Central Nervous System

2nd year Respiratory-Therapy

2020/2021

Prof. Zienab Alrefaie

Physiology Department
CNS
THE BRAIN &
THE SPINAL
CORD
Peripheral Nervous System
Any nerves outside the brain and
spinal cord

12 pairs of cranial nerves

31 pairs of spinal nerves
 Divisions of CNS
CNS - central nervous system
consists of brain and spinal cord
 Central Nervous System

Brain
Mass of nerve tissue
Protected by membranes & the cranium
or skull
 Cerebrum
Largest section of the
Reasoning & thinking
Memory
Speaking
Sensation
Vision
Hearing
Voluntary body movement
 Cerebrum
The cerebrum forms the bulk of the brain and is supported on
the brain stem. The cerebrum is divided into two
hemispheres. Each hemisphere controls the activities of the
side of the body opposite that hemisphere. Each
hemisphere is further subdivided into four lobes:
a) Frontal lobe; This lobe is responsible for voluntary motor
function and higher mental functions such as judgment and
foresight, affect, and personality.
b) Temporal lobes; These lobes are responsible for hearing, speech
in the dominant hemisphere, vestibular sense, behavior, and
emotion.
c) Parietal lobe; This lobe is responsible for sensory function,
sensory association areas, higher level processing of general
sensory modalities,
d) Occipital lobe; This lobe is responsible for vision.
Brain Stem; is composed of:

Midbrain. . The midbrain provides conduction pathways to and from

higher and lower centers.
Pons. It contains conduction pathways between the medulla and
higher brain centers. It also serves to connect the two halves of the
cerebellum.
Medulla oblongata : Contained the vital centers for the regulation of
respirations, heart, and vasomotor activity, swallowing.
 D. Cerebellum
• Responsible for:
Coordination of fine movements
Balance & posture
Structural unit of CNS
 Sensory System
Sensory system is composed of:

Receptors
Sensory pathways (ascending tracts)
Sensory cortex
 Receptors
Definition: a specialized structures at the peripheral end
of afferents which:
Functions:
- recognize; detect changes Detectors
- transform stimulus ⇛ impulse Transducers
- generate action potentials Generators
Types: mechano, thermo, chemo, noci, photo..
Properties
Specificity
Excitability
• Sensory receptors: specialized to
respond to changes in environment
(stimuli)
• Three ways to classify receptors: by type
of stimulus, body location, and
structural complexity
Classification by Stimulus Type
Mechanoreceptors—respond to touch,
pressure, vibration, and stretch
Thermoreceptors—sensitive to changes in
temperature
Photoreceptors—respond to light energy
(example: retina)
Chemoreceptors—respond to chemicals
(examples: smell, taste, changes in blood
chemistry)
Classification by Stimulus Type
(cont.)

Nociceptors—sensitive to pain-causing
stimuli (examples: extreme heat or cold,
excessive pressure, inflammatory
chemicals)
 Classification by Location

Exteroceptors
Respond to stimuli arising outside body
Receptors in skin for touch, pressure, pain, and
temperature
Most special sense organs
 Classification by Location
(cont.)
Interceptors (visceroceptors)
Respond to stimuli arising in internal viscera
and blood vessels
Sensitive to chemical changes, tissue stretch,
and temperature changes
 Classification by Location
(cont.)
Proprioceptors
Respond to stretch in skeletal muscles,
tendons, joints, ligaments, and connective
tissue coverings of bones and muscles
Inform brain of one's movements
 Classification by Receptor
Structure
Majority of sensory receptors belong to one
of two categories:
Simple receptors of the general senses
Modified endings of sensory neurons
Are found throughout body and monitor most types
of general sensory information
Receptors for special senses
Vision, hearing, equilibrium, smell, and taste
All are housed in complex sense organs
Processing at the receptor level

Generating a signal: For sensation to occur, the

stimulus must excite a receptor, and the AP must
reach CNS
Stimulus energy must match receptor specificity (touch
receptors do not respond to light… specificity)
Stimulus must be applied within receptive field
Transduction must occur—energy of stimulus is
converted into graded potential called generator
potential or receptor potential … excitability
Graded potentials must reach threshold → AP
Processing at the receptor level
Adaptation: Change in sensitivity in presence
of constant stimulus
Receptor membranes become less responsive
Receptor potentials decline in frequency or stop
Phasic receptors: (fast-adapting) send signals at
beginning or end of stimulus
Examples: receptors for pressure, touch, and smell
Tonic receptors: adapt slowly or not at all
Examples: nociceptors and most proprioceptors
 Ascending Tracts
Pathways of three neurons conduct sensory
impulses from receptors upward to appropriate
cortical regions
First-order neurons
Conduct impulses from receptor level to second-order
neurons in the spinal cord
Second-order neurons
Transmit impulses to third-order neurons in thalamus
Third-order neurons
Conduct impulses from thalamus to the somatosensory
cortex
Sensory Pathways; Anterolateral System
(Spinothalamic Tracts)

Lateral:
Temperature
and Pain

Ventral:
Crude touch
and Pressure
 Sensory Pathways; Dorsal Column

Proprioception
Fine touch
Vibration
 Spinothalamic Dorsal column sensations
sensations
Lateral Ventral
spinothalamic spinothalam
ic
sense a) pain a) crude a) Fine touch
b) temp touch b) Vibration sense
b) itch & c) Proprioceptive sensation (sense of
tickle position and sense of movement).
d) deep pressure
e) Stereognosis.
Sensor All sensations are All sensations are transmitted in Aβ fibers
y fibers transmitted by Aδ and C
fibers
Sensor The receptors of all • for fine touch are pacinian corpuscle ,
y spinothalamic sensations miessner's corpuscle , merkel's disc
recept are free nerve endings and ruffini endings.
ors • For vibration sense the receptors are
pacinian corpuscles and miessner's
corpuscles,
• for proprioceptive sensations the
receptors are pacinian corpuscle and
Golgi tendon organs as well as muscle
spindle.
 Sensations transmitted by the dorsal
column tract
Parameter Fine touch Vibration Proprioception stereognosis

Reseptors Meissners Pacinian Muscle spindle Different

corpuscle and corpuscle and and golgi tendon mechanoreceptors.
merkels disc meisners organ
corpuscle
Mechanism of Mechanical deformation of the receptors
stimulation

Adaptation Rapidly adapting receptors the most rapid is pacinian and the least is
merkels discs

Afferent nerve Aβ fibers

Tract Dorsal column tract

Sensory Sensory cortex

center
 Sensations transmitted by the spinothalamic tract
Parameter Fast pain Slow pain Temperature Crude touch
Reseptors Free nerve Free nerve Free nerve Free nerve
endings endings endings endings

Mechanism Chemical Chemical Metabolic rate Mechanical

of mediators like mediators like changes deformation
stimulation histamine histamine
prostaglandins prostaglandins

Adaptation Slow Slow Moderate Rapid

Afferent Aδ C fibers Aδ and C C fibers
nerve fibers
Tract Lateral Lateral Lateral Ventral
neospinothala paleospinothal spinothalamic spinothalamic
mic amic

Sensory Sensory Thalamus Thalmus and Thalamus

center cortex sensory cortex
 Sensory cortex
Interpretation of sensory input occurs in the
sensory cortex
Aspects of sensory perception:
Stimulus Intensity: ability to detect a stimulus
(requires summation of impulses)
Stimulus locality: identifying site or pattern of
stimulus
Pattern recognition: recognition of familiar or
significant patterns in stimuli …. modality
 Sensory cortex
Feature abstraction: identification of more
complex aspects and several stimulus
properties
Quality discrimination: ability to identify sub-
modalities of a sensation (e.g., sweet or sour
tastes)
 Sensory cortex
• Somatosensory Area I – S I.
(Brodmann area 1,2,3) – post central gyrus
parietal lobe.
• Somatosensory area II – S II.
(Brodmann area no. 40) in the wall of sylvian
fissure which separate temporal lobe from
frontal & parietal lobes.
• Sensory Association area (Broadmann
area 5 & 7) located in parietal lobe behind
S I.
 Sensory cortex
a map of the
human cerebral
cortex, that is
divided into about
50 distinct areas
called
Brodmann's areas
based on
histological
structural
differences.
Areas 1, 2, and 3, which constitute PRIMARY
SOMATOSENSORY AREA I, 40 is SECONDARY
SOMATOSENSORY AREA II and areas 5 and 7, which
constitute the SOMATOSENSORY ASSOCIATION AREA.
 Sensory cortex
From specific sensory nuclei of thalamus,
neurons carrying sensory information project
into two somatic sensory areas of the cortex,
S I & SII.
In addition, SI project to SII.
Generally, when we use the term
somatosensory cortex, we mean SI area.
Representation of the different areas of the
body in somatosensory area I of the cortex
- Body is represented upside down
- Size of cortical area for a particular part of
the body is proportionate to the no. of
receptors.
– Very large area receives impulses coming from
lips, face, and hand (thumb) also parts of mouth
concerned with speech.
- Trunk & back has small area of presentation in
sensory cortex.
- Each side of the cortex receives
information from opposite side of the
bodyody.
Synaptic Transmission
 Communication between neurons
at a synaptic junction

1. Action potential arrives at

a synaptic end bulb.
2. Depolarization of membrane
causes the opening of Ca++
channels.
3. Increase in (Ca ++) inside of
presynaptic neuron triggers
exocytosis of neurotransmitter
4. Neurotransmitter diffuses across
synaptic cleft and binds to
receptor (ligand-gated channel)
on postsynaptic neuron
 Communication between neurons
at a synaptic junction

5. Na+ channels open causing a

depolarization (Na+ channels)
EPSP (excitatory postsynaptic
potential) or a
hyperpolarization (Cl-
channels) IPSP (inhibitory post-
synaptic potential) of the
postsynaptic neuron.
6. If depolarization reaches a
threshold, an action potential is
generated on the postsynaptic
neuron.
Communication between neurons
at a synaptic junction
Characteristics of synaptic transmission

- One way conduction

- Synaptic delay (0.5 ms)
- Synaptic fatigue
- High sensitivity to:
Blood pH, O2 level, glucose level and
drugs
Motor Division of the CNS
 Components of reflex arc
• Stimulus
• Receptor
• Sensory neuron (Afferent)
• Center: the incoming sensory
impulse connects with an outgoing motor
impulse
• Motor neuron (Efferent)
• Effector: the organ of the body that
responds.
 Types of reflexes
• Polysynaptic • Superficial
• Monosynaptic • Deep
• Visceral

Number of synapses Site of receptors

Polysynaptic Superficial Reflexes

Planter, abdominal and cremaseteric reflexes

Visceral reflex
Withdrawal reflex
Stretch reflex
It is reflex contraction of skeletal muscle in
response to stretch.
 Components of stretch reflex
Stimulus : Stretch of the muscle.
Receptor : Muscle spindle (intrafusal
muscle fibers)
Afferent : Primary and secondary
endings
Center : Anterior horn cells ( AHCs)
Efferent : Aα motor fibers
Effector : extrafusal muscle fibers
Response : Contraction of the muscle
 Pathway of stretch reflex

51 Prof. Z. Alrefaie
Responses of the muscle spindles to
stretch:
Dynamic response:
rate of change of muscle length (beginning
or end of stretch)

Static response:
changes in the muscle length (throughout
stretch)
Supraspinal control of stretch reflex

Facilitatory areas Inhibitory areas

 Types of stretch reflex
1. Dynamic stretch reflex: sudden stretch
leads to brief contraction. It is the basis of
the tendon jerks.
2. Static stretch reflex: steady stretch leads to
maintained contraction. It is the basis of the
muscle tone.
3. Negative stretch reflex: muscle shortening
leads to relaxation.
4. Inverse stretch reflex: overstretch of the
muscle leads to muscle relaxation through
activity of the Golgi tendon organs.
Inverse stretch reflex
Tendon jerks
Stretching of muscle tendon
stimulates muscle spindles
Muscle spindle
(stretch receptor)
Stretch

Spinal
cord
REFLEX
ARC

Contraction

Activation of motor
neuron produces reflex
muscle contraction
 Muscle tone
• Definition
• Mechanism of muscle tone
• Muscle tone does not cause fatigue
• Functions of muscle tone
- Protects against gravity
- Helps venous return and lymphatic
drainage
- Gives background to motor activity
Motor Cortex
Premotor area 6
Pyramidal Tract
Corticobulbar fibers
 Functions of pyramidal system

1) The pyramidal fibers (crossed

corticospinal) are responsible for fine skilled
movements of fingers, toes and face.

2) It is facilitatory to stretch reflex.

3) The uncrossed (ventral corticospinal

tracts) provide gross positioning movements.
 The Extrapyramidal system

64 Prof. Z. Alrefaie
 Pyramidal Extrapyramidal
system system
Origin Cortical only cortical & extracortical

Tract Mononeuronal Multineuronal

Terminat Cranial nerve Spinal neurons (not at
nuclei and motor the cranial nuclei)
neurons in the
spinal cord
Spinal N. alpha neurons Alpha & gamma N.
Function fine skilled gross movements &
movements some tracts are
&increases facilitatory, others are
Prof. Z. Alrefaie 65
muscle tone. inhibitory
 Effects of lesion of area 4
1- Paralysis of the skeletal muscles, commonly
monoplegia in the opposite (contralateral) side.

2- Permanent loss of fine and skilled movements.

3- Inhibition of the stretch reflex, so the paralyzed

muscles are flaccid, and the tendon jerks are weak.

4- Loss of the superficial reflexes.

5- +ve Babinski’s sign, mainly dorsiflexion of the big
toe.
 Effects of lesion of area 6
1- Weakness of gross movements, muscle paresis, on the
contralateral side.

2- Muscle spasticity and exaggerated tendon jerks.

3- Positive Babinski's sign (mainly fanning of toes).

4- Appearance of the grasp reflex.

5- Motor aphasia due to damage of Broca's area, Motor

apraxia due to damage of hand skills area and Loss of
voluntary eye movements and head rotation on opposite
side.
 UMNL/ LMNL

Damage to either the upper motor

or lower motor neurons
Leading to paralysis
 UMNL
Causes
Commonest is hemorrhage in the internal
capsule

Extent of paralysis
Wide, the tract supplies the body half

Side of paralysis
Opposite to the lesion
 UMNL
Tone and reflexes
Hypertonia and exaggerated deep reflexes
Loss of extrapyramidal inhibition on gamma
efferents
Positive Babinski’s sign and clonus

Superficial reflexes
Lost, their facilitation is by motor cortex
UMNL
 UMNL

Wasting of muscles
Minimal or absent due to spasticity

Response to electrical stimuli

Normal
 LMNL
Causes
Poliomyelitis, nerve injury, neuro-muscular
disorder

Extent of paralysis
localized, depending on site of the lesion

Side of paralysis
Same side
 LMNL

Tone and reflexes

Hypotonia and absent deep and superficial
reflexes
The stretch reflex arc is cut
 LMNL
Wasting of muscles
Severe; muscles don’t contract. Neither
voluntarily, nor reflex

Response to electrical stimuli

Reaction of degeneration
Lesion in the internal capsule
Lesion in the internal capsule
Acute stage:
Flaccid hemiplegia and loss of reflexes on
the contralateral side (2-6 weeks)

Chronic stage:
Contralateral hemiplegia: The paralysis of
UMNL.
Cord Transection
 Cord Transection
1- Immediate loss of all sensations below
the level of the lesion

2- UMNL below the level of the lesion.

3- LMNL at the level of the lesion due to

damage of spinal motor neurons.
Cerebellum
 Functions of cerebellum
*Control of posture and equilibrium.
*Coordination of movements.
*Planning of rapid movements.
*Prevents overshooting of
movement.
 Neocerebellar ataxia
- Hypotonia & pendular knee jerk
- Ataxia
– Dysmetria
– Intention tremor (kinetic tremor)
– Rebound phenomenon
– Adiadokokinesia
– Decomposition of movement
– Dysartheria (staccato speech)
– Nystagmus
– Drunken gait in archicerebellar lesion.
83 Prof. Z. Alrefaie
 Basal ganglia

1. The caudate nucleus.

2. The putamen.
3. The globus pallidus.
4. The subthalamic nucleus.
5. The substantia nigra.
The normal functions of the basal ganglia
depends on the balance between various
excitatory and inhibitory transmitters.

The predominance of inhibitory neurons in

the basal ganglia inhibit the excessive
activity of the motor cortex and prevent
undesirable movements.
 Functions of the basal ganglia
Cognitive control of motor activity,
converting thoughts into motor action.
Execution of the subconscious learned
patterns of motor activity as
Initiation of subconscious automatic
movements like swinging of the arms during
walking.
 Parkinsonism
Lesion in: substantia nigra. Degeneration of
dopaminergic neurons
Hyperkinetic and hypokinetic features

• Rigidity
• Static tremors
• Akinesia
 Parkinsonism

88 Prof. Z. Alrefaie