ANATOMY and PHYSIOLOGY

of
NERVOUS SYSTEM
NERVOUS SYSTEM
➢ The nervous system has three specific functions:
1. Sensory input.
• Sensory receptors in skin and organs respond to external and internal stimuli by generating nerve signals that
travel to the brain and spinal cord.
• For example, temperature sensors in the skin may signal to the brain that the air surrounding the body is cold.
2. Integration
• The brain and spinal cord interpret the data received from sensory receptors all over the body, and signal
• the appropriate nerve responses.
• To continue the example of body temperature, sensory information from temperature receptors is sent to the
hypothalamus, the brain center that controls body temperature.
3. Motor output
• The nerve signals from the brain and spinal cord go to the effectors, which are muscles, glands, and
• Organs — in other words, structures that will have an effect.
• Muscle contractions, gland secretions, and changes in organ function are responses to stimuli received by
sensory receptors.
• For example, when adjusting body temperature, the hypothalamus triggers shivering—skeletal muscles
contract rhythmically, producing heat that warms the body.
➢ It is important to remember that the nervous system maintains homeostasis by receiving sensory information, integrating
that information, and making an appropriate response.

Two Divisions of the Nervous System:

A. CENTRAL NERVOUS SYSTEM - which have a central location—they lie in the midline of the body.
• Brain
• Spinal cord
B. PERIPHERAL NERVOUS SYSTEM
which is further divided into the afferent (sensory) and efferent (motor) divisions, includes all the cranial and spinal nerves.
• Cranial Nerves (12 pairs)
• Spinal nerves (31 pairs)
• Autonomic Nervous System CENTRAL NERVOUS SYSTEM

Brain Spinal cord

PERIPHERAL NERVOUS SYSTEM

sensory (afferent) nerves — motor (efferent) nerves —
carry sensory information carry motor information
into brain and spinal cord from CNS to erectors

somatic sensory nerves:

autonomic motor nerves:
signals from skin, skeletal somatic motor nerves:
visceral sensor nerves: signals to smooth muscle,
muscles, signals to skeletal
signals from body organs cardiac muscle, glands,
joints, tendons, special muscles, voluntary
Involuntary
senses

sympathetic parasympathetic
division division
“fight or flight” “rest and digest”

The CNS and PNS communicate with each other. Somatic sensory and visceral sensory nerves carry information to the brain and spinal cord. Somatic
motor nerves signal skeletal muscles and autonomic motor nerves signal smooth muscle, cardiac muscle, and glands.
Neurotransmitter
• AKA “chemical messengers”
Function:
• Neurotransmission of signals across a chemical synapse such as the NMJ ( neuromuscular junction)
Different neurotransmitters:
1. Dopamine
• Influences movement, learning, attention, and emotion.
Problems caused by Imbalance:
• (↑) Oversupply linked to Schizophrenia
• (↓) Undersupply linked to tremors and decreased mobility in Parkinson’s disease and ADHD
2. Serotonin
• Affects mood, hunger, sleep, and arousal
• “happy hormone”
Problems caused by Imbalance:
• (↓) Undersupply linked to Depression
• (↑) Some antidepressant drug raise serotonin levels ( Mania)
3. Acetylcholine (Ach)
• Enables muscles action, learning, and memory
• Behavior , memory, attention, muscle
Problems caused by Imbalance:
• Ach-producing neurons deteriorate as Alzheimer’s disease progresses.
4. GABA (gamma aminobutyric acid)
• A major inhibitory neurotransmitter
Problems caused by Imbalance:
• (↓) Undersupply linked to seizures, tremors, and insomnia, anxiety
• (↑) oversupply linked to Sedation
4. Norepinephrine
• Helps control alertness and arousal
Problems caused by Imbalance:
• (↑) depressed mood, racing heart, manic, elevated blood pressure
• (↓) Undersupply can depress mood and cause ADHD-like attention problems. Lack of energy, lack of drive, reduce
focus on goals
5. Glutamate
• A major excitatory neurotransmitter
• Involved in memory
Problems caused by imbalance:
• (↑) Oversupply can overstimulate the brain, producing migraines or seizures; this is why some people avoid MSG
(monosodium glutamate) in food.
• (↓) Undersupply Lou Gehrig’s disease
Amyotrophic lateral sclerosis (or ALS, is a progressive nervous system disease that affects nerve cells in the brain and
spinal cord, causing loss of muscle control. AKA Lou Gehrig's disease
6. Endorphin & Enkephalin
• Converts painful stimuli into pleasure.
Problems caused by Imbalance:
• (↑) potentially involved in addiction
• (↓) Undersupply can sense of inadequacy, inability to combat pain
Nervous Tissue
• Made up of just two principal types of cells:
1. Neurons
• also called nerve cells - which generate and transmit nerve signals
2. Neuroglia
• which nourish and support the neurons.
Types of Neurons
• Neurons can be classified according to their physiologic function and anatomical structure.
• Three types of neurons:
1. Sensory neurons
• take nerve signals from sensory receptors to the CNS.
2. Interneurons
• also known as association neurons, occur entirely within the CNS
3. Motor neurons
• are multipolar neurons that take nerve signals from the CNS to muscles, organs, or glands
• Motor neurons cause muscle fibers to contract, organs to modify their function, or glands to secrete.
Embryological Divisions of the Brain
1. FOREBRAIN (PROSENCEPHALON)
a. Telencephalon (cerebrum)
b. Diencephalon (thalamus, epithalamus, hypothalamus)
2. MIDBRAIN (MESENCEPHALON)
a. Corpora quadrigemina
b. Cerebral peduncles
3. HINDBRAIN (PHOMBENCEPHALON)
a. Metencephalon (cerebellum, pons)
b. Myelencephalon(medulla oblongata)
CENTRAL NERVOUS SYSTEM
• The CNS, consisting of the brain and spinal cord, is composed of gray matter and white matter.
Gray matter
• is gray because it contains cell bodies and short, non-myelinated fibers.
White matter
• is white because it contains myelinated axons that run together in bundles called tracts.

A. BRAIN
• It is described as that part of the central nervous system contained within the skull
• It is the most complex and largest mass of nervous tissue in the body and contains billions of nerve cells.

• The average weight od the adult human brain:

a. Male: 1380 grams
b. Female 1250 grams
• The brain grows rapidly up to the 5th year of life and stops growing after the age of 20.
• The weight decreases during old age. A fully developed brain completely fills the cranial cavity.

❖ Gray matter – composed of nerve cell bodies.

❖ White matter – composed of myelinated nerve fibers
❖ Nucleus – a mass of gray matter (nerve cells) in any part of the brain and spinal cord.
❖ Ganglion – cluster of nerve cells located outside the brain and spinal cord.
❖ Nerve, nerve root, nerve cord or Ramus - bundles of nerve fibers outside the brain and spinal cord
❖ Commissure – a band of fibers joining corresponding opposite parts of the brain and spinal cord.
B. CEREBRUM (TELENCEPHALON) – “true brain”
• This is the largest portion of the brain comprising 7/8 of the total weight.
• It contains the center for sensory and motor activities, and is the seat of reason, memory, and influence.
• The surface called the cerebral cortex – is composed of gray matter that is thrown into twisting folds and
infoldings.
• Each bulge is a convolution called gyrus.
• The intervening furrows in between the gyri:
o if it is shallow is called sulcus
o If it is deep called fissure
o The innermost part is made up of white matter.
• Divided into two cerebral hemisphere (R & L)
o Joined by the corpus callosum
o Has contralateral control of the body
✓ Right side prominence: music, arts, visual
✓ Left side hemisphere: logic, math, linguistic (language)

Fissures of the Cerebrum:

1. Longitudinal Fissure - Creates Right & Left Hemisphere
• Extends from the posterior to the anterior aspect, almost completely dividing the cerebrum into 2
hemisphere.
o The hemisphere are “mirror twins”, each with a full set of centers for sensory and motor activities of
the body and each associated with one side of the body.
o The hemisphere are connected in the midline by the corpus callosom, which is composed of nerve
fibers. Its function is to allow the two hemisphere to share learning and memory.
 2. Lateral Sulcus of Sylvian Fissure (Sylvian Fissure) - Separate TEMPORAL lobe from Frontal and Parietal lobes
• This fissure lies between the frontal and parietal lobes above and the temporal lobe below.
• Associated with the centers for speech and hearing.
3. Central Sulcus of Rolando (Rolandic Fissure) - Separates Frontal and Parietal lobes
• Between the frontal and parietal lobes
• Associated with the centers for both motor and sensory functions.
4. Parieto-occipital Fissure
• Between the parietal and occipital lobes
5. Transverse Fissure - Separates Cerebellum from the Occipital lobe
• Between the cerebrum and cerebellum

LOBES OF THE CEREBRAL CORTEX

A. Frontal lobe
• It includes all areas of the cortex lying anterior to the central sulcus and above the lateral sulcus.
• It is the site of the center fro motor functions (controls movement); intelligence, memory and personality
BROCA’S AREA
• Motor speech center ( ability to speak or articulate)
COGNITIVE ABILITY
• Thinking, judgement, short term memory (working memory)

B. Parietal Lobe
• It extends from the central sulcus to the parieto-occipital sulcus, about 4/5 of the way around the cortex.
• It has the center for sensory functions.
• General sensation
o pain., pressure, heat, cold
• Spatial ability
o Orientation to space & dimension
 C. Temporal Lobe
• This is lobe lies below the lateral sulcus.
• Center for hearing and olfaction.
WERNICK'S AREA - understand speech
D. Occipital Lobe
• It occupies the posterior extremity of the cerebral hemisphere.
• Center for vision

E. Insula (Island of Reil)

• Lobe found within the lateral cerebral fissure
• Limbic center and seat of emotions.

FUNCTIONS OF THE CEREBRUM:

1. Primary motor area (pre-central gyrus)
• Lies in the frontal lobe immediately anterior to the central sulcus
• This is the area for voluntary movements
• The motor area of the right hemisphere controls voluntary muscle movements on the left side of the body and
vice-versa

2. Pre-motor area
• Lies in front of the motor area
• Exerts a controlling influence over the motor area, ensuring an orderly series of movements.
• Necessary for sppech.
3. Pre-frontal area
• Responsible for behavoir, character, and emotional state of the individual
4. Primary sensory/ somesthatic area (Post-central gyrus)
• Lies behind the central sulcus
• Sensations of pain, temperature, pressure and touch, position and movement sensations are received and
interpreted.

5. Parietal area
• Obtaining and retaining accurate knowledge of objects

6. Sensory speech area

• Lies behind the lower part of the parietal region
• Spoken words are perceived here

7. Auditory or hearing area

• Lies below the lateral sulcus within the temporal lobe
• Center for hearing
8. Smell area
• Within the temporal lobe

9. Taste area
• Above the lateral sulcus in the deep layers of the sensory area

10. Visual area

• Around the cacarine fissure including the greater part of the occipital
C. DIENCEPHALON
1. Thalamus
• A large mass of gray matter located in the cerebral hemisphere functioning as “relay station” between the
cerebrum and the rest of the brain and spinal cord.
o Relay/transmits impulses to cerebral cortex
o Regulation of sleep, consciousness, and alertness
2. Hypothalamus
• It lies below the thalamus, forming part of the lateral walls of the 3rd ventricle.
• It contains temperature-regulating mechanisms and relations with the pituitary gland.
• This area is concerned with the sensations of hunger, thirst, and defense reactions including fear and rage.
D. MIDBRAIN
• The midbrain is located between the forebrain and hindbrain.
• It connects the cerebrum with the pons and cerebellum and is concerned with motor coordination.
It consist of:
1. Cerebral peduncles
• A pair of cylindrical bodies made up of nerve fiber tracts which connect the forebrain with the hindbrain.
2. Cerebral aqueduct of Sylvius) (Iter)
• Canal which connects the 3rd and 4th ventricles of the brain (important part)
3. Corpora quadrigemina
• Four rounded nuclear masses consisting of:
a. Superior colliculi – upper 2 for visual reflexes
b. Inferior colliculi – lower 2 fro auditory reflexes
E. CEREBELLUM – “little brain”
• Lies behind the central sulcus
E. CEREBELLUM – “little brain”
• The cerebellum occupies the posterior cranial fossa.
• It is oval in shape with a central constriction and two lateral expanded portions.
• The constricted central portion is called vermis and the lateral expanded parts of the cerebellar hemisphere.
• Gray matter forms of cortex placed on the surface, transversed by numerous sulci.
• It is separated from the cerebrum by the tentorium cerebelli – a membranous layer derived from the
meninges.
• Cognition, balance and coordination (Romberg's test)

Lobes of the cerebrum

a. Anterior – concerned with posture
b. Posterior – coordination of movements
c. Flocculonodular lobe – equilibrium.

F. BRAINSTEM
1. PONS VAROLLI
• This part of the brain is situated in front of the cerebellum between the midbrain and the medulla oblongata.
• It is a bridge-like structure composed almost entirely of white matter linking the various parts of the brain and
serving as a relay station from the medulla to the higher cortical centers.
• It joins the two halves of the cerebellum.
• There is a pneumotaxic center in the pons that participates in the regulation of repiration.
Cranial nerves that emerge from the pons:
1. Trigeminal nerve 5th CN
2. Abducens nerve 6th CN
3. Facial nerve 7th CN
4. Vestibulocochlear nerve 8th CN
2. MEDULLA OBLONGATA
• The medulla oblongata extends from the pons varolli above and is continuous with the spinal cord below.
• It is approximately 2.5 cm long and pyramidal in shape being narrow below and above.
• The nerve cells of the medulla are grouped to form “nuclei”, out of which the following cranial nerves arise:
1. Glossopharyngeal nerve 9th CN
2. Vagus nerve 10th CN
3. Spinal accessory nerve 11th CN
4. Hypoglossal nerve 12th CN

Functions of medulla oblongata:

1. Organ of conduction for the presence of impulses between the spnal cord and the brain.
2. Contains centers for control of bodily functions:
a. Cardiac inhibitory center
• Constantly discharges impulse to hold the heart to a slower rate through the vagus nerve
(CNX)
b. Vasoconstrictor center
• Causes narrowing of the arteries
c. Respiratory center
• Controls the rate and depth of respiration
d. Reflex centers
• Sneezing, coughing, vomiting, winking, and the movements and secretions of the alimentary
canal
G. MENINGES
• The meninges are composed of the membranes that cover the brain ans spinal cord.
• There 3 major layers:
1. Dura mater (1st layer)
• Consist of 2 layers of dense fibrous containing many blood vessles.
• The outer layer takes the place of the periosteum on the inner surface of the skull bones and the
inner layer provides a protective covering for the brain and spinal cord.
• The two layers are closely adherent except where the inner sweeps inward between the:
a. Cerebral hemisphere – falx cerebri
b. Cerebellar hemisphere - falx cerebelli
c. Cerebrum and cerebellum – tentorium cerebelli
2. Arachnoid mater (middle)
• The arachnoid layer is a delicate serous membrane situated between the dura and pia mater.
• It is separated from the dura by a potential space known as the subdural space, and from the pia
mater by a definite space, the subarachnoid space where the cerebrospinal fluid flows.
3. Pia mater
• A fine vascular membrane consisting mainly of minute blood vessel that are supported by fine
connective tissue.
• It closely invests the brain completely covering the convolutions and dipping down into each fissure.
• It also continues downward to cover the spinal cord.
• At the end of the spinal cord, it continues as the filum terminale which fuses with the coccyx.

Ventricles of the brain and cerebrospinal Fluid

1. Lateral Ventricles
• Lie within the cerebral hemisphere one on either side of the median plane.
• They are separated from each other by a thin membrane known as septum pellucidum.
 • They are separated from each other by a thin membrane known as septum pellucidum.
• Within the walls of these ventricles, there is a highly vascular membrane known as choroids plexus,
where the cerebrospinal fluid (CSF) is derived from the blood,
2. Third Ventricle
• Contains CSF and situated below the lateral ventricles between the diencephalons.
• It communicates with the lateral ventricles through the interventricular foramen of Monroe.

3. Fourth Ventricle
• This is a lozenge-shaped cavity containing CSF below and behind the third ventricle, in front of the
cerebellum and behind the pons.
• It communicates with the third ventricle above by a canal known as the aqueduct of Slyvius or iter.
• In the roof, there is an opening called the foramen of Magendie.
• In the lateral wall, there are two openings called the foramina of Luschka.
• Through these three openings, the ventricle communicates with the subarachnoid space.
• And the CSF circulates from one to the other.

CEREBROSPINAL FLUID
• This is formed, and secreted within the ventricles of the brain by the choroid plexus.
• It is clear, slightly alkaline fluid consisting of water, protein, some glucose, lymphocytes and hormones.
• The average amount of CSF is 80 – 200 Ml.

Pathway of CSF:
Choroid plexus → Lateral ventricles → interventricular foramen of Monroe → Third ventricle →
aqueduct of Sylvius or iter → Fourth ventricle → lateral foramina of Luschka and median foramen
of Mgendie → subarachnoid space → absorbed trough the arachnoid villi. And drained into superior
sagittal sinus → back to the circulation
CEREBROSPINAL FLUID
• This is formed, and secreted within the ventricles of the brain by the choroid plexus.
• It is clear, slightly alkaline fluid consisting of water, protein, some glucose, lymphocytes and hormones.
• The average amount of CSF is 80 – 200 Ml.

Pathway of CSF:
Choroid plexus → Lateral ventricles → interventricular foramen of Monroe → Third ventricle →
aqueduct of Sylvius or iter → Fourth ventricle → lateral foramina of Luschka and median foramen
of Mgendie → subarachnoid space → absorbed trough the arachnoid villi. And drained into superior
sagittal sinus → back to the circulation

Functions of the CSF:

1. Supports and protects delicate structures of the brain and spinal cord
2. Maintains a uniform pressure around these structures.
3. Acts a cushion and shock absorber for the brain and spinal cord
4. Keep brain and spinal cord moist.

Blood supply of the brain

There are two pairs of arteries which are the main blood supply of the brain.
1. Internal carotid artery
• Form the common carotid, enters the cranial cavity though the carotidtd canal
2. Vertebral arteries
• Form the subclavian artery ascends by passing through the vertebral foramina of the cervical vertebrae.
• It enters the foramen magnum and unite to from the basilar artery.
 Circle of Willis
• An arterial anastomosis at the base of the brain.
• It is formed by the union of branches of the internal carotid arteries and the branches from the basilar artery.
• It is important to equalize the circulation of the blood to the brain and in case of a block in one of these arteries,
it provides for blood reaching the affected area.

Blood drainage of the Brain

• The blood drainage is through the large venous sinuses derived from the dura mater and into the internal
jugular veins at either side of the neck.

H. SPINAL CORD
• The spinal cord is the elongated, almost cylindrical part of the CNS which lies within the vertebral canal.
• It is continues with the medulla oblongata above and extends from upper border of the atlas to the lower border of
the 1st lumbar vertebra in the adult.
• It narrows down down as the conus medullaris, where it gives rise to the thread-like filum terminale and
terminates in the first coccygeal vertebra.
• It presents two enlargements:
1. Cervical enlargement – at the level of C4 to T2
2. Lumbar enlargement – at the level of T10; widest at T12
• The spinal cord is the nervous tissue link between the brain and the organs of the body.
• Similarly , sensory nerves from the skin and other organs enter and pass upwards in the spinal cord to the brain.

Internal structure of the Spinal Cord

• The spinal cord is composed of gray matter in the center surrounded by white matter.
• The nerve cells are in the gray matter while the nerve fibers comprise the white matter.
PERIPHERAL NERVOUS SYSTEM
Structure of a Nerve
• Endoneurium surrounds each fiber
• Groups of fibers are bound into fascicles by perineurium
• Fascicles are bound together by epineurium

CRANIAL NERVES:
• There are 12 pairs arising from different areas of the brain.
• They function generally as purely sensory, purely motor, or mixed sensory and motor.

CN I Olfactory – sensory
• These are the nerves of the sense of smell.
• Their nerve endings arise in the upper part of the nose and pass upwards thorugh the ethmoid bone to reach
the olfactory center in the temporal lobe.

CN II Optic – sensory
• These are the nerves of the sense of sight.
• The fibers originate from the retina of the eye and combine to form the optic nerve.
• The center for sight is in the calcarine area of the occipital bone.

CN III Oculomotor – motor

• These nerves arise from the midbrain.
• They supply the extraocular muscles except the lateral rectus and superior oblique, the ciliary muscle which
alter the shape of the lens, and the levator palpebra superioris which raises the upper eyelid.
CN IV Trochlear - motor
• Arise from the midbrain; supplies the superior oblique muscle of the eyeball.

CN V Trigeminal – mixed
• The largest of the cranial nerves and arise from the pons.
• They are the chief sensory nerves for the face and head for temperature, pain and toch.
• The motor fibers stimulate the muscles of mastication.
Three divisions:
1. Opthalmic
2. Maxillary
3. Mandibular

CN VI Abducens – motor
• These nerve arise also from the pons.
• They supply the lateral rectus muscle of the eyeball.

CN VII Facial – mixed

• From the pons.
• Motor fibers supply the muscles of facial expression.
• Sensory fibers supply the taste buds to the anterior 2/3 of the tongue.

CN VIII Vestibulocochlear (auditory) – sensory

• Vestibular nerves arise from the semicircular canals and convey impulses to the cerebellum.
• Cochlear nerves originate in the organ of Corti in the inner ear and convey impulses to the temporal lobe.
CN IX Glossopharyngeal Nerve – mixed
• Arise from the medulla oblongata.
• Motor fibers stimulate muscles of the tongue and pharynx.
• Sensory fibers convey impulses to the cerebral cortex from the posterior 1/3 of the tongue, tonsils and pharynx
and from the taste buds in the tongue and pharynx.

CNX Vagus – mixed

• They arise from the medulla oblongata and pass down through the neck, thorax and abdomen.
• The motor fibers supply the smooth muscles of the internal organs while the sensory fibers convey impulses
from the lining membranes of the same structures.

CNXI Spinal accessory – motor

• Arise from nerve cells in the medulla oblongata and the spinal cord.
• Their fibers supply sternocleidomastoid and trapezius muscles.

CN XII Hypoglossal – motor

• Arise from the medulla oblongata.
• Supplies the extrinsic muscles of the tongue (genioglossus, hyoglossus, styloglossus)
SPINAL NERVES
• There are 31 pairs of spinal nerves numbered according to the level of the spinal cord from which they emerge:
8 Cervical
9 Thoracic
10 Lumbar
5 Sacral
1 Coccygeal

There are 5 large plexuses formed on each side of the spinal column.
1. Cervical plexus (C1-C4)
• Formed from the first 4 cervical nerves
• This supplies the back and side of the head and front of the neck
• Gives off the phrenic nerve to supply the diaphragm
2. Brachial plexus (C5 - T1)
• Lower 4 cervical and 1st thoracic supplies the skin and muscles of the upper limb.
• Gives off the circumflex, radial, median, ulnar and musculocutaneous nerves.
3. Thoracic plexus (T1 – T12)
• Composed of 11 pairs of intercostals nerves between the ribs
• The 12th pair is known as the subcostal nerve
4. Lumbar (L1 – L4)
• 2 major nerves derived from the lumbar plexus:
1. Obturator nerve
• From anterior division of L2 – L4 and supplies the skin and muscles of the medial aspect of the
thigh
2. Femoral nerve
• From posterior division of L2 – L4 and supplies the skin and muscles on anterior aspect of the
thigh.
AUTONOMIC NERVPUS SYSTEM
• The autonomic or voluntary part of the nervous system controls the functions of the body carried out automatically
(e.g., increase in heart rate, respiration, blood pressure).
• The effects of autonomic control are essential for homeostasis and include stimulation or depression of glandulare
secretion and contraction of cardiac and smooth muscle tissue.

A. Sympathetic or Thoracolumbar
• The nerve fibers arise from all the thoracic and first lumbar segments of the spinal cord.
• It is more primitive, exerting its effect through epinephrine from the adrenal glands.
• It is involved in stress situations, so-called £flight or fight”.

B. Parasympathetic or Cranioscaral
• The nerve fibers arise from the 3rd, 7th, and 10th cranial nerve and 2nd – 4th sacral nerves.
• It is more advanced structurally and functionally and acts primarily on smooth muscles, and glands in the gut.
• It is involved in the rest period, the “repose and repair”.
Examples of Autonomic Response

ORGAN SYMPATHETIC PARASYMPATHETIC

Pupil of the eye Dilatation Constriction

Heart rate Increase Decrease

Bronchi Dilatation Constriction

Gastric glands Inhibition Secretion

Urinary bladder Contraction Relaxation

Peripheral Blood Vessel Vasoconstriction Vasodilatation

Penis Ejaculation Erection

GIT motility Decrease Increase

GIT sphincters Contraction Relaxation