REVIEW OF ANATOMY AND PHYSIOLOGY OF THE NERVOUS SYSTEM

KRISTINE JUNE M. CAPILI, M.D.

 Controls all motor, sensory, autonomic, cognitive, and behavioral activities

Function of the Nervous System

Structural Classification
Central nervous system
Brain Spinal cord

Peripheral nervous system

Cranial nerves Spinal nerves Sensory receptors

Functional Classification
Sensory/ afferent division
Somatic sensory fibers Visceral sensory fibers

Motor/ efferent division

Somatic nervous system Autonomic nervous system
Parasympathetic nervous system Sympathetic nervous system

NEUROTRANSMITTERS
Communicate messages from one neuron to another or from a neuron to a specific target tissue Manufactured and stored in synaptic vesicles Enable conduction of impulses across the synaptic cleft Has an affinity for specific receptors in the postsynaptic bulb

Neurotransmitters
Communicate messages from one neuron to another or to a specific target tissue
Neurotransmitters can potentiate, terminate, or modulate a specific action or can excite or inhibit a target cell See Table 60-1 Many neurologic disorders are due to imbalance in neurotransmitters

NEUROTRANSMITTERS
Acetylcholine (major transmitter of the parasympathetic nervous system) Serotonin Dopamine Norepinephrine (major transmitter of the sympathetic nervous sytem) Gamma-aminobutyric acid (GABA) Enkephalin, endorphin

Brain
Cerebral gray matter/ cortex
Frontal lobe Parietal lobe Occipital lobe Temporal lobe Central lobe (insula)

Cerebral white matter

Corpus callosum Hippocampus Basal ganglia

Cerebral cortex
Both the left and right cortex interpret sensory data, store memory, learn and form concepts
LEFT CORTEX
Has dominance for systematic analysis, language speech, mathematics, abstraction, and reasoning

RIGHT CORTEX
Has dominance for assimilation and activities such as dancing, gymnastics, music and art appreciation

Frontal lobe
Precentral gyrus
Primary motor cortex Controls voluntary motor activities

Premotor area Brocas area Prefrontal areas

Frontal lobe
Precentral gyrus Premotor area
Also associated with voluntary motor activities

Brocas area Prefrontal areas

Frontal lobe
Precentral gyrus Premotor area Brocas area
Motor speech

Prefrontal areas

Frontal lobe
Precentral gyrus Premotor area Brocas area Prefrontal areas
Control attention span over time (concentration) Motivation Ability to formulate or select goals Ability to plan, initiate, maintain or terminate actions Ability to self-monitor, use feedback Contribute to reasoning, problem solving activities and emotional stability by inhibiting the limbic areas of the cerebrum

Parietal lobe
Primary somatic area
Postcentral gyrus Primary receptive (interpretation) areas for tactile sensations such as temperature, touch and pressure

Somatic association area Right parietal areas Left parietal areas

Parietal lobe
Primary somatic area Somatic association area
Same Concept formation and abstraction

Right parietal areas Left parietal areas

Parietal lobe
Primary somatic area Somatic association area Right parietal areas
Dominant for spatial orientation and awareness of size and shape (stereognosis) and body position

Left parietal areas

Assist with right-left orientation and mathematics

Occipital lobe
Primary visual receptive (interpretation) area Visual association area
Where visual memories are stored, which contribute to a persons ability to visually recognize and understand his or her environment

Temporal lobe
Primary auditory receptive (interpretation) area Sensory auditory association areas
Left
Spoken language Memories are stored here

Right
Sound memories such as music, animal sounds, noises are stored here

Wernickes area
For language comprehension

Central lobe (insula)

Located deep within the lateral sulcus Nerve fibers for taste pass through the parietal lobe to the insualr lobe

Meninges and Related Structures

Cross Section of the Spinal Cord Showing the Major Spinal Tracts

FUNCTIONS OF THE SPINAL CORD AND SPINAL ROOTS

Roots of 31 pairs of spinal nerves arise from the cord Separates into posterior roots (sensory) and anterior roots (motor) Damage to posterior roots result in loss of sensation Damage to anterior roots result in flaccid paralysis

FUNCTIONS OF THE SPINAL CORD AND SPINAL ROOTS

Message conduction by ascending (sensory) and descending (motor) pathways Ascending tracts
Lateral spinothalamic tracts Anterior spinothalamic tracts
Carry sensation for pain, temperature, and crude touch

Posterior tracts
Carry sensation for fine touch and vibration

FUNCTIONS OF THE SPINAL CORD AND SPINAL ROOTS

Descending tracts
Lateral and anterior corticospinal (pyramidal) tracts
Fibers originate in the motor cortex of the brain and travel to the brainstem and down the spinal cord Mediate voluntary purposeful movements and stimulate certain muscular actions while inhibiting others Carry fibers that inhibit muscle tone

FUNCTIONS OF THE SPINAL CORD AND SPINAL ROOTS

Descending tracts
Rubrospinal, anterior and lateral reticulospinal, and tectospinal (extrapyramidal) tracts
Pathways between the cerebral cortex, basal ganglia, brainstem and spinal cord outside the pyramidal tract Maintain muscle tone and gross body movements

Cranial Nerves

SPINAL NERVES
31 pairs; 8 cervical, 12 thoracic, 5 lumbar, 5 sacral, 1 coccygeal The dorsal roots are sensory and transmit sensory impulses from specific areas of the body to the dorsal ganglia DERMATOMES
Is the band of skin innervated by the sensory root (dorsal root) of a single spinal nerve

The ventral roots are motor and transmit impulses from the spinal cord to the body

UPPER AND LOWER MOTOR NEURONS

Upper motor neurons
Originate in the cerebral cortex, the cerebellum,, and the brain stem and modulate the activity of the lower motor neurons UMN fibers make up the descending motor pathways and are located entirely within the CNS

UPPER AND LOWER MOTOR NEURONS

Lower motor neurons
Are located either in the anterior horn of the spinal cord gray matter or within cranial nerve nuclei in the brain stem Axons of both extend through peripheral nerves and terminate in skeletal muscle Are located in both the CNS and the peripheral nervous system

COMPARISON OF UMN AND LMN LESIONS

UMN LESIONS
Loss of voluntary control Increased muscle tone Muscle spasticity No muscle atrophy Hyperactive and abnormal reflexes

LMN LESIONS
Loss of voluntary control Decreased muscle tone Flaccid muscle paralysis Muscle atrophy Absent or decreased reflexes

Dermatome Distribution

Autonomic Nervous System

Functions to regulates activities of internal organs and to maintain and restore internal homeostasis Sympathetic NS
Fight or flight responses Main neurotransmitter is norepinephrine

Parasympathetic NS
Controls mostly visceral functions

Regulated by centers in the spinal cord, brain stem, and hypothalamus

Anatomy of the Autonomic Nervous System

Each time anyone comes in contact with us, they must become different and better people because of having met us. We must radiate Gods love. We must know that we have been created for greater things, not just to be a number in the world, not just to go for diplomas and degrees, this work and that work. We have been created in order to love and to be loved. Love does not measure it just gives.

- Mother Theresa -