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CH 12 THE CENTRAL NERVOUS SYSTEM

100 billion neurons and 10-50 trillion neuroglia, which has a mass of about 100g

The Brain
-control center for registering sensation, correlating with them with one another and with stored information, making
decisions

Regions and organization

• Adult brain regions:
-‐ Cerebral hemispheres
-‐ Diencephalon
-‐ Brain stem (midbrain, pons, medulla oblongata)
-‐ Cerebellum
• Spinal cord
-‐ Central cavity surrounded by a gray matter core
-‐ External white matter composed of myelinated fiber
tracts

Ventricles
• Arise from the expansions of the lumen (cavity) of the embryonic neural tube
• connected to one another and with the central canal of the spinal cord
• lined with ependymal cells (a type of neuroglia)
• hollow chambers filled with cerebrospinal fluid
Include:
• paired lateral ventricles (one deep within each cerebral hemisphere)
-‐ large C-‐shaped chambers that reflect the pattern of cerebral growth
-‐ anteriorly: lateral ventricles lie close together, separated only by a thin median membrane called the
septum pellucid
-‐ each lateral ventricle communicates with the third ventricles via a channel called an interventricular
foramen
• third ventricle (in the diencephalon)
-‐ continuous with fourth ventricle via the canal‐like cerebral aqueduct that runs through the midbrain
• fourth ventricle (in) the hindbrain)
-‐ continuous with the central canal of the spinal cord inferiorly
-‐ three openings mark the walls of the fourth ventricle: the paired lateral apertures in the side walls
and the median aperture in its roof (these apertures connect the ventricles to the subarachnoid
space, a fluid-‐filled space surrounding the brain)
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Cerebral hemispheres
• form the superior part of the brain – account for about 83% of total brain mass
• seat of intelligence, imagine things that never existed before
• paired, include more than half of the brain mass
• surface markings:
-‐ gyri: elevated ridges of tissue (singular: gyrus)
-‐ sulci: shallow grooves between gyri (singular: sulcus)
-‐ fissures: deep grooves that separate large regions of the brain
• longitudinal fissure – separates the cerebral hemispheres
• transverse cerebral fissure – separates the cerebral hemispheres from the cerebellum below
• Lobes:
-‐ frontal- face,front
-‐ parietal- pain
-‐ temporal-sensation, touch
-‐ occipital- vision
-‐ insula- buried deep within the lateral sulcus and covered by portions of all other lobes
• Sucli:
-‐ central sulcus: lies in the frontal plane and separates the frontal lobe from the parietal lobe
-‐ precentral sulcus: anteriorly borders the central sulcus
-‐ postcentral sulcus: posteriorly borders the central sulcus
-‐ parieto-‐occipital sulcus: separates the occipital lobe from the parietal lobe
-‐ lateral sulcus: outlines the flaplike temporal lobe and separates it from the parietal and frontal lobes
• anterior cranial fossa: houses the frontal lobes
• middle cranial fossa: houses the anterior parts of the temporal lobes
• posterior cranial fossa: houses the brain stem and cerebellum

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• Each cerebral hemisphere has three basic regions:

-‐ A superficial cortex of gray matter
-‐ An internal white matter
-‐ The basal nuclei (islands of gray matter situated deep within the white matter)

1. Cerebral Cortex:
• thin superficial layer of grey matter (neuron cell bodies, dendrites, associated glia and blood vessels)
• 40% of total brain mass
• site of conscious mind: enables us to be aware of ourselves and our sensations, to communicate, remember and
understand, and to initiate voluntary movements
• gray matter- less myosin
• functional regions of the cortex – specific motor and sensory functions are localized in discrete cortical areas called
domains (many higher mental functions, such as memory and language, appear to have overlapping domains and
are spread over large areas of the cortex)
• Remember:
1. contains three kinds of functional areas: motor areas, sensory areas, and association areas
-‐ motor areas: control voluntary movement
-‐ sensory areas: conscious awareness of sensation
-‐ association areas: integrate diverse information
2. each hemisphere is mainly concerned with the sensory and motor functions of the opposite
(contralateral) side of the body
3. although largely symmetrical in structure, the two hemispheres are not entirely equal in function
 there is lateralization (specialization) of cortical functions
4. no functional area of the cortex acts alone

Motor areas
 Primary motor cortex, premotor cortex, Broca’s area and the frontal eye field – lie in the posterior
part of the frontal lobes and control voluntary movement

1. Primary (somatic) -4
-‐ Located in the precentral gyrus of each hemisphere
-‐ Large neurons, called pyramidal cells¸ in these gyri allow us to consciously control the precise
or skilled voluntary movements of our skeletal muscles
-‐ Their long axons form the massive voluntary motor tracts called the pyramidal tracts (or
corticospinal tracts)
-‐ Most of the neurons in these gyri control muscles inbody areas having the most precise
motor control (eg. face, tongue, hands)
-‐ Motor innervations of the body is contralateral: the left primary motor gyrus controls muscles
on the right side of the body, and vice versa
-‐ Individual pyramidal motor neurons control muscles that work together in a synergistic way to
perform a given movement

2. Premotor cortex –primary gustatory

-‐ Located in the frontal lobe just anterior to the precentralgyrus
-‐ Controls learned motor skills of a repetitious or patterned nature (such as playing a musical
instrument or typing)
-‐ Coordinates the movement of several muscle groups either simultaneously or sequentially,
mainly by sending activating impulses to the primary motor cortex
-‐ Also influences the motor activity more directly by supplying about 15% of pyramidal tract
fibers
-‐ Also appears to be involved in planning movements – uses sensory information received from
other cortical areas, it can control voluntary actions that depend on sensory feedback

3. Broca’s area – 44 & 45

-‐ Located anterior to the inferior region of the premotor cortex
-‐ Present in one hemisphere only
-‐ A special motor speech area that directs the muscles involved in speech production
-‐ Also becomes active as we prepare to speak and think about (plan) many voluntary motor
activites other than speech

4. Frontal eye field –

 -‐ Located partially in and anterior to the premotor cortex and superior to Broca’s area -‐
controls voluntary movement of the eyes

 Sensory Areas
Areas concerned with conscious awareness of
sensationOccur in the parietal, insular, temporal and
occipital lobes

1. Primary somatosensory cortex

-‐ Located in the postcentral gyrus of the parietal lobe
-‐ Neurons in this gyrus receive information from the general (somatic) sensory receptors in the
skin and from proprioceptors (positions sense receptors) in skeletal muscles, joints and
tendons
-‐ The neurons then identify the body region being stimulated– an ability called spatial
discrimination
-‐ The amount of sensory cortex devoted to a particular body region is related to that region’s
sensitivity (that is, how many receptors it has), not to the sizeof the body region

2. Somatosensory association cortex

-‐ Located just posterior to the primary somatosensory cortex and has many connections with it
-‐ Integrates sensory inputs (temperature, pressure etc) relayed to it via the primary
somatosensory cortex to produce an understanding of an object being felt: its size, texture,
and the relationship of its parts
-‐ Eg. when you reach into your pocket, your somatosensory association cortex draws upon
stored memories of past sensory experiences to perceive the objects you feel

3. Visual areas
-‐ Primary visual (striate) cortex – located on the extreme posterior tip of the occipital lobe (but
most of it is buried in a deep sulcus). The largest of all cortical sensory areas, the primary
visual cortex receives visual information that originates in the retina of the eye
-‐ Visual association area – surrounds the primary visual cortex and covers much of theoccipital
lobe. The visual association area uses past visual experiences to interpret visual stimuli
(colour, form, and movement), enabling us to recognize objects or faces.

4. Auditory areas
-‐ Primary auditory cortex – located in the superior margin of the temporal lobe abutting the
lateral sulcus. Sound energy exciting the hearing receptors in the inner ear causes impulses to
be transmitted to the primary auditory cortex, where they are nterpretedi as pitch, loudness,
and location.
-‐ Auditory association area – located posterior to the primary auditory cortex. Permits the
perception of the sound stimulus (which we ‘hear’ asspeech, a scream, music, thunder etc).
Wernicke’s area includes parts of the auditory cortex.

5. Olfactory cortex
-‐ Primary olfactory (smell) cortex – located on the medial aspect of the temporal lobe in a
small region called the piriform lobe. Afferent fibers from smell receptors in the superior
nasal cavities send impulses along the olfactory tracts that are ultimately relayed to the
olfactory cortices. The outcome is conscious awareness of different smells
-‐ The olfactory cortex is part of the primitiverhinencephalon, which includes all parts of the
cerebrum that receive olfactory signals. The only portionsof the human rhinencephalon still
devoted to smell are the olfactory bulbs and tracts and the greatly reduced olfactory cortices.
During the course of evolution, parts of the rhinencephalon took on new functions concerned
chiefly with emotions and memory.

6. Gustatory cortex
-‐ Gustatory (taste) cortex – involved in the perception of taste stimuli -‐
Located in the insula just deep to the temporal lobe

7. Visceral sensory areas

-‐ The cortex of the insula just posterior to the gustatory cortex is involved in conscious
perception of visceral sensations
-‐ Include upset stomach, full bladder, and the feeling that your lungs will burst when you hold
your breath for too long

8. Vestibular (equilibrium) cortex

-‐ Posterior part of the insula and adjacent parietal cortex -‐
Responsible for conscious awareness of balance

 Multimodal association areas

  Most of the cortex is complexly connected, receivinginputs from multiple senses and sending
outputs to multiple areas – these areas are called multimodal association areas
 Information flow:
-‐ Sensory receptors
-‐ To the appropriate primary sensory cortex
-‐ To a sensory association cortex
-‐ To the multimodal association cortex
 Multimodal association cortex allows us to give meaning to the information that we receive, store it
in memory if needed, tie it to previous experience and knowledge, and decide what action to take.
 Once the course of action has been decided, those decisions are relayed to the premotor cortex,
which in turn communicates with the motor cortex
 The multimodal association areas can be divided into threeparts:

1. Anterior association area:

-‐ In the frontal lobe
-‐ Most complicated cortical region
-‐ Involved with intellect, complex learning abilities (called cognition), recall and personality
-‐ Contains working memory – necessary for the production of abstract ideas, judgement,
reasoning, persistence, and planning

2. Posterior association area:

-‐ Large region encompassing parts of the temporal, parietal and occipital lobes
-‐ Plays a role in recognising patterns and faces, localizing usand our surroundings in space and
in binding different sensory inputs into a coherent whole
-‐ Also involved in understanding written and spoken language

3. Limbic association area:

-‐ Includes the cingulated gyrus, the parahippocampal gyrus and the hippocampus
-‐ Part of the limbic system
-‐ Provides the emotion impact that makes a scene important to us
-‐ The hippocampus establishes memories that allow us to remember particular incidents

 Lateralization of cortical functioning

 We use both cerebral hemispheres for almost every activity
But each hemisphere has unique abilities not shared by the other–
calledlateralizationCerebral dominance: designates the hemisphere that is dominant
for language
In most people (90%):
-‐ the left hemisphere has greater control over language abilities, maths and logic
-‐ The right hemisphere is more free-‐spirited, involved in visual-‐spatial skills, intuition, emotion,
and artistic and musical skills
-‐ In the remaining 10% of people, the roles of the hemispheres are reversed or the hemispheres
share their functions equally
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2. Cerebral White Matter:

• Deep to the cortical gray matter
• Responsible for communication between cerebral areas and between the cerebral cortex and lower CNS centre
• Consists largely of myelinated fibers bundled into large tracts which are classified according to the direction in
which they run:
-‐ Commissural
-‐ Association
-‐ Projection
• Commissures (run horizontally) -‐ composed of commissural fibers, connect corresponding gray areas of the
two hemispheres, enabling them to function as a coordinated whole.
-‐ The largest commissure is the corpus callosum, which lies superior to the lateral ventricles, deep within the
longitudinal fissure.
• Association fibers (run horizontally) – connect different parts of the same hemisphere.
-‐ Short association fibers connect adjacent gyri
-‐ Long association fibers are bundled into tracts and connect different cortical lobes
• Projection fibers (run vertically) – these fibers either enter the cerebral cortex from the lower brain or cord
centres, or descend from the cortex to lower areas.
-‐ Sensory information reaches the cerebral cortex and motor output leaves it through these fibers
-‐ They tie the cortex to the rest of the nervous system and to the body’s receptors and effectors
-‐ Internal capsule: the compact band of projection fibers at the top of the brain stem
-‐ Corona radiate: the fanlike arrangement of projection tract fibers that go through the cerebral white matter
to the cortex

3. Basal Nuclei
• LOCATION: Deep within the cerebral white matter
• Receive input from the entire cerebral cortex, as well as form other subcortical nuclei and each other
• The output nucleus of the basal nuclei (globus pallidus) and the substantia nigra project to the premotor and
prefrontal cortices – so they influence muscle movements directed by the primary motor cortex
• FUNCTION: important in starting, stopping and monitoring the intensity of movements executed by the cortex.
(initiate and terminate body movements) Also, inhibit antagonistic and unnecessary movements.
• The caudate nucleus, putamen, and globus pallidus constitute most of the mass of each group of basal nuclei
• Lentiform nucleus: the putamen and globus pallidus together
-‐ flanks the internal capsule laterally
• Corpus striatum: Lentiform and caudate nuclei together
• Functionally associated with the subthalamic nuclei (located in the lateral part of the diencephalon) and the
substantia nigra (of the midbrain)

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Dienchaphalon:
• Forms the central core of the forebrain
• Rely station for sensory impulses
• Consists largely of three paired structures:
-‐ thalamus
-‐ Hypothalamus
-‐ Epithalamus

• These gray matter areas collectively enclose the third ventricle

Thalamus:
• FUNCTION: the relay station for information coming into the cerebral cortex
• contains a large number of nuclei – each nuclei has a functional specialty
• and each projects fibers to and receives fibers from a specific region of the cerebral cortex
• Largest
• impulses having to do with similar functions are relayed as a group via the internal capsule to the appropriate area
of the sensory cortex as well as t specific cortical areas

Hypothalamus:
• LOCATION: below the thalamus
• FUNCTION: the main visceral control centre of the body, influences many body activities, emotion, controls
homeostasis, hunger, sexual responses (vitally important to overall homeostasis)
• Contain mammillary bodies: (paired pea like nuclei that bulge anteriorly from the hypothalamus) relay stations in
the olfactory pathways
• Infundibulum: a stalk of hypothalamic tissue that connects the pituitary gland to the base of the hypothalamus
• Its chief homeostatic roles are:
1. Autonomic control centre – regulates ANS activity by controlling the activity of centres in the brain stem
and spinal cord
2. Centre for emotional response – lies at the centre of the limbic system (the emotional part of the brain).
The hypothalamus acts through ANS pathways to initiate most physical expressions of emotion.
3. Body temperature regulation – contains the body’s thermostat and initiates sweating and shivering to
maintain a constant body temperature. Neurons monitor blood temperature and receive input from other
temperature receptors in the brain and body.
4. Regulation of food intake – responds to changing blood levels of certain nutrients or hormones, and
regulates feelings of hunger and satiety
5. Regulation of water balance and thirst – when body fluids become too concentrated, hypothalamic nuclei
become excited and trigger the release of antidiuretic hormone (ADH) from the posterior pituitary (ADH
causes kidneys to retain water). The same conditions also stimulate hypothalamic neurons in the thirst
centre.
6. Regulation of sleep-‐wake cycles – sets the timing of the sleep cycle in response to daylight-‐darkness
cues received from the visual pathways
7. Control of endocrine system functioning – acts as the helmsman of the endocrine system in two
waysits releasing and inhibiting hormones control the secretion of hormones by the anterior pituitary
gland and its supraoptic and periventricular nuclei produce the hormones ADH and oxytocin’s.

Epithalamus:
• LOCATION: The most dorsal portion of the diencephalon
• Forms the roof of the third ventricle
• Pineal gland (extends from its posterior border) – secretes the hormone melatonin (a sleep-‐inducing signal
and antioxidant)
• FUNCTION: helps regulate the sleep‐wake cycle
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Brain stem
• Three main regions:
-‐ Midbrain
-‐ Pons
-‐ Medulla oblongata
• Organization is similar to that of the spinal cord– deep gray matter surrounded by white matter fiber tracts (but
the brain stem has nuclei of gay matter embedded in the white matter)
• FUNCTION:
-‐ produce the rigidly programmed, automatic behaviours necessary for survival
-‐ provides a pathway for fiber tracts running between higher and lowerneural centres
-‐ heavily involved in the innervations of the head (brain stem nuclei are associated with 10 of the 12 pairs of
cranial nerves

Midbrain:
• LOCATION: between the diencephalon and the pons
• Contracts both nuclei and tracts
• Function: Pupil diameter, coordinated eye movement, turning head towards the noise
• Cerebral peduncles: vertical pillars that hold up the cerebrum
-‐ each peduncle contains a large pyramidal motor tract descending toward the spinal cord
• Cerebral aquaduct: a hollow opening which connects the thirds and fourth ventricles
• Superior colliculi: visual reflex centres that coordinate head and eye movements when we visually follow a moving
object
• Inferior colliculi: part of the auditory relay from the hearing receptors of the ear to the sensory cortex

Pons: bridge
• LOCATION: The bulging brain stem region wedged between the midbrain and the medulla oblongata
• Forms part of the anterior wall of the fourth ventricle
• Chiefly composed of conduction tracts
-‐ Deep projection fibers run longitudinally and complete the pathway between higher brain centres and the
spinal cord
-‐ Superficial ventral fibers run transversely and dorsally – connect the pons to the two sides of the cerebellum

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Function: breathing,swallowing,

Pneumotaxic and

Medulla Oblongata:
• Most inferior part of the brain stem
• Blends into the spinal cord at the level of the foramen magnum
• Olives: oval swellings caused mainly by the wavy folds of gray matter of the underlying inferior olivary nuclei
-‐ These nuclei relay sensory information on the state ofstretch of muscles and joints in the cerebellum
• FUNCTION: autonomic reflex centre involved in maintaining body homeostasis
• Important visceral motor nuclei found in the medulla include:
-‐ Cardiovascular centre (includes the cardiac centre, which adjusts the force and rate of heart
contraction to meet the body’s needs, and the vasomotor centre, which changes blood vessel
diameter to regulate blood pressure)
-‐ Respiratory centres (generate the respiratory rhythm and control the rate and depth of breathing)
-‐ Various other centres (regulate such activities as vomiting, hiccupping, swallowing, coughing and
sneezing

CRANIAL NERVES:
Sensory, motor or mixed

Oh S Olfactory Bulb
Oh S Optic Nerve
Oh Mo Oculomotor Nerve
To Mo Trochlear Nerve
Touch Mixed Trigominal Nerve
And MO Abducers Nerves
Feel Both Facial Nerve
Very S
Giant Both
Volcano Both
Ah! M
Hot! M

Sensory –carry neurons and axon

Motor- has brain stem
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Cerebellum
• 11% of brain mass, little brain, occupies the inferior and posterior aspects of the cranial cavity
• LOCATION: dorsal to the pons and medulla, protrudes under the occipital lobes (attached to brainstem)
• Separated from the occipital lobes by the transverse cerebral fissure
• FUNCTION: provides the precise timing and appropriate patterns of skeletal muscle contraction for smooth,
coordinated movements and agility needed for our daily living (driving, typing, playing an instrument)
• Cerebellar activity occurs subconsciously

Anatomy:
• Bilaterally symmetrical
• Two cerebellar hemispheres (connected by the vermis)
← ANTERIOR LOBE- POSTERIOR LOBE- govern subconscious aspects of skeletal muscle movements
← cerebrum-neocereberum- coodination
← FLOCCULONODULAR LOBE/ ARCHI CEREBELLUM- equilibrium and balance
• Surface is heavily convoluted
• Folia: fine, transversely oriented gyri on covering the surface of the cerebellum
• Primary fissure: on the top of the cerebellum
• Has a thin outer cortex of gray matter, internal white matter and small, deeply situated,paired masses of gray
matter
• Separated into posterior and anterior lobes: coordinate body movement
• White matter (aka arbor vitae): shape resembles a branching tree
• Gray matter (aka cerebellar cortex)
• Cerebellar peduncles: connect cerebellum to the brain stem
-‐ Superior cerebellar peduncles: (connect cerebellum to midbrain) carry instructions from neurons in the deep
cerebellar nuclei to the cerebral motor cortex
-‐ Middle cerebellar peduncles: (connect cerebellum to pons) carry one-‐way communication from the pons
to the cerebellum, advising the cerebellum of voluntary motor activities initiated by the motor cortex
-‐ Inferior cerebellar peduncles: (connect cerebellum to medulla) convey sensory information to the
cerebellum from muscles proprioceptors throughout the body and the vestibular nuclei of the brain stem –
concerned with equilibrium and balance
• Cerebellum has no direct connections to the cerebral cortex

Cerebellar processing:
• Functional scheme of cerebellar processing:
-‐ Motor areas of the cerebral cortex notify the cerebellum of their intent to initiate voluntary muscle
contractions via relay nuclei in the brain stem
-‐ Cerebellum receives information from proprioceptors throughout the body and from visual and equilibrium
pathway – this information enables the cerebellum to evaluate body position and momentum.
-‐ The cerebella cortex calculates the best way to coordinate the force, direction, and extent of muscle
contraction to prevent overshoot, maintain posture, and ensure smooth, coordinated movements
-‐ The cerebellum dispatches to the cerebral motor cortex its ‘blueprint’ for coordinating movement. Cerebellar
fibers also send information to brain stem nuclei, which in turn influence motor neurons in the spinal cord.

Cognitive function of the cerebellum:

• The cerebellum recognizes and predicts sequences of events so that it may adjust for the multiple forces exerted on
a limb during complex movements involving several joints

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Functional Brain Systems
• Functional brain systems are networks of neurons that work together by span relatively large distances in the brain,
so they cannot be localized to specific brain regions
• Examples: limbic system and reticular formation

The Limbic System: (emotional brain- declarative memory)

• A group of structures located on the medial aspect of each cerebral hemisphere and diencephalon
• Its cerebral structures encircle the upper part of the brain stem and corpus callosum
• Long term memory
• Includes:
-‐ parts of the rhinencephalon
-‐ the amygdala (an almond-‐shaped nucleus that sits on the tail of the caudate nucleus)
-‐ hypothalamus
-‐ anterior thalamic nuclei
• the fornix and other fiber tracts link these limbic system regions together
• FUNCTION: our emotional, or affective (feelings), brain
• Two parts are particularly important in emotions:
-‐ Amygdala: recognizes angry and fearful facial expressions, assesses danger, and elicits the fear response
-‐ the anterior part of the cingulated gyrus: plays a role in expressing our emotions through gestures and in
resolving mental conflicts when we are confused

The Reticular Formation:

Regulates motor function
Regulates sleep-wake cycle

• extends through the central core of the medulla oblongata, pons and midbrain
• composed of loosely clustered neurons in what is otherwise white matter
• these neurons form three broad columns along the length of the brain stem:
-‐ the midline raphe nuclei
-‐ medial (large cell) group of nuclei
-‐ lateral (small cell) group of nuclei
• feature: farflung axonal connections – individual reticular neurons project to the hypothalamus, thalamus, cerebral
cortex, cerebellum, and spinal cord – making reticular neurons ideal for governing the arousal of the brain asa
whole
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Protection of the Brain

• Bone (skull)
• Membranes (meninges)
• Watery cushion (cerebrospinal fluid)
• Blood‐brain barrier

Meninges
• Three connective tissue membranes that lie just external to the CNS organs
• Functions:
1. Cover and protect the CNS
2. Protect blood vessels and enclose venous sinuses
3. Contain cerebrospinal fluid
4. Form partitions in the skull
• External to internal:
1. dura mater
2. arachnoid mater
3. pia mater

Dura Mater:
• strongest meninx
• double –layered external covering
• two layers of fibrous connective tissue (around the brain)
-‐ periosteal layer (superficial) – attached to the inner surface of the skull (the periosteum)
-‐ meningeal layer (deeper) – forms the true external covering of the brain and continues caudally in the
vertebral canal as the spinal dura mater
• the two dural layers are fused together except in certain areas, where they separate to enclose dural venous
sinuses that collect venous blood from the brain and direct it into theinternal jugular veins of the neck
• the dura mater extends inward to form flat partitions that subdivide the cranial cavity  dural septa limits
excessive movement of the brain within the cranium:
-‐ falx cerebri: in the longitudinal fissure between the cerebral hemispheres (attached to the crista galli of the
ethmoid bone)
-‐ falx cerebelli: runs along the vermis of the cerebellum
-‐ tentorium cerebelli: (resembles a tent over the cerebellum) horizontal dural fold extends into the transverse
fissure between the cerebral hemispheres (which it helps to support) and the cerebellum

Arachnoid Mater:
• middle layer of weblike extensions
• loose brain covering
• separated from the dura mater by the subdural space
• subarachnoid space (beneath the arachnoid mater) contains CSF and blood vessels
• arachnoid villi protrude into the superior sagittal sinus and permit CSF reabsorption

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Subdural Space- located between dura mater and arachnoid mater

Pia mater:
• layer of delicate vascularised connective tissue that clings tightly to the brain
• richly invested with tiny blood vessels
• only can be seen in spinal cord

cranium and the cranial meninges surrounds and protect the brain

Cerebrospinal Fluid
• found in and around the brain and spinal cord
• 80-150 ml , contains glucose, proteins, lactic acid,
• choroid plexus- produces cerebrospinal fluid
• Composition:
-‐ Watery solution
-‐ Less protein and different ion concentrations than plasma
-‐ Constant volume
• Functions:
-‐ Gives buoyancy to the CNS organs (reduces brain weight)
-‐ Protects the CNS from blows and other trauma
-‐ Nourishes the brain and carries chemical signals
Typically, an interruption in blood flow for 1 or 2 minutes impairs neuronal function and total deprivation of oxygen for
about 4 minutes causes permanent injury.

Supply of glucose must be continuous.

Lack sugar causes dizziness, convulsions,

Choroid Plexuses:
• Hang from the roof of each ventricle
• Produce CSF at a constant rate
• Frond-shaped clusters of capillaries enclosed first by pia mater and then by a layer of ependymal cells
• Ependymal cells have ion pumps to control the composition of the CSF and help cleanse CSF by removing waste
• Some CSF enters the central canal of the spinal cord but more enters the subarachnoid space via the lateral and
median apertures in the walls of the fourth ventricle

Blood‐Brain Barrier
• A protective mechanism that helps maintain a stable environment forthe brain
• Separates neurons from some blood borne substances
• Blood borne substances in the brain’s capillaries must pass through three layers before they reach the neurons:
1. The endothelium of the capillary wall
2. A relatively thick basal lamina surrounding the external face ofeach capillary
3. The bulbous ‘feet’ of the astrocytes clinging tothe capillaries (provide signal to endothelium for the
formation of tight junctions)
• Selective barrier:
-‐ Allows nutrients to move by facilitated diffusion
-‐ Allows any fat-‐soluble substances to pass, including alcohol, nicotine, and anaesthetics
• Absent in some areas (eg. vomiting centre and the hypothalamus) where it is necessary to monitor the chemical
composition of the blood

Traumatic Brain Injuries

Concussion-
Contusion-
Cerebral-
Cerebrovascular Accident-
Alzheimer’s Disease-

The Spinal Cord

Extends from the medulla oblongata to the region of T12

Below T12 is the causa epuina (collection of spinal nerves)
Enlargement occur in the cervical and lumbar regions
Gross Anatomy and Protection
• Enclosed in the vertebral column
• Extends from the foramen magnum of the skull to thelevel of the first or second lumbar vertebra
• Functions:
-‐ Provides two-‐way communication to and from the brain
-‐ Contains spinal reflex centres
• Protection:
-‐ Bone
-‐ Meninges
-‐ CSF
• Spinal dura mater – not attached to the vertebrae
• Epidural space: between the vertebrae and the spinal dura mater
-‐ Filled with soft padding of fat and a network of veins
• CSF filled the subarachnoid space between the arachnoid and pia matermeninges
• Spinal cord ends between L1 and L2
• Dural and arachnoid membranes extend to S2
• Conus medullaris: the cone-‐shaped end of the spinal cord
• Filum terminale: fibrous extension from the conus medullaris covered by pia mater; anchors the spinal cord to the
coccyx
• Denticulate ligaments: extensions of the pia mater that secure the cord to the dura mater
• 31 pairs of spinal nerves
• Cervical and lumbar enlargements: thickening of spinal cord when nerves shoot off to the arms and legs
• Cauda equina: collection of nerves roots at the inferior end of the vertebral canal
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Cross-‐sectional anatomy
• Two grooves in the spinal cord (partially divide it into left and right halves):
-‐ Ventral (anterior) median fissure
-‐ Dorsal (posterior) median sulcus

Gray matter and spinal roots:

• Gray matter looks like a butterfly
• Mirror-‐image gray masses are connected by the gray commissure (encloses the central canal)
• Dorsal horns: posterior projections of gray matter (consist entirely of interneurons that receive somatic and visceral
sensory input)
• Ventral horns: anterior projections of gray matter (somatic motor neurons whose axons exit via the ventral roots)
-‐ the amount of ventral gray matter present at a given level of thespinal cord reflects the amount of skeletal
muscle innervated at that level (so the ventral horns are the largest in the limb-‐innervating thoracic and
lumbar regions of the cord)
• Lateral horns: present in the thoracic and lumbar segments of the cord (sympathetic neurons that serve visceral
organs)
• Ventral root: derived from several ventral rootlets (contain both somatic and autonomic efferents  serve
both motor divisions of the peripheral nervous system)
• Dorsal roots: formed from afferent fibers carrying impulses from peripheral sensory receptors
-‐ Dorsal root ganglion: an enlarged region of the dorsal root containing the cell bodies of associated sensory
neurons
• Dorsal and ventral roots are every short and fuse laterally to form the spinal nerves (part of the peripheral nervous
system)
• The spinal gray matter can be divided further according to its neurons’ relative involvement in the innervations of
the somatic and visceral regions of the body. Four zonesare evident within the gray matter:
-‐ Somatic sensory (SS)
-‐ Visceral (autonomic) sensory (VS)
-‐ Visceral motor (VM)
-‐ Somatic motor (SM)

White Matter:
• Composed of myelinated and unmyelinated nerve fibers that allow communication between different parts of the
spinal cord and between the cord and the brain
• Fibers run in three directions:
-‐ consists mostly of ascending (sensory) and descending (motor) tracts -‐
transverse tracts (commissural fibers) cross from one side to the other
• white matter on each side of the cord is divided into three white columns (or funiculi):
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-‐ dorsal (posterior)
-‐ lateral
-‐ ventral (anterior)
• each tract is made up of axons with similar destinations andfunctions

26 spinal (bones)

Spinal Nerves
• 31 pairs of mixed nerves named according to
their point: of issue from the spinal cord:
-‐ 8 cervical (C1-‐C8)
-‐ 12 thoracic (T1-‐T12)
-‐ 5 lumbar (L1-‐L5)
-‐ 5 sacral (S1-‐S5)
-‐ 1 coccygeal (C0)

Note: the first seven pairs of nerves exit the vertebral canal superior to the vertebrae for which they are names.
Below the cervical level, each spinal nerve leaves the vertebral column inferior to the same-‐numbered vertebra.

• Each nerve connect to the spinal cord by two roots – the dorsal root and the ventral root
• Ventral roots:
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-‐ Contain motor (efferent – away from CNS) fibers from the ventral horn motor neurons -‐
Fibers innervate skeletal muscles
• Dorsal roots:
-‐ Contain sensory (afferent – toward the CNS) fibers from sensory neurons in the dorsal root ganglia -‐
Conduct impulses from peripheral receptors
• Dorsal and ventral roots unite to form spinal nerves, which then emerge from the vertebral column via the
intervertebral foramina

• Each spinal nerve branches into mixed rami:

-‐ Dorsal ramus
-‐ Larger ventral ramus
-‐ Meningeal branch
-‐ Rami communicantes (autonomic pathways) join to the ventral rami inthe
 SO:
-‐ Roots lie medial to and form the spinal nerves, and each root is strictly sensory or motor
-‐ Rami lie distal to and are lateral branches of the spinal nervesand, like spinal nerves, carry both sensory
and motor fibers

Innervation of Specific body regions

• All ventral rami (except for T2-‐T12) branch and join one another lateral to the vertebral column, forming
interlacing nerve networks called plexuses (cervical, brachial, lumbar and sacral regions)
-‐ Within a plexus, fibers from the various ventral rami criss-‐cross one another and become redistributed so
that 1) each resulting branch of the plexus contain fibers from several spinal nerves and 2) fibers from each
ventral ramus travel to the body periphery via several routes  so each muscle in a limb receives its
nerve supply from more than one spinal nerve (injury to one spinal segment or root cannot completely
paralyse any limb muscle)

Back:
• The back is innervated by dorsal rami via several branches

Anterolateral Thorax and Abdominal Wall:

• Ventral rami of T2-‐T12 course anteriorly as intercostal nerves – supply muscles of the ribs, anterolateral thorax,
and abdominal wall

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Cervical Plexus:
• Formed by ventral rami of C1-‐C4
• Innervates skin and muscles of the neck, ear, back of
head and shoulders
• MOST IMPORTANT NERVE: Phrenic nerve – major
motor and sensory nerve of the diaphragm (receives
fibers from C3-‐C5)
• NOTE: cutaneous nerves – supply only the skin

Brachial Plexus:
• Formed by ventral rami of C5-‐C8 and T1 (and often C4 and T2)
• It gives rise to the nerves that innervate the upper limb
• Major branches of this plexus:
-‐ Roots – five ventral rami (C5-‐T1)
-‐ Trunks – upper, middle, lower
-‐ Divisions – anterior and posterior
-‐ Cords – lateral, medial and posterior
• The brachial plexus ends in the axilla, where its threecords wind along the axillary artery and then give rise to the
main nerves of the upper limb:
-‐ Axillary nerve: innervates the deltoid, teres minor, and skin and joint capsule of the shoulder (runs
posterior to the surgical neck of the humerus)
-‐ Musculocutaneous nerve: innervates the biceps brachii and brachialis and skin of lateral forearm (runs
inferiorly into the arm)
-‐ Median nerve: innervates the skin, most flexors and pronators in the forearm, and some intrinsic muscles of
the hand (descends through the arm to the anterior forearm)
-‐ Ulnar nerve: supplies the flexor carpi ulnaris, part of the flexor digitorum profundus, most intrinsic muscles of
the hand, and skin of medial aspect of hand (descend along th medial aspect of the arm toward the elbow,
swings behind the medial epicondyle, and then followsthe ulna along the medial forearm)
-‐ Radial nerve: innervates essentially all extensor muscles, supinators, and posterior skin of limb (wraps
around humerus, then runs anteriorly around the lateral epicondyle at the elbow where it divides into a
superficial branch that follows the lateral edge of the radius to the hand and adeep branch that runs
posteriorly)

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Lumbar Plexus:
• Arises from L1-‐L4
• Lies within the psoas major muscle
• Innervates the thigh, abdominal wall, and psoas muscle
• Femoral nerve – (runs under inguinal ligament) innervates quadriceps and skin of anterior thigh and medial surface
of leg
• Obturator nerve – passes through obturator foramen to innervate adductor muscles

Sacral Plexus:
• Arises from L4 – S4
• Serves buttock, lower limb, pelvic structures, and perineum
• Sciatic nerve –
-‐ Longest and thickest nerve of the body
-‐ Innervates the hamstring muscles, adductor magnus, and most muscles in the leg and foot
-‐ Composed of two nerves: tibial and common fibular nerves (wrapped in a common sheath)
• Tibial nerve –
-‐ Runs through the popliteal fossa (the region just posterior to theknee joint)
-‐ Innervates the posterior compartment muscles of the leg and the skin of the posterior calf and sole of the
foot
-‐ At the knee...branches to: sural nerve (serves the skin of the posterolateral leg)
-‐ At the ankle...branches to: medial and lateral plantar nerves (serve most of the foot)

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 • Common fibular nerve –
-‐ Wraps around neck of the fibula, then divides into superficial and deep branches
-‐ Innervate the knee joint, skin of the anterior and lateral leg and dorsum of the foot, and muscles of the
anterolateral leg (the extensors that dorsiflex the foot)
• Next largest sacral plexus branches: superior and inferior gluteal nerves (innervate the buttock and tensor fasciae
latae muscles)

Innervation of skin:
• Dermatone: the area of skin innervated by the cutaneous branches of a single spinal nerve
• All spinal nerves except C1 participate in dermatomes
• Most dermatones overlap, so destruction of a single spinal nerve will not cause complete numbness

Innervation of Joints:
• Hilton’s Law: any nerve serving a muscle that produces movement at a joint also in nervates the joint and the skin
over the joint
• Example: the knee is crossed by the quadriceps, gracilis, and hamstring muscles. The nerves to these muscles are
the femoral nerve anteriorly and branches of the sciatic and obturator nerves posteriorly – so these nerves
innervates the knee joint as well.
Autonomic Nervous System
Extended series
Involuntary branch of the nervous system
Consists only motor nerves

Two divisions
- Sympathetic ( increase activities, flight responses)
Unusual stimulus
Exercise, Anxiety
- Parasympathetic division ( involuntary actions, rest and digest)
Housekeeping activities
Maintains necessary body functions
Conserves energy

Differences between somatic and autonomic nervous system