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					Chapter 14 Structure and Function of the Neurologic System Mosby items and derived items © 2010, 2006 by Mosby, Inc., an affiliate of Elsevier Inc. Overview of the Nervous System  Central nervous system (CNS)   Brain and spinal cord Peripheral nervous system (PNS)    Cranial nerves Spinal nerves Pathways • Afferent (ascending; sensory to spinal column) • Efferent (descending; innervate effector organs) Mosby items and derived items © 2010, 2006 by Mosby, Inc., an affiliate of Elsevier Inc. 2 Overview of the Nervous System  PNS  Somatic nervous system • Motor and sensory pathways regulating voluntary motor control of skeletal muscle  Autonomic nervous system (ANS) • Motor and sensory pathways regulating the body’s internal environment through involuntary control of organ systems   Sympathetic Parasympathetic Mosby items and derived items © 2010, 2006 by Mosby, Inc., an affiliate of Elsevier Inc. 3 Cells of the Nervous System  Neuron   Variable size and structure throughout the nervous system Cellular constituents • Microtubules, neurofibrils, Nissl substances • Some neurons, such as olfactory neurons, continue to divide Mosby items and derived items © 2010, 2006 by Mosby, Inc., an affiliate of Elsevier Inc. 4 Neuron  Three components   Cell body (soma) • Located mainly in the CNS • Densely packed cell bodies in the CNS are nuclei • Densely packed cell bodies in the PNS are ganglia Dendrites • Receptive portion of the neuron (sends impulses to cell body) Mosby items and derived items © 2010, 2006 by Mosby, Inc., an affiliate of Elsevier Inc. 5 Neuron  Axons   Carry nerve impulses away from cell body Axon hillock • Cone-shaped, Nissl-free area where the axon leaves the cell body  Initial segment of the axon • Area of axon with lowest threshold for stimulation, so action potentials begin here Mosby items and derived items © 2010, 2006 by Mosby, Inc., an affiliate of Elsevier Inc. 6 Neuron  Axons    Myelin • Segmented layer of lipid material • Insulating substance • Formed and maintained by the Schwann cell Endoneurium • Delicate layer of connective tissue around each axon Neurilemma • Thin membrane between the myelin sheath and the endoneurium Mosby items and derived items © 2010, 2006 by Mosby, Inc., an affiliate of Elsevier Inc. 7 Neuron  Axons  Nodes of Ranvier • Regular interruptions of the myelin sheath  Saltatory conduction • Flow of ions between segments of myelin rather than along the entire length of the axon   Divergence • Ability of branching axons to influence many neurons Convergence • Branches of numerous neurons converging on one or a few neurons Mosby items and derived items © 2010, 2006 by Mosby, Inc., an affiliate of Elsevier Inc. 8 Structural Classification of Neurons  Based on the number of processes extending from the cell body     Unipolar Pseudounipolar Bipolar Multipolar Mosby items and derived items © 2010, 2006 by Mosby, Inc., an affiliate of Elsevier Inc. 9 Functional Classification of Neurons  Sensory   Associational   Transmit impulses from sensory receptors to the CNS Transmit impulses from neuron to neuron Motor  Transmit impulses from the CNS to an effector organ Mosby items and derived items © 2010, 2006 by Mosby, Inc., an affiliate of Elsevier Inc. 10 Neuroglia   “Nerve glue” Support the neurons of the CNS     Astrocytes Oligodendroglia (oligodendrocytes) Microglia Ependymal cells Mosby items and derived items © 2010, 2006 by Mosby, Inc., an affiliate of Elsevier Inc. 11 Neuroglia Mosby items and derived items © 2010, 2006 by Mosby, Inc., an affiliate of Elsevier Inc. 12 Nerve Injury and Regeneration  Wallerian degeneration  Occurs distal to the cut • Swelling appears • Neurofilaments hypertrophy • Myelin sheath shrinks and disintegrates • Axon portion degenerates and disappears Mosby items and derived items © 2010, 2006 by Mosby, Inc., an affiliate of Elsevier Inc. 13 Nerve Injury and Regeneration  Proximal to the cut      Swelling and dispersal of the Nissl substance Cell increases in metabolic activity, protein synthesis, and mitochondrial activity New terminal sprouts project from proximal segment Process limited to myelinated axons • Generally only in the PNS Depends on location, type of injury, inflammatory response, and scar tissue formation Mosby items and derived items © 2010, 2006 by Mosby, Inc., an affiliate of Elsevier Inc. 14 Neuroglia Mosby items and derived items © 2010, 2006 by Mosby, Inc., an affiliate of Elsevier Inc. 15 Nerve Impulse  Neurons generate and conduct electrical and chemical impulses by selectively changing the electrical portion of their plasma membranes and influencing other nearby neurons by the release of neurotransmitters Mosby items and derived items © 2010, 2006 by Mosby, Inc., an affiliate of Elsevier Inc. 16 Synapses    Region between adjacent neurons Impulses are transmitted across the synapse by chemical and electrical conduction Presynaptic neurons and postsynaptic neurons  Connections between pre- and postsynaptic neurons • Axoaxonic • Axosomatic • Axodendritic • Dendrodentritic Mosby items and derived items © 2010, 2006 by Mosby, Inc., an affiliate of Elsevier Inc. 17 Synapses  Neurotransmitters       More than 30 substances (e.g., dopamine, GABA, endorphins) Excitatory (excitatory postsynaptic potential) Inhibitory (inhibitory postsynaptic potential) Synaptic boutons Synaptic cleft Summation    Temporal summation Spatial summation Facilitation Mosby items and derived items © 2010, 2006 by Mosby, Inc., an affiliate of Elsevier Inc. 18 Central Nervous System  Forebrain   Midbrain   Cerebral hemispheres Corpora quadrigemina, tegmentum, and cerebral peduncles Hindbrain (brain stem)  Cerebellum, pons, and medulla Mosby items and derived items © 2010, 2006 by Mosby, Inc., an affiliate of Elsevier Inc. 19 Central Nervous System  Reticular formation   Network of connected nuclei that regulate viral reflexes, such as cardiovascular and respiratory function Together with the cerebral cortex is referred to as the reticular activating system Mosby items and derived items © 2010, 2006 by Mosby, Inc., an affiliate of Elsevier Inc. 20 Central Nervous System Mosby items and derived items © 2010, 2006 by Mosby, Inc., an affiliate of Elsevier Inc. 21 Central Nervous System  Forebrain  Telencephalon • Cerebrum   Gyri, sulci, and fissures Gray matter and white matter • Cerebral nuclei (basal ganglia) Mosby items and derived items © 2010, 2006 by Mosby, Inc., an affiliate of Elsevier Inc. 22 Forebrain Mosby items and derived items © 2010, 2006 by Mosby, Inc., an affiliate of Elsevier Inc. 23 Forebrain Mosby items and derived items © 2010, 2006 by Mosby, Inc., an affiliate of Elsevier Inc. 24 Central Nervous System   Hemispheres (right, left) Frontal lobe  Prefrontal • Goal-directed behavior  Premotor • Basal ganglia  Primary motor area  Broca speech area Mosby items and derived items © 2010, 2006 by Mosby, Inc., an affiliate of Elsevier Inc. 25 Central Nervous System  Parietal lobe   Occipital lobe   Sensory input Visual cortex Temporal lobe  Wernicke area (speech) Mosby items and derived items © 2010, 2006 by Mosby, Inc., an affiliate of Elsevier Inc. 26 Central Nervous System  Diencephalon     Epithalamus Thalamus Hypothalamus Subthalamus Mosby items and derived items © 2010, 2006 by Mosby, Inc., an affiliate of Elsevier Inc. 27 Central Nervous System  Midbrain    Corpora quadrigemina (tectum) • Superior and inferior colliculi Tegmentum • Red nucleus and substantia nigra Basis pedunculi Mosby items and derived items © 2010, 2006 by Mosby, Inc., an affiliate of Elsevier Inc. 28 Central Nervous System  Hindbrain (metencephalon)    Cerebellum Pons Myelencephalon  Medulla oblongata Mosby items and derived items © 2010, 2006 by Mosby, Inc., an affiliate of Elsevier Inc. 29 Central Nervous System Mosby items and derived items © 2010, 2006 by Mosby, Inc., an affiliate of Elsevier Inc. 30 Spinal Cord  Lies within the vertebral canal and is protected by the vertebral column     Connects the brain and the body Conducts somatic and autonomic reflexes Provides motor pattern control centers Modulates sensory and motor function Mosby items and derived items © 2010, 2006 by Mosby, Inc., an affiliate of Elsevier Inc. 31 Spinal Cord  Sections   Cervical, thoracic, lumbar, and sacral Horns    Posterior Lateral Anterior Mosby items and derived items © 2010, 2006 by Mosby, Inc., an affiliate of Elsevier Inc. 32 Spinal Cord Mosby items and derived items © 2010, 2006 by Mosby, Inc., an affiliate of Elsevier Inc. 33 Spinal Cord Mosby items and derived items © 2010, 2006 by Mosby, Inc., an affiliate of Elsevier Inc. 34 Spinal Cord Mosby items and derived items © 2010, 2006 by Mosby, Inc., an affiliate of Elsevier Inc. 35 Reflex Arc     Receptor Afferent (sensory) neuron Efferent neuron Effector Mosby items and derived items © 2010, 2006 by Mosby, Inc., an affiliate of Elsevier Inc. 36 Reflex Arc Mosby items and derived items © 2010, 2006 by Mosby, Inc., an affiliate of Elsevier Inc. 37 Upper and Lower Motor Neurons  Upper motor neurons     Efferent pathways primarily relaying information from the cerebrum to the brainstem or spinal cord Synapse with interneurons Destruction = partial recovery Lower motor neurons    Neurons having direct influence on muscles Cell bodies originate in gray matter of spinal cord, but their axons extend into the PNS Destruction = permanent paralysis Mosby items and derived items © 2010, 2006 by Mosby, Inc., an affiliate of Elsevier Inc. 38 Neuromuscular Junction Mosby items and derived items © 2010, 2006 by Mosby, Inc., an affiliate of Elsevier Inc. 39 Motor Pathways     Lateral corticospinal Corticobulbar Basal ganglia Vestibulospinal Mosby items and derived items © 2010, 2006 by Mosby, Inc., an affiliate of Elsevier Inc. 40 Sensory Pathways    Anterior spinothalamic Lateral spinothalamic Posterior (dorsal)    Three neuron chain Ipsilateral transmission Contralateral transmission Mosby items and derived items © 2010, 2006 by Mosby, Inc., an affiliate of Elsevier Inc. 41 Protective Structures  Cranium   Eight bones • Frontal • Occipital • Temporal (2) • Parietal (2) • Sphenoid • Ethmoid Galea aponeurotica Mosby items and derived items © 2010, 2006 by Mosby, Inc., an affiliate of Elsevier Inc. 42 Protective Structures  Meninges  Protective membranes surrounding the brain and spinal cord • Dura mater • Arachnoid • Pia mater Mosby items and derived items © 2010, 2006 by Mosby, Inc., an affiliate of Elsevier Inc. 43 Meninges Mosby items and derived items © 2010, 2006 by Mosby, Inc., an affiliate of Elsevier Inc. 44 Protective Structures   Cerebrospinal fluid (CSF) and the ventricular system CSF is a clear, colorless fluid similar to blood plasma and interstitial fluid    125 to 150 ml Produced by the choroid plexuses in the lateral, third, and fourth ventricles Reabsorbed through the arachnoid villi Mosby items and derived items © 2010, 2006 by Mosby, Inc., an affiliate of Elsevier Inc. 45 Protective Structures  Vertebral column  33 vertebrae • 7 cervical, 12 thoracic, 5 lumbar, 5 fused sacral, and 4 fused coccygeal  Intervertebral disks • Nucleus pulposus Mosby items and derived items © 2010, 2006 by Mosby, Inc., an affiliate of Elsevier Inc. 46 Vertebral Column Mosby items and derived items © 2010, 2006 by Mosby, Inc., an affiliate of Elsevier Inc. 47 Vertebral Column Mosby items and derived items © 2010, 2006 by Mosby, Inc., an affiliate of Elsevier Inc. 48 Blood Supply to the Brain      800 to 1000 ml per minute CO2 is the primary regulator for CNS blood flow Internal carotid and vertebral arteries Arterial circle (circle of Willis) Blood-brain barrier Mosby items and derived items © 2010, 2006 by Mosby, Inc., an affiliate of Elsevier Inc. 49 Blood Supply to the Brain Mosby items and derived items © 2010, 2006 by Mosby, Inc., an affiliate of Elsevier Inc. 50 Blood Supply to the Brain Mosby items and derived items © 2010, 2006 by Mosby, Inc., an affiliate of Elsevier Inc. 51 Blood Supply to the Brain Mosby items and derived items © 2010, 2006 by Mosby, Inc., an affiliate of Elsevier Inc. 52 Blood Supply to the Brain Mosby items and derived items © 2010, 2006 by Mosby, Inc., an affiliate of Elsevier Inc. 53 Blood Supply to the Spinal Cord  Vertebral arteries    Anterior spinal arteries Posterior spinal arteries Aorta Mosby items and derived items © 2010, 2006 by Mosby, Inc., an affiliate of Elsevier Inc. 54 Blood Supply to the Spinal Cord INSERT Figure 14-22 Mosby items and derived items © 2010, 2006 by Mosby, Inc., an affiliate of Elsevier Inc. 55 Peripheral Nervous System  31 pairs of spinal nerves     Names correlate with the vertebral level from which they exit Mixed nerves Arise from the anterior and posterior horn cells of the spinal cord 12 pairs of cranial nerves  Sensory, motor, and mixed Mosby items and derived items © 2010, 2006 by Mosby, Inc., an affiliate of Elsevier Inc. 56 Peripheral Nervous System  Fascicles    Rami Plexuses     Bundles of myelinated axons in the PNS Brachial plexus Lumbar plexus Sacral plexus Dermatomes Mosby items and derived items © 2010, 2006 by Mosby, Inc., an affiliate of Elsevier Inc. 57 Peripheral Nervous System Mosby items and derived items © 2010, 2006 by Mosby, Inc., an affiliate of Elsevier Inc. 58 Autonomic Nervous System    Located in both the CNS and PNS Coordinates and maintains a steady state among the visceral (internal) organs Neurons    Preganglionic (myelinated) Postganglionic (unmyelinated) Two divisions   Sympathetic Parasympathetic Mosby items and derived items © 2010, 2006 by Mosby, Inc., an affiliate of Elsevier Inc. 59 Sympathetic Nervous System  Mobilizes energy stores in times of need   Receives innervation from cell bodies located from the first thoracic through the second lumbar   “Fight or flight response” Thoracolumbar division Sympathetic (paravertebral) ganglia Mosby items and derived items © 2010, 2006 by Mosby, Inc., an affiliate of Elsevier Inc. 60 Sympathetic Nervous System Mosby items and derived items © 2010, 2006 by Mosby, Inc., an affiliate of Elsevier Inc. 61 Parasympathetic Nervous System  Functions to conserve and restore energy   Receives innervation from cell bodies located in the cranial nerve nuclei and sacral region of the spinal cord   “Rest or repose response” Craniosacral division Preganglionic neurons travel to ganglia close to the organs they innervate Mosby items and derived items © 2010, 2006 by Mosby, Inc., an affiliate of Elsevier Inc. 62 Parasympathetic Nervous System Mosby items and derived items © 2010, 2006 by Mosby, Inc., an affiliate of Elsevier Inc. 63 Neurotransmitters and Neuroreceptors of the ANS  Sympathetic preganglionic fibers   Sympathetic postganglionic fibers   Acetylcholine and cholinergic receptors Norepinephrine and adrenergic receptors Parasympathetic pre- and postganglionic fibers  Acetylcholine and cholinergic receptors Mosby items and derived items © 2010, 2006 by Mosby, Inc., an affiliate of Elsevier Inc. 64 Neurotransmitters and Neuroreceptors of the ANS Mosby items and derived items © 2010, 2006 by Mosby, Inc., an affiliate of Elsevier Inc. 65 Aging and the Nervous System  Structural changes       Decrease in the number of neurons Decreased brain weight and size Increased adherence of the dura mater to the skull Fibrosis and thickening of the meninges Narrowed gyri and widened sulci with a corresponding increase in the size of the subarachnoid space Basal ganglia and ventricular system • Aberrations in vascular structures Mosby items and derived items © 2010, 2006 by Mosby, Inc., an affiliate of Elsevier Inc. 66 Aging and the Nervous System  Cellular changes     Deposition of lipofuscin Presence of senile plaques Multiple neurofibrillary tangles Lewy bodies Mosby items and derived items © 2010, 2006 by Mosby, Inc., an affiliate of Elsevier Inc. 67 Aging and the Nervous System  Functional changes  Slowed response to neural signals Mosby items and derived items © 2010, 2006 by Mosby, Inc., an affiliate of Elsevier Inc. 68 Tests of Nervous System Function    Skull and spine roentgenograms Computed tomography Magnetic resonance imaging     Magnetic resonance angiography Positron emission tomography scan Brain scan Cerebral angiography Mosby items and derived items © 2010, 2006 by Mosby, Inc., an affiliate of Elsevier Inc. 69 Tests of Nervous System Function      Myelography Echoencephalography (ultrasound) Electroencephalography Evoked potentials Cerebrospinal fluid analysis Mosby items and derived items © 2010, 2006 by Mosby, Inc., an affiliate of Elsevier Inc. 70
 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 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