ANATOMY AND PHYSIOLOGY The nervous system is an intricate, highly organized network of billions of neurons and neuroglia.

The structures that make up the nervous system include the brain, cranial nerves, spinal nerves, ganglia, enteric plexuses and sensory receptors. The two main subdivisions of the nervous system are the central nervous system and the peripheral nervous system. The central nervous system consists of the brain and spinal cord. The brain is the center for registering sensations, correlating them with one another and with stored information, making decisions and taking actions. It also is the center for the intellect, emotions, behavior, and memory. The major parts of the brain include: the brain stem, cerebellum, diencephalon, and cerebrum. The spinal cord is connected to a section of the brain called the brainstem and runs through the spinal canal. Cranial nerves exit the brainstem. Nerve roots exit the spinal cord to both sides of the body. The spinal cord carries signals (messages) back and forth between the brain and the peripheral nerves.

The brain stem is continuous with the spinal cord and consists of the medulla oblongata, pons, and midbrain. The medulla oblongata forms the inferior part of the brain stem. The medulla contains the cardiac, respiratory, vomiting and vasomotor centers and deals with breathing, heart rate and blood pressure. The pons is a bridge that connects parts of the brain with one another. The midbrain extends from the pons to the diencephalon. The midbrain is a short section of the brain stem between the diencephalon and the pons.

Posterior to the brain stem is the cerebellum. Traditionally, the cerebellum has been known to control equilibrium and coordination and contributes to the generation of muscle tone. It has more recently become evident, however, that the cerebellum plays more diverse roles such as participating in some types of memory and exerting a complex influence on musical and mathematical skills. Superior to the brain stem is the diencephalon, which consists of the thalamus, hypothalamus, and epithalamus. The limbic system is a complex set of structures that lies on both sides of the thalamus, just under the cerebrum. It includes the hypothalamus, the hippocampus, the amygdala, and several other nearby areas. It appears to be primarily responsible for our emotional life, and has a lot to do with the formation of memories. In this drawing, you are looking at the brain cut in half, but with the brain stem intact. The part of the limbic system shown is that which is along the left side of the thalamus (hippocampus and amygdala) and just under the front of the thalamus (hypothalamus):

The hypothalamus is a small part of the brain located just below the thalamus on both sides of the third ventricle. (The ventricles are areas within the cerebrum that are filled with cerebrospinal fluid, and connect to the fluid in the spine.) It sits just inside the two tracts of the

optic nerve, and just above (and intimately connected with) the pituitary gland. The hypothalamus is one of the busiest parts of the brain, and is mainly concerned with homeostasis. Homeostasis is the process of returning something to some set point. It works like a thermostat: When your room gets too cold, the thermostat conveys that information to the furnace and turns it on. As your room warms up and the temperature gets beyond a certain point, it sends a signal that tells the furnace to turn off. The hypothalamus is responsible for regulating your hunger, thirst, response to pain, levels of pleasure, sexual satisfaction, anger and aggressive behavior, and more. It also regulates the functioning of the autonomic nervous system (see below), which in turn means it regulates things like pulse, blood pressure, breathing, and arousal in response to emotional circumstances. The hypothalamus receives inputs from a number of sources. From the vagus nerve, it gets information about blood pressure and the distension of the gut (that is, how full your stomach is). From the reticular formation in the brainstem, it gets information about skin temperature. From the optic nerve, it gets information about light and darkness. From unusual neurons lining the ventricles, it gets information about the contents of the cerebrospinal fluid, including toxins that lead to vomiting. And from the other parts of the limbic system and the olfactory (smell) nerves, it gets information that helps regulate eating and sexuality. The hypothalamus also has some receptors of its own, that provide information about ion balance and temperature of the blood. The hypothalamus sends instructions to the rest of the body in two ways. The first is to the autonomic nervous system. This allows the hypothalamus to have ultimate control of things like blood pressure, hear trate, breathing, digestion, sweating, and all the sympathetic and parasympathetic functions. The other way the hypothalamus controls things is via the pituitary gland. It is neutrally and chemically connected to the pituitary, which in turn pumps hormones called releasing factors into the bloodstream. As you know, the pituitary is the so-called master gland, and these hormones are vitally important in regulating growth and metabolism. The hippocampus consists of two horns that curve back from the amygdala. It appears to be very important in converting things that are in your mind at the moment (in short -term memory) into things that you will remember for the long run (long-term memory). If the hippocampus is damaged, a person cannot build new memories, and lives instead in a strange world where everything they experience just fades away, even while older memories from the

time before the damage are untouched! This very unfortunate situation is fairly accurately portrayed in the wonderful movie Memento, as well as in a more light-hearted movie, 50 First Dates. But there is nothing light-hearted about it: Most people who suffer from this kind of brain damage end up institutionalized. The amygdalas are two almond-shaped masses of neurons on either side of the thalamus at the lower end of the hippocampus. When it is stimulated electrically, animals respond with aggression. And if the amygdala is removed, animals get very tame and no longer respond to things that would have caused rage before. But there is more to it than just anger: When removed, animals also become indifferent to stimuli that would have otherwise have caused fear and even sexual responses. Supported on the diencephalon and brain stem is the cerebrum, which is the largest part of the brain. The cerebrum is the largest part of the brain and controls voluntary actions, speech, senses, thought, and memory. The surface of the cerebral cortex has grooves or unfoldings (called sulci), the largest of which are termed fissures. Some fissures separate lobes. The convolutions of the cortex give it a wormy appearance. Each convolution is delimited by two sulci and is also called a gyrus (gyri in plural). The cerebrum is divided into two halves, known as the right and left hemispheres. A mass of fibers called the corpus callosum links the hemispheres. The right hemisphere controls voluntary limb movements on the left side of the body, and the left hemisphere controls voluntary limb movements on the right side of the body. Almost every person has one dominant hemisphere. Each hemisphere is divided into four lobes, or areas, which are interconnected.

The frontal lobes are located in the front of the brain and are responsible for voluntary movement and, via their connections with other lobes, participate in the execution of sequential tasks; speech output; organizational skills; and certain aspects of behavior, mood, and memory. The parietal lobes are located behind the frontal lobes and in front of the occipital lobes. They process sensory information such as temperature, pain, taste, and touch. In addition, the processing includes information about numbers, attentiveness to the position of ones body parts, the space around ones body, and one's relationship to this space. The temporal lobes are located on each side of the brain. They process memory and auditory (hearing) information and speech and language functions. The occipital lobes are located at the back of the brain. They receive and process visual information. Neurons are nerve cells that transmit nerve signals to and from the brain at up to 200 mph. The neuron consists of a cell body (or soma) with branching dendrites (signal receivers) and a projection called an axon, which conduct the nerve signal. At the other end of the axon, the axon terminals transmit the electro-chemical signal across a synapse (the gap between the axon terminal and the receiving cell). The word "neuron" was coined by the German scientist Heinrich Wilhelm Gottfried von Waldeyer-Hartz in 1891 (he also coined the term "chromosome").

The axon is a long extension of a nerve cell, and takes information away from the cell body. Bundles of axons are known as nerves or, within the CNS (central nervous system), as nerve tracts or pathways. Dendrites bring information to the cell body. Myelin coats and

insulates the axon (except for periodic breaks called nodes of Ranvier), increasing transmission speed along the axon. Myelin is manufactured by Schwann's cells, and consists of 70-80% lipids (fat) and 20-30% protein. The cell body (soma) contains the neuron's nucleus (with DNA and typical nuclear organelles). Dendrites branch from the cell body and receive messages. A typical neuron has about 1,000 to 10,000 synapses (that is, it communicates with 1,000-10,000 other neurons, muscle cells, glands, etc.). DIFFERENT TYPES OF NEURONS

There are different types of neurons. They all carry electro-chemical nerve signals but differ in structure (the number of processes, or axons, emanating from the cell body) and are found in different parts of the body.

Sensory neurons or bipolar neurons carry messages from the body's sense receptors (eyes, ears, etc.) to the CNS. These neurons have two processes. Sensory neuron account for 0.9% of all neurons. (Examples are retinal cells, olfactory epithelium cells.)

Motoneurons or Multipolar neurons carry signals from the CNS to the muscles and glands. These neurons have many processes originating from the cell body. Motoneurons account for 9% of all neurons. (Examples are spinal motor neurons, pyramidal neurons, Purkinje cells.)

Interneurons or Pseudopolare (Spelling) cells form all the neural wiring within the CNS. These have two axons (instead of an axon and a dendrite). One axon communicates with the spinal cord; one with either the skin or muscle. These neurons have two processes. (Examples are dorsal root ganglia cells.)

Neurotransmitters are chemicals which relay, amplify, and modulate signals between a neuron and another cell. Some neurotransmitters are commonly described as "excitatory" or "inhibitory". The only direct effect of a neurotransmitter is to activate one or more types of receptors. Commonly, they are classified into three categories - amino acids, monoamines and peptides. Neurotransmitters like glutamate, aspartate, glycine, serine and gamma aminobutyric

acid (GABA) fall into the category of amino acids. On the other hand dopamine neurotransmitter, serotonin, melatonin, epinephrine and norepinephrine are the monoamine neurotransmitters. Calcitonin, glucagon, vasopressin, oxytocin and beta-endorphin are some of the neuroactive peptides. There are about 50 neuroactive peptides till now, with new ones being discovered regularly. Apart from these, acetylcholine, adenosine and nitric oxide are some other noteworthy neurotransmitters. Acetylcholine It is the first neurotransmitter to be discovered in the year 1921. This neurotransmitter is responsible for stimulating muscles. It activates the motor neurons that control the skeletal muscles. It is also concerned with regulating the activities in certain areas of the brain, which are associated with attention, arousal, learning and memory. People with Alzheimer's disease are usually found to have a substantially low level of acetylcholine. Dopamine Dopamine is the neurotransmitter that controls voluntary movements of the body and is associated with the reward mechanism of the brain. In other words, dopamine regulates the pleasurable emotions, and drugs like cocaine, heroin, nicotine, opium and even alcohol increase the level of this neurotransmitter, for which the user of such drugs feels good. Decreased level of dopamine is associated with Parkinson's disease, while the patients of schizophrenia are usually found to have excess dopamine in the frontal lobes of the brain. Serotonin Serotonin is an important inhibitory neurotransmitter, which has been found to have a significant effect on emotion, mood and anxiety. It is also involved in regulating sleep, wakefulness and eating. A significantly low serotonin level is found to be associated with conditions like depression, suicidal thoughts and obsessive compulsive disorder. Many antidepressant drugs work by affecting the level of this neurotransmitter. Gamma Aminobutyric Acid (GABA)

GABA is an inhibitory neurotransmitter that slows down neuron activity in order to prevent their over excitation, which could lead to anxiety. GABA is a non-essential amino acid, that is produced by the body from glutamic acid. A low level of GABA can have an association with anxiety disorders. Alcohol and drugs like barbiturates can influence GABA receptors.

Glutamate Glutamate is an excitatory neurotransmitter. It is the most commonly found neurotransmitter in the central nervous system. Glutamate is mainly related with functions like learning and memory. An excess of glutamate is however toxic for the neurons. An excessive glutamate production may be related with the disease, known as amyotrophic lateral sclerosis (ALS) or Lou Gehrig's disease. Epinephrine and Norepinephrine

Epinephrine is an excitatory neurotransmitter, that is derived from norepinephrine. Epinephrine controls mental focus and attention. Norepinephrine is also an excitatory neurotransmitter and it regulates mood and both physical and mental arousal. Increased secretion of norepinephrine raises the heart rate and blood pressure. Endorphins Endorphins are the neurotransmitters that resemble the opioid compounds like opium, morphine and heroin in structure. In fact, their effect on the body is also similar to the effect produced by the opioid compounds. Like opioids, endorphins can reduce pain, stress and promote calmness and serenity. These are the neurotransmitters that enable some animals to hibernate by slowing down metabolism, respiration and heart rate.

CRANIAL NERVES

Cranial nerves are nerves that emerge directly from the brain stem, in contrast to spinal nerves which emerge from segments of the spinal cord. There are 12 pairs cranial nerves emerging from the brain, and these are:

Cranial nerve number Name

Sensory, Motor or Both Purely Sensory Purely Sensory Transmits the sense of smell; Located Function

Olfactory nerve

in olfactory foramina of ethmoid Transmits visual information to the brain; Located in optic canal Innervates levator palpebrae superioris, superior

II

Optic nerve

III

Oculomotor nerve

Mainly Motor

rectus, medial rectus,inferior rectus, and inferior oblique, which collectively perform most eye movements; Located in superior orbital fissure Innervates the superior oblique muscle, which

IV

Trochlear nerve

Mainly Motor

depresses, rotates laterally (around the optic axis), and intorts the eyeball; Located insuperior orbital fissure

Trigeminal nerve

Both Sensory Receives sensation from the face and innervates and Motor Mainly Motor the muscles of mastication Innervates the lateral rectus, which abducts the eye; Located insuperior orbital fissure

VI VII

Abducens nerve Facial nerve

Both Sensory Provides motor innervation to the muscles of

and Motor

facial expression, posterior belly of the digastric muscle, and stapedius muscle, receives the

special sense of taste from the anterior 2/3 of the tongue, and provides secretomotor innervation to the salivary the lacrimal glands (except gland; Located parotid) and and runs

through internal

acoustic

canal to facial

canal and exits at stylomastoid foramen Vestibulocochlear nerve (or auditoryVIII vestibular nerveor statoacoustic nerve) Mostly sensory Senses sound, rotation and gravity (essential for balance & movement). More specifically. the vestibular branch carries impulses for

equilibrium and the cochlear branch carries impulses for hearing.; Located in internal

acoustic canal Receives taste from the posterior 1/3 of the tongue, provides secretomotor innervation to the parotid gland, and provides motor

IX

Glossopharyngeal nerve

Both Sensory and Motor

innervation to the stylopharyngeus (essential for tactile, pain, and thermal sensation. Some sensation is also relayed to the brain from the palatine tonsils. Sensation is relayed to opposite thalamus and some hypothalamic nuclei.

Located in jugular foramen Supplies branchiomotor innervations to most

laryngeal and all pharyngeal muscles (except Both Sensory and Motor the stylopharyngeus, which is innervated by the glossopharyngeal); provides parasympathetic fibers to nearly all thoracic and abdominal viscera down to

Vagus nerve

the splenic flexure; and receives the special

sense of taste from the epiglottis. A major function: controls muscles for voice and resonance and the soft palate. Symptoms of damage: dysphagia (swallowing problems),velopharyngeal insufficiency. Located in jugular foramen Accessory XI nerve Controls sternocleidomastoid and trapezius

(or cranial accessory nerve or spinal

muscles, overlaps with functions of the vagus. Mainly Motor Examples of symptoms of damage: inability to shrug, weak head movement; Located in jugular foramen Provides motor innervation to the muscles of the

accessory nerve)

XII

Hypoglossal nerve

Mainly Motor

tongue and other glossal muscles. Important for swallowing (bolus formation) and speech

articulation. Located in hypoglossal canal