NEUROSCIENCE AND NEUROLOGICAL DISORDERS

NEUROSCIENCE AND NEUROLOGICAL DISORDERSNEUROSCIENCE1. NEUROANATOMY2. NEUROPHYSIOLOGY3. NEUROCHEMISTRY4. NEUROPATHOLOGY5. NEURO - PHARMACOLOGY ?NEUROLOGICAL DISORDERS6. CLINICAL NEUROLOGY

THE NERVOUS SYSTEMFK Neurophysiology Smt IV18 & 21 04 2011K.KARNA

The Nervous System1. Central Nervous System (CNS) a. Brain b. Spinal cord 2. Peripheral Nervous System (PNS) a. Cranial nerves b. Spinal nerves c. Autonomic Nervous System (VISCERAL EFFERENT) Sensory / afferent somatic Motor / efferent somatic Afferent visceral Efferent visceral

NEUROPHYSIOLOGYFK Neurophysiology18&21 042011K.Karna

INFORMATIONEXTERNALINTERNALEXTERNALINTERNALSENSORY DIVISION - MOTOR DIVISION ENVIRONTMENTINPUTBIT/SECPERCEPTIONBIT/SECOUTPUTENVIRONMENTBIT/SEC

INFORMASI

ORGANIZATION OF THE NSGENERAL DESIGN OF THE NS1. CELLS OF THE NS2. SENSORY DIVISION OF THE NS SENSORY RECEPTOR3. MOTOR DIVISION THE EFFECTORS4. PROCESSING OF INFORMATION5. STORAGE OF INFORMATIONMAJOR LEVELS FUNCTIONAL OF THE CNS1. CORTICAL LEVEL2. SUBCORTICAL LEVEL3. SPINAL CORD LEVELCNS SYNAPSE

CNS SYNAPSE

TYPE OF SYNAPSESPHYSIOLOGIC ANATOMY OF THE SYNAPSECHEMICAL SUBSTANCES THAT FUNCTION AS SYNAPTIC TRANSMITTERELECTRICAL EVENTS DURING NEURONAL EXCITATION AND NEURONAL INHIBITION SPECIAL FUNCTION OF DENDRITES IN EXCITING NEURONSRELATION OF STATE OF EXCITATION OF THE NEURON TO RATE OF FIRINGSOME SPECIAL CHARACTERISTICS OF SYNAPTIC TRANSMISSION

CELL OF THE NS1

NEURONAL PHYSIOLOGY

Cell of the NS: Neurone and NeurogliaElectrical Activity in neuronNuclei, Ganglia, Tracts, and NervesSynapses

CELL OF THE NS1 Neuron : Basic structural and functional unit of the NS Neuronal structureThe Cell bodyThe DendritesThe axon Functional type Sensory neuron (afferent)InterneuronMotor neuron (efferent)

CELLS OF THE NS2 Supporting cells and functionCNS :AstrocytesOligodendrocytesMicrogliaEpendymalPNSSatellite cellsSchwann cells

NEURONE : BASIC STRUCTURAL AND FUNCTIONAL UNIT OF THE NS Figure 2 : NEURONE

?1. NEURONE and NEUROGLIA NEURONE

NEUROGLIA

Nerve fibersNerve fibers : collection of many axons maybe mixed (sensory and motor nerves)Nerve fiber types and functionNumerical classification sometimes use for sensory neuronsRelative susceptibility of mammalian A, B, and C nerve fibers to conduction block produce by various agentsSomatic motor nerves innervate skeletal muscle Autonomic nerves innervate smooth muscle, cardiac muscle, and glands

Table 2-1 Nerve fiber types in mammalian nerveA and B fibers are myelinatedC fibers are unmyelinated

Fiber typeFunctionFiber diameter (m)Conduction velocity(m/s)Spike duration (ms)Absolute refractory periode (ms)A

B

C dorsal root

Sympathetic Proprioception;somatic motorTouch; pressure;MotorMotor to muscle spindlesPain; cold; touch

Preganglionic auto-nomic

Pain, temp., some mechano reception, reflex Responses Postganglionic S12-20

5-12

3-6

2-5

Table 2-2 Numerical classification sometimes use for sensory neuronsTable 2.3 Relative susceptibility of mammalian A, B, and C Nerve fibers to conduction block produced by varous agents

NumberOriginFiber TypeI a I b II

III

IVMuscle spindle Annulospiral ending Golgi tendon organ Muscle spindle, flower spray ending, touch, pressure Pain and cold receptors, some touch receptors Pain, temperature and other receptors A A A

A

Dorsal root C

Susceptibility to:Most susceptibleIntermediateLeast susceptibleHypoxia Pressure Local anaestheticsB A CA B BCC A

ORTHODROMIC ORTHODROMICSALTATORY CONDUCTIONSoma cellTerminal axon

Electrical Activity in Neuron

1. (INPUT ZONE)AXON HILLOCK2.(TRIGGER ZONE)3.(CONDUCTING ZONE)AXONAXON TERMINAL4.(OUTPUT ZONE)

ELECTRICAL PHYSIOLOGY

INTENSITY - Subthreshold- Threshold- Submaximal- Maximal- Supramaximal(Depolarize stimuli)SINGLE STIMULUS

SPATIAL SUMMATION

SENSORY DIVISION OF THE NS SENSORY RECEPTORA. 2

CLASSIFICATION OF THE SENSORY DIVISION

SOMESTHESIA (SOMATIC SENSATION)The Mechanoreceptive senses: tactile, positionThe Thermoreceptive senses: heat, cold.The Nociceptive sense: pain

SPECIAL SENSEVisualAuditory OlfactoryGustatory Equilibrium

CLINICAL CLASSIFICATIONExteroceptive sensationsProprioceptive sensationsVisceroseptive sensationsEnteroceptive sensations

SENSORY DIVISION OF THE NS SENSORY RECEPTORSENSORY RECEPTORSSensory receptors detect and transduce/transform stimulus energy into receptor (generator) potential serves as a stimulus for the generation of an AP or release of neurotransmitterSENSORY PATHWAYS FOR TRANSMITTING SIGNALSInformation about stimulus is transmitted to the CNSThe Dorsal Column Medial Lemniscal SystemAnterolateral systemSOMATOSENSORY CORTEX: Elicit a reflex respons, alter behaviour, or produce a conscious sensation

GENERAL SENSORY MECHANISMReseptor classificationSource of the stimulusExteroceptorsProprioceptorsVisceroceptorsEnteroceptorsType of stimulus energiMechanoreceptors ThermoreceptorsPhotoreceptorsChemoreceptors NociceptorsType of sensation: touch,heat, cold, pain, light, sound, taste, and smell receptorsRate of adaptation: slowly adapting (tonic,static), and rapidly adapting (phasic,dynamic) receptors

Figure 2 : SOMATOSENSORY AXIS OF THE NS

Sensory Pathways for Transmitting Somatic Signals into CNS Dorsal Column Medial Lemniscal SystemTouch sensation requiring a high degree of localization of the stimulusTouch sensastion requiring transmission of the gradation of intensityPhasic sensation, such as vibratory sensationsSensation that signal movement against the skinPosition sensation from the jointPressure sensation having to do with the degree of judgment of pressure intensity

Sensory Pathways for Transmission Somatic Signal into CNS Anterolateral systemPain Thermal sensation including both warm and cold sensastionCrude touch and pressure sensation capable of onlycrude localizing ability on the surface of the body Tickle and itch sensationsSexual sensation

PHYSICOCHEMICAL STIMULISENSORY RECEPTORSSENSORY PATHWAY TO CNS (NERVE)Thalamus (Medulla, Pons,Cerebellum, Mescencephalon)Reticular Substance Spinal cord SENSORY PATHWAY IN CNS (TRACT)AREAS OF THE CEREBRAL CORTEX

MOTOR DIVISION THE EFFECTOR3

Figure 3 SKELETAL MOTOR NERVE AXIS OF THE NS

COMPONENTS OF THE MOTOR CONTROL SYSTEMCEREBRAL MOTOR CORTEX IS RESPONSIBLE FOR GENERATING THE IDEA FOR VOLUNTARY MOVEMENTS AND ISSUING THE MOTOR COMMANDS FOR THEIR EXECUTIONSUBCORTICAL CENTERS IS RESPONSIBLE FOR MODULATING AND COORDINATING THE MOTOR COMMANDS SO THAT TASKS ARE PROPERLY CARRIED OUTTHE BASAL GANGLIATHE CEREBELLUMTHE BRAIN STEM

SPINAL CORD REFLEX

RESEPTORSUNCONCIOUS INFORMATION - PROPRIOCEPTIVE INFO.CONCIOUS INFORMATION VISUAL AND CUTANEOUS INFO.

GENERAL PRINCIPLES MOTOR CONTROL SYSTEMMOTOR OUTPUTREFLEXIVE OR INVOLUNTARY VOLUNTARYCONTROL OF AXIAL & DISTAL MUSCLEMEDIAL OR VENTRAL PATHWAYS - CONTROL MUSCLE OF THE TRUNK AND PROXIMAL PORTIONS OF THE LIMBS (FLEXOR) - POSTURAL ADJUSMENTS AND GROSS MOVEMENT. e.g VENTRAL CORTICOSPINAL TRACT AND MEDIAL DESCENDING PATHS FROM BRAIN STEM (THE TECTOSPINAL,RETICULOSPINAL AND VESTIBULOSPINAL TRACTS) - ADJUSMENTS OF PROXIMAL MUSCLE AND POSTURE.LATERAL PATHWAYS - DISTAL PORTIONS OF THE TRUNK - FINE AND SKILLED MOVEMENT e.g LATERAL CORTICOSPINAL TRACT AND RUBROSPINAL TRACT DISTAL LIMB MUSCLE PARTICULARLY LAT,CORTICOSPINAL TRACT. SKILL VOLUNTARY MOVEMENTPYRAMIDAL SYSTEM, EXTRAPYRAMIDAL SYSTEM, UPPER MOTOR NEURON AND LOWER MOTOR NEURON

LOWER MOTOR NEURONBRAIN STEMRETICULARFORMATIONVESTIBULAR NUCLEUSBASAL NUCLEIRED NUCLEUS THALAMUSCEREBELLUMCEREBRAL CORTEX VESTIBULOSPINAL TR RUBROSPINAL TRRETICULOSPINAL TRCORTICOSPINAL TR.

MOTOR FUNCTION OF SPINAL CORDORGANIZATION OF THE SPINAL CORD FOR MOTOR FUNCTIONANTERIOR MOTOR NEURONS- ALPHA MOTOR NEURONS- GAMMA MOTOR NEURONSINTERNEURONSRENSHAW CELL INHIBITORY SYSTEM (RECURRENT INHIBITION) LATERAL INHIBITION TO FOCUS OR SHARPEN ITS SIGNAL. PROPRIOSPINAL FIBERS MULTISEGMENTAL REFLEX

RECEPTOR FUNCTION OF MUSCLE SPINDLEMUSCLE SPINDLESEND INFORMATION TO NS MUSCLE LENGTH OR RATE OF CHANGE OF ITS LENGTHGOLGI TENDON ORGAN TENDON TENSION OR RATE OF CHANGE OF TENSION

THE STATIC RESPONS & THE DYNAMIC RESPONSTHE STATIC RESPONSE RESPONS OF BOTH THE PRIMARY AND SECONDARY ENDINGS TO THE LENGTH OF THE RECEPTOR (STRETCH SLOWLY)DYNAMIC RESPONSE RESPONSE OF THE PRIMARY ENDING (LENGTH OF THE SPINDLE RECEPTOR INCREASES SUDDENLY).. THE PRIMARY ENDING RESPONDS EXTREMELY ACTIVELY TO RAPID RATE OF CHANGE IN SPINDLE LENGTH

Smooth muscle, Cardiac muscle, glandANSSkeletal

4 PROCESSING OF INFORMATION

5 STORAGE OF INFORMATION

B. MAYOR LEVELS OF CNS FUNCTIONCORTICALSUBCORTICALSPINAL CORD

MAYOR LEVELS OF CNS FUNCTION CORTICAL LEVEL: Nuklei, TractusSUBCORTICAL: Nuklei, Ascending & Descending Tract,SPINAL CORD: Nuklei, Ascending & Descending Tract

CORTICAL LEVELPERCEPTION SENSORY SIGNAL AND MOTORIK SIGNAL VOLUNTARY

FUNCTION OF SPESIFIC CORTICAL AREAS

I. PRIMARY CORTEX (MOTOR AND SENSORY) II. SECONDARY CORTEX / ASSOCIATION AREA (MOTOR AND SENSORY)

THE CEREBRAL CORTEX, INTELECTUAL FUNCTION of THE BRAIN: LEARNING and MEMORY

THE CEREBRAL CORTEXTHE CORTICAL NEURONGRANULAR OR STELLATE - SHORT AXON - LOCAL SIRCUIT NEURON- NEUROTRANSMITTER: GLUTAMATE (EXCITATORY) OR GABA (INHIBITORY)FUSIFORM - LONG AXONS - PROJECT TO THALAMUSPYRAMIDAL - LONG AXONS - PROJECT TO OTHER LOCATIONS IN THE SAME OR OPPOSITE HEMISPHERE AND TO SUBCORTICAL LOCATIONS SUCH AS THE RED NUCLEUS, BASILAR PONS, AND SPINAL CORD

THE CEREBRAL CORTEX THE CORTICAL NEURON - SIX HORIZONTAL LAYERS LAYERS I, II, III SPECIALIZED TO RECEIVE INPUT FROM AND PROJECT TO OTHER PARTS OF THE CORTEX IN THE SAME OR OPPOSITE HEMISPHERELAYER IV RECEIVES INCOMING SENSORY SIGNAL FROM THE THALAMUSLAYER V LONG SUBCORTICAL PROJECTIONS TO BRAIN STEM AND SPINAL CORDLAYER VI CORTICOTHALAMIC FIBERS

ASSOCIATION AREA OF CORTEXPARIETO-OCCIPITO-TEMPORAL AREAThe posterior parietal area the spatial coordinates for all parts of the contralateral side of the body.Wernickes area language comprehensionArea in the angular gyrus the initial processing of visual language (reading)Anterior part of the occipital lobe for naming objectsPrefrontal association area to plan complex patterns and sequens movement Brocas area involved in the motor aspects of speech and receive input from Wernickes. It provides output to the nearby motor cortex that controls the muscles required for speech productionLimbic association cortex (include anterior pole of temporal lobe,ventral aspect of the frontal lobe and a portion of the cingulate cortex) the complex processes of emotional and motivational behaviour- connected with limbic system(hypothalamus,amygdala,and hipocampus

Facial recognition area ventromedial surfaces of the occipital and temporal lobes

THE DOMINANT HEMISPHERE NON-MOTOR AREATHE DOMINANT HEMISPHERE WERNICKES, BROCAS AREA - are more highly developed in one hemisphere (95 % of all individuals the left hemisphere dominant (right handed)damage WERNICKES AREA ( a general interpretative function) inability to understand spoken or written languageNON DOMINANT HEMISPHERE THAT CORRESPONDS TO WERNICKEs AREA understanding the emotional content or intonation of spoken language (communication)

The Dominant HemisphereLeft hemisphere (right handed)Logic taskAnaliticalFragmenter SequentialVerbal Mathematical, Communication, Filosofi ( THOUGHT/ PEMIKIR)Right hemisphere (left handed)Skill non verbalHolisticCreative ( pencipta)

FUNCTION OF THE BRAIN IN COMMUNICATION LANGUAGE INPUT AND OUT PUT AUDITORY PERCEPTION : BRAIN PATHWAYS FOR PERCEIVING THE HEARD WORD AND THEN SPEAKING SENSORY APHASIA / WERNICKES APHASIA

VISUAL PERCEPTION : PERCEIVING THE WRITEN WORD AND THEN SPEAKING THE SAME WORD MOTOR APHASIA / BROCAS APHASIA

THE PREFRONTAL ASSOCIATION CORTEX HIGHER INTELLECTUAL FUNCTIONSLARGE LESIONDECREASED AGGRESSIVENES AND INAPPROPRIATE SOCIAL RESPONSES LESION INVOLVE THE VENTRAL ASPECT OF THE PREFRONTAL CORTEX, THE LIMBIC ASSOCIATION AREAINABILITY TO PROGRESS TOWARD GOALS OR TO CARRY SEQUENTIAL THOUGHTS PREFRONTAL CORTEX AS THE SITE OF WORKING MEMORY

FUNCTION OF THE CORPUS CALLOSUM AND ANTERIOR COMMISSURETHE TRANSFER OF INFORMATION BETWEEN HEMISPHERES

THOUGHT, CONSCIOUSNESS, AND MEMORYMEMORY TRACESHABITUATIONMEMORY SENSITIZATIONMEMORY- SHORT TERM MEMORIES- INTERMEDIATE LONG TERM MEMORY- LONG TERM MEMORY

B. 2 SUBCORTICAL LEVEL

JARAS PROYEKSI SPESIFIK KE KORTEKS BAGIAN NON SPESIFIK RETIKULAR

SPINAL CORD LEVEL

LECT.REFLEX TASK 1724102007 REFLEX

REFLEKS

DEFINISI : RESPONS SS YANG TIDAK DISADARI, AUTOMATIS TERHADAP SUATU RANGSANG SENSORIK INTERNAL DAN EKSTERNALJALUR / LINTASAN YANG BERPERAN DALAM AKTIVITAS REFLEKS LENGKUNGAN REFLEKS (REFLEKS ARC) 1. RECEPTOR SENSORIK2. NEURON AFEREN3. PUSAT INTEGRASI / SINAPS4. NEURON EFEREN5. EFEKTOR

REFLEKS

INERVASI RECIPROCAL ( PERSARAFAN TIMBAL BALIK ) : AGONIST DAN ANTAGONIS INVERSE STRETCH REFLEX / AUTOGENIC INHIBITION RANGSANG TERLALU KUAT RESPONS TERHENTI

MACAM AKTIVITAS REFLEKS

BERDASARKAN PUSAT INTEGRASI a. REFLEKS SPINALIS (TK. MED.SPINALIS)b. REFLEKS BULBAR (TK SUBCORTIKAL)c. REFLEKS CORTIKAL (TK.CORTIKAL)2. LOKASI RECEPTOR SENSORIKa. EKSTEROSEPTIF (SUPERFICIAL R.)b. PROPRIOSEPTIF ( DEEP R. )c. VISCEROSEPTIF ( VISCERAL R. )

MACAM REFLEKS

3. JUMLAH SINAPS / INTERNEURON ANTARA AFEREN DAN EFEREN a. R. MONOSINAPTIK b. R. POLISINAPTIK4. DIBAWA (INBORN R. / UNCONDITIONED R.) DIDAPAT (ACQUIRED / CONDITIONED R.)5. REFLEKS FISIOLOGIS PATHOLOGIS

SUPERFICIALREFLEXESAFFERENTCENTEREFFERENT1. CORNEA 2. NASAL 3.PHARINX,UVU.4.UPPER ABDM5 LOWER ABDM.6.CREMASTER7. PLANTAR8. ANAL

DEEP REFLEXESVVIXTh7,8,9,19Th10,11,12FEMORALN.TIBIALISPUDENDAL

PONSBRAINSTEMMEDULLA /MOTh7,8,9,10 MSTh10.11,12 MSL1S I,2S1,2VIIV,VII,IX,XXTh 7,8,9,10Th 10,11,12GENITOFEMORN.TIBIALN.PUDENDAL.1.JAW2.BICEPS3.TRICEPS4.PRIOSTEORADIAL5.WRIST-FLEXI6.WRIST EXTENSI7.PATELLAR8.ACHILLESVMusculocutaneousRADIALRADIAL MEDIAN RADIALFEMORALTIBIALPONSC 5, 6C 6,7C 6,7,8C 6,7,8C7,8L2,3,4S 1,2VMUSC.CUTANEUSRADIALRADIALMEDIANRADIALFEMORALTIBIAL

VISCERALREFLEXES

1.LIGHT2.ACOMMODATION3.CILIOSPINAL4.OCULARCARDIAC5.CAROTID SINUS6.BULBOCAVERNOS.7.BLADDER , RECTAL

AFFERENT

IIIISENSORIS Th I,2VIXPUDENDALPUDENDALCENTER

MIDBRAINOCCIPIT.CORTTh 1,2 MOMOS 2, 3, 4S 2, 3, 4EFFERENT

IIIIIICERVICAL S.XXPELVIC ANSPUDENDAL & ANS

SYNAPSE6

TYPE OF SYNAPSE

SYNAPTIC TRANSMISSIONCHARACTRISTIC OF SYNAPTIC TRANSMISSIONOne way conductionIPSP and EPSP NeurotransmitterSynaptic delay Fatigue Effect acidosis and alkalosis Effect of hypoxia: cessation of O2 in a few second inexcitability and then 3 to 7 second the person become conscious.Effect of drug: coffe, tea, and cocoa (cafein, theophyllin, theobromine) increase neuronal excitability. Glycine (inhibitory effect), anaesthetic.Special functions of dendrites in exciting neuron:- Large spatial field of excitation of the dendrites (80-95%), 5 20% in neuronal soma - most dendrite cannot transmit AP but they can transmit signal by electronic conduction

SECOND MESSENGERSYSTEM. Transmitter substance activated G protein to Release G protein 4 effects1.Opening ion channel2. Activating an enzyme in neuronal mb.3.Activating an intracellular enzyme system4. Causing gene transcription

SMALL MOLECULE, RAPIDLY ACTING NEUROTRANSMITTERSNEUROPEPTIDE, SLOWLY ACTING TRANSMITTERS OR GROWTH FACTORClass I: AcetylcholineClass II: The amines Nor Epinephrine (NE) Epinefrin (E) Dopamine Serotonin HistamineClass III: Aminoacids amino-butyricacids (GABA) Glysine Glutamate AspartateClass IV Nitric Oxide (NO)Hypothalamic Releasing Hormone Thyrotropin RH (T RH) Luteinizing hormone- RH (LH-RH) Somatostatin (GH-IF)Pituitary peptide ACTH Endorpine Melanocytes Stimulating Hormone Prolactine, LH, TSH, GH Vasopressin (ADH), OxytosinPeptide that act on gut and brain Leucine Enkephaline, Methionine Enkep. Substance P, Gastrin, CCK, VIP Nerve growth factor, Brain drive - neurotropic factor, Neurotensine Insulin, GlucagonFrom other tissues Angiotensin II, Bradykinin, Carnosin, Sleep peptide, Calcitonin

TERIMAKASIH

INDEPENDENT LEARNINGNEURONS AND SYNAPSES AT GLANCEFunction Neuron and Supporting Cells Neuron basic functional unit of ns- Electrogenesis- All or None Transmission- Secretion of neurotransmitterSynaptics Transmission- Electrical synaps- Chemical synapsMajor Levels of CNS Function- spinal cord level- Subcortical level- Cortical level

LEARNING TASKDESCRIBE THE STRUCTURE OF NEURON AND EXPLAIN THE FUNCTIONAL SIGNIFICANCE OF ITS PRINCIPAL REGIONCLASSIFY NEURONS ON THE BASIS OF THEIR STRUCTURE AND FUNCTIONDESCRIBE THE LOCATIONS AND FUNCTION OF THE DIFFERENT TYPES OF SUPPORTING CELLSEXPLAIN WHAT IS MEANT BY THE BLOOD - BRAIN BARRIER AND DISCUSS ITS SIGNIFICANCEDESCRIBE THE NEURILEMMA AND EXPLAIN HOW IT FUNCTIONS IN THE REGENERATION OF CUT PERIPHERAL NERVE FIBERSEXPLAIN HOW A MYELIN SHEATHS IS FORMEDDEFINE POLARIZATION, DEPOLARIZATION, REPOLARIZATION, AND HYPERPOLARIZATIONEXPLAIN THE ACTION OF VOLTAGE-REGULATED Na+ AND K+ CHANNELS AND DESCRIBE EVENTS THAT OCCUR DURING THE PRODUCTION OF AN ACTION POTENTIALDESCRIBE THE PROPERTIES OF ACTION POTENTIALS AND EXPLAIN THE SIGNIFICANCE OF ALL-OR NONE LAW AND REFRACTORY PERIODE