102BMS

Human Physiology in Health and

Disease

Neurophysiology Lecture 1
 Module Learning Outcomes
Neurophysiology
102BMSAims Lectures 1 + 2
DemonstrateNeurophysiology
a broad knowledge
Lectures 1and
+ 2 appreciation of human

physiology in health at both a systems and cellular level.

Apply knowledge of normal human physiology,

pathophysiology and pharmacology to an understanding
disease states and their treatment.

Communicate scientific information in a coherent and concise

manner in either a written or oral format.

Work effectively with others in preparation and delivery of a group

task.
Neurophysiology lectures: Content

Physiological control and integration:

Nervous system: function, organisation, differentiation between
central and peripheral nervous systems and their respective sub-
divisions (somatic and autonomic (sympathetic and
parasympathetic)).

neurones and supporting cells, electrical activity in axons, synaptic

transmission, neurotransmitters.
 What is the Nervous System?

Electrochemical communication system

The human nervous system controls

everything from breathing and
producing digestive enzymes, memory,
cognitive functions and consciousness
systems
OrganisationNeurophysLectures 1 +
2
Central Nervous System
Brain and Spinal Cord

Peripheral Nervous System

Cranial Nerves and Spinal Nerves

Autonomic Nervous System (ANS)

Anatomical Divisions 1 + 2

Ganglia part of PNS

Collection of neuronal cell bodies
Organisation of the Nervous System
102BMS
Neurophysiology Lectures 1 + 2

Dr Jane Furness
Jane.furness@coventry.ac
.uk
CNS - The Brain

1.4Kg (average)

Simple Neural Tube folds into the most complex and mysterious organ of the
body

What are the outcomes if problems arise at early stage development ?

100 billion neurons Probably another 100 billion non-neuron

Brain Structures and
Functions
Four lobes of the Cerebral Cortex

Planning,
emotion, mood Sensory information
behaviour, Touch, pain temperature
motor function sensation
smell

Visual
information
processing

Auditory information, Cerebellum

interpretation of Coordination and
speech, memory balance
 The Brain Matter

‘Information super
Neurons
highway’

Glial cells
Connects different
Blood areas of brain
vessels
Sensory and motor
pathways
The CNS: GLIAL CELLS

• Approximately 90% of cells in the CNS are not neurons

• Glial cells commonly called neuroglia or simply glia

• Greek for "glue“

• Glial cells do not initiate or conduct nerve impulses

• But they are responsible for:

• Provide support and nutrition
• Maintain homeostasis
• Remove dead neurons
• Destroy pathogens
• Form myelin
Somatic Nervous System = Voluntary Nervous System

Single motor neuron travels directly to the skeletal muscle without the
mediation of ganglia

Consists of:

• Peripheral nerve fibres that send sensory information to the CNS

• Motor nerve fibres that project to skeletal muscle

• Reflex arc- neural circuit automatic link between a sensory input and
a specific motor output
Sensory and motor pathways
Sensory Receptors
Receptor type are activated by stimuli
Receptors Stimuli

Baroreceptors pressure
Chemoreceptors chemical
Mechanoreceptors mechanical stress or strain

Nociceptors pain
Photoreceptors light
Proprioceptors sense of position
Thermoreceptors temperature, either heat, cold or
both
Gustatory receptors Chemicals in food
Reflex Arcs
 Spinal Reflexes

Fast / automatic responses to a specific stimuli, preserve homeostasis

Autonomic Nervous System

Involuntary division of the nervous system Acts without conscious

awareness Nerve impulses go to following effectors: Smooth muscle /
Cardiac muscle / Glands
Autonomic Nervous System (ANS)

• Functions to maintain homeostasis by automatic control

• Exerts influence by rapid transmission of electrical impulses via

nerve fibres

• Coordinates cardiovascular, respiratory, digestive, urinary &

reproductive functions

• Visceral effectors do not depend on the ANS to function

Thoracolumbar division

Travel with spinal nerves T1 – L2

Neurons innervate organs in the head,

chest, abdomen and pelvis

NE is the neurotransmitter so actions are

adrenergic (for adrenaline)
Sympathetic – Flight or Fight
Stimulation of preganglionic neurons
Release acetylcholine (ACh) at
• Heightened mental
synapses with ganglionic neurons alertness
=excitatory
Release neurotransmitters at • Increased metabolic rate
specific target organs
• Reduced digestive &
Most sympathetic ganglionic neurons
urinary functions
release noradrenaline (NA)
Andrenergic • Activation energy reserves
Some release Ach
e.g. brain, skin skeletal muscle
• Increased respiratory rate
& bronchodilation
• Increased heart rate &
Effects of NA at postsynaptic
membrane persist for up to 30 seconds
blood pressure
Significantly longer than duration of • Activation sweat glands
Ach effects (20msecs)
PARASYMPATHETIC

Neurotransmitter is ACh so
actions classified as
cholinergic
Acts to oppose/balance the actions of
sympathetic division

Does not discharge as a complete system;

only affects specific organs (e.g.
stomach, eye) – so no massive unpleasant
symptoms upon activation

In non-emergencies - allows us to "rest" and

"digest“
Stimulation PNS Rest and Digest

• Constriction of pupils
All parasympathetic postganglionic fibres release
acetylcholine
Cholinergic • Decreased metabolic rate

Synthesised from acetyl coenzyme A (acetyl CoA) and • Decreased heart rate & blood
choline pressure
• Increased secretion by salivary
Two major receptors for acetylcholine & digestive glands
Nicotinic (nAChR)
Muscarinic (mAChR)
• Increased motility & blood flow in
Effects of ACh are short lived digestive tract
As most is inactivated by acetylcholinesterase (AChE)
Thus effects are localised & last few seconds at most • Stimulation of urination &
defecation
• Sexual arousal & stimulation of
sexual glands
Differences between Sympathetic and Parasympathetic

Sympathetic nervous system (SNS)

Short preganglionic fibres
Long postganglionic fibres

Parasympathetic nervous system

(PNS)
Long preganglionic fibres
Short postganglionic fibres
Dual innervation by the ANS

Most organs are – dual innervation

Consider the heart

Parasympathetic (vagal) innervation: ↓ contraction

Sympathetic innervation ↑ contraction

However, at rest vagal innervation dominates heart rate

The Neuron2

Dr Jane Furness
Jane.furness@coventry.ac
.uk
DENDRITES

• Tree-like extensions at the beginning of a neuron

• Help increase the surface area of the cell body and are covered with synapses

• Receive information from other neurons and transmit electrical stimulation to the
cell body
 THE CELL BODY

• Where the signals from the dendrites are joined/integrated and passed on

• The cell body and the nucleus do not play an active role in the transmission of
the neural signal
• Serve to maintain the cell and keep the neuron functional
THE AXON

Long cytoplasmic process

Propagates an action potential (electrical impulse)
Schwann cell provides and maintains myelin sheaths on axons
‘electrical tape’
Myelin sheath wraps many times around the axon
 MYELINATED NEURONS
• The axons of many neurons are encased in a fatty myelin sheath
(schwann cells) – like the plastic covering of electrical wire!
• Function: to speed up the rate of electrical conduction
• Where the sheath of one Schwann cell meets the next, the axon is
unprotected.
• The sodium channels of myelinated neurons are confined to these
spots (called nodes of Ranvier).
Classification of Neurons

Sensory neuron /10 million

(afferent neurons)

Interneuron / 20 billion
(located between sensory
and motor neurons

Motor neuron / half million

(efferent neurons)

Monitor Internal / External environment / Process this information

Direct behaviour and body processes
Structural Classifications of Neurons
Neuroglia of the PNS
NEURONS VERSUS OTHER CELLS?

Neurons are similar to other cells in the body because:

• Surrounded by a cell membrane
• Have a nucleus that contains genes
• Contain cytoplasm, mitochondria and other organelles
• Carry out basic cellular processes such as protein synthesis and energy
production

Neurons differ from other cells in the body because:

• Have specialised extensions called dendrites and axons
• Communicate with each other through an electrochemical process – via
electrical impulses called ‘Action Potentials’ (AP).
• Contain some specialised structures (for example, synapses) and chemicals
(for example, neurotransmitters)
What happens when things go wrong
 When things go wrong…Demyelinating Diseases

Multiple Sclerosis (MS) / autoimmune disease directed

against the myelin or oligodentrocytes
Trigger unclear / viral antigen / higher incidence in
temperate regions than tropics, where childhood was
spent not adulthood
Linked to a number of genetic alleles for the human
leukocyte antigen (HLA) system
Twice as common in women as men

Most common demyelinating disease of the PNS

Landry-Guillain-Barre syndrome
Ascending neurological syndrome develops
Autoimmunity to myelin sheath. Patients generally recover
as the PNS has ability to remyelinate
Diseases of the Nervous System

• We are unable to generate new neurons with age and this leads to cognitive
decline

• Dementia (from Latin demens, dement- 'out of one's mind'):

• a chronic or persistent disorder of the mental processes caused by brain
disease or injury and marked by memory disorders, personality changes,
and impaired reasoning

• The impairment is over and above what is to be expected from normal ageing

• Neuroplasticity
Alzheimer's Disease

• Most common type of dementia,

• 70% of people in care homes have
first described by the German dementia or severe memory loss
neurologist Alois Alzheimer
• 225,000 will develop dementia this
year
• Chronic neurodegenerative disease
with an insidious onset and one person every 3 minutes will
progressive but slow decline. develop dementia
• Women have slightly greater chance
• Most cases develop aged 65+years developing disease
• 1 in 20 over 65years
• 1 in 6 over the age of 80
• 40,000 with early onset (before Can vary greatly from person to person
65 years)
Dementia and Alzheimer’s

• Risk developing Alzheimer's increases with age

• 70% of people in care homes have dementia or severe memory loss

• 225,000 will develop dementia this year

one person every 3 minutes will develop dementia

• Women have slightly greater chance developing disease

• Can vary greatly from person to person
 Recognised to have 3 broad stages
1. Mild
• Gradual loss of brain function
• Minor memory problems
• ‘forgetfulness’

2. Moderate
• Confabulation
• invent events/conversations to fill in gaps in memory
• Disorientation
• Language problems
• Inability to find correct word (dysphasia)
• These symptoms can result in alarm & frustration/mood changes

3. Severe
• Severe disorientation & confusion
• Violence
• Hallucinations & paranoid delusions
• Ignore personal hygiene, incontinence
 Aetiology

• Number of changes occur in the

structure and functioning of the cells in
the brain
• ‘sticky protein’, Beta-amyloid builds up
between neurons
• Protein ‘Tau’ develops tangles inside
neurons
• Microglia cells have a role
• Exact cause unknown

Thought that it is unlikely to be

a single cause The Amyloid Theory
 11 Hallmarks – Signs and Symptoms

• Memory loss that disrupts daily life

• Challenges in planning or solving problems
• Difficulty completing familiar tasks at home, work, leisure
• Confusion with time or place
• Trouble understanding visual images and spatial relationships
• New problems with words in speaking or writing
• Misplacing things and losing the ability to retrace steps
• Decreased or poor judgement
• Changes in mood and personality
• Withdrawing from work or social activities
• Depression very common with AD
 Risk Factors for Dementia

• Age • CAD
• Family history • Type 2 Diabetes
• MCI • High Blood Pressure High
• Down’s syndrome total blood cholesterol levels
• Genetics • Obesity
• Ethnicity
• Severe head/whiplash
injury
Images from Alzheimer’s Association
Diagnosis
• Cognitive testing
• Physical examination
• Laboratory investigations
• Imaging (CT / MRI)
• Patient approach
• Personalised care
• Education, support and
resources
• Pharmacological and
nonpharmacological treatments /
therapies
Goals of Treatment
• To enhance or prevent decline in
cognitive function
• Reduce behavioural and
psychological symptoms
• Improve quality of life for both
individual and carer
• Both pharmacological and non-
pharmacological treatments
should be used
 Motor Neuron Disease (MND)
• Rare condition where motor neurons damaged / destroyed
• Motor neurons control important muscle activity, such as:
• Gripping, walking, speaking, swallowing, breathing
• As the condition progresses, sufferers will find these activities
increasingly difficult (and eventually impossible) to do

• Affects 2 in every 100,000 people in the UK each year

• Generally develops in those aged 60+yrs, slightly higher incidence in men

than women
• Researchers believe that the cause is probably a combination of genetic and
environmental factors that build up throughout life

• There is no single test to diagnose MND and diagnosis is based mainly on

the opinion of a neurologist

• No cure & is a severely life-shortening condition for most people

Other Examples……..

• Parkinson's disease
• Reduction in dopamine production

• Depression

• Biopolar disorder

• Schizophrenia
Any Questions?

Please remember to check

Moodle before each session
and complete the preparatory
work- especially for
workshops

Please e-mail or come to

academic surgery if you need
any clarification

See you next week!

Reading
Anatomy and Physiology textbooks

Anatomy and Physiology from Kortext

Fundamentals of Anatomy and Physiology, 10th edn.

Martini, F.H., Nath, J.L. and Bartholomew, E.F. (2015)

Dr Jane Furness
Jane.furness@coventry.ac
.uk