Notes on the Nervous System

The nervous system is usually divided into: (a) central nervous system (brain and spinal cord) (b) peripheral nervous system (peripheral nerves and ganglia) The peripheral nervous system is divided into a somatic system and visceral (autonomic) system. Nervous tissue consists of neurons (nerve cells and their processes) and supportive elements. Neuroglia in the central nervous system and Schwann cells in the peripheral nervous system are the supportive elements. The Neuron: The neuron is a cellular element and, as a highly specialized cell, it carries out the function of nervous transmission. The neuron is like many other cells within the body in that it consists of a nucleus with an associated nucleolus and a cytoplasm which is rich in organelles, the most prominent of which are the rough-surfaces endoplasmic reticulum (Nissl substance), mitochondria, and the Golgi apparatus. In almost all of the many varieties of neurons, there are two kind of processes: the dendrites and the axon. The Dendrites: (1) are direct extensions of the cytoplasm. (2) are generally multiple. (3) provide an increased surface area, the dendrite zone, to allow for synaptic interaction. The Axon: (1) There is only one per neuron. (2) This process arises from a conical elevation of cytoplasm which is devoid of rough-surfaced endoplasmic reticulum (Nissl) and this area is called the axon hillock. (3) It is usually thinner and longer than the dendrites of the same neuron. (4) It may be surrounded by a myelin sheath which is produced by the olidodendrocytes in the CNS and by the Schwann cells in the PNS. Discontinuities in this myelin sheath occur at intervals known as the nodes of Ranvier. Though many axons are myelinated (myelinated nerve fibers), there are numerous others that possess no myeline sheath (unmyelinated nerve fibers). (5) At its ending, the axon transmits impulses: (a) to other neurons (the site of the impulse transmission is the synapse); (b) to effector cells such as muscle fibers and gland cells. The junction with skeletal muscle fibers constitutes a motor end plate.

The Action Potential: An impulse traveling along a neuron is an electrical phenomena initiated by a temporary change in the permeability of the neurons cell membrane. The membrane possesses specific sites for the active transport of sodium ions (Na+) and potassium ions (K+). At these sites, sodium is transported out of the cell, and potassium is transported inward. Both ions tend to return to their original positions through pores, but Na+ ions are less successful than the K+ ions. Thus, the unstimulated neuron accumulates a larger concentration of positive ions (both Na+ and K+) outside its membrane than in its cytoplasm. A voltmeter would measure this difference at about 70 mV (with the inside of the neuron being negative). This is called the resting potential or the membrane potential. A sufficient stimulus (mechanical, chemical, or electrical) causes a radical but temporary change in the permeability of the affected membrane region. The membrane possesses specific channels that can allow sodium to pass, and others for potassium. In a resting membrane both are closed. A stimulus causes the Na channel to open, and accumulated Na ions outside the membrane rush into the interior by diffusion. This movement is sufficient enough to change the potential difference. This change, in turn, causes the K channels to open, allowing a loss of K ions from the cytoplasm (and so the initial gain in Na+ (positive ions) is countered by the loss of K+ (positive ions)). As a result, the cytoplasm once again is negatively charged. The charge reversal (from negative to positive to negative) is called the action potential. Immediately after the action potential, the Na and K channels close again and the two types of ions are pumped back to their original sites. During this refractory period of several milliseconds, an additional stimulus will not lead to another action potential. Initiation of the action potential at any point of a neurons membrane acts as a stimulus to the adjacent membrane material; therefore, the effect is an action potential flowing along the membrane. The result is

that the message moves quickly over the length of a motor neurons axon. It is also the message that flows along and into a muscle fiber that has been stimulated by events at a motor end plate, because the membrane of a muscle fiber can act like that of a neuron. The Synapse: The synapse is the site of contact between two neurons; it may be, and most commonly is, between an axon and a dendrite (contacts between an axon and the cell body and between axons and axons have been observed). A typical synapse seen between an axon and dendrite (axodendritic synapse) has the following properties: (1) As the axon terminal reaches the synaptic site, it forms a bulbous head called a bouton. This bouton, which constitutes the presynaptic element of the synapse, contains numerous mitochondria and specialized vesicles (synaptic vesicles) which contain the various neurotransmitters (acetylcholine is the primary one). (2) The dendrite, which constitutes the postsynaptic element of the synapse, is separated from the bouton by a cleft which varies in width from 150 to 200 angstroms. (3) This axodendritic synapse is NOT a site where cytoplasmic continuity is established between the axon and the dendrite, as both presynaptic and postsynaptic elements are separated by a cleft. However, via the process of synaptic vesicle release, this axodendritic synapse establishes a functional (chemical) continuity across the expanse of the cleft. Classification of Neurons: (1) Multipolar Neurons: Most abundant; somatic and visceral motor, and associational. (2) Pseudounipolar Neurons (also known as unipolar neurons): Somatic and visceral sensory neurons; cell bodies are located in cranial sensory and dorsal root ganglia; peripheral process goes out to receptor and central process travels into the central nervous system. (3) Bipolar Neurons: Special sensory neurons; cell bodies are located in special sense organs. Groups of Neurons: Nucleus: cluster of nerve cells bodies within the central nervous system. Ganglion: cluster of nerve cell bodies outside the central nervous system. Cortex: layered arrangement of nerve cell bodies on the surface of the cerebrum and cerebellum (gray matter). Supportive Elements: Neuroglia are the supportive elements of the central nervous system. There are several types. (1) Astrocytes: fibrous and protoplasmic; their perivascular feet end on capillaries. They are located between capillary (or pia matter) and neurons and are implicated in the blood-brain barrier. Approximately 80% of brain capillary surfaces are covered by perivascular end feet of astrocytes.

(2) Oligodendrocytes: Oligodendrocytes function in the myelinization of central nervous system axons. (3) Microglia: Microglia are the phagocytic macrophage-like cells of the central nervous system. Supportive Elements of the Peripheral Nervous System: (1) Schwann (neurilemmal) Cells: These are involved in the myelinization of peripheral nervous system axons. (2) Satellite Cells: These cells surround nerve cell bodies in the ganglia of the peripheral nervous system. The Central Nervous System The central nervous system is made up of the brain and the spinal cord. The Spinal Cord: If one were to examine a cross section through any level of the spinal cord, the following would be seen: 1. A centrally located H-shaped mass which contains the cell bodies of multipolar neurons. This Hshaped mass is divided into dorsal and ventral columns, or horns. Cell bodies responsible for sensory phenomena are located in the dorsal horns, cell bodies for motor phenomena in the ventral horns. This Hshaped mass is collectively referred to as the gray matter. 2. Peripheral to this H-shaped mass, white matter, made up primarily of myelinated nerve fibers. 3. Entering the spinal cord at the apex of the dorsal horn is the dorsal root of the spinal nerve. The cell bodies of these fibers are pseudounipolar and are located in the dorsal root ganglion. The ventral root exits from the ventral horn of the gray matter. The cell bodies of these fibers are multipolar and located in the ventral horn. 4. White matter is divided into three masses of fibers known as funiculi. The three funiculi are: (1) the dorsal funiculus (located between the dorsal midline and the dorsal root) (2) the lateral funiculus (located between the dorsal and ventral roots) (3) the ventral funiculus (located between the ventral root and the ventral midline) Within each funiculus are bundles of fibers (axons) called tracts. The fibers within a specific tract have a common origin, termination, and function and either descend or ascend in the cord. 5. An orderly arrangement of gray and white matter that remains constant throughout the spinal cord, varying only in relative mass. The spinal cord viewed as a whole has the following characteristics:

- It is cylindrical (~0.5 in. in diameter and 18 in. in length) and has a cervical and lumbar enlargements, due to the involvement of these cord levels with the innervations of the upper and lower limbs, respectively. - It runs within the bony vertebral canal but is shorter than the canal since vertebral column growth exceeds cord growth. The spinal cord ends at vertebral level L1-L2 (lumbar 1-2). - It is protected not only by the bony vertebral column but also by three connective tissue sheaths known collectively as the meninges (dura mater, arachnoid membrane, and pia matter). Cerebrospinal fluid is in the subarachnoid space (between the arachnoid and pia) and bathes the cord and cushions it from shock. - There are 31 pairs of spinal nerves that are connected to the cord by dorsal and ventral roots: - 8 cervical - 12 thoracic - 5 lumbar - 5 sacral - 1 coccygeal - The spinal nerves exit from the vertebral canal through intervertebral foramina. - It is because the cord ends at vertebral level L2 that lumbar punctures can be done safely below that level. The Brain: The brain is divided into three parts: (1) the cerebrum (two cerebral hemispheres) (2) the brain stem (consisting of the medulla, pons, midbrain, and diencephalon) (3) the cerebellum The cerebrum consists of two hemispheres that are joined by a broad band of commissural fibers called the corpus callosum. Eminences (projections) on the surface are known as gyri and the furrows are known as sulci or fissures.

The cerebral hemisphere is divided into five lobes: (1) frontal contains the major motor areas (motor speech area). (2) parietal is concerned with sensory impressions such as touch, pressure, and pain. (3) occipital is concerned with vision. (4) temporal is concerned with hearing. (5) insula is found deep within the Sylvian fissure.

The medulla oblongata is structurally derived from the myelencephalon and is continuous with the spinal cord at the foramen magnum and extends to the caudal portion of the pons. The medulla controls movement of eyelids, sneezing, coughing, chewing, swallowing, and vomiting, and contains centers for the autonomic control of respiration, heartbeat, contractility of blood vessels, visceral movements (like peristalsis), and glandular secretion. The pons is essentially a crossing and relay station for nerve tracts. It is a conduit through which the cerebral cortex communicated with the cerebellum. It contains the motor nucleio that exert control over facial expression and mastication. It also possesses cell bodies that control lacrimination and salivation. The midbrain serves as a relay center for audiotory and optic phenomena. It houses the oculomotor nucleus, which controls extraocular movements, and exerts autonomic control over papillary constriction and the process of accommodation. The diencephalon is itself divided into the thalamus and the hypothalamus. The thalamus: 1. Maintains the internal environment of the organism. 2. Processes all sensory input except olfactation. 3. Maintains a subconscious sense of comfort. 4. Serves as the main relay station between the cerebrum and the rest of the nervous system.

5. Serves in the integration of motor activities via its relay activity between the basal ganglia, the cerebellum and the cerebral cortex. The hypothalamus regulates body temperature, osmotic balance, blood pressure, and sleep. The cerebellum is derived from the metencephalon. It integrates unconscious proprioceptive impulses, integrates and modulates vestibular functions and body equilibrium. The cerebellum is also responsible for muscular synergy of the body. It coordinates the smooth, accurate, and orderly sequences of muscular contraction and movement. The Peripheral Nervous System The peripheral nervous system is made up of a somatic portion and an autonomic portion, The somatic portion of the peripheral nervous system is made up of cranial nerves and spinal nerves. The cranial nerves are those peripheral nerves which leave the brain. It is customary to subdivide the cranial nerves into twelve pairs and to number and name the pairs as follows: No. I II III Nerve Olfactory Optic Oculomotor General Components Sensory Sensory Motor Peripheral Termination and Modality Supplied Nasal mucosa olfaction Rods and cones of retina vision Superior, inferior, and medial rectus muscles and inferior oblique muscle rotates eyeball Damage to the Nerve Results in Anosmia; Parosmia Visual field defects Strabismus or squint deviation of the eyeball; Diplopia double vision

Motor

Dilated pupil; To a muscle which constricts pupil To ciliary muscle whose contraction Loss of light reflexes Loss of thickens lens accommodation Superior oblique muscle rotates eyeball Muscles of mastication mastication Skin of face and mucosa of mouth and nose supplies sensation Strabismus and diplopia Paralysis of the muscles of mastication Loss of sensation over the distribution of V; Loss of reflex; Tic douloureux pain

IV V

Trochlear Trigeminal

Motor Motor

Sensory

over the distribution of V VI VII Abducens Facial Motor Motor Lateral rectus muscle moves eyeball laterally Muscles of facial expression Loss of ability to abduct eyeball Facial paralysis (Bells palsy); Expressionless face with a drooping mouth Loss of taste on the anterior two-thirds of the tongue Vertigo, nystagmus, and nausea Deafness

Sensory

Taste buds on the anterior twothirds of the tongue Cristae of semicircular canals provide for equilibrium Hair cells in the organ of Corti provide for hearing Parotid gland provides for glandular secretion Taste buds on the posterior onethird of the tongue Epiglottis, root of tongue, soft palate Palate and pharyngeal constrictors and intrinsic muscles of larynx Via the cardiac and pulmonary ganglia to the cardiac muscle and to the smooth muscle and the glands of the pulmonary and GI systems provides for autonomic regulation of the above named organs. Trapezius and sternomastoid muscles

VIII

Vestibulocochlear Sensory (Vestibular portion) Sensory (Cochlear portion)

IX

Glossopharyngeal

Motor Sensory

Loss of secretion Loss of taste on the posterior one-third of the tongue Loss of gag reflex Aphonia and dysphonia Autonomic disturbances

Sensory X Vagus Motor Motor

XI

Spinal Accessory

Motor

Difficulty rotating head or raising

shoulder XII Hypoglossal Motor Muscles of the tongue Paralysis of tongue

Spinal Nerves: Thirty-one pairs of spinal nerves are connected to the spinal cord. Like any nerve, a spinal nerve is composed of nerve fibers (axons and their Schwann cell sheaths) coursing together outside the central nervous system. Spinal nerves are surrounded by well-organized protective sheaths (i.e. endoneurium, perineurium, and epineurium). Spinal nerves contain both sensory and motor fibers. a) Sensory: 1) from receptors in skin and skeletal muscles (GSA general somatic afferent) 2) from receptors in smooth muscles in walls of organs and blood vessels (GVA general visceral afferent) b) Motor: 1) to skeletal muscle (GSE general somatic effect) 2) autonomic fibers to smooth muscle, cardiac muscle, and glands (GVE general visceral efferent) Sensory Pathway: A typical sensory pathway contains three neurons in a chain from the receptor on the surface of the body to consciousness in the cerebral cortex (primary: 1, secondary: 2, tertiary: 3 neurons). 1 Neuron - primary neuron has its pseudounipolar cell body in the dorsal root ganglion; its peripheral process goes out to the receptor through the spinal nerves. - its central process follows the dorsal synapses in the CNS with a second-order neuron. 2 Neuron - has its multipolar cell body in the central nervous system; those concerned with pain and temperature are found within the spinal cord; those concerned with touch and pressure are localized in the medulla of the brain. - The axon of the 2 neuron then crosses the midline and ascends to the thalamus, where it synapses with a third order (3 ) neuron. 3 Neuron - has its multipolar cell body in the thalamus; its axon ascends to the cerebral cortex.

Voluntary Motor Pathway: A typical voluntary motor pathway contains two neurons from the cerebral cortex to the effector organ in the skeletal muscle. Neuron 1: (upper motor neuron) has its multipolar cell body in the cerebral cortex; its axon descends, crosses the medulla, and terminates in relation to lower motor neurons found in the ventral horn. Neuron 2: (lower motor neuron) has its multipolar cell body in the ventral horn of the spinal cord; its axon (efferent fiber) leaves the spinal cord through the ventral root and follows the spinal nerve to the skeletal muscle, where it terminates as a motor end plate.

Autonomic Nervous System: The autonomic nervous system innervates all smooth muscle, cardiac muscle, and glands. The autonomic nervous system is divided into a sympathetic (flight or fight) component and a parasympathetic (maintains homeostatis) components. The differences are summarized below Sympathetic Thoracolumbar outflow (T1-L2) Short preganglionic Long preganglionic Ganglia close to spinal cord Emergency stress system Epinephrine (neurotransmitter) Innervates skin Chain ganglion Innervates adrenal gland Parasympathetic Craniosacral outflow (cranial nerves III, VII, IX, X, and S2-S4) Long preganglionic Short preganglionic Ganglia close to the organ Steady-state system (homeostatic) Acetylcholine (neurotransmitter) No skin innervations No chain ganglion No adrenal innervations

Similarities of the two divisions: sympathetic (thoracolumbar), parasympathetic (craniosacral): a) Involuntary system: innervates smooth muscle, cardiac muscle, glands, and organs b) Two neuron system: - first neuron inside CNS (preganglionic) - second neuron outside CNS in ganglion (postganglionic) c) Fibers run with cranial nerves, spinal nerves, and alone as splanchnic nerves.

Summary Action of the Autonomic Nervous System Organ Heart Vasculature Blood Digestive (peristalsis) Bladder Bronchial Tree Glands Sympathetic Increases rate Constricts vessels Increases pressure Decreases rate Relaxes muscles Dilates Increases activity Parasympathetic Decreases rate Dilates vessels Decreases pressure Increases rate Contracts muscles Constricts Decreases activity

The Reflex Arc: Typical pathway of a reflex may be outlined as follows: Sensory receptor on dendrite of dorsal root ganglion cell ganglion cell axon of cell dorsal root dorsal horn of spinal cord either directly to motor cell in ventral horn or via internuncial (association) neuron to ventral horn motor cell axon via ventral root spinal nerve effector organ (e.g. muscle)

General Terminology For Describing the Craniospinal Nerves General sensory or general somatic afferent (GSA) General visceral afferent (GVA) Special sensory or special afferent (SSA) Special sensory or special visceral afferent (SVA) Visceral motor or visceral efferent (GVE) Pain, temperature, and touch; proprioception, vibration, pressure, and discrimination Pain due to distension - Vision - Equilibrium, and hearing - Smell - Taste - Smooth muscle, cardiac muscle, and glands - Levator palpebrae superioris, sphincter papillae, and ciliary muscle of accommodation - Lacrimal, submandibular, and sublingual glands - Parotid gland - Cardiac and smooth muscle All skeletal muscle All spinal nerves; cranial nerves (denoted CN), V, VII, IX, X All spinal nerves and CN X CN II CN VIII CN I CN VIII All spinal nerves; sympathetic component CN III

CN VII CN IX CN X All spinal nerves and CN III, IV, V, VI, VII, IX, XI, XII

Somatic motor or general somatic efferent (GSE)