Central Nervous System Brain Spinal cord Peripheral Nervous system Cranial Nerves Spinal nerves ANS Cells

Cells of the nervous system: Neuron: basic functional unit of the brain It is composed of: Dendrites- brach type of structures for receiving electrochemical messages. Cell body- afferent Axon long projections that carries electrical impulses away (efferent) Myelinated sheath composes some part of the neuron increases the speed for conduction Ganglia/Nuclei- nerve cell occurring in clusters Center- cluster of cell bodies with the same function Neuroglial cells 50 times greater in number than neurons Serve to support, protect, and nourish neurons. Neurotransmitters communicate messages from one neuron to another specific target tissue. Potentiates, terminates, modulates a specific action; It can either excite or inhibit activity of the target cell. All brain fxn are modulated through: Neurotransmitter Receptor site activity Memory and cognitive process Synaptic Vesicles neurons are manufactured and stored. Electrical action Axon Nerve terminals Releasing neurotransmitters from synapse Transported into the synapse binding to receptors in the postsynaptic cell membrane.

It can either be destroyed by the enzymes produced or reabsorbed.

THE CENTRAL NERVOUS SYSTEM: Brain:

2 % of the total body weight 1400 g- young 1200 g elder The major areas of the brain: o Cerebrum o Brain stem o Cerebellum

Cerebellum: Composed of 2 hemispheres o Thalamus and hypothalamus o Basal Ganglia Brain stem: Mid brain Pons Medulla Cerebellum: located under the cerebrum and behind the brainstem. Gyri- wrinkled appearance that is result of many folded layers or convulotions. Sulcus- located between each gyrus. Great longitudinal fissures- separate the cerebrum into R and L hemispheres Corpus callosum- joins the 2 hemispheres at the lower portion of the fissure. Cerebral Cortex made up of gray matter approximately 2-5 mm in depth. Innermost layer and composed of myelinated nerve fibers and neurological cells. Forms a pathway. These pathways connect the cortex with lower portions of the brain and spinal cord.

Cerebral Hemispheres: 1. Frontal Largest; front of the brain. Concentration, abstract thought, information storage, memory, motor function. Contains: Brocas areao Located in the Left hemisphere and is critical for motor control of speech. o Persons affect, judgement, personality, inhibitions. 2. Parietal Sensory lobe Posterior to the frontal lobe Analyzes sensory information Relays interpretation of this information Persons awareness of body position in space, size, shape, discrimination and R-L orientation. 3. Temporal Located inferior to the frontal and parietal lobes Auditory receptive areas and plays a role in memory of a sound and understands language and music. 4. Occipital Posterior to the parietal lobe Visual interpretation and memory Corpus callosum- thick collection of nerve fibers that connects the two hemispheres of the brain, is responsible for transmission of information from one side to another. Information transferred: Sensation Memory Learned Discrimination

Right handed people and some left handed people: Cerebral dominance on the L side of the brain for: Verbal Linguistic Arithmetic Calculation Analytic Function Non dominant hemisphere Geometric Spatial Visual Pattern Musical CN I and II Located in the cerebrum Basal Ganglia- masses of nuclei located in the cerebral hemispheres that are responsible for control and fine motor movements. (Hands and lower extremities) Thalamus lies on the other side of the third ventricle and acts primarily as a relay station except smell. Memory Sensation Pain Hypothalamus anterior and inferior to the thalamus, beneath and lateral to the third ventricle Infudibulum of the hypothalamus connects it to the posterior pituitary gland. Plays important role in the endocrine system because it regulates the Pituitary secretion of hormones. Hypothalamus influences: metabolism Reproduction Stress response Urine production Pituitary works with the hypothalamus

Maintenance of fluid balance through: 1. Hormonal Release 2. Maintains temperature regulation promoting vasodilation

vasoconstriction and

Hypothalamus- hunger center and appetite control. Contains: Sleep wake cycle BP Aggressive and sexual behaviour Emotional Response Controls ANS Optic Chiasm- two optic tracts cross Mamilliary bodies- olfactory reflexes and emotional response to odors. Brain stem: Midbrain Pons Medulla Oblongata Midbrain- connects the pons and the cerebellum with the cerebral hemisphere. o Sensory and motor pathways o Auditory and visual reflexes o CN III- IV Pons- Motor and sensory pathway -respiration Medulla- Motor fibers from the brain to the spinal cord -most fibers cross an d decussate -CN IX-XII - Respiration, BP, HR, Coughing, Vomiting, Swallowing Cerebellum- posterior to the midbrain, pons and below occipital lobe. o Integrates sensory info to provide smooth coordinated movements. o Fine movements, balance, position (postural) Sense o Proprioception (Awareness where each part of the body is) Structures protecting the brain:

-Brain contained in the rigid skull, protects it from injury. Frontal Temporal Parietal Occipital Sphenoid Suture lines- joins the bones in the skull Fossae- identations of the skull base Anterior fossa- frontal lobe Middle fossa- temporal lobe Posterior fossa- cerebellum -brain stem Meninges- Cover the brain and spinal cord o Provide protection, support, nourishment Durameter Arachnoid Pia Mater Dura Mater Outermost layer; brain and spinal cord Tough , thick, inelastic, fibrous and gray. Three major extensions of the dura: Falz cerebri- folds between the 2 hemispheres Tentorium- fold between the occipital lobe Falx Cerebelli- tough membranous shelf o Located between the R and L side of the cerebellum. Herniation- excess pressure that occurs in the cranial cavity. Brain tissue may be compressed against theses dural folds/ displaced around them or downward. Epidural space- potential space that esxists between the dura and skull, periosteum and the dura in the vertebral column. Subdural Space- bloodblodd/ abscess can accumulate in these space.

Arachnoid o Middle, midbrain o Extremely thin delicate memebrane that closely resembles a spider web. Sub arachnoid- space under the arachnoid. Contains: arachnoid villi - unique fingerlike projections -absorbs CSF in the venous system Blood Bacteria

Laboratory Analysis: Color: Clear Specific Gravity: 1.007 (normal) Protein count WBC Glucose Other electrolyte levels CSF may be tested for: Immunoglobulins Presence of bacteria Normal CSF: (+) WBC (-) RBC Cerebral Circulation: 15 percent of CO -750 ml per minute Several Aspects of blood circulation: (Blood supply to the Brain) First: Arterial and venous Circulation- not parallel in other organs in the body because the venous system plays a part in CSF absorption. Second: Collateral Circulation- Circle of Willis- BF to be redirected on demand. Third: BV in the brain have 2 layers; they make them more prone to rupture when weakened or under pressure. Arteries: Arterial Blood Supply 85 percent Brain originates from the Common carotid artery First bifurcation of the aorta Internal Carotid Arteries Arise from bifurcation of the aorta to the anterior circulation of the brain Cerebral arteries Branch from the subclavian arteries Supply most of the posterior circulation of the brain

Subarachnoid space enter

Villi becomes obstructed leads to Communicating Hydrocephalus.

Pia Mater o Innermost thin, transport layer that hugs the brain closely and extends into every fold of the brains surface.

Cerebrospinal Fluid: CSF o Clear and colorless fluid that is produced in the choroid plexus of the ventricles. o Circulates around the brain and spinal cord. Four ventricles Right and Left Ventricle 3rd and 4th ventricle Intraventricular foramen/ Foramen of monro- two lateral ventricles open. Third and fourth- connect via the Aqueduct of Sylvius. Fuorth Ventricle- drains CSF into the subarachnoid space on the surface of the brain and spinal cord. CSF- Drained in the arachnoid villi Obstructive hypothalamus- blockage of the CSF. CSF- important in the immune and metabolic functions. Rate production: 500 ml per day Ventricles and Subarachnoid space- 150 ml of fluid. Composition of CSF- blood plasma

o Basilar arteries 15 Two branches of the posterior cerebral arteries Posterior portion of the circulation andanterior carotid circulation remain separate. Circle of Willis- provide collateral circulation if one vessels supplying it becomes occluded or ligated. Aneurysms- outpouchings of the BV due to vessel wall weakness. o Hemorrhagic stroke veins- does not follow the arterial circulation
veins--- brains surface --- larger veins --- subarachnoid spaceDural Sinuses

Resembles horse tail. Meninges- protect the spinal cord.

The network of sinuses carries venous outflow From the brain and empties into the Internal Jugular veins, returning the blood into the heart. Cerebral Veins- they do not have valves to prevent blood from flowing backward and depend on gravity and BP for blood flow BLOOD BRAIN BARRIER: Endothelial cells of the brains capillaries. CNS- inaccessible to many substances that circulates in the blood plasma. CSF filter: astrocytes Capillary Endothelial Cells Blood brain barrier has a protective function which can be altered by: Trauma Cerebral edema Cerebral Hypoxemia The spinal cord: extending from the cerebral hemispheres. Connection between the brain and periphery 45 cm long and aboutthickness of a finger Foramen magnum (base of the skull) lower border of the first lumbar vertebra. Conus Medullaris- fibrous band that tapers the spinal cord. Cauda Equina- continuing below the second lumbar space. o Nerve roots that extend beyond the conus

Cross sectional view: (inside) H- shaped central core of nerve cell bodies ( gray matter) Outside- surrounded by ascending and descending tracts (White matter) Lower part of the H Broader than the upper portion Corresponds to the anterior horns Anterior horns: Contain cells with fibers that form anterior roots and are essential for voluntary and reflex activity of muscles. Posterior portion: contains cells- serve as a relay station in the sensory / reflex pattern. Lateral horn: thoracic region of the spinal cord projection from each side at the crossbar ofH-shaped structure of gray metter. They give rise to the autonomic fibers of sympathetic division. Fibers spinal cord fibers are released into thoracic and lumbar segments Spinal tracts: White matter of the spinal is composed of: Myelinated sheath Unmyelinated sheath Glial cells- fast conducting myelinated fibers Tracts- fiber bundles + common function 6 ascending tracts: Fasciculus Cuneatus and Gravilus/ posterior columns o deep touch, pressure vinbration, position, passive motion FIbers opposite side of medulla cerebral cortex Anterior and posterior spinocerebellar tracts o conduct sensory impulses from muscle spindles o coordinated muscle contraction o Terminate in the cerebellum

 Anterior and lateral spinothalamic tracts- conduction of pain, temp, proprioception, fine touch, and vibratory sense. o Cross opposite side of the cord- ascend to the brain- terminates in the thalamus. Anterior and lateral corticospinal tract Conduction Opposite side of the brain Medulla Voluntary muscle activity The other 3 vestibulospinal tracts o Descend uncrossed o Involved in autonomic functions o Sweating o Pupil dilatation o Circulation o Involuntary muscle control Corticobullar: voluntary need Facial muscle movement Rubrospinal and reticulospinal Involuntary muscle movement Vertebral column: 7 cervical 12 Thoracic 5 Lumbar 5 fused mass vertebrae Nerve roots exit from the vertebral column through the intervertebral foramina Vertebrae separated by disks, except for the first and 2nd cervical, the sacral and coccygeal vertebrae. Vertebra- ventral solid body - Dorsal segment/ arch Arch- two pedicles Two laminae Vertebral body Arch Pedicles Laminae encase and protect the spinal cord.

The peripheral nervous system: Cranial nerves Spinal nerves ANS CRANIAL NERVES Cerebral hemisphere: I Olfactory Sensory Sense of smell II Optic S Visual Activity Visual fields Mid brain: III Occulomotor Motor Muscles that move the eye lid, pupillary constriction, less accomodation IV Pons: V Troclhear Trigeminal Motor Mixed Muscles that move the eye facial sensation Corneal Reflex Mastication Muscles that move the eye Facial Expression Muscle Movement Salivation, tearing, taste Sensation in the ear Taste Sensation in pharynx and tongue Muscles of Pharynx, larynx, and soft palate Sensation in external ear, Pharynx, larynx, thoracic and abdominal viscera Parasympathetic innervation of pharynx and abdominal organs. Stenocleidomastoid Trapezius Muscles movement of the tongue

VI VII

Abducens Facial

Motor Mixed

IX

Glossopharyngeal M

Vagus

Mixed

XI XII

Spinal Accessory Motor Hypoglossal Motor

SPINAL NERVES 31 PAIRS OF SPINAL NERVES: 8 Cervical 12 Thoracic 5 Lumbar 5 Sacral 1 Coccygeal Spinal Nerve: Ventral body Dorsal Sensory impulses and transmit sensory impulses Dermatomes Location: Specific areas Dermatomes to the Dorsal horn ganglia Dorsal sensory fibers- somatic - Carrying information about pain, temp, touch, and position sense - From the tendons, joints and body surfaces - Visceral, carrying information from internal organs Visceral fibers of ventral root - Autonomic Fibers - Controls the cardiac muscles and glandular secretions Autonomic Nervous system Regulates activities of internal organs. Such as the heart, lungs, BV, digestive organs and glands. Maintenance and restoration of internal homeostasis Sympathetic Nervous system fight or flight response Parasympathetic Nervous System visceral functions ANS most body organs - Regulated by the centers of the spinal cord, brain stem and hypothalamus. -

motor and transmit impulses from the spinal cord to the body

ANS PREGANGLIONIC NEURON o Located in the brain or spinal cord o Extends to the autonomic ganglia POSTGANGLIONIC NEURON o Located in the autonomic ganglia o Axon synapses with the target tissue and innervates the effector organ These responses are sustained far longer than neurogenic responses to ensure maximal functional efficiency on the part of receptor organs, such as blood vessels. Hypothalamus subcortical center for the regulation of visceral and somatic activities, serving an inhibitory- excitatory role in the ANS. Link the ANS with the thalamus, cortex, olfactory apparatus, and the pituitary gland. Mechanisms for the control of visceral and somatic reaction that were originally Control of metabolic process, fat, carbo, h2o metabolism, regulation of BT, arterial pressure, mascular and glandular activity of the GI tract, control of genital functions, sleep cycle.

Autonomic Nervous System: Anatomical Functional Sympathetic Nervous System Fight/ Flight response Physical and emotional causes: Increase sympathetic impulses Bronchioles dilate which may cause easy gas exchange. Heart contraction are stronger and faster. Arteries of the heart and voluntary muscles dilate which carries more blood to these organs. Peripheral blood vessels constrict w/c causes cold skin Liver releases glucose which causes quick energy. Decrease peristalsis. Hair stands on the end. Increase perspiration. o Norepinephrine- noradrenaline o Location: Thoracic Lumbar located @ the spinal cords Sympathetic discharge, same as if the body has been injected with adrenaline. Axons/ preganglionic- C8 or 2nd / 3rd thoracic segment Postganglionic supply the extremities and are distributed to BV, sweat glands, smooth muscle tissue in the skin. Prevertebral plexus Supply: o Head and neck o Thorax o Abdomen and plexus Solar plexus Supply: o Adrenal glands o Kidneys o Liver o Spleen o Stomach

o Duodenum o T4 T1 Sympathetic syndromes: