Ch.

12 Central Nervous System

1/21/15 6:10 PM

Structural Organization
1. Central Nervous System the central switchboard of incoming & outgoing messages;
primary organs are the brain & spinal cord
a. Nuclei: a collection of dendrites within the CNS
b. Tracts: collection of axons of the neurons within the CNS
2. Peripheral Nervous System connects CNS to the rest of the body
a. Ganglia: located outside of the spinal cord
b. Nerves: extend from ganglions, extending to distant regions of the body to allow
CNS to connect to those regions
Functional Organization
1. Sensory Nervous System detects & transmits stimuli from receptors to CNS
1. Somatic sensory: processes sensory info; (consciously aware of stimuli eyes,
ears, skin; ex: tactile receptors in skin sends sensory info to brain & gives us the
feeling of touch)
2. Visceral sensory: processes sensory info that is not consciously perceived from
blood vessels & internal organs such as the heart (BP to CNS)
2. Motor Nervous System motor output from CNS to effector organs such as the
muscle/gland
1. Somatic motor: processes motor output that innervates skeletal muscles &
generally under voluntary control
2. Autonomic motor: processes motor output that innervates smooth & cardiac
muscles or various glands & is generally involuntarily
1. Sympathetic: responsible for Fight or Flight response; utilizes the
neurotransmitter Norepinephrine
1. Fight or Flight: characterized by increase of heart rate, which increases BP
as well as the rate & depth of breathing; activated by fear (dangerous
situations), etc.

2. Parasympathetic: responsible for Rest & Digest response; utilizes the

neurotransmitter Acetyl Choli
1. Rest & Digest: activated after a meal; actively is responsible for the
secretion of various digestive enzymes to break down the meal
CNS Development
1. When a sperm fertilizes an egg it results with a zygote
2. The zygote goes through several cell divisions to give rise to a multicellular structure
known as morula
3. Morula differentiates into a blastocyst
4. Blastocyst gives rise to primary germ layers
5. The ectoderm which is one of the germ layers, differentiates & gives rise to the neuronal
tube
6. The neuronal tube consists of 3 parts: forebrain, midbrain & the hindbrain in the embryo
that is one month old
a. As the embryo develops these primary structures give rise to other structures:
i. Forebrain: develops to give rise to the telencephalon which develops into an
adult brain structure known as the cerebrum & the diencephalon which
consists of 3 major parts, the thalamus, hypothalamus & epithalamus
ii. Midbrain: develops into mesencephalon which is part of the brain stem of an
adult
iii. Hindbrain: develops into metencephalon which gives rise to the pons in the
brainstem & the cerebellum of an adult; & myelencephalon which gives rise
to the medulla oblongata in the brainstem of an adult
Adult Brain: Overview
4 primary structures:
1. Cerebrum: largest part of the brain structures that is responsible for all higher brain fx
including complex reasoning, thoughts, intelligence, long term memory storage, &
personality
2. Cerebellum: responsible for the maintenance of equilibrium and body balance
3. Brain Stem: primitive part of the brain (made up of the midbrain, pons & medulla
oblongata) that is responsible for involuntary responses such as regulating the heart
rate, breathing & body temperature
4. Diencephalon: deep within the brain (made up of 3 primary parts central thalamus,
hypothalamus, & epithalamus; hypo = below; epi = above)
White & Gray Matter
The brain is made up of 2 types of matter

Gray Matter: located in cerebral cortex & made up of the cell bodies & dendrites of neurons
White Matter: located deep within the brain & is made up of a collection of axons; appears
white due the axons being myelinated
Cranial Meninges
The brain is housed within the cranial cavity of the skull & is protected by the flat bones of
the cranium from physical injury; surround the brain itself is a set of membranes known as
cranial meninges which consists of 3 layers1. Pia Mater: innermost layer that is made up of delicate, loose areolar CT
2. Arachnoid Mater: middle layer that is made up of a delicate collection of collagen &
elastic fibers (resembles a spider-web)
a. Arachnoid trabeculae: is the collection of the collagen & elastic fibers
b. Subarachnoid space: space in between these fibers that are filled with
cerebrospinal fluid (CSF);
c. blood vessels can be found within the arachnoid mater which supplies blood to
the neuronal tissue of the brain
3. Dura Mater: the outer most layer that is made up of tough, dense irregular CT that
consists of 2 sub-layers in which both layers are typically fused to one another except in
regions where they separate to form large blood-filled cavities known as dural venous
sinuses (which are responsible for draining blood away from the brain) a. Periosteal layer: is in direct contact with the flat bone which forms the cranium of
the skull
b. Meningeal layer: direct contact with arachnoid layer
*Meningitis: inflammation of meninges caused by bacterial &/or viral agents
can be treated by a course of antibiotics or antiviral medication.
Cranial Ventricles
Within the brain are cavities known as cranial ventricles, these cranial ventricles are
responsible for the production of CSF that is found within the subarachnoid space.
1. Lateral ventricles: the larger ventricles located in the cerebrum
2. 3rd ventricle: located within the diencephalon
3. 4th ventricle: located within the cerebellum & brain stem
*These ventricles are all connected to each other
lateral ventricle is connected to the 3rd ventricle via interventricular foramen (foramen =
opening; inter = between; intra = within)
3rd ventricle is connected to the 4th ventricle via a channel called cerebral aqueduct
(aqueduct = channel)

Cerebrospinal Fluid (CSF)

CSF is involved in providing 3 primary fx:
1. Buoyancy: allows brain to float within the cranial cavity; decreases the weight of the
brain up to 96% (without CSF, brain would be crushed by its own weight)
2. Protection: acts as a shock absorber & provides cushion for the brain from
mechanical/physical injury (ex: during a car accident, when your head moves back &
forth from impact, the CSF slows the movement of your brain; without it, the brain will
hit the bones of the cranium resulting in mechanical/physical injury to the neuronal
tissue of the brain)
3. Stability: inhibits & reduces fluctuations in temperature & internal chemicals within the
cranial cavities

CSF Formation
o Choroid Plexus: located in each cranial ventricle; is involved in the formation of
CSF; it is made up of 2 structures:
i. continuous capillaries: tiny blood vessels via the Pia mater
ii. ependymal cells: a layer of the neuroglial cells that surrounds the capillaries

o
o

CSF is formed from blood as some of the fluid is filtered out of the blood, it is
modified by the ependymal cells to give rise to the CSF
CSF has the same composition as the blood plasma minus blood plasma proteins
such as hemoglobin, albumin, -globulins, -globulins, -globulins, etc. (these
proteins are too big to pass barriers)

CSF Circulation
1. CSF is formed from the choroid plexus of the lateral ventricles
2. As it is formed, it flows into the 3rd ventricles through the interventricular
foramen
3. From the 3rd ventricle, it flows into the 4th ventricle through the cerebral aqueduct
4. From the 4th ventricle, it can:
a. enter the central canal of the spinal cord, or

b. leave through the lateral apertures/medial apertures

5. CSF can then enter the subarachnoid space
6. Within the subarachnoid space, CSF will circulate to provide stability, buoyancy &
protection to the brain against injury
7. As it flows through the subarachnoid space, excess CSF drains from the
subarachnoid space due to the pressure difference & is pushed out via the
arachnoid villi & enters the blood via dural venous sinuses (which contains blood)
a. if excess CSF is not drained, it will build up, resulting in i. Children Hydrocephalus: where there is blockage (that is due to a
defect in the arachnoid villi) in the drainage of the CSF into the
dural venous sinuses, the head of the child doubles/triples in size
because the cranial sutures are not yet fused together, allowing the
head to expand as the pressure goes outward
ii. Adults does not result in head enlargement because the sutures
between the bones (frontal, parietal, temporal, occipital bones)
that form the cranium are fused together & closed; the pressure
can go outward due to these fused sutures allowing the pressure
to go inward towards the neuronal tissue of the brain, destroying
those brain tissues results in cognitive impairment (unless
treated through the insertion of venous shots to the abdominal
cavity to allow drainage of the excess fluid )

Blood-Brain Barrier (BBB)

BBB are gate keepers that selectively allow certain substances to enter the brain & make
contact with the central neurons while preventing other substances such as toxins present in
the blood from entering to prevent any damage to the neurons
o neurons must be protected as they do not regenerate; they are rare cell types of the
body that does not generally under go cell division once they are gone, they are gone
forever; resulting in some cognitive impairment
which is why there is a need for protective mechanisms via the cranial cavity,
dural meninges, CSF, & BBB
BBB are made up of 3 structures:
1. Endothelial cells: make up the bulk of tiny blood vessels = continuous capillaries;
endothelial cells are fused together via the tight jx which acts as a glue that connects
the cells together forming a continuous layer of capillaries
a. Tight jx are significant - the material has to pass through the cell membrane of
the endothelial cells rather than squeezing in between the cells in order to enter
the interstitial fluid that surrounds the neurons in the brain
i. the cell membrane is selectively permeable, so by forcing the materials to
pass through the cell membrane, a greater degree of control of which
substances can enter is established
o cell membrane is made up of phospholipids, so any substance that has to
pass through must be small & lipid-soluble
2. Basement membrane: made up of glycoproteins; fuses the endothelial cells to the
perivascular feet of the astrocytes
3. Astrocytes: specialized neuroglial cells; extends cytoplasmic processes that wrap around
the continuous capillaries forming another barrier through which the material must pass
through in order to reach the sensitive neurons
a. astrocytes wrap the perivascular feet around the continuous capillaries, &

b. the perivascular feet also wrap themselves around the neurons

*Any material has to pass through both the endothelial cells & the cell membranes, & then
has to enter the astrocytes in which the astrocytes present the material to the neurons
o this allows to protect neurons against various toxic chemicals
o both endothelial cells & astrocytes can modify these chemicals as they are transporting
& presenting them to the neurons
*Psychoactive drugs small & lipid soluble drugs that can penetrate & pass through the
BBBs, entering the brain, bringing about some effect
o ex: alcohol, coffee, nicotine from cigarettes, cocaine, heroine, general anesthesia
*Parkinsons disease is caused by a deficiency of the neurotransmitter, Dopamine, which is
neither small or lipid-soluble; so artificial Dopamine cannot penetrate these BBBs to
relieve the symptoms of the disease
o L-Dopa (psychoactive drug) is small & lipid soluble allowing it to penetrate the BBBs, &
once it enters the interstitial fluid it is converted into Dopamine
Cerebrum: Overview
Cerebrum is made up of 2 cerebral hemispheres in which each hemisphere controls the
opposite side of the body 1. Left hemisphere: controls the right side of the body
2. Right hemisphere: controls the left side of the body
*this is due to the projection tracts which decussate or cross over in the spinal cord
o
o
o

longitudinal fissure: divides the left & right hemisphere, except at the point where they
connect through the corpus callosum
corpus callosum: allows for the communication between the left & right hemispheres
the cerebrum folds into itself forming convulations to allow for it to be more compact,
letting it fit within the limited space inside the cranium
1. Convulations are made up of -

a. Gyrus/Gyri: peaks
b. Sulcus/Sucli: depressions

Cerebrum Division
The Cerebrum is organized into Gray matter & White matter
1. Gray matter (collection of cell bodies & dendrites of neurons) is organized into 2
structures:
a. Cerebral cortex: the folds on the outer shell of the brain
b. Cerebral nuclei: little interior islands of gray matter
2. White matter (collection of axons): inner white matter that occupies the interior of the
cerebrum & presents the tracts that allow for communication between the different parts
of the cerebrum
Cerebral Cortex
The cerebral cortex, the outer shell, is organized into 5 functional lobes
1. Frontal lobe has 4 important areas:
a. Prefrontal cortex: anterior portion that is responsible for higher brain fxs such as
reasoning, complex thoughts, intelligence, & personality
b. Primary motor cortex: involved in the contraction of skeletal muscles which
enables voluntary muscle movements
c. Premotor cortex: involved in processing highly complex learned motor behavior &
storage of long term memories associated with complex sequences of skeletal
muscle movements/contractions required for complex motor activities (such as
riding a bike, playing a piano, etc.
i. is located between the prefrontal & primary motor cortex
d. Brocas area: involved with language & specifically with the production of speech;
responsible for the contraction of the skeletal muscles associated with the mouth,
lips & tongue, in order to produce comprehensible speech
* MRIs & CAT scans are utilized to visualize different areas of the brain during cognitive
tests to see which areas of the brain is active characterized by a high level of glucose
utilization which lights up on the CAT scan
2. Parietal lobe has 2 important areas:
i. Primary somatosensory cortex: anterior portion that processes sensory
information from tactile receptors in the skin, resulting in a conscious
perception of touch as well as the ability to determine whether an object is
hot or cold to touch & pressure

ii. Somatosensory association area: posterior portion involved with the storage
of long term memory associated with how a specific object feels to touch
(allows you to determine an object without looking at it)
iii. Central sulcus/fissure: separates the frontal lobe from the parietal lobe
3. Temporal lobe has 3 primary areas:
i. Primary auditory cortex: processes sensory information from the hair cells
located in the inner ear, allowing to consciously perceive sound/hearing
ii. Auditory association area: responsible for the storage of long term memory
of sounds heard in the past which enables to determine how voices of
different people sound, songs, etc.
iii. Primary olfactory cortex: processes sensory information from olfactory cells
located in the nasal cavity allowing to consciously perceive various
odors/smells
iv. Lateral sulcus: separates temporal lobe from parietal lobe
4. Occipital lobe has 2 areas:
i. Primary visual cortex: receives sensory information from photoreceptors of
the retina in the eye, enabling the conscious perception of sight
ii. Visual association area: stores long term memories associated with visual
information allowing to recognize places previously visited, individuals by
facial features, etc.
o damage to this association area results in a type of memory loss
(amnesia) known as face blindness (the inability to recognize
individuals by facial features)
individuals who have this damage causes them to rely on
the auditory association area to determine the individual
based on how they sound
iii. Parieto-occipital sulcus: separates the parietal lobe from the occipital lobe
5. Insular lobe (Insula) has 2 areas:
i. Primary gustatory cortex: involved in processing sensory information from
the gustatory cells located within the taste buds on the surface of the
tongue, allowing to consciously perceive various tastes
ii. Visceral sensory area: processes visceral information from internal organs
(ex: stomach, urinary bladder, etc.)
o when the stomach fills with food, it expands, & activates
mechanoreceptors which sends a nerve impulse to the visceral
sensory area resulting in the feeling of being full (tells you to stop
eating)
o as the urinary bladder fills with urine, it stretches which activates
mechanoreceptors in the bowl of the urinary bladder & sends nerve
impulses to visceral sensory area resulting in the increasing
urgency to urinate
Multimodal Association Areas
Multimodal association areas occupy the cerebral cortex in more than one lobe (occupies
both parietal & temporal lobes)
1. Wernickes area: involved with the understanding/comprehension of both written &
spoken language, allowing you to understand as well as distinguish between languages,
etc
a. Brocas area & Wernickes area communicate with one another to produce
comprehensible speech

2. Gnostic area: involved in the integration of all the sensory information (visual, auditory,
olfactory, gustatory, somatosensory) to create a clear picture of the current activity

Motor & Sensory Homunculus

1. Motor Homunculus
a. Precentral gyrus: body parts (ex: fingers, face, etc) that require detailed &
precise types of movements is reflected by the fact, that a great amount of the
primary motor cortex is devoted to such a control (require a greater degree or
greater surface area of the primary motor cortex)
1. Sensory Homunculus
a. Postcentral gyrus: Body parts/areas that are very sensitive (ex: lips, tongue,
fingertips) have a greater concentration of tactile receptors within the skin, have
a more greater areas of the primary somatosensory cortex devoted to process
that sensory information
Brain Plasticity
Brain plasticity is the ability of the brain to rewire itself
1. Learning
a. As a child grows, the relative numbers of the neurons stays the same, however,
as the child is learning & experiencing new sensations, the neighboring neurons
extend cytoplasmic processes the dendrites & axons making connections with
other neighboring neurons
b. As the child is re-emphasizing things learned through repetition, those
connections increase in number; through repetition the information that is
learned, is stored through the extensions of the dendrites to the neighboring
neurons
c. The extensions create a network
2. Blind Individuals
a. Blind individuals typically have an increased somatosensory & auditory perception
(hearing & touch)
i. the primary somatosensory cortex & primary auditory cortex sends tracts
into the occipital lobe & takes over the primary visual cortex (which is no
longer being used)
*Parts of the brain work together to accomplish a single task (an interconnectivity)

ex: To play the violin:

1. requires a contraction of the skeletal muscles & voluntary movement requiring
the primary motor cortex
2. playing the violin is a complex motor task that requires the premotor cortex
3. when touching the strings of the violin it activates tactile receptors which sends
impulses to the primary somatosensory cortex
4. to play the violin, you need to look at the violin & the strings, this activates
photoreceptors in the retina of the eye, which sends impulses to the primary
visual cortex
5. the sound being generated from playing the violin stimulates the hair cells of the
inner ear which activates AP to send impulses to the primary auditory cortex

Cerebral Nuclei
Deep within the cerebrum are cerebral nuclei that represents a collection of the cell bodies,
dendrites & axons of the neuron
o

The general fx of the cerebral nuclei is to start, stop & monitor the intensity of the
skeletal muscle contraction initiated by the primary motor cortex of the frontal lobe to
produce smooth movements & prevent antagonistic & unnecessary movement

Some
1.
2.
3.

Damage to the cerebral nuclei results in:

too little of movement & slow movement (Parkinsons disease), or
too much movement & jerky movement (Huntingtons disease)

several types of cerebral nuclei include

Caudate nucleus:
Putamen:
Globus pallidus:

Inner White Matter

o Cerebrum is made up of inner white matter

o
o

Inner white matter is made up of tracts (collection of axons)

There are 3 Major types of Tracts
1. Association tracts: allow for the communication between different parts of the
brain within the same hemisphere, there are 2 subtypes:
a. arcuate fibers: shorter tract that allows for the communication between
different parts of the brain of the same lobe
b. longitudinal fasciculi: longer tract that allows for the communication
between 2 or more different lobes within the same hemisphere
2. Commissural tracts: allows communication between the 2 (left & right)
hemispheres; represented by the corpus callosum as it connects the 2 hemispheres
3. Projection tracts: allows communication between the brain & spinal cord; it
connects higher brain centers (cerebrum) to the brain stem, cerebellum & then to
the spinal cord

Cerebral Lateralization
Cerebral lateralization refers to the fact that the 2 cerebral hemispheres are
specialized for different tasks
1. Categorical Hemisphere (left hemisphere) is responsible for:
a. Language it contains Brocas area
b. Reasoning & Analytical skills it contains Wernickes area
2. Representational Hemisphere (right hemisphere) is responsible for:
c. Imagination & Storytelling
d. Musical & artistic abilities)
*One of the hemispheres is always more dominant than the other in 95% of the
population, the left/categorical hemisphere is more dominant than the
right/representational hemisphere
*Co-dominance can exist where neither of the hemispheres are more dominant than the
other (ex: people who are ambidextrous)
Diencephalon

The Diencephalon consists of 3 major structures

1. Thalamus
a. 2 important fxs:
i. acts as a relay center for the sensory information in which it routes the
sensory information to appropriate areas of the cerebral cortex
ii. acts as a gate keeper, in which it filters irrelevant sensory information,
allowing only certain sensory information to be passed on to the cerebral
cortex to be consciously perceived
b. LSD (psychoactive drug) that can cross BBBs & inhibits the fx of the thalamus &
allows all types of sensory information to reach the cerebral cortex & be
consciously perceived, overpowering its ability to process the information,
resulting in visual & auditory hallucinations (seeing & hearing things that are not
real)
2. Epithalamus contains 2 important structures
a. Habenular nucleus: responsible for processing visceral & emotional responses to
various odors/smell
b. Pineal gland: responsible for the production & secretion of the hormone,
melatonin, which regulates the circadian rhythm (sleep & wake cycle)
3. Hypothalamus has many fx:
a. it controls the Autonomic Nervous System, in which it regulates heart rate, BP,
digestion & breathing
b. it controls the Endocrine system, in which it controls the secretion from a master
endocrine gland called the pituitary gland
i. the pituitary gland controls the secretions from other endocrine glands
within the body
c. Thermoregulation it regulates the temperature of the body, maintaining it at
37C
i. central thermoreceptors in the hypothalamus continuously monitor the
temperature of the blood, any variation in which the temperature is
below/above 37C in the blood will initiate a response by the hypothalamus
o if the temperature is below 37C, it initiates a response such as shivering
thermogenesis to generate heat which increases the temperature
o if the temperature is above 37C, it initiates a response such as sweating,
which then results in evaporative cooling which is when the sweat
evaporates from the surface of the skin to take away heat, bringing the
temperature down
d. Control of food & water intake
i. Food intake:
o chemoreceptors within the hypothalamus continuously monitor glucose
levels & amino acids in the blood
o as amino acid levels go down, the chemoreceptors are activated, resulting
in the increase of hunger

when hunger occurs, eating follows the carbohydrates obtained from

food are broken down into glucose, where glucose is absorbed in the
blood, increasing glucose levels
o as you eat, the stomach expands & mechanoreceptors are activated in
which it sends nerve impulses to the hypothalamus, resulting in the
sensation of being full
ii. Water intake:
o osmoreceptors in the hypothalamus monitor osmolarity of the blood (how
concentrated the blood is with the solutes)
o so after a meal, as carbohydrates, lipids, & proteins are broken down into
glucose & amino acids, these solutes are absorbed into the blood,
increasing the blood concentration/osmolarity which then activates the
osmoreceptors resulting in thirst
o when thirsty, you drink water the water gets absorbed into the blood
which then dilutes the blood concentration & brings the blood osmolarity
down & back to normal
e. Control of circadian rhythms the hypothalamus controls the secretion of
melatonin from the pineal gland
f. Regulates emotional responses the hypothalamus controls the limbic system
which is involved emotional response (rage, anger, fear, sadness, pleasure,
happiness, etc.)
g. Sex drive via controlling the limbic system
o

Brainstem
The brainstem consists of 3 parts
1. Midbrain
a. Superior colliculi: known as the visual reflex centers which help to track a moving
object with our eyes & also reflexively/involuntarily make you turn your head in
the direction of a visual stimulus (such as an approaching car)
b. Inferior colliculi: act as auditory reflex centers that causes you to involuntarily
turn your head in the direction of a sound (such as a loud bang)
c. Red nucleus:
i. appears red in preparations due to the red staining (iron) pigments that it
contains
ii. responsible for keeping our back muscles (specifically the erector spinae) in
a state of perpetual contraction to maintain posture while sitting or walking
d. Substantia nigra:
i. appears black in preparations due to the black staining pigment melanin
ii. associated with the production of the neurotransmitter Dopamine

iii. plays a crucial role in controlling unnecessary jerky movements (resting

tremors)
iv. damage to the substantia nigra & consequent decrease in Dopamine leads
to the signs & symptoms associated with Parkinsons disease (where
individuals exhibit slow, voluntary movements & resting tremors particularly
in the hands & head)
2. Pons
a. Pontine respiratory centers: the most important & crucial structure of the pons
that regulates the rate & depth of breathing; there are 2 areas of the pontine
respiratory centers
i. apneustic area: promotes breathing (occurs during exercise)
ii. pneumotaxic area: inhibits breathing
o occurs during inhalation as you inhale, the lungs are filled with air to a
point where you cant breath anymore, this is due to the activation of
mechanoreceptors which sends impulses to the pneumotaxic area which
inhibits breathing to prevent overstretching the lungs (overstretching of
the lungs damage the sensitive pulmonary alveoli)

3. Medulla Oblongata
The medulla oblongata is involved with many autonomic fxs, the 3 principle fxs include:
a. Cardiac center: controls heart rate & stroke volume (strength/force of cardiac
contraction)
b. Vasomotor center: controls the diameter of the blood vessels
i. control via vasoconstriction resulting in the decrease of the diameter, or
ii. control via vasodilation resulting in the increase of the diameter
*both cardiac & vasomotor centers are crucial in regulating BP
c. Medullary Respiratory center: establishes the basic rhythm of breathing, ensuring
a continuous mechanical ventilation (breath in & out) especially when asleep
i. the medullary respiratory center work with the pontine respiratory centers,
creating these groups:
o Ventral group
o Dorsal group

ii. damage to the medullary respiratory centers occurs in which the individual
stops breathing when asleep such individuals require to be hooked up to a
ventilator during sleep
iii.
Cerebellum
Cerebellum Anatomy
1. Cerebellum is made up of 2 cerebellar hemispheres (left & right), both consists of:
a. Anterior lobe
b. Posterior lobe
2. The interior of the cerebellum is made up of Gray & White matter:
a. Gray matter is contained within the cerebellar cortex & isolated cerebellar
nuclei
b. White matter represented by a tree-like structure called the arbor vitae
Cerebellum Function
Cerebellum generally keeps the brain aware of where the head is relative to the trunk of
the body & integrates from the proprioceptors & vestibular organs; primary functions
include:
1. Coordination & fine tuning of body movements
a. Cerebral cortex rough draft (blue)
b. Propriorecepetors (yellow)
c. Cerebellum
i. Integration (green)
ii. Final draft (red)
2. Maintains body balance & posture
a. Vestibular organs

b. Proprioreceptors
Limbic System
1. Hippocampus: central to the formation of new memories
a. Memory formation
i. short term memory
ii. long term memory
iii. encoding: moving memory from short term to long term
b. Amygdala
i. Emotional responses
ii. Animals that have a damaged amygdala will show no fear to objects that
have been once feared in the past
Reticular Formation
The reticular formation extends throughout the brainstem into the diencephalon and
includes:
1. Reticular activating system: keeps us in the state of mental alertness
a. receives & processes sensory information from the eyes, ears & tactile receptors
within the skin
b. projects that sensory information to the appropriate areas of the cerebral cortex,
making us consciously aware of such sensation
2. General Anesthesia administered to the pt prior to surgery, rendering the pt
unconscious at the level of the reticular activating system, inhibiting the neurons & stops
the sensory information from projecting into the cerebral cortex therefore makes the
pt unconscious & unaware of the painful stimulation during surgery
Brain Wave Patterns & EEG
o EEG (Electroencephalogram): records the electrical activity of neurons giving rise to
brain waves there are 4 principle categories:

Alpha waves: present in individuals that are awake & are in a calm, relaxed state
Beta waves: present in individuals that are concentrated on a cognitive task (ex:
studying)
Theta waves: mostly present in young children; present in adults in which it
occurs prior to sleep, deep meditation, during drowsiness
Delta waves: present during deep sleep or under general anesthesia
*The clinic significance of the EEG is that it can help to diagnose various neurological
disorders, ranging from epilepsy to coma
Epilepsy: neurological disorder in which the neurons are generating & transmitting action
potentials either too frequently or too rapidly, resulting in convulsions (seizures) in
which there are 2 major forms:
o Petit mal seizures (absence seizures):
typically occurs in children (<10 yrs old)
tend to disappear as the child grows older
less severe
during the seizure the face is expressionless & the child loses consciousness
for several seconds

Grand mal seizures (tonic-chronic seizures)

typically occur in adults
more severe
the seizure is characterized by:
strong skeletal muscle contractions so strong, that it can sometimes
break bones
loss of control of bladder & bowel control where urinating & defecating
occurs involuntarily
may also severely bite their tongues

Treatment for epilepsy:

anticonvulsive medication administered through the rectum
deep brain implants it sends a small electrical charge to the overactive area of
the brain in which it resets the area to a normal pattern of generating action
potentials

Brain Integration
o Areas of the brain connect & communicate with another at any single moment of any
given time, resulting in the integration of both sensory & motor output
These higher brain functions depend on the process of brain integration:
Intelligence
Reasoning
Logic
Cognitive skills
Football Analogy*

Brain Disorders
1. Brain Injuries
a. Concussion: results from a serious blow to the head, causing a loss of
consciousness for several seconds or minutes
i. after regaining consciousness, symptoms include:
o headache
o state of delirium (state of mental confusion)
ii. concussions have a cumulative effect over time, leading to a loss of brain
mass which results in:
o loss of cognitive faculties (reasoning, thoughts, intelligence)
o onset of major depression
iii. common in contact sports such as football
b. Contusion: more severe form of concussion in which the blow to the head results
in the bruising of brain in which there is bleeding in the brain
i. such damage may result in Amnesia loss of memory
o Anterograde amnesia:
characterized by the inability to form new long term
memories
results from damage to the hippocampus
o Retrograde amnesia:
characterized by the inability to retrieve previously stored
long term memories
ii. Coma: results from the damage to the reticular activating system causing a
state of unconsciousness

characterized by delta waves

2. Cerebrovascular Accident (stroke): results from a brain tissue being deprived of oxygen
(for >10 min), leading to the death of the neuronal tissue; there are 2 types of strokes:
a. Ischemic stroke: result of the build up of fatty plaque within the bulb of the
cerebral arteries that supply the blood to the neuronal tissues
i. Embolus: traveling blood clot; that can get stuck within the plaque & can
block the blood flow to a specific area of the brain, depriving it from oxygen
& leading to the death of the neuronal tissue
b. Hemorrhagic stroke: result of an aneurysm, the bursting of the cerebral arteries,
causing bleeding within the brain
i. the ball of the cerebral arteries can form into balloon-like structures, where
any blow to the head may cause a rupture of the cerebral artery, resulting in
an aneurysm
ii. the aneurysm then causes bleeding within the brain
iii. bleeding within the brain, then interrupts the delivery of oxygen to the
brain, resulting in brain damage
* signs & symptoms of a stroke varies depending on which part of the brain is
affected
3. Degenerative Brain Disorders
a. Alzheimers disease
i. typically occurs around the age of 65
ii. characterized by Dementia: slow progressive loss of cognitive fxs memory,
personality, etc
o memory loss is gradual; it starts with small things such as
forgetting the keys, forgetting to turn off the oven, etc & then
progresses more severely as the brain mass is lost, resulting in
the inability to not recognize closest family members
affects the speech area, resulting in a loss of language
abilities
affects prefrontal cortex, resulting in personality changes
iii. Cortical atrophy: decrease in size, refers to the loss of brain mass
o as neurons die off & brain mass is lost, it results in the
enlargement of the lateral & 3rd ventricles
o loss of neurons = loss of brain mass, causing cognitive impairment;
neuronal death is caused by:
the accumulation of neurofibrillary tangles within the axons,
impairing axonal transport, leading to the death of the
neurons
the accumulation of defective amyloid precursor proteins
within the neurons, leading to their death
b. Parkinsons disease
i. due to the degeneration & loss of neurons from the substantia nigra
(midbrain)
o loss of these neurons means there is a decrease in the synthesis &
secretions of Dopamine
results in signs & symptoms of Parkinsons disease, such as:
- slow, voluntary movements
- expressionless face
- stiff posture
- resting tremors (particularly in hands)

ii. Treatment of the Parkinsons disease include:

o
L-Dopa
o Deep brain implants sends small electrical charge to prevent
resting tremors
o Stem cell theory transplanting embryonic neurons into the
substantia nigra
c. Huntingtons disease
i. hereditary disorder (follows autosomal dominance of inheritance)
ii. onset of disease is about 35-45 yrs of age
iii. individuals live ~15 yrs after the 1st appearance of the symptoms of the
disease
iv. symptoms include:
o start with face twitching, with then
o progresses into jerky movements such as arm, leg twitching, etc
v. symptoms then lead to the failure of the diaphragm & pulmonary
ventilation, causing the inability to breath in & out, resulting in death
vi. characterized by the accumulation of the tactile protein known as huntintin
& death of the neurons (particularly within the cerebral nuclei)

Spinal Cord: Overview

1. Spinal cord connects the brain to the rest of the body allowing for the communication
between the brain & the body
2. It connects to the brain at the level of the medulla oblongata of the brainstem &
moves inferiorly all the way down to the L1 vertebrae of the vertebral column
3. Spinal cord divides into 4 parts:
1. Cervical part gives rise to the spinal nerves (C1-C8), allowing for the
communication with the distant parts of the body
2. Thoracic part gives rise to spinal nerves T1-T12
3. Lumbar part gives rise to nerves L1-L5
4. Sacral part gives rise to nerves S1-S5 & CX1
1. Conus medullaris: point where the spinal cord terminate
1. Caude equine: a collection of nerve plexuses (after conus medullaris)
2. Filum terminale: CT that attaches the cauda equine terminally to the
coccyx of the vertebral column
Spinal Meninges
Spinal cord is enclosed & protected by spinal meninges
The spinal meninges are made up of 3 layers:
o Dura mater (most outer layer) made up of tough, dense irregular CT
within the Dura mater is the epidural space that is made up of a collection of
adipose & areolar CT
the epidural space provides cushion for the spinal cord within the vertebral
column
o Arachnoid mater (middle layer) made up of a collection of collagen &
elastic
fibers
the subarachnoid space is located in between the elastic fibers

the subarachnoid space contains CSF, which protects the spinal cord from
mechanical shock
Pia mater ( inner layer) made up of delicate, loose areolar CT & is in
direct
contact with the spinal cord

Spinal Cord: Anatomy

Spinal cord contains Gray & White matter
o Gray matter (located centrally) made up of cell bodies & dendrites of neurons
organized into horns
posterior horns (posterior side of spinal cord)
lateral horns (lateral side of spinal cord)
anterior horns (anterior side of spinal cord)
o White matter (located peripherally) made up of axons of neurons
organized into tracts located in the funiculi
posterior funiculus (in between the posterior horns)
lateral funiculus (in lateral horns)
anterior funiculus (in anterior horns)
Spinal Cord Gray Matter (reflex integration)
Gray matter is involved in Reflex Integration (processes of reflexes)
o Posterior horns houses sensory axons & interneurons; receives sensory information
from the periphery (PNS) to the spinal cord
it has somatic sensory neurons that carries sensory info that is consciously
perceived (ex: touch), &
visceral sensory neurons that carries sensory info that is not consciously
perceived (ex: baroreceptors BP)
o Anterior Horn houses somatic motor neurons; innervates skeletal muscles
o Lateral Horn houses autonomic motor neurons that carries motor output from the
spinal cord to the PNS, specifically to the effector organs (cardiac muscles, smooth,
muscles/glands)
Reflex Integration
Reflex initiates the contraction of the skeletal muscle involuntarily
1. Stimulus activates a receptor (ex: pain receptor)
2. Receptor activates the sensory neuron which carries sensory information from PNS to
CNS, resulting in the action potential traveling toward the spinal cord
3. This information will then be integrated with respect to the interneuron which
connects the sensory neuron to the motor neuron which sends motor output from
CNS towards effector muscle
4. Another AP moves from the spinal cord to the effector muscle, resulting in the
contraction of that muscle & allows for that area of the body to pull away from the
stimuli causing pain
5. The sensory info will reach the cerebral cortex & be perceived as such, but only once
we have removed the hand from the stimuli
Reflex: Classification
Reflexes can be classified:
1. based on the effectors being innervated, they are classified into:
o visceral reflex: innervate glands, smooth & cardiac muscle tissue
a. Ex: baroreceptors of the aorta which monitors & regulates BP a reflex
we are not consciously aware of

o somatic reflex innervate skeletal muscles

a. Ex: withdrawal reflex during touching something that is hot
2. based on complexity of the reflex, they are classified into:
o monosynaptic reflex: has only a single synapse only 2 neurons, 1 sensory
neuron which synapses with the monosynaptic motor neuron
a. Ex: stretch reflex specialized sensory receptors integrated within the
skeletal muscle are stretched, activating AP towards the spinal cord &
causes the motor neuron to shoot the AP to the muscle, causing it to
contract resulting in the extension; this reflex prevents overstretching of
the muscles where overstretching can damage/tear muscle fibers
o polysynaptic reflex: more complex, many synapses in which it has 3 or more
neurons making up that reflex (sensory neuron, interneuron, motor neuron)
a. Ex: withdrawal reflex if you touch a stimuli, it activates receptors &
therefore activates a sensory neuron which shoots an AP towards the
spinal cord resulting in the motor neuron generating a nerve impulse
towards the muscle, causing it to involuntarily contract & remove it from
stimuli & prevent damage
Spinal Cord: White Matter (impulse conduction)
White matter is organized into areas called funiculi that is made up of a collection of
tracts, 2 basic tracts are:
1. Ascending tracts (inner)
o directs sensory information towards the brain
o divides into 2 pathways:
a. Somatosensory pathways (consciously aware)
starts with some somatic receptors such as the tactile receptors
in the skin ( ex on the right side of the body)
the tactile receptors in the skin will activate the primary neuron
& activate an AP leading into the spinal cord
within the spinal cord, the primary neuron will synapse with the
secondary neuron
the secondary neuron will decussate (cross over) to the other
side of the spinal cord
the axons will form the ascending tract which will travel to the
thalamus of the brain where it will synapse with the tertiary
neuron
the tertiary neuron will project to a specific area of the primary
somatosensory cortex (ex - of the left cerebral hemisphere)
resulting in the perception of touch
b. Viscerosensory pathways (unconsciously aware)
consists of visceral receptors such as baroreceptors in the aorta
visceral receptors activate the primary neuron which synapses
with the secondary neuron
the secondary neuron projects into the hypothalamus keeping
the brain informed of what the BP of the body is at all times
hypothalamus regulates the BP
o
2. Descending tracts (outer)
o directs motor information from the brain to the spinal cord to the PNS (effector)

o divided into 2 pathways:

a. Direct pathway (innervates skeletal muscle tissue; voluntary control)
consists of upper motor neurons (where cell bodies reside;
within the primary motor cortex) that extend to the midbrain,
pons, medulla oblongata, to the spinal cord where it decussates
in the spinal cord, the upper motor neurons synapses with the
lower motor neurons
lower motor neurons innervate the skeletal muscle
b. Indirect pathway (innervates smooth muscle, cardiac muscle & glands;
involuntary control)
starts with upper motor neurons that originates from
hypothalamus
upper motor neurons synapse with interneurons
at the spinal cord, neurons synapse with lower motor neurons
lower motor neurons then innervates the smooth
muscle/cardiac muscle & glands , allowing hypothalamus to
control heart rate, digestion & secretion from endocrine &
exocrine glands (sebaceous glands/sweat glands)
Decussation for most pathways occur at the spinal cord or medulla oblongata

Spinal Cord Disorders

1. Spina Bifida
most common in undeveloped, 3rd world countries
result of a failure of the terminal portion of the neural tube to close properly during
development
vitamin deficiency (specifically folic acid) during pregnancy causes Spina bifida (70%)
Spina bifida comes in 2 forms:
a. Spina bifida occulta
i. milder form of Spina bifida
o the dura mater remains intact
ii. characterized by the absence of the complete closure of the terminal
process in the vertebrae
b. Spina bifida cystica
i. more severe
o dura mater is not properly closed, causing CSF & cauda equine to
leak out, forming a bulge seen on the back
ii. if not removed surgically, it will result in paraplegia
o Paraplegia: paralysis of the lower limbs; causing the inability walk
o surgical removal involves draining the fluid, sealing/closing suture
the opening of the wound as well as seal/close the dura mater
2. Spinal Cord Injury
spinal cord injury results in 2 conditions:
a. Paraplegia: paralysis of the lower limbs (legs)
i. caused by the injury to the thoracic, lumbar & sacral part of the spinal cord
b. Quadriplegia: paralysis in upper & lower limbs (arms & legs)
i. caused by the damage to the cervical part of the spinal cord