ANATOMY AND PHYSIOLOGY

NERVOUS SYSTEM

The nervous system is involved in some way in nearly every body function. We can
consider the nervous system as a communication system, receiving signals from and sending
commands to different areas of the body. It is the master controlling and communicating
system of the body. Every thought, action, and emotion reflect its activity. The nervous
systems signaling device, or means of communicating with body cells, is electrical impulses,
which are rapid and specific and cause almost immediate responses.

FUNCTIONS OF THE NERVOUS SYSTEM:

1. Receiving sensory input – Sensory receptors monitor numerous external and internal
stimuli. Sensations from some stimuli, such as vision, hearing, taste, smell, touch, pain,
body position, and temperature. Other stimuli, such as blood pH, gas gases, and blood
pressure, are processed at a subconscious level.

2. Integrating information – The brain and spinal cord are the major organs for
processing sensory input and initiating responses. The input may produce an immediate
response, be stored as memory, or be ignored.

3. Controlling muscles and glands – Skeletal muscles normally contract when

stimulated by the nervous system. Thus, by controlling skeletal muscle, the nervous
system controls the major movements of the body.

4. Maintaining homeostasis – The nervous system plays an important role in

homeostasis. This function depends on the nervous system’s ability to detect, interpret,
and respond to changes in internal and external conditions. In response, the nervous
system can stimulate or inhibit the activities of other systems to help maintain a constant
internal environment.

5. Establishing and maintaining mental activity – The brain is the center of mental
activity, including consciousness, memory, and thinking.
STRUCTURAL CLASSIFICATION

The nervous system can be divided into two major divisions: the central nervous
system and the peripheral nervous system.

1. Central nervous system – consists of the

brain and spinal cord, which occupy the
dorsal body cavity and act as the integrating
and command centers of the nervous system.

2. Peripheral nervous system – consists of

all the nervous tissue outside the CNS,
including the nerves and ganglia.

ORGANIZATION OF THE NERVOUS

SYSTEM

The sensory division of the peripheral nervous system (PNS) detects stimuli and
conducts action potentials to the central nervous system (CNS). The CNS interprets incoming
action potentials and initiates action potentials that are conducted through the motor division
to produce a response. The motor division is divided into the somatic nervous system and the
autonomic nervous system.

NERVOUS TISSUE: STRUCTURE AND FUNCTION

Even though it is complex, nervous is made up of just two principal types of cell –
supporting cells and neurons.

 SUPPORTING CELLS
Supporting cells in the CNS are “lumped together” as neuroglia, literally meaning
“nerve glue”.

 Glial cells – or simply called

neuroglia, carry out different
functions that enhance neuron
function and maintain normal
conditions within nervous tissue.
Glial Cells of the CNS

 Astrocytes – Highly branched that Provide structural support; regulate

neuronal signaling; contribute to blood-brain barrier; help with neural tissue
repair.
 Ependymal cells – Epithelial-like cells that line ventricles of brain and
central canal of the spinal cord; circulate cerebrospinal fluid (CSF); some
form choroid plexuses, which produce CSF
 Microglia – small, mobile cells that protect CNS from infection; become
phagocytic in response to inflammation.
 Oligodendrocytes – Cells with processes that can surround several axons.
The cell processes form myelin sheaths around axons or enclose
unmyelinated axons in the CNS.

Glial Cells of PNS

 Schwan cells – single cells surrounding axons that form myelin sheaths
around axons or enclose unmyelinated axons in the PNS.
 Satellite cells - found around the cell bodies of certain neurons of the PNS.
These cells provide support and nutrition to the neurons and protect the
neurons from heavy-metal poisons, such as lead and mercury.

NEURONS

It is also called nerve cells, receive stimuli, conduct action potentials, and transmit signals to
other neurons or effector organs. A neuron has 3 parts; (1) a cell body and 2 types of
processes, called (2) dendrites and (3) axons.

 CELL BODY - contains a

single nucleus.
 DENDRITES - short, often
highly branching
cytoplasmic extensions.
Receive information from
other neurons or from
sensory receptors and
transmit the information
toward the neuron cell body.
 AXON - a single long cell
process extending from the
neuron cell body.
 Axon Hillock - the area where the axon leaves the neuron cell body.

TYPES OF NEURONS
The body’s neurons vary in function and in structure. As such, neurons can be classified
on the basis of their function as well as their structure.

1. Multipolar neurons - have many

dendrites and a single axon. Most of the
neurons within the CNS and nearly all motor
neurons are multipolar.
2. Bipolar neurons - have 2 processes: one dendrites and one axon. Bipolar neurons are
located in some sensory organs, such as in the retina of the eye and in the nasal cavity.

3. Pseudo-unipolar neurons - have a single process extending from the cell body. This
process is divided into 2 extensions a short distance from the cell body. One extends to the
periphery, and the other extends to the CNS. The 2 extensions function as a single axon with
small, dendrite-like sensory receptors at the periphery.

NEUROTRANSMITTERS
TYPE PHYSIOLOGICAL MECHANISM OF CLINICAL EXAMPLE
EFFECTS ACTION

Acetylcholine (Ach) Found in the brain, spinal Excitatory or Alzheimer’s disease

cord, PNS - controls sleep inhibitory Myasthenia gravis
and wakefulness cycle,
signals muscles to become
alert.

Norepinephrine (NE) Causes changes in Excitatory Excess - anxiety disorders

attention, learning and Deficit - memory loss, social
memory, sleep and withdrawal, depression
wakefulness, mood
regulation.

Serotonin Found only in the brain - Inhibitory Plays an important role in

controls of food intake, anxiety and mood disorder
sleep and wakefulness, and schizophrenia.
temperature regulation, Contribute to delusions,
pain control, sexual hallucinations, and
behavior, and regulates withdrawn behavior in
emotions. schizophrenia.

Dopamine Controls complex Excitatory Schizophrenia, other

movements, motivation, psychoses, movement
cognition, regulates disorders (Parkinsons)
emotional response.

Gamma-aminobutyric Modulates other Inhibitory Anxiety disorders, epilepsy,

acid (GABA) neurotransmitters rather and other neurological
than to provide a direct disorders (Huntington
stimulus. disease and Parkinsons
disease)

Glutamate Results in neurotoxicity if Excitatory Brain damage, stroke,

levels are too high. hypoglycemia, hypoxia and
some degenerative diseases
such as Huntington or
Alzheirmers.

Epinephrine Controls flight or fight Excitatory Anaphylaxis, cardiac arrest,

response asthma and septic shock.

MYELIN SHEATH
 Myelin sheaths are specialized layers that wrap around the
axons of some neurons. These myelin sheaths are formed by the
cell processes of Oligodendrocytes in the CNS and Schwann cells
in the PNS. Axons with these myelin sheaths are called
myelinated axons. Myelin is an excellent insulator that prevents
almost all ion movement across the cell membrane. Gaps in the
myelin sheath, called nodes of Ranvier, occur about every
millimeter between the myelinated areas. Ion movement can occur at the nodes of Ranvier.

Unmyelinated axons lack the myelin sheaths; however,

these axons rest in indentation of the Oligodendrocytes in the
CNS and the Schwan cells in the PNS. A typical small nerve,
which consists of axons of multiple neurons, usually contains
more unmyelinated axons than myelinated axons.

ORGANIZATION OF NERVOUS TISSUE

 GRAY MATTER - consists of groups of neuron cell bodies and their dendrites,
where there is very little myelin. In the CNS, gray matter on the surface of the brain is
called the cortex, and clusters of gray matter located deeper within the brain are
called nuclei. Similarly, the PNS contains gray matter. In the PNS, a cluster of
neuron cell bodies is called a ganglion.

 WHITE MATTER - consists of bundles of parallel axons with their myelin sheaths,
which are whitish in color. White matter of the CNS forms nerve tracts, or
conduction pathways, which propagate action potentials from one area of the CNS to
another. White matter of the PNS consists of bundles of axons and associated
connective tissue that form nerves.

ACTION POTENTIAL CONDUCTION

Once an action potential is generated, it is

conducted along the cell membrane. The pattern of
action potential conduction along a neuron cell
membrane may occur in one of two ways:
1. CONTINUOUS CONDUCTION - occurs in
unmyelinated axons. An action potential in one part
of a cell membrane stimulates local currents in
adjacent parts of the cell membrane. The lock
currents in the adjacent membrane produce an
action potential. By this means, the action potential
is conducted along the entire axon cell membrane.
.
2. SALTATORY CONDUCTION - occurs in
myelinated axons. In this process, an action
potential at one node of ranvier causes a local
current to flow through the surrounding
extracellular fluid and through the cytoplasm of the
axon to the next node, stimulating an action potential at that node of ranvier. SALTATORY
conduction greatly increases the conduction velocity because the nodes of ranvier make it
unnecessary for action potentials to travel along the entire cell membrane.
THE SYNAPSE
 A synapse is a junction where the axon
of one neuron interacts with another neuron or
with cells of an effector organ, such as a
muscle or gland.
 Presynaptic terminal - the end of the
axon from this.
 Postsynaptic membrane - the
membrane of the dendrite or effector
cell.
 Synaptic cleft - the space separating
the Presynaptic and postsynaptic
membranes.

NEURONAL PATHWAYS

Within the CNS, neurons are organized to form pathways ranging from relatively
simple to extremely complex. The 2 simplest pathways are:
 CONVERGING PATHWAY - two or more neurons synapse with the same
postsynaptic neuron. This allows information transmitted in more than one neuronal
pathway to converge into a single pathway.
 DIVERGING PATHWAY - the axon from one neuron divides and synapses with
more than one other postsynaptic neuron. This allows information transmitted in one
neuronal pathway to diverge into two or more pathways.

CENTRAL NERVOUS SYSTEM

Consists of the brain and spinal cord, which occupy the dorsal body cavity and act as the
integrating and command centers of the nervous system.

BRAIN

The brain is the largest and

most complex mass of nervous tissue in
the body, it is commonly discussed in
terms of its four major regions –
cerebral hemispheres, diencephalon,
brainstem and cerebellum.

 Cerebral Hemispheres – collectively called cerebrum, have two functions: the

right cerebral hemisphere receives sensory input from and controls muscular activity
in the left half of the body. The left cerebral hemisphere receives input from and
controls muscles in the right half of the body.
 Gyri. The entire surface of the cerebral hemispheres exhibits elevated ridges of
tissue called gyri, separated by shallow grooves called sulci.
 Fissures. Less numerous are the deeper grooves of tissue called fissures, which
separate large regions of the brain; the cerebral hemispheres are separated by a
single deep fissure, the longitudinal fissure.
 Lobes. Other fissures or sulci divide each hemisphere into a number of lobes,
named for the cranial bones that lie over them.
 Parietal lobe - The primary somatosensory area is located in the parietal lobe
posterior to the central sulcus; impulses traveling from the body’s sensory receptors
are localized and interpreted in this area.
 Occipital lobe - The visual area is located in the posterior part of the occipital lobe.
 Temporal lobe - The auditory area is in the temporal lobe bordering the lateral
sulcus, and the olfactory area is found deep inside the temporal lobe.
 Frontal lobe - The primary motor area, which allows us to consciously move our
skeletal muscles, is anterior to the central sulcus in the front lobe

 Diencephalon – the part of the brain between the brainstem and the cerebrum. Its
main components are the thalamus, the epithalamus, and the hypothalamus.
 Thalamus – the largest part of the diencephalon, consists of a cluster of nuclei and
is shaped somewhat like a yo-yo, with two large, lateral parts connected in the
center by a small interthalamic adhesion. The thalamus influences mood and
registers an unlocalized, uncomfortable perception of pain
 Epithalamus – is a small area superior and posterior to the thalamus. It consists of a
few small nuclei which are involved in the emotional and visceral response to odors,
and the pineal gland. Pineal gland is an endocrine gland that may influence the onset
of puberty.
 Hypothalamus – is the most inferior part of the diencephalon; it contains several
nuclei that are very important in maintaining homeostasis. Hypothalamus plays a
center role in the control of body temperature, hunger, and thirst.
  Mammillary bodies. The mammillary bodies, reflex centers involved in olfaction
(the sense of smell), bulge from the floor of the hypothalamus posterior to the
pituitary gland.
 Brain Stem – connects the spinal cord to the remainder of the brain. It consists of
the medulla oblongata, the pons, and the midbrain. The brainstem contains several
nuclei involved in vital body functions, such as the control of heart rate, blood
pressure, and breathing.
 Medulla oblongata – the most inferior portion of the brainstem and is continuous
with the spinal cord. The medulla oblongata contains discrete nuclei with specific
functions, such as regulation of heart rate and blood vessel diameter, breathing,
swallowing vomiting, coughing, sneezing, balance, and coordination.
 Pons – superior to the medulla oblongata. It contains ascending and descending
nerve tracts, as well as several nuclei. Some of the nuclei in the pons relay
information between the cerebrum and the cerebellum. Other nuclei in the pons
control functions such as chewing and salivation.
 Midbrain – just superior to the pons, is the smallest region of the brainstem. The
midbrain contains nuclei that are involved in coordinating eye movements and
controlling pupil diameter and lens shape.
 Cerebellum – is attached to the brainstem by several large connections called
“cerebral peduncles”. These connections provide routes of communication between
the cerebellum and other parts of the CNS. Cerebellum provides precise timing for
skeletal muscle activity and controls our balance and equilibrium.

OTHER BRAIN FUNCTIONS

 Communication Between the Right and Left Hemispheres

-The right cerebral hemisphere receives sensory input from and controls muscular
activity in the left half of the body
-The left cerebral hemisphere receives input from and controls muscles in the
right half of the body.

 Speech - the speech area is in the left cerebral cortex. Two major critical areas are
involved in speech
-Sensory speech area – or the (Wernicke area), located in the parietal lobe,
functions in understanding and formulating coherent speech.
-Motor speech area – or the Broca area, located in the frontal lobe, controls the
movement necessary for speech.

 Memory – the storage of memory can be divided into three stages: working, short-
term, and long term.
-Working memory – brain briefly stores information required for immediate
performance tasks.
-Long term memory also be divided into based on the type of memory:
 Declarative memory – or explicit memory, involves the retention of
facts (e.g. names, place, age etc.)
 Procedural memory – or reflexive memory, involves the
development of motor skills. Only one small amount of procedural
memory is lost over time.
 Short term memory – stored by a mechanism involving increased
synaptic transmission.
SPINAL CORD

The spinal cord extends from the

foramen magnum at the base of the skull to
the second lumbar vertebra. Spinal nerves
communicate between the spinal cord and
the body.
 Cauda equina – inferior end of the
spinal cord and spinal nerves exiting
there resembles a horse’s tail.
 Length – the spinal cord is
approximately 17 inches (42cm)
long.
 Spinal nerves – 31 pairs of spinal
nerves arise from the cord and exit
from the vertebral column to serve
the body area close by.

Gray Matter of the Spinal Cord and Spinal Roots

The gray matter of the spinal cord looks like a butterfly or a letter H in cross section
with posterior horns and anterior horns.

 Central canal – is a fluid-filled space in the center of the spinal cord, containing
CSF.
 Dorsal root and Ventral root – unite just lateral to the spinal cord to form a spinal
nerve.
 Dorsal root ganglions – it contains the cell bodies of pseudo-unipolar
 Spinal nerves - the dorsal and ventral roots fuse to form the spinal nerves.

White Matter of the Spinal Cord

White matter consists of myelinated axons. The white matter in each half of the spinal
cord is organized into three columns: dorsal (posterior), ventral (anterior), and lateral
columns. Each column of the spinal cord contains ascending and descending tracts, or
pathways.

 Ascending tracts - consist of axons that conduct action potentials towards the brain.
 Descending tracts – consists of axons that conduct action potentials away from the
brain
 Regions. Because of the irregular shape of the gray matter, the white matter on each
side of the cord is divided into three regions- the dorsal, lateral,
and ventral columns; each of the columns contains a number of fiber tracts made up
of axon with the same destination and function.
 Sensory tracts. Tracts conducting sensory impulses to the brain are sensory,
or afferent, tracts.
 Motor tracts. Those carrying impulses from the brain to skeletal muscles are motor,
or efferent, tracts.
 PROTECTION OF THE CENTRAL NERVOUS SYSTEM

MENINGES
The three connective tissue membranes,
the minges, surround and protect the brain and
spinal cord.
 Dura mater - the most superficial and
thickest of the meninges. It serves as a
protective function for the brain,
particularly at times when the integrity
of the skull is not intact.
 Falx cerebri – the extension of
the dura between cerebral
hemispheres.
 Tentorium cerebelli – between
the cerebrum and cerebellum.

 Arachnoid mater – very thin, wispy meningeal membrane.

 Subdural space – space between dura mater and arachnoid mater.

 Pia mater - third meningeal membrane. Very tightly bound to the surface of the
brain and spinal cord.

 Subarachnoid space – space between the arachnoid and pia mater, which is filled
with cerebrospinal fluid and contains blood vessels.

CEREBROSPINAL FLUID
Cerebrospinal fluid (CSF) bathes the brain and spinal cord, providing a protective
cushion around the CNS.

 Choroid plexuses – produce the CSF. These plexuses are specialized structures
made of ependymal cells and are located in the ventricles. CSF fills the brain
ventricles, the central canal of the spinal cord, and the Subarachnoid space.
 PERIPHERAL NERVOUS SYSTEM

The peripheral nervous system (PNS) consists of all the nerves and ganglia outside
the brain and spinal cord. The PNS collects information from numerous sources both inside
and on the surface of the body and relays it by way of sensory neurons to the CNS.

CRANIAL NERVES
The 12 pairs of cranial nerves are
designated by Roman numerals from I to
XII. There are 2 general categories of
cranial nerve function: sensory and motor.
Sensory functions can be divided into the
special senses, such as vision, and the more
general senses, such as touch and pain in the
face. Motor functions are subdivided into
somatic motors and parasympathetic.
Somatic motor cranial nerves innervate
skeletal muscles in the head and neck.
Parasympathetic cranial nerves innervate
glands, smooth muscle throughout the body,
and cardiac muscle of the heart.

S - Sensory
M - Somatic Motor
NUMBER NAME GENERAL SPECIFIC FUNCTION
FUNCTION

I Olfactory S Smell

II Optic S Vision

III Oculomotor M Ability to move and blink your eyes.

IV Trochlear M Ability to move your eyes up and down or

back and forth.

V Trigeminal S, M Sensations in your face and cheeks, taste

and jaw movements.

VI Abducens M Ability to move your eyes.

VII Facial S, M, Facial expressions and sense of taste.

VIII Vestibulocochlear S Sense of hearing and balance.

IX Glossopharyngeal S, M, Ability to taste and swallow.

X Vagus S, M, Digestion and heart rate.

XI Accessory M Shoulder and neck muscle movement.

XII Hypoglossal M Ability to move your tongue.

SPINAL NERVES AND NERVE PLEXUSES
 The spinal nerves arise along the spinal cord from the union of the dorsal roots and
ventral roots. All the spinal nerves contain axons of both sensory and somatic motor neurons
and thus are called mixed nerves.

PLEXUSES OF THE SPINAL NERVES

PLEXUS ORIGIN MAJOR MUSCLES SKIN
NERVES INNERVATED INNERVATED

Cervical C1-C4 Phrenic  Several neck  Neck and

muscles posterior
 Diaphragm head

Brachial C5 - TI Axillary  Two shoulder  Part of

Radial muscles shoulder
Musculocutaneous  Posterior arm  Posterior
Ulnar and forearm arm,
Median muscles forearm,
(extension) and hand
 Anterior arm  Radial
muscles surface
(flexors) of
 Two anterior forearm
forearm  Ulnar
muscles side of
(flexors), most hand
intrinsic hand  Radial
muscles side of
 Most anterior hand
forearm
muscles
(flexors), some
intrinsic hand
muscles

Lumbosacral L1-S4 Obturator  Medial thigh  Medical

Femoral muscles thigh
Tibial (adductors)  Anterior
Common Fibular  Anterior thigh thigh,
muscles medial
(extensors) leg, and
 Posterior thigh foot
muscles  Posterior
(flexors), leg and
anterior and sole of
posterior leg foot
muscles, most  Anterior
foot muscles and
 Lateral thigh lateral
and leg, some leg,
foot muscles dorsal
(top) part
of foot

Coccygeal S5 & Co  Pelvic floor  Skin over

 muscles coccyx

AUTONOMIC NERVOUS SYSTEM

The ANS comprises motor neurons that carry action potentials from the CNS to the
periphery. The autonomic neurons innervate smooth muscle, cardiac muscle, and glands.
Autonomic functions are largely controlled unconsciously.

 Sympathetic Division - also known as the fight or flight division of the ANS prepares
a person for physical activity. These actions include increasing heart rate and blood
pressure, dilating respiratory passageway to increase airflow, and stimulating the
release of glucose from the liver for energy and it also inhibits digestive activities.
The sympathetic division is referred to as a “fight or flight” system because it
prepares the person either to stand and face a threat or to leave the situation as
quickly as possible.

 Parasympathetic Division - also known as the rest or digest division of the ANS as it
is generally consistent with resting conditions. Increased activity of the
parasympathetic division stimulates involuntary activities, such as digestion,
defecation, and urination. Parasympathetic division enhances the digestion and
absorption of food and at the same time, it lowers heart rate, which lowers blood
pressure, and constricts air passageways, which decreases airflow.

EFFECTS OF THE ANS ON VARIOUS TISSUES

TARGET SYMPATHETIC EFFECTS PARASYMPATHETIC

EFFECTS

Heart Increases rate and force of Decreases rate

contraction

Blood vessels Constrict and dilates None

Lungs Dilates bronchioles Constricts bronchioles

Eyes Dilates pupil, relaxes ciliary Constricts pupil, contracts

muscle to adjust lens for far ciliary muscle to adjust lens for
vision near vision

Intestinal and stomach Decreases motility, contracts Increases motility, relaxes

walls sphincters sphincters

Liver Breaks down glycogen, Synthesize glycogen

releases glucose

Adipose tissue Breaks down lipids None

Adrenal gland Secretes epinephrine, None

norepinephrine

Sweat glands Secretes sweat None

Salivary glands Secretes thick saliva Secretes watery saliva

Urinary bladder Relaxes muscle, contricts Contracts muscle, relaxes

sphincter sphincter

Pancreas Decreases secretion of Increases secretion of digestive

digestive enzymes and insulin enzymes and insulin