One function of the spinal cord is to carry sensory
information to and from the brain

 Ascending tracts
 Carry sensory information up to the brain

 Descending tracts
 Carry motor information down from the brain to muscles
and glands

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CNS: Spinal Cord (cont.)

 Reflexes
 Another function of the spinal cord is to participate in
reflexes
 Reflex – a predictable, automatic response to stimuli

Receptor Sensory Neurons

Interneurons

Effectors Motor Neurons

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CNS: Brain
 Four sections
 Cerebrum
 Diencephalons
 Brain stem
 Cerebellum

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CNS: Brain – Cerebrum

 Largest section
 Two cerebral hemispheres
 Connected by a thick bundle of nerve fibers called
the corpus callosum
 Longitudinal fissure between hemispheres
 Sulci – grooves on surface
 Gyri or convolutions – bumps of brain matter
between sulci Brain

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CNS: Brain – Cerebrum (cont.)

 Lobes
 Frontal Frontal Parietal
 Motor areas for voluntary
body movements
 Parietal
 Somatosensory – interprets
sensations
 Temporal
 Auditory – interprets sounds Temporal
Occipital
 Occipital
 Interprets what a person sees

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CNS: Brain – Cerebrum (cont.)

 Cortex  Ventricles
 Outer layer – gray  Interconnected
matter cavities within the
 Contains about 75% brain
of all neurons
 Inner layer – white matter  Filled with CSF
 Functions
 Interpret sensory information
 Initiate body movements
 Stores memories and creates emotions

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CNS: Brain – Diencephalon

 Between the cerebral hemispheres superior to
the brain stem
 Thalamus
 Relay station for sensory information going to the
cerebral cortex for interpretation
 Hypothalamus
 Maintains homeostasis by regulating vital
activities Brain

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CNS: Brain – Brain Stem

 Connects the cerebrum to  Medulla oblongata
the spinal cord  Inferior portion of brain
 Midbrain stem
 Just beneath
 Directly connected to spinal
diencephalon cord
 Controls both visual
 Controls many vital
and auditory reflexes activities, such as heart rate,
blood pressure, and
 Pons breathing
 Rounded bulge on
underside of brain stem
 Between midbrain and
medulla oblongata
Brain
 Regulates respiration

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CNS: Brain – Cerebellum

 Location
 Inferior to the occipital lobes of the cerebrum
 Posterior to the pons and medulla oblongata
 Coordinates
 Complex skeletal muscle contractions that are
needed for body movements
 Fine movements
Brain

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Preventing Brain and Spinal Cord

Injuries
 Wear appropriate  Children should be in
protective gear for car seats appropriate
sports for age and weight
 Avoid diving into
unknown waters
 Know how to get help
quickly in emergencies
 Always wear seat belts
 Follow traffic rules and
 Follow safety rules on signs while walking,
playgrounds biking, or driving
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SUPER!
Apply Your Knowledge
Match the following:
H Meninges
___ A. Carry motor information from brain
D Ascending tracts
___ B. Stores memories and creates emotions
A Descending tracts
___ C. Grooves on the surface of the cerebrum
B Cerebral cortex
___ D. Carry sensory information to the brain
F Hypothalamus
___ E. Predictable, automatic response to stimuli
C Sulci
___ F. Maintains homeostasis
G Cerebellum
___ G. Coordinates skeletal muscle contractions
E Reflexes
___ H. Protects the brain and spinal cord

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Peripheral Nervous System

 Nerves that branch
off the CNS

 Peripheral nerves
 Two types:
 Cranial nerves

 Spinal nerves

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PNS: Cranial Nerves

I.   Olfactory nerves
 Carry smell information to the brain for interpretation

II.  Optic nerves

 Carry visual information to the brain for interpretation

III. Oculomotor nerves
 Found within the muscles that move the eyeball, eyelid,
and iris

IV. Trochlear nerves

 Act in the muscles that move the eyeball.

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PNS: Cranial Nerves (cont.)

V.  Trigeminal nerves
 Carry sensory information from the surface of the
eye, the scalp, facial skin, the lining of the gums,
and the palate to the brain for interpretation
 Also found within the muscles needed for
chewing
VI. Abducens nerves
 Act in the muscles that move the eyeball

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PNS: Cranial Nerves (cont.)

VII. Facial nerves
 Found in the muscles of facial expression as
well as in the salivary and tear glands
 Also carry sensory information from the
tongue
VIII. Vestibulocochlear nerves
 Carry hearing and equilibrium information
from the inner ear to the brain for
interpretation

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PNS: Cranial Nerves (cont.)

IX. Glossopharyngeal nerves
 Carry sensory information from the throat and
tongue to the brain for interpretation
 Also act in the muscles of the throat
X. Vagus nerves
 Carry sensory information from the thoracic and
abdominal organs to the brain for interpretation
 Also found within the muscles in the throat,
stomach, intestines, and heart

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PNS: Cranial Nerves (cont.)

XI. Accessory nerves
 Found within the muscles of the throat, neck,
back, and voice box

XII. Hypoglossal nerves

 Found within the muscles of the tongue

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PNS: Spinal Nerves

 Peripheral nerves originating from the spinal
cord

 31 pairs of spinal nerves

 8 pairs of cervical nerves (C1 through C8)
 12 pairs of thoracic nerves (T1 through T12)
 5 pairs of lumbar nerves (L1 through L5)
 5 pairs of sacral nerves (S1 through S5)
 1 pair of coccygeal nerves (C0) Spinal
Nerves

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PNS: Spinal Nerves (cont.)

 Dermatome
 Skin segment innervated by spinal nerve
 C1 is not associated with a dermatome

 Ventral root
 Axons of motor neurons only

 Dorsal root
 Axons of sensory neurons only
 Dorsal root ganglion
 Contains cell bodies of sensory neurons

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PNS: Spinal Nerves (cont.)

 Main portions of spinal nerves fuse to form
nerve plexuses
 Cervical – supply skin and muscles of neck
 Phrenic nerve originates from this plexus
 Controls diaphragm
 Brachial – control muscles in the arms
 Lumbosacral – lower abdomen, external genitalia,
buttocks, thighs, legs, and feet
 Sciatic nerve originates from this plexus
Spinal
 Controls muscles of legs Nerves

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PNS: Somatic Nervous System

 Nerves that connect the CNS to skin and skeletal
muscle
 “Voluntary” nervous system
 Controls skeletal muscles, which are under voluntary
control

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PNS: Autonomic Nervous System

 Nerves that connect the CNS to organs and other
structures
 “Involuntary” nervous system
 Motor neurons located in ganglia
 Neuron cell bodies outside the CNS

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PNS: Autonomic Nervous System (cont.)

 Sympathetic division
 “Fight or flight” – Prepares body for stressful or
emergency situations
 Neurons release neurotransmitter norepinephrine
 Increases heart and breathing rates
 Slows down muscles of the stomach and intestines
 Dilates pupils
 Constricts blood vessels – increases blood pressure

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PNS: Autonomic Nervous System (cont.)

 Parasympathetic division
 Prepares body for rest and digesting
 Controls most of the body’s organs
 Releases acetylcholine
 Slows heart and breathing rates
 Constricts pupils
 Activates muscles of stomach and intestine
 No communication with blood vessels
 Sympathetic and parasympathetic divisions are
antagonistic
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Apply Your Knowledge

What is the difference between the sympathetic and
parasympathetic nervous systems?
ANSWER: The sympathetic nervous system prepares the
body for stress. It releases norepinephrine, causing an
increase in heart and respiratory rate, slows down the GI
system, and dilates pupils. The sympathetic system also
controls constriction of blood vessels.
The parasympathetic system prepares the body for resting
and digesting. It releases acetylcholine, which slows heart
and respiratory rate, constricts pupils and stimulates the GI
system. It has no effect on most blood vessels.
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Neurologic Testing
 Typical neurologic examination
 State of consciousness
 Reflex activity
 Speech patterns
 Motor patterns

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Neurologic Testing: Diagnostic Procedures

 Lumbar puncture  Computerized
tomography (CT) scan
 Magnetic resonance
imaging (MRI)  Electroencephalogram
(EEG)
 Positron emission
tomography (PET) scan  X-ray

 Cerebral angiography

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Neurologic Testing – Cranial Nerve Tests

 Olfactory nerves (Cranial nerve I)
 Have patient smell various substances
 Cranial nerves III, IV, and VI
 Have patient track movement of finger
 Cranial nerve V
 Have patient clench teeth, feel jaw muscles

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Neurologic Testing – Cranial Nerve Tests (cont.)

 Cranial nerve VII
 Check patient’s facial expression

 Cranial nerve XII

 Have patient extend his tongue and move it from
side to side

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Neurologic Testing: Reflex Testing

 Areflexia
 Absence of a reflex

 Hyporeflexia
 Decreased reflex

 Hyperreflexia
 Stronger-than-normal reflex

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Neurologic Testing: Reflex Testing

 Biceps reflex
 Absence indicates spinal cord damage in the
cervical region

 Knee reflex
 Absence may indicate damage to lumbar or
femoral nerves

 Abdominal reflexes
 Used to evaluate damage to thoracic spinal nerves
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Apply Your Knowledge

Match the following:
ANSWER:
C State of consciousness
___ A. Determines the health of
peripheral nerves
A Reflex activity
___ B. Loss of balance,
abnormal posture
D Speech patterns
___ C. Stupor, delirium,
B vegetative
___ Motor patterns D. Loss of ability to form words

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Common Diseases and Disorders

Disease/Disorder Description
Alzheimer’s Progressive, degenerative disease of
disease the brain
Amyotrophic Lou Gehrig’s disease
lateral sclerosis Degeneration of neurons in the spinal
(ALS) cord and brain
Bell’s palsy Weak or paralyzed facial muscles

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Common Diseases and Disorders (cont.)

Disease/Disorder Description
Brain tumors and Abnormal growths
cancers Can be primary or secondary tumors
Most common – gliomas
Epilepsy and Occurs as a result of bursts of
seizures electrical signals that disrupt normal
brain functioning
Guillain-Barré Body’s immune system attacks the
Syndrome PNS
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Common Diseases and Disorders (cont.)

Disease/Disorder Description
Headaches
Tension Episodic or chronic
Migraines With aura/without aura
Cluster Form of migraines; occurs in groups
Meningitis Inflammation of meninges
Multiple Chronic disease of CNS
sclerosis (MS) Myelin is destroyed

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Common Diseases and Disorders (cont.)

Disease/Disorder Description
Neuralgias Disorders causing nerve pain
Parkinson’s Progressive and degenerative motor
disease system disorder
Sciatica Damage to sciatic nerve
Stroke Brain cells die because of an
inadequate blood flow; “brain attack”

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Apply Your Knowledge

True or false: ANSWER: Bravo!
T Alzheimer’s disease is a progressive degenerative disease of
___
the brain.
F Epilepsy is due to degenerative neurons in the spinal cord
___
and brain. Due to a burst of electrical signals that disrupt brain function.

F Neuralgias are motor system disorders.

___
They are group of disorders referred to as nerve pain.

T Stroke occurs when brain cells die because of inadequate

___
blood flow.

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In Summary
 Functions of the nervous system
 Detecting and interpreting sensory information
 Making decision about that information
 Responding to and carrying out motor functions
 Neurons are responsible for functions
 Divisions
 CNS – brain and spinal cord
 PNS – cranial and spinal nerves
Knowledge of this system is essential when assisting the
physician during a neurologic exam

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End of Chapter

Activity of the nervous

system improves the
capacity for activity, just as
exercising a muscle makes
it stronger.”
~ Dr. Ralph Gerard

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