Nervous System

• NERVOUS SYSTEM: Introduction: Cells of Nervous System (Neuron),

Accessory cells of N.S. and Organization of N.S.
• (a) Brain; Meninges (Cerebrum cerebral Lobes. Ventricles, Cerebellum
Anatomy of Cerebellum, Brain Stem Mid-Brain. Pons. Medulla
Oblongata, Diencephalon. Thalamus Hypothalamus and Cranial
Nerves).
• (b) Spinal Cord Meninges (C.S.F. Internal Structure, Sensory and
Motor Pathway, Spinal Reflexes, Peripheral spinal Nerves, Autonomic
Nervous System includes Sympathetic N.S. and Parasympathetic
Nervous System).
Cranium
• The cranium (skull) is the skeleton of the head. It is composed of 22
named bones. A series of bones form its two parts, the neurocranium
and viscerocranium. The neurocranium is the bony case of the brain
and its membranous coverings, the cranial meninges.
• It also contains proximal parts of the cranial nerves and the
vasculature of the brain. The neurocranium in adults is formed by a
series of eight bones: four singular bones centered on the midline
(frontal, ethmoidal, sphenoidal, and occipital), and two sets of bones
occurring as bilateral pairs (temporal and parietal)
• The neurocranium has a dome-like roof, the calvaria (skullcap), and a
floor or cranial base (basicranium). The bones forming the calvaria are
primarily flat bones, formed by intramembranous ossification of head
mesenchyme from the neural crest.
• The bones contributing to the cranial base are primarily irregular
bones with substantial flat portions (sphenoidal and temporal)
formed by endochondral ossification of cartilage (chondrocranium) or
from more than one type of ossification.
• Most calvarial bones are united by fibrous interlocking sutures
however, during childhood, some bones (sphenoid and occipital) are
united by hyaline cartilage (synchondroses—cartilaginous joints). The
spinal cord is continuous with the brain through the foramen
magnum, a large opening in the cranial base
• The ethmoid bone is an irregular bone that makes a relatively minor
midline contribution to the neurocranium but is primarily part of the
viscerocranium. The so-called flat bones and flat portions of the
bones forming the neurocranium are actually curved, with convex
external and concave internal surfaces.
• The viscerocranium (facial skeleton) comprises the facial bones that
mainly develop in the mesenchyme of the embryonic pharyngeal
arches. The viscerocranium forms the anterior part of the cranium,
and it consists of the bones surrounding the mouth (upper and lower
jaws), nose/nasal cavity, and most of the orbits (eye sockets or orbital
cavities).
• The viscerocranium consists of 15 irregular bones:
• 3 singular bones centered on or lying in the midline (mandible, ethmoid,
and vomer)
• 6 bones occurring as bilateral pairs (maxillae; inferior nasal conchae; and
zygomatic, palatine, nasal, and lacrimal bones). The maxillae and
mandible house the teeth, that is, they provide the sockets and
supporting bone for the maxillary and mandibular teeth. The maxillae
contribute the greatest part of the upper facial skeleton, forming the
skeleton of the upper jaw, which is fixed to the cranial base. The
mandible forms the skeleton of the lower jaw, which is movable because
it articulates with the cranial base at the temporomandibular joints.
• Facial Aspect of Cranium
• Features of the anterior or facial (frontal) aspect of the cranium are
the frontal and zygomatic bones, orbits, nasal region, maxillae, and
mandible.
• The frontal bone, specifically its squamous (flat) part, forms the
skeleton of the forehead, articulating inferiorly with the nasal and
zygomatic bones.
• The zygomatic bones (cheek bones, malar bones), forming the prominences
of the cheeks, lie on the inferolateral sides of the orbits and rest on the
maxillae.
• The anterolateral rims, walls, floor, and much of the infra-orbital margins of
the orbits are formed by these quadrilateral bones. A small zygomaticofacial
foramen pierces the lateral aspect of each bone. The zygomatic bones
articulate with the frontal, sphenoid, and temporal bones and the maxillae.
• Inferior to the nasal bones is the pear-shaped piriform aperture, the anterior
nasal opening in the cranium. The bony nasal septum can be observed
through this aperture, dividing the nasal cavity into right and left parts. On
the lateral wall of each nasal cavity are curved bony plates, the nasal conchae
• The maxillae form the upper jaw. Their alveolar processes include the
tooth sockets (alveoli) and constitute the supporting bone for the
maxillary teeth. The two maxillae are united at the intermaxillary
suture in the median plane. The maxillae surround most of the
piriform aperture and form the infraorbital margins medially. They
have a broad connection with the zygomatic bones laterally and an
infra-orbital foramen inferior to each orbit for passage of the infra-
orbital nerve and vessels
• The mandible is a U-shaped bone with an alveolar part that supports
the mandibular teeth. It consists of a horizontal part, the body, and a
vertical part, the ramus. Inferior to the second premolar teeth are the
mental foramina for the mental nerves and vessels.
• The mental protuberance, forming the prominence of the chin, is a
triangular bony elevation inferior to the mandibular symphysis, the
osseous union where the halves of the infantile mandible fuse.
• Lateral Aspect of Cranium
• The lateral aspect of the cranium is formed by both neurocranium and
viscerocranium. The main features of the neurocranial part are the
temporal fossa, the external acoustic meatus opening, and the
mastoid process of the temporal bone. The main features of the
viscerocranial part are the infratemporal fossa, zygomatic arch, and
lateral aspects of the maxilla and mandible.
• The temporal fossa is bounded superiorly and posteriorly by the superior
and inferior temporal lines, anteriorly by the frontal and zygomatic bones,
and inferiorly by the zygomatic arch. The superior border of this arch
corresponds to the inferior limit of the cerebral hemisphere of the brain.
• The zygomatic arch is formed by the union of the temporal process of the
zygomatic bone and the zygomatic process of the temporal bone. In the
anterior part of the temporal fossa, 3–4 cm superior to the midpoint of
the zygomatic arch, there is a clinically important area of bone junctions:
the pterion. It is usually indicated by an H-shaped formation of sutures
that unite the frontal, parietal, sphenoid (greater wing), and temporal
bones. Less commonly, the frontal and temporal bones articulate.
• Sometimes all four bones meet at a point. The external acoustic
meatus opening (pore) is the entrance to the external acoustic
meatus (canal), which leads to the tympanic membrane (eardrum) .
The mastoid process of the temporal bone is postero-inferior to the
external acoustic meatus opening. Anteromedial to the mastoid
process is the styloid process of the temporal bone, a slender needle-
like, pointed projection.
• The infratemporal fossa is an irregular space inferior and deep to the
zygomatic arch and mandible and posterior to the maxilla
• Occipital Aspect of Cranium
• The posterior or occipital aspect of the cranium is composed of the
occiput (L. back of head, the convex posterior protuberance of the
squamous part of the occipital bone), parts of the parietal bones, and
mastoid parts of the temporal bones .
• CRANIAL MENINGES
• The cranial meninges are membranous coverings of the brain that lie
immediately internal to the cranium.
• Meninges
• The meninges are composed of three membranous connective tissue
layers:
• 1. Dura mater (dura): tough, thick external fibrous layer.
• 2. Arachnoid mater (arachnoid): thin intermediate layer.
• 3. Pia mater (pia): delicate internal vasculated layer.
• The intermediate and internal layers (arachnoid and pia) are continuous
membranes that collectively make up the leptomeninx (G. slender
membrane)
• The arachnoid is separated from the pia by the subarachnoid
(leptomeningeal) space, which contains cerebrospinal fluid (CSF). This fluid
filled space helps maintain the balance of extracellular fluid in the brain.
CSF is a clear liquid similar to blood plasma in constitution. It provides
nutrients but it has less protein and a different ion concentration. CSF is
formed by the choroid plexuses of the four ventricles of the brain. This fluid
leaves the ventricular system and enters the subarachnoid space between
the arachnoid and pia mater, where it cushions and nourishes the brain.
Dura matter
• The cranial dura mater (dura), a thick, dense, bilaminar membrane, is
also called the pachymeninx (G. pachy, thick + G. menix, membrane).
It is adherent to the internal table of the calvaria. The two layers of
the cranial dura are an external periosteal layer, formed by the
periosteum covering the internal surface of the calvaria, and an
internal meningeal layer, a strong fibrous membrane that is
continuous at the foramen magnum with the spinal dura covering the
spinal cord.
• Sensory endings are more numerous in the dura along each side of
the superior sagittal sinus and in the tentorium cerebelli than they are
in the floor of the cranium.
• Blood from the brain drains into the sinuses within the dura. The
dural venous sinuses are endothelium-lined spaces between the
periosteal and meningeal layers of the dura. They form where the
dural septa attach along the free edge of the falx cerebri and in
relation to formations of the cranial floor. Large veins from the surface
of the brain empty into these sinuses and most of the blood from the
brain ultimately drains through them into the internal jugular veins
(IJVs).
• Arachnoid Mater and Pia Mater
• The arachnoid mater and pia mater (or simply arachnoid and pia;
together the leptomeninges) develop from a single layer of
mesenchyme surrounding the embryonic brain, becoming the parietal
part (arachnoid) and visceral part (pia) of the leptomeninx . The
derivation of the arachnoid–pia from a single embryonic layer is
indicated in the adult by the numerous web-like arachnoid trabeculae
passing between the arachnoid and pia, which give the arachnoid its
name
• The arachnoid and pia are in continuity immediately proximal to the
exit of each cranial nerve from the dura mater. The cranial arachnoid
mater contains fibroblasts, collagen fibers, and some elastic fibers.
Although thin, the arachnoid is thick enough to be manipulated with
forceps.
• The avascular arachnoid, although closely applied to the meningeal
layer of the dura, is not attached to the dura. It is held against the
inner surface of the dura by the pressure of the CSF in the
subarachnoid space.
• The cranial pia mater is an even thinner membrane than the
arachnoid. It is highly vascularized by a network of fine blood vessels.
The pia is difficult to see, but it gives the surface of the brain a shiny
appearance. The pia adheres to the surface of the brain and follows
all its contours. When the cerebral arteries penetrate the cerebral
cortex, the pia follows them for a short distance, forming a pial coat
and a peri-arterial space.
Meningeal Spaces
• Of the three meningeal “spaces” commonly mentioned in relation to
the cranial meninges, only one exists as a space in the absence of
pathology:
• The dura–cranial interface (extradural or epidural “space”) is not a
natural space between the cranium and the external periosteal layer
of the dura because the dura is attached to the bones. It becomes an
extradural space only pathologically (e.g., when blood from torn
meningeal vessels pushes the periosteum away from the cranium).
• The potential or pathological cranial epidural space is not continuous
with the spinal epidural space (a natural space occupied by epidural fat
and a venous plexus) because the former is external to the periosteum
lining the cranium, and the latter is internal to the periosteum covering
the vertebrae.
• The dura–arachnoid interface or junction (“subdural space”) is likewise
not a natural space between the dura and arachnoid. A space may
develop in the dural border cell layer as the result of trauma, such as a
hard blow to the head.
• The subarachnoid space, between the arachnoid and pia, is a real space
that contains CSF, trabecular cells, arteries, and veins.
Structural organization of the
nervous system
• It is divided into two parts
• Central Nervous System
• Brain
• Spinal cord
• Peripheral Nervous System
• Nerves
• Ganglia

Dr. Sairah Hafeez

• The nervous system enables the body to react to continuous changes in its
internal and external environments. It also controls and integrates the
various activities of the body, such as circulation and respiration.
• For descriptive purposes, the nervous system is divided Structurally into the
central nervous system (CNS), consisting of the brain and spinal cord, and
the peripheral nervous system (PNS), the remainder of the nervous system
outside of the CNS.
• Functionally into the somatic nervous system (SNS), autonomic nervous
system (ANS) and enteric nervous system.
• Nervous tissue consists of two main cell types: neurons (nerve cells) and
neuroglia (glial cells), which support the neurons:
Brain
• The brain is the body’s controller and coordinator of almost all of its
functions. It is the organ that raised mankind to the summit of the
animal world. It is a delicate structure that is enclosed in a rigid
cranium; however, it can be damaged by a blow to the head,
compressed by a tumor, or deprived of oxygen by a leak or clot of
blood in one of the cerebral arteries.
• Parts of Brain
• The brain (contained by the neurocranium) is composed of the
cerebrum, cerebellum, and brainstem.
• When the calvaria and dura are removed, gyri (folds), sulci (grooves),
and fissures (clefts) of the cerebral cortex are visible through the
delicate arachnoid–pia layer.
• Whereas the gyri and sulci demonstrate much variation, the other
features of the brain, including overall brain size, are remarkably
consistent from individual to individual.
• The cerebrum (L. brain) includes the cerebral hemispheres and basal
ganglia. The cerebral hemispheres, separated by the falx cerebri within
the longitudinal cerebral fissure, are the dominant features of the brain.
• Each cerebral hemisphere is divided for descriptive purposes into four
lobes, each of which is related to, but the boundaries of which do not
correspond to, the overlying bones of the same name.
• From a superior view, the cerebrum is essentially divided into quarters
by the median longitudinal cerebral fissure and the coronal central
sulcus. The central sulcus separates the frontal lobes (anteriorly) from
the parietal lobes (posteriorly).
• In a lateral view, these lobes lie superior to the transverse lateral sulcus and
the temporal lobe inferior to it. The posteriorly placed occipital lobes are
separated from the parietal and temporal lobes by the plane of the parieto-
occipital sulcus, visible on the medial surface of the cerebrum in a hemisected
brain.
• The anterior most points of the anteriorly projecting frontal and temporal
lobes are the frontal and temporal poles.
• The posterior most point of the posteriorly projecting occipital lobe is the
occipital pole. The hemispheres occupy the entire supratentorial cranial
cavity. The frontal lobes occupy the anterior cranial fossae, the temporal
lobes occupy the lateral parts of the middle cranial fossae, and the occipital
lobes extend posteriorly over the tentorium cerebelli.
• The diencephalon is composed of the epithalamus, thalamus, and
hypothalamus and forms the central core of the brain.
• The midbrain, the rostral part of the brainstem, lies at the junction of the
middle and posterior cranial fossae. CN III and IV are associated with the
midbrain.
• The pons is the part of the brainstem between the midbrain rostrally and the
medulla oblongata caudally. The pons lies in the anterior part of the posterior
cranial fossa. CN V is associated with the pons.
• The medulla oblongata (medulla) is the most caudal subdivision of the
brainstem that is continuous with the spinal cord. The medulla lies in the
posterior cranial fossa. CN IX, X, and XII are associated with the medulla,
whereas CN VI–VIII are associated with the junction of the pons and medulla.
• The cerebellum is the large brain mass lying posterior to the pons and
medulla and inferior to the posterior part of the cerebrum.
• It lies beneath the tentorium cerebelli in the posterior cranial fossa. It
consists of two lateral hemispheres that are united by a narrow
middle part, the vermis.
• Ventricular System of Brain
• The ventricular system of the brain consists of two lateral ventricles
and the midline 3rd and 4th ventricles connected by the cerebral
aqueduct. CSF, largely secreted by the choroid plexuses of the
ventricles, fills these brain cavities and the subarachnoid space of the
brain and spinal cord.
• The lateral ventricles, the 1st and 2nd ventricles, are the largest cavities of the
ventricular system and occupy large areas of the cerebral hemispheres. Each
lateral ventricle opens through an interventricular foramen into the 3rd
ventricle.
• The 3rd ventricle, a slit-like cavity between the right and the left halves of the
diencephalon, is continuous postero-inferiorly with the cerebral aqueduct, a
narrow channel in the midbrain connecting the 3rd and 4th ventricles.
• The pyramid-shaped 4th ventricle in the posterior part of the pons and
medulla extends inferoposteriorly. Inferiorly, it tapers to a narrow channel
that continues into the cervical region of the spinal cord as the central canal.
CSF drains into the subarachnoid space from the 4th ventricle through a
• Nerves are either cranial nerves or spinal (segmental) nerves or
derivatives of them. Except in the cervical region, each spinal nerve
bears the same letter–numeral designation as the vertebra forming
the superior boundary of its exit from the vertebral column.
• In the cervical region, each spinal nerve bears the same letter–
numeral designation as the vertebra forming its inferior boundary.
Spinal nerve C8 exits between vertebrae C7 and T1. The cervical and
lumbar enlargements of the spinal cord occur in relationship to the
innervation of the limbs.
• A nucleus is a collection of nerve cell bodies in the CNS. A bundle of
nerve fibers (axons) within the CNS connecting neighboring or distant
nuclei of the cerebral cortex is a tract.
• The brain and spinal cord are composed of gray matter and white matter.
• The nerve cell bodies lie within and constitute the gray matter; the
interconnecting fiber tract systems form the white matter. I
• n transverse sections of the spinal cord, the gray matter appears roughly
as an H-shaped area embedded in a matrix of white matter. The struts
(supports) of the H are horns; hence, there are right and left posterior
(dorsal) and anterior (ventral) gray horns.
Neuron
• The basic unit of the nervous system is the individual nerve cell, or
neuron.
• The central nervous system contains more than 100 billion neurons.
• Neurons operate by generating electrical signals that move from one
part of the cell to another part of the same cell or to neighboring
cells. In most neurons, the electrical signal causes the release of
chemical messengers— neurotransmitters —to communicate with
other cells.

Dr. Sairah Hafeez

Dr. Sairah Hafeez
Structure and Maintenance of
Neurons
• A typical neuron consists of the soma or cell body and two types of
processes: the axon and dendrites.
• Apart from the usual intracellular organelles, such as a nucleus and
mitochondria, the neuron contains neurofibrils and neurotubules.
• Long extensions, or processes , connect neurons to each other and
perform the neurons’ input and output functions.

Dr. Sairah Hafeez

• A neuron’s cell body (or soma ) contains the nucleus and ribosomes and thus
has the genetic information and machinery necessary for protein synthesis.
• The axon , sometimes also called a nerve fiber , is a long process that extends
from the cell body and carries outgoing signals to its target cells. In humans,
axons range in length from a few microns to over a meter. The region of the
axon that arises from the cell body is known as the initial segment (or axon
hillock ).
• The axon arises from the axon hillock of the soma and is responsible for the
transmission of efferent neural signals to nearby or distant effectors (muscle
and glandular cells) and adjacent neurons. Axons often have branches
(collaterals) that further divide and terminate in swellings called synaptic
knobs or terminal buttons.
Dr. Sairah Hafeez
• The initial segment of axon is the “trigger zone” where, in most
neurons, propagated electrical signals are generated.
• These signals then propagate away from the cell body along the axon
or, sometimes, back along the dendrites. The axon may have
branches, called collaterals . Near their ends, both the axon and its
collaterals undergo further branching

Dr. Sairah Hafeez

• The dendrites are a series of highly branched outgrowths of the cell
body. In the PNS, dendrites receive incoming sensory information and
transfer it to integrating regions of sensory neurons. In the CNS,
dendrites and the cell body receive most of the inputs from other
neurons, with the dendrites generally taking a more important role.
Branching dendrites increase a cell’s surface area—some neurons may
have as many as 400,000 dendrites.
• The neuron receives afferent signals (excitatory and inhibitory) from a
few to sometimes several thousands of other neurons via its
dendrites (usually arborescent) and sums the signals along the cell
membrane of the soma (summation).
Dr. Sairah Hafeez
• Knoblike outgrowths called dendritic spines increase the surface area
of dendrites still further, and there are often ribosomes present. The
presence of protein synthesis machinery allows dendritic spines to
remodel their shape in response to variation in synaptic activity,
which may play a key role in complex processes like learning and
memory
• The axons of many neurons are covered by sheaths of myelin, which
usually consists of 20 to 200 layers of highly modified plasma
membrane wrapped around the axon by a nearby supporting cell.

Dr. Sairah Hafeez

Structural Classification of Neurons
• Structural classification of neurons is based upon the number of
processes that extend out from the cell body. Three major groups
arise from this classification: multipolar, bipolar, and unipolar
neurons.
• Multipolar neurons are defined as having three or more processes
that extend out from the cell body. They comprise of more than 99%
of the neurons in humans, and are the major neuron type found in
the CNS and the efferent division of the PNS. All of the motor neurons
that control skeletal muscle and those comprising the ANS are
multipolar neurons.

Dr. Sairah Hafeez

• Bipolar neurons have only two processes that extend in opposite
directions from the cell body. One process is called a dendrite, and
another process is called the axon. Although rare, these are found in
the retina of the eye and the olfactory system.
• Unipolar neurons have a single, short process that extends from the
cell body and then branches into two more processes that extend in
opposite directions. The process that extends peripherally is known as
the peripheral process and is associated with sensory reception. The
process that extends toward the CNS is the central process. Unipolar
neurons are found primarily in the afferent division of the PNS.

Dr. Sairah Hafeez

• This common process separates into a peripheral process, conducting
impulses from the receptor organ (e.g., touch, pain, or temperature
sensors in the skin) toward the cell body, and a central process that
continues from the cell body into the CNS. The cell bodies of
pseudounipolar neurons are located outside the CNS in sensory
ganglia and are thus part of the PNS. Neurons communicate with each
other at synapses, points of contact between neurons.
 Bipolar

Multipolar

Unipolar

Dr. Sairah Hafeez

Dr. Sairah Hafeez
Neuroglia
• Neuroglia (glial cells or glia), approximately five times as abundant as
neurons, are nonneuronal, nonexcitable cells that form a major
component of nervous tissue, supporting, insulating, and nourishing
the neurons. In the CNS, neuroglia include oligodendroglia,
astrocytes, ependymal cells, and microglia (small glial cells). In the
PNS, neuroglia include satellite cells around the neurons in the spinal
(posterior root) and autonomic ganglia and Schwann (neurolemma)
cells.