Nervous System And Neurological Disorders:

A Nursing Management Perspective

1. Which of the following is a component of the midbrain?

A. Cerebral hemisphere
B. Tegmentum C. Cerebellum D. Medulla oblongata

2. Which of the following is an insulating substance for the neuron?

A. Schwann cells

B. Myelin
C. Neuroglial cells D. Node of Ranvier

3. Which of the following neurotransmitters is released from the postganglionic parasympathetic axon terminal?
A. B. C. D. Acetylcholine Epinephrine Norepinephrine Dopamine

4. Which of the following best describes successive, rapid impulses recieved from a single neuron on the same synapse?
A. B. C. D. Temporal summation Spatial summation Actuation Facilitation

5. Which of the following is not part of the meninges surrounding the brain?
A. Dura mater
B. Anterior fossa C. Pia mater D. Endosteal layer

The Nervous System

A physical organ system like any other

The master controlling and communicating system of the body

3 Important Functions of the Nervous System:

It receives information from the environment and inside the body. It interprets the information it receives. It makes the body respond to the information.

Nervous System

Figure 11.1

Overview and Organization of the Nervous System

The Nervous System

Central Nervous System (CNS)

Peripheral Nervous System (PNS)

Brain

Spinal Cord

Motor Neurons

Sensory Neurons

Somatic Nervous System voluntary movements via skeletal muscles Sympathetic - Fight-or-Flight

Autonomic Nervous System organs, smooth muscles Parasympathetic - maintenance

Cells of the Nervous System

A Review of the Structure

The Neuron
Basic units of the nervous system Receive, integrate, and initiate body response Operate through electrical impulses

Provide an instant method of cellular communication with other neurons through chemical signals

The Neuron
Organization Billions of Neurons (estimates of 100 billion) Very complex interconnections Create systems/circuits that can function independently (parallel processing) Simple decisions passed to higher levels for that add additional information to create generate more complex decisions (hierarchical processing) Very expensive - less than 2% of weight but uses 20% of energy

Functional Classification of Neurons

Sensory (afferent) neurons Carry impulses from the sensory receptors Cutaneous sense organs Proprioceptors detect stretch or tension Motor (efferent) neurons Carry impulses from the central nervous systeM Interneurons (association neurons) Found in neural pathways in the central nervous system Connect sensory and motor neurons

More nerve terms

nerve fibers nerve nucleus
(plural: nucleii)
Dendrites and axions A bundle of dendrites and axions

p. 277

A group of neuron cell bodies INSIDE the brain and spinal cord
A group of neuron cell bodies OUTSIDE the brain and spinal cord The space connecting one neuron to another A chemical which transmits an electrical impulse from one neuron to the next 16

ganglion
(plural: ganglia)

synapse neurotransmitter

Glial cells
100 billion neurons 10x more glial cells than neuros Glial cells
Support neurons (literally, provide physical support, as well as nutrients) Cover neurons with myelin Clean up debris Housewives

Types of Supporting Cells of the Nervous System

Astrocytes

Microglia (CNS)
Ependymal cells (CNS) Oligodendrocytes(CNS)

Astrocytes
Regulate external environment (ions, etc.) Most abundant glial cell May contribute to blood-brain barrier and to synapses

Nervous Tissue: Support Cells

Microglia (CNS)
Spider-like phagocytes
Remove debris

Ependymal cells (CNS)

Line cavities in the brain and spinal cord Circulate cerebrospinal fluid

Nervous Tissue: Support Cells

Oligodendrocytes (CNS)
Produce myelin sheath around nerve fibers in the central nervous system

Neuron Anatomy and Neural Communication

Neurons
The largest part of a typical neuron is the cell body. It contains the nucleus and much of the cytoplasm.
Cell body

Neurons
Dendrites Cell Body

Synapse

Myelin Sheath

Axon of another neuron

Axon

Dendrites of another neuron

Cell Body

Neurons
The Nucleus in the Center

Dendrites

Neurons

Axon

Action Potential

Neurons

Myelin Sheath

Neurons

Myelin Sheath
Fatty material made by glial cells Insulates the axon Allows for rapid movement of electrical impulses along axon Nodes of Ranvier: gaps in myelin sheath where action potentials are transmitted Speed of neural impulse Ranges from 2 200+ mph

3 Functions of the Neuron

3.Transmission 1.
Reception

2. Conduction

Neuron Function
Electrical Activity
Used to transmit signal within neuron

Chemical Activity
Used to transmit signal between neurons Synapse small gap that physically separates neurons

Neuron Function
Electrical Activity
Resting Potential
Inside negative (-70 mV) compared to outside Inside has high K+ (negativity comes from proteins & other negative ions) Outside has high Na+ Forces at work
Electrical Diffusion

Neuron Function
Chemical (Neurotransmitter) Activity
Leads to graded potentials in neuron
Excitatory NTs causes depolarization in neuron Initiatory NTs causes hyperpolarization in neuron

Neuron Excitation & Inhibition

Neuron - Synapse

Synapse Types
Multiple ways of connecting
Examples
Axon to Dendrite excite or inhibit neuron Axon to Axon Terminal moderate NT release Axon to Extracellular Space or blood potential for diffuse effects

Synapse Types

Synapse Function
Neurotransmitter cycle in Axon Terminals
Synthesis Storage Release Inactivation Reuptake Degradation

Neural transmission problems if cycle disrupted (e.g., drugs) at any step

Synapse Function

Synapse Function

What is a Neurotransmitter?
A substance that is released at a synapse by a neuron and that effects another cell, either a neuron or an effector organ, in a specialized manner This seems clear, but application becomes fuzzy

Neurotransmitter
Neurotransmitter is made by the pre-synaptic neurone and is stored in synaptic vessels at the end of the axon. The membrane of the postsynaptic neurone has chemicalgated ion channels called neuroreceptors. These have specific binding sites for neurotransmitters.

Chemical Synaptic Transmission

4 steps: Synthesis of transmitter Storage & release of transmitter Interaction of transmitter with receptor in postsynaptic membrane Removal of transmitter from synaptic cleft

Classifying Neurotransmitters
Once divided into 2 classes:

Cholinergic use acetylcholine (ACh)

Adrenergic - use norepinephrine or epinephrine

Cholinergic Synapses
Acetylcholine is a common transmitter. Synapses that have acetylcholine transmitter are called cholinergic synapses.
This is an electron micrograph of synapses between nerve fibres and a neurone cell body.

Central Nervous System: CNS

Brain

Brain
The bodys control center. Receives messages from and sends messages to all organs and tissues of the body. It controls both voluntary and involuntary activities.

 A mass of billions of neurons. These neurons are surrounded by cells called glia, or glial cells, which support (hold the neurons in place) and supply them with nutrients.

Usual pattern of gray/white in CNS

White exterior to gray _________________ Gray surrounds hollow central cavity Two regions with____________________________ additional gray called cortex Cerebrum: cerebral cortex _____________________________ Cerebellum: cerebellar cortex

Gray and White Matter

Gray Matter is in the innermost layer
External and outer portion of the Cerebrum is Cortex Cerebrum and cerebellum have

Inner gray: brain nuclei (not cell nuclei)

Clusters of cell bodies Remember, in PNS clusters of cell bodies were called ganglia More words: brains stem is caudal (toward tail)
to the more rostral (noseward) cerebrum

Major Parts of the Adult Brain

Cerebrum Diencephalon Brainstem Cerebellum

 Cerebrum It is the largest part of the brain. It is the seat of human intelligence.

Cerebral cortex
Executive functioning capability Gray matter: of neuron cell bodies, dendrites, short unmyelinated axons
100 billion neurons with average of 10,000 contacts each

No fiber tracts (would be white) 2-4 mm thick (about 1/8 inch) Brodmann areas (historical: 52 structurally different areas given #s) Neuroimaging: functional organization
(example later)

Cerebral cortex
All the neurons are interneurons
By definition confined to the CNS They have to synapse somewhere before the info passes to the peripheral nerves

Three kinds of functional areas

Motor areas: movement Sensory areas: perception Association areas: integrate diverse information to enable purposeful action

Cerebral hemispheres: note lobes

Divided the lobes into right & left sides

divides frontal from parietal lobes

Each half of the cerebrum deals with the opposite side of the body: The left half of the cerebrum controls the right side of the body. The right half of the cerebrum controls the left side of the body.

Taste and touch

Speech and movement

Sight

Hearing and smell

Note the lobes, fissures and sulci.

Ventricles
Central cavities expanded Filled with CSF (cerebrospinal fluid) Lined by ependymal cells (these cells lining the choroid plexus make the CSF: see later slides) Continuous with each other and central canal of spinal cord
In the following slides, the ventricles are the parts colored blue

 Lateral ventricles
Paired, horseshoe shape In cerebral hemispheres Anterior are close, separated only by thin Septum pellucidum

 Third ventricle
In diencephalon Connections
Interventricular foramen Cerebral aqueduct

 Fourth ventricle
In the brainstem Dorsal to pons and top of medulla Holes connect it with subarachnoid space

Subarachnoid space
Aqua blue in this pic Under thick coverings of brain Filled with CSF also Red: choroid plexus

________

(more later)

Surface anatomy
Gyri (plural of gyrus)
Elevated ridges Entire surface

Grooves separate gyri

A sulcus is a shallow groove (plural, sulci) Deeper grooves are fissures

Parietooccipital sulcus

Lateral sulcus

Transverse cerebral fissure

 Smell (olfactory sense): uncus

Deep in temporal lobe along medial surface

 fMRI: functional magnetic resonance imaging Cerebral cortex of person speaking & hearing Activity (blood flow) in posterior frontal and superior temporal lobes respectively

Motor areas
Anterior to central sulcus Primary motor area
Precentral gyrus of frontal lobe (4) Conscious or voluntary movement of skeletal muscles

 Primary motor area continued

Precentral gyrus of frontal lobe Precise, conscious or voluntary movement of skeletal muscles Large neurons called pyramidal cells Their axons: form massive pyramidal or corticospinal tracts
Decend through brain stem and spinal cord Cross to contralateral (the other) side in brainstem Therefore: right side of the brain controls the left side of the body, and the left side of the brain controls the right side of the body

Motor areas continued

Brocas area (44): specialized motor speech area
Base of precentral gyrus just above lateral sulcus in only one hemisphere, usually left Word articulation: the movements necessary for speech Damage: can understand but cant speak; or if can still speak, words are right but difficult to understand

Motor areas continued

Premotor cortex (6): complex movements asociated with highly processed sensory info; also planning of movements Frontal eye fields (inferior 8): voluntary movements of eyes

Homunculus little man

Body map: human body spatially represented
Where on cortex; upside down

Association Areas
Remember Three kinds of functional areas (cerebrum)
1. Motor areas: movement 2. Sensory areas: perception

3. Association areas: everything else

Association Areas
Tie together different kinds of sensory input Associate new input with memories Is to be renamed higher-order processing areas

Prefrontal cortex: cognition

This area is remodeled during adolescence until the age of 25 and is very important for well-being; it coordinates the brain/body and inter-personal world as a whole

Intellect Abstract ideas Judgment Personality Impulse control Persistence Complex Reasoning Long-term planning

Social skills Appreciating humor Conscience Mood Mental flexibility Empathy

Executive functioning e.g. multiple step problem solving requiring temporary storage of info (working memory)

Wernickes area
Region involved in recognizing and understanding spoken words

Junction of parietal and temporal lobes One hemisphere only, usually left (Outlined by dashes) Pathology: comprehension impaired for written and spoken language: output fluent and voluminous but incoherent (words understandable but dont make sense; as opposed to the opposite with Brocas area)

Basal ganglia
Cooperate with cerebral cortex in controlling movements Communicate with cerebral cortex, receive input from cortical areas, send most of output back to motor cortex through thalamus Involved with stopping/starting & intensity of movements

Transverse section

 Internal capsule passes between diencephalon and basal ganglia to give them a striped appearance
Caudate and lentiform sometimes called corpus striatum because of this

Basal ganglia
Cooperate with cerebral cortex in controlling movements Communicate with cerebral cortex, receive input from cortical areas, send most of output back to motor cortex through thalamus Involved with stopping/starting & intensity of movements Dyskinesias bad movements
Parkinsons disease: loss of inhibition from substantia nigra of midbrain everything slows down Huntington disease: overstimulation (choreoathetosis) degeneration of corpus striatum which inhibits; eventual degeneration of cerebral cortex (AD; genetic test available) Extrapyramidal drug side effects: tardive dyskinesia
Can be irreversible; haloperidol, thorazine and similar drugs

Basal ganglia
Note relationship of basal ganglia to thalamus and ventricles

Transverse section again

Diencephalon (part of forebrain)

Contains dozens of nuclei of gray matter

Thalamus Hypothalamus Epithalamus (mainly pineal)

Thalamus (egg shaped; means inner room)

Coronal section

Hypothalamus
Coronal section

Diencephalon surface anatomy

Hypothalamus is between optic chiasma to and including mamillary bodies

Olfactory bulbs Olfactory tracts Optic nerves Optic chiasma (partial cross over) Optic tracts Mammillary bodies
(looking at brain from below)

Diencephalon surface anatomy

Hypothalamus is between optic chiasma to and including mamillary bodies

(from Ch 14: cranial nerve diagram)

Hypothalamus
Below thalamus Main visceral control center
Autonomic nervous system (peripheral motor neurons controlling smooth and cardiac muscle and gland secretions): heart rate, blood pressure, gastrointestinal tract, sweat and salivary glands, etc. Emotional responses (pleasure, rage, sex drive, fear) Body temp, hunger, thirst sensations Some behaviors Regulation of sleep-wake centers: circadian rhythm (receives info on light/dark cycles from optic nerve) Control of endocrine system through pituitary gland Involved, with other sites, in formation of memory

Hypothalamus
(one example of its functioning)
Control of endocrine system through pituitary gland

Epithalamus
Third and most dorsal part of diencephalon Part of roof of 3rd ventricle Pineal gland or body (unpaired): produces melatonin signaling nighttime sleep Also a tiny group of nuclei

Coronal section

Brain Stem

Midbrain Pons Medulla oblongata

Midbrain

Corpora quadrigemina:

__Cerebral peduncles____
Contain pyramidal motor tracts

XVisual reflexes XAuditory reflexes

_______Periaqueductal gray
(flight/flight; nausea with visceral pain; some cranial nerve nuclei)

______Substantia nigra (degeneration causes Parkingsons disease)

Pons Also contains several CN and other nuclei

__Middle cerebellar peduncles_

3 cerebellar peduncles__ (one to each of the three parts of the brain stem)

Dorsal view

Medulla oblongata

_______Pyramids

____pyramidal decussation

Dorsal view

With all the labels.

Brain Stem in mid-sagittal plane Note cerebral aqueduct and fourth ventricle*

Cerebellum
Separated from brain stem by 4th ventricle

Functions of cerebellum
Smoothes, coordinates & fine tunes bodily movements Helps maintain body posture Helps maintain equilibrium

Also some role in cognition

Damage: ataxia, incoordination, wide-based gait, overshooting, proprioception problems

Functions of cerebellum
How?
Gets info from cerebrum re: movements being planned Gets info from inner ear re: equilibrium Gets info from proprioceptors (sensory receptors informing where the parts of the body actually are) Using feedback, adjustments are made

Functional brain systems

(as opposed to anatomical ones)

Networks of distant neurons that function together

Limbic system Reticular formation

Limbic system
(not a discrete structure - includes many brain areas)

Limbic system continued

Called the emotional brain

Is essential for flexible, stable, adaptive functioning

Necessary for emotional balance, adaptation to environmental demands (including fearful situations, etc.), for creating meaningful connections with others (e.g. ability to interpret facial expressions and respond appropriately), and more

Reticular formation
Runs through central core of medulla, pons and midbrain
Reticular activating system (RAS): keeps the cerebral cortex alert and conscious Some motor control

Brain protection
1. Skull 2. Meninges 3. Cerebrospinal fluid 4. Blood brain barrier

 The brain is contained in the rigid skull, which protects it from injury. The major bones of the skull are the frontal, temporal, parietal, and occipital bones. These bones join at the suture lines

The Skull

Meninges - DAP
1. Dura mater: 2 layers of fibrous connective tissue, fused except for dural sinuses
Periosteal layer attached to bone Meningeal layer - proper brain covering

2. Arachnoid mater 3. Pia mater

Dura mater - dural partitions

Subdivide cranial cavity & limit movement of brain

Falx cerebri
In longitudinal fissure; attaches to crista galli of ethmoid bone

Falx cerebelli
Runs vertically along vermis of cerebellum

Tentorium cerebelli
Sheet in transverse fissure between cerebrum & cerebellum

 Arachnoid mater
Between dura and arachnoid: subdural space Dura and arachnoid cover brain loosely Deep to arachnoid is subarachnoid space
Filled with CSF Lots of vessels run through (susceptible to tearing)

Superiorly, forms arachnoid villi: CSF valves

Allow draining into dural blood sinuses

 Pia mater
The Inner most membrane, thin, transparent layer, that hugs the brain following convolutions

Cerebral Circulation
Brain arteries
Two Internal carotid Arteries Two Vertebral Arteries

Brain arteries

Circle of Willis

Blood-Brain Barrier
Tight junctions between endothelial cells of brain capillaries, instead of the usual permeability Highly selective transport mechanisms Allows nutrients, O2, CO2 Not a barrier against uncharged and lipid soluble molecules; allows alcohol, nicotine, and some drugs including anesthetics

Cerebrospinal Fluid CSF

Made in choroid plexuses (roofs of ventricles)
Filtration of plasma from capillaries through ependymal cells (electrolytes, glucose)

500 ml/d; total volume 100160 ml (1/2 c) Cushions and nourishes brain Assayed in diagnosing meningitis, bleeds, MS

CSF circulation: through ventricles, median and lateral apertures, subarachnoid space, arachnoid villi, and into the blood of the superior sagittal sinus

CSF: -Made in choroid plexus -Drained through arachnoid villus

 Hydrocephalus: excessive accumulation

Brain, sagittal sec, medial view

1. Cerebral hemisphere 2. Corpus callosum 3. Thalamus 4. Midbrain 5. Pons 6. Cerebellum 7. Medulla oblongata

Pons & cerebellum, sagittal section, medial view

1. 2. 3. 4. 5. 6. Midbrain Cerebellum Pons Medulla oblongata Inferior colliculus Superior medullary velum 7. Fourth ventricle
You dont need to know #s 5 & 6)

Central Nervous System

The Spinal Cord

Spinal Cord
Extends from the medulla oblongata to the region of T12 Below T12 is the cauda equina (a collection of spinal nerves) Enlargements occur in the cervical and lumbar regions

Spinal Cord Anatomy

Central canal filled with cerebrospinal fluid

Figure 7.19

Spinal Cord
It is the link between the peripheral nervous system and the brain. Functions 1. Sensory and motor innervation of entire body inferior to the head through the spinal nerves 2. Two-way conduction pathway between the body and the brain 3. Major center for reflexes

What is a reflex?

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Stretch reflex

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The Reflex Arc

Reflex rapid, predictable, and involuntary responses to stimuli Reflex arc direct route from a sensory neuron, to an interneuron, to an effector

Simple Reflex Arc

Slide 7.24

The Withdrawal Reflex

Previously known as the Flexor Reflex Involves multiple levels and synapses
1.Painful stimulus detected 2.Ipsilateral extensors inhibited 3.Ipsilateral flexors excited 4.Limb is withdrawn 5. Contralateral extensors excited
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The Startle Reflex

Known as the Moro Reflex in infants Is associated with withdrawal in the pain reflex Frequently involved in PTSD as a hyper-arousal response to stimuli Likely to upregulate the ANS
East Coast Physical Therapy

Types of Reflexes and Regulation

Autonomic reflexes

Somatic reflexes

Components of the Spinal Cord

H shaped on cross section Dorsal half of H: cell bodies of interneurons Ventral half of H: cell bodies of motor neurons No cortex (as in brain) Hollow central cavity (central canal) Gray matter surrounds cavity White matter surrounds gray matter.
Dorsal (posterior)
white

Central canal______

gray

Ventral (anterior)

Spinal cord anatomy

Gray commissure with central canal Columns of gray running the length of the spinal cord
Anterior (ventral) horns (cell bodies of motor neurons) Posterior (dorsal) horns (cell bodies of interneurons)

Lateral horns in thoracic and superior lumbar cord

* * * *

Spinal Cord Organization

Gray matter of the Spinal Cord

Gray Matter is consisting mostly of cell bodies of neurons under myelinated nerve fibers.

Occurs in the Cortex of the brain, basal ganglia, and Central portion of H-shaped in the spinal cord.

gray

White matter of the spinal cord

(myelinated and unmyelinated axons) Ascending fibers: sensory information from sensory neurons of body up to brain Descending fibers: motor instructions from brain to spinal cord
Stimulates contraction of bodys muscles Stimumulates secretion from bodys glands

Major fiber tracts in white matter of spinal cord

sensory motor

Damage: to motor areas paralysis to sensory areas - paresthesias

Major ascending pathways for the somatic senses

(thousands of nerve fibers in each) 2 Spinocerebellar tract: proprioception from skeletal muscles to cerebellum of same side (dont cross) 2 Dorsal column: discriminative touch sensation through thalamus to somatosensory cortex (cross in medulla) 2 Spinothalamic tract: carries nondiscriminate sensations (pain, temp, pressure) through the thalamus to the primary somatosensory cortex (cross in spinal cord before ascending)

Descending Tracts
a) Pyramidal tracts: Lateral corticospinal cross in pyramids of medulla; voluntary motor to limb muscles Ventral (anterior) 2- corticospinal cross at spinal cord; voluntary to axial muscles b) The Rubrospinal/ Reticulospinal Tract (An Extrapyramidal Tract): conduct impulses which involved the involuntary muscle movement

Protection:
3 meninges: dura mater (outer) arachnoid mater (middle) pia mater (inner) 3 potential spaces epidural: outside dur subdural: between dura & arachnoid subarachnoid: deep to arachnoid

Spinal cord coverings and spaces

http://www.eorthopod.com/images/ContentImages/pm/pm_general_esi/pmp_g eneral_esi_epidural_space.jpg

Dura mater Arachnoid mater Pia mater

 The bones of the vertebral column surround and protect the spinal cord and normally consist of: 7 cervical, 12 thoracic, 5 lumber vertebrae, 5 sacrum (a fused mass of five vertebrae), and terminate in the coccyx.

Vertebral Column

Vertebral Column
Nerve roots exit from the vertebral column through the intervertebral foramina (openings). The arch is composed of two pedicles and two laminae supporting seven processes. The vertebral body, arch, pedicles, and laminae all encase the vertebral canal.

Reminders .
Enhancement Hours: 8 hours Enhancement Time: 8 am 4pm Break Time:
Am: 10: 00 10: 15 Pm: 3:00 3:15 pm

Enhancement Topics:
Peripheral Nervous System Review Nenrological Assessment Diagnostic Tests and Nursing Responsibilities Nursing Pharmacology Pain, Temperature, and Sensory Function

Enhancement Diagnostic Test

NeuroAnatomy and Physiology

1. Which of the following is true regarding Brocas area?

A. B. C. D. Responsible for receptive speech Responsible for motor speech Results in the inability to hear Is often found in the right cerebral hemisphere

2. Which of the following is a cellular structure that selectively inhibits substances from entering the brain?
A. B. C. D. Circle of Willis Vertebral artery Blood-brain barrier Nucleus pulposus

3. Which of the following is not part of the peripheral nervous system?

A. B. C. D. Brain Somatic nervous system Afferent pathways Cranial nerves

4. Which of the following is true regarding the cerebellum?

A. B. C. D. Makes up fibers of the corticospinal tract Maintains balance or posture Controls respiration Location of cranial nerves V through VIII

5. Which of the following is a function of the thalamus?

A. Major integrating center for afferent impulse B. Maintenance of internal environment C. Voluntary visuomotor movements D. Movements of the auditory system

6. Which of the following is responsible for structural support within a cell?

A. B. C. D. Nissl substance Dendrites Microfilaments Microtubules

7. A patient experiences a brain injury and the medulla oblongata is affected. Which of the following would you least expect to occur due to this injury?
A. B. C. D. Alterations in heart rate Alterations in respirations Alterations in blood pressure Alterations in balance and posture

8. If a male client experienced a cerebrovascular accident (CVA) that damaged the hypothalamus, the nurse would anticipate that the client has problems with: A. body temperature control. B. balance and equilibrium. C. visual acuity. D. thinking and reasoning.

The Nervous System

Central Nervous System (CNS)

Peripheral Nervous System (PNS)

Brain

Spinal Cord

Motor Neurons

Sensory Neurons

Somatic Nervous System voluntary movements via skeletal muscles Sympathetic - Fight-or-Flight

Autonomic Nervous System organs, smooth muscles Parasympathetic - maintenance

The Peripheral Nervous System

the cranial nerves, The spinal nerves, the autonomic nervous system.

CRANIAL NERVES

12 Nerves of Cranial

Spinal nerves
31 pairs attached through dorsal and ventral nerve roots Lie in intervertebral foramina
Dorsal Root Ganglion

Ventral Root Ganglion

Division of 31 Spinal Nerves based on vertebral locations

8 cervical 12 thoracic 5 lumbar 5 sacral 1 coccygeal Cauda equina (horses tail)

pain, temperature, touch, and position sense from the tendons, joints, and body surfaces; or visceral

From Spinal Cord

To the Body

Overview of Nervous System

Copyright 2007, 2006, 2001, 1994 by Mosby, Inc., an affiliate of Elsevier Inc.

Peripheral Nervous System:

AUTONOMIC NERVOUS SYSTEM

Main function is to maintain internal homeostasis. Two subdivisions of ANS: The sympathetic system (activated by stress, prepares body for fight or flight response). The parasympathetic system (conserves, restores, and maintains vital body functions, slowing heart rate, increasing gastrointestinal activity, and activating bowel and bladder evacuation).

Divisions of the autonomic nervous system

The Autonomic Nervous System

Has two neurons in a series extending between the centers in the CNS and the organs innervated. The first neuron, the preganglionic neuron, is located in the brain or spinal cord, and its axon extends to the autonomic ganglia. There, it synapses with the second neuron, the postganglionic neuron, located in the autonomic ganglia, and its axon synapses with the target tissue and innervates the effector organ.

Craniosacral division,

75%

Fig. 11.40 ANS preganglionic parasympathetic fibers arise from the brain and sacral region of the spinal cord.

Parasympathetic Responses

Sympathetic Division of Motor Nerves

THORACOLUMBAR DIVISION

Neurotransmitters
Acetylcholine functions to maintain HOMEOSTASIS. Preganglionic fibers are cholinergic and secrete acetylcholine: Postganglionic parasympathetic and sympathetic fibers of sweat glands are also cholinergic.
Norepinephrine and epinephrine function to respond to STRESS All other postganglionic sympathetic fibers are adrenergic and secrete norepinephrine

Neurotransmitter Receptors
Acetylcholine binds to two cholinergic receptors:
muscarinic receptors: effector cells at parasympathetic postganglionic terminals VISCERAL nicotinic receptors: synapses between preand postganglionic fibers and at neuromuscular junctions of skeletal muscles - SOMATIC

Epinephrine and norepinephrine bind to two adrenergic receptors:

- alpha and beta receptors, which give different responses at the target organ

Sympathetic activation
Adrenal medulla activation Contraction of arteriolar smooth muscles

Release of epinephrine and norepinephrine

Vasoconstriction Increased peripheral resistance

Increased strength of contraction of heart

Increased blood pressure

Sympathetic activation
Stimulation of receptors of muscle vasculature Vasodilation Stimulation of receptors of bronchiole vasculature Increased bronchodilation Increased oxygenation

Peripheral vasoconstriction

Metabolic effects

Increased venous return

Shifts cardiac output to muscles

Increased release of epinephrine

Increased cardiac output

Increased blood flow to muscles

Glycogenolysis in the liver

Glycolysis in muscle

Breakdown of adipose tissue

Increased blood sugar

Increased lactic acid

Release of free fatty acids

SYMPATHETIC RESPONSES

Comparison of Somatic and Autonomic Nervous Systems