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Chapter 10Chapter 10Nervous SystemNervous System
Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved.
22
The Nervous SystemThe Nervous System
Central Nervous SystemCentral Nervous System
BrainBrain
Spinal CordSpinal Cord
Peripheral Nervous SystemPeripheral Nervous System
Cranial NervesCranial Nerves
Spinal NervesSpinal Nerves
Autonomic Nervous SystemAutonomic Nervous System
Sympathetic NervesSympathetic Nerves
Parasympathetic NervesParasympathetic Nerves
33
IntroductionIntroduction
Nervous system:Nervous system:
Complex: 10 billion nerve cellsComplex: 10 billion nerve cells
Voluntary and involuntary functionsVoluntary and involuntary functions
Nerves carry electrical messagesNerves carry electrical messages
External and internal receptorsExternal and internal receptors
44
Introduction Introduction (cont’d.)(cont’d.)
Nerve cells:Nerve cells:
MicroscopicMicroscopic
Collected into macroscopic nervesCollected into macroscopic nerves
Carry electrical messages all over the Carry electrical messages all over the bodybody
55
Nervous System Nervous System Two major divisions:Two major divisions: Central nervous systemCentral nervous system
BrainBrain Spinal cordSpinal cord
Peripheral nervous systemPeripheral nervous system
cranial nervescranial nerves spinal nervesspinal nerves
66
General Structure of the General Structure of the Nervous System Nervous System (cont’d.)(cont’d.)
Cranial and spinal nervesCranial and spinal nerves Sensory nerves carry messages toward the brain.Sensory nerves carry messages toward the brain.
Motor nerves carry messages from the brain.Motor nerves carry messages from the brain.
Mixed nerves carry both sensory and motor Mixed nerves carry both sensory and motor fibers.fibers.
Sensory receptorsSensory receptors
77
General Structure of the General Structure of the Nervous System Nervous System (cont’d.)(cont’d.)
Autonomic nervous system:Autonomic nervous system: Carries impulses from the central nervous system Carries impulses from the central nervous system
to organs.to organs.
The autonomic nervous system contains a large The autonomic nervous system contains a large group of nerves that function automatically.group of nerves that function automatically.
It controls heart, blood vessels, glands, and It controls heart, blood vessels, glands, and involuntary muscles like intestines, and hollow involuntary muscles like intestines, and hollow organs such as stomach and urinary bladder.organs such as stomach and urinary bladder.
88
Automomic Nervous SystemAutomomic Nervous System
SympatheticSympathetic nerves stimulate body under nerves stimulate body under stress.stress.
ParasympatheticParasympathetic nerves balance sympathetic nerves balance sympathetic system. system. Slow heart rateSlow heart rate Lower blood pressureLower blood pressure
99
Divisions of the Central and Divisions of the Central and Peripheral Nervous System – Peripheral Nervous System –
page 346page 346
1010
Neurons, Nerves, and GliaNeurons, Nerves, and Glia
NeuronNeuron = individual nerve cell= individual nerve cell
Dendrite – branching fibers of neuronDendrite – branching fibers of neuron
Cell nucleusCell nucleus
Neurons, Nerves, and GliaNeurons, Nerves, and Glia
AxonAxon – carry impulses away – carry impulses away
Myelin sheath Myelin sheath – fatty tissue that covers the – fatty tissue that covers the axon giving it a white color (white matter)axon giving it a white color (white matter)
Gray Matter Gray Matter – cell bodies of neurons not – cell bodies of neurons not covered with a myelin sheath.covered with a myelin sheath.
1111
1212
Neurons, Nerves, and GliaNeurons, Nerves, and Glia
SynapseSynapse – space where nervous impulse jumps from – space where nervous impulse jumps from one neuron to anotherone neuron to another
Terminal end fibers - Terminal end fibers - (secrete neurotransmitters)(secrete neurotransmitters)
NeurotransmittersNeurotransmitters - transfer impulse across synapse - transfer impulse across synapse
GangliaGanglia - small clusters of nerve cell bodies outside - small clusters of nerve cell bodies outside the brain and spinal cord.the brain and spinal cord.
1313
NeurotransmittersNeurotransmitters – chemicals that – chemicals that control the transfer of an impulse across control the transfer of an impulse across the synapsethe synapse
AcetylcholineAcetylcholine NorepinephrineNorepinephrine EpinephrineEpinephrine DopamineDopamine SerotoninSerotonin EndorphinsEndorphins
1515
Neurons, Nerves, and Glia Neurons, Nerves, and Glia (cont’d.)(cont’d.)
Glia cells: Glia cells:
Maintain health of nervous systemMaintain health of nervous system
Do not transmit impulsesDo not transmit impulses
1616
Four Types of Glial Cells – Four Types of Glial Cells – p. 348p. 348
Astrocytes (astroglial cells) Astrocytes (astroglial cells) – transport H20 and salts– transport H20 and salts
Microglia (microglial cells) Microglia (microglial cells) – protect neurons in response to – protect neurons in response to inflammationinflammation
Oligodendroglia (oligodendroglial cellsOligodendroglia (oligodendroglial cells) – form myelin sheath.) – form myelin sheath.
Ependymal Ependymal –line membranes in the brain and spinal cord.–line membranes in the brain and spinal cord.
1818
The Brain p. 348– The Brain p. 348– Controls body Controls body activities, weighs about 3 lbsactivities, weighs about 3 lbs
1919
The CerebrumThe Cerebrum
Largest section of brainLargest section of brain
Surface has nerve cells called cerebral cortex.Surface has nerve cells called cerebral cortex.
Manages speech, vision, smell, movement, Manages speech, vision, smell, movement, hearing, and thoughthearing, and thought
2020
Cerebrum – page 350Cerebrum – page 350
Spaces in the middle of the cerebrum are Spaces in the middle of the cerebrum are called called ventriclesventricles..
Ventricles contain Ventricles contain cerebrospinal fluid cerebrospinal fluid (CSF). This fluid cushions the brain.(CSF). This fluid cushions the brain.
CSFCSF can be removed for testing or relief of can be removed for testing or relief of pressure on the brain.pressure on the brain.
2222
The Brain The Brain Cerebellum Cerebellum
Coordinates voluntary movements Coordinates voluntary movements Maintains balanceMaintains balance
2323
The BrainThe Brain
Thalamus Thalamus Integrates and monitors impulses from skin Integrates and monitors impulses from skin
(pain)(pain)
2424
HypothalamusHypothalamus
Controls body temperature, sleep, appetite, Controls body temperature, sleep, appetite, sexual desire, and emotionssexual desire, and emotions
Regulates release of hormones from pituitary Regulates release of hormones from pituitary glandgland
Monitors sympathetic and parasympathetic Monitors sympathetic and parasympathetic nervous systemsnervous systems
2525
The BrainThe Brain
The BrainstemThe Brainstem
PonsPons Bridges cerebrum and cerebellum with rest of Bridges cerebrum and cerebellum with rest of
the brainthe brain
Houses nerves for face and eyesHouses nerves for face and eyes
2626
The Brainstem The Brainstem (cont’d.)(cont’d.)
Medulla oblongataMedulla oblongata Connects spinal cord to brainConnects spinal cord to brain
Nerve tracts from side to sideNerve tracts from side to side
Regulates:Regulates:• Blood vesselsBlood vessels• HeartHeart• Respiratory systemRespiratory system
2929
The Spinal Cord and Meninges The Spinal Cord and Meninges page 351page 351
Spinal cordSpinal cord
3131
VOCABULARY-page 353VOCABULARY-page 353
Acetylcholine Acetylcholine – neurotransmitter released at – neurotransmitter released at
nerve cellsnerve cells
afferent nervesafferent nerves – Carry messages toward brain – Carry messages toward brain
and spinal cordand spinal cord
Arachnoid membraneArachnoid membrane – Middle meninges layer– Middle meninges layer
VOCABULARY-page 353VOCABULARY-page 353
3232
Astrocyte – type of nerve cell that transports
water and salts from capillaries
autonomic nervous system – controls
involuntary body functions
3333
AxonAxon – microscopic fiber that carries the – microscopic fiber that carries the
nervous impulse along a nerve cell.nervous impulse along a nerve cell.
blood-brain barrierblood-brain barrier – capillaires that – capillaires that
selectively let certain substances enter brain selectively let certain substances enter brain
tissue and keep others out.tissue and keep others out.
VOCABULARY- pg 353VOCABULARY- pg 353
VOCABULARY- pg 353VOCABULARY- pg 353
3434
cauda equina – collection of spinal nerves
below the end of the spinal cord.
cell body – part of nerve cell that contains
the nucleus
Brainstem – lower portion brain containing
pons and medulla.
VOCABULARY- pg 353VOCABULARY- pg 353
3535
central nervous systemcentral nervous system – brain and spinal cord – brain and spinal cord
CerebellumCerebellum – posterior part of brain that – posterior part of brain that
coordinates muscle movements and maintains coordinates muscle movements and maintains
balance.balance.
cerebral cortexcerebral cortex – outer region of brain;containing – outer region of brain;containing
sheets of nerve cells; gray matter of the brainsheets of nerve cells; gray matter of the brain
VOCABULARY- pg 353VOCABULARY- pg 353
cerebrospinal fluid (CSF)cerebrospinal fluid (CSF) – Fluid that – Fluid that
circulates throughout brain and spinal cordcirculates throughout brain and spinal cord
Cerebrum Cerebrum – largest part of brain – largest part of brain
responsible for voluntary muscle activity, responsible for voluntary muscle activity,
vision, speech, taste, hearing, thought, vision, speech, taste, hearing, thought,
and memory.and memory.
3636
3737
DendriteDendrite – microscopic branching fiber of a nerve cell – microscopic branching fiber of a nerve cell
that is the first part to receive the nervous impulsethat is the first part to receive the nervous impulse
dura materdura mater – thick, outermost layer of the meninges – thick, outermost layer of the meninges
surround and protecting the brain and spinal cordsurround and protecting the brain and spinal cord
efferent nervesefferent nerves – carry messages away from brain – carry messages away from brain
and spinal cord.and spinal cord.
VOCABULARY- pg 353-354VOCABULARY- pg 353-354
3838
VOCABULARY – page 354VOCABULARY – page 354
HypothalamusHypothalamus – –
medulla oblongatamedulla oblongata ––
Meninges Meninges – 3 protective layers that – 3 protective layers that surround brain and spinal cordsurround brain and spinal cord
VOCABULARY – page 354VOCABULARY – page 354
motor nervesmotor nerves – carry messages away from – carry messages away from brain and spinal cord to muscles and brain and spinal cord to muscles and organs. (efferent)organs. (efferent)
myelin sheathmyelin sheath – White fatty tissue that – White fatty tissue that surrounds, and insulates the axon of the surrounds, and insulates the axon of the nerve cell. Myelin speeds conduction along nerve cell. Myelin speeds conduction along axonsaxons
3939
4141
NeuronNeuron – nerve cells that carries – nerve cells that carries impulses throughout the bodyimpulses throughout the body
NeurotransmitterNeurotransmitter – chemical – chemical messenger released at the end of a messenger released at the end of a nerve cell that stimulates or inhibits nerve cell that stimulates or inhibits another nerve, muscle, or gland cell.another nerve, muscle, or gland cell.
VOCABULARY- page 354VOCABULARY- page 354
4242
VOCABULARY- page 354VOCABULARY- page 354
parasympathetic nerves – Involuntary, autonomic nerves that regulate normal body functions such as HR, breathings and muscles of GI tract
peripheral nervous system – Cranial, spinal, and autonomic nerves, nerves outside the brain and spinal cord.
4444
VOCABULARY – pg 355VOCABULARY – pg 355 pia materpia mater – Thin, delicate inner membrane of – Thin, delicate inner membrane of
meningesmeninges
PlexusPlexus – interlacing network of nerves – interlacing network of nerves
ReceptorReceptor – organ that receives a nervous – organ that receives a nervous
stimulation and passes it on to nerves within stimulation and passes it on to nerves within
the body.the body.
VOCABULARY – pg 355VOCABULARY – pg 355
sciatic nervesciatic nerve – nerve extending from the – nerve extending from the
base of the spine down the thigh, lower base of the spine down the thigh, lower
leg, and foot.leg, and foot.
Spinal nervesSpinal nerves – 31 pairs of nerves arising – 31 pairs of nerves arising
from the spinal cord. from the spinal cord.
4545
4848
VOCABULARY- pg 355VOCABULARY- pg 355
sympathetic nervessympathetic nerves – Autonomic nerves – Autonomic nerves that influence bodily functions involuntarily that influence bodily functions involuntarily in times of stressin times of stress
Vagus nerveVagus nerve – 10– 10thth crainial nerve. Leaves crainial nerve. Leaves the lead and wanders into abdominal and the lead and wanders into abdominal and thoracic cavitites.thoracic cavitites.
ventricles of the braventricles of the brainin – Canals in the – Canals in the brain that contain cerebrospinal fluidbrain that contain cerebrospinal fluid
5050
QUICK QUIZQUICK QUIZ::
1.1. A sheet of nerve cells that A sheet of nerve cells that produces a rounded fold on produces a rounded fold on the surface of the cerebellumthe surface of the cerebellum
A.A. microglial microglial B.B. gyrus gyrusC.C. parenchyma parenchymaD.D. stroma stroma
5151
2.2. The thin, delicate inner The thin, delicate inner membrane of the meningesmembrane of the meninges
A.A. pia mater pia materB.B. dura mater dura materC.C. parenchyma parenchymaD.D. stroma stroma
QUICK QUIZQUICK QUIZ::
5252
COMBINING FORMS COMBINING FORMS page 356page 356
cerebell/ocerebell/o cerebellumcerebellum
cerebr/ocerebr/o cerebrumcerebrum
dur/odur/o dura materdura mater
Subdural hematomaSubdural hematoma
Combining FormCombining Form MeaningMeaning
5353
Nervous SystemNervous System
encephal/oencephal/o brainbrain EncephalitisEncephalitis EncephalopathyEncephalopathy AnencephalyAnencephaly
gli/ogli/o glial cellsglial cells
Glioblatoma – highly malignant tumorGlioblatoma – highly malignant tumor
5555
lept/olept/o thin, slenderthin, slender
mening/omening/o membranes, membranes, meninges meninges
my/omy/o muscle muscle
myel/omyel/o spinal cord spinal cord
Combining FormCombining Form MeaningMeaning
Combining Forms p. 357Combining Forms p. 357
Combining FormsCombining Forms
neur/oneur/o nerve nerve
pont/opont/o ponspons
radicul/oradicul/o nerve rootnerve root
5656
5757
thalam/othalam/o thalamusthalamus
thec/othec/o sheath sheath ((refers to refers to meningesmeninges) )
vag/ovag/o vagus nervevagus nerve
Combining FormCombining Form MeaningMeaning
COMBINING FORMS p. 357-358COMBINING FORMS p. 357-358
5858
alges/o, algesiaalges/o, algesia
algiaalgia
caus/ocaus/o
Sensitivity to painSensitivity to pain
PainPain
BurningBurning
Combining FormCombining Form Meaning Meaning
page 358-359page 358-359
Combining FormsCombining Forms
comat/ocomat/o
esthesi/o,esthesi/o, esthesi/aesthesi/a
kines/o, -kinesiakines/o, -kinesia
Deep sleepDeep sleep
Feeling, nervous Feeling, nervous sensationsensation
movementmovement
5959
6060
-kinesis, -kinesis, kinetickinetic
--lepsylepsy
lex/olex/o
(bradykinesia)(bradykinesia)
(epilepsy)(epilepsy)
(dyslexia)(dyslexia)
Combining FormCombining Form Meaning – word use Meaning – word use
COMBINING FORMS COMBINING FORMS page 359 - 360page 359 - 360
Combining FormsCombining Forms
Combining FormCombining Form
-paresis-paresis
-phasia-phasia
Meaning – word useMeaning – word use
(hemiparesis)(hemiparesis)
(aphasia)(aphasia)
6161
6262
-plegia-plegia
-praxia-praxia
-sthenia-sthenia
ParalysisParalysis
ActionAction
StrengthStrength
Combining FormCombining Form Meaning Meaning
page 360-361page 360-361
Combining FormsCombining Forms
Combining FormCombining Form
syncop/osyncop/o
tax/o tax/o
Meaning – word useMeaning – word use
cut offcut off
order, coordinationorder, coordination
6363
6464
QUICK QUIZQUICK QUIZ::
3.3. Which term means nerve Which term means nerve pain?pain?
A.A. cephalgia cephalgiaB.B. analgesia analgesiaC.C. hypalgesia hypalgesiaD.D. neuralgia neuralgia
6565
QUICK QUIZQUICK QUIZ::
4.4. Which type of hematoma occurs Which type of hematoma occurs between the skull and the dura between the skull and the dura as a result of a ruptured as a result of a ruptured meningeal artery, usually after a meningeal artery, usually after a fracture of the skull?fracture of the skull?
A.A. subdural subduralB.B. epidural epidural C.C. intracerebral intracerebral
6666
Pathologic Conditions – p 361Pathologic Conditions – p 361
HydrocephalusHydrocephalus
Spina bifidaSpina bifida Spina bifida cysticaSpina bifida cystica Spina bifida occultaSpina bifida occulta
Degenerative, Movement, and Degenerative, Movement, and Seizure Disorders p. 363-364Seizure Disorders p. 363-364
Alzheimer disease Alzheimer disease (AD)(AD)
Amyotrophic lateral Amyotrophic lateral sclerosis (ALS)sclerosis (ALS)
EpilepsyEpilepsy
Huntington diseaseHuntington disease
Multiple sclerosis (MS)Multiple sclerosis (MS)
Myasthenia gravis Myasthenia gravis (MG)(MG)
PalsyPalsy
Parkinson diseaseParkinson disease
Tourette syndromeTourette syndrome6868
7171
Infectious Disorders – page 366Infectious Disorders – page 366
Herpes zoster (shingles)Herpes zoster (shingles)
MeningitisMeningitis
Human immunodeficiency virus (HIV) Human immunodeficiency virus (HIV) encephalopathyencephalopathy
7373
Traumatic Disorders – page 367Traumatic Disorders – page 367
Cerebral concussionCerebral concussion::
Temporary brain dysfunction after Temporary brain dysfunction after injury, usually clears within 24 injury, usually clears within 24 hourshours
Cerebral ContusionCerebral Contusion
Bruising of brain Bruising of brain tissue through tissue through direct trauma to direct trauma to headhead
Neurological Neurological deficits persist deficits persist longer than 24 longer than 24 hourshours
7474
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CVA cerebral vascular accident – CVA cerebral vascular accident – page 368page 368
ThromboticThrombotic — — blood clot in artery leaving blood clot in artery leaving to the brainto the brain
EmbolicEmbolic — — dislodged clot that travels to dislodged clot that travels to cerebral arteriescerebral arteries
HemorrhagicHemorrhagic — — a blood vessel, such as a blood vessel, such as the cerebral artery breaks, and bleeding the cerebral artery breaks, and bleeding occursoccurs
7777
Clinical Procedures – page 371Clinical Procedures – page 371
X-ray TestsX-ray Tests
Cerebral angiographyCerebral angiography
Computed tomography (CT) of the Computed tomography (CT) of the brainbrain
MyelographyMyelography
Clinical Procedures – page 371Clinical Procedures – page 371 MRIMRI - Magnetic resonance Imaging - Magnetic resonance Imaging
MRAMRA - Magnetic resonance - Magnetic resonance angiogramangiogram
PET PET - Positron emission scan- Positron emission scan
EEG EEG - Electroencephalography- Electroencephalography7878
7979
Lumbar Puncture (LP)Lumbar Puncture (LP)
A needle is inserted in the spinal cord for A needle is inserted in the spinal cord for removal of CSF.removal of CSF.
8383
PET scan reveals the cellular level metabolic PET scan reveals the cellular level metabolic changes occurring in an organ or tissue. changes occurring in an organ or tissue.
8484
PET Scan - Positron Emission PET Scan - Positron Emission Tomography Tomography
The red color shows the highest level of The red color shows the highest level of glucose utilization, yellow represents less glucose utilization, yellow represents less utilization and blue shows the least. utilization and blue shows the least.
8585
Abbreviations page 374Abbreviations page 374AbbreviationsAbbreviations ADAD
AFPAFP
ALSALS
AVMAVM
Alzheimer diseaseAlzheimer disease
alpha-fetoproteinalpha-fetoprotein
amyotrophic lateral sclerosisamyotrophic lateral sclerosis
arteriovenous malformationarteriovenous malformation
Abbreviations – page 374 Abbreviations – page 374
CNS CNS central nervous systemcentral nervous system
CTCT computed tomographycomputed tomography
CVACVA cerebrovascular accidentcerebrovascular accident
CSFCSF cerebrospinal fluidcerebrospinal fluid
8686
8787
EEGEEG
GABAGABA
ICPICP
LPLP
ElectroencephalogramElectroencephalogram
gamma-aminobutyric acidgamma-aminobutyric acid
intracranial pressureintracranial pressure
lumbar puncturelumbar puncture
AbbreviationsAbbreviations
AbbreviationsAbbreviations
MACMAC
MGMG
MRAMRA
MRIMRI
monitored anesthetic caremonitored anesthetic care
myasthenia gravismyasthenia gravis
magnetic resonance magnetic resonance angiographyangiography
magnetic resonance imagingmagnetic resonance imaging
8888
8989
1/2 P1/2 P
PETPET
SzSz
TBITBI
HemiparesisHemiparesis
positron emission positron emission tomographytomography
SeizureSeizure
traumatic brain injurytraumatic brain injury
AbbreviationsAbbreviations