THE NERVOUS SYSTEM

By- Bezawit worku

([Link] public health, Msc. Clinical Anatomy )

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 Objectives
At the end of this session you are expected to
Name the divisions of the nervous system

Define neuron and state the function of each parts.

Understand locate the parts of the brain and spinal cord

Name the protections of brain and spinal cord

Name cranial nerves with their function

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 The Nervous System

It is divided into
Central Nervous System (CNS)

 Brain
 Spinal cord

Peripheral Nervous System

(PNS)
 Cranial nerves

 Spinal nerves

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 General functions of the nervous system:

1. To detect changes and feel sensations

2. To initiate appropriate responses to changes

3. To organize information for immediate use and store it for

future use.

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 NERVE CELLS AND NERVE FIBRES
 The nervous tissue consists of 2 types of
cells :

1) Excitable cells which transmit nerve

impulses and constitute the neurons.

2) Non-excitable cells which do not transmit

impulses.
 But act as connective tissue cells which
support the neurons; these are called
neuroglia cells.

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 Synapse
 A synapse is a junctional zone
between the neurons .
 Where the axon terminals of one
neuron come in contact with the cell
body or dendrites of the next neuron.
 At this synapse a chemical
transmitters are secreted.

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Neuron Anatomy
Extensions outside the cell body
 Dendrites – conduct impulses toward the cell body
 Axons – conduct impulses away from the cell body

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 Structural Classification of Neurons
 Multipolar neurons – many extensions from the cell body

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 Structural Classification of Neurons
Bipolar neurons – one axon and one dendrite

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 Structural Classification of Neurons
 Unipolar neurons – have a short single process leaving the cell
body

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 Neuroglia cells.
These cells comprise the following types:

1. Astrocytes: also act as phagocytes to clear away

cellular debris.

2. Oligodendrocytes : concerned with the

formation of myelin sheaths inside the C.N.S

(Schwann cells form myelin sheaths outside the

C.N.S)

3. Microglia: They help to remove out necrotic

degenerated nerve tissue by phagocytosis

4. Ependymal cells: line the ventricles of the brain

and central canal of the spinal cord.

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 Myelination in the CNS

Myelination in the PNS

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 Central nervous system (CNS)
 The Brain lies within the cranial
cavity
 Its hemispheric surface has gyri
and sulci.
It consists of :
 Cerebrum
 Cerebellum
 Diencephalons
 Brain stem

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 1. Cerebrum
Is the largest portion of the brain.
 Accounts for about 80% of total
brain
It can be further divided into
 Right hemispheres
 Left hemispheres
 Connected internally by corpus
callosum
 The 2 cerebral hemispheres are
separated from the cerebellum by
tentorium cerebelli.
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 Lobes of cerebrum

 Each cerebral hemisphere is

subdivided into 4 lobes by deep
sulci called fissures.
 The central sulcus (fissure of
Rolando)
 Between frontal and parietal
lobe.

 The lateral sulcus

 Between frontal,parietal and
temporal lobes.
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 Frontal Lobe
 Forms the anterior portion of
each hemisphere.
 Bounded by the :-

 Lateral sulcus & central sulcus

Concerned with
• Initiating voluntary motor
impulses
• Responses related to memory

• Emotions, reasoning, judgment,

verbal communications, etc
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 Temporal lobe
Lying below the lateral sulcus.
 Located below the parietal
lobe and the posterior
portion of the frontal lobe.
 Separated from both by the
lateral sulcus.
 Extends from the temporal
pole to the occipital lobe.
 Contains auditory centers

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 Parietal lobe:
 Extends from the central sulcus
to the occipital lobe
 Lies superior to the temporal
lobe.
 Posterior to the central sulcus.

 Is the primary sensory area

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 Occipital lobe
Forms the posterior portion
of the cerebrum.
Lies superior to the
cerebellum.
 Separated from cerebellum
the tentorium cerebelli.
Contains the visual cortex

The principal function of the

occipital lobe is concerned with
vision.

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 Functions of Cerebrum
 Frontal
o voluntary motor functions
o Planning, mood , smell and social judgment
 Parietal
o Receives and integrates sensory information
 Occipital
o visual center of brain
 Temporal
o Areas for hearing , smell

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2. Diencephalon
 It is the second subdivision of the brain and almost completely
surrounded by the cerebral hemispheres

Divide in to:
 Thalamus

 Hypothalamus

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 Thalamus
 Paired, large, avoid mass of gray
matter, constituting nearly 4/5th (80%)
of the diencephalon.
 Its principal function is to act as a relay
center for all sensory impulses, except
smell, to the cerebral cortex
 Sensory relay station where sensory
signals can be edited, sorted, and
routed

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 Thalamus
 Lateral geniculate nuclei:

Relay visual information.

 Medial geniculate nuclei:

Relay auditory information.

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 Hypothalamus
 Smallest portion of the diencephalon.
 Lies below the thalamus and above the
pituitary gland.
 The hypothalamus performs vital
functions
 Thermoregulation (thermostat)
 Food & water intake (hunger &
satiety)
 Sleep & circadian rhythms
 Emotional behavior
 Anger, aggression, fear.

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 3. The brain stem
 It is the portion of the brain that
attaches to the spinal cord .
 The brain stem is the part of the
brain between the spinal cord
and the diencephalon.
 Includes

 Midbrain

 Pons

 Medulla oblongata
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 A. Midbrain (Mesencephalon)
 It is a short section of the brain stem
b/n the diencephalon and the pons.
 Several kinds of reflexes are
integrated in midbrain including
visual and auditory reflex.
 Midbrain also keep the head upright
and maintain balance of
equilibrium.
 Cranial nerves 3&4 (oculomotor and
trochlear) exit from the midbrain
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 B. Pons
 Found b/n the midbrain and the
medulla oblongata
 Literally means “bridge”

 With in Pons two respiratory centers

that work with those in medulla to
produce normal breathing rate.
 Sensory and motor nuclei for 3
cranial nerves , Trigeminal (5),
Abducens (6), Facial (7) found.

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C. Medulla oblongata
 Most inferior region of the brain
stem.
 It is a bulbous structure between
pons anteriorly and the spinal cord
posteriorly, at the level of the
foramen magnum .
 Connected to the cerebellum by
the inferior cerebellar peduncle
 Consists of several important
nuclei for cranial nerves.
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 Function of Medulla oblongata

Function as control of vital viscera include:

Cardiac center- regulate heart beat which can be conducted by
ventricular diastole & systole
Vasomotor center- regulate blood vessels

Respiratory centers- regulate respiratory role by broncho

dilation.
Reflex centers - coordinate reflex actions

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 4. Cerebellum
 It is the second largest structure in
the brain.
 The cerebellum lies in the lower
part of posterior cranial fossa.
 Occupies the inferior and
posterior aspect of the cranial
cavity.
 The tentorium cerebelli separates
it from the occipital and temporal
lobes.

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 Cerebellum
The cerebellum consists of
 Two hemispheres
 The vermis a central constricted
area
Functions of cerebellum
Balance
 Coordinating skeletal muscle
 Impulses for voluntary muscular
movement

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 Vasculature of brain
 Although brain accounts for only
about 2.5% of body weight.
 It receives about one sixth of the
cardiac output
 One fifth of the oxygen consumed
by the body at rest.
The blood supply to the brain is
derived from
 Internal carotid and vertebral
arteries
 The venous drainage is returned by
cerebral veins.

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Spinal Cord

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 The Spinal Cord….CONTD
 The spinal cord does not extend the full length of the vertebral
column, ending in the superior lumbar region
 At 3 months after conception it extends to the coccyx

 At the time of birth it ends at L3

 It attains the adult position , when terminating at the level of the

intervertebral disc between L1 and L2

 But it does vary among people, ranging from T12 to the superior

margin of L3
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 Spinal Cord
Gross Appearance
 Cylindrical in shape
 Begins at foramen magnum & ends at
L1 (adult), L3 (child)
 Occupy upper 2/3 of vertebral canal;
about 45 cm long
Stabilized in position
• Filum terminale- pia mater anchors
cord to coccyx
• Denticulate ligament
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 The Spinal Cord….CONTD
 The spinal cord runs through the
vertebral canal.
 From the foramen magnum
superiorly to the level of vertebra
L1 or L2 inferiorly.

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 The Spinal Cord….CONTD
 The spinal cord is protected
by
 Bone (vertebrae)
 Cerebrospinal fluid
 Meninges

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Spinal Cord

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The Spinal Cord: Functions

 Through the nerves that attach to it, the spinal cord is involved in
the sensory and motor innervation of the entire body inferior to the
head
 It provides a two-way conduction pathway for signals between the
body and the brain
 It is a major center for reflexes

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 The Spinal Cord….CONTD
 The spinal cord terminates in a
tapering cone shaped structure
called the conus medullaris.
 The cone tapers into a long filament
of connective tissue, the Filum
terminale.
 Covered with pia mater and attaches
to the coccyx inferiorly

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 The Spinal Cord….CONTD
 The spinal cord has enlargements
where the nerves serving the upper
and lower limb arise
 Cervical enlargement

 Lumbar enlargement
Cervical enlargement - C4-T1 supply
upper limbs
Lumbar enlargement - T9-T12 supply
lower limbs

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 The Spinal Cord….CONTD

 There are 31 pairs of spinal nerves (PNS) that arise from the
spinal cord by paired roots
 Exit from the vertebral column via the intervertebral foramina

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The Spinal Cord….CONTD

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 Meninges
 Membranous coverings of CNS

 Have three layers from outside to

inside
 Dura mater

 Arachnoid mater

 Pia mater.

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 The dura mater
 It is the outermost covering of the
brain.
 It is firmly adherent to the inner
surface of the skull bones .
 It is in contact with bone

 Composed primarily of dense

connective tissue.
 The cranial dura mater is a double-
layered structure.

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 The dura mater…….
 The thicker outer periosteal layer
adheres tightly to the cranium.
 The spinal dura mater is single
layered and is similar to the
meningeal layer of the cranial dura
mater.
 At the margin of the foramen
magnum, the cranial dura becomes
continuous with the spinal dura.

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 VASCULATURE OF DURA MATER

 The arteries of the dura supply more blood to the calvaria than
to the dura.
 The largest of these vessels, the middle meningeal artery.

 It is a branch of the maxillary artery

Innervation of dura
 The dura innervated by meningeal branches from the
trigeminal nerve (CN V)

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 2. The arachnoid mater
It is the middle of the three meninges.

 The subarachnoid space is located between the

arachnoid mater and the pia mater.
The subarachnoid space contains the CSF.

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3. The Pia mater
 The deepest meninx attached to the surfaces of the CNS

 It is composed of modified loose fibrous connective tissue.

 It is highly vascular

 Ligamentum denticulate is the lateral extensions of the pia mater

which attaches the spinal cord to the dura mater.
 Both the pia mater and the arachnoid mater specialize over the

roofs of the ventricles to form the choroid plexuses.

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 Cerebrospinal fluid
 It is the fluid which circulates in the ventricles and the central
canals of the CNS and also fills the subarachnoid space.
 The CSF is secreted by the choroid plexuses in the ventricles of
the brain
 Functions:

 Shock absorption

 Support

 Nourishment

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 Cerebrospinal fluid
 The average amount of the CSF in adult is
about 135 ml.
 It is constantly absorbed and produced in the
rate of 400 to 500 ml daily, i.e. the CSF is
replaced (renewed) three times daily.
 The pressure of the CSF is normally about
100 mm water.
 Any obstruction to the normal passage of the
CSF causes increased intracranial pressure; a
condition known as hydrocephalus.

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PERIPHERAL NERVIOUS SYSTEM

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 Peripheral nervous system
 The (PNS) consists of nerve fibers and cell bodies outside the
CNS that conduct impulses to or away from the CNS.

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 Nerves
The nerves entering provide the following important functions:

 Sensory innervation to the skin and deep structures such as the

joints
 Motor innervation to the muscles

 Sympathetic vasomotor nerves that influence the diameters of

the blood vessels
 Sympathetic secretomotor supply to the sweat glands.
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 Types nerves
 Nerves are either cranial nerves or spinal nerves, or derivatives of
them.
 Cranial nerves exit the cranial cavity through foramina magnum.

 Are identified by a descriptive name (e.g., “trochlear nerve”) or a

Roman numeral (e.g., “CN IV”).
 11 of the 12 pairs of cranial nerves arise from the brain.

 CN XI (spinal accessory) arises from the superior part of the spinal

cord.

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 Spinal (segmental) nerves

 Exit the vertebral column (spine)

through intervertebral foramina.
 Spinal nerves arise in bilateral
pairs from a specific segment of
the spinal cord.
 31 pairs of nerves arising from
spinal cord segments .
 Identified by a letter and number
(e.g. “T4”) spinal cord and their
superior-to-inferior order
 (C, cervical; T, thoracic; L,
lumbar; S, sacral; Co,
coccygeal).
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 CRANIAL NERVES

•12 pairs of cranial

nerves.

•All are distributed in

the head & neck,
except CN-X.

•All nerves except CN-

XI originate from the
brain.

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 CRANIAL NERVES
 As they arise from the CNS, some cranial nerves convey only
sensory fibers.
 Some only motor fibers, and some carry a mixture of both types of
fibers.

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 CRANIAL NERVES
The 12 pairs of cranial nerves can be grouped in several ways:
1. according to their central location:
Cranial nerves I & II, (olfactory & optic nerves), are connected to
telencephalon(cerebrum) & diencephalon, respectively.
Nerves III & IV (oculomotor & trochlear nerves), are connected
with the midbrain.
Trigeminal (V), Abducens (VI), & facial (VII) nerves are located
in the pons.
Cranial nerves (VIII, IX, X, XI, & XII) are associated with the
medulla oblongata.
It is important to know this location plan because if a patient
exhibits signs of a specific cranial nerve injury, then the site of the
lesion can be pinpointed.
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 CRANIAL NERVES
2. Another way to group cranial nerves is according to
their functional neuronal components:
 Some have only sensory neurons:
CN - I, the olfactory nerve, concerned with smell
CN - II, the optic nerve, which deals with vision
CN – VIII, the vestibulo-cochlear nerve, concerned
with hearing and equilibriun.
 Some others are composed only of motor neurons:
CN – III, CN – IV, CN – VI, CN – XI & CN – XII.
 Others are composed of mixed neurons:
CN – V, CN – VII, CN – IX & CN – X.

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CRANIAL NERVES

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CRANIAL NERVES

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 I. Olfactory Nerve

• Sense of smell
• Damage causes impaired sense of smell
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 II. Optic Nerve

 Provides vision
 Damage causes blindness in visual field
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 III. Oculomotor Nerve

 Eye movement, opening of eyelid, constriction of pupil, focusing

 Damage causes drooping eyelid, dilated pupil, double vision,
difficulty focusing and inability to move eye in certain directions
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 VI. Trochlear Nerve

 Eye movement (superior oblique muscle)

 Damage causes double vision and inability to rotate eye
inferolaterally
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V. Trigeminal Nerve

 Sensory to face
(touch, pain and
temperature) and
muscles of
mastication

Damage produces
loss of sensation
and impaired
chewing
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 VI. Abducens Nerve

Provides eye movement (lateral rectus m.)

 Damage results in inability to rotate eye laterally and at rest eye
rotates medially
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VII. Facial Nerve

 Motor - facial expressions;

salivary glands and tear,
nasal and palatine glands
 Sensory - taste on anterior
2/3’s of tongue
 Damage produces sagging
facial muscles and disturbed
sense of taste (no sweet and
salty).

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VIII. Vestibulocochlear Nerve

 Provides hearing and sense of balance

 Damage produces deafness, dizziness, nausea, loss of balance
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IX. Glossopharyngeal Nerve

• Swallowing, salivation,
gagging and respiration
• Sensations from
posterior 1/3 of tongue
• Damage results in loss
of bitter and sour taste and
impaired swallowing

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 X. Vagus Nerve

 Swallowing, speech,
regulation of viscera
 Damage causes
 Hoarseness or
loss of voice
 Impaired
swallowing and
fatal if both are cut
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 XI. Accessory Nerve

 Swallowing, head, neck and shoulder movement

 Damage causes impaired head, neck, shoulder movement; head turns
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towards injured side
XII. Hypoglossal Nerve

 Tongue movements for speech, food manipulation and swallowing

If both are damaged – can’t protrude tongue
If one side is damaged – tongue deviates towards injured side;
see ipsilateral atrophy
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 Clinical conditions
Injury to the Abducent Nerve:
Because CN VI has a long
intracranial course - often
stretched when intracranial
pressure rises.
A brain tumor may compress
CN VI, causing paralysis of
lateral rectus muscle.

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 Injury to Cranial Nerve XII- Hypoglossal
Nerve
 Hemi paralysis of the tongue
results.
 When protruded, the tongue
points toward the weak side due
to the unopposed action of the
opposite genioglossus muscle.

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 CN IX, Glossopharyngeal injury

 The pharyngeal ("gag") reflex is evaluated by stimulating the

posterior pharyngeal wall on each side with a sterile, blunt object
(e.g., tongue blade)

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 Spinal Nerves
 Spinal nerves are the paths of
communication between the spinal cord
and specific regions of the body.
 The spinal cord appears to be segmented
because the 31 pairs of spinal nerves
emerge from intervertebral foramina.
 Each pair of spinal nerves arise from a
spinal segment.

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 Sciatic nerve
 The sciatic nerve is the thickest
(largest) nerve in the body.
 It is about 1.5 to 2 cm wide.

 The sciatic nerve extends from the

pelvis .
 It divides into terminal branches tibial
and common peroneal (common
fibular) nerves.

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 Injections into the buttock are safe only in the superiolateral
quadrant of the buttock (approximating the superior border of the
gluteus maximus)

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Thank you!
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