Introduction to the Nervous System

Definitions

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  • Ganglion: collection of nerve cell bodies (in the PNS)
  • Tract: bundle of axons in the CNS
  • Nerve: bundle of axons in the PNS
  • Bundles of axons can be all from the same modality but are normally ‘mixed’
    • Modalities: somatic sensory, somatic motor, special sensory, visceral afferent, sympathetic, parasympathetic
  • Spinal nerves and branches are mixed - somatic motor, somatic sensory, and sympathetic
  • 5 cranial nerves are mixed

Motor or sensory

  • Motor (efferent): action potential towards body wall, body cavity, or organ
  • Sensory (afferent): action potential towards the brain

Central nervous system

  • Brain and spinal cord - central controller

The brain

Structure
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The spinal cord

  • Connects with brain
  • Passes through foramen magnum
  • Protected by vertebral column
  • 4 segments:
    • Cervical (C1-C7)
    • Thoracic (T1-T12)
    • Lumbar (L1-L5)
    • Sacral (S1-S5)/coccygeal (Co)
  • 2 enlargements (cervical and lumbosacral) for innervation and control of limbs
  • Ends at L1/L2 IV disc level - conus medullaris
  • Lumbar and sacral spinal nerve roots descend in the vertebral canal and form the cauda equina

Peripheral nervous system

  • All the other nerve tissues not within the CNS
  • Peripheral nerves are bundles of axons wrapped in connective tissue, which are traveling to/from the same structure
    • Bundles of nerves can leave as 'branches'
  • Spinal nerves: connect with spinal cord
  • Cranial nerves: connect with brain
  • Autonomic nerves: innervate organs, smooth muscle, glands
    • Visceral afferents, sympathetic nerves, parasympathetic nerves

Spinal nerves

  • The spinal cord connects bilaterally with spinal nerves - 31 pairs
  • A spinal nerve is named after the vertebrae above it, except for cervical region where they are named according to the vertebrae below (C8 exits between C7 and T1 vertebrae)
  • The spinal nerves supply the soma (body wall)
  • Located only within the IV foramina
  • From the IV foramina, they connect with:
    • Structures of the soma via rami
    • The spinal cord via roots and rootlets
  • Posterior rami: supply small posterior strip of the soma (back)
  • Anterior rami: supply the remainder of the posterior part, the lateral and the anterior parts of the strips of the soma
    • Supply all the limbs via plexus - networks of intertwined anterior rami
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Plexuses
  • Cervical plexus: C1-C4 anterior rami, supplies the posterior scalp, neck wall, diaphragm
  • Brachial plexus: C5-T1 anterior rami, supplies the upper limb
  • Lumbar plexus: L1-L4 anterior rami, supplies the lower limb
  • Sacral plexus: L5-S4 anterior rami, supplies the lower limb, gluteal region and perineum
Dermatomes
  • Area of skin supplied by both the anterior and posterior rami of a spinal nerve
    • Exception - limbs (no posterior rami)
  • T4 dermatome - nipple
  • T10 dermatome - umbilicus
  • Dermatome maps used to illustrate dermatomes

Cranial nerves

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Cranial foraminae
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Somatic nervous system

  • Soma: body wall (external environment)
    • Includes head and neck walls, chest walls, back, diaphragm, abdominal wall, pelvic wall, limbs
    • Structures - skin, fascia, skeletal muscle, skeleton, internal lining of body cavities

Sensory receptors

  • Mechanoreceptors: coarse and fine touch, vibration, proprioception
  • Thermoreceptors: temperature
  • Nociceptors: pain (sharp, stabbing, well localised)

Somatic sensation pathway to the brain

Sensory receptors stimulated → anterior ramus → plexus (e.g. lumbar) → dorsal root ganglion → dorsal roots → dorsal rootlets → posterior horn → cross over midline and action potentials ascend towards brain

Motor innervation pathway to skeletal muscle

Somatic motor axons cross over in brainstem then descend to anterior horn → anterior rootlets → anterior roots → spinal nerves → plexus → synapse onto skeletal muscle which contracts

Spinal reflexes

  • Rapid - misses out pathways to brain
  • Involuntary - protective function

Autonomic nervous system

  • Visceral motor system (internal environment): includes viscera, glands, smooth and cardiac muscle and external lining of organs
    • Locations - internal organs in body cavities, body wall organs
  • Sensory neurons: sense internal environment - heart rate, blood pressure, digestion, gland secretions
    • Visceral afferent: organ sensory nerves
      • Sense touch, temperature, pain (pain usually poorly localised and dull, may be sharp if colicky)
  • Motor neurons: respond to changes in internal environment
    • Dual motor control - sympathetic and parasympathetic nerve supply

Sympathetic division of ANS

  • Supplies all internal organs, body wall organs and arterioles
  • ‘Flight or fight’ response
Sympathetic outflow
  1. Originates from autonomic centres in brain
  1. Passes down spinal cord
  1. Exits spinal cord with T1-L2 spinal nerves
  1. Travel to sympathetic chains running the length of vertebral column
  1. Pass into all spinal nerves
    1. Anterior and posterior rami supply body wall structures
  1. ‘Hitch a ride’ with arteries to all head and neck organs and skin
  1. Travel via splanchnic nerves to reach organs

Parasympathetic division of ANS

  • Often supplies same internal organs as sympathetic division, does not supply body wall organs or arterioles
  • ‘Rest and digest’ response
Parasympathetic outflow
  • All parasympathetic axons leave the CNS via cranial nerves III, VII, IX and X and via sacral spinal nerves
  • Parasympathetic ganglia in head travels to lacrimal gland and salivary glands
  • Vagus nerve supplies organs of the neck, chest and abdomen as far as the mid-gut
  • Sacral spinal nerves ‘carry’ parasympathetic axons to the hindgut, pelvis and perineum

Summary of neurone types

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