The nervous system is considered to be the most complex

morphological structure of the human body . It consists of over 100

billion neurons that provide integration and coordination of the body
with the external and internal environment. It can be considered a real
computer, which constantly receives information from external or
internal environment, analyzes the information received and develop
appropriate responses.
The nervous system is divided morphologically and functionally :
- Somatic nervous system receives information from musculo
-articular or cutaneous receptors as well as sensory information ( visual,
auditory, gustatory , olfactory or equilibrium) . It is controlled voluntarily
and its main effector organ is the striated muscle ;
- Autonomic nervous system receives information from
osmoreceptors , baroreceptors and chemoreceptors located in the
structure of different tissues or organs . It can not be controlled

Both the somatic nervous system and the autonomic have two distinct
components: a central component (central nervous system ) and a
peripheral component ( peripheral nervous system )

The nervous system is formed of of parenchyma and stroma .

CNS parenchyma consists of all nerve cells. Stroma is composed of glial cells , blood vessels and fine
connective
elements .
At all levels of the CNS there are two different structures, morphologically and functionally :
Gray

matter
matter

White

The gray matter is arranged in columns ( bone marrow ) , islands (in the brainstem and diencephalon )
or forms the cortex (the area of the cerebral hemispheres and cerebellum).
Histologically it is formed of:
Neuron bodies
Dendrites
The initial unmyelinated portion of the axon
Glial cells
Capillary network which allow a highly oxidative metabolism specific for neurons
Nerve cells have multiple extensions that connect to each other through various synapses forming a
plexiform network called neuropil.
The white matter is composed of:
axons arranged parallel, grouped in bundles or cords
Between the axons there are many glial cells , and in particular oligodendrocyte that have a role in the
formation of the myelin sheath surrounding axons .
Capillaries (less numerous in the white matter)
Myelinated

Macroscopically, the spinal

cord presents:
- Anterior median fissure;
- Posterior median sulcus;
- Two collateral grooves
arranged symmetrically on the
side of the median plane,
places of emergence of the
anterior roots of the spinal
nerves;
- Two collateral grooves ,
arranged a side of posterior
median sulcus, representing
the place of penetration of the
posterior spinal nerve roots in
the spinal cord.
The gray matter is arranged in the center, surrounded by white matter. In
longitudinal section it has the form of a continuous column for the entire spinal cord
length. In cross-section is typically arranged, symmetrically in relation to the median
plane, in the form of the letter "H" or two crescent joined together by a strip of gray
matter called the gray commissure.
Gray commissure is traversed throughout its length by the ependymal canal,

Each symmetrical half of the gray matter

presents :
- An anterior horn, shorter and with a greater
transverse diameter consisting of a head and a
base. It contains large motor neurons, whose axons
form the anterior root of the spinal nerve .
- A posterior horn narrower and longer ,
consisting of a head, cervix and base. It contains
smaller oval sensory or association neurons
- A lateral horn more obvious between C7 - L2
disposed between the base of the anterior horn and
posterior horn base , consisting of small neurons ,
spherical , fusiform or oval with autonomic
function . They are sympathetic preganglionic
autonomic neurons ( cervico -dorsal region of the
spinal cord ) or parasympathetic ( sacral region of
the spinal cord ) .
- The reticular substance ( Deiters ) consists of
small islands of gray matter separated by fine

Histologically, the gray matter contains neurons, glial cells, amyelinated nerve fibers
representing dendrites and axons, blood vessels and a small amount of perivascular
connective tissue .
In anterior horns are many types of neurons. The most numerous are the alpha neurons
. These neurons are called radicular neurons because their axons pass in white matter ,
receive the myelin sheath and enters the anterior spinal nerve root structure. They are
stellate large, multipolar with a diameter between 60-120 m. Their dendrites make
synapses with pyramidal and extrapyramidal tract axons or with the axons of sensory
neurons in the posterior horns.
These motor neurons innervate striated skeletal muscle fibers .
Gamma neurons are multipolar neurons , small size , with various shapes that innervate
muscle fibers within motor neuromuscular spindles.

The glial cells in the gray matter

are
the
parenchymal
glial
cell(
macroglia,
protoplasmic
macroglia,
microglia,
oligodendrocyte rare) and epithelial
glial cell(ependymal) that guards
the ependymal canal.

The posterior horns contain sensory neurons , polymorphic ,

oval , fusiform , of varying sizes , from 6-70 micrometres
arranged in several layers ( layer Rolando , the Clarke etc)
incompletely defined. Their dendrites realize synapses in the
posterior horn with axons of the pseudo-unipolar neurons in the
spinal ganglia and their axons pass in white matter , entering
the constitution of the ascending tracts.
Other neurons in the posterior horns are association neurons ,
which connect sensory neurons and the motor of the anterior
horns at the same level or at different levels of the neurax.
The lateral horns have autonomic neurons: sensitive in the
posterior half and motor, preganglionic in the anterior half.
They are oval or fusiform neurons with a diameter of 15 to 20
m. Their dendrites realize synapses with the axons of sensory
neurons in the spinal ganglia. Their axon join the somatomotor fibers of the anterior roots, forming preganglionic fibers
that stop in the paravertebral sympathetic ganglia or pelvic
parasympathetic ganglia.

Regarding the length of the axon:

Golgi I- long axon neurons. Their axon passes in the white matter
of the spinal cord.
radicular neurons- anterior horn and anterior half of lateral hornforms the anterior root of the spinal nerve
cord neurons- posterior horn and posterior half of lateral hornascendant tracts
Golgi II- short axon neurons. Their axon doesnt leave the gray
matter. They have association role.
Regarding their function:
Sensory neurons (autonomic and somatic)
Motor neurons(autonomic and somatic)
Association neurons

Neuronal extensions (dendrites and axons) present in the gray matter are
devoid of myelin sheath and participate in the neuropil.

The white matter of the spinal cord is disposed outside the gray matter and is
organized into three pairs of cords :
- Anterior cords that communicate with each other through the white anterior
commissure exchanging nerve extensions;
- Lateral cords delimitated by the anterior and posterior roots of the spinal nerves ;
- Posterior cords disposed between the dorsal roots of the spinal nerves and the
posterior median sulcus.
The spinal cords white matter consists of myelinated nerve fibers grouped into
bundles . These fibers are either endogenous or exogenous .
The endogenous fibers are represented by axons that of neurons located in the
gray matter of the spinal cord at different levels. These fibers can be: short fibers and
long fibers.
Endogenous short fibers are called spino - spinal fibers because arise in the spinal cord
and realize synapses with other neurons in different levels of the spinal cord. This type
of fibers form the fundamental fascicle .
Endogenous long fibers have the perikaryon located in the dorsal horns of the spinal
cord and myelinated axons pass into the lateral or anterior cord and reach the thalamus
, cerebellum and brainstem . These fibers form the main ascendant sensitive fascicles:
- Spino - thalamic lateral fascicle located in the lateral cord, leading thermal and pain
sensitivity;
- Spino - thalamic anterior fascicle- anterior cord- tactile sensitivity ;
- Direct spino cerebellar fascicle (Flechsing) and cross spino cerebellar fascicle

Exogenous fibers are the myelinated axons with the neuronal body located outside the
spinal cord. Regarding their path these fibers are classified into: fibers ascending and
descending fibers .
I. exogenous ascending fibers have the perikaryon located in the spinal ganglion. Their
axons enter the spinal cord through the posterior root directly into the posterior cord , have
an ascendig path towards the medulla oblongata forming the spino - bulbar fascicles ( Goll
and Burdach ) . These bundles are sensitive and lead fine tactile sensitivity and conscious
proprioceptive sensitivity.
II . Exogenous descending fibers originate in the upper floors of the central nervous system
( cerebral cortex , midbrain , pons, medulla oblongata , cerebellum ) . The descending
tracts are large pyramidal and extrapyramidal pathways. They are effector pathways
controlling voluntary and involuntary motility.
The pyramid tracts called cortico -spinal pathways have the perikaryon located in the
cerebral cortex , the motor neocortex . In their descending path they go through the
cerebral peduncle, the pons and medulla oblongata , through the bulbar pyramids. Here,
the medial fibers cross forming the decussation of pyramids and the lateral ones do not
cross, thus forming in the spinal cord two fascicles with symetric arrangement regarding the
median plane:
-Direct pyramid fascicle- anterior cords of the white matter
-Cross pyramid fascicle- lateral cord of the white matter
The extrapyramid tracts have the perikaryon located both in the cortex and in various
nuclei located in the midbrain , pons, medulla , cerebellum . The main extrapyramid tracts
are Tecto -spinal fascicle, Rubro-spinal , nigro -spinal , olivo -spinal , reticulo -spinal etc .
Descending fibers , both pyramid and extrapyramid make synapses with motor neurons in

Formed of: - medulla

- pons
- midbrain
Gray matter: Aggregates of neurons (known
as nuclei or gray matter isles)- the
parenchyma
White matter: spino-talamic ascendant
tracts and cortico-spinal descendent tractsmyelinated axons

The stroma is formed of glial cells and

connective tissue septa with blood vessels
originating in the meninges.

In the brainstem the reticular substance is better

developed than in the spinal cord. It is made up of
islands of nerve cells, different in shape, size and
function, separated by many nerve fibers, more or less
organized in fascicles.
Regarding the histologic appearance of the nuclei of
the reticular substance two areas were described:
- The median area- rich in neurons:
- The lateral area- poorer in nerve cells.
The reticular substances nuclei receive afferences
directly from the spinal cord, the medulla and pons
nuclei, the cerebellum, hippothalamus and even from the
cerebral cortex. They send efferent fibers to the spinal
reticular substance, to autonomic neurons in the
brainstem, hypothalamus, thalamus and cerebral cortex.
In the nuclei of the reticular substance several groups of
dopaminergic neurons, noradrenergic and serotonergic
have been observed.

Called " intermediate brain " , diencephalon

consists of several nerve formations : the
thalamus , hypothalamus , metathalamus and
epithalamus .

The thalamus is a bulky mass of gray matter

located in the dorsal diencephalon . Its
structure is uneven because of the division of
neurons in several groups of nuclei. These
nuclei contain neurons Golgi type I with long
axons that project to the cerebral cortex and
Golgi type II neurons that have short axons with
association function.

The hypothalamus , located in the floor of the

third ventricle , consists of several nuclei :
anterior , middle and posterior . It receives
afferences from the retina, the olfactory
mucosa , the reticular substance and cerebral
cortex and sends efferent fibers to the
hippocampus, midbrain reticular substance and
to the autonomic nuclei of brainstem and spinal
cord. Also , the hypothalamus is connected
structurally with the neurohypophisys through
the anterior nuclei and controls the secretory
activity of the adenohypophysis by middle
nuclei . Hypothalamic nuclei also have
autonomic sympathetic and parasympathetic
function.

The metathalamusul is made up of four

neuronal groups known as the geniculate
bodies :
- Medial geniculate corpus - relay station for auditory

The cerebellum is located in the lower floor of the posterior skull, behind the brainstem ,
under the occipital lobe of the cerebral hemispheres .

It consists of :
- Two cerebellar hemispheres ( neo-cerebelum ) ;
- Vermis ( paleo-cerebellum ) an elongated midian part that joins the cerebellar hemispheres.

It is formed of gray matter and white matter.

The gray matter is disposed on the surface of the cerebellum and forms cerebellar cortex. It
has a thickness of about 1 mm and covers the cerebellar hemisphere and vermis . Inside the
cerebellar masses the gray matter forms islands called cerebellar nuclei (dentate,
emboliform , globose and fastigii) .

The white matter is located on the inside of the cerebellum consisting of afferent and efferent
myelinated nerve fibers.

The gray matter

The cortex of the cerebellum has a specific cellular
architecture. Thus, from the surface to the depth
three different layers are visible in light microscopy:
- Molecular layer;
- Purkinje cell layer;
- Granular layer.

The molecular layer is well developed. It consists of few stellate cells

and Golgi type II cell with associative function. It also contains many
dendrites of Purkinje cells from the underlying layer and axons
originating in the granular layer. The fibers are oriented both
perpendicular to the surface of the cerebellar cortex as well as
parallel to it. This layer contains numerous synapses being an
associative layer.
Purkinje cells layer consists of a single row of Purkinje cells . The
dendrites of these cells climb in the molecular layer where they
realize synapses with the " T " axon of the granular cells. Their axon
descends through the granular layer in white matter where it realizes
synapses with the neurons of the dentate nucleus. In the granular
layer, the Purkinje cell axons emit collaterals to neighboring making
axo - axonal synapses. The body Purkinje cell synapses with ' terminal
panier " cells present in the granular layer and with the hanger"
fibers originating in the pons nuclei.
The granular layer is made up of a large number of granular cells
( about 2 million/mm3 ) . Dendrites of these cells form a special
synapse called "cerebellar glomerulus". Cerebellar glomerulus is a
cluster of synapses made between granular cell dendrites and axons
of "muscle" cells or Golgi cell axons, wrapped by glial capsule.
Axons ascend to the molecular layer where they bifurcate in " T " and
create synapses with Purkinje cell dendrites .

The white matter

Contains myelinated afferent and efferent nerve fibers. These
fibers are either endogenous or exogenous .
Exogenous fibers are afferent fibers that have the perikaryon in
the spinal cord , the medulla , the pons, or even brain cortex.
They form spino - cerebellar tracts, bulbo - cerebellar , reticulo
cerebellar or cortico- ponto cerebellar tracts .
Some of these afferent fibers , called hanger fibers and muscle
fibers, performs special synapses in the cerebellar cortex.
Hanger fibers originate in the medullas ovlivar nucleus, they
pass through the cerebellar white substance as myelinated
fibers and penetrate the cerebellum cortex where they lose
their myelin sheath. After traversing the granular layer give
numerous branches ending "clinging like vines" around Purkinje
cell dendrites or body. They have direct excitatory action on
Purkinje cells and Golgi cells.
Muscle fibers are thick , wavy , highlighted more easily . They
come from many fascicles ( spino - , Ponto- , vestibulo - and
reticulo - cerebellar ) . In the cerebellar cortex they lose their
myelin sheath and give numerous branches forming the
cerebellar glomerulus. On their length they have short and thin

Endogenous fibers originate in the cerebellar cortex

or cerebellar nuclei. Purkinje cell axons, cross the
granular layer, they gain the myelin sheath and head
towards the cerebellar nuclei where they realize
synapses. The axons of these neurons form tracts
that go to the vestibular nuclei in the medulla, to the
reticular substance of the brainstem or to the red
nucleus or towards the thalamus.
Glial cells of the cerebellum are:
- Fibrous and protoplasmic astrocytes are more
numerous in the cerebellar cortex;
- The microglia present in both the gray matter and
white matter;
- The oligodendrocyte is present especially in the
white matter;
- Fananas glial cell in the molecular layer;
- Bergman glial cell also known as radial epithelial
cells present in the Purkinje cells layer.

Cerebral hemispheres are the most developed segment of the CNS , they occupy
over 80 % of the skull. They are formed of:
- The gray matter formes the cerebral cortex on the surface of hemispheres
with a thickness of 3-5 mm and the striatum at the base of the cerebral hemispheres;
- White substance disposed within the cerebral hemispheres , composed of
myelinated nerve fibers that come and go from the cerebral cortex or linking different
areas of the cerebral hemispheres.
The gray matter
The cortex represents the largest concentration of neurons and synapses. It is
considered that it could contain between 14 and 26 billion neurons. The number of
synapses is huge , some authors showing that there are about 1012 synapses/cm3 of
cerebral cortex . The total area of the cerebral cortex was estimated at 1924 cm2.
In terms of structural , functional and phylogenetic in the cerebral cortex there are
two areas :
paleo-cortex or allo-cortex , the oldest representing 1/12 of the surface of the
cortex . It has a cellullar arangement forming two layers of neurons and is located in
the hippocampus ;
neo-cortex or isocortex , the largest area ( dealing 11/12 of the surface of the
cortex ) and the structurally complex . It is composed of 6 layers of neurons .
Histologically, the cerebral cortex is formed of:

Cytoarchitectonics of the cerebral cortex

The distribution of neurons in the cerebral cortex is extremely varied,
which made many authors identify 20 to over 200 different cortical
areas morphologically different. With all this great variability in the
isocortex six layers of overlapped nerve cells can be identified. From
the surface to the depth of the cerebral hemispheres, there are :
- Molecular or plexiform layer , just under the meninges , is poor in
nerve cells, but is rich in dendrites and axons of neurons belonging to
the underlying layers . Neurons are fusiform , pyriform cells Cajal and
Golgi II cells with short axon . This layer has association function.
- External granular layer is richer in neurons than the above layer . It
consists of small granular cells, particularly neurons Golgi type II,
Martinotti cells with ascending axon and small and medium pyramidal
neurons. It has association function .
- External pyramidal layer consists mainly of small and medium-sized
pyramidal cells and rare granular neurons. Dendrites of pyramidal
cells move towards the surface of the cerebral cortex and they
branch especially in the molecular layer. The axon goes towards the
white matter of the cerebral hemispheres. It has motor function.
- Internal granular layer has a high density of granular neurons and
few medium size pyramidal cells small . It has receptor function.
- Internal pyramidal layer contains mainly pyramidal cells small ,
medium and large ones ( Betz cells ). Because of these large cells ,
some authors have called the internal pyramidal layer the ganglionar
layer. It has the motor function.
- Polymorphic layer consists of a mixture of the various cell sizes and

The uneven distribution of nerve cells in the isocortex led

to its division:
- Homeotypic isocortex (containing all 6 cell layers),
subdivided into:
- isocortex of frontal type- pyramidal cells;
- isocortex of parietal type- granular cells;
- Heterotypic isocortex (characterized by the almost
complete absence of some layers):
- Agranular isocortex type present in the motor area,
characterized by the absence of the granular layer and
the presence of a large number of pyramidal cells;
- Granular isocortex type characterized by the absence
of pyramidal cells and granular layers pronounced
development.
The allocortexul or arhipalium is characterized by a
reduced development and absence of stratification. Its
structure has only layers 1 and 6.

Myelo-architectonics of the cerebral cortex

Is formed by the arrangement of neuronal extensions
Neuronal extensions (dendrites and axons) in the
cerebral cortex are the amyelinic nerve fibers, afferent,
efferent or association. These fibers are classified into:
- Tangential fibers- horizontal, parallel to the surface,
grouped in layers
- Superficial stria or tangential plexus of Exner in the molecular
layer
- Lamina difibrosa located in the external granular layer (less
developed);
- Bechterew stria located in the superficial part of the external
pyramidal layer;
- External Baillarger's stria located in the internal granular layer;
- Internal Baillarger's stria located in the internal pyramidal layer;
- Infrastriated layer located in the polymorphic layer.
- Radial fibers are formed mainly by the dendrites and
axons of neurons that form afferent and efferent cortical
fascicles

The white matter

Represents the most voluminous component of the
cerebral hemispheres. Disposed under the cortex,
the white matter is formed only of nerve fibers
wrapped in myelin sheath and glial cells.
In its structure different nerve fibers categories can
be observed:
- Afferent fibers that form the sensory-sensory
pathways specific and nonspecific;
- Efferent or motor fibers that emerge from the
cortex;
- Association fibers:
-Unilateral association fibers
-Bilateral association fibers passing from one
hemisphere to the other, found in the structure of
the corpus callosum and white commissure
(anterior and posterior).

Glial cells of the cerebral hemispheres

Parenchymal glial cell- astrocyte, microglia
and oligodendrocyte
Epithelial (Ependymal) glial cells- covers the
cavities of the CNS, forming in the lateral
ventricle the choroid plexus.
Choroid Plexus
Are found in roof of 3rd & 4th
ventricles and walls of lateral
ventricles. Composed of
fibrovascular core of loose
connective tissue and blood vessels
covered by specialized ependymal
cells. These cells contain microvilli
and cilia on their apical surface.
Main function is to produce
cerebrospinal fluid. CSF passes from
ventricles to subarachnoid space and
then enters the venous circulation via

1. Dura mater (pachymeninges)

dense irregular connective tissue.
There is an epidural space above
and a subdural space below.
2. Arachnoid avascular connective
tissue covered on both sides by a
simple squamous epithelium.
Sends down fibrous trabeculae into
the subarachnoid space to connect
the arachnoid with the pia mater.
Subarachnoid space is filled with
CSF and communicates with the
ventricles of the brain; it also
contains blood vessels
(subarachnoid hemorrhage).
Arachnoid villi (Pacchioni
granules) perforate through the
dura mater, allowing CSF to flow
into the venous sinuses. In old
persons they can calcify generating
nodules.
3. Pia mater loose connective
tissue, very vascular. Partially
follows blood vessels that enter the
brain, resulting in a perivascular
space around these vessels lined by
pia mater. On its inner surface it is

Blood-Brain Barrier functional barrier

composed of endothelial cells with tight
junctions, their basement membranes, and
astrocyte vascular processes. It has
selective permeability.

Is formed of nerves and nervous ganglia

Nerve Fibers -- an axon or collection of axons, plus any surrounding
sheaths of ectodermal origin. The presence or absence of a sheath, and
the nature of the sheath (cytoplasm vs. myelin) are used to further
characterize nerve fibers.
1. Unmyelinated Fibers
a. Small axons in the PNS are embedded in clefts of the cytoplasm of
Schwann cells. Each Schwann cell can sheathe (but not myelinate) a
dozen axons.
b. In the CNS, the majority of axons are unmyelinated. The axons are NOT
sheathed by any type of cell.
2. Myelinated Fibers
Axons that become myelinated are generally larger than 1 M in diameter.
Myelin is deposited just beyond the axon hillock and continues to near the
region of termination of the axon.
a. Myelin is laid down by Schwann cells. The membranes of the Schwann
cell wrap around the axon several times and fuse to form a myelin sheath.
The sheath is interrupted by gaps called nodes of Ranvier which represent
the spaces between adjacent Schwann cells along the length of the axon.
A Schwann cell can only myelinate a single axon; however, each axon is
myelinated by several Schwann cells.
b. In the CNS, myelin is laid down by oligodendrocytes. Each cell can

Nerves = groups or bundles of nerve fibers covered by connective

tissue.
1. Epineurium the outer layer of dense connective tissue. It
surrounds several nerve bundles. Contains blood vessels and
lymphatics.
2. Perineurium connective tissue and flattened epithelial cells
that surrounds each bundle (fascicle) of nerve fibers. Cells are
joined by tight junctions to provide a barrier to passage of most
macromolecules (blood-nerve barrier).
3. Endoneurium thin layer of reticular fibers that surround
individual nerve fibers.

On the trail of the posterior spinal nerve

root in the spinal canal , there is one small ,
oval structure called the spinal ganglion. In
longitudinal section the following histological
structures are observed:
- Fibrous connective capsule on the outside ;
- A cortical area ;
- Axial zone .
The capsule is a connective, fibrous
structure tissue, composed of collagen fibers
arranged in lamellae and rare reticulin fibers
and fibroblasts . Fine connective tissue septa
and blood vessels penetrate inside the ganglion
forming the organs stroma.
Cortical area is disposed just under the
capsula and it is formed of a cluster of neurons
and glial cells. There are two types of neurons :
- Pseudounipolar somatosensory neurons ;
- Pseudounipolari autonomic-sensoty
neurons ;
The perikaryons are spherical shaped with
sizes ranging from 15 to 70 and even 120
microns . They have a single amyelinic
extension that forms a glomerulus surrounding
the neuronal body and then divides in two
branches:
-The axon penetrates the spinal cord
through the posterior root
-The dendrite- towards the periphery,
forming the sensory nervous ending
Both the neuronal body and its extension

They are formed of groups of neurons located on

the trail of vegetative nerves. Thus , one side and the
other of the spine there are two paravertebral
sympathetic chain ganglia; around some blood vessels,
or in the vicinity of some organs there are autonomic
nerve plexus ( celiac plexus , heart , etc. ) and in the
walls of internal organs there are intramural ganglia.
Autonomic ganglia, whether sympathetic or
parasympathetic , presents a similar structural
organization.
At the periphery the ganglion has a fibrous capsule
which sends inner connective septa containing blood
capillaries .
The neuronal bodies are arranged in small islands
between connective bundles and bundles of
myelinated axonal fibers ( preganglionic ) and
amyelinic (postganglionic ) . Perineuronal satellite cells
form a capsule enclosing each perikaryon isolating it
from the connective tissue.
Autonomic neurons are multipolar neurons with a
variable diameter of from 15 to 60 microns. They have
many dendrites of variable length and a single axon is
distributed towards effector organ ( smooth muscle
cells , glandular cells ).
In autonomic ganglia we can find cells with
endocrine function, secreting catecholamines