THE NERVOUS

SYSTEM
Chapter 12
 Mass of only 2 kg (4.5 lb), about 3% of total body weight

Organization The nervous system is one of the smallest and yet the
most complex of the 11 body systems.

of the Organized into two main subdivisions: the central

nervous system and the peripheral nervous system.
Nervous
System Neurology deals with normal functioning and disorders
of the nervous system.

A neurologist (noo-ROLō-jist) is a physician who

diagnoses and treats disorders of the nervous system.
The Central Nervous System (CNS)
• It consists of the brain and spinal cord
• The brain is the part of the CNS that is located in the skull and
contains about 85 billion neurons.
• The spinal cord is connected to the brain through the foramen
magnum of the occipital bone and is encircled by the bones of the
vertebral column. The spinal cord contains about 100 million
neurons.
• It is also the source of thoughts, emotions, and memories.
• Most signals that stimulate muscles to contract and glands to secrete
originate in the CNS.
The Peripheral Nervous System
(PNS)
• It consists of all nervous tissue outside the CNS.
• Components of the PNS include nerves and sensory receptors.
• A nerve is a bundle of hundreds to thousands of axons plus associated
connective tissue and blood vessels that lies outside the brain and spinal
cord.
• Twelve pairs of cranial nerves emerge from the brain and thirty-one pairs
of spinal nerves emerge from the spinal cord.
• The term sensory receptor refers to a structure of the nervous system that
monitors changes in the external or internal environment.
• Examples of sensory receptors include touch receptors in the skin,
photoreceptors in the eye, and olfactory (smell) receptors in the nose.
The PNS is divided into sensory and motor
divisions
1. The sensory or afferent division of the PNS conveys input
into the CNS from sensory receptors in the body.
•This division provides the CNS with sensory information
about the somatic senses (tactile, thermal, pain, and
proprioceptive sensations) and special senses (smell, taste,
vision, hearing, and equilibrium).
Motor division
2. The motor or efferent division of the PNS conveys output from the CNS to
effectors (muscles and glands).
• This division is further subdivided into a somatic nervous system and an
autonomic nervous system.
• The somatic nervous system (SNS) (sō-MAT-ik; soma = body) conveys output
from the CNS to skeletal muscles only.
its motor responses can be consciously controlled, the action of this part of
the PNS is voluntary
• The autonomic nervous system (ANS) (aw′-tō-NOM-ik; auto- = self; -nomic =
law) conveys output from the CNS to smooth muscle, cardiac muscle, and
glands.
its motor responses are not normally under conscious control, the action of
the ANS is involuntary
The ANS is comprised of two main branches, the
sympathetic division and the parasympathetic
division.
For example, neurons of the sympathetic part increase heart
rate, and neurons of the parasympathetic division slow it
down.
In general, the parasympathetic part takes care of
“rest-and-digest” activities, and the sympathetic division
helps support exercise or emergency actions—the so-called
“fight-or-flight” responses.
A third branch of the autonomic nervous
system are the enteric plexuses.
• The enteric plexuses helps regulate the activity of the smooth muscle
and glands of the digestive canal.
• Although the enteric plexuses can function independently, they
communicates with and are regulated by the other branches of the
ANS.
 Functions of the Nervous System
1. Sensory function.
Sensory receptors detect internal stimuli, such as an increase in
blood pressure, or external stimuli (for example, a raindrop landing on
your arm).
This sensory information is then carried into the brain and spinal
cord through cranial and spinal nerves.
2. Integrative function
The nervous system processes sensory information by analyzing it
and making decisions for appropriate responses—an activity known
as integration.

3. Motor function
Once sensory information is integrated, the nervous system may
elicit an appropriate motor response by activating effectors (muscles
and glands) through cranial and spinal nerves.
Stimulation of the effectors causes muscles to contract and
glands to secrete.
 Histology of Nervous Tissue
Nervous tissue comprises two types of cells—neurons and
neuroglia.
Neurons- possess electrical excitability (ek-sīt′-a-BIL-i-tē), the ability to
respond to a stimulus and convert it into an action potential. A stimulus is
any change in the environment that is strong enough to initiate a nerve
impulse. A nerve impulse (action potential) is an electrical signal that
propagates (travels) along the surface of the membrane of a neuron.
It begins and travels due to the movement of ions (such as sodium and
potassium) between interstitial fluid and the inside of a neuron through
specific ion channels in its plasma membrane. Once begun, a nerve impulse
travels rapidly and at a constant strength.
Parts of a Neuron
• Most neurons have three parts: (1) a cell body, (2) dendrites, and (3)
an axon
• Neuronal cell bodies also contain free ribosomes and prominent
clusters of rough endoplasmic reticulum, termed Nissl bodies (NIS-el).
• The cytoskeleton includes both neurofibrils (noo-rōFĪ-brils),
composed of bundles of intermediate filaments that provide the cell
shape and support, and microtubules (mī-krōTOO-būls′), which assist
in moving materials between the cell body and axon.
Part of Neuron
• Aging neurons also contain lipofuscin (līp′-oFYŪS-īn), a pigment that
occurs as clumps of yellowish-brown granules in the cytoplasm.
• These bumps are caused by many small projections of the plasma
membrane, called somatic spines, which are receptor sites that bind
chemical messengers from other neurons.
• A collection of neuron cell bodies outside the CNS is called a ganglion
(GANG-lē-on = sculling or knot; ganglia is plural).
Part of Neuron
• A nerve fiber is a general term for any neuronal process (extension)
that emerges from the cell body of a neuron.
• Dendrites (DEN-drīts = little trees) are the receiving or input portions
of a neuron. The plasma membrane of dendrites, like the cell body,
contains numerous receptor sites for binding chemical messengers
from other neurons called dendritic spines.
• The single axon (= axis) of a neuron propagates nerve impulses
toward another neuron, a muscle fiber, or a gland cell.
• An axon is a long, thin, cylindrical projection that often joins to the
cell body at a cone-shaped elevation called the axon hillock (HIL-lok =
small hill).
Part of Neuron
• In most neurons, nerve impulses arise at the junction of the axon
hillock and the initial segment, an area called the trigger zone, from
which they travel along the axon to their destination.
• The cytoplasm of an axon, called axoplasm, is surrounded by a plasma
membrane known as the axolemma (lemma = sheath or husk). Along
the length of an axon, side branches called axon collaterals may
branch off, typically at a right angle to the axon.
• The axon and its collaterals end by dividing into many fine processes
called axon terminals or axon telodendria
The site of communication between two neurons or between a neuron
and an effector cell is called a synapse (SIN-aps)
Th tips of some axon terminal swell into bulb-shaped structures called
synaptic end bulbs; others exhibit a string of swollen called
varicosities.
Both synaptic end bulbs and varicosities contain many tiny
membrane-enclosed sacs called synaptic vesicles that store a chemical
called a neurotransmitter
A neurotransmitter is a molecule released from a synaptic vesicle that
excites or inhibits another neuron, muscle fiber, or gland cell.
Slow axonal transport
• It conveys axoplasm in one direction only— from the cell body toward
the axon terminals.
• The slower system, which moves materials about 1–5 mm per day
Fast axonal transport
• Capable of moving materials a distance of 200–400 mm per day, uses
proteins that function as “motors” to move materials along the
surfaces of microtubules of the neuron’s cytoskeleton.
• Occurs in an anterograde (forward) direction moves organelles and
synaptic vesicles from the cell body to the axon terminals.
• Occurs in a retrograde (backward) direction moves membrane vesicles
and other cellular materials from the axon terminals to the cell body to
be degraded or recycled.
Structural Diversity in Neurons
• Neurons display great diversity in size and shape. For example, their
cell bodies range in diameter from 5 micrometers (μm) (slightly
smaller than a red blood cell) up to 135 μm (barely large enough to
see with the unaided eye).
• The pattern of dendritic branching is varied and distinctive for
neurons in different parts of the nervous system. A few small neurons
lack an axon, and many others have very short axons. As we have
already discussed, the longest axons are almost as long as a person is
tall, extending from the toes to the lowest part of the brain
Classification of Neurons
• Structural Classification
Structurally, neurons are classified according to the number of processes
extending from the cell body.
1. Multipolar neurons usually have several dendrites and one axon. Most
neurons in the brain and spinal cord are of this type, as well as all motor
neurons
2. Bipolar neurons have one main dendrite and one axon. They are found in
the retina of the eye, the inner ear, and the olfactory area (olfact = to
smell) of the brain.
3. Pseudounipolar (soo′-dō-ū-ni-PŌ-lar) or unipolar neurons have
dendrites and one axon that are fused together to form a continuous
process that emerges from the cell body.
Classification of Neurons
• Functional Classification
Functionally, neurons are classified according to the direction in
which the nerve impulse is conveyed with respect to the CNS
1. Sensory neurons
2. Motor neurons
3. Interneurons or association neurons
Neuroglia
make up about half the volume of the CNS.
derives from the idea of early histologists that they were the “glue”
that held nervous tissue together
Generally, neuroglia are smaller than neurons, and they are 5 to 25
times more numerous.
glia do not generate or propagate nerve impulses,
they can multiply and divide in the mature nervous system
In cases of injury or disease, neuroglia multiply to fill in the spaces
formerly occupied by neurons.
Gliomas
Brain tumors
derived from glia
Neuroglia of the CNS
• Astrocytes-These star-shaped cells have many processes and are the
largest and most numerous of the neuroglia.
1. Protoplasmic astrocytes- have many short branching processes and
are found in gray matter.
2. Fibrous astrocytes -have many long unbranched processes and are
located mainly in white matter
The processes of astrocytes make contact with blood capillaries,
neurons, and the pia mater (a thin membrane around the brain and
spinal cord).
Oligodendrocytes
• These resemble astrocytes but are smaller and contain fewer
processes.
• responsible for forming and maintaining the myelin sheath around
CNS axons
• The myelin sheath is a multilayered lipid and protein covering around
some axons that insulates them and increases the speed of nerve
impulse conduction.
Microglial cells or Microgliocytes
• These neuroglia are small cells with slender processes that give off
numerous spinelike projections.
• function as phagocytes
• They remove cellular debris formed during normal development of
the nervous system and phagocytize microbes and damaged nervous
tissue.
Ependymal Cells
• are cuboidal to columnar cells arranged in a single layer that possess
microvilli and cilia
• These cells line the ventricles of the brain and central canal of the
spinal cord.
• Functionally, ependymal cells produce, possibly monitor, and assist in
the circulation of cerebrospinal fluid.
Neuroglia of the PNS
1. Schwann Cells
• These cells encircle PNS axons. Like oligodendrocytes, they form the myelin
sheath around axons.
• A single oligodendrocyte myelinates several axons, but each Schwann cell
(SCHVON or SCHWON) or neurolemmocyte myelinates a single axon.
• One Schwann cell can also enclose as many as 20 or more unmyelinated
axons
2. Satellite Cells
• These flat cells surround the cell bodies of neurons of PNS ganglia
• providing structural support
• regulate the exchanges of materials between neuronal cell bodies and
interstitial fluid.
Gray and White Matter
• White matter is composed primarily of myelinated axons. The whitish
color of myelin gives white matter its name.
• The gray matter of the nervous system contains neuronal cell bodies,
dendrites, unmyelinated axons, axon terminals, and neuroglia. It
appears grayish, rather than white, because the Nissl bodies impart a
gray color and there is little or no myelin in these areas.
• Blood vessels are present in both white and gray matter. In the spinal
cord, the white matter surrounds an inner core of gray matter that,
depending on how imaginative you are.
Electrical Signals in Neurons: An Overview
• Graded potentials- short-distance communication only
• Action potentials- allow communication over long distances within
the body
• muscle action potential- an action potential in a muscle fiber
• nerve action potential (nerve impulses)- When an action potential
occurs in a neuron (nerve cell).
The plasma membrane of excitable cells
exhibits a membrane potential, an
electrical potential difference (voltage)
across the membrane.
In excitable cells, this voltage is termed
the resting membrane potential.
The membrane potential is like voltage
stored in a battery. If you connect the
positive and negative terminals of a
battery with a piece of wire, electrons
will flow along the wire. This flow of
charged particles is called current. In
living cells, the flow of ions (rather than
electrons) constitutes the electrical
current.
 Ion Channels
• When ion channels are open, they allow
specific ions to move across the plasma
membrane, down their electrochemical
gradient—a concentration (chemical)
difference plus an electrical difference.
• ions move from areas of higher
concentration to areas of lower
concentration (chemical part of the
gradient)
• positively charged cations move toward a
negatively charged area, and negatively
charged anions move toward a positively
charged area (the electrical aspect of the
gradient)
 The resting membrane potential exists
because of a small buildup of negative
ions in the cytosol along the inside of the
Resting membrane, and an equal buildup of
Membrane positive ions in the extracellular fluid
(ECF) along the outside surface of the
Potential membrane.
The resting membrane potential arises from three
major factors:

1. Unequal distribution of ions in the ECF and cytosol.

2. Inability of most anions to leave the cell.
3. Electrogenic nature of the Na+ –K+ ATPases
Graded Potentials

• A graded potential is a small deviation

from the resting membrane potential that
makes the membrane either more
polarized (inside more negative) or less
polarized (inside less negative).
• Hyperpolarizing graded potential- When
the response makes the membrane more
polarized (inside more negative)
• Depolarizing graded potential- When the
response makes the membrane less
polarized (inside less negative)
 An action potential (AP) is a sequence of rapidly occurring events
that decrease and reverse the membrane potential and then
eventually restore it to the resting state. In a neuron, an AP is
called nerve impulse.
Action Potentials

A nerve impulse has two main phases: a depolarizing phase and a

repolarizing phase.

According to the all-or-none principle, if a stimulus is strong

enough to generate an action potential, the impulse generated is
of a constant size. A stronger stimulus does not generate a larger
action potential. Instead, the greater the stimulus strength above
threshold, the greater the frequency of the action potentials.
A nerve impulse occurs in the membrane of the axon of
a neuron when depolarization reaches a certain level
termed the threshold (about −55 mV in many neurons).

A nerve impulse will not occur in response to a

subthreshold stimulus, a weak depolarization that
cannot bring the membrane potential to threshold.

However, a nerve impulse will occur in response to a

threshold stimulus, a stimulus that is just strong
enough to depolarize the membrane to threshold.

Several nerve impulses will form in response to a

suprathreshold stimulus, a stimulus that is strong
enough to depolarize the membrane above threshold.
• During the depolarizing phase, the negative
membrane potential becomes less negative,
reaches zero, and then becomes positive.
• During the repolarizing phase, the membrane
potential is restored to the resting state of −70
mV.
• Repolarizing phase there may be an
after-hyperpolarizing phase, during which the
membrane potential temporarily becomes more
negative than the resting level.
Signal Transmission at Synapses
• Synapse (SIN- aps) is a region where communication occurs between
two neurons or between a neuron and an effector cell (muscle cell or
glandular cell).
• The term presynaptic neuron (pre- = before) refers to a nerve cell
that carries a nerve impulse toward a synapse. It is the cell that sends
a signal.
• A postsynaptic cell is the cell that receives a signal. It may be a nerve
cell called a postsynaptic neuron (post- = after) that carries a nerve
impulse away from a synapse or an effector cell that responds to the
impulse at the synapse
Electrical
Synapses
an electrical synapse, action
potentials conduct directly
between the plasma
membranes of adjacent
neurons through structures
called gap junctions.
Electrical synapses have two
main advantages:
1. Faster communication. Because action potentials conduct
directly through gap junctions, electrical synapses are
faster than chemical synapses.
2. Synchronization. Electrical synapses can synchronize
(coordinate) the activity of a group of neurons or muscle
fibers. In other words, a large number of neurons or
muscle fibers can produce action potentials in unison if
they are connected by gap junctions.
Chemical synapses

• Although the plasma

membranes of presynaptic
and postsynaptic neurons
in a chemical synapse are
close, they do not touch.
• A chemical synapse
produces one-way
information transfer—from
a presynaptic neuron to a
postsynaptic neuron.
There are two major types of neurotransmitter
receptors:
• Ionotropic receptors and metabotropic receptors.
• An ionotropic receptor contains a neurotransmitter binding site and
an ion channel.
• A metabotropic receptor contains a neurotransmitter binding site
and is coupled to a separate ion channel by a G protein.
 • Diffusion, enzymatic degradation, and
uptake by cells (neurons and neuroglia).

Neurotransmitter
1. Diffusion. Some of the released
neurotransmitter molecules diffuse away
from the synaptic cleft. Once a
neurotransmitter molecule is out of reach of

is removed from its receptors, it can no longer exert an

effect.
2. Enzymatic degradation. Certain
neurotransmitters are inactivated through

the synaptic cleft enzymatic degradation. For example, the

enzyme acetylcholinesterase breaks down
acetylcholine in the synaptic cleft.

in three ways: 3. Uptake by cells. Many neurotransmitters

are actively transported back into the
neuron that released them (reuptake).
Others are transported into neighboring
neuroglia (uptake)
 Neurotransmitters
Both excitatory and inhibitory neurotransmitters are present in the
CNS and the PNS. A given neurotransmitter may be excitatory in some
locations and inhibitory in others.
Neurotransmitters can be divided into two classes based on size:
(1) small-molecule neurotransmitters (acetylcholine, amino acids,
biogenic amines, ATP and other purines, nitric oxide, and carbon
monoxide), and
(2) neuropeptides, which are composed of 3 to 40 amino acid
 Neural Circuits
Neurons in the central nervous system are organized into
networks
 Diverging
circuit
The nerve impulse from a single
presynaptic neuron causes the
stimulation of increasing numbers of cells
along the circuit.
For example, a small number of neurons
in the brain that govern a particular body
movement stimulate a much larger
number of neurons in the spinal cord.
Sensory signals are also arranged in
diverging circuits, allowing a sensory
impulse to be relayed to several regions
of the brain.
 Convergence Circuit
Several presynaptic neurons synapse
with a single postsynaptic neuron. This
arrangement permits more effective
stimulation or inhibition of the
postsynaptic neuron
For example, a single motor neuron
that synapses with skeletal muscle
fibers at neuromuscular junctions
receives input from several pathways
that originate in different brain regions
Reverberating circuit
In this pattern, the incoming impulse stimulates
the first neuron, which stimulates the second,
which stimulates the third, and so on. Branches
from later neurons synapse with earlier ones.
This arrangement sends impulses back through
the circuit again and again. The output signal
may last from a few seconds to many hours,
depending on the number of synapses and the
arrangement of neurons in the circuit.
Among the body responses thought to be the
result of output signals from reverberating
circuits are breathing, coordinated muscular
activities, waking up, and short- term memory
Parallel after- discharge
circuit
In this circuit, a single presynaptic
cell stimulates a group of neurons,
each of which synapses with a
common postsynaptic cell.

Parallel after-discharge circuits may

be involved in precise activities such
as mathematical calculations.
Neural circuits include simple series
 Regeneration and Repair
of Nervous Tissue
The nervous system exhibits plasticity (the
capability to change based on experience),
but it has very limited powers of
regeneration (the capability to replicate or
repair damaged neurons)
 The birth of new neurons from
undifferentiated stem cells, is normally
very limited. Repair of damaged axons
does not occur in most regions of the CNS.

Neurogenesis Axons and dendrites that are associated

with a neurolemma in the PNS may
undergo repair if the cell body is intact, the
Schwann cells are functional, and scar
tissue formation does not occur too
rapidly
Disorders: Homeostatic
Imbalances

Multiple sclerosis (MS)

• disease that causes a progressive destruction
of myelin sheaths surrounding neurons in the
CNS

Epilepsy
• characterized by short, recurrent attacks of
motor, sensory, or psychological malfunction,
although it almost never affects intelligence.
The attacks, called epileptic seizures, afflict
about 1% of the world’s population.
Excitotoxicity
A high level of glutamate in the
interstitial fluid of the CNS causes
excitotoxicity (ek- sī′-tō- tok- SIS-i-
tē)—destruction of neurons
through prolonged activation of
excitatory synaptic transmission.
 Depression
a disorder that affects over 18 million people each year in the
United States. People who are depressed feel sad and helpless,
have a lack of interest in activities that they once enjoyed, and
experience suicidal thoughts.
A person with major depression experiences symptoms of
depression that last for more than two weeks.
A person with dysthymia (dis- THĪ- mē-a) experiences episodes
of depression that alternate with periods of feeling.
A person with bipolar disorder, or manic-depressive illness,
experiences recurrent episodes of depression and extreme
elation (mania).
A person with seasonal affective disorder (SAD) experiences
depression during the winter months, when day length is
short
The Spinal Cord and Spinal Nerves
Chapter 13
Protective Structures
• Vertebral Column- The spinal cord is located within the vertebral
canal of the vertebral column. The surrounding vertebrae provide a
sturdy shelter for the enclosed spinal cord. The vertebral ligaments,
meninges, and cerebrospinal fluid provide additional protection.
• Meninges-The meninges (me-NIN-jēz; singular is meninx [MĒ-ninks])
are three distinct protective, connective tissue coverings that encircle
the spinal cord and brain.
• The spinal meninges cover the spinal cord (Figure 13.1a) and are
continuous with the cranial meninges, which cover the brain.
Three meninges are coverings
that run continuously around
the spinal cord and brain
• Dura mater- The most superficial of the three
spinal meninges is a thick strong layer
composed of dense irregular connective tissue
• Arachnoid mater- This layer, the middle of the
meningeal membranes, is a thin, avascular
covering comprised of cells and thin, loosely
arranged collagen and elastic fibers. It is called
the arachnoid mater because of its spider’s-web
arrangement
• Pia mater- This innermost meninx is a thin
transparent connective tissue layer that adheres
to the surface of the spinal cord and brain.
 The spinal cord begins as a continuation of the medulla
oblongata and ends at about the second lumbar vertebra in
an adult.

External The spinal cord contains cervical and lumbosacral

enlargements that serve as points of origin for nerves to
the limbs.
Anatomy of
the Spinal The tapered inferior portion of the spinal cord is the conus
medullaris, from which arise the filum terminale and cauda
equina.
Cord
Spinal nerves connect to each segment of the spinal cord
by two roots. The posterior root contains sensory axons,
and the anterior root contains motor neuron axons.
 The anterior median fissure and the posterior median sulcus
partially divide the spinal cord into right and left side.
Internal
Anatomy of The gray matter in the spinal cord is divided into horns, and
the white matter into funiculi. In the center of the spinal
cord is the central canal, which runs the length of the spinal
the Spinal cord.

Cord Parts of the spinal cord observed in transverse section are

the gray commissure; central canal; anterior, posterior, and
lateral gray horns; and anterior, posterior, and lateral white
funiculi, which contain ascending and descending tracts.
These bundles, which may extend long distances up or down
the spinal cord, are called tracts.
Sensory (ascending) tracts consist of axons that conduct nerve
impulses toward the brain.
Tracts consisting of axons that carry nerve impulses from the
brain are called motor (descending) tracts. Sensory and motor
tracts of the spinal cord are continuous with sensory and
motor tracts in the brain.
SPINAL NERVES
The 31 pairs of spinal nerves are named and numbered according
to the region and level of the spinal cord from which they emerge.

There are 8 pairs of cervical, 12 pairs of thoracic, 5 pairs of

lumbar, 5 pairs of sacral, and 1 pair of coccygeal nerves

Spinal nerves typically are connected with the spinal cord by a

posterior root and an anterior root. All spinal nerves contain
both sensory and motor axons (they are mixed nerves).
 THREE CONNECTIVE TISSUE BRANCHES OF A SPINAL NERVE
COVERINGS ASSOCIATED WITH INCLUDE THE POSTERIOR
SPINAL NERVES ARE THE RAMUS, ANTERIOR RAMUS,
ENDONEURIUM, PERINEURIUM, MENINGEAL BRANCH, AND
AND EPINEURIUM. COMMUNICATING RAMI.

ANTERIOR RAMI OF NERVES

T2–T12 DO NOT FORM
THE ANTERIOR RAMI OF SPINAL
PLEXUSES AND ARE CALLED
NERVES, EXCEPT FOR T2–T12,
INTERCOSTAL NERVES. THEY ARE
FORM NETWORKS OF NERVES
DISTRIBUTED DIRECTLY TO THE
CALLED PLEXUSES
STRUCTURES THEY SUPPLY IN
INTERCOSTAL SPACES.
•Sensory neurons within spinal
nerves serve specific, constant
segments of the skin called
dermatomes.
•Knowledge of dermatomes
helps a physician determine
which segment of the spinal
cord or which spinal nerve is
damaged
 The cervical plexus is formed by the roots
(anterior rami) of the first four cervical

Cervical nerves (C1–C4), with contributions from C5.

Nerves of the cervical plexus supply the skin

Plexus and muscles of the head, neck, and upper

part of the shoulders; they connect with
some cranial nerves and innervate the
diaphragm.
 The roots (anterior rami) of spinal

Brachial nerves C5–C8 and T1 form the

brachial plexus

Plexus Nerves of the brachial plexus supply

the upper limbs and several neck and
shoulder muscles.
 The roots (anterior rami) of
spinal nerves L1–L4 form the
Lumbar lumbar plexus.
Nerves of the lumbar plexus

Plexus supply the anterolateral

abdominal wall, external
genitals, and part of the lower
limbs
 The roots (anterior rami) of spinal
nerves L1–L5 and S1–S4 form the
sacral plexus.
Sacral and Nerves of the sacral plexus supply
the buttocks, perineum, and part of
the lower limbs.
Coccygeal The roots (anterior rami) of the
spinal nerves S4–S5 and the
coccygeal nerves form the coccygeal
Plexuses plexus.
Nerves of the coccygeal plexus
supply the skin of the coccygeal
region
 The white matter tracts in the spinal cord are
highways for nerve impulse propagation. Along
these tracts, sensory input travels toward the brain,
and motor output travels from the brain toward
skeletal muscles and other effector tissues.
Sensory input travels along two main routes in the
Spinal Cord white matter of the spinal cord: the posterior
funiculi and the spinothalamic tract.
Physiology
Motor output travels along two main routes in the
white matter of the spinal cord: direct pathways
and indirect pathways.
A reflex is a fast, predictable sequence of involuntary actions, such as
muscle contractions or glandular secretions, which occurs in response
to certain changes in the environment. Reflexes may be spinal or cranial
and somatic or autonomic.
The Stretch Reflex
Tendon Reflex
The Flexor and Crossed Extensor Reflexes
Crossed extensor reflex
Somatic reflexes of clinical significance are
the following:
• Patellar reflex (knee jerk). This stretch reflex involves extension of the leg
at the knee joint by contraction of the quadriceps femoris muscle in
response to tapping the patellar ligament
• Achilles reflex (a-KIL-ēz) (ankle jerk). This stretch reflex involves plantar
flexion of the foot by contraction of the gastrocnemius and soleus muscles
in response to tapping the calcaneal (Achilles) tendon.
• Babinski sign (ba-BIN-skē) or extensor plantar reflex. This reflex results
from gentle stroking of the lateral outer margin of the sole. The great toe
extends, with or without a lateral fanning of the other toes.
• Abdominal reflex. This reflex involves contraction of the muscles that
compress the abdominal wall in response to stroking the side of the
abdomen.
 The spinal cord can be
damaged in several ways.
Outcomes range from
Disorders: little or no long-term
neurological deficits to
Homeostatic severe deficits and even
death.
Imbalances
Traumatic Injuries
• Most spinal cord injuries are due to trauma as a result of factors such as
automobile accidents, falls, contact sports, diving, and acts of violence.
• Monoplegia (mon′-ō-PLĒjē-a; mono- = one; -plegia = blow or strike) is
paralysis of one limb only.
• Diplegia (di- = two) is paralysis of both upper limbs or both lower limbs
• Paraplegia (para- = beyond) is paralysis of both lower limbs.
• Hemiplegia (hemi- = half) is paralysis of the upper limb, trunk, and lower
limb on one side of the body, and
• quadriplegia (quad- = four) is paralysis of all four limbs.
 C1–C3: no function maintained from the neck
down; ventilator needed for breathing; electric
wheelchair with breath, head, or
shoulder-controlled device required (see Figure A)

C4–C5: diaphragm, which allows breathing

C6–C7: some arm and chest muscles, which

allows feeding, some dressing; manual wheelchair
required (see Figure B)
T1–T3: intact arm function

T4–T9: control of trunk above the umbilicus

T10–L1: most thigh muscles, which allows walking

with long leg braces (see Figure C) •

L1–L2: most leg muscles, which allows walking

with short leg braces (see Figure D