PLT COLLEGE, INC.

Bayombong, Nueva Vizcaya

Institute of Health Sciences –College of Nursing

Nursing Care Management (NCM 102)

Curative and Rehabilitative Nursing
rvous System

The nervous system is an electrochemical communication system that does 4 things:

1. It receives sensory messages from the external environment.

2. It organizes information and integrates it with already stored information.

3. It uses integrated information to send out messages to muscles and glands, producing organized movement and secretions.

4. It provides the basis for conscious experience.

The structure of the nervous system

1. The Central Nervous system - spinal cord and brain - consists of tracts. Tracts are bundles of axons forming a pathway
2. The Peripheral Nervous system - everything else - consists of nerves. Nerves are bundles of axons of sensory or motor neurons
existing outside of the CNS

a. Skeletal (somatic) - voluntary muscle control of skeletal muscles. This system controls the motor neurons and is under voluntary
control.

b. Autonomic NS - muscles and gland of internal organs (e.g. heart).

 A major difference between skeletal and autonomic NS is that a skeletal muscle is inactive when the motor neuron is not
sending it a signal. However, the autonomic motor neuron only modifies the activity of the visceral muscle that it acts on.
Visceral muscles have built in, nonneural mechanisms for generating activity.

The three types of Neurons

1. Sensory neurons - sends information from the sensory organs, through the nerves, into the CNS. The sensory Neuron is
stimulated by stimuli, send impulse to spinal cord
2. Motor neurons - carry messages from CNS, through nerves, to operate muscles and glands (the most of these - 100 billion at
least)
3. Interneurons - exist only within the CNS. They carry messages from 1 set of neurons to the other. They can bring information
from different sources together into one location in the CNS. An interneuron in the spinal cord simultaneously sends impulse to:
a. Motor neuron in the finger
b. to the brain

The structure of the Neuron

a. Cell body contains the nucleus and other things found in most cells. It also produces neurotransmitters which are stored in
synaptic vesicles.
b. Dendrites - receives incoming signals from other neurons. They look like plant roots.

c. Axons - a single tubelike fiber that is thicker and longer than Dendrites. It is used by the neuron to transmit an electrical impulse
to other neurons. They may be tiny or up to a meter in length.

d. Myelin sheath - a fatty white substance which grows around the axon. It speeds the neural impulse by insulating the axon
(increases conduction). Not all neurons have myelinated axons.

e. Axon terminal - the end of the axon.

f. Synapse - the area between the axon terminal and the dendrites. Neurons do not actually touch each other.

The sympathetic and parasympathetic divisions of the autonomic nervous system.

1. Sympathetic - arousal for defensive action (prepares body for fight or flight), increases heart rate and blood pressure, increases
blood sugar, dilates arteries to increase blood flow to muscles, relaxes the bladder, stimulates adrenal glands, and cools the body
with perspiration. This makes you alert and ready for action
2. Parasympathetic - When the stressor is over, this takes over. Calming, conserves energy, produces the opposite effect (Decreases
heart rate, etc)

The spinal cord

The spinal cord serves three important functions:

1. Organizes information to and from the brain.

2. Organizes certain reflexes.

3. Generates rhythmic components of locomotor movements.

Reflexes - involves an automatic response to stimuli.

The structures of the brain

1. The Central Core

a. Medulla

 hooked directly onto spinal cord

 controls breathing, digestion, heart rate

b. Cerebellum

 looks like a little brain

 in control of force and range of movement.

 helps initiate and control rapid limb movement (kicking, punching)

  plays a role in eye movement

 plays a role in body equilibrium when standing

c. Pons

 assists cerebellum in controlling movement and posture

d. Midbrain

 visual reflexes
 auditory reflex

 motivation of movement

e. Reticular formation

 involved in sleep and arousal, excites cerebral cortex

f. Thalamus

 the relay center of the brain

g. Hypothalamus

 connected with the limbic system and some consider it to be part of the Limbic system
 main purpose is to control the internal environment of the body. It does this by

 influences the pituitary gland - which releases hormones

 influences drive states such as thirst and hunger

 influences activity of the Autonomic NS

 involved in emotions

h. Endocrine system

 secrete hormones
 adrenal gland - secretes epinephrine and norepinephrine - regulates heart rate, blood pressure and blood sugar level

 Pituitary gland - responsible for growth, master gland

i. The Limbic system

 Hippocampus - memory for new events

 plays a role in emotional behavior
2. The Cerebral Cortex - gray matter

 newest portion of the brain

 covers the rest of the brain.

 about 1/8 inch thick, contains billions of neurons

 80% of total brain volume

 can be divided into 4 regions or lobes (occipital, temporal, parietal, frontal)

Cortical Areas

Primary motor area - located in the frontal lobe

 the finer the movement of a body part, the larger the area it takes up on the primary motor area.

Primary sensory areas - the more sensitive a body part is to perception, the larger area it takes up (i.e. the tongue)

Visual area - fibers from the right side of both eyes go to the right side of the brain.

Association areas - all other parts of the brain

 Receives input from the sensory areas

 Receives input from lower parts of the brain

 Involved in perception, thought, decision-making

Cerebral Hemispheres

Left hemisphere - responsible for speech, math computations, processes right visual area

Right hemisphere - spatial tasks, visualizing in 3-D, processes left visual filed

Communicate via Corpus Callosum

Split brain patients (read about in your text)

Other areas of the brain

Wernicke's area - in left temporal lobe in most people language comprehension.

Broca's area - usually on left hemisphere - speech production problems

The Central Nervous System
How do the Neurons communicate?

Action Potential - an electrical charge which is produced by a change in the chemical balance of the fluids inside and surrounding the
neurons.

 At resting state, the axon contains fluid that is made up of negatively charged ions and is surrounded by fluid that is
comprised of positively charged ions (polarization)
 Polarization is maintained by the cells ability to control whether or not some atoms are allowed in.

 When a nerve is stimulated by something (light, pressure, heat) it fires, the gates of the axon begin to open and positively
charged ions begin to enter the axons which “depolarize" the cell. This continues until the neuron reaches its threshold and
sends an impulse though the axon to the dendrite of the next neuron. Then it returns to its resting state.

 The action potential acts on an all-or none principle. It has to reach the threshold before it will fire, and then it fires
completely.

 This process occurs repeatedly at about 100 times per second.

 When the impulse gets to the end of the axon, it reaches the Axon terminal or presynaptic ending.

 The impulse is carried across the synapse by a neurotransmitter - when the action potential reaches the terminal,
neurotransmitter molecules are released into the synapse...some of which will bind to the postsynapticmembrane.

Neurotransmitter - a chemical substance - over 70 different ones identified

Once it crosses the gap, it binds to receptor sites on the dendrites (causing the gates to open) If the neurotransmitter doesn't fit the
receptor, it gets taken back up by the first neuron (reuptake)

Some Neurotransmitters

1. Ach - responsible for muscle communication, affects memory.

2. Serotonin - affects mood, eating behavior.

3. Dopamine

4. Endorphins - natural opiates - released in response to pain and vigorous exercise

So how do we know all of this about the brain?

 Brain imaging techniques

 PET

 MRI

 SPECT

 MEG