PHYSIOLOGY || HIGHER CENTERS || DR. BARBON & DR.

VILA

HIGHER CENTERS
-Higher centers are the neural REVIEW (DR. VILA LECCTURE)
centers present in the CNS (brain Neurons are classified as:
and spinal cord) that regulates/ Based on the number of processes:
controls the activity of the organ systems in the
▪ Unipolar
body
▪ Pseudounipolar
- Example: Respiratory Center – Located in the
▪ Bipolar
dorsal respiratory group of neurons in the medulla.
▪ Multipolar
Lower Center – Sources of Cranial Nerves and Based on length:
Spinal Nerves – Where CN & SP enters and exits. ▪ Golgi Type 1
▪ Golgi Type 2
Sensory Neuron – conduct impulses towards the Based on function:
center so it will form synapse ▪ Sensory
CENTRAL NERVOUS SYSTEM ▪ Motor
▪ Mixed/Both (Sensory & Motor) -
- Main function is to process and receive SSMMBMSBBMM
information from the internal or external
environment of the body for us to produce an
appropriate mental and motor response. PNS FURTHER DIVIDED INTO
Divided into: Brain and Spinal Cord Cranial Nerves & Spinal Nerves – in anatomy
▪
▪ Somatic Nervous System & Autonomic
IT IS DIVIDED INTO 2: CNS & PNS Nervous System – in physiology
CNS FURTHER DIVIDED INTO
▪ Remember 1st sem, In Skeletal
▪ Brain & Spinal Cord – in anatomy Muscle (Somatic Nervous
▪ Higher Center & Lower Center – in physiology System). In ANS, effectors would
1. Higher Center – Brain (in general) still be muscle but this time,
2. Lower Center – Brain Stem & Spinal they are smooth muscle and
Cord cardiac muscle.
▪ Glands secrete secretions thru
Why is it in lower center it is Brain Stem & Spinal Cord? the contractions of
Spinal Nerves based on function is classified as: myoepithelial cells
▪ Mixed (both motor and sensory) because based on
Bell Magendie Law it states that you divide the THE BRAIN IS DIVIDED INTO:
spinal cord into posterior (sensory) and anterior 1. Cortical level - The cortex
(motor) 2. Subcortical level - Includes the brain stem
▪ In Dorsal Root Ganglion, it is ganglion because it A. SPINAL CORD
is a collection of nerve cell body outside central
▪ We often think of the spinal cord as being only a
nervous system conduit for signals from the periphery of the body to
▪ Parts of Neuron: 1) Soma/Perikaryon/Cell Body the brain, or in the opposite direction from the brain
where Dentrites and Axons emerged back to the body. This is far from the truth. Even after
▪ Inside the central nervous system, it is called the spinal cord has been cut in the high neck region,
nucleus many highly organized spinal cord functions still occur.
For instance, neuronal circuits in the cord can cause:
DR. VILA LECTURE 1. Walking movements,
In neurology, NEVER EVER interchange the word posterior 2. Reflexes that withdraw portions of the body
and dorsal, anterior and ventral from painful objects,
o Ventral is further divided into: 3. Reflexes that stiffen the legs to support the
▪ Ventro-Anterior – for motor body against gravity,
▪ Ventro-Posterior – for sensory 4. Reflexes that control local blood vessels,
a) Ventro-Postero Medial gastrointestinal movements, or urinary
b) Ventrol-Postero Lateral excretion.
▪ Ventro-Lateral – for motor ▪ In fact, the upper levels of the nervous system often
o Antero-Ventral – Limbic System operate not by sending signals directly to the periphery
o Ventro-Anterior Nucleus is damaged of the body but by sending signals to the control
▪ Manifestation of the patient: centers of the cord, simply "commanding" the cord
• Motor is damage therefore centers to perform their functions.
paralysis (‘di makagalaw) ▪ Gray Mater of the Spinal Cord contains Axons which
are unmyelinated
▪ White Mater of the Spinal Cord is called white
because it reflects light. It contains neurons which
are myelinated

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PHYSIOLOGY || HIGHER CENTERS || DR. BARBON & DR. VILA

SUBDIVIDED

5 LEVELS OF THE SPINAL CORD

▪ Supplies most of the upper extremities

SPINAL CORD SECTION
and cephalic region
▪ 7 Spinal Cord SEGMENTS
▪ 8 Spinal NERVES (C1-C8)
CERVICAL
▪ C3 has a component to innervate your
diaphragm (Respiration)
▪ Controls tissues or parts of body
▪ Muscles of the upper extremities

▪ 12 spinal nerves (T1-T12)

THORACI ▪ Innervates the chest and abdomen
▪ Chest area
C Thoracic neurons in spinal cord
▪ BELL MAGENDIE LAW
control also abdominal muscles

▪ 5 spinal nerves (L1-L5)

▪ Innervates the lower extremities
LUMBAR ▪ Lower extremities (and pelvic region
but mostly controls the lower
extremities

▪ 5 spinal nerves - Magendie Law did not give name to lateral side
▪ For the bowel, bladder and sexual - Has nothing to do with lateral trunk, but the
SACRAL function lateral part works for autonomics.
▪ Controls the pelvic region ▪ Autonomic neurons in spinal cord arises
from the lateral portion of spinal cord
▪ Sometimes there is one spinal nerve - Thoracolumbar – sympathetic
COCCYX from coccyx. - Sacral – parasympathetic
▪ No functions at all
POSTERIOR HORN OF THE SPINAL CARD /
DORSAL HORN OF THE SPINAL CORD
Important here are the ones with important - Sensory in function
functions: - Afferent Signals
- Example: Dorsal Root Ganglion, Dorsal Horn
LEVEL OF PRINCIPAL DERMATOMES - Destruction ! Anasthesia (without sensation)
ANTERIOR HORN OF THE SPINAL CORD /
VENTRAL HORN OF THE SPINAL CORD
- Motor in function
- Efferent Signals
- Destruction ! Paralysis

Ventral Anterior Part of the CNS

- It’s not redundant
- Can happen

REXED LAMINAE
SENSORY LAMINAE
LAMINA I - VI Located Dorsal / Posteriorly
Dorsal Horn / Posterior Horn

BOTH SENSORY AND MOTOR (BUT

MORE ON MOTOR)
LAMINA VII Lateral Horn /
▪ Each spinal nerve has a corresponding specific level of Intermedio Lateral Column (not
the skin horn)
▪ Memorize this so you will know the specific level of
the horn which is affected if there is an absence of
sensation in one particular area
▪ Example: You can’t feel the touch sensation applied
to the perineum The affected level is S2-S4
o This abnormality is associated with difficulty

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PHYSIOLOGY || HIGHER CENTERS || DR. BARBON & DR. VILA

MOTOR LAMINAE
Located Vental / Anteriorly Complete Injury in the spinal cord (anterior, dorsal,
Ventral Horn / Anterior Horn ventral)
When damaged ! "
Phlegia (Paralysis) SPINAL SHOCK
LAMINA VIII - IX - Problem with motor, sensory, and autonomics
▪ Hemi-Phlegia (half
paralysis)
▪ Para-Phlegia (both lower So when cervical gets destroyed (injured)
extremities)
"
Paresis (Weakness)
Throcacic, Lumbar, Sacral is affected
Surrounds the central canal
LAMINA X No known function Injury to upper part of cervical neurons (C1,C2,C3)
"
T1 – L2 – has lateral horn Death

SPINAL CORD FUNCTIONS

- Center for reflex actions
- Reflex activity whether motor or sensory because Injury to the lower cervical
SC has motor and sensory part. "
- Autonomic is also included (lateral part) Still alive but comatose
- Ventral Horn is continuously active sending impulses Diaphragm is still working because the phrenic nerve
to the muscles specially when we’re awake arises from the upper cervical therefore still breathing
- Thoracolumbar region for sympathetic
- Sacral region for parasympathetic
- Somatic (sensory) and automatic afferent pathways BRAIN
- Somatic (motor) and automatic efferent pathways
Provides communicating branches for the automatic 5 MAJOR REGIONS
nervous system
MEDULLA OBLANGATA
-
Center for micturition and defecation
Exerts tonic influence on muscles
MYELENCEPHALO
FROM
Muscles always contracted especially when N RHOMBENCEPHALON
we’re awake (ventral horn) is the muscles
involving in maintaining posture PONS & CEREBELLUM
- Involve in the execution of motor commands METENCEPHALO
Only at execution because on the FROM
production of motor commands (or paggawa N RHOMBENCEPHALON
ng utos) happened at higher part of the
spinal cord, at the cerebral cortex. MIDBRAIN
Motor commands came from the cerebral MESENCEPHALON
cortex FROM MESENCEPHALON
Execution. You will perform the command;
we need the spinal cord that’s why we have THALAMUS,
the cortico-spinal tract so that impulses SUBTHALAMUS,
from the cortex are then transmitted down HYPOTHALAMUS,
to the muscle using the spinal cord (that’s
DIENCEPHALON EPITHALAMUS
why spinal cord is responsible for the
EXECUTION). FROM PROSENCEPHALON
Brain stem can also interfere with the
muscles in the body, the cortico-bulbar CEREBRAL CORTEX
tract. (CEREBRUM) &
Cortico-bulbar tract is responsible for TELENCEPHALON BASAL GANGLIA
muscles in the head area and neck. FROM PROSENCEPHALON
But below the neck is the spinal cord, the
cortico-spinal tract ** The brain has five major regions which come from the 3
subdivisions of rostral portion of the neural tube
EXAMPLES FROM DR. BARBON’S LECTURE
(Procencephalon, Mesencephalon and Rhombencephalon)
SO WHEN SPINAL CORD GETS INJURED (OR DESTROYED)
- Problem can be seen below the level of injury MAJOR PARTS OF THE CEREBRAL CORTEX (part of
brain):
Example is ventral horn (motor) gets injured 1. Frontal
" 2. Temporal
Patient will complain paresis (muscle weakness) or 3. Parietal
paralysis 4. Occiptal

But when the dorsal (sensory) gets injured

" 1. MYELENCEPHALON
Problem arises with sensation

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PHYSIOLOGY || HIGHER CENTERS || DR. BARBON & DR. VILA

MEDULLA OBLANGATA
- When it exists the foramen magnum, it becomes
the spinal cord
- The structure of the lower medulla oblangta is
almost the same structure with the spinal cord
- If you have Fasciculus Gracilis & Fasciculus
Cuneatus in lower medulla oblongata, you also
have it the spinal cord.
- They are collectively called the Dorsal Column
Pathway in the level of the spinal cord.
- But when it decussates in the lower level of
medulla oblongata, it is now called Medial
Lemniscus Pathway
- Control visceral functions PRIMARILY
1. Cardio Vascular System
2. Respiratory
3. Digestive

VASOMOTOR CENTER
BARORECEPTORS 2. METENCEPHALON
- Control activity of vascular system & the heart PONS & CEREBELLUM
(aortic and carotid sinus) ▪ Respiratory and urinary bladder control
Maintains BP, concentrated mostly on major ▪ Will also help in respiratory activity and
vessels (aorta and carotid arteries) urinary bladder
Carotid & Aortic Sinuses ▪ Vestibular control eye movement
PONS
▪ Interferes with the spinal cord for continuous
CHEMORECEPTORS influence on the muscles involving in
- Control activity of respiratory system (Aortic maintaining posture especially when you’re
and carotid bodies) awake.
Carotid & Aortic Bodies ▪ CNs associated with the pons are
- The respiratory control is present mostly in the - V, VI, VII and part of VIII (5-6-7-part of
dorsal region 8)
▪ For the respiratory activity (but primarily in
AUDITORY / VESTIBULAR INPUTS medulla oblongata)
- Cranial nerves mostly associated with the medulla 1. Pneumotaxic Center
are 2. Apneustic Center
▪ VIII, IX, X, XI, XII and a part of V
▪ 8-9-10-11-12- and part of 5
BRAINSTEM REFLEXES ▪ For the urinary bladder control
- Brainstem is involved in maintain posture ▪ For vestibular control
especially the midbrain and pons ▪ Cranial nerve V is the main associated CN
o The biggest cranial nerves that arises from the
GUSTATORY pons
- Gastrointestinal Tract, for taste o The reflex associated are
- CN VII for anterior 2/3 of the tongue taste buds mostly innervated by CN V
and ▪ Jaw jerk reflex
- CN IX for posterior 1/3 of the tongue taste buds ▪ Corneal reflex (sensory nerve is V1
- CN X for pharynx and motor nerve is VII for orbicularis
oculi)
GAG REFLEX, COUGH REFLEX, VOMITING REFLEX ▪ Tearing , sneezing, sucking and
- Respiratory activity sensation of the face
CN IX and X ▪ Involved in motor control of the face (facial
expression)
CRANIAL CN VII
NAME FUNCTION
NERVE
▪ Damage to pons can cause SLOWER inspiratory
VIII Vestibulocochle Auditory/ activity.
ar Vestibular CEREBELLUM / HINDBRAIN
Motor memory is located here that’s why when
IX Glossopharynge Cardiovascular you have Alzheimer ’s disease, you still know how
al to drive but the problem is how will you go back.
You still know how to write but the problem is
X Vagus Cardiovascular
that you don’t know what to write
XI Spinal Accessory Respiratory ▪ Maintains balance in general (in writing
generally)
XII Hypoglossal Respiratory ▪ Mostly concerned with motor coordination
especially rapid movement.
▪ Allows the body to perform a smooth, well-
coordinated and timed movement
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PHYSIOLOGY || HIGHER CENTERS || DR. BARBON & DR. VILA
▪ Feed Forward Regulation
- The cerebellum anticipates your
movement.
- Before you perform the movement,
impulses are already being created in the
cerebellar area preparing your body for
the said activity.
- You see activity in the cerebellum before
you observe the movement, mostly rapid
movements, allowing your body to
maintain balance even if you do fast
motor activity.
- Feed-forward regulation of motor activity
(motor coordination, motor learning and
equilibrium) involves activity of CN VIII
▪ Utilized for optimization and correction of
postural function (tone, posture and balance)
▪ The cerebellum also controls the coordination
and timing of the muscles for speech
▪ Injured cerebellum ! a person is unable to
perform
▪ rapid motor activities
▪ Dysdiadochokinesia (DDK)
o Unable to perform rapid alternating
movements
o With normal or un-injured cerebellum
close
opening of hands is easy to perform but
with
injured cerebellum, it‟s difficult
To test for normal cerebellar function is
▪
“Finger-Nose
Test” rapidly performed (fast motor activity)
▪
3. MESENCEPHALON
MIDBRAIN
- Cranial nerves associated with the midbrain are CN
III and IV
- Other nerves that can be involved in extraoccular
muscles is CN VI which is the abducens nerve.
▪ CN IV is sometimes known as the stupid
nerve because it comes from the back
then goes ventrally.
▪ If the midbrain is destroyed, the
functional activity of the lower part of
the brainstem is affected causing
decerebrate rigidity.
- Concerned with RIGHTING REFLEXES/
CORRECTING REFLEXES
▪ Most important on maintaining correct
posture
▪ Are reflexes concerned with positioning
the body and the eyes in reference to the
environment
▪ If someone pushes you and na-out of
balance ka, your body will perform
certain movements to maintain certain
position (example are extending the arm
or extremities)
▪ Also pag pinagalaw yung ulo, you bring it
back to an upright position (yung correct
position nya) yung gusto mo parati tama
and posisyon ng katawan especially the
head.
- Involved in acoustic relay and vestibular
apparatus
▪ Utricle, saccule, and semicircular canals
also help determine body position
- Involved in control of eye movement
▪ Pupillary reflex (direct and consensual
reflexes) by flashing a light sensory is
CN II and motor is CN III that will produce
a pupillary constriction
▪ Lens reflex (accommodation and
convergence reflex) the pupil will
constrict, the eye will converge and at
the same time the lens will thicken to
focus on an object approaching the
eyeball (CN III)
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PHYSIOLOGY || HIGHER CENTERS || DR. BARBON & DR. VILA
REVIEW:
HYPOTHALAMUS
CN which has no nucleus is CN I & II because it is
cortical.
CN X (Vagus Nerve), ang pinaka-pakilamerang
o From the word “vagral” (pagala-gala)
4. DIENCEPHALON
THALAMUS
▪Sensory and motor relay to the cerebral cortex,
visual inputs (CN II)
▪ Are of higher center responsible for
maintenance of consciousness
▪ Seat of consciousness
▪ Considered as the main sensory and motor relay
station of the brain
o All impulses will go to the thalamus
before ascending into the cortex
o All impulses from the motor cortex will go
to the thalamus before it descends to the
brainstem and spinal cord
EPITHALAMUS
▪ Generally made up of pineal gland
▪ Concern with sleep-wake cycle
▪ Responsible for Biologic Rhythm
SUBTHALAMUS
▪ Helps regulate motor activity of the basal
ganglia
▪ Releases glutamate
▪ Injury to the sub-thalamic nuclei will produce the
condition known as Contralateral Hemiballismus
(Ballism) – Sudden wild flinging movement of the
extremities contralateral to the side of the lesion
THALAMIC NUCLEI
HEAD GANGLION OF THE AUTONOMIC NERVOUS
SYSTEM
Has a lot work because endocrine glands can
affect almost all parts of the body
▪ Mainly responsible for Autonomic and Endocrine
control
o No control to the activities of skeletal
muscles
o Other tissues of the body are affected
especially those that are controlled by
the ANS and those involved in the
endocrine system
▪ More important between the two is hypothalamus
because thalamus functions only as a relay
station – responsible for distributing the different
impulses created in the CNS. So if you have a
problem with thalamus, you will have problem
with all (motor, sensory) since you are a relay
station.
▪ It is the head ganglion of the ANS
o Destruction of hypothalamus can cause
disturbance to the ANS
▪ Internal body functions regulated by the
hypothalamus:
o Cardiovascular, Respiratory, Body water
and electrolyte balance, Anterior
hypothalamus, Osmoreceptors – detects
fluid osmolality, Thirst centers – also
affected by the osmoreceptors,
Gastrointestinal secretory activities,
Endocrine and autonomic functions
▪ It has an area for reproduction, emotions, fear
and rage
o This is because the hypothalamus is part
of the limbic system
▪ For Thermoregulation
HYPOTHALAMIC NUCLEI
- The HIGHEST CENTER
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PHYSIOLOGY || HIGHER CENTERS || DR. BARBON & DR. VILA

PARAVENTRICULAR & SUPRAOPTIC

▪ ADH - produced mostly by paraventricular
▪ OXY - produced mostly by supraoptic
LATERAL REGION, DORSAL & VENTROMEDIAL NUCLEI
▪ Regulate Food intake
▪ Control of aggression
o Kaya pag wala
PRE-OPTIC; ANTERIOR & POSTERIOR
HYPOTHALAMUS
▪ Regulation of body temperature
▪ Thermoregulation
▪ Kaya pag nasira ‘to, you don’t have the
ability to
maintain normal body temperature and the
body
will become dependent on the temperature
of the
environment
POSTERIOR HYPOTHALAMUS
▪ Sleep/wake cycle & consciousness
SUPRACHIASMATIC NERVE
▪ Circadian rhythms, the biological clock of the
body
MAMMILLARY BODY
▪ Short-term memory (located in
hypothalamus)
▪ Hippocampal region is for long-term memory
▪ together with temporal lobe
ARCUATE NERVE
▪ Source of releasing hormones
ZEITGEBERS
Resetting of the sleep-wake cycle
Because Light
Common to call center agents that’s why they’re
office is too bright to keep them awake
Sleep wake cycle can be change. Some people can
stay awake at night and sleeps in the morning, it’s
called “ZEITGEBER” Sleep Cycle common to call
center agents.
Major factor involved is the presence of light.

5. TELENCEPHALON
BASAL GANGLIA / BASAL NUCLEI Caudate and Putamen is the striatum that usually
▪ MOTOR (FEEDBACK REGULATION) – corrects and communicates with substancia nigra, Antigro-Striatal
evaluates movement as they happen. Tract
o Cerebellum is Feedforward Regulation Lentiform is putamen and globus pallidus
▪ You prepare the body for the
activity
o In Telencephalon is Feedback
Regulation
▪ During or when they are actually
doing the movement.
▪ Very important in the initiation of movement and
support of on-going motor activity.
▪ Involve in thalamocortical motor inhibition

Amydaloid Nuclear Complex (Amydala) is not

part of basal ganglia but by Limbic System

CEREBRAL CORTEX
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PHYSIOLOGY || HIGHER CENTERS || DR. BARBON & DR. VILA

- Responsible for a much higher function like: LONG TERM POTENTIATION

1. Sensory perception You always move and do that certain activity
2. Cognition therefore it enhances the actvitiy of the body
3. Memory and learning Activity of neurons in the cortex is modified by the
4. Language actvity of the person kaya kung right handed ka
5. Behavior and Emotions
ano mas active? – Left, why? Because fibers cross.
6. Motor planning and voluntary movements
- The only cranial nerve involved in the cortex is CN Kaya nag iimprove ang activity ng right hand mo,
I (olfactory nerve) activity of left cortex.
AMBIDEXTROUS – people who can equally use both
4 LOBES FROM FRONTAL – OCCIPTAL / PARTS the
right and the left hands

MOTOR HOMONCULUS
1. FRONTAL LOBE - Representation of the parts of the body stimulated
Main function is for motor planning and execution by the primary motor cortex (Pre-central gyrus)
▪
of motor commands - Movements are elicited with the least amount of
▪ Separated to the parietal lobe by the Central electrical stimulation to these areas
Sulcus (of Rolando) - The distortion of the various body parts in the
▪ Separated from the temporal lobe by the Lateral homunculus indicates approximately how much of
Fissure (Sylvian Fissure) the cortex is devoted to their motor control.
▪ Divides parietal from occipital is Parieto-Occipiral - The face and fingers has a greater
Sulcus on lateral side, fissure on medial side representation with the lower extremities
- If stroke affects BA 4, manifestations that you can
easily see with the patients are in the face and
fingers
- The larger the representation in the homunculus,
accurate movement is produced (Example is
dexterity of the hand)

BROCA’S APHASIA
Example: “I-go-market-buy-food”
Conjuctions, prepositions are gone
o Milder form
Neologism / New form words – moderate to severe
form
o Common in children who are still learning
to talk because their Broca’s Area are not
fully developed
o Nervous System will develop until 9 yearss
old
WERNICKE’S AREA
Sensory speech area
Responsible for undestanding spoken language
WERNICKE’S APHASIA
o Inability to understand spoken language
Example: When you ask the patient what is your
name then they response with “I go to the market”
You heard (no deafness) but can’t understand –
“Parang ngayon, naririnig nyo ko pero di ‘nyo
ko naiintindihan” –Dr. Vila XD
Umaattend kang lecture pero di mo naman
naiitndihan ang lecture –Wernicke’s Aphasia

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PHYSIOLOGY || HIGHER CENTERS || DR. BARBON & DR. VILA

AGRAPHIA, ALEXIA
(ANGULAR GYRUS & SUPRAMARGINAL GYRUS)
Inability to understand written language
Nagbasa ka, wala ka naman naintidhan
AGRAPHIA
o Inability to write even without defect in
motor
ALEXIA
o Can read but can’t understand (feel ko
meron ako neto lalo na sa gross hahaha)

GLOBAL APAHSIA
Damaged Broca’s Area, Wernicke’s Area

SUPERIOR LONGITUDINAL FASCICULUS & ARCUATE

FASCICULUS
Connects Broca’s Area to Wernicke’s Area
Damaged to this ! CONDUCTION APHASIA
o You ask what is the name ! he wants to
answer because his wernicke’s area
understand ! he wants to answer ! but
2. PARIETAL LOBE the connection between wernicke’s and
▪ Largest white commissure – corpus callosum that broca’s is damaged therefore wernicke’s
will connect left and right area can’t transmit impulse/answer to
▪ Generally , it is somato-sensory in function broca’s area. You will try to correct your
▪ For perception and interpretation of sensory wrong answer repeatedly ! ecolalia
impulses
▪ It has the Primary Somatosensory Area (BA 3,1,
2)

SENSORY HOMONCULUS
- The sensory homunculus is an expression of place
coding of somatosensory information (post-central
gyrus BA 3,1,2)
- The map is distorted because the volume of neural
tissue devoted to a body region is proportional to
the density of its innervations
- You have greater sensation or more localization on
the lips compared to the back. As well as in your
tongue and face compared to the body.

DORSAL COLUMN
For fine-touch and fine-pressure sensation,
proprioception, vibratory sensation
SPINOTHALAMIC
For crude touch, crude pressure, thermal, pain,
and sexual sensations
GUSTATORY AREA
Mostly cranial nerves
Chorda Tymphani
Facial nerve
Glossopharyngeal Nerve
Vagus Nerve
SENSE OF TASTE
Same side analysis (IPSILATERAL)
Uncrossed pathway
Pag nasira mo ang gustatory cortex on the right
side ! problem is also on the right side of the
tongue
MOTOR AND SOMATIC SENSORY
Kabilaan
Problem on right side ! manifestation will be
seen on
the left

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PHYSIOLOGY || HIGHER CENTERS || DR. BARBON & DR. VILA

▪ Different events happened in life.

▪ Example is when you graduated summa cum laude
SEMANTIC MEMORY
▪ Notes that you remember.
▪ Example is the national anthem

4. OCCIPITAL LOBE
▪ For visual processing and perception

INJURY TO PRIMARY VISUAL CORTEX – BA 17

▪ Central blindness
▪ The blindness is not whole, but divided (hati-hati)
termed hemianopsia.
INJURY TO VISUAL ASSOCIATION AREA – BA 18 & 19
▪ Normal visual field but you can’t recognize what
VESTIBULAR SENSE you see.
▪ Vestibular areas ▪ No complete analysis of visual impulses
▪ At the boundaries of somatosensory cortex – BA 2 VISUAL AGNOSIA
and 3
▪ Is due to the destruction of association areas
▪ Part of BA 7 because you can’t complete analysis of impulses
transmitted or received by the primary centers.
▪ Blindness to all not just by not recognizing the
face but even object you can‟t recognize

PROSOPAGNOSIA
- Inability to recognize faces, seen in injuries
affecting the inferior occipital region, anterior
temporal area and fusiform gyrus.
- Face blindness

OTHER ASSOCIATION AREAS

- Conglomerate the inputs of cortex and association
3. TEMPORAL LOBE areas to produce better association with the stimulus.
- The role of association areas that are not adjacent to
the area: They allow intercommunication between
the different primary centers.
- Activities of visual, somatic, auditory centers are
transmitted to such association areas (non-adjacent)
creating a communication between the different
centers eventually they create impulses that are
transmitted towards the frontal lobe; which is why
every time there is somatic sensation there is motor
activity.

Primary Gustatory Area – BA 43 - Every time you activate the posterior parietal
Primary Olfactory – BA 34 association cortex the impulse will go to the frontal
MEDIAL TEMPORAL LOBE area.
Vital for declarative or long term memory - Every time there is sensation = There is Motor
-
Episodic and semantic memory Response.
-
It has connections to the limbic system, which - The response is always appropriate or correct to what
-
participates in emotional behavior and regulates ANS is affecting your body

POSTERIOR PARIETAL ASSOCIATION AREAS

▪ OCCIPITO-PARIETAL-TEMPORAL AREAS
- Spatial coordination of body parts and
surroundings
o This area dictates where is left side,
right side, where is the hand or foot
- Language comprehension (Wernicke’s area)
EPISODIC MEMORY
- Processing of visual language (reading)
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PHYSIOLOGY || HIGHER CENTERS || DR. BARBON & DR. VILA

- Naming of persons/ objects

- Other neurons closed to the primary centers
that is present in the occipital, parietal and
temporal areas.

PRE-FRONTAL ASSOCIATION AREAS

▪ Plan complex patterns and sequence of
movements
▪ Prognostication
▪ Planning for the future
▪ Correlation
▪ Conscience
▪ Do activities in accord with existing moral laws
▪ Calculation / Solve complicated mathematical, o This is why before an emotion comes out,
legal, or philosophical problems
you should think about the response that
▪ Decision making to do the best course of action you will give.
in response to a sensation ▪ If there is damage in the limbic system
▪ Injury leads to DYSEXECUTIVE SYNDROME o No emotion; poker face, seen in old
▪ Primary Centers – IDIOTYPIC AREAS people with Alzheimer’s Disease and
▪ Association areas – HOMOTYPIC AREAS Senile dementia (Same sila ng
▪ Injuries AGNOSIA manifestations: Inability to remember
recent activities and lack of emotions,
only long term memories remain.
Nagkaka difference lang sila sa vascular
injury.)
LEFT PRE-FRONTAL AREA
Responsible for intelligence , calculation and
rationalization
Smart patient
RIGHT PRE-FRONTAL AREA
Artistic ALZHEIMER’S DISEASE
Designer
▪ Progressive loss of short-term (episodic) memories
Geometric
followed by general loss of cognitive function
Good in arts, angle
death
Intuition (kutob)
▪ Atrophy of the hippocampus and entorhinal cortex
▪ Loss of cholinergic and other neurons in the
cerebral cortex, and severe loss of cholinergic
neurons in the nucleus basalis of Meynert (basal
forebrain)
5. LIMBIC SYSTEM ▪ Cytopathologic hallmarks is the presence of
▪ The allocortex and juxtallocortex intracellular neurofibrillary tangles of the
▪ Includes the cingulate and parahippocampal gyri, hyperphosphorylated tau protein that normally
amygdala and hippocampal formation binds to microtubules and extracellular senile
▪ Has major connections to the olfactory tract plaques which have a core of beta amyloid
▪ Cognitive Mapping peptides (A beta) surrounded by altered nerve
▪ Along with the hypothalamus (PAPEZ CIRCUIT) fibers and reactive glial cells.
concerned with sexual behavior, emotions (rage/ ▪ Present in:
fear and satisfaction) and motivation o 17% of the population ages 65-69
▪ For emotions and Memory o 40-50% in ages 95 and above
▪ Limbic System includes the:
1. Amygdala ▪ Similar problem in elderly is called SENILE
2. Hippocampus DEMENTIA OF THE ALZHEIMER TYPE which is
3. Parahippocampus always associated with vascular disorders
4. Cingulate gyrus
▪ There is also connection that is concerned for
sexual behavior and moderation
▪ Prolong after discharge is common after
stimulation of the limbic system LIMBIC SYSTEM IS DIVIDED INTO 2 MAJOR SET:
▪ The response of the limbic system can’t be
turned off at will. REWARDS CENTERS
o If it is stimulated, response will be there ▪ Located along the course of the medial forebrain
for a long time (ventral tegmental area) and nucleus accumbens:
o Activities involving the hypothalamus and - Lateral nucleus of the hypothalamus
limbic function are not easily turned off - Ventromedial nucleus of the
at will hypothalamus
▪ If nagawa mo na wala nang ▪ Septum
balikan ▪ Some areas in the amygdala
▪ Thalamus
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▪ Basal ganglia ▪ Bulk of the neocortex is interconnected through

▪ Basal tegmentum of the mesencephalon
▪ STRONG STIMULATION OF THE REWARD CENTERS
TAMENESS/ PLEASURABLE SENSATIONS
▪ Activated by agents like amphetamine, alcohol,
nicoptine, morphine, heroin and cocaine
increases dopamine acting on D3 receptors
ADDICTION
▪ Long term intake of these agents leads to
TOLERANCE, need to increase amount of agents
taken.
the corpus callosum
▪ Linked by Corpus callosum and commissural
fibers
▪ Activities in the two hemispheres are coordinated
by interconnections through the cerebral
commisures.
CEREBRAL DOMINANCE
- Appears at around 5-7 years old
- The hemisphere could either be representational
(non-dominant hemisphere) and categorical
(dominant hemisphere)
- In some people, the dominant hemisphere is for
complex activities (matalino) and the non-
dominant is for the artistic side

PUNISHMENT CENTERS
▪ Central gray area around the aqueduct of Sylvius
(mesencephalon) extending upward into the
periventricular zones of hypothalamus and
thalamus
▪ Some areas in the amygdala
▪ Hippocampus (also involved in learning)
▪ STRONG STIMULATION OF THE PUNISHMENT
CENTERS RAGE REACTION
▪ Activated by agents that block pos-synaptic D3
dopaminergic receptors
▪ Activations of the rostral areas (midline
pre=optic areas) FEAR AND ANXIETY
▪ Destruction of the areas loss of fear, tame
forgetful, extreme curiosity, excessive sex
drives
▪ Seen in bitemporal lobectomies with removal of
some limbic structures (amygdala)

KLÜVER-BUCY SYNDROME
▪ Secondary to the destruction of amygdala
▪ They have excessive sex drive, aggressive and
they have loss of fear
▪ The patient can’t control the emotion
▪ Seen in bilateral temporal lobotomies with
removal amygdala

CEREBRAL HEMISPHERES
▪ Activities in the two hemispheres are
coordinated by interconnections through the
cerebral commisures.
▪ Activity of the right is shared with the left

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BROCA’S AREA 44 and 45

▪ Essential for vocalization
▪ Fluency and vocalization
ARCUATE FASCICULUS (PARIENTAL OPERCULUM)
▪ Connects the Wernicke’s to Broca’s area
ANGULAR GYRUS (BA 39)
▪ Processes information from words that are
read

APHASIA
WERNICKE’S AREA INJURY
▪ FLUENT APHASIA
o Receptive Aphasia / Posterior Aphasia /
Sensory Aphasia
o Senseless answers to Q
o Fluent means you can understand the
word but you don’t know what the word
LOOK AT THE SCREEN AND SAY THE COLOR NOT THE she said
WORD o Example: “sheir” (chair) !
“YELLOW BLUE ORANGE” youunderstand it.

LEFT – RIGHT CONFLICT BROCA’S AREA INJURY

Look at the screen and say the color not the word ▪ NON-FLUENT APHASIA
o Expressive aphasia, motor/ anterior
aphasia)
o You cannot understand it

ARCUATE FASCICULUS INJURY

▪ Anomic aphasia, alexia, agraphia, acalcula
▪ ALEXIA – You cannot understand what you read
▪ DYSLEXIC – You can have understanding on what
you read, problem is analysing
▪ AGRAPHIA – Person cannot copy
▪ ACALCULA – Cannot calculate

MASSIVE CEREBROCORTICAL INJURIES

Ang malakas gumana sa katawan ng tao ay ang ▪ GLOBAL APHASIA
Dominant Hemisphere, e ang dominant gusto
magbasa.
The right brain tries to name the color

HEMISPHERIC DOMINANCE – HANDEDNESS

CORTICAL AREAS – LANGUAGE

WERNICKE’S AREA (NEAR BA 22)
▪ Comprehension of auditory and visual
informations
▪ A child born deaf cannot speak because she will
not hear any words to learn therefore ! mute
▪ But if born normal, heard words then eventually
becomes deaf ! can speak because born with
normal hearing
▪ Kaya nga diba bawal mag salita ng masama sa
bata, kasi gagayahin nya ‘yun

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THEORY OF LAMARCK
▪ If you are always using a body part, the
presentation of that body part in the
homunculus also increases undergoes
development
▪ So for right handed person, there are more
representation on the right arm located on the left
cortex
▪ If you don’t part in the homunculus decreases
▪ Neurons can undergo PLASTICITY – change in
function if a certain problem arises, especially
when receptors are destroyed that send impulses
to the higher center

CEREBRAL CIRCULATION
▪ Common carotid arteries - Anterior circulation
▪ Vertebral arteries - Posterior circulation

VERTEBRAL ARTERIES
▪ Brain stem, cerebellum, posterior and ventral
surfaces of the cerebral hemispheres
▪ EXTERNAL CAROTID ARTERY
o Face, Scalp and covering of brain which is
the MENINGES
▪ INTERNAL CAROTID ARTERY
o Surrounding the eyes
o Large portion of the brain
COMMON CAROTID ARTERIES
▪ External carotid artery - Face, scalp and meninges
▪ Internal carotid artery
- Middle and anterior cerebral arteries
- Orbit and large portion of the brain
▪ With the help of basilar artery
▪ Vertebral arteries ! basilar artery ! that will
supplied the posterior part of higher center
o Posterior part of brain stem,
cerebellum
o A little ventral part of cerebral
hemisphere
o MOSTLY on POSTERIOR
OBSTRUCTION in ANTERIOR CEREBRAL ARTERY
CIRCLE OF WILLIS
OBSTRUCTION in MIDDLE CEREBRAL ARTERY
▪ Contralateral spastic paralysis and anesthesia
▪ Greater effect ! face & upper limbs
Lesser effect ! on the lower limbs
▪
Parietal damaged ! Contralateral loss of
▪
sensations
Aphasia, agraphia, acalculia & finger agnosia
▪
(astereognosis)
o Aphasia because large part of cerebral
cortex is affected
o At what part of middle?
▪ Wernicke‟s, Parietal,
Operculum
▪ Paresis and hypesthesia of the contralateral
side
▪ Mainly the lower limbs
▪ Transcortical Apraxia
o Cannot perform easily certain somple
movements
o Contralateral
▪ Left arm cannot be moved in response to a
command
▪ Urinary incontinence – Pudendal the anterior
part of sacral cord (and sometime fecal
incontinence)

OBSTRUCTION in POSTERIOR CEREBRAL ARTERY

▪ Visual problems
o Homonymous Hemianopsia
▪ Same side
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▪ Left side of R & L eye

▪ Both temporal side of both eyes
o Tunnel Vision / Central Vision
▪ Only sees the center
▪ Some patients with macular sparing
▪ Thalamic syndrome – attacks of severe pain with
decreased touch, pain and thermal sensations
▪ Hemichorea (galaw ng galaw ang isang side)
▪ Hemiballismus – violently involuntary movements
of half side of the body
▪ Alexia (difficulty of reading) without agrapia
o Can copy your writing but unable to read

PROTECTION OF THE CNS

1. Bones (Skull and vertebrae)
2. Meninges
▪ Dura, Arachnoid
▪ Pia mater - closest to the brain
3. Cerebrospinal Fluid
- Produced from choroid plexuses and
found in the subarachnoid space
- Drained by arachnoid granulation
(paconian bodies)
- It creates shock to provide buoyancy to
the brain.
- Clear, colorless, alkaline
- 120-180 mm water

NOTES
- BROKEN LINES – ADDITIONAL NOTES FROM D2

SOURCES
- DR. FELIPE BARBON PPT & RECORDINGS
- DR. LEANDRO VILA SECTION C2 BATCH
2022 RECORDING
- D2 2021 TRANS FOR HIGHER CENTERS

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