Human Anatomy

PHYE 75

Cody Mally, ATC, MA

Mark Fletcher, MD

 

 
 
 
 
 
 
 
 
 
 
 
 

Nervous System Lectures

Nervous System

Two Control and integration systems in the body.  Nervous system and endocrine system (mainly metabolic regulation).

Functions:
    1) sense stimuli
    2) interpret and integrate
    3) react to stimuli.

Components:
    1) Sensory – Senses changes in the internal or external environment
    2) Integrative – Analyzes data, stores data, decides which stimuli are important, and makes decisions regarding appropriate behaviors.
    3) Motor – Responds to stimuli through muscular contractions or glandular secretion.

2 Principle Divisions:
    1) CNS – Brain and Spinal Cord
                Most impulses that stimulate muscles or glands originate in the CNS.
                Connected to sensory receptors, muscles, and glands in the peripheral parts of the body by the PNS.

    2) PNS – Cranial, spinal, peripheral nerves
                a. Afferent (sensory) neurons: impulses going to the CNS, Input.
                b. Efferent (motor) neurons: impulses going away from the CNS, Output.
                c. Association (interneurons) neurons: neither sensory nor motor.  Forms links between other neurons.  Carries impulses from sensory
                    to motor.  Integrative function.
                d. Autonomic motor neurons (efferent) – involuntary
                    Information to smooth muscle in the digestive, respiratory(bronchioles), Cardiovascular(heart, blood vessels), and integumentary
                    systems(sweat glands).

            Two divisions of PNS:
                a. Somatic NS – Sensory neurons that convey information from cutaneous ( pacinian corpuscles, mechanoreceptors, pain receptors, golgi
                    tendon organs) and special sense receptors(olfactory, retinal cells, auditory, taste) to the CNS which direct impulses to skeletal muscle
                    (voluntary).
                b. Autonomic NS – Sensory receptors from the vicera to the CNS which direct impulses to smooth muscle, cardiac muscle, and various
                    glands (involuntary).
                        Motor portion has 2 branches;
                             i. Sympathetic – “Fight or Flight” Causes changes that prepare body for immediate action.
                                    1) Increases heart rate, breathing, dilates pupils
                                    2) increases blood pressure, raises blood sugar.
                             ii. Parasympathetic – “Rest and Repose” Causes changes that favors conservation and storage of energy.
                                    1) Slowing of heart rate, constriction of pupils
                                    2) decreased BP, Increase insulin/facilitates storage of glucose.

                                    Vicera receive instructions from both systems.  Opposing functions (usually).
 

Neuron – Nerve cell with the ability to respond to stimuli and convert the stimulus into a nerve impulse.
            - small electrochemical current that controls nerve function.
            - Three parts of Neuron:
            1) Cell body (soma) – nucleus surrounded by cytoplasm containing typical organelles (lysosomes – cellular digestion,
            mitochondria – cellular  powerhouse/ATP production, gogi complexes – protein packaging/receptor production)
                    a. Additionally, neurons also contain Nissl bodies (protein synthesis) and neurofibrils (support, cell shape) in their cytoplasm.
            2) Dendrite (L.tree) – input portion of neuron.
                    a. Relays info from the external environment to the cell body
                    b. Tree shaped array of dendrites converging on cell body.
                    c. Non-Myelinated.
            3) Axon – Thin, cylindrical projection (usually myelinated) that conducts nerve impulses toward another neuron, muscle fiber, or gland cell.
                    a. Axons terminate at fine processes called axon terminals
                    b. Myelin Sheath (neurolemma) – axons are surrounded by multilayered, phospholipid containing, segmented coverings called myelin
                    sheaths (sheath of Schwann).  Myelin sheaths serve to increase speed of nerve impulse conduction and maintain health/integrity of the
                    fiber. (Saultatory  conduction – gap to gap)
                    c. Schwann Cells – cells that create the myelin sheaths, closely associated with axon.
                    d. Nodes of Ranvier – gaps between Schwann cells

                    e. Multiple Sclerosis – Disease process that creates hard scars (scleroses) in the myelin sheaths.  This sclerosis damages the neuron inside
                    the sheath so that they have impaired nerve conduction or no conduction at all.  Leads to muscle atrophy, coordination difficulties,
                    vision, hearing, etc problems depending what part of spinal cord or brain MS is affecting.

Synapse – The juction between two neurons or between a neuron and its effector (muscle or gland).  The tips of the axon terminals swell into bulb shaped synaptic end bulbs (buttons, boutons).
     Types of Synapses:
        1) Axo-axonic – axon-axon synapse
        2) Axo-somatic – axon-soma(cell body) synapse
        3) Axo-dendritic – axon-dendrite synapse

Structural Class of Neurons-
        1) Bipolar – Neuron has one dendrite and one axon (found in retinal, inner ear, olfactory area of brain)
        2) Unipolar – One process extending from cell body and are always sensory neurons.
        3) Multipolar – Several dendrites, one axon. (brain, spinal cord)

Functional Classes of Neurons-
        1) Sensory (afferent) – information to spinal cord
        2) Motor (efferent) – information from spinal cord/brain to effectors
        3) Interneurons (association) – all other neurons **90% of neurons in body are this type*.
 
 

Reflex Arc

    Reflexes – fast, predictable, automatic responses to changes in the environment that help maintain normal physiological activities.
        1) Somatic reflexes – stimuli results in contration of skeletal muscles (knee jerk)
        2) Visceral(autonomic) reflexes – responses of smooth muscle, cardiac muscle, and glands (heart rate, respiration, digestion, urination, defecation)

    Monosynaptic arc – Sensory neuron sends message directly to motor neuron
        1) one synapse
        2) knee jerk

    Polysynaptic arc – sensory neuron sends message by way of an interneuron (association neuron) to several motor neurons
        1) stepping on a tack – withdrawal reflex (coordination of several muscles)

    Receptor Organ:  Receptor end of dendrite or specialized receptor cell in sensory organ.

    Sensory Neuron: Dendrite, cell body, and axon of sensory neuron (unipolar).  Transmits nerve impulse from receptor into spinal cord or brain.

    Association Neuron – Axon, dendrite, cell body of…
         Neuron within brain or spinal cord (serves as an integrative or processing cell)
    Motor Neuron – Axon, dendrite, cell body of….Transmits nerve impulse from brain and spinal cord to effector organ.

    Effector Organ – responds to motor neuron impulse with an appropriate action (reflex, gland secretion, contraction).

End of lecture 1

Lecture 2:

CNS
    1) Brain – Largest and most complex part of the nervous system
                 -estimated to have 100 billion neurons
        A) 4 Parts –
             i. brainstem – connects brain to spinal cord
                    1. Medulla oblongata
                    2. Pons
                    3. Midbrain
             ii. diencephalon – superior to brainstem
                    1. consists of thalamus and hypothalamus
                    2. located between the cerebral hemispheres
             iii. cerebrum – largest portion of mature brain
                    1. Occupies most of cranium
                    2. Has Right and Left hemispheres
             iv. cerebellum – inferior to cerebrum and posterior to brainstem

    2)Spinal Cord

PNS
    1) afferent and efferent nerves
    2) 12 Pairs of cranial nerves arising from brain
    3) 31 pairs of spinal nerves arising from spinal cord

            Somatic fibers connect to skin and skeletal muscle
            Autonomic fibers connect to viscera, blood vessels
 

Meninges of Brain and Spinal Cord – Connective tissue coverings that encircle the spinal cord and brain.

 3 Layers:
        1) Dura mater (tough mother) – most superficial layer
                a. Dense, tough, irregular connective tissue layer
                b. Continues into vertebral canal as a stroing tube-like sheath that surrounds the spinal cord.
                c. Outer surface is called periosteal, inner surface is called meningeal.
                d. Epidural Space – space between dura and vertebral column, filled with fat and connective tissue “cushioning”
                e. Subdural Space – deep to dura and superficial to 2nd meningeal layer

        2) Arachnoid mater (spidery mother) – thin, spider-web like network of connective tissue
                a. Continuous with the arachnoid of the spinal cord.
                b. Subarachnoid Space – deep to arachnoid and superpicial to 3rd meningeal layer
        3) Pia mater (little mother) – thinnest layer containing nerves and blood vessels.
                a. Attached directly to surface of brain and spinal cord
                b. Dentinculate ligaments – thickenings of pia mater that suspend the spinal cord in the middle of the dural sheath, protecting cord
                    from shock and displacement.
        4) Meningitis – inflammation of the meninges (arachnoid and pia mater) due to bacterial or viral infection.
                a. Can result in mental status changes, loss of vision, hearing, progressing to death without treatment

Cerebrum – composed off an outer portion of grey matter – the cerebral cortex(neuronal) – and an inner portion of while matter (axonal).
     Functions:
        1) Controls higher brain functions
        2) Interprets sensory impulses
        3) Initiates muscle movements
        4) Stores memory, reasoning, determines intelligence\

    During Embryonic development the grey matter develops faster then the while matter
        1) Results in infoldings of the brain
        2) Folds are called gyri (gyrus)
        3) Deep grooves between gyri are called sulci (sulcus)
        4) Large grooves that separate areas of the brain are called fissures
                a. Longitudinal Fissure – separates brain into R and L hemispheres.
                     i. The hemispheres are connected by a white matter bridge – Corpus Callosum
                     ii. In 90% of the population, the Left hemisphere is dominant for language-related activities of speech, writing, reading,
                        and complex intellectual functions (verbal, analytical, and computational skills)

Lobes (bilateral) –
        1) Frontal
               a.  Most anterior portion of each cerebral hemisphere.
               b. Bordered posteriorly by the central sulcus
               c. Bordered inferiorly by lateral sulcus
               d. Functions:
                     i. Concentration
                     ii. Planning
                     iii. Problem solving
                     iv. Primary motor area – pre-central gyrus, just anterior to central sulcus (homunculus map)
                     v. Motor speech area (Broca’s area) in L hemisphere anterior to primary motor cortex.
                     vi. Phineas Gage story
          2) Parietal
                a. Separated from frontal lobe by central sulcus
                b. Post-central gyrus – primary somatosensory area of cerebral cortex(touch, temperature, pressure, pain) – also homonculus map
                c. Association area – understanding speech, using words to express thoughts and feelings (wernicke’s area – L parietal lobe).

           3) Temporal
                a. Interprets sensory experiences especially auditory input.
                b. Differentiates sounds as speech, music, noise
                c. Responsible for hearing pitch and rhythm

            4) Occipital
                a. Combines visual images and other sensory experiences
                b. Association – relates present to past visual experiences and recognition of what is seen
                c. Sensory – Primary visual area, detects shape, color, movement
                d. “black out” –with injury to occipital area of head

Diencephalon: 4 Parts

        1) Thalamus
                a. 3 cm long
                b. relay station for sensory impulses that reach cerebral cortex from spinal cord.

        2) Hypothalamus
                a. Thalamus Controls many body activity –“homeostasis”
                b. Links nervous systemm to endocrine system
                c. Control Autonomic nervous system (smooth muscle, gland secretion, heart rate, peristalsis, bladder fxn)
                d. Associated with feelings of rage/aggression
                e. Regulates body temperature
                f. Hunger and thirst regulation

        3) Epithalamus (Pineal Gland)
               a. secretes melatonin – release governed by dark-light cycle, thought to be involved with sleep cycles.

       4) Ventricles (Third Ventricle part of Diencephalon)
                a. Fluid filled cavities within the brain.
                     i. Lateral ventricles located in the hemispheres of the cerebrum.
                     ii. 3rd Ventricle is a verticle slit anterior to, and at the midline of the thalamus connecting the lateral ventricles and the 4th ventricle
                     iii. 4th Ventricle lies between the brain stem and the cerebellum

                b.  Filled with CSF (cerebrospinal fluid) – clear, colorless fluid
                     i. Composed of glucose, proteins, lactate, electrolytes, and a few lymphocytes
                     ii. CSF circulates throught sub-arachnoid space, lateral ventricles, 3rd, and 4th ventricles , as well as in the subarachnoid in spinal cord.
                     iii. Function of CSF:
                            a) Mechanical protection (brain is floating in CSF) from trauma
                            b) Chemical protection (blood brain barrier)
                            c) Circulates nutrients and waste products

Brain Stem

    1) Pons (bridge – connects spinal cord with brain and parts of brain with each other)
                a Rounded bulge on anterior of brainstem where it separates midbrain from medulla oblongata
                b. Relay nuclei in pons connect sensory and motor impulses from medulla(and SC) to higher brain center
                c. Important for arousal, alertness
                d. Controls respiration along with medulla

    2) Medulla Oblongata – superior to foramen magnum, inferior to Pons
                b Contains all ascending and descending tracts that connect spinal cord and various parts of the brain.
                c. Pyramids – on ventral side of medulla, contain large motor tracts passing from the cerebral cortex to the spinal cord.
                    These fibers cross over as they enter the medulla (fibers from the Right cortex cross to the left medulla and and supply
                    left sided musculature) = pyramidal decussation
                d. Association Nuclei responsible for visceral reflexes
                     i. Heart rate
                     ii. Basic rhythm of breathing
                     iii. Regulates blood pressure by controling diameter (tone) of blood vessels (and by heart rate)

Cerebellum - Inferior and posterior region of brain
        1) Posterior to medulla and pons, Inferior to occipital lobes
        2) Function:
                a. Maintains equilibrium, muscle tone, coordination
                b. Integration sensory information received from receptors in muscles, tendons, joints, and special sense organs (vestibulo-cochlear, visual)
End of lecture 2

Lecture 3:

Spinal Cord
        1) Extends from the medulla to the superior boarder of L2 in adults. Conducts nerve impulses from brain to the periphery
        2) Spinal Nerves
                a. Mixed nerves (motor, sensory, autonomic) that distribute to discrete locations of the body. Originate from the joining of
                    anterior (motor) and posterior (sensory) roots from SC in the intervertebral foramen.  The posterior (dorsal) root has a
                    ganglion (dorsal root ganglion) which houses the cell bodies of sensory neurons.
                b. 31 pairs
                     i. 8 cranial (only 7 cervical vertebrae??)
                     ii. 12 thoracic
                     iii. 5 lumbar
                     iv. 5 sacral
                     v. 1 coccygeal
                c. Rami: spinal nerve divides into several branches (rami) after.
                     i. Dorsal ramus – serves deep muscles and skin of dorsal  surface of trunk
                     ii. Ventral ramus – serves muscles and structures of upper and lower extremities and lateral and ventral trunk.
                     iii. Rami communicantes – components of the autonomic nervous system
                d. Dermatomes: The skin of the entire body is supplied by spinal nerves carrying somatic sensory information being carried
                    to spinal cord.  All spinal nerves (except C1) supply branches to the skin.  The area of skin that provides sensory input to
                    each pair of spinal nerves is called a DERMATOME
                e. Plexuses – Ventral rami of  spinal nerves (except T2-T12) form networks (bilateral) by joining with other adjacent rami = plexus.
                     i. Cervical
                     ii. Brachial
                     iii. Lumbar
                     iv. Sacral
                f. Intercostal Nerves (T2-T12) do not enter plexuses
                     i. Directly innervate the stuctures they supply.

        3) Spinal Meninges – Same as cranial meninges
        4) Conus medullaris -  Spinal cord tapers to a cone at about L2 level.  There is no spinal cord below L2, just nerves.  “Safe area”
            for lumbar puncture (spinal tap)
        5) Cauda equina – “horse’s tail” – roots of spinal nerves L! to S5,C1 that extend from the conus medullaris and exit spinal canal at
            their respective levels
        6) Filum terminale – Extension of pia mater that extends inferiorly from conus and anchors spinal cord to coccyx.

        7) Regions of Spinal Cord
                a. Gray matter – nerve cell bodies and unmyelinated (gray) axons of association and motor neurons
                     i. Posterior horns
                     ii. central canal (contination of 4th ventricle extending the entire length of  SC)
                     iii. Lateral horns
                     iv. Anterior horns
                     v. Gray commissure
                b. White matter – bundles of myelinated axons of sensory and motor neurons.
                     i. Posterior funiculus (column) – Main Sensory tracts
                     ii. Lateral funiculus – motor, pain/temp, sensory
                     iii. Anterior funiculus – motor, pain/temp, sensory
                     iv. White commisure – anterior to gray commisure, axons from each side of spinal cord cross over(decussate) at while commisure
                c. Ascending Tracts = Sensory (tract = distinct bundle of nerve fibers having a common origin or destination and carrying similar
                    information) Continuous with sensory areas in the brain
                     i. Spinothalamic tract (lateral and anterior) – conveys information sensing pain, temp, crude touch, deep pressure.
                     ii. Posterior column tracts or fasiculus gracilis, fasiculus cuneatus) – conveys sensory information:
                            a. Proprioception (muscle, tendon, joint movement and awareness)
                            b. Discriminative touch
                            c. Two-point discrimination
                            d. Pressure
                            e. vibration
                d. Descending Tracts = Motor, continuous with sensory areas in the brain
                     i. Pyramidal tracts – convey nerve impulses for precise, voluntary movemtents of skeletal muscles
                            a. Lateral corticospinal
                            b. Anterior corticospinal
                            c. Corticobulbar
                     ii. Extrapyramidal tracts -convey nerve impulses for:
                            – automatic movements
                            – coordinating body movements with visual stimuli
                            – maintainance of skeletal muscle tone/posture
                            – maintainance of balance/equilibrium by regulating muscle tone in response to head movements.
                        a. Rubrospinal
                        b. Tectospinal
                        c. Vestibulospinal
 
 

End of lecture 3

Beginning of Lecuture 4
 
 
 

Cranial Nerves – Part of the PNS
        1) 12 pair, 10 originate from the brainstem, all pass through foramina of the skull.
            a. Some contain sensory nerves only, others are mixed(motor + sensory).
            b. Motor fibers include somatic and autonomic efferent
        2) Nerves ( type, function)
            a. Olfactory (I) - Sensory
                 i. Smell

            b. Optic (II) – Sensory
                 i. Vision

            c. Oculomotor (III) – Motor
                 i. Eyelid, eye movement, pupillary constriction

            d. Trochlear (IV) – Motor
                 i. Eye movement

            e. Trigeminal (V) – Mixed
                 i. Chewing(motor), Sensation(touch , pain, temp) to face and forehead

            f. Abducens (VI) – Mixed
                 i. Lat. Movement of eye(Motor), proprioception of eye(sensory)

            g. Facial (VII) – Mixed
                 i. Mm of facial expression, saliva and tear excretion (motor), taste and proprioception (sensory)

            h. Vestbulocochlear (VIII)- Sensory
                 i. Vestibular – Equilibrium, Cochlear – hearing

            i. Glossophyaryngeal (IX) – Mixed
                 i. Saliva secretion, swallowing(motor), taste, BP regulation(sensory)

            j. Vagus (X) – Mixed
                 i. Visceral muscle movement, gland secretion(motor), Visceral sensation(sensory)

            k. Accessory (XI) – Motor
                 i. Swallowing, head mvts(SCM, traps – motor), proprioception (sensory)

            l. Hypoglossal (XII) – Motor
                 i. Tongue movements(speech, swallowing)

Autonomic Nervous System – Regulates activity of smooth muscle, cardiac muscle, and glandular function.
      Usually operates without conscious control.  Called autonomic because was originally thought to function autonomously without the
        interaction of the CNS.  Separated into two parts.
            1) Autonomic Motor pathways:
                    a. Two neuron sequence.  1st neuron is called a preganglionic neuron.  Its cell body lies in the brain or spinal cord.
                        Its axon is myelinated – a preganglionic fiber, which passes out of CNS or spinal cord as a part of a cranial or spinal nerve.
                        The preganglionic fiber then separates from the nerve and synapses with the post ganglionic neuron in a autonomic gangion.
                        The post ganglionic fiber (unmyelinated ) terminates in a visceral effector.
                    b. Ganglia – Collection of cell bodies outside the CNS
                    c. Neurotransmitters:
                         i. All presynaptic fibers use Acetyl Choline.
                         ii. Postganglionic fibers of the Sympathetic division use Norepinephrine (NE).
                         iii. Post ganglionic fibers of the Parasympathetic use Acetyl Choline (ACh).
                    d. Dual Innervation – Organs tend to be supplied by both areas.  Serve opposing functions

            2) Sympathetic division – “Excitation”
                    a. Also known as the Thoracolumbar division – Preganglionic neurons have cell bodies in the lateral gray horns of T1-L2
                    b. Ganglia are close to CNS (sypathetic or paravertebral chain) and distant from visceral effectors (divergence) -
                        short pregnglionic, long post ganglionic
                    c. Preganglionic fibers may synapse with 20 or more postganglionic fibers that spread throught the body.
                        For this reason, sympathetic reponses are widespread reponses throughout the body = “fight of flight”

            3) Parasympathetic division – “inhibition”
                    a. Craniosacral division – preganglionic neurons have cell bodies in Cranial nerves III, VIII, IX, X and in the lateral gray horns of S2-S4
                    b. Ganglia are terminal ganglia and are located at the end of the autonomic motor pathway close to or within the wall of visceral organs
                    – long preganglionic, short post ganglionic
                    c. Usually only synapse with 4-5 postganglionic fibers supplying the same organ – parasympathetic effects tend to be localized.

    Cholinergic Neurons – Ach = Acetylcholine
            1) Neurotransmitter , released at synapse
            2) All preganglionic neurons (both symp and para)

   Adrenergic Neurons – NE = Norepinephrine
            1) Sympathetic postganglionic neurons

End of Lecture 4