MODULE 21 ● Smaller type A gamma motor nerve fibers.

● 5 micrometer
THE NERVOUS SYSTEM 2: ● Go to intrafusal fiber
MOTOR AND INTEGRATIVE NEUROPHYSIOLOGY ○ Small, constitute middle of the muscle spindle
○ Helps control basic muscle tone

ORGANIZATION OF THE SPINAL CORD FOR MOTOR Interneurons

FUNCTIONS
● Present in ALL areas of gray matter.
● 30X numerous as AMN (anterior motor neuron)
● Sensory root - AKA dorsal/posterior root ● Small, highly excitable
● Gray matter neurons: ● Fire: 1500 X per sec
○ Anterior motor neurons ● Interconnected to one another which is responsible
○ Interneurons for integrative functions.
● Neuronal circuits:
Anterior Motor Neurons ○ Diverging
○ Converging
○ Repetitive discharge

● Corticospinal tract (CST)

○ Terminate ALMOST entirely on interneurons.

MUSCLE SENSORY RECEPTORS -

MUSCLES SPINDLES AND GOLGI TENDON
ORGANS - AND ROLES IN MUSCLE
CONTROL
2 sensory receptors:
1. Muscle spindles
2. Golgi tendon organs

● Located in each segment of the anterior horns of the Muscle spindles

cord gray matter. ● Send information about muscle length or rate of
● 50 to 100% larger than most of the others. change of length
● Two types:
○ Alpha motor neurons
○ Gamma motor neurons Golgi tendon organs
● Transmit informations about tension and rate of
Alpha Motor Neurons change of tension

● Rises to large type A alpha motor nerve fibers Receptor Functions of Muscle Spindle
● 14 micrometer
● Motor unit - stimulation of one type A alpha nerve Structure and Motor Innervation of the Muscle
excites 3 to hundreds skeletal muscle fibers. Spindle

Gamma Motor Neurons ● Muscle spindle

○ 3-10 mm each
○ 3-12 intrafusal muscle fibers which is attach to
extrafusal fibers

● Intrafusal muscle fibers : gamma motor nerve fibers

(aka gamma efferent fibers)
● Extrafusal muscle fibers : alpha motor nerve fibers
(aka alpha efferent fibers)

Sensory Innervation of the Muscle Spindle

● 2 sensory endings:
○ Primary afferent
○ Secondary afferent
GROUP 4: Barra, Bompally, Cayasan, Chintapandu, Duallo, Dura, Gampong, Lamata, Pallavena
Primary ending

● AKA primary afferent or annulospiral ending

● Type Ia fibers
● 17 micrometer
● 70 - 120 meter/sec

Secondary Ending

● AKA secondary afferent/ending

● Type II
● 8 micrometer

Neuronal circuitry of the stretch reflex

COMPONENTS:
● Type Ia proprioceptor nerve fiber
○ Originates from muscle spindle
○ Enters Dorsal root of spinal cord
○ A branch goes to Anterior Horn of cord gray matter
○ Synapses with Anterior motor neurons
● Type II proprioceptor nerve fibers
○ Terminate on interneurons in cord gray matter
○ Transmit delayed signals

Dynamic and static stretch reflexes

Dynamic and static responses of the muscle spindle
● DYNAMIC STRETCH REFLEX (DSR)
2 types of muscle spindle intrafusal fibers: ○ Elicited by rapid stretch or unstretch from
Primary Sensory Endings
1. Nuclear bag fiber ○ Effect: Causes the muscle that is stretched or
○ 1 to 3 in each spindle unstretched to increase or decrease
2. Nuclear chain fiber Contraction
○ 3 to 9 in each spindler ● STATIC STRETCH REFLEX (SSR)
○ Excite ONLY secondary ending ○ DSR is done after a fraction of a second after
muscle is stretched or unstretched, SSR
● Nuclear bag fiber and Nuclear chain fiber continues for a prolonged period thereafter
○ Excite primary nerve ending ○ Elicited by continuous signals from both
Primary and Secondary Endings
● Static response ○ Effect: To maintain constant degree of
○ Primary and secondary endings CONTINUE to muscle contraction
transmit their signals for at least several minutes
IF muscle spindle remains stretched. Clinical applications of the stretch reflex
○ Muscle is slowly stretched
1. KNEE JERK AND OTHER MUSCLE JERK
● Dynamic response ○ Excites Dynamic Stretch Reflex to cause lower
○ Stimulus of the primary ending leg to “jerk”
○ Primary ending responds to rapid rate of change ○ Used to assess sensitivity of stretch reflexes:
in spinal length. ■ Degree of Facilitation of Spinal Cord
○ Muscle is rapidly stretch Centers
○ Jerk is greatly exaggerated or abrogated when
there is presence or absence of muscle
spacity during there are:
■ Lesions in Motor areas of brain (eg.
Stroke, brain tumor)
GROUP 4: Barra, Bompally, Cayasan, Chintapandu, Duallo, Dura, Gampong, Lamata, Pallavena
 ■ Diseases that excite Bulboreticular
facilitatory area of brain stem
2. CLONUS
● Oscillation of muscle jerks
● Occurs when Stretch reflex is highly sensitized
by facilitatory impulses from brain
Brain areas for the control of the gamma motor system
Signals come from:
● Bulboreticular facilitatory region of brain stem
○ Concerned with anti gravity contractions by
controlling anti gravity muscles (rich in muscle
spindle receptors)
● Impulses transmitted to Bulboreticular region from:
○ Cerebellum
○ Basal ganglia
○ Cerebral cortex

The role of muscle spindle system during tense action

● Brain transmits excitatory signals through the

Role of the muscle spindle in voluntary motor activity
● 31% of all motor nerve fibers to muscle are Small
Type A gamma efferent fibers rather than Large
Type A alpha fibers
● When signals from brain excite the Alpha motor
neurons, in most instances, gamma motor neurons
also excited : COACTIVATION of Both Extrafusal
and Intrafusal Skeletal muscle fibers → Both
contract at the same time
gamma nerve fibers to the intrafusal muscle fibers of
the muscle spindles.
● This shortens the ends of the spindles and stretches
the central receptor regions, thus increasing their
signal output
● But, if the spindles on both sides of each joint are
activated at the same time, reflex excitation of the
skeletal muscles on both sides of the joint also
increases, producing tight, tense muscles opposing
each other at the joint.
● NET EFFECT: the position of the joint becomes
strongly stabilized, and any force that tends to
move the joint from its current position is opposed by
highly sensitized stretch reflexes operating on both
sides of the joint

What are Extrafusal and Intrafusal Muscle fibers? What is its significance?
● stabilization aids tremendously in performing the
Extrafusal fibers Intrafusal fibers additional detailed voluntary movements (of
fingers or other body parts) required for intricate
Standard skeletal muscle Specialized sensory motor procedures
fibers organs (proprioceptors)
FLEXOR REFLEX AND WITHDRAWAL REFLEX
Innervated by Alpha Innervated by Gamma
motor neurons motor neurons ● In decerebrate animal, almost any type of
cutaneous sensory stimulus from a limb is likely
Generate tension by Detect amount and rate to cause the flexor muscles of the limb to
contraction of change in length of contract, thereby withdrawing the limb from the
muscle stimulating object. This reflex is called the flexor
reflex.
What is the purpose of contracting both extrafusal and
intrafusal fibers? ● This is elicited most powerfully by stimulation of
1. Keeps length of receptor portion of the muscle pain endings, such as by a pinprick, heat,
spindle from changing during the course of the wound, so it is also called as nociceptive
whole muscle contraction (i.e. keeps reflex from reflex, or simply a pain reflex.
opposing muscle contraction) ● If some part of the body other than limbs is
2. Maintains proper damping function (aka Signal painfully stimulated, that part will similarly be
averaging) of muscle spindle (i.e. prevent withdrawn from the stimulus, but the reflex may
oscillation or jerkiness of body movements) not be confined to flexor muscles. Therefore, the
many patterns of these reflexes in the different
areas of the body are called withdrawal reflexes.

GROUP 4: Barra, Bompally, Cayasan, Chintapandu, Duallo, Dura, Gampong, Lamata, Pallavena
Neuronal mechanism of the flexor reflex Pattern of withdrawal during flexor reflex

● Depends on which sensory nerve is stimulated.

● The cord integrative centers cause contraction
of the muscles that can most effectively remove
the pained part of the body away from the object
causing the pain.
● Applicable to the limbs because of their highly
developed flexor reflexes.

CROSSED EXTENSOR REFLEX

● About 0.2 to 0.5 second after a stimulus elicits

a flexor reflex in one limb, the opposite limb
begins to extend.
● Extension of the opposite limb can push the
entire body away from the object that is causing
the painful stimulus in the withdrawn limb.

Neuronal mechanism of the crossed extensor reflex

● Signals from sensory nerves cross to the

opposite side of the cord to excite extensor
Basic types of circuits:
muscles
● Usually does not begin until 200 to 500
1. Diverging circuits to spread the reflex to the
milliseconds after onset of the initial pain
necessary muscles for withdrawal.
stimulus, hence many interneurons are involved
2. Circuits to inhibit the antagonist muscles, called
in the circuit between the incoming sensory
reciprocal inhibition circuits.
neuron and the motor neurons of the opposite
3. Circuits to cause afterdischarge that lasts many
side of the cord responsible for the crossed
fractions of a second after the stimulus is
extension.
over.The pathways for eliciting the flexor reflex
● After the painful stimulus is removed, the
do not pass directly to the anterior motor
crossed extensor reflex has an even longer
neurons but instead pass first into the spinal
period of after discharge than does the flexor
cord interneuron pool of neurons and only
reflex results from reverberating circuits among
secondarily to the motor neurons.
the interneuronal cells.
The shortest possible circuit is a three- or four-neuron
pathway; however, most of the signals of the reflex
traverse

Within a few milliseconds after a pain sensory nerve

begins to be stimulated, the flexor response appears.
Then, in the next few seconds, the reflex begins to
fatigue, which is characteristic of essentially all complex
integrative reflexes of the spinal cord. Finally, after the
stimulus is over, the contraction of the muscle returns
toward the baseline, but because of afterdischarge, it
takes many milliseconds for this contraction to occur.

This myogram demonstrates the relatively long latency

before the reflex begins and the long afterdischarge at
the end of the stimulus. The prolonged afterdischarge is
of benefit in holding the pained area of the body away
from the painful object until other nervous reactions
cause the entire body to move away.

GROUP 4: Barra, Bompally, Cayasan, Chintapandu, Duallo, Dura, Gampong, Lamata, Pallavena

RECIPROCAL INHIBITION AND RECIPROCAL
INNERVATION
● This is a phenomenon in which when a stretch
reflex excites one muscle, it often
simultaneously inhibits the antagonist muscles.
● A moderate but prolonged flexor reflex is elicited
from one limb of the body; while this reflex is still
being elicited, a stronger flexor reflex is elicited
in the limb on the opposite side of the body. This
stronger reflex sends reciprocal inhibitory
signals to the first limb and depresses its degree
of flexion. Finally, removal of the stronger reflex
allows the original reflex to reassume its
previous intensity.
REFLEX AND POSTURE LOCOMOTION
Positive supportive reaction
● This reflex is so strong that if an animal whose
spinal cord has been transected for several
months—after the reflexes have become
exaggerated—is placed on its feet, the reflex
often stiffens the limbs sufficiently to support the
weight of the body.
● The locus of the pressure on the pad of the foot
determines the direction in which the limb will
extend;
Magnet reaction - Pressure on one side causes
extension in that direction. This reaction helps keep an
animal from falling to that side.
GROUP 4: Barra, Bompally, Cayasan, Chintapandu, Duallo, Dura, Gampong, Lamata, Pallavena
Cord “righting” reflexes
● When a spinal animal is laid on its side, it will
make uncoordinated movements to try to raise
itself to the standing position.
● In the case of an opossum with a similar
transection of the thoracic cord (between the
levels for forelimb and hindlimb innervation), the
walking movements of the hindlimbs are hardly
different from those in a normal opossum,
except that the hindlimb walking movements are
not synchronized with those of the forelimbs.
Stepping and walking movements Rhythmical
movements of a single limb
Rhythmical stepping movements - are frequently
observed in the limbs of spinal animals.
● Even when the lumbar portion of the spinal cord
is separated from the remainder of the cord and
a longitudinal section is made down the center
of the cord to block neuronal connections
between the two sides of the cord and between
the two limbs, each hindlimb can still perform
individual stepping functions.
● Forward flexion of the limb is followed a second
or so later by backward extension
● This oscillation back and forth between flexor
and extensor muscles can occur even after the
sensory nerves have been cut, and it seems to
result mainly from mutually reciprocal
inhibition circuits within the matrix of the cord,
oscillating between the neurons controlling
agonist and antagonist muscles.
The sensory signals from the footpads and from the
position sensors around the joints - play a strong role
in controlling foot pressure and frequency of stepping
when the foot is allowed to walk along a surface.
The stumble reflex - If the top of the foot encounters an
obstruction during forward thrust, the forward thrust will
stop temporarily; then, in rapid sequence, the foot will be
lifted higher and proceed forward to be placed over the
obstruction.Thus, the cord is an intelligent walking
controller.
Reciprocal stepping of the opposite limbs
● If the lumbar spinal cord is not split down its
center, every time stepping occurs in the forward
direction in one limb, the opposite limb ordinarily
moves backward.
● This effect results from reciprocal innervation
between the two limbs.
SLEEP
Sleep - is defined as unconsciousness from which a
person can be aroused by sensory or other stimuli.
 ● It is to be distinguished from coma, which is
unconsciousness from which a person cannot
be aroused.
Each night, a person goes through stages of two major
types of sleep that alternate with each other:
(1) rapid eye movement sleep (REM sleep), in which
the eyes undergo rapid movements even though the
person is still asleep,
(2) slow-wave sleep or non-REM (NREM) sleep, in
which the brain waves are strong and of low frequency.
Types of sleep as to the following:
Slow-wave sleep
● This sleep is exceedingly restful and is
associated with decreases in peripheral vascular
tone and many other vegetative functions of the
body.
● For example, 10% to 30% decreases occur in
blood pressure, respiratory rate, and basal
metabolic rate.
● Although slow-wave sleep is frequently called
“dreamless sleep”, dreams and sometimes even
nightmares do occur during slow-wave sleep.
● The dreams of slow-wave sleep are usually not
remembered because consolidation of the
dreams in memory does not occur.
REM (Paradoxical, Desynchronized) Sleep
● occurs in episodes that occupy about 25% of the
sleep time in young adults; each episode
normally recurs about every 90 minutes.
● This type of sleep is not so restful and it is often
associated with vivid dreaming.
● In a normal night of sleep, bouts of REM sleep
lasting 5 to 30 minutes usually appear on
average every 90 minutes in young adults.
● When a person is extremely sleepy, each bout of
REM sleep is short and may even be absent.
REM sleep has several important characteristics:
1. It is an active form of sleep
2. The person is even more difficult to arouse by
sensory stimuli
3. Muscle tone throughout the body is exceedingly
depressed, indicating strong inhibition of the
spinal muscle control areas.
4. Heart rate and respiratory rate usually become
irregular, which is characteristic of the dream
state.
5. Despite the extreme inhibition of the peripheral
muscles, irregular muscle movements do occur
in addition to the rapid movements of the eyes.
6. The brain is highly active in REM sleep, and
overall brain metabolism may be increased as
much as 20%.
GROUP 4: Barra, Bompally, Cayasan, Chintapandu, Duallo, Dura, Gampong, Lamata, Pallavena
● This type of sleep is also called paradoxical
sleep because it is a paradox that a person can
still be asleep, despite the presence of marked
activity in the brain.
● In summary, REM sleep is a type of sleep in
which the brain is quite active.
● However, the person is not fully aware of the
surroundings and therefore is truly asleep.
Explain the Basic Theories of Sleep as to the
following:
● Earlier theory, the excitatory areas of the upper
brain stem (Reticular Activating System) simply
became fatigued during waking day and became
inactive as result.
● In the current view, sleep is caused by an active
inhibitory process.
● In transecting the brainstem at the level of the
midpons created a brain cortex that never sleeps.
● This center appears to be required to cause sleep
by inhibiting other parts of the brain.
Mechanisms that can cause sleep - A possible
specific role for serotonin
Stimulation of several specific areas of the brain can
produce sleep with characteristics near those of natural
sleep.
● Raphe nuclei in the lower half of the pons and
the medulla
○ Most conspicuous stimulation area for causing
almost natural sleep
○ Comprising a thin sheet of special neurons
located in the midline.
○ Nerve fibers from these nuclei spread:
○ locally in the brainstem and reticular
formation
○ upward into thalamus, hypothalamus,
limbic system, and neocortex of
cerebrum
○ extend downward into spinal cord
terminating in posterior horns
■ Where they can inhibit incoming
sensory signals
○ Many nerve endings of fibers from these raphe
neurons secrete serotonin.
○ Serotonin - is a transmitter substance
associated with the production of sleep
 ■ When a drug that blocks the formation of
serotonin is administered to an animal, the
animal often cannot sleep for the next several
days.
● Stimulation of some areas in the nucleus of the
Tractus Solitarius
○ Also cause sleep
○ Terminate in the medulla and pons for visceral
sensory signals entering by way of the vagus
and glossopharyngeal nerves.
● Stimulation of several parts regions in the
diencephalon
○ Stimulation can be promoted by the following:
■ The rostral part of the hypothalamus,
mainly in the suprachiasmatic area
■ An occasional area in the diffuse nuclei of
the thalamus
Cycle between Sleep and Wakefulness
● This overall theory could explain the rapid
transitions from sleep to wakefulness and from
wakefulness to sleep.
The role of Orexin in Arousal and Wakefulness
Orexin (Hypocretin)
● Is produced by neurons in the hypothalamus that
provide excitatory input to many other areas of the brain
where there are orexin receptors.
● Loss of orexin signals → defective orexin receptors or
destruction producing neurons
● E.g.
○ Narcolepsy
■ A sleep disorder characterized by overwhelming
daytime drowsiness and sudden attacks of sleep
that can occur, even when a person is talking or
working.
○ Cataplexy
GROUP 4: Barra, Bompally, Cayasan, Chintapandu, Duallo, Dura, Gampong, Lamata, Pallavena
■ Patients with narcolepsy may also experience a
sudden loss of muscle tone that can be partial or
even severe enough to cause paralysis during
the attack.
● THESE OBSERVATION, point to an important role of
orexin in maintaining wakefulness, but their contribution
to the normal daily cycle between sleep and
wakefulness is unclear.
Discuss the Important physiological functions of sleep
● The specific physiological functions of sleep,
however, remain a mystery and are the subject
of much research.
● Sleep exists in all mammals, and after total
deprivation there is usually a period of
“catch-up” or “rebound” sleep; after selective
deprivation of REM or slow-wave sleep, there is
also a selective rebound of these specific stages
of sleep.
● Mild sleep restriction over a few days may
degrade cognitive and physical performance,
and health of a person.
Sleep cause 2 major types of physiological effects:
1. Effects on the major nervous system
2. Effects on the other functional system of the
body
● Sickness-induced sleep, its beneficial
response is that it diverts the organism’s energy
resource from neural and motor demands to
fighting off infections or injurious insults.
● Lack of sleep certainly affects the functions
of the CNS.
● Prolonged wakefulness is often associated
with progressive malfunction of the thought
process and abnormal behavioral activities
sometimes.
● In addition,
○ Increased sluggishness of thoughts
○ Person become irritable
○ Psychotic after forced wakefulness
● We can assume that sleep in multiple ways
restores both normal levels of brain activity
and normal balance among different
functions of CNS.
Sleep has been postulated to serve many functions:
1. Natural maturation
2. Facilitation of learning or memory
3. Targeted erasure of synapse to forget
unimportant that might clutter the synaptic
network
4. Cognition
5. Clearance of metabolic waste products
generated by neural activity in the awake brain
6. Conservation of metabolic energy
● There is some evidence for each of these
functions, but evidence supporting each of these
ideas has been challenged.
 ● We might postulate that the principal value of
sleep is to restore natural balance among the
neuronal centers, which is necessary for
overall health.
Define Brain waves
● Electrical recording from the surface of the brain
or even the outer surface of the head
demonstrate that there is continuous electrical
activity in the brain.
● Intensities of brain waves: range from 0-200
microvolts
● Frequencies of brain waves: range from once
every few second to 50 or more per second
● Both intensity and the pattern of this electrical
activity are determined by the level of excitation
of different parts of the brain resulting from
sleep, wakefulness, or brain disorder such as
epilepsy or psychoses.
2. Beta waves
3. Theta waves
● Electroencephalogram (EEG) is the entire
record of brain waves.
● Classification of waves: alpha, beta, theta
and delta waves
● Characteristics of waves: dependent on the
degree of activity in the respective parts of the
cerebral cortex, and changed markedly between
the states of wakefulness and sleep and coma.
● EEG can discern the irregular and no specific
pattern of brain waves. Sometimes, distinct
patterns appear which characterize specific
abnormalities of the brain such as epilepsy.
TYPES OF BRAIN WAVES AND ITS ORIGIN
In healthy people, most waves in the EEG can be
classified as:
● Alpha
● Beta
● Theta
● Delta waves
GROUP 4: Barra, Bompally, Cayasan, Chintapandu, Duallo, Dura, Gampong, Lamata, Pallavena
1. Alpha waves
Frequencies: between 8 and 13 cycles/sec
Voltage: about 50 microvolts
➔ rhythmical waves
➔ found in the EEGs of almost all healthy adults
when they are awake and in a quiet, resting
state of cerebration.
➔ occur most intensely in the occipital region but
can also be recorded from the parietal and
frontal regions of the scalp.
➔ During deep sleep, the alpha waves disappear.
➔ When the awake person’s attention is directed to
some specific type of mental activity, the alpha
waves are replaced by asynchronous, higher
frequency but lower voltage beta waves.
Frequencies: greater than 14 cycles/ sec and as high as
80 cycles/sec.
➔ recorded mainly from the parietal and frontal
regions during specific activation of these parts
of the brain.
Frequencies: between four and 7 cycles/sec.
➔ occur normally in the parietal and temporal
regions in children
➔ occur during emotional stress in some adults,
particularly during disappointment and
frustration.
➔ occur in many brain disorders, often in
degenerative brain states.
4. Delta waves
Frequencies: less than 3.5 cycles/sec
➔ voltages two to four times greater than most
other types of brain waves.
➔ Occur in very deep sleep, in infancy, and in
persons with serious organic brain disease.
➔ Occur in the cortex of animals that have had
subcortical transections in which the cerebral
cortex is separated from the thalamus.
➔ Occur strictly in the cortex independent of
activities in lower regions of the brain.
Origin of Alpha Waves
➔ will not occur in the cerebral cortex without
cortical connections with the thalamus
➔ stimulation in the nonspecific layer of reticular
nuclei that surround the thalamus or in “diffuse”
nuclei deep inside the thalamus often sets up
electrical waves in the thalamocortical system at
a frequency between 8 and 13/sec
➔ Results from oscillation presumably cause the
 periodicity of the alpha waves and the
synchronous activation of literally millions of
cortical neurons during each wave.
Origin of Delta Waves
➔ Transection of the fiber tracts from the thalamus
to the cerebral cortex, which blocks thalamic
activation of the cortex and thereby eliminates
the alpha waves, nevertheless does not block
delta waves in the cortex.
➔ Some synchronizing mechanism can occur in
the cortical neuronal system by itself—mainly
independent of lower structures in the brain—to
cause the delta waves.
➔ occur during deep slow-wave sleep, which
suggests that the cortex then is mainly released
from the activating influences of the thalamus
and other lower centers.
Seizures
➔ are temporary disruptions of brain function
caused by uncontrolled excessive neuronal
activity.
➔ Depending on the distribution of neuronal
discharges, seizure manifestations can range
from experiential phenomena that are barely
noticeable to dramatic convulsions.
➔ Symptomatic seizures usually do not persist if
the underlying disorder is corrected.
➔ Approximately 5% to 10% of the population will
have at least one seizure in their lifetime
Epilepsy
➔ a chronic condition of recurrent seizures that can
also vary from brief and nearly undetectable
symptoms to periods of vigorous shaking and
convulsions.
➔ not a single disease,
➔ hereditary factors appear to be important,
➔ estimated to affect approximately 1% of the
population, or 65 million people worldwide.
Clinical symptoms:
➔ Heterogeneous and reflect multiple underlying
pathophysiological mechanisms that cause
cerebral dysfunction and injury, such as: trauma,
stroke, tumors, infection, or degenerative
changes.
● Epileptogenic Drugs or pathological factors that
increase neuronal excitation or impair inhibition
tend to be (i.e., predisposing a person to
epilepsy). Effective antiepileptic drugs attenuate
excitation and facilitate inhibition.
Two Major types of Epileptic seizures
(1) FOCAL SEIZURES (ALSO CALLED PARTIAL
SEIZURES)
➔ begin in a small localized region of the cerebral
GROUP 4: Barra, Bompally, Cayasan, Chintapandu, Duallo, Dura, Gampong, Lamata, Pallavena
cortex or deeper structures of the cerebrum and
brain stem and have clinical manifestations that
reflect the function of the affected brain area.
➔ These lesions can promote extremely rapid
discharges in the local neurons; when the
discharge rate rises above several hundred per
second, synchronous waves begin to spread
over adjacent cortical regions. Localized
reverberating circuits (waves resulted from this )
➔ may gradually recruit adjacent areas of the
cortex into the epileptic discharge zone.
➔ The process spreads to adjacent areas at a rate
as slow as a few millimeters per minute to as
fast as several centimeters per second.
➔ After recovery from the seizure the person may
have no memory of the attack, except for the
aura
➔ results from some localized organic lesion or
functional abnormality, such as :
(1) scar tissue in the brain that pulls on the adjacent
neuronal tissue
(2) a tumor that compresses an area of the brain, (3) a
destroyed area of brain tissue,
(4) congenitally deranged local circuitry.
Jacksonian march
➔ Cause a progressive march of muscle contractions
throughout the opposite side of the body, that begins in
the mouth to the legs or marching in the opposite
direction
Postictal period
➔ The time after the seizure, prior to the return of normal
neurological function.
CLASSIFICATION OF FOCAL SEIZURES
1. Simple partial seizures
➔ when there is no major change in consciousness
➔ may be preceded by an aura, with sensations such as
fear, followed by motor signs, such as rhythmic jerking
or tonic stiffening movements of a body part
2. Complex partial seizures
➔ when consciousness is impaired.
➔ may also begin with an aura followed by impaired
consciousness and strange repetitive movements
(automatisms), such as chewing or lip smacking
➔ Attacks of this type frequently involve part of the limbic
portion of the brain, such as the hippocampus, the
amygdala, the septum, and/or portions of the temporal
cortex.
Behaviors to describe:
● Psychomotor, temporal lobe, and limbic seizures
(2) GENERALIZED SEIZURES
➔ characterized by diffuse, excessive, and uncontrolled
neuronal discharges that at the outset spread rapidly
and simultaneously to both cerebral hemispheres
through interconnections between the thalamus and
 cortex.
➔ subdivided primarily on the basis of the ictal
motor manifestations which, in turn, depend on
the extent to which subcortical and brainstem
regions participate in the seizure.
A. Generalized Tonic-Clonic (Grand Mal)
Seizures)
➔ characterized by an abrupt loss of
consciousness and extreme neuronal
discharges in all areas of the brain—the cerebral
cortex, the deeper parts of the cerebrum, and
even the brain stem
➔ Discharges transmitted all the way into the
spinal cord sometimes cause generalized tonic
seizures of the entire body, followed toward the
end of the attack by alternating tonic and
spasmodic muscle contractions called
tonic-clonic seizures.
➔ lasts from a few seconds to 3 to 4 minutes.
➔ characterized by post seizure depression of the
entire nervous system
➔ This demonstrates that high-voltage,
high-frequency discharges occur over the entire
cortex.
➔ The same type of discharge occurs on both
sides of the brain at the same time,
demonstrating that the abnormal neuronal
circuitry responsible for the attack strongly
involves the basal regions of the brain that drive
the two halves of the cerebrum simultaneously.
What Initiates a Generalized Tonic-Clonic
Seizure?
● Idiopathic
● hereditary predisposition to epilepsy (about 1 of
every 100 persons)
Factors that can increase the excitability of the abnormal
“epileptogenic” circuitry enough to precipitate attacks:
1. Strong emotional stimuli
2. Alkalosis caused by overbreathing
3. Drugs
4. Fever
5. Loud noises or flashing lights
What Stops the Generalized Tonic-Clonic Attack?
➔ factors that terminate the attack are not well
understood
➔ active inhibition occurs by inhibitory neurons that
have been activated by the attack.
B. Absence Seizures (Petit Mal Seizures)
➔ begin in childhood or early adolescence and
account for 15% to 20% of epilepsy cases in
children.
➔ involve the thalamocortical brain activating
system
GROUP 4: Barra, Bompally, Cayasan, Chintapandu, Duallo, Dura, Gampong, Lamata, Pallavena
➔ a patient may have one such attack in many
months or, in rare cases, may have a rapid
series of attacks, one after the other.
➔ The usual course is for the absence seizures to
appear first during childhood or adolescence
and then to disappear by the age of 30 years.
➔ will initiate a generalized tonic-clonic (grand mal)
attack.
Absence syndrome or absence epilepsy
➔ characterized by 3 to 30 seconds of
unconsciousness or diminished consciousness,
during which time the person often stares and
has twitch-like contractions of muscles, usually
in the head region, especially blinking of the
eyes;
➔ this phase is followed by a rapid return of
consciousness and resumption of previous
activities
➔ Results from oscillation of (1) inhibitory thalamic
reticular neurons (which are inhibitory
gamma-aminobutyric acid [GABA]-producing
neurons) (2) excitatory thalamocortical and
corticothalamic neurons.
Roles of specific neurotransmitter systems in brain
disorders:
Clinical studies of patients with different psychoses or
different types of dementia have suggested that many of
these conditions result from diminished function of
neurons that secrete a specific neurotransmitter.
Depression and manic psychoses
Mental depression psychosis
● Which occurs in more than 8 million people in
the United States
● Caused by diminished formation in the brain of
norepinephrine or serotonin, or both.
● Depressed patients experience symptoms of
grief, unhappiness, despair, and misery.
● Often lose their appetite and sex drive and have
severe insomnia.
Norepinephrine-secreting neurons
● Located in the brain stem, especially in the locus
ceruleus.
Serotonin-producing neurons Located in the midline
raphe nuclei of the lower pons and medulla
Reserpine
● frequently causes depression.
TREATMENT:
1. Monoamine oxidase inhibitors, which block
destruction of norepinephrine and serotonin once
they are formed
2. Tricyclic antidepressants, such as imipramine
and amitriptyline, which block reuptake of
norepinephrine and serotonin.
Bipolar disorder or manic- depressive psychosis
● Some patients with mental depression alternate
between depression and mania.
Lithium compounds
● Effective in treating the manic phase of the
condition.
Schizophrenia
Schizophrenia comes in many varieties. One of the
most common types is seen in the person who:
● hears voices and has delusions,
● Intense fear, or
● Other types of feelings that are unreal.
There are reasons to believe that schizophrenia results
from one or more of 3 possibilities:
1. Multiple areas in the cerebral cortex prefrontal
lobes in which neural signals have become
blocked or where processing of the signals
becomes dysfunctional;
2. Excessive excitement of a group of neurons that
secrete dopamine
3. Abnormal function of a crucial part of the brain’s
limbic behavioral control system centered
around the hippocampus.
L-dopa
● Releases dopamine in the brain, which is
advantageous for treating Parkinson's disease,
but can cause schizophrenia.
Drugs effective in treating schizophrenia:
1. Chlorpromazine,
2. Haloperidol, and
3. Thiothixene
Alzheimer’s disease
● Is defined as premature aging of the brain
● Usually beginning in mid-adult life and
progressing rapidly to extreme loss of mental
powers—similar to that seen in very old age.
● The clinical features of Alzheimer's disease
include:
○ Amnesic type of memory impairment,
○ Deterioration of language, and
○ Visuospatial deficits.
● Uncommon until the late phases of the disease:
o Motor and sensory abnormalities,
o Gait disturbances, and
o Seizures
● Common form of dementia in elderly persons;
GROUP 4: Barra, Bompally, Cayasan, Chintapandu, Duallo, Dura, Gampong, Lamata, Pallavena
● More than 5.5 million people in the United
States
● About two-thirds of Americans with Alzheimer’s
disease are women.
● The percentage of persons with Alzheimer's
disease approximately doubles with every 5
years beyond age 65, with about 30% of
85-year- olds having the disease.
GENERAL ORGANIZATION OF THE AUTONOMIC
NERVOUS SYSTEM
Autonomic Nervous System
● Is the portion of the nervous system that controls
most visceral functions of the body.
● Control arterial pressure, gastrointestinal motility,
gastrointestinal secretion, urinary bladder
emptying, sweating, body temperature, and
many other activities.
● Activated mainly by centers located in the spinal
cord, brain stem, and hypothalamus.
● Often operates through visceral reflexes.
● 2 major subdivisions:
○ Sympathetic nervous system
○ Parasympathetic nervous system
Shows the general organization of PNS:
1. One of the two paravertebral sympathetic
chains of ganglia that are interconnected with
the spinal nerves on the side of the vertebral
column,
2. Prevertebral ganglia (the celiac, superior
mesenteric, aorticorenal, inferior mesenteric,
and hypogastric),
3. Nerves extending from the ganglia to the
different internal organs.
The sympathetic nerve fibers originate in the spinal
cord along with spinal nerves between cord segments
T1 and L2.
***********************See Appendix************************
Preganglionic and Postganglionic Sympathetic
Neurons
2 two neurons:
1. Preganglionic neuron and
2. Postganglionic neuron.
The fibers then can take one of the following three
courses:
1. They can synapse with postganglionic
sympathetic neurons in the ganglion that they
enter
2. They can pass upward or downward in the chain
and synapse in one of the other ganglia of the
chain; or
3. They can pass for variable distances through the
chain and then through one of the sympathetic
 nerves radiating outward from the chain, finally
synapsing in a peripheral sympathetic ganglion.
Postganglionic sympathetic neuron
● Originates either in one of the sympathetic chain
ganglia or in one of the peripheral sympathetic
ganglia.
Sympathetic Nerve Fibers in the Skeletal Nerves.
● These sympathetic fibers are all very small
type C fibers, and they extend to all parts of the
body via the skeletal nerves.
● They control the blood vessels, sweat glands,
and piloerector muscles of the hairs. About
8% of the fibers in the average skeletal nerve
are sympathetic fibers, indicating their great
importance.
Sympathetic fibers from cord segment T1 generally
pass as follows:
1. Up the sympathetic chain to terminate in the
head;
2. From T2 to terminate in the neck;
3. From T3, T4, T5, and T6 into the thorax;
4. From T7, T8, T9, T10, and T11 into the
abdomen;
5. From T12, L1, and L2 into the legs.
Preganglionic sympathetic nerve fibers pass, without
synapsing, all the way from the intermediolateral horn
cells of the spinal cord, through the sympathetic
chains, then through the splanchnic nerves, and finally
into the two adrenal medullae.
It is the endings of Preganglionic sympathetic nerve
fibers that secrete the adrenal hormones:
1. Epinephrine
2. Norepinephrine
Parasympathetic fibers leave the CNS through cranial
nerves:
● III, VII, IX, and X;
● Additional parasympathetic fibers leave the
lowermost part of the spinal cord through the
second and third sacral spinal nerves and
occasionally the first and fourth sacral
nerves.
************************See Appendix***********************
About 75%
● Parasympathetic nerve fibers are in the vagus
nerves (cranial nerve X), passing to the
bladder, and lower portions of the ureters.
BASIC CHARACTERISTICS OF SYMPATHETIC AND
PARASYMPATHETIC FUNCTION
GROUP 4: Barra, Bompally, Cayasan, Chintapandu, Duallo, Dura, Gampong, Lamata, Pallavena
Cholinergic and adrenergic fibers – secretion of
acetylcholine or norepinephrine
The sympathetic and parasympathetic nerve fibers
secrete mainly one or the other of two synaptic
transmitter substances:
1. Acetylcholine or
2. Norepinephrine
Cholinergic
● The fibres that secrete acetylcholine.
Adrenergic
● Those that secrete norepinephrine.
● A term derived from adrenalin, which is an
alternate name for epinephrine.
Either all or almost all of the postganglionic neurons of
the parasympathetic system are also cholinergic.
Most of the postganglionic sympathetic neurons are
adrenergic.
Acetylcholine
● Secreted by terminal nerve endings of the
parasympathetic system all or virtually all.
● AKA parasympathetic transmitter
Norepinephrine
● Secreted by almost all of the sympathetic nerve
endings but a few secrete acetylcholine.
● AKA called a sympathetic transmitter.
Synthesis of acetylcholine, its destruction after
secretion, and its duration of action
Varicosities
● Bulbous enlargements where filaments touch or
pass over or near the cells to be stimulated.
● It is in these varicosities that the transmitter
vesicles of acetylcholine or norepinephrine
are synthesized and stored.
● Also in the varicosities are large numbers of
mitochondria that supply ATP, which is required
to energize acetylcholine or norepinephrine
synthesis.
Acetylcholine
● Is synthesized in the terminal endings and
varicosities of the cholinergic nerve fibers,
where it is stored in vesicles in highly
concentrated form until it is released.
Synthesis of norepinephrine and, its removal, and its
duration of action
Axoplasm of the terminal nerve endings of adrenergic
nerve fibers
 ● Synthesis of norepinephrine begins but is
completed inside the secretory vesicles. The
basic steps are the following:
In the adrenal medulla, this reaction goes still one step
further to transform about 80% of the norepinephrine into
epinephrine, as follows:
After secretion of norepinephrine by the terminal nerve
endings, it is removed from the secretory site in 3 ways:
1. Reuptake into the adrenergic nerve endings by
an active transport process, accounting for
removal of 50% to 80% of the secreted
norepinephrine;
2. Diffusion away from the nerve endings into the
surrounding body fluids and then into the
blood, accounting for removal of most of the
remaining norepinephrine; and
3. Destruction of small amounts by tissue
enzymes. One of these enzymes is monoamine
oxidase, which is found in the nerve endings,
and another is catechol-O- methyl transferase,
which is present diffusely in the tissues.
Receptors on the effector organs.
● Before acetylcholine, norepinephrine, or
epinephrine secreted at an autonomic nerve
ending can stimulate an effector organ, it must
first bind with specific receptors on the effector
cells.
● The receptor is on the outside of the cell
membrane, bound as a prosthetic group to a
protein molecule that penetrates all the way
through the cell membrane. Binding of the
transmitter substance with the receptor causes
conformational change in the structure of the
protein molecule.
● In turn, the altered protein molecule excites or
inhibits the cell,most often by:
○ causing a change in cell membrane
permeability to one or more ions or
○ activating or inactivating an enzyme
attached to the other end of the receptor
protein,where it protrudes into the
interior of the cell.
Excitation or Inhibition of the Effector Cell by
Changing Its Membrane Permeability
● Because the receptor protein is an integral part
of the cell membrane, a conformational
change in structure of the receptor protein
often opens or closes an ion channel through
the interstices of the protein molecule, thus
altering the permeability of the cell membrane
to various ions.
● For example, sodium and/or calcium ion
channels frequently become opened and allow
rapid influx of the respective ions into the cell,
usually depolarizing the cell membrane and
exciting the cell.
GROUP 4: Barra, Bompally, Cayasan, Chintapandu, Duallo, Dura, Gampong, Lamata, Pallavena
● At other times, potassium channels are opened,
allowing potassium ions to diffuse out of the cell,
which usually inhibits the cell because loss of
electropositive potassium ions creates hyper
negativity inside the cell.
● In some cells, the changed intracellular ion
environment will cause an internal cell action,
such as a direct effect of calcium ions to
promote smooth muscle contraction.
●
Receptor Action by Altering Intracellular “Second
Messenger” Enzymes
● Another way a receptor often functions is to
activate or inactivate an enzyme (or other
intracellular chemical) inside the cell.
● The enzyme often is attached to the receptor
protein where the receptor protrudes into the
interior of the cell.
● For example, binding of norepinephrine with its
receptor on the outside of many cells increases
the activity of the enzyme adenylyl cyclase on
the inside of the cell, which causes formation of
cyclic adenosine monophosphate (cAMP).
● The cAMP in turn can initiate any one of many
different intracellular actions, with the exact
effect depending on the specific effector cell and
its chemical machinery.
● It is easy to understand how an autonomic
transmitter substance can cause inhibition in
some organs or excitation in others.
● This is usually determined by the nature of the
receptor protein in the cell membrane and the
effect of receptor binding on its conformational
state.
● In each organ, the resulting effects are likely to
be different from those in other organs.
Two principal types of Acetylcholine receptors -
Muscarinic and Nicotinic Receptors
● Acetylcholine activates mainly two types of
receptors,which are called muscarinic and
nicotinic receptors.
● The reason for these names is that muscarine, a
poison from toadstools, activates only
muscarinic receptors and will not activate
nicotinic receptors, whereas nicotine activates
only nicotinic receptors. Acetylcholine activates
both of them.
● Muscarinic receptors, which use G proteins as
their signaling mechanism, are found on all
effector cells that are stimulated by the
postganglionic cholinergic neurons of either the
parasympathetic nervous system or the
sympathetic system.
● Nicotinic receptors are ligand-gated ion
channels found in autonomic ganglia at the
synapses between the preganglionic and
postganglionic neurons of both the sympathetic
and parasympathetic systems. (Nicotinic
 receptors are also present at many non
autonomic nerve endings—for example, at the
Adrenergic Receptors - Alpha and Beta Receptors
● Two major classes of adrenergic receptors also
exist; they are called alpha receptors and beta
receptors.
● There are two major types of alpha receptors,
alpha1 and alpha2,which are linked to different
G proteins.
● The beta receptors are divided into beta1, beta2,
and beta3 receptors because certain chemicals
affect only certain beta receptors.
● The beta receptors also use G proteins for
signaling.
● Norepinephrine and epinephrine, both of which
are secreted into the blood by the adrenal
medulla, have slightly different effects in exciting
the alpha and beta receptors.
● ●
Adrenergic Receptors and Function
Excitatory and Inhibitory Actions of Sympathetic and
Parasympathetic Stimulation on Specific organs
● Parasympathetic stimulation causes excitation in
some organs but inhibition in others.
● Also, when sympathetic stimulation excites a
particular organ, parasympathetic stimulation
sometimes inhibits it.
● However, most organs are dominantly controlled
by one or the other of the two systems.
● There is no generalization one can use to
explain whether sympathetic or parasympathetic
stimulation will cause excitation or inhibition of a
particular organ.
EYES:
Two functions of the eyes are controlled by the
autonomic nervous system:
1. the pupillary opening
2. the focus of the lens
GROUP 4: Barra, Bompally, Cayasan, Chintapandu, Duallo, Dura, Gampong, Lamata, Pallavena
● Sympathetic stimulation contracts the meridional
fibers of the iris that dilate the pupil, whereas
parasympathetic stimulation contracts the
circular muscle of the iris to constrict the pupil.
● The parasympathetics that control the pupil are
reflexively stimulated when excess light enters
the eyes, this reflex reduces the pupillary
opening and decreases the amount of light that
strikes the retina.
Glands of the Body:
● The nasal, lacrimal, salivary, and many
gastrointestinal glands are strongly stimulated
by the parasympathetic nervous system, usually
resulting in copious quantities of watery
secretion.
● The glands of the alimentary tract most strongly
stimulated by the parasympathetics are those of
the upper tract, especially those of the mouth
and stomach.
Sympathetic stimulation has a direct effect on
most alimentary gland cells to cause formation
of a concentrated secretion that contains high
percentages of enzymes and mucus.
● It also causes vasoconstriction of the blood
vessels that supply the glands and in this way
sometimes reduces their rates of secretion.
● The sweat glands secrete large quantities of
sweat when the sympathetic nerves are
stimulated, but no effect is caused by stimulating
the parasympathetic nerves.
● sweating could be called a parasympathetic
function, even though it is controlled by nerve
fibers that anatomically are distributed through
the sympathetic nervous system.
● The sweat glands are stimulated primarily by
centers in the hypothalamus that are usually
considered to be parasympathetic centers.
● The apocrine glands, despite their close
embryological relation to sweat glands, are
activated by adrenergic fibers rather than by
cholinergic fibers and are also controlled by the
sympathetic centers of the central nervous
system rather than by the parasympathetic
centers.
Intramural Nerve Plexus of the Gastrointestinal
System:
● The gastrointestinal system has its own intrinsic
set of nerves known as the intramural plexus or
the intestinal enteric nervous system, located in
the walls of the gut.
● Also, both parasympathetic and sympathetic
stimulation originating in the brain can affect
gastrointestinal activity mainly by increasing or
decreasing specific actions in the
gastrointestinal intramural plexus.
● Parasympathetic stimulation, in general,
increases the overall activity of the
gastrointestinal tract by promoting peristalsis
 and relaxing the sphincters, thus allowing rapid
propulsion of contents along the tract.
● Normal motility functions of the gastrointestinal
tract are not very dependent on sympathetic
stimulation.
● However, strong sympathetic stimulation inhibits
peristalsis and increases the tone of the
sphincters.
● The net result is greatly slowed propulsion of
food through the tract and sometimes decreased
secretion as well—even to the extent of
sometimes causing constipation.
HEART
● sympathetic stimulation increases the overall
activity of the heart.
● This effect is accomplished by increasing both
the rate and force of heart contraction.
● Parasympathetic stimulation causes mainly
opposite effects—decreased heart rate and
strength of contraction.
● To express these effects in another way,
sympathetic stimulation increases the
effectiveness of the heart as a pump, as
required during heavy exercise, whereas
parasympathetic stimulation decreases heart
pumping, allowing the heart to rest between
bouts of strenuous activity.
Systemic Blood Vessels:
● Most systemic blood vessels,especially those of
the abdominal viscera and skin of the limbs, are
constricted by sympathetic stimulation.
● Parasympathetic stimulation has almost no
effects on most blood vessels.
● Under some conditions, the beta adrenergic
function of the sympathetic causes vascular
dilation instead of the usual vascular
constriction.
● However, this dilation occurs rarely except after
drugs have paralyzed the sympathetic alpha
vasoconstrictor effects which, in most blood
vessels, are usually far dominant over the beta
effects.
Effect of Sympathetic and Parasympathetic
Stimulation on Arterial Pressure
● The arterial pressure is determined by two
factors, propulsion of blood by the heart and
resistance to flow of blood through the
peripheral blood vessels.
● Sympathetic stimulation increases both
propulsion by the heart and resistance to flow,
which usually causes a marked acute increase
in arterial pressure but often very little change in
long-term pressure unless the sympathetic also
stimulates the kidneys to retain salt and water at
the same time.
● Conversely, moderate parasympathetic
GROUP 4: Barra, Bompally, Cayasan, Chintapandu, Duallo, Dura, Gampong, Lamata, Pallavena
stimulation via the vagal nerves decreases
pumping by the heart but has virtually no effect
on vascular peripheral resistance.
● Therefore, the usual effect is a slight decrease in
arterial pressure.
Effects of Sympathetic and Parasympathetic
Stimulation on Other Functions of the Body
● In general, most of the endodermal structures,
such as the ducts of the liver, gallbladder, ureter,
urinary bladder, and bronchi, are inhibited by
sympathetic stimulation but excited by
parasympathetic stimulation.
● Sympathetic stimulation also has multiple
metabolic effects such as release of glucose
from the liver and an increase in blood glucose
concentration, glycogenolysis in liver and
muscle, skeletal muscle strength, basal
metabolic rate, and mental activity.
● Finally, the sympathetic and parasympathetics
are involved in execution of the male and female
sexual acts.
Enumerate and discuss the functions of the Adrenal
medulla
● Stimulation of the sympathetic nerves to the
adrenal medullae causes large quantities of
epinephrine and norepinephrine to be released
into the circulating blood, and these two
hormones in turn are carried in the blood to all
tissues of the body.
● On average, about 80% of the secretion is
epinephrine and 20% is norepinephrine.The
circulating epinephrine and norepinephrine have
almost the same effects on the different organs
as the effects caused by direct sympathetic
stimulation, except that the effects last 5 to 10
times as long because both of these hormones
are removed from the blood slowly over a period
of 2 to 4 minutes.
● The circulating norepinephrine causes
constriction of most of the blood vessels of the
body; it also increases activity of the heart,
inhibits the gastrointestinal tract,dilates the
pupils of the eyes, and so forth.
● Epinephrine causes almost the same effects as
those caused by norepinephrine, but the effects
differ in the following respects. First,
epinephrine, because of its greater effect in
stimulating the beta receptors, has a greater
effect on cardiac stimulation than does
norepinephrine.
● Second, epinephrine causes only weak
constriction of the blood vessels in the muscles,
in comparison with much stronger constriction
caused by norepinephrine.
● Because the muscle vessels represent a major
segment of the vessels of the body, this
difference is of special importance because
 norepinephrine greatly increases the total
peripheral resistance and elevates arterial
pressure, whereas epinephrine raises the
arterial pressure to a lesser extent but increases
the cardiac output more.
● A third difference between the actions of
epinephrine and norepinephrine relates to their
effects on tissue metabolism.
● Epinephrine has 5 to 10 times greater metabolic
effect as does norepinephrine.
● Indeed, the epinephrine secreted by the adrenal
medullae can increase the metabolic rate of the
whole body as much as 100% above normal, in
this way increasing the activity and excitability of
the body.
● It also increases the rates of other metabolic
activities, such as glycogenolysis in the liver and
muscle and glucose release into the blood.
● In summary, stimulation of the adrenal medulla
causes release of the hormones epinephrine
and norepinephrine, which together have almost
the same effects throughout the body as direct
sympathetic stimulation, except that the effects
are more prolonged, lasting 2 to 4 minutes after
the stimulation is over.
Differentiate the sympathetic and parasympathetic
“Tone”
➔ Sympathetic and parasympathetic systems are
continually active
➔ The basal rates of activity are known as Sympathetic
Tone and Parasympathetic Tone.
➔ The value of tone allows a single nervous system to
both increase and decrease the activity of a
stimulated organ.
➔ For example:
Sympathetic tone normally keeps almost all the systemic
arterioles constricted to about one-half their
maximum diameter
⬇ ➔ For example,
By increasing the degree of sympathetic stimulation
above normal
⬇ After cardiac vagotomy increases the heart
These vessels can be constricted even more
(Or) By decreasing the stimulation below normal,
⬇ gastrointestinal system has long lasting effects
The arterioles can be dilated.
➔ Thus, the sympathetic system can cause
vasoconstriction or vasodilation by increasing or
decreasing its activity, respectively.
Tone cause by basal secretion of Epinephrine and
Norepinephrine by the Adrenal medulla
➔ The normal resting rate of secretion by the adrenal
medulla is about:
◆ Epinephrine: 0.2 μg/kg/min
GROUP 4: Barra, Bompally, Cayasan, Chintapandu, Duallo, Dura, Gampong, Lamata, Pallavena
◆ Norepinephrine: 0.05 μg/kg/min
➔ These quantities are enough to maintain the blood
pressure almost normal even if all direct
sympathetic pathways to the cardiovascular system
are removed.
➔ It is obvious that much of the overall tone of the
sympathetic nervous system results from basal
secretion of epinephrine and norepinephrine in
addition to the tone resulting from direct sympathetic
stimulation.
Effect of Loss Sympathetic or Parasympathetic Tone
after Denervation
➔ After a sympathetic or parasympathetic nerve is
cut, the innervated organ loses its sympathetic
or parasympathetic tone.
➔ In many blood vessels, for example, cutting the
sympathetic nerves results in substantial
vasodilation within 5 to 30 seconds.
➔ Intrinsic tone in the smooth muscle of the
vessels increases
◆ increased tone caused by increased smooth
muscle contractile force (chemical
adaptations in the smooth muscle fibers)
◆ increased sensitivity to the effects of
circulating catecholamines secreted by the
adrenal medulla.
⬇
Restore almost Normal Vasoconstriction
➔ The same effects occur in most other effector
organs whenever sympathetic or
parasympathetic tone is lost.
➔ Intrinsic compensation soon develops to return
the function of the organ almost to its normal
basal level.
➔ In the parasympathetic system, the
compensation sometimes requires many
months.
Loss of parasympathetic tone to the heart
⬇
rate to 160 beats/ min
➔ Likewise, loss of parasympathetic tone to the
on the gut.
Discuss the Autonomic Reflexes in relation to
individual organ systems
CARDIOVASCULAR AUTONOMIC REFLEXES
➔ Several reflexes in the cardiovascular system
help control the arterial blood pressure and heart
rate.
➔ One of these reflexes is the baroreceptor reflex
 ◆ Stretch receptors called baroreceptors are ◆ Gallbladder emptying,
located in the walls of several major arteries, ◆ Kidney excretion of urine,
including especially the internal carotid ◆ Sweating,
arteries and the arch of the aorta. ◆ Blood glucose concentration, and
➔ When these become stretched by high pressure ◆ Many other visceral functions
⬇
Signals are transmitted to the brain stem “Alarm” or “Stress” Response of the
⬇ Sympathetic nervous system
They inhibit the sympathetic impulses to the
heart and blood vessels and excite the ➔ When large portions of the sympathetic nervous
parasympathetics system discharge at the same time (a MASS
⬇ DISCHARGE)
The arterial pressure to fall back toward normal. ➔ This action increases the ability of the body to
perform vigorous muscle activity in many ways,
GASTROINTESTINAL AUTONOMIC REFLEXES as summarized in the following list:
➔ Autonomic Reflexes principally controls the 1. Increased arterial pressure
uppermost part of the gastrointestinal tract and 2. Increased blood flow to active muscles
the rectum. concurrent with decreased blood flow to
➔ For example, organs such as the gastrointestinal tract and
◆ The smell of appetizing food or the presence the kidneys that are not needed for rapid
of food in the mouth initiates signals motor activity
⬇ 3. Increased rates of cellular metabolism
These nuclei in turn transmit signals through the throughout the body
parasympathetic nerves to the secretory glands 4. Increased blood glucose concentration
of the mouth and stomach. 5. Increased glycolysis in the liver and in muscle
⬇ 6. Increased muscle strength
causing secretion of digestive juices sometimes 7. Increased mental activity
even before food enters the mouth. 8. Increased rate of blood coagulation

◆ When fecal matter fills the rectum at the other ➔ The sum of these effects permits a person to
end of the alimentary canal, perform far more strenuous physical activity than
⬇ would otherwise be possible.
Sensory impulses initiated by stretching the ➔ Either mental or physical stress can excite the
rectum are sent to the sacral portion of the sympathetic system.
spinal cord ➔ It is frequently said that the purpose of the
⬇ sympathetic system is to provide extra
A reflex signal is transmitted back through the activation of the body in states of stress,
sacral parasympathetics to the distal parts of the which is called the SYMPATHETIC STRESS
colon RESPONSE.
⬇
These signals result in strong peristaltic ➔ The sympathetic system is especially strongly
contractions that cause defecation. activated in many emotional states.
➔ SYMPATHETIC ALARM REACTION - also
OTHER AUTONOMIC REFLEXES called the fight-or-flight reaction because an
➔ Emptying of the urinary bladder is controlled animal in this state decides almost instantly
in the same way as emptying of the rectum. whether to stand and fight or to run.
◆ Stretching of the bladder sends impulses to ➔ In either event, the sympathetic alarm reaction
the sacral cord, makes the animal’s subsequent activities
⬇ vigorous.
In turn causes reflex contraction of the bladder
and relaxation of the urinary sphincters
⬇
Promoting micturition.

➔ Sexual Reflexes, are initiated both by psychic

stimuli from the brain and by stimuli from the
sexual organs

➔ Other autonomic control functions include reflex

contributions to the:
◆ Regulation of pancreatic secretion,
GROUP 4: Barra, Bompally, Cayasan, Chintapandu, Duallo, Dura, Gampong, Lamata, Pallavena
ADDITIONAL NOTES

Doc Cantilla and Doc Tan

● Study Physiological Anatomy of
Preganglionic and Postganglionic Neurons

Sympathetic Parasympathetic

Origin of T1- L2 Cranial nerves 3,

Preganglionic (Thoracolum 7, 9, 10 & Spinal
Neuron bar area) nerves S2-S4
(Craniosacral
area)

Length of Short Long

Preganglionic
Neuron

Neurotransmitter Acetylcholine
in Preganglionic
Neuron

Preganglionic Cholinergic
fibers are called
Doc Abel
Receptor type in Nicotinic Receptors ● Mydriasis - dilation of pupils
Postganglionic ● Miosis - constriction of pupils
Neuron ● Muscle tensed - caused by sympathetic NS
● Examples of Reflexes
Length of Long Short ○ Sneeze
Postganglionic ○ Cough
Neuron ○ Drinking
○ Cornea Irritation
Neurotransmitter Norepinephrine Acetylcholine
in Effector
○ Muscle reflexes
Organs ● Types of Insomnia
(Postganglionic ○ Acute - short term; 1-6 mos
Neurons) ○ Chronic - long term; > 6 mos
○ Transient - < 1 month
Postganglionic Adrenergic Cholinergic ● Define Polysomnography - Sleep study
fibers are called ● Familiarize the Brain waves

Receptor Type in Adrenergic Muscarinic

Organ

What do you call the ff:

● Group of Neuronal body in CNS - Nucleus
● Group of Neuronal body in PNS - Ganglion
● Group of Axons - Tract

Where can you find the ganglia of sympathetic :

● Preganglionic Neuron-Interomedio-lateral horn
● Postganglionic Neuron -Sympathetic chain
● Sensory Neuron - Dorsal root ganglion

GROUP 4: Barra, Bompally, Cayasan, Chintapandu, Duallo, Dura, Gampong, Lamata, Pallavena
APPENDIX

GROUP 4: Barra, Bompally, Cayasan, Chintapandu, Duallo, Dura, Gampong, Lamata, Pallavena
GROUP 4: Barra, Bompally, Cayasan, Chintapandu, Duallo, Dura, Gampong, Lamata, Pallavena