III.

INTRODUCTION
Background of the Study
Patient X is a 1-year-old female, who was admitted at Capitol
University Medical Center last May 4, 2022, at 12MN. She was
admitted with a chief complaint of high grade fever and cough and
was later diagnosed with ¬Complex febrile seizure R/O PCAP.
The group decided to study this case to acquire knowledge
and understanding with regards to the condition—febrile seizure.
Obtaining information about the disease could help in providing
quality care for clients experiencing this condition and render
appropriate nursing interventions to promote general health of the
client. Research on the condition will aid student nurses in
understanding the disease process, thus, helps in planning for the
health management.
VI. ANATOMY AND PHYSIOLOGY

Our bodies couldn’t operate without the nervous system - the

complex network that coordinates our actions, reflexes, and
sensations. Broadly speaking, the nervous system is organized
into two main parts, the central nervous system (CNS) and
the peripheral nervous system (PNS).
The CNS is the processing centre of the body and consists
of the brain and the spinal cord. Both of these are protected by
three layers of membranes known as meninges. For further
protection, the brain is encased within the hard bones of the
skull, while the spinal cord is protected with the bony vertebrae
of our backbones. A third form of protection is cerebrospinal
fluid, which provides a buffer that limits impact between the
brain and skull or between spinal cord and vertebrae.
VI. ANATOMY AND PHYSIOLOGY

GREY AND WHITE MATTER

In terms of tissue, the CNS is divided into grey matter and
white matter. Grey matter comprises neuron cell bodies and their
dendrites, glial cells, and capillaries. Because of the abundant
blood supply of this tissue, it’s actually more pink-coloured than
grey.
In the brain, grey matter is mainly found in the outer
layers, while in the spinal cord it forms the core ‘butterfly’ shape.
White matter refers to the areas of the CNS which host
the majority of axons, the long cords that extend from neurons.
Most axons are coated in myelin - a white, fatty insulating cover
that helps nerve signals travel quickly and reliably. In the brain,
white matter is buried under the grey surface, carrying signals
across different parts of the brain. In the spinal cord, white matter
is the external layer surrounding the grey core.
VI. ANATOMY AND PHYSIOLOGY
The Brain
If the CNS is the processing centre
of the human body, the brain is its
headquarters. It is broadly organized
into three main regions - the forebrain,
the midbrain, and the hindbrain. The
largest of these three is the forebrain
(derived from the prosencephalon in the
developing brain). It contains the large
outermost layer of the brain, the wrinkly
cerebral cortex, and smaller structures
towards its centre, such as the thalamus,
hypothalamus, and the pineal gland.
VI. ANATOMY AND PHYSIOLOGY

The forebrain
Cerebrum and cerebral cortex
The cerebrum is where most of the important brain functions
happen, such as thinking, planning, reasoning, language processing,
and interpreting and processing inputs from our senses, such as
vision, touch, hearing, taste and smell.
The outer layer of the cerebrum is called the cerebral cortex, and in
each hemisphere it is traditionally divided into four lobes - frontal,
parietal, occipital and temporal. Communications between the two
hemispheres are maintained by a fibrous bridge called the corpus
callosum, which is formed in utero.
VI. ANATOMY AND PHYSIOLOGY

Control Centers for making sense of our bodies

Apart from the cerebrum, the forebrain also contains several
small, but highly important structures located towards the centre of
the brain and are included in the limbic system. Collectively these
are called the diencephalon and they are involved in regulating
things like the body’s sensory perception, motor functions, and
hormones.
The thalamus consists of two lobes of grey matter tucked
away right under the cerebral cortex. It is a prime processing centre
for sensory information, as it links up the relevant parts of the
cerebral cortex with the spinal cord and other areas of the brain
important for our senses. The thalamus also controls sleep.
VI. ANATOMY AND PHYSIOLOGY

Control Centers for making sense of our bodies

The hypothalamus is quite small, only about the size of an
almond. As its name suggests, it can be found right underneath the
thalamus, and despite its small size it is actually the major control
centre of the autonomic motor system. It is involved in some
hormonal activity and connects the hormonal and nervous systems.
The hypothalamus also works to regulate things like our blood
pressure, body temperature, and overall homeostasis.
The pineal gland is even smaller than the hypothalamus -
only about the length of a grain of rice - and is tucked between the
two lobes of the thalamus. It is actually shaped like a tiny pinecone,
and its main job is to produce the hormone melatonin, which
regulates our sleep-wake cycles. Just like the hypothalamus, it is
also involved in regulating hormonal functions.
 VI. ANATOMY AND PHYSIOLOGY
The midbrain (derived from the mesencephalon in the developing brain)
serves as the vital connection point between the forebrain and the
hindbrain. It’s the top part of the brainstem, which connects the brain to the spinal
cord.
The hindbrain (derived from the rhombencephalon in the developing brain)
is the lowest back portion of the brain, containing the rest of the
brainstem made up of medulla oblongata and the pons, and also the cerebellum - a
small ball of dense brain tissue nestled right against the back of the brainstem.
Parts of the brain
The brain’s cerebral cortex is the outermost layer that gives the brain its
characteristic wrinkly appearance. The cerebral cortex is divided lengthways into
two cerebral hemispheres, each of which traditionally have been divided into four
lobes: frontal, parietal, temporal and occipital.
VI. ANATOMY AND PHYSIOLOGY

Lobes of the brain

The brain’s cerebral cortex is the
outermost layer that gives the brain its
characteristic wrinkly appearance. The
cerebral cortex is divided lengthways into
two cerebral hemispheres connected by the
corpus callosum. Traditionally, each of the
hemispheres has been divided into four
lobes: frontal, parietal, temporal and
occipital.
VI. ANATOMY AND PHYSIOLOGY

Bumps and grooves of the brain

In humans, the lobes of the brain are
divided by a number of bumps and grooves.
These are known as gyri (bumps) and sulci
(groves or fissures). The folding of the brain,
and the resulting gyri and sulci, increases its
surface area and enables more cerebral cortex
matter to fit inside the skull.
VI. ANATOMY AND PHYSIOLOGY
Frontal Lobe
The frontal lobe is separated from the
parietal lobe by a space called the central
sulcus, and from the temporal lobe by the
lateral sulcus.

Parietal Lobe
The parietal lobe is behind the frontal
lobe, separated by the central sulcus. Areas
in the parietal lobe are responsible for
integrating sensory information, including
touch, temperature, pressure and pain.
VI. ANATOMY AND PHYSIOLOGY
Temporal lobe
Separated from the frontal lobe by the
lateral fissure, the temporal lobe also
contains regions dedicated to processing
sensory information, particularly important
for hearing, recognizing language, and
forming memories.
Occipital lobe
The occipital lobe is the major visual
processing centre in the brain.
VI. ANATOMY AND PHYSIOLOGY
Spinal Cord
The spinal cord is part of the central nervous system
and consists of a tightly packed column of nerve tissue that
extends downwards from the brainstem through the central
column of the spine.
Spinal nerves
Two rows of spinal nerves - bundles of axons - emerge
on either side of the cord through the bony ridges of the
vertebrae. There are 31 pairs of these nerves, each
representing a segment of the spinal cord which is further
divided into five regions. From top to bottom, these are:
• 8 cervical (neck)
• 12 thoracic (chest)
• 5 lumbar (abdominal)
• 5 sacral (pelvic)
• 1 coccygeal (tailbone) segment
VI. ANATOMY AND PHYSIOLOGY

Neurons
Neurons (also called neurones or nerve cells)
are the fundamental units of the brain and nervous
system, the cells responsible for receiving sensory
input from the external world, for sending motor
commands to our muscles, and for transforming and
relaying the electrical signals at every step in
between. More than that, their interactions define
who we are as people. Having said that, our roughly
100 billion neurons do interact closely with other
cell types, broadly classified as glia (these may
actually outnumber neurons, although it’s not really
known).
VI. ANATOMY AND PHYSIOLOGY

Axon – The long, thin structure in which

action potentials are generated; the
transmitting part of the neuron. After
initiation, action potentials travel down
axons to cause release of neurotransmitter.

Dendrite – The receiving part of the neuron.

Dendrites receive synaptic inputs from
axons, with the sum total of dendritic inputs
determining whether the neuron will fire an
action potential.
VI. ANATOMY AND PHYSIOLOGY

Spine – The small protrusions found on

dendrites that are, for many synapses, the
postsynaptic contact site.

Action potential – Brief electrical event

typically generated in the axon that signals
the neuron as 'active'. An action potential
travels the length of the axon and causes
release of neurotransmitter into the synapse.
The action potential and consequent
transmitter release allow the neuron to
communicate with other neurons.
VI. ANATOMY AND PHYSIOLOGY
Types of neurons
Sensory neurons
Sensory neurons are the nerve cells that are activated by
sensory input from the environment - for example, when you touch
a hot surface with your fingertips, the sensory neurons will be the
ones firing and sending off signals to the rest of the nervous system
about the information they have received.
VI. ANATOMY AND PHYSIOLOGY
Types of neurons
Motor neurons
Motor neurons of the spinal cord are part of the central
nervous system (CNS) and connect to muscles, glands and organs
throughout the body. These neurons transmit impulses from the
spinal cord to skeletal and smooth muscles (such as those in your
stomach), and so directly control all of our muscle movements.
There are in fact two types of motor neurons: those that travel from
spinal cord to muscle are called lower motor neurons, whereas
those that travel between the brain and spinal cord are called upper
motor neurons.
VI. ANATOMY AND PHYSIOLOGY
Types of neurons
Interneurons
As the name suggests, interneurons are the ones in between -
they connect spinal motor and sensory neurons. As well as
transferring signals between sensory and motor neurons,
interneurons can also communicate with each other, forming
circuits of various complexity. They are multipolar, just like motor
neurons.
VI. ANATOMY AND PHYSIOLOGY
Types of glia
Microglia
Microglia are the brain’s immune cells, serving to
protect it against injury and disease. Microglia identify when
something has gone wrong and initiate a response that removes
the toxic agent and/or clears away the dead cells. Thus microglia
are the brain’s protectors.
Macroglia
Astrocytes
Astrocytes are star-shaped cells that maintain a
neuron’s working environment. They do this by controlling the
levels of neurotransmitter around synapses, controlling the
concentrations of important ions like potassium, and providing
metabolic support.
VI. ANATOMY AND PHYSIOLOGY
Oligodendrocytes
Oligodendrocytes provide support to axons of
neurons in the central nervous system, particularly
those that travel long distances within the brain. They
produce a fatty substance called myelin, which is
wrapped around axons as a layer of insulation. Similar
in function to insulation layers around power cables,
the myelin sheath allows electrical messages to travel
faster, and gives white matter its name—the white is
the myelin wrapped around axons. Multiple sclerosis
is caused by a loss of the myelin sheath around
neurons
VI. ANATOMY AND PHYSIOLOGY
OTHER TYPES OF MACROGLIA
Central Nervous System
Ependymal cells: Ependymal cells line the
spinal cord and ventricles of the brain. They
are involved in creating cerebrospinal fluid
(CSF).
Radial glia: Radial glial cells are progenitor
cells that can generate neurons, astrocytes
and oligodendrocytes.
VI. ANATOMY AND PHYSIOLOGY
Peripheral Nervous System
Schwann cells: Similar to oligodendrocytes
in the central nervous system, Schwann cells
myelinate neurons in the peripheral nervous
system.
Satellite cells: Satellite cells surround
neurons in the sensory, sympathetic and
parasympathetic ganglia and help regulate the
chemical environment. They may contribute
to chronic pain.
Enteric glial cells: Enteric glial cells are
found in the nerves in the digestive system.
VI. ANATOMY AND PHYSIOLOGY

Corpus callosum
The two hemispheres in your brain are connected by a thick
bundle of nerve fibers called the corpus callosum that ensures both
sides of the brain can communicate and send signals to each other.
A combination of sensory, motor and cognitive information is
constantly being transferred between hemispheres via this neural
highway.
VI. ANATOMY AND PHYSIOLOGY
The hindbrain
The hindbrain (developmentally derived from the
rhombencephalon) is one of the three major regions of our
brains, located at the lower back part of the brain. It
includes most of the brainstem and a dense coral-shaped
structure called the cerebellum. The brainstem is one of the
most important parts of the entire central nervous system,
because it connects the brain to the spinal cord and
coordinates many vital functions, such as breathing and
heartbeat.
There are three main parts of the hindbrain - pons,
cerebellum, and medulla oblongata. Most of the 12
cranial nerves are found in the hindbrain.
 VI. ANATOMY AND PHYSIOLOGY

Pons
The pons gets its name from the Latin word for ‘bridge’, and it
connects the rest of the brainstem to the cerebral cortex. Bulbous in
shape, it sits right underneath the midbrain and serves as a coordination
centre for signals and communications that flow between the two brain
hemispheres and the spinal cord.
Four cranial nerves are found in the pons: the abducens nerve helps
coordinate eye movement; the facial nerve coordinates movement and
sensation in the face; the vestibulocochlear nerve processes sounds and
helps us maintain balance; and the trigeminal nerve coordinates chewing
and carries sensory information from the face and the head.
VI. ANATOMY AND PHYSIOLOGY

Cerebellum
Behind the pons and the rest of the brainstem sits a structure
called the cerebellum (Latin for ‘little brain’). In cross-section, this
part looks like a layered, wrinkly coral. Just like the cortex, it has two
hemispheres, with a dense layer of grey matter surrounding an inner
region of white matter. It also contains special neurons called
Purkinje cells, capable of processing many signals at once due to
their highly complex dendrite branches.
VI. ANATOMY AND PHYSIOLOGY

Medulla oblongata
The lower part of both the brainstem and the overall hindbrain is
the medulla oblongata, where the brain transitions to the spinal cord. It
is only about 3cm long, but the medulla is an indispensable nerve tract
which contains the control centres for our autonomic vital functions -
heart rate, blood pressure, breathing - and many involuntary reflexes
such as swallowing and sneezing.
The medulla contains both white and grey matter, and four cranial
nerves stem from this region: the glossopharyngeal nerve coordinates
some taste sensations and mouth movements; the vagus nerve controls
mouth movements, voice and the gag reflex; the accessory nerve
coordinates head and neck movements; and the hypoglossal nerve
controls tongue movements and muscles involved in our speech.
VI. ANATOMY AND PHYSIOLOGY
The midbrain
Located towards the base of your brain is a small but important
region called the midbrain (derived from the developmental
mesencephalon), which serves as a vital connection point between the
other major regions of the brain - the forebrain and the hindbrain.
The midbrain is the topmost part of the brainstem, the
connection central between the brain and the spinal cord. There are
three main parts of the midbrain - the colliculi, the tegmentum, and
the cerebral peduncles. Of the 12 cranial nerves, two thread directly
from the midbrain - the oculomotor and trochlear nerves,
responsible for eye and eyelid movement.
VI. ANATOMY AND PHYSIOLOGY

Colliculi
At the top of the midbrain are the colliculi, which derives its
name from the Latin word for ‘hill. It contains two pairs of bulging,
layered bundles of neurons called the superior and inferior colliculi.
The superior ones work on preliminary processing of visual signals
before they are passed on to the occipital lobe at the back of the head.
The inferior ones do work on auditory signals before those are passed
through the thalamus to the main auditory processing centre in the
cortex.
VI. ANATOMY AND PHYSIOLOGY

Tegmentum
The tegmentum (Latin for ‘hood’) actually stretches down the
length of the brainstem, but a portion of it forms a part of the
midbrain. It contains two areas named after specific colours: the
iron-rich red nucleus (which actually looks pink) is involved in the
coordination of movements; the periaqueductal grey is a dense
region of grey matter and is involved in suppressing pain. The
tegmentum in the midbrain also contains connections that play a
role in keeping us alert.
VI. ANATOMY AND PHYSIOLOGY

Cerebral peduncles
The back of the midbrain contains a pair of large nerve fibre bundles that
connect the rest of the brainstem to the forebrain. These cerebral peduncles are the
main highway for signals that need to be transported from the cortex to other parts of
the central nervous system (CNS), and are especially important for body coordination.

Cranial Nerves
The cranial nerves are a set of 12 paired nerves in the back of your brain. Cranial
nerves send electrical signals between your brain, face, neck and torso. Your cranial
nerves help you taste, smell, hear and feel sensations. They also help you make facial
expressions, blink your eyes and move your tongue.
A number of cranial nerves send electrical signals between your brain and
different parts of your neck, head and torso. These signals help you smell, taste, hear
and move your facial muscles.
VI. ANATOMY AND PHYSIOLOGY

What are the types of cranial nerves?

• Your 12 cranial nerves each have a specific function. Experts categorize
the cranial nerves based on number and function:
Olfactory nerve: Sense of smell.
Optic nerve: Ability to see.
Oculomotor nerve: Ability to move and blink your eyes.
Trochlear nerve: Ability to move your eyes up and down or back and forth.
Trigeminal nerve: Sensations in your face and cheeks, taste and jaw
movements.
Abducens nerve: Ability to move your eyes.
VI. ANATOMY AND PHYSIOLOGY

Facial nerve: Facial expressions and sense of taste.

Auditory/vestibular nerve: Sense of hearing and balance.
Glossopharyngeal nerve: Ability to taste and swallow.
Vagus nerve: Digestion and heart rate.
Accessory nerve (or spinal accessory nerve): Shoulder and neck
muscle movement.
Hypoglossal nerve: Ability to move your tongue.
VII. PATHOPHYSIOLOGY